People showing a sample of urine to the physician Constantine the African.

Uroscopy is the historical medical practice of visually examining a patient's urine for pus, blood, or other symptoms of disease.

The first records of uroscopy as a method for determining symptoms of an illness date back to the 4th millennium BC, and became common practice in Classical Greece. Later reaching medical predominance during the Byzantine Era & High Middle Ages, the practice eventually was replaced with more accurate methods during the early modern period, with uroscopy being considered inadequate due to the lack of empirical evidence and higher standards of post-Renaissance medicine.

In modern medicine, visual examination of a patient's urine may provide preliminary evidence for a diagnosis, but is generally limited to conditions that specifically affect the urinary system such as urinary tract infections, kidney and bladder issues, and liver failure.

History

Records of urinalysis for uroscopy date back as far as 4000 BC, originating with Babylonian and Sumerian physicians.^[1] At the outset of the 4th century BC Greek physician Hippocrates hypothesized that urine was a "filtrate" of the four humors, and limited possible the diagnoses resulting from this method to issues dealing with the bladder, kidneys, and urethra.^[2] This in turn led another Greek physician, Galen, to refine the idea down to urine being a filtrate of only blood, and not of black bile, yellow bile, or phlegm.

Byzantine medicine followed, though it maintained its roots from Greco-Roman antiquity, and continued the application and study of uroscopy – it eventually becoming the primary form of ailment diagnosis. Byzantine physicians created some of the foundational codifications of uroscopy, with the most well known example being a 7th-century guide on uroscopic methods: Theophilus Protospatharius's On Urines. The work, along with others, became widely popular and accelerated the rate at which uroscopy spread throughout the Mediterranean. Over time these Byzantine works inspired further interpretation by other prominent culture's scholars (like the Arab Jewish Isaac Israeli ben Solomon and his urine-hue classification chart), though greater propagation led to a widened application of uroscopy and eventually uroscopic diagnoses of non-urinary related diseases and infections became standard.^[3]

Pivotal in the spread of uroscopy, Constantine the African's Latin translations of Byzantine and Arab texts inspired a new era in uroscopic interest specifically in western Europe throughout the High Middle Ages.^[4] Despite this popularization, uroscopy was still mostly maintained by the principals Hippocrates's and Galen's first postulated, aided by Byzantine interpretations that were further disseminated during this period in works by French physicians of the era Bernard de Gordon and Gilles de Corbeil.^[4]

The practice was upheld as the standard until the beginning of the 16th century when influence from cultural movements like the Renaissance inspired the re-examination of its methods, both to re-evaluate its effectiveness and explore new applications. During this period, a lack of empirical evidence supporting uroscopy and the introduction of new medical practices developed using the scientific method contributed to its gradual decline among licensed physicians. Early modern doctors, like the Swiss medical pioneer Paracelsus, began researching more empirically qualified approaches to diagnosis and treatment – an integral part of the Medical Renaissance and its redefining how we look at medicine —which only further hastened the decline of uroscopy.^[4] Since the beginning of the 17th century the practice has been largely considered unverifiable and unorthodox, and became a subject of satire (including multiple satirical references in the plays of Shakespeare). It was still practiced by "unlicensed practitioners" by popular demand up until around the beginning of the 19th century.^[1]

Though uroscopy is no longer popular in modern medicine, examples of its preliminary diagnostic utility still exist in simplified and empirically proven forms.^[5]

Incidentally, as the decline of uroscopy continued a new form of divination emerged from its remnants in "Uromancy" – the analysis of one's urine for fortune-telling or state-reading purposes. Although uromancy initially gained interest in the 18th and 19th centuries, it is rarely practiced and unknown to most in the present era.

Procedures and conventions

The Medical Alchemist vt. The Uroscopy by Franz Christoph Janneck (1703–1761), (Science History Institute)

Practitioners of uroscopy are referred to as uroscopists. In the era in which uroscopy was a popular way of thinking, one of the major benefits was the lack of surgical operations, lending itself to the most conservative of adherents to the Hippocratic Oath.

Urine wheel

Uroscopy Wheel

The uroscopy wheel is a diagram that linked the color of urine to a particular disease. It usually has twenty different uroscopy flasks with urine of different colors aligned around the border of the circle. Each flask has a line that connects it to a summary of a particular disease. This allowed doctors to have a quick reference guide to twenty different types of urine.^[6]

Common diseases identified by uroscopic methods

See also

• Urinalysis
• Urology

References

Wikimedia Commons has media related to Uroscopy.

• Buckland, Raymond (2003). The fortune-telling book: the encyclopedia of divination and soothsaying. Visible Ink Press. p. 493. ISBN 1-57859-147-3.

External links

• Library of Congress: Exploring Uroscopy in Early Medical Texts