MO1033URINE EXAMINATION - A CHALLENGE FOR NEPHROLOGISTS FROM ANCIENT TIMES

Abstract

Abstract Background and Aims Extensive archaeological material indicates that records of the treatment of kidney disease without examining the cause and solely by examining the appearance of urine date back to ancient times. To this day, the basic clinical approach to nephrology patient included an overview of freshly sampled urine from the uncatheterized bladder and monitoring of urine output.The aim of the paper is to analyze the history of the urine analysis. Method Data were collected from books, magazines, encyclopedias and databases. Results The first nephrological experiences and doctrines that connected the clinical picture with diseases of the urinary bladder, kidneys or liver were written down in the opus Corpus Hippocraticium, which contains a total of 53 works. Opus Hippocraticium contains in its work Aphorisms a total of 22 aphorisms dedicated to uroscopy. Such examinations revealed specific changes in urine that were considered important for the onset and maintenance of the disease (Predictions II paragraphs 567,569,571). Galen (Claudios Galenos) is the most famous representative of Roman medicine and a follower of the teachings of Hippocrates. In his work De crisibus (K IX, 550-668) he described in detail the changes in urine.The physicians who marked the first and second centuries with their work on urine specificities were Selius Aurelianus (Tarde Passiones V, 3) and Cornelia Celsus (De Medicina 4:17). The apostate Oribazi (Oribasius of Pergamum; 325-403) wrote a "Medical Collection" which consists of 70 books. The importance of uroscopy for the prognosis of diseases is also described in the texts on secretions in this collection.Etius of Amida wrote (Aetius 502-575) a very semi-paired collection of "Sixteen Books of Medicine". In Book V of his work he wrote 15 chapters on the characteristics of urine. He incorporated the described changes in urine into the theory of four types of body fluids. Due to the advanced approach, this collection became the basis of all subsequent works on uroscopy.Pavle Eginski (625-690) is an Alexandrian student who practiced uroscopy and is the author of seven books entitled "Excerpts from Medicine" in which he introduces new concepts and describes in detail how to collect and examine urine. At that time, the greatest contribution to uroscopy was considered to have been made by Magnus Emesianus with his classification of urine characteristics.The most famous representative of medicine from the Byzantine era is Theophilus Protospatorius (VII century) a physician, monk, and philosopher of the Byzantine period wrote (De Urinis 68-70), a treatise on urine which was translated into Arabic and Hebrew and highly esteemed among the urologists of the time. Serbian medieval medicine was a synthesis of Western European and Byzantine science.Scientific access to treatment and permanent medical education was provided in the monastery hospitals (typical of the Hilandar / Studenica monastery), but very few manuscripts from that period have been preserved. The most extensive and significant medieval medical manuscript in the Serbian language is the "Hilandar Medical Codex".In the "Journal of Uroscopy", 62 paragraphs are dedicated to Byzantine uroscopy-macroscopic examination of changes in urine. Uroscopy has been developed until the introduction of the forerunner microscope for examining urine at the end of the 16th century. The application of microscopy in the examination of urine is constantly being improved, and the first automatic analysis of urinary sediment was done in 1985. Conclusion Although urine analysis has been used since ancient times, today the diagnosis depends a lot on the quality of interpretation of the findings. Despite attempts to standardize urine sediment analysis using various methods as a cheap and non-invasive method, it is still not sufficiently used in differentiating different kidney diseases.