‘Uroscopy in Early Modern Europe’ reviewed by Jessica Legacy

‘Uroscopy in Early Modern Europe’ by Michael Stolberg (Ashgate, 2015)

SteinUroscopy is an out-dated medical practice involving the examination of urine. Physicians inspected urine colour, texture, and quality in order to detect disease and the degree of a patient’s health. Michael Stolberg opens his book, Uroscopy in Early Modern Europe with the claim that ‘this book is about one of the most important practices in the history of Western medicine’ (p. 1). In five chapters, Stolberg chronicles the scope of uroscopy in early modern medicine and everyday culture. The book begins with a good literature review and argues a need for research that traces a topic, often considered unpleasant to assess or discuss, and its relation to broader cultural developments in medicine throughout history.

The period investigated Uroscopy in Early Modern Europe spans far beyond where one might place ‘early modern Europe.’ Stolberg includes sources from the fifteenth to the nineteenth centuries. The chapters are not arranged chronologically, but thematically, and address topics such as theoretical foundations, everyday practices, cultural significance, and eventual replacement practices. In the first chapter, Stolberg portrays a history of uroscopy that traverses the classes of practitioners, including laypersons, non-academic professionals, and academic physicians. The second chapter offers a concise summary of early modern medical theories of urine production and includes valuable and informative case histories, depicting the extent to which uroscopy was relied upon. The third chapter is largely focused on women and the routine of uroscopy; however, the motive for focusing on women is unclear, as uroscopy was not especially targeted to women; nor was it the only means of diagnosing pregnancy. Even more misleading, the subject matter of this chapter is veiled under the rubric of ‘popular culture,’ although Stolberg fails to define his use of this term. In addition to examining the portrayal of these medical practitioners from a social and cultural perspective, the book contains a large sampling of fully coloured plates of early modern paintings rendering physicians in their practices. Chapter four investigates the depiction of uroscopists in early modern genre painting. Finally, the fifth chapter traces the gradual decline of uroscopy and its eventual fall into disgrace. Stolberg includes a spectacular quote from a critic who likens uroscopists to vultures circling around a ‘piss pot’ (p. 129). Overall, the book presents a satisfying picture of the practice of uroscopy throughout the history of medicine from late medieval to modern practices.

Rather than tracing the history of uroscopic techniques to the individuals credited with their creation and adaptation, or delving—as so many medical historians tend to do—into book history, Stolberg approaches the topic of uroscopy anthropologically, presenting it as a reflection of everyday practices and lived experiences. As a result, the book succeeds in depicting a cross-section of early modern society through a sampling of health service providers and recipients. Stolberg attempts to arrange his findings ‘from below,’ or via the perspective of the patient. However, describing an arrangement where the patient is situated beneath the physician reveals the difficulty in this approach. Stolberg’s effort is to be commended, but material sourced from the patient is simply lacking from this era and, despite his best efforts, much of the content centres around the views of the physician. Nevertheless, this book provides valuable insight into the broader landscape of early modern medicine. For example, Stolberg’s discussion of the uroscopy colour wheel reveals the limitations of medieval and early modern printing technology in making accurate guides, along with our inability to decode the specifics of old practices. He concludes that these charts were probably more aesthetic than useful, and that the accompanying text is more instructive. In addition, this everyday portrayal of uroscopy required the handling and transportation of urine, most often delivered by messengers or family members. These agents were implicated in the medical exchange through allegedly affecting the accuracy of diagnosis.

One element that arises unexpectedly from the book is the scepticism and mistrust between physician and patient. According to Stolberg, uroscopy appears to harbour a similar tension. Despite some physician’s scepticism or outright disbelief in the efficacy of uroscopy, patients would often mistrust a physician who refused to practice uroscopy. Case histories in this book reveal that patients would go so far as to try and trick a physician by switching the specimen or withholding information. Additionally, Stolberg reveals that the scenes in paintings depicting the examination of urine are far from accurate. Rather than illustrating a realistic portrayal, these images convey an emotional drama, juxtaposing the weakened and motionless patient with the active physician examining his specimen. As the book unfolds, it becomes apparent that uroscopy was as much a ritual for establishing authority as a diagnostic procedure. The final chapter reveals the surprising hold of uroscopy over patients, despite its gradual waning in practice. Stolberg argues that the decline begins with Vesalius in the sixteenth century; and yet uroscopy was in high demand from patients during the same period and up to the early nineteenth century. This timeline of slow decline shows that even while physicians long discredited some of the worth of uroscopy, patients demanded it. This tension in the medical exchange reveals the agency of the patient in these practices.

While Uroscopy in Early Modern Europe chisels a space for uroscopy in the wider context of medical humanities, there are some minor elements that, for the sake of critique, might be addressed. First, Stolberg argues that uroscopy in the early modern period has not been given the same attention as its medieval practices; however, he fails to establish his parameter of when his early modern period begins. This would be particularly helpful as he extends his examination well beyond when one typically considers the early modern period. Additionally, it would be useful for the reader if he explained what, in terms of his approach, makes the two eras different. Along the same vein, ‘vital spirits’ are briefly mentioned but Stolberg does not define this term. This would benefit a reader who is unfamiliar with spirits’ role in medieval and early modern medicine. Additionally, the vital spirits are woefully neglected in medical scholarship, and a text on uroscopy would have much to say about the influence of spirits in medicine on culture and society. Finally, at times the book is frustratingly edited. As mentioned at the beginning of this review, chapter three is fragmented, and as a result the continuity of the book is interrupted. Furthermore, there is a missing thumbnail and an infuriating inconsistency of the use of quotations around the term doctress. However, as these are minor irritations, it goes to show that Stolberg produced a thoughtful book that extends early modern medical practices beyond leeches and humours.

Reviewed by Jessica Legacy, who is a 3rd year PhD researcher at the University of Edinburgh. Her work focuses on early fifteenth-century medical folded almanacs and their contribution to the medieval ontological understanding of the body. She also examines the sensory spirits and the ways in which the senses were used to contextualize the physically souled body on earth. She is the former editor of Forum: University of Edinburgh Postgraduate Journal of Culture & the Arts, and is the lead organizer of Pilgrim’s Prize, a modernized adaptation of The Canterbury Tales told through online media.

Correspondence to Jessica Legacy.

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