An authentic handbook on pee

Compared to the large medical compendia, the small size of Ms. 690 of the University Library of Utrecht is striking. The twelfth-century work on uroscopy is made of 41 folios and is bound in a simple, thick parchment cover with visible binding. It’s written with care and appears well-used. Frequent flipping of its pages have left the edges dirty and there are small notes and signs in the margins. Arguably the most noteworthy thing about this manuscript is that it appears to have been altered little in 800 years’ time.

Well used, well kept

Encountering medieval manuscripts that have not undergone restauration, rebinding or other alterations, is a rare treat. Since its creation, Ms. 690 appears to have hardly been altered, if at all. Quite a feat for a manuscript of at least 800 years’ age. Though the title on the cover has been written in a later hand, the manuscript has probably been bound in its sturdy parchment from the very beginning. The five quires have been individually bound with strips of parchment twisted into a kind of thread. They are affixed to the cover without connecting to each other, and show no sign of rebinding. In the middle of the quires, an extra strip of parchment is used to enforce the stress points where the parchment ‘thread’ runs through the leaves. Dirt has accumulated on the pages, but they are still clean underneath these extra strips. All signs that the manuscript has not been altered.

The size of the manuscript suggests that it could have been used as a handy work of reference. It certainly is used: we frequently encounter writing in the margins. Not all marginalia have been made by users. The copyist also used the space in the margin to correct mistakes. He did this through expunction, adding dots underneath the wrong text, and adding the correction in the margin. Nevertheless, users have left their own traces. At some point, foliation was added and whoever did so, also specified in the table of contents where each section started and marked these sections in the margins. Users that were perhaps bored, drew a little dog’s face (f. 18v) and something that looks like an eye (f. 36v). At one point, someone apparently struggled with the abbreviations and wrote them out in the margin. Much easier.

Despite the traces of use, it still seems like the manuscript was handled rather carefully, because it survived the test of time rather well. This is what these simple, handy reference works must have looked like in the twelfth century. Despite the impressiveness of the great illuminated works, most people in the Middle Ages will probably have thought of these little works when they thought about books, as it was what they encountered most.

Peeking at pee with De Urinis

The manuscript contains one single text: De Urinis by Isaac Israeli ben Salomon. De Urinis is an elaborate, but relatively short text about the observation of urine and the conclusions one could draw from that. It explains what scent, colour, viscosity, sediment and even taste of urine can reveal about one’s health (Massry 2009). The text consists of ten parts:

  1. The science of uroscopy, placing it in context of the four temperaments, particularly in relation to the blood;
  2. The importance of nocturnal urine;
  3. Types of urine in relation to pathology;
  4. Urine as humor-discharging fluid;
  5. Types of urine by colour;
  6. The state of the body judging by its colour;
  7. Types of urine based on clarity and viscosity;
  8. Sediment in relation to pathology;
  9. Types of urine in coherence with sediment;
  10. Different types of urine and sediments and their meaning.

The work offers a clear overview of the art of uroscopy. This text was of enormous influence on islamic medicine (where uroscopy was of great importance) and contributed to the rise of uroscopy as one of the most important branches of medicine in the Middle Ages (Prioreschi 2001). Ms. 690 is a remarkably early witness of this.

Rediscovered as the work of Isaac Israeli ben Salomon

We don’t know a lot about the author of the manuscript. Isaac Israeli (Isḥāq ibn Sulaimān al-Isrāʿīlī) was a Jewish doctor and philosopher, born in Egypt and died around the year 932 or 950 (there is some controversy on this). Between 875 and 904 he was presumably employed as ophthalmologist in Cairo. He then moved to Tunesia, where he worked as a personal physician and wrote texts in Arabic. His contemporary peers regarded him as a genius. His work De Urinis was translated in Latin by Constantine the African (died ca. 1098-1099), who produced copious amounts of translations of Arabic works. He neglected to attribute them to their respective authors, leading medieval scholars to believe Constantine himself was the author of these works. Some 400 years later this was established to be untrue. Coincidentally, it is around the same time that the cover of Ms. 690 received the title “Liber Ysaac filii Salomonis de urinis”.

Further reading

  • Canton, A. dal, & M. Castellano, ‘Theory of urine formation and uroscopic diagnosis in the Medical School of Salerno’, in: Kidney International 34 (1988), p. 273-277.
  • Collins, K.E. & M. Sussman, ‘Isaac Israeli and his Book of Urine’, in: Scottish Medical Journal 44 (1999), p. 86-88.
  • Fontana, E. (ed.), Il libro delle urine di Isacco l’Ebreo tradotto dall’arabo in Iatino da Constantino Africano (Pisa, 1966).
  • Massry, S.G., ‘Isaac Judaeus Israeli: a Jewish founder of the origins of nephrology’, in: Journal of Nephrology 22 (2009), p. 8-11. (Online )
  • Prioreschi, P. A history of medicine, vol. IV: Byzantine and islamic medicine (Omaha, 2001).

 

12th century
Manuscript
Linda Brakenhoff, April 2017
In the margin, fol 16v.
Dog's face, fol.18v.
Contents fol.1r.
eye, fol.36v.

Isaac Israeli ben Solomon, De Urinis. Utrecht, University Library, Ms. 690 (Ms. 2 E 18)

  • West-Europe, ca. twelfth century.
  • Parchment, 41 fols., 177 x 121 cm.
  • Pregothic, 1 column.
  • Latin, translated from the Arabic by Constantine the African.
  • Red initials, 1 to 5 lines tall, only sporadically adorned with pen decoration. Sketched dog’s face (f. 18v). Small drawing resembling an eye (f.36v).
  • Parchment cover, contemporary?