On the Evolution of Pediatrics and the Emergence of Pediatric Nephrology

A man and a child presenting their urine samples for examination by a doctor, surrounded by his attendants and students. Inspection of the gross characteristics of the urine in the special flask (matula) shown in the figure was one of the most common methods (uroscopy) for the diagnosis of disease in adults and children. In the Middle Ages, the matula became the symbol of the doctor. By the end of the seventeenth century, uroscopy began to be replaced by urine microscopy, although urine microscopy was not widely practiced. In 1909, Abraham Jacobi, a proponent of urine microscopy in children, lamented the failure to recognize glomerular nephritis in children as “deplorable as the diagnosis at any age is readily made by the examination of urine.”