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Sediments or Precipitates
بقول ابن سینا: رسُوب البول
Avicenna’s Wisdom about the Urinary Sediments or Precipitates
First of all, it should be clear that according to Avicenna the meaning of term “sediment” is not “that which sinks to the bottom of the vessel.” Sediments are those whole substances that are denser in essence than wateriness, which separates out from the wateriness regardless of whe-ther they settle down or not, floats or not, sinks or not.” Therefore Avicenna used to note seven characters pertaining to a sediment such as its structure, quantity, quality, the arrangement of its components, position, duration, and mode of permixture. For complete details about the sediments, you must refer to the “Cannon of Medicine”, here I will only elaborate few of import-ant points related to the macroscopic examination of urinary sediments or precipitates.
Natural Sediments: According to the Avicenna “natural sediments are white, sinks to the bottom of the vessel and their particles are in continuity, uniform, and all alike. In contour, they are rounded, light, homogeneous, delicate, like the deposits that form in the rosewater (Arq-e-Gulab)”. He said that “natural sediments are the evidence of normal digestion and maturation”,
He also explained about the difference between Natural sediments and other things as he said the “Natural or good sediments resemble pus and crude serous humor when they are tenuous, but pus is different in possessing fetor, crude serous humor is different in compact and not homogeneous.”
Black, Green sediment: Haly Abbas says “it is a fatal sign if it comes after being strongly red”.
Red sediment: “These denote the dominance of sanguineous humor (sanguineous plethora); if it continues to be present for a long time it denotes inflammation of the liver.”
Yellow Sediments: “These denote great heat because these are produced by bilious humor.”
White Sediments: “These are sometimes good, sometimes bad. That is, when these are mucoid, ichorous, or foamy; because this shows that the urine is not a completed secretion.”
If the sediments settle rapidly, it is a good sign, showing that maturation is correct. If these settle slowly, it is not good, as it shows deficient of maturation, according to their amount.
Avicenna also points out the higher prevalence of urinary sediments in obese people with a sedentary lifestyle compared to thin and lean people. He said “In thin persons, the abnormal sediments of the urine are scanty and sink down differently according to the state of health, especially if the person is accustomed to exercise or to practice laborious arts. The sediments are abundant only in obese persons and in those of bad habits”.
According to the Modern Medicine
In contemporary medicine the protocol is to perform numerous lab tests to diagnose sediments but whatever the diagnosis of urinary sediments. These can occur due to improper protein met-abolism, kidney problems, or many other conditions and diseases that can be a nightmare to have. The best approach is a forward-thinking lifestyle where the person pays attention to their overall health & maintains a lifestyle of healthy diet & enough water & exercise to stay healthy.
The following are the naked eye characters of some of the common sediments:
1. If urinary sediments are Cloudy, Translucent or Semi-transparent and Non-crystalline.
These indicate the presence of bacteria, spermatozoa, tube casts, cells from urinary passages, or scanty precipitates of mucin.
2. If urinary sediments are Cloudy, Translucent and Crystalline.
These indicate the presence of small oxalate of lime crystals or colorless crystals of uric acid.
3. If urinary sediments are Whitish and Non-crystalline.
These indicate the presence of pus in acid urine (as in some cases of pyelonephritis and renal abscess). Amorphous phosphates. vaginal cells in large quantities and starch also cause this.
4. If urinary sediments are Pale Buff-yellow, Brownish-yellow or Pink.
These indicate the presence of Amorphous urates.
5. If urinary sediments are Smoky, brownish-red or Bright red.
These indicate presence of blood from the kidney or oozing slowly from the urinary passages.
6. If urinary sediments are Adhesive, dark or Bright-red Clots.
These indicate the blood, resulting from abundant hemorrhage in the bladder or urinary passages. When the urine becomes alkaline, blood clots become darker in color and adhesive.
7. Very Adhesive, Translucent, Jelly-like, with whitish or yellowish opaque.
These indicate the presence of so-called muco-pus, associated with chronic cystitis.
8. Whitish, Crystalline heavy sediments.
These indicate Phosphate of lime (opaque white) or Oxalate of lime (translucent white).
9. Yellow or Reddish-brown, Non-crystalline sediments.
These indicate urate of sodium or ammonium.
10. Pale Yellow, Reddish-brown, Orange, Brick Red, Crystalline.
These indicate the Uric acid crystals.
This information must not be thought to be as sure as the knowledge gained by a careful physi-cian’s examination. For more details about urinary sediments read book “Urology in Cannon”.
Suggested Readings
- Fogazzi, G. B. (2010). The urinary sediment. An integrated view. Penerbit Buku Kompas.
- Kern, W. H. (1971). Epithelial cells in urine sediments. American journal of clinical pathology, 56(1), 67-72.
- Gruner OCA. Treatise on the Canon of Medicine of Avicenna, AMS Edition Published In, AMS Press Inc., New York, 1973, 323-353.1.
- Armstrong JA, Urinalysis in Western culture: A brief history, Kidney International. 2007; 71(5):384-387.
- Avicenna’s Canon of medicine by O. C. Gruner.
Tag:Urology in Canon