Reviewed by Olivia Weisser (University of Massachusetts Boston)
Published on H-Albion (March, 2016)
Commissioned by Jeffrey R. Wigelsworth
Making sense of the body in early modern Europe often entailed evaluating the stuff that came out of it. The color, consistency, and odor of blood, spit, vomit, and stool offered insights into otherwise invisible processes. But perhaps the most commonly assessed bodily fluid of all was urine. Physicians would raise urine flasks to the light to examine the color and texture of their contents, or shake and swirl them to evaluate the urine’s consistency. Small bubbles on the surface indicated a headache. Foam foretold gas. Such evaluations enabled physicians to divine the nature and progress of diseases “just as one recognizes one’s own face looking into a mirror” (p. 19). Michael Stolberg’s Uroscopy in Early Modern Europe recovers the history of this practice by reconstructing it from the perspectives both of ordinary sufferers and learned physicians. By privileging contemporary beliefs about the body over modern standards of objective evidence, we can better understand how and why people trusted uroscopy for so long.
The book opens by demonstrating the ubiquity of uroscopy in early modern life. Stolberg walks through the techniques and interpretations involved, as well as accompanying challenges. It was nearly impossible to create uniform color charts, for instance, and the terms used to describe colors had varied meanings over time. Interpretations of urine were based not merely on visual observations, but also the complex and shifting principles of humoral pathology. Urine was thought to be blood concocted from food that was strained out by the kidneys. Its color indicated how effectively the body digested food, which in turn was a measure of vital heat.
These theoretical underpinnings overturn common misperceptions of uroscopy as strictly empirical. They also help explain why the practice retained its appeal for so long. Uroscopy offered visual evidence of long-held beliefs about the body. It was widely presumed, for instance, that illness could result from morbid matter collected and settled within the body. Cloudy urine was thought to provide evidence of this phenomenon. In addition to fitting well within the medical cosmology of the time, uroscopy had a practical utility. It was relatively cheap, enabled physicians to perform diagnoses remotely, and ensured anonymity in sensitive cases. For this last reason, uroscopy offered a popular means of determining pregnancy. More than a diagnostic procedure, Stolberg argues, uroscopy was a ritualized way of communicating meanings of observable corporeal phenomena.
In addition to drawing on medical treatises, casebooks, and autobiographical writing, the book offers a much-welcomed analysis of Dutch genre art. While obviously staged, these paintings offer lay perceptions, since artists had to meet the expectations of potential buyers. Art historians have argued that uroscopy was ridiculed and derided in art, but Stolberg finds just the opposite. Physicians examining urine in artwork of the era were characterized much like alchemists whose specialized knowledge could unlock the secrets of nature. Stolberg notes that uroscopists in artwork were often surrounded by objects of inquiry, such as glass vessels and globes, which symbolized a privileged access to knowledge unattainable from books.
Uroscopy began to fade by the eighteenth century, but even then the practice was still somewhat respected. Consultation letters from the time show that it remained a dimension of diagnosis, although it shifted to the background as patients’ bodies and biographies took center stage. The practice only began to lose favor altogether by the nineteenth century, which Stolberg links to increasing threats to physicians’ professional authority as patient demands shifted.
Individual chapters of Uroscopy in Early Modern Europe would most likely appeal to scholars working within related subfields. Yet, as a whole, the book makes significant contributions to scholarship by complicating grand narratives in the history of medicine. Historians, for example, have traced the declining significance of subjective patient narratives in clinical encounters as new technologies, such as thermometers, reinvented medicine as an “objective” interpretation of bodily signs. This book qualifies that story, as ursocopy offered a long-enduring, widely popular approach to diagnosis that did not entail patients’ accounts. Likewise, modern medical advances, historians have argued, eliminated women’s reliance on their own bodily sensations to determine pregnancy. Uroscopy, however, shows demand for an “objective” test long before the invention of technologies that rendered women’s subjective sensations obsolete—a test, I might add, that is remarkably similar to the one women use today to determine pregnancy. This book is brimming with illustrative details and inspires readers to rethink historical narratives about medical professionalization, shifting diagnostic practices, and the ways patients shape medical discourses. Most of all, it reveals the importance of examining long forgotten beliefs and practices.
If there is additional discussion of this review, you may access it through the network, at: https://networks.h-net.org/h-albion.
Olivia Weisser. Review of Stolberg, Michael, Uroscopy in Early Modern Europe.
H-Albion, H-Net Reviews.
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