Piss Prophets & The Wheel of Urine

L0030213 U. Binder, Epiphaniae medicorum, 1506.I recently watched an episode of Dr Oz in which he pontificated about the colour of some unfortunate woman’s urine in front of millions of viewers. She offered up a cup of what looked like diluted molasses to the good doctor for judgement. ‘Dehydration,’ Dr Oz decreed.  ‘More water!’

(As if she didn’t have a sneaky suspicion of this already from the looks of the dark, murky fluid residing in the bottom of the plastic cup.)

Watching this spectacle reminded me of the medieval urine wheel used to diagnose disease based on the colour, smell and taste of a person’s urine. And yes, I did say taste. I’ll return to that point in a minute.

Before stethoscopes, blood tests and x-rays, a pot of pee was a crucial diagnostic tool. Due to the enduring influence of the Greco-Roman physician, Galen (131-201 AD), medical practitioners believed that urine was vital in gauging the health of a person’s liver, where blood was thought to be produced. Analysing urine was the best way to determine whether a patient’s four humours (blood, phlegm, yellow and black bile) were in balance.

The wheel consisted of 20 colours ranging from ‘white as wellwater’ to ‘ruddy as pure intense gold’ and lastly ‘black as very dark horn.’ George III (1738-1820) reportedly had purple urine. This could have been a sign of a rare condition known as porphyria which can manifest itself in many of the neurological disorders for which the ‘Mad King’ was known.

M0013714 Miniature: a physician examining a urine flask.Of course, examining a person’s urine inside a dark chamber pot proved problematic, so practitioners created a round-bottomed glass flask shaped like a bladder called a matula. Indeed, the image of the doctor holding up the urine-filled flask to the light came to epitomize medicine during this period, and is still a recognized symbol today.

The smell and taste of a patient’s urine were equally important when determining a course of treatment, and often corresponded with specific colours. In 1674, the English physician Thomas Willis described the urine of a diabetic as ‘wonderfully sweet as if it were imbued with honey or sugar.’ He also noted that diabetic urine was often the colour of honey, something observed by earlier practitioners using the urine wheel. Willis went on to coin the term mellitus (literally honey sweet) in diabetes mellitus, and for a long time, the condition was known as ‘Willis’s disease.’

The urine wheel may not have been useful in diagnosing diseases as we understand them today; however, it was used in standard practice during the medieval period. By the 16th and 17th centuries, urine wheels had become so prolific due to the printing press that all sorts of people were using them, including unlicensed medical practitioners, or quacks. The practice of uroscopy—using urine to analyse a patient’s health—soon turned into uromancy, which was something altogether different.

L0025265 A physician examining a flask of urine brought by a young woUromancy is the art of divination using urine. Piss prophets (as they were known) each had a different method for predicting the future. Some took omens from the urine’s colour; others from its taste. Most commonly, piss prophets ‘read the bubbles’ seconds after it hit the divination bowl. The presence of large bubbles spread far apart signified that the urinator was about to come into a lot of money. Conversely, the presence of small bubbles packed tightly together signified illness, loss or the death of a loved one. Even pregnant women visited piss prophets to the hopes of learning the sex of their babies.

Today, physicians no longer taste our urine, nor do they spend much time contemplating its smell or colour (Dr Oz aside). That said, asking a patient to pee into an impossibly tiny cup is not an uncommon request, as anyone entering a hospital or medical office today knows. One can’t help but think the experience would be much more enjoyable if the doctor, upon being presented with the warm cup of cloudy liquid, poured it into a divination bowl and told us we were all going to be rich.

Just like him.

The Dangers of [Georgian] Vanity

Huzzar2The other day, I walked through the makeup section of a department store just outside of Chicago. Every step of the way, I was bombarded by sales attendants trying to sell me the latest anti-aging potions. There was Rodial Snake Venom—an anti-wrinkle cream which allegedly simulates the paralysing effects of a viper bite to reduce expression lines in the face—as well as a host of other products including Freeze 24/7, which purports to be a ‘clinically proven dream cream.’ Topping the list of quack remedies was the ‘Vampire Facelift,’ a non-surgical procedure involving the reinjection of gel-like substance derived from the patient’s own blood.

With all these products on the market today, you might think that we are uniquely obsessed with finding eternal youth. Yet, people in the 18th century were equally concerned with turning back the hands of time, and their beauty regime could be just as futile (and toxic) as our own.

Read the full article on Huzzar: The 18th-Century Inspired Fashion and Lifestyle Webzine.

