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Section of History of Medicine, Department of Experimental Medicine and Pathology, University of Rome 'La Sapienza', Rome, Italy.
Black urine is recorded in all ancient urology as a negative prognostic sign, often linked with the presence of blood; its presence can also be considered as a sign of massive hemolytic crisis, especially if associated with specific nosological patterns. The Hippocratic case of Epidemics III, 11 has recently been diagnosed as an intermittent acute porphyria. Despite the difficult 'retrospective' diagnosis of an ancient case, it seems likely that the Hippocratic physicians empirically knew clinical associations of symptoms that modern medicine could consider as the first descriptions of porphyria.
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