Hektoen International

A Journal of Medical Humanities

The village uroscopist

Alexandru Sonoc
Sibiu, Romania

The Village Physician
David Teniers the Younger (1610-1690)
Brukenthal National Museum, Sibiu, Romania

A physician sits in his studio at a table on which stand several covered vases. He has a book in his left hand and holds in his right hand a glass flask against the light coming in through the window. Nearby there is a furnace where his curing concoctions are prepared in a glass flask. Some books lie on the floor. To the left of the physician a worried looking older peasant woman is seen waiting. A curious man (identified by J. De Maere as the physician’s assistant and earlier on as the woman’s husband) looks in from behind the door, perhaps to announce the next patient or to bring the gifts somebody brought as payment. Near the furnace are two covered pots, one on the window, two others on the table. J. De Maere considers that these pots could contain food with which the peasants paid the physician.1

The furnace and the books identify the main character as a physician. He practices uroscopy, making medical diagnoses by looking at the urine. He does this under various conditions of temperature and light, and to do this must use a flask made of transparent glass of even thickness in order to avoid changes in color differences or distortion of the shape of the urine contents. The flask, called a urinal, became the attribute of St. Cosmas, the unmercenary physician.

David Teniers the Younger also painted other works of interest to the history of the medicine, such as The Surgical Operation and The Alchemist (both in Museo del Prado, Madrid). But the Sibiu painting most strikingly resembles two others, both named The Village Quack (from the Musée Royal des Beaux-Artsin Brussels and the Staatliche Kunsthalle in Karlsruhe), of which for certain compositional reasons it could be considered a variant.2,3 S. Marta remarked that the work in Sibiu is painted with empathy and benevolent irony,3 perhaps reflecting the attitude of the artist towards the poor sick people and the condition of their physicians, but also expressing some doubts about the efficacy of their cures. Other Dutch painters 4 also seem to have had negative views about uroscopy 5,6 because of its connection with divination and astrology7,8 sometimes ridiculing it by comparing it with uromancy as practiced by village quacks. As J. De Maere has remarked, even the Netherlands had made little progress since the Middle Ages, as miracles and superstitions were still moving the people, hygiene was lacking, medicine was ineffective, the mean age at death was 40, and the physician was still regarded as one of the notables of the village.1,9

The painting from Sibiu was mentioned in the handwritten catalogue of the Brukenthal collection as a work of a painter from the Netherlands.10 In the first printed catalogue, it was already attributed to David Teniers the Younger.11 Later, because of doubts expressed by some connoisseurs, it was thought to been only painted according to the said artist.12 These doubts were no more expressed in the catalogues of 190113,14 or in the album published in 1936.15 The later research kept the attribution to Teniers and dated the painting about 1660.1,2

Editor’s note

Uroscopy, the naked eye examination of the urine for diagnostic purposes, is as old as medicine itself, and was based on the assumption that abnormal processes in the body could be identified by visual inspection. It was advocated by Hippocrates, though without much enthusiasm. Several Greek physicians practiced uroscopy and developed a complex diagnostic model based on the theories of the four humors. Many treatises on uroscopy were published in antiquity and later by Byzantine, Arab, and Latin physicians. Uroscopic theory and practice reached an apogee between the nineteenth and fourteenth century at the medical school in Salerno in southern Italy, which at the time was a melting pot of different cultures. Over the years the school produced several masters of medicine or magistri, who wrote (or translated from Arabic) books expounding rules and diagnostic systems based on uroscopy. Among these magisters one finds Isaac Ebreus Isaac (880-940), one of its major exponents, who assembled in his Guida Medicorum many of the principles of uroscopy. Subsequently Magister Maurus formulated a theory that fluids were separated in the body by the stomach and liver, with generation of humors (1250). Gilles de Corbeil, a Frenchman, went to Salerno, then returned to Paris and wrote “Songs on Urinary Judgements,” a composition in verse that remained popular until the 16th century. A 13th century anonymous manuscript titled “De Urinis” expounds in detail the principles of uroscopy and contains aphorisms such as:

  • Clear urine, pale or almost green indicates pain in the stomach in males, but in women it means inflammation or phlegm from the umbilicus to the throat, and thirst.
  • Small volume urine which is sulphurous indicates diarrhea.
  • Urine which is red with fluid beams indicates disease of the spleen.
  • A red circulus means pain in the head due to blood.
  • Urine of a vicious woman is quite colored, cloudy by night and dense in the morning.
  • Urine of a virgin is clear, white, light, and transparent, with very small bubbles on the surface.