Death & Childhood in Victorian England

CD2I remember many childhood days spent propped up on my grandmother’s couch with a tower of pillows. I’d watch the day peacefully unfold from her picture window. One month, it was bronchitis. The next, it was pneumonia. My mother—then a nursing student—rushed me in and out of doctors’ offices and emergency rooms, where I was poked, prodded and eventually sent home with a bag full of medications.

Principals were notified; classes were missed. Friends brought armfuls of heavy books home each day after school with daily assignments. I’d hear their voices in the other room but never see their faces. Contagion was always a risk.

This was the life of a sick child.

At the time, I felt incredibly sorry for myself. Why couldn’t I enjoy good health like the rest of my girlfriends? Why did I have to stay indoors day after day, and swallow pills that made me nauseated and dizzy?

Years on, however, I began to realise that I was actually very lucky.  This wasn’t just the life of a sick child. This was the life of a sick child in the 1980s.

Today, we often associate death with old age. But we don’t have to go back far in history to find a time when childhood was both dangerous and deadly.

CD3Victorian children were at risk of dying from a lot of diseases that we’ve eradicated or can control in the 21st century, like smallpox, measles, whooping cough, diphtheria, and dysentery (to name just a few). Death was a common visitor to Victorian households; and the younger one was, the more vulnerable he or she would be.

In 1856, Archibald Tait—the future Archbishop of Canterbury—lost five children in just as many weeks to scarlet fever. [1] When the fever wasn’t fatal, it nearly always weakened the child who often died months or even years later from complications.  Indeed, this is the fate of Beth in Louisa May Alcott’s famous book, Little Women (1868/9).

Tuberculosis was also a common killer in the 19th century. On 26 April 1870, Louisa Baldwin (mother of the future prime minister, Stanley Baldwin) wrote in her diary:

I paid a sad call at the Worths where 2 children seem to be at the point of dying, the poor terrible little baby has constant fits & little Madge two years old, who has been ill 12 days with congestion of the lungs. This is the second time I’ve seen them in this illness…we went into next door where we saw poor little Miss Lee evidently very near the end, but sweet and affectionate as ever. [2]

_8No one was immune. The great scientist, Charles Darwin, lost his 10-year-old daughter, Annie [left], to tuberculosis in 1851. In his personal memoir, the grief-stricken father wrote: ‘We have lost the joy of the household, and the solace of our old age…Oh that she could now know how deeply, how tenderly we do still & and shall ever love her dear joyous face.’ [3] By the mid-19th century, tuberculosis accounted for as many as 60,000 children’s deaths per year. [4]

Literature from the period reflects the prevalence of children’s deaths in Victorian England. The dying child makes a frequent appearance in 19th-century novels. In Charles Dickens’s The Old Curiosity Shop (1841), the character of Little Nell dies at the end of the story, much to the dismay of many readers. When describing the scene to his illustrator, George Cattermole, the novelist wrote:

The child lying dead in the little sleeping room, which is behind the open screen. It is winter-time, so there are no flowers; but upon her breast and pillow, and about her bed, there may be strips of holly and berries, and such free green things. Window overgrown with ivy. The little boy who had that talk with her about angels may be by the bedside, if you like it so; but I think it will be quieter and more peaceful if she is alone. I want it to express the most beautiful repose and tranquility, and to have something of a happy look, if death can…I am breaking my heart over this story, and cannot bear to finish it. [5]

CD4Though children died with frequent regularity during the Victorian period, a child’s death was still seen as particularly tragic. Even Dickens could not help but mourn the passing of his young, fictitious character [depicted by Cattermole, right].

As a historian, people often ask me if I would have liked to have lived in the past. My answer is always a resounding ‘NO!’ When you consider that only 40 per cent of children born in the 1850s reached their 60th birthday—and less than 10 per cent reached their 80th—I feel very lucky indeed to have been born in 1982.

My life expectancy is 78.


1. D. P. Helm ‘”A Sense of Mercies”: End of Life Care in the Victorian Home’ (Masters Thesis, University of Worcester, 2012), p. 15.
2. Diary of Louisa Baldwin 1870, 26th April 1870. Baldwin papers. 705:775/8229/7 (ii), Worcestershire Record Office. Originally quoted in Helm.
3. The original manuscript is in the Darwin Archive of Cambridge University Library (DAR 210.13). You can find the entire transcript online here.
4. J. Lane, A Social History of Medicine: Health, Healing and Disease in England 1750‐1950 (London, 2001), p.142.
5. Letter from Dickens to Cattermole.

