Iorio Luigi, Lamagna Mario
G Ital Nefrol. 2014 Mar-Apr;31(2).
The formation of persistent little bubbles in urine, similar to those of beer, was noticed since ancient times by the first scholars of uroscopy. The diagnostic interest, rare and uncertain in Hippocrates, has increased over time. The Hippocratic school limited itself to observe the sign without interpreting the pathophysiology and they did not compare it with other clinical signs. Hippocratic texts only expressed an opinion on the severity and prognosis of the pathology which had produced it. Galen does not differ much from the Hippocratic school, however he tries to interpret the cause of the formation of bubbles in urine. Certainly, because of being unfamiliar to the laws of fluids and to the surperficial tension of liquids, he believes that the air contained in the bubbles of the foam in the urine comes from inside the organism. However, he realizes that the foam in urine is formed only when the urine is denser (more viscous).The Byzantine uroscopy, with Theophilus Protospatharius and Stephen of Athens considers the presence of foam quite important. In fact, they state that the bubbles appear in the urine when there is a severe failure of the organism. It is a sign of the attempt of the body to eliminate the bad humours produced in the different zones where digestion takes place. Several authors from the School of Salerno express different opinions on the production of foam in urine. Cofone affirms it derives from the putrefied blood in dense urine and he also uses this sign for diagnostic and prognostic results. Mattheus Archiepiscopus confirms Galens belief that the foam derives from wind bubbles produced in the stomach. The "De Urinis" of Maestro Mauro is strongly influenced by the writings of Constantine the African, who reports the experience of Isaac. The "humani corporis regiones" and the "regiones urine" are described and therefore Mauro tries to localize in which region of the body the bad humours were produced. In particular, the chapter on "De ycteritia" is an exact description of the foam in urine generated by the elimination of bad humours produced in excess by the liver (bile salts).
自古以来，尿液中出现类似啤酒泡沫的持续性小气泡就被最早的尿液检查学者所注意到。希波克拉底时代对这一现象的诊断价值关注较少且不明确，但随着时间推移，其诊断意义有所增加。希波克拉底学派只是观察到了这一征象，并未对其病理生理学进行解释，也未将其与其他临床体征进行比较。希波克拉底文献仅对产生该现象的疾病的严重程度和预后表达了一种观点。盖伦与希波克拉底学派的观点差异不大，但他试图解释尿液中气泡形成的原因。当然，由于他不熟悉流体定律和液体表面张力，他认为尿液泡沫中的空气来自生物体内部。然而，他意识到尿液中的泡沫仅在尿液密度更大（更黏稠）时才会形成。拜占庭时期的尿液检查，以狄奥菲卢斯·普罗托斯帕塔里乌斯和雅典的斯蒂芬为代表，认为泡沫的存在相当重要。事实上，他们指出当机体严重功能衰竭时，尿液中就会出现气泡。这是身体试图排出在不同消化部位产生的不良体液的一种迹象。萨勒诺学派的几位作者对尿液中泡沫的产生表达了不同观点。科丰认为它源于浓稠尿液中腐败的血液，他还将这一征象用于诊断和预后判断。马修斯大主教证实了盖伦的观点，即泡沫源于胃中产生的气泡。毛罗大师的《尿液论》深受非洲人康斯坦丁著作的影响，后者记录了伊萨克的经验。书中描述了“人体部位”和“尿液部位”，因此毛罗试图确定不良体液是在身体的哪个部位产生的。特别是关于“黄疸”的章节，精确描述了肝脏（胆汁盐）产生过多不良体液而排出时尿液中产生的泡沫。
