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April 1963

Is It Bile or Bilirubin?

Arch Intern Med. 1963;111(4):405-406. doi:10.1001/archinte.1963.03620280005002

From time to time there appear articles which make a plea for greater specificity in speaking and writing.1,2 This is as it should be, since precision in the communication of knowledge is important to the progress of science. In line with this thesis, we shall point out reasons for abandoning the inappropriate use of "bile in the urine," a term long entrenched in medical tradition.

Exactly how or when this phrase became common jargon is not certain. As early as 400 B.C. Hippocrates described jaundice and mentioned dark urine.3 In the 13th Century John Actuarius wrote that discolored urine resulted from admixture with bile, or, more rarely, with blood.4 Richard Bright, in an excellent treatise on jaundice published in 1836, referred to the urine of his patients as being "highly tinged with bile" or "loaded with bile."5 In 1845 Scherer isolated a crude preparation of biliverdin