Articella (The Little Art of Medicine)

or are about to be made, omitting many things; he also handed down an imperfect discipline, so that many things are sought by those who were made physicians afterward; and not being able to find a solution in any way, one is compelled to seek another doctrine, and not in vain: because from those things which they have learned, they distinguish to observe, and to guess or conjecture obscure matters and intellects from those manifest things. For the apt inspection of urines makes manifest the non-appearing and patient places, and how they are disposed, and according to what crasis temperament/mixture of qualities each one of them is, or whether they are disposed according to nature, or are constituted beyond nature, or are disposed outside of nature, and according to what crasis each one of them is.

¶ For diligent inspection of urine is naturally suited to be a not-false messenger of the strength that operates health, in whatever way it is impeded in its proper work. Therefore, it is best for us, wishing to treat of urines, to invoke Christ, our true God, to be a helper and guide in such a doctrine, so that we may deserve to complete this [work] undiminished and undefrauded. We must, therefore, define what the urine itself is, then manifest the place in which it is born, from thence the place in which it is discerned, and then thus begin the doctrine according to their genera and species and differences.

Definition of urine.

Urine, therefore, is the straining of the blood and other humors. This, however, others have called a superfluity similar to whey; others, watery; others, the putrefaction of the blood. Concerning the names, therefore, let there be no contention. ¶ Urine is born, therefore, in the branched vein likely referring to the renal vein spread around the top of the liver in water, [where] the strength making the blood completes its work. Its generation is such, with the blood being formed and a perturbation having been made in it. Whatever is light and seeking the upper parts, by way of the red cholera bile, the superfluity is born to be; it takes that, the receiver, the gallbladder placed near the liver; the earthy, however, and as if the dregs of the blood, the spleen draws through its passage. Therefore, the watery superfluity is left with the blood; the kidneys, taking this through the middle kilis vein/channel—that is, the deep vein—form it into the constitution of urine. But someone might ask, and with merit: why, with the gallbladder and the spleen receiving the superfluities of the blood from the top of the liver, did the loins, placed nearby, not receive the watery superfluity? And we say: because of a great necessity. Nature kept this. For the branched vein that operates the blood is placed at the top of the liver, and it confers through its branches the kili vein, explained near the curvatures of the liver through certain narrow and round passages. The blood, therefore, existing as thick according to its constitution, and not being able to pass through the narrow ways without impediment, there was a need for the watery superfluity to be present with it, so that by the subtlety of the watery superfluity, the blood might easily pass with it to the kili vein, because the watery superfluity is impelled to the branch of the kili vein which lies near the spine of the back from above to below; and through it and through the passages of the loins, both right and left—placed according to the Greek letter referring to the Greek letter lambda, often used to describe anatomical bifurcations in their position—they draw this superfluity from the kili vein of the loins through those passages. Then, thus forming it and transmuting it into the essence of urine, they transmit it through the urinary passages to the urine-receiving bladder. ¶ And if, indeed, the blood is sincere and pure and perfect, it is manifest that its superfluity will also be such. If, however, according to some case, the strength operating the blood has been impeded from completing its work, such is the watery superfluity that we call urine. For this reason, therefore, sometimes thin and white urines appear; sometimes, however, thick and white, the blood having been made cruder, and the digestion of the blood having been made imperfect and as if cruder; another, however, is [made] from blood that is over-incensed and as if boiling, [and] such and its superfluity becomes [so]. Therefore, because of such

causes, urines are also changed according to species.

Here he places a notification of natural urine.

Let us speak, therefore, of that urine which is according to nature, which is made from the perfect creation of the blood, what it ought to be, and let us define good urine, which is also named according to nature; [as for that] which exceeds this, we consider it not according to nature, but beyond nature.

¶ The definition of it is, therefore, such: urine which is according to nature is good, as Hippocrates says, having a white and flat and equal hypostasis sediment. It is manifest, indeed, that with the substance following as moderate and the color as opportune, a definition defining it as perfect is made. ¶ Urine is good, the substance indeed moderate, the hypostasis truly white and flat and equal, the color truly red or sub-red, and participating a little in redness because of the limpidity and the time likewise following. Magnus said that this sub-red and sub-rubid urine is good. We, however, have made a moderation of both; but whatever according to any of these four either abounds or has less, we say this is not according to nature. ¶ Concerning colors and hypostases, therefore, it is not the time to speak; for the preceding speech will teach it. But for the present time, let us speak of the effusion, because every urine according to its substance is an effusion. For the substance of urine is moisture; many of the wise physicians have called this moisture an effusion, because what has been effused into the members is looked at or perceived in it. The differences of such an effusion, however, are two: subtlety and thickness, and from these mixed, there is a temperament; but the temperament itself which is according to nature is not divided. A subtle effusion, therefore, is either voided thin and remains thin, or is voided thin and becomes bright and thick; and the former, indeed, is the indigestion of the latter; but having become bright and transmuted into thickness, it signifies the beginning of digestion. ¶ Similarly, also, the thick is divided doubly: either it is voided thick and remains such, or it is voided indeed thick, but the sediment becomes thin; and the former shows a strong perturbation of humors made in the body, [but] the latter [shows] that the perturbation is being determined, and [that] the digestion is rising again by the operation of the blood. We shall join, therefore, the substance to the color, and we shall determine the signs that are made from them concerning the complexions and in human infants, and in whatever way they are sick. And because the white color precedes other colors, and a thin effusion precedes other qualities in effusion, let us compose the thin and white substance. ¶ Concerning thin and white urine, or concerning urine with a thin substance and white color.

A thin and white substance of urine signifies many things. For urine coming very thin and white in healthy people signifies much drinking along with abundant food, and especially if the wine is meager and light. But such urine in children is bad; for watery urines in children are very bad; such urine coming signifies a weakness of strength, as in old age, which is according to nature. It signifies also a weakness from a long-lasting illness which has been called by the wise physicians "the old age of illness." ¶ Urine thin and white and voided much, and similar to diabetes excessive urination, signifies what the wise physicians have called famidam a term for a specific urinary affliction, and some of the greatest of those wise men have called it diarria diarrhea/flow in urines. Others, however, [call it] dyplaton a term for double urination; it appears not with the person having themselves according to nature, but disposed beyond nature, according to a hot intemperance of the loins. Therefore, because of an infinite attraction of the loins disposed beyond nature, such urine comes. ¶ Urine thin and white, voided much in ephemeral fevers, signifies that it is failing. For by such... and in that which is according to nature [regarding] the coldness and temperament of the liver, thin and white urines are voided; and because of efraxi obstruction, it comes.