Pisse prophecy: a brief history of urinalysis

Abstract

This article has reviewed a few of the major historic aspects of urine examination from ancient times to the twentieth century. It is a most fascinating history for it mirrored that of the history of medicine itself. The recognition of the importance of urine in diagnosis was made over 6000 years ago by several of the earliest civilizations, and a few of their clay tablets have been found that give us some insight into their observations and conclusions. However, the progress in analysis and its clinical significance was often slow and frequently littered with charlatanism. Visual inspection alone, and prognostication therefrom, was shown to be inadequate as a single means of diagnosis, and over 600 years ago Paracelsus, as well as others, began to reject ancient dogma and searched for new approaches to the analysis of urine by using chemical distillation techniques. Progress in anatomy and physiology, coupled with the understanding of organ function, provided a fertile field for the investigation of the composition of the urine and associating its chemical constituents with specific disease states. The advent of the microscope caused scientists to examine all body fluids, especially the urine, and to record their observations as an aid to diagnosis--the beginnings of medical microscopy. This century has also seen remarkable advances in the field of urinalysis: dipstick testing, the application of modern chemical and microscopic techniques to constituent analysis, automation, and, most recently, monoclonal antibody and recombinant gene technology to enhance and improve urine examination. In short, urinalysis, the first of all laboratory tests, began as and still remains a most valuable and highly important means of diagnosis in clinical medicine.