G Ital Nefrol 2018; 35 (Supplement 70) – ISSN 1724-5990 – © 2018 Società Italiana di Nefrologia BEGINNINGS OF MODERN NEPHROLOGY: PEOPLE AND FACTS The historical relevance of urine and the future implications Vincenzo Savica 1 , Carlo Alberto Ricciardi 2 , Pietro Bellinghieri 2 , Giovanni Duro 1 , Biagio Ricciardi 3 , Guido Bellinghieri 2 1 A. Monroy Institute of Biomedicine and Molecular Immunology, National Research Council Palermo, 2 University of Messina 3 Division of Nephrology Taormina, ASP, Messina Corresponding Author: Prof. Savica Vincenzo Via E. Geraci 23, 98123 - Messina, Italy. E-mail: visavica@tin.it Introduction In the ancient times urine was considered a sacred element and were related to Hindu’s ceremonies and to Tantric religious traditions (1). Urine was not considered as a waste product of the body but a distilled product selected from the blood. The Sanskrit book Shivambu’ kalpa Vidhi (5000 years bC) reported that urine can be useful product for the humans. Sumerian doctors were the first to use uroscopy as depicted in graphic clay tablets (4000 years bC) , whereas Assyrian- Babylonian mixed the urine of woman with alcohol to diagnose pregnancy (1). Egyptians were the first to diagnose diabetes using “urine excess”. Libri Ermetici of God Thoth, Egyptian source from the late second century bC, reported the description of the different urine characteristics as white, black, fat, foggy, and foamy (1). Egyptians seemed to use urine of a woman to water some seeds as a pregnancy test: if the seeds sprouted, the test was considered positive (likely due to the presence of growth factors) (1). Essenians, Jewish, and Christians used urine to body massage. In Susruta Samhita book there was a description of 10 different types of (1). In China and India dropping urine to the ground was used as a possible test for diabetes, whether ants were attracted and gathered on the urine drops due to the presence of sugar. Early Jewish-Christian traditions reported their interest on urine related to urinotherapy. In The Bible (Prov: 5:15-19, Jesus 36, 16) urine was interpreted as image of peace and prosperity. Urinotherapy was also reported in the Apocalypse too. Uroscopy and Urinotherapy Pythagoras (580-495 bC), Hippocrates (460-377 bC) diagnosed gonorrhea, and tuberculosis taking advantage of the different color of urine. Diodorus from Sicily (90-27 bC) in the volume 33 of his “Bibliotheca” reported that at his time urine was used as to improve teethes health (1). Galen (129-201 aC) pointed his attention toward urine and blood using systematically uroscopy; thus, the first systematic approach seems to be starting in the ancient Greece (1). Galen, Plinius (23-79 aC), and other Greek physicians recommended the therapeutic use of urine to cure burns, inflammations, and skin diseases. Theophilus (813-842 aC), famous in Byzantium in VII century, reported urine modifications associated with different pathological states. In Roman Empire, there were persons named “fellones” who were collecting urine from house to house because urine was recommended for the treatment of ulcers. Moreover urine was also used to whiten senator’s togas (1-3). In antique Pompeii, there was a public officer named “latrinaro”, who was operating under emperor mandate that obliged the men to urinate in public facilities; if they do not urinate in public facilities “the latrinaro” squeezed their testicles (1-3). Catullo (84-54 bC), the famous Roman poet, reported that Celtibers used urine to brush teeth and that the pharmacist of Cicero cured toothache with berry brew with urine collected from virgin woman. Moreover the Roman women made beauty masks using donkey urine (1). In medieval time, it was common to taste urine to identify the presence of sugar and diagnose diabetes. Paracelsus ABSTRACT The relevance of urine examination has been reported since the ancient times. Urine was connected to religious traditions attracting the interest of the people as “the elixir of long life”. Indeed, it seems that urine was not considered as a waste product but rather as a distilled product selected from the body. Many different sources (the Sanskrit book ‘Shiwambu kalpa’, Sumerian, Assyrian- Babylonian, Egyptians, Essenians, Jewish-Christians, Greek and roman philosophers) reported a number of evidences not only regarding uroscopy but also about the use of urine as therapy. Humans produce 10 billion liters of urine and in a lifetime a human can fill an Olympic swimming pool with the urine produced. Urine is used as electric generator, space fuel, storage battery, and fertilizer. The introduction of mass spectrometry in the study of urine could represent a goal for identify diagnostic biomarkers for kidney diseases. KEYWORDS: Uroscopy, Urinotherapy, Urine Mass Spectrometry