Around the early 19th century, when diagnosing diseases, European physicians relied on a chart known as the “Urine Wheel.”
This circular chart represented 20 different colors of urine, corresponding to various related health conditions and their characteristic odors. Naturally, in order to conduct the examination, the physician needed to engage their visual, olfactory, and gustatory senses.
Uroscopy
Urine examination is a medical diagnostic method that has been in existence for a very long time. According to archaeological findings, it likely originated in antiquity, around the 4th millennium BCE.
Urine Wheel.
The first practitioners of urine examination were Babylonian and Sumerian physicians (Mesopotamia, Middle East). By the early 4th century BCE, this method of diagnosis was recognized by Greek physicians, quickly evolving into the most popular diagnostic technique: Uroscopy.
The diagnosis was based on two criteria: temperature and color. Uroscopy physicians utilized a transparent glass urinal with a thin neck and a round bottom. They first checked the temperature of the patient’s urine while observing the amount of bubbles and impurities…
Since the temperature of urine drops very quickly, physicians had to race against time. In the 19th century, Richard Bright (1789 – 1858) invented a technique that allowed for the examination of “cooled urine” by heating water and immersing the cooled urinal containing the urine.
Next came the observation of color. If the urine appeared white, it indicated damage to the spleen, edema, or nephritis. If the urine was burgundy in color, the patient might be suffering from hepatitis or a ruptured vein… Over time, Greek physicians established a urine color chart that became widely used.
Diagnostic Chart
Urine examination for diagnosis has a history of at least 6,000 years. (Photo: Ancient-origins.net).
The urine color chart was designed in a circular format, divided into 20 sections, each corresponding to a specific color and associated symptoms or diseases. This chart is referred to as the “Urine Wheel.”
Ancient and medieval Greek physicians always had the “Urine Wheel” at hand or memorized it. After checking the patient’s urine temperature, they would immediately compare it visually to reach a diagnosis.
The “Urine Wheel” was continuously “upgraded” by physicians as they added their own experiences and discoveries. In the 13th century, physician and poet Gilles de Corbeil (France) even composed a poem about uroscopy. This piece highlighted four urine colors to note: green, white, blue, and burgundy, along with their corresponding health conditions.
By the 16th century, the “Urine Wheel” was well-known among all households. Europe viewed this chart as a revolutionary advancement in medicine; not only physicians but also ordinary citizens sought to have an “Urine Wheel” on hand for self-diagnosis at home. Some physicians even diagnosed and prescribed medication without meeting the patient, simply by examining a urine sample.
On the market, paintings and books featuring the “Urine Wheel” emerged. Untrained “quacks” rushed to replicate it, deceiving patients and profiting from their ailments.
Smelling and Tasting
Thomas Willis (1621 – 1675), physician who coined the medical term ‘mellitus’ (diabetes). (Photo: Wikipedia.org)
To make accurate diagnoses, merely observing color was not enough. From the earliest years of uroscopy, in addition to tactile skills (temperature checks), physicians required olfactory and gustatory skills as well.
In the 17th century, physician Thomas Willis (1621 – 1675) – a pioneer in the study of brain anatomy, the nervous system, and influential muscles, was also captivated by the “Urine Wheel.” He participated in improving this chart, providing a crucial observation: “The urine of a diabetic patient has a sweet taste similar to honey or syrup.”
Moreover, Dr. Willis coined the medical term mellitus (diabetes). In his time, diabetes was often referred to as Willis’s disease, commemorating the name of its discoverer.
By the mid-19th century, the “Urine Wheel” firmly held its status as the “most reputable diagnostic chart.” From commoners to nobles, even kings were examined and treated by physicians based on comparisons with it.
Even King George III (1738 – 1820) left behind a uroscopy record indicating that his urine was purple. This was a sign that the king might be suffering from a porphyrin metabolic disorder (a condition related to the nervous system). It was rumored that due to this illness, King George III became increasingly tyrannical, eventually becoming a notorious despot.
By the late 19th century, chemical analysis began to be used for urine testing. Thanks to its accuracy, it quickly rendered uroscopy obsolete, including the “Urine Wheel.”
Today, the West retains only a few “Urine Wheel” charts. “Most of them are printed in black and white first and then colored later,” researcher Duroselle-Melish (UK) noted.
Because the color charts from the medieval and early modern periods were not very diverse, and the artists coloring them were not necessarily physicians, they lacked accuracy. Comparisons reveal inconsistencies between different charts. In other words, even from the criterion of color, the “Urine Wheel” was not consistent.
Despite these limitations, the “Urine Wheel” remains an important medical document. It serves as foundational knowledge, contributing to the development of future diagnostic methods based on urine examination.
