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The Pee-in-a-Cup Test, circa 1500

By Cristina Luiggi The Pee-in-a-Cup Test, circa 1500 Before X-rays and MRIs could peer inside the human body, physicians turned to bodily wastes, particularly urine, in order to make diagnoses. The practice of uroscopy arose from the observation that the color, consistency, smell, and even taste of urine change with different ailments. With a sample of the ailing person’s urine, physicians and laymen alike turned to widely popular illustrations known as urine whe

By | November 1, 2010

The Pee-in-a-Cup Test, circa 1500

Before X-rays and MRIs could peer inside the human body, physicians turned to bodily wastes, particularly urine, in order to make diagnoses. The practice of uroscopy arose from the observation that the color, consistency, smell, and even taste of urine change with different ailments. With a sample of the ailing person’s urine, physicians and laymen alike turned to widely popular illustrations known as urine wheels to make their diagnoses. While some associations were clearly flawed—such as the idea that turbidity could indicate that a woman was not a virgin—in many ways uroscopy paved the way for modern laboratory medicine.

© Center for Manuscript and Rare Books / The Royal Library, Copenhagen
Bubbles in the urine have been known to be a really bad sign since the days of Hippocrates, who took it to be a sign of ailing kidneys. The father of medicine turned out to be correct, in fact, as a chronic disease of the kidneys known as proteinuria can produce an excess of protein in the urine, resulting in a decrease in surface tension and foaming. Medieval urine wheels, however, ascribed it to a defect in the lungs, which caused “windiness” in the urine, Diskin says.
1 - Urine was collected in these bladder-shaped glass vessels, called matulae, and were held up to the light by physicians for close inspection. During the Middle Ages, the matula became a symbol of a physician’s authority, American nephrologist Charles Diskin says, much like the stethoscope is today.
2 - The madness of King George III—the British sovereign during the American Revolution—has long been thought to be a result of porphyria, an inherited disease that affects the nervous system. Meticulous notes kept by the King’s physician describe his frequent abdominal pains and blue urine. Porphyria, however, is not associated with blue urine, but red, Diskin notes. This has led to the theory that the king suffered from a condition known as indicanuria, in which a bacterial overgrowth due to chronic constipation turns the urine blue. “That would also explain his abdominal pains,” he adds. As for the King’s madness, well, “maybe he was just crazy.”
© Center for Manuscript and Rare Books / The Royal Library, Copenhagen
3 - The theories behind uroscopy, which were rooted in the long-standing humoral theory of disease, grew increasingly intricate over time, sometimes leading to a poor understanding by the scribes and even the practitioners. In this rare manuscript of unknown authorship and origin, for example, some of the urine colors don’t match the descriptions and the contents of two of four circles surrounding the urine wheel have been incorrectly switched.
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Comments

November 11, 2010

It is well known among nursing-home staff that urinary tract infections (UTIs) often are associated with signs of dementia. Indeed, sudden onset of apparent dementia in a previously normal patient may be the first symptom of a UTI in an older person. Therefore, it is possible that King George III's madness was, after all, associated with the cause of his blue urine.

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