A New Look at the Role of Urinalysis in the History of Diagnostic Medicine
By William L. White
Clinical Chemistry, Vol. 37:1 (1991)
Introduction: Before this century, urine was the predominant body fluid used by the physician for diagnosis and prognosis. Uroscopy, or urinalysis by the senses, has usually been treated disparagingly in historical accounts of diagnostic medicine. Although uroscopy was at times used fraudulently, the thoughtful use of urinalysis was probably an important part of diagnosis for the physician, even before the chemical analysis of urine.
The laboratory of today is ready to offer the physician an extraordinary array of analytical services in many different body fluids; yet until the technological advances of the 20th century, urine was the only practical body fluid for most diagnostic purposes. Furthermore, before the 18th century the physician had no laboratory to call upon; his only method for examining this crucial body fluid was the use of his own senses: sight, smell, and (at times) taste. Thus, urinalysis by the senses, often referred to as uroscopy, is an important component in the history of diagnostic medicine.
Although publications have dealt, in part, with the role of uroscopy in the history of clinical chemistry, bizarre and fanciful aspects have generally been emphasized, rather than its positive role in diagnosis and prognosis.
Just over a century ago, the English physician William Roberts, who later published the first paper on the observation of bacteria in fresh urine, wrote:
…the amount of information concerning a urine which may be obtained through the unaided senses of smell and sight far exceeds, both in precision and extent, what is usually supposed.