Urinalysis, Part 1

Last post mentioned that a medieval illustrator indicated a physician by showing him holding a flask. There was a very specific substance in that flask, and it wasn't blood; it was urine. Blood's color rarely looked different from person to person or ailment to ailment, but urine could be different in many ways.

I talked about a book all about urine a few years ago, but let's get into some more detail now.

Medieval physicians saw at least 20 different visual cues in urine when assessing a patient's health. This was such a common practice in Western Europe that William of Rubruck, writing about his travels in the Mongol Empire for Louis IX of France, mentions his surprise that their physicians didn't examine urine.

Let's look at some of the statements made by Giles Corbeil (fl.1200) in his 352-verse De urinis, written for students on uroscopy. He starts with the basics:

The physician who wishes to be considered an expert judge of urine must consider with care the following things: what sort, what it is, what is in it, how much, how often, where, when, age, nature, sex, exercise, anger, diet, anxiety, hunger, movement, baths, ointment, drink.

He explains what healthy urine looks like; it seems the flask of urine is swirled and then sediment is allowed to settle:

Color, consistency, duration, form, and place are the determining characteristics of urinary sediment. The color should be white, the consistency continuous, the form conical, the place the bottom of the vessel, and the duration marked. If the sediment is all these – white, continuous, lasting, conical – digestion will be good, virtue strong, and natural action will flourish with a triple activity: it whitens, it cleanses, and it condenses, concentrates, and unites.

The smart physician could also predict death from urine:

A very limited quantity of urine, passed with difficulty, livid and oily, foreshadows death. Urine tinged green indicates jaundice, spasm, severe fever, and finally death.

We'll look at more methods of diagnosis tomorrow, as well as some specific cases.