Dying the Good Death: The Kate Granger Story


Recently, I had the privilege of interviewing Kate Granger, a 31-year-old physician who was diagnosed with an aggressive form of sarcoma in 2011 and given less than 5 years to live.

Kate made headlines in British newspapers when she announced that she was going to tweet from her deathbed, using her own death as a communication tool for opening up discussions about mortality. Kate and I talked about everything from the ‘over-medicalisation’ of death in the 21st century, to how she wants to die at home surrounded by friends and family.

Click here to read the interview on Medium.

I hope you find her message as inspiring as I did.

Death Salon Cabaret: The Uncommon Corpse


I was 17 years old when I saw my first dissected body at a chiropractic school of medicine just outside of Chicago. Since then, I’ve seen thousands more, some more disturbing than others. There have been disembodied body parts floating in jars; whole bodies splayed open, covered in shellac and nailed to wooden platforms; even corrosion casts uncovering the tiniest details of the human vascular system. Each one has provoked a reaction inside me. Each one has deepened my resolve to share the stories of the people who died and the anatomists who cut open and preserved their bodies in earlier centuries.

On Friday, October 18th I’ll be talking about some of the more unsettling specimens I’ve encountered in my research at the Death Salon Cabaret in Los Angeles. The night will be hosted by Lord Whimsy, and will consist of fast-paced talks interspersed with artistic performances focusing on ‘the idea of the rare corpse that will not simply fade into the background of history…the bodies that were not lost to the ground or the pyre but insisted on staying longer and forcing the living to face their mortality.’

HBSpeakers include Paul Koudounaris, author of The Empire of Death and Heavenly Bodies—two books which explore Europe’s catacombs and ossuaries with lavish photographs (see right); Jeff Jorgenson, owner of Elemental Cremation & Burial and advocate for green death practices; Bess Lovejoy, author of Rest in Pieces: The Curious Fates of Famous Corpses; Sarah Troop, host of The Cabinet of Curiosities Podcast; Joy Nash, Los Angeles-based actor; and Christine Colby, managing editor of Penthouse.

There will also be haunting musical performances by Gothic Beauty, Jill Tracy, and ‘Death Troubadour,’ Adam Arcuragi.

So if you find yourself in LA next month—and you aren’t faint of heart—come to the Death Salon Cabaret at the Bootleg Theatre. I promise you won’t be disappointed…though you may be advised not to eat before my presentation!

Rumour has it that even the Grim Reaper will be there for photos… I just hope he’s taller than me.

Click here to book your tickets

DO NOT SIT! A History of the Birthing Chair

ChairI was standing on the second floor of Surgeons’ Hall in Edinburgh waiting for my film crew to begin rolling for my upcoming documentary, Medicine’s Dark Secrets, when I spied a chair (left) in the corner. At that point in the day, I was exhausted and my attention to detail was diminishing with each passing second. Heartened by the sight of a chair, I quickly made my way towards my desired rest stop. Just as I began my descent into blissful comfort, however, I noticed a sign with big bold lettering: Museum Object: Please DO NOT SIT!

Just seconds before plopping my full weight down onto an antique chair, I awkwardly manoeuvred myself back into a standing position and looked around to make sure no one had seen my faux pas.

Upon closer inspection, I realised how obvious my mistake had been. This was no ordinary chair. It had a semi-circle cut from the seat, and looked tremendously uncomfortable. Indeed, I’d have to sit with my legs straddling either side of this awkward contraption to even remain balanced on it.

This was an 18th-century birthing chair.


Today, the idea of giving birth while sitting upright in a wooden chair may seem torturous.  But long before delivery rooms, stirrups, forceps and foetal monitors, a woman gave birth at home in a chair with the aid of her midwife and other female friends, relatives and neighbours. These women were known as the ‘gossips’, for they spread the word to all the women in the community when another went into labour. The ‘gossips’ supported the mother-to-be during this time by praying with her, preparing special foods, and helping the midwife with any other menial tasks that needed doing.

When the time came, the pregnant woman would be propped up in the birthing chair. The midwife would sit below her, ready to catch the baby, while other women supported and comforted her from above. After the delivery, the exhausted mother would then be lead back to her bed, which remained unsullied from the birth itself.

_8Overtime, birthing became the purview of the medical community. Midwives were replaced by male-midwives (the precursor to the modern-day obstetrician), who introduced forceps into the delivery. Birthing chairs were modified to accommodate these changes. Take, for example, the one on the left. The arm and foot rests on this wooden chair could be adjusted for the mother’s comfort; and (most importantly), the back could fold down, converting it into a bed or an operating table—a necessary feature if forceps were to be used.

