Urinalysis

Excerpt

Around 6,000 years ago, laboratory medicine began with the analysis of human urine as uroscopy, which later became termed urinalysis. The word "uroscopy" derives from two Greek words: "ouron," which means urine and "skopeoa," which means to 'behold, contemplate, examine, inspect'. Ancient physicians spoke of urine as a window to the body's inner workings and reflected different diseases. For instance, Hindu civilizations recognized a "sweetness" in certain people's urine, which attracted black ants. Hippocrates (460–355 BC) hypothesized that urine was a filtrate of the humors in the body, originating from the blood filtered through the kidneys. In Aphorisms, he described bubbles on the surface of fresh urine as a sign of long-term kidney disease and associated urinary sediment with fever. Galen used the phrase "diarrhea of the urine" to describe excessive urination. Theophilus Protospatharius, a seventh-century physician who wrote the first manuscript focused exclusively on urine called "De Urinis", determined heating urine would precipitate proteins, documenting proteinuria as a disease state. Ismail of Jurjani, an eleventh-century physician, acknowledged food and aging altered urine composition and was the first to propose 24 hours urine collection.

By the late 12th-century, a French scholar named Gilles de Corbeil taught and classified 20 different types of urine, recording differences in urine sediment and color. De Corbeil also introduced the "matula," a glass vessel in which a physician could assess color, consistency, and clarity. In 1630, Nicolas Fabricius de Peiresc, a French astronomer and naturalist, did the first microscopic description of urine crystals as "a heap of rhomboidal bricks." Posteriorly, in the early-mid 1800s, Richard Bright, an English physician, pioneered the field of kidney research leading him to be ultimately recognized as the "father of nephrology." These few examples illustrate how urinalysis was the first laboratory test developed in the history of medicine, how it has been persistently used for several thousand years, and how it continues to be a formidable and cost-effective tool to obtain crucial information for diagnostic purposes.