 

References

  1. Jan De Maere, Nicolas Sainte Fare Garnot, Bruegel, Memling, Van Eyck… La collection Brukenthal. Ouvrage publié à ľoccasion de ľexposition Bruegel, Memling, Van Eyck… La collection Brukenthal au musée Jacquemart-André du 11 septembre 2009 au 11 janvier 2010 (Bruxelles: Fonds Mercator: 2009, 110-113).
  2. Van Eyck, Memling, Breughel. Arcydzieła malarstwa z kolekcij Brukenthal National Museum w Sibiu / Masterpieces from the collection of the Brukenthal National Museum in Sibiu (Gdańsk: Muzeum Narodowe w Gdańsku, 2010, 156).
  3. Daniela Dâmboiu, Guy Thewes, Danièle Wagener (Hg.), Brueghel, Cranach, Tizian, van Eyck. Meisterwerke aus der Sammlung Brukenthal (München: Deutscher Kunstverlag, 2012,163).
  4. Friedrich von Zglinicki, Die Uroskopie in der bildenden Kunst. Eine kunst- und medizinhistorische Untersuchung über die Harnschau. (Darmstadt: E. Giebeler, 1982)
  5. Walter Wütrich, Die Harnschau und ihr Verschwinden. (Zürich: Juris Druck und Verlag, 1967).
  6. Michael Stolberg, Die Harnschau. Eine Kultur- und Alltagsgeschichte. (Köln – Weimar: Böhlau- Verlag, 2009).
  7. Laurence Muolinier-Brogi, Guillaume ľAnglais, le frondeur de ľuroscopie médiévale. (Genève: Droz, 2011).
  8. Muolinier-Brogi 2012 – Laurence Muolinier-Brogi, Ľuroscopie au Moyen Âge. Lire dans une verre la nature de ľhomme. (Paris: Honoré Champion, 2012).
  9. Kay P. Jankrift, Mit Gott und schwarzer Magie. Medizin in Mittelalter. (Stuttgart: Theiss Verlag, 2005).
  10. Der älteste handschriftliche Katalog – The handwritten catalogue, kept in the Library of the Brukenthal National Museum of Sibiu (mss. 628), ca. 1800.
  11. Die Gemälde- Galerie des freiherrlichen v. Brukenthalischen Museums in Hermannstadt (Hermannstadt: 1844, 77-78, cat. nr. 272).
  12. Freiherr Samuel von Brukenthal’sches Museum in Hermannstadt: Führer durch die Gemäldegalerie, herausgegeben von der Museumsverwaltung, vierte Auflage, (Hermannstadt: 189326, cat. nr. 164).
  13. M. Csaki, Baron Brukenthal’sches Museum in Hermannstadt. Führer durch die Gemäldegalerie, 5. Aufl. (Hermannstadt: Selbstverlag des Museums, 1901,313, cat. nr. 1120).
  14. M. Csaki, Baron Brukenthalisches Museum in Hermannstadt. Führer durch die Gemäldegalerie, 6. Aufl. (Hermannstadt: Selbstverlag des Museums, 1909, 347-348, cat. nr. 1166).
  15. Deutsche Buchgilde in Rumänien (ed.), Alte Meister. Fünfunddreissig Gemälde aus der freiherrlich Brukenthalischen Sammlung(Hermannstadt: Verlag von Krafft & Drotleff, 1936,12).
  16. Daniela Dâmboiu, Guy Thewes, Danièle Wagener (Hg.), Brueghel, Cranach, Tizian, van Eyck. Meisterwerke aus der Sammlung Brukenthal (München: Deutscher Kunstverlag, 2012).

ALEXANDRU GH. SONOC, PhD, MA, MS, Brukenthal National Museum, Sibiu, Romania

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