Birthing chairs were coveted pieces, and often passed down from generation to generation as family heirlooms. Little by little, however, the hospital became the locale of birth and eventually the chairs were discarded.

That said, many examples still exist today in museums around the world. Thinking back on the one in Edinburgh, I am comforted by the sign with its big, bold letters. Clearly, I was not the first to try to sit in the birthing chair; and I doubt I will be the last.

Renaissance Rhinoplasty: The 16th-Century Nose Job

L0058567 Artificial nose, Europe, 1601-1800The 16th century was a particularly bad time for noses. In 1566, the famous astronomer, Tycho Brahe, had his sliced off during a duel and was forced to wear a replacement reportedly made of silver and gold. [1] Others lost theirs in similar fights, or to cancerous tumours that ate away the cartilage on their faces. But the biggest culprit to noses during this period was the new disease sweeping through Europe: syphilis.

Before the discovery of penicillin in 1928, syphilis was incurable. Its symptoms were as terrifying as they were unrelenting. Those who suffered from it long enough could expect to develop unsightly skin ulcers, paralysis, gradual blindness, dementia and what today is known as ‘saddle nose’—a grotesque deformity which occurs when the bridge of the nose caves into the face and the flesh rots away.

As syphilis raged throughout 16th-century Europe, the ‘saddle nose’ became a mark of shame, symbolizing the victim’s moral and bodily corruption. Some, in desperation, turned to surgeons to help disguise their deformities. One man in particular was renowned for his skills: the Italian surgeon, Gaspare Tagliacozzi.

L0032530 G. Tagliacozzi, De curtorum chirurgia per inBefore Tagliacozzi, most surgeons used the ‘Indian Method’ for nasal reconstruction. This involved cutting a nose-sized section of skin from the forehead and attaching it to the bridge of the nose to maintain a steady blood supply. The flap was then twisted into place and sewn over the damaged area, thus providing a suitable ‘replacement’ for the lost nose but leaving one’s forehead scarred.

Tagliacozzi had an entirely different approach. His process involved partially cutting a flap of skin from the upper arm, reshaping it into a nose, and then grafting it to the damaged nasal cavity (see right image). The patient’s arm would then be held in place using bandages for approximately 2 weeks while the graft attached itself to the face. Afterwards, the surgeon severed the new ‘nose’ from the arm and began reshaping and contouring the piece of skin.

A 16th-century contemporary described the surgery:

First they gave the patient a purgative. Then they took pincers and grabbed the skin in the left arm between the shoulder and the elbow and passed a large knife between the pincers and the muscle, cutting a slit in the skin. They passed a small piece of wool or linen under the skin and medicated it until the skin thickened. When it was just right, they cut the nose to fit the end of the little skin flap. Then they snipped the skin on the arm at one end and sewed it to the nose. They bound it there so artfully that it could not be moved in any way until the skin had grown onto the nose. When the skin flap was joined to the nose, they cut the other end from the arm. They skinned the lip of the mouth and sewed the flap of skin from the arm onto it, and medicated it until it was joined to the lip. Then they put a metal form on it, and fastened it there until the nose grew into it to the right proportions. It remained well formed but somewhat whiter than the face. It’s a fine operation and an excellent experience. [2]

The entire procedure could take up to 5 months, and no doubt caused considerable pain and discomfort to the patient during the process.

_*That aside, Tagliacozzi boasted of his skill, claiming that the noses he reconstructed were better than the originals. Yet when he died in 1599, so too did his method.  Over the next several hundred years, surgeons continued to prefer the ‘Indian Method’ when performing rhinoplasty, citing that Tagliacozzi’s technique left the new nose vulnerable to cold winters, when it often turned purple and fell off. On rare occasions, however, the ‘Italian Method’ was employed, such as the case of a soldier whose face was severely damaged in July 1944 (see above picture).

Unlike his surgical techniques, Tagliacozzi’s mantra persisted long after his death and is still quoted by modern-day plastic surgeons, who see him as the ‘father’ of their discipline:

We restore, rebuild, and make whole those parts which nature hath given, but which fortune has taken away. Not so much that it may delight the eye, but that it might buoy up the spirit, and help the mind of the afflicted. [3]

1. Recent forensic tests conducted on Brahe’s skeletal remains suggest that the nose may, in fact, have been made of copper.
2. Originally qtd in William Eamon, The Professor of Secrets: Mystery, Medicine and Alchemy in Renaissance Italy (2010), pp. 95-96.
3. G. Tagliacozzi, De Curtorum Chirurgia per Insitionem (1597).