Public Health

Making Sense Of Colors And Shapes In The Toilet

A urine wheel from the early 16th century describes the color, smell and taste of urine, and then links them to diseases. i i

A urine wheel from the early 16th century describes the color, smell and taste of urine, and then links them to diseases. From Epiphanie Medicorum by Ullrich Pinder. hide caption

itoggle caption From Epiphanie Medicorum by Ullrich Pinder.
A urine wheel from the early 16th century describes the color, smell and taste of urine, and then links them to diseases.

A urine wheel from the early 16th century describes the color, smell and taste of urine, and then links them to diseases.

From Epiphanie Medicorum by Ullrich Pinder.

If you haven't heard, yesterday was World Toilet Day, and its sponsors, the Water Supply and Sanitation Collaborative Council and the World Toilet Organization, suggest you take a moment to consider the profound luxury of good sanitation. A mind-boggling 2.6 billion people on Earth don't have toilets, and WSSCC and WTO are among the parties set on bringing that number down.

Here at Shots, we're all for "breaking the taboo around the toilet" (see our recent posts on squatting and fake feces). And we get the sense that there's more confusion out there about what ends up in the toilet than most people would care to admit. And so for World Toilet Day, we're sharing a couple of infographics we stumbled upon recently.

Let's start with the early 16th-century urine wheel at the top of this page, which we first spotted on a Scientific American blog. The wheel was first published in 1506 in a book by Ullrich Pinder, a German physician, and describes the color, smell and taste (yes, taste!) of urine, and then links them to diseases.

A physician examines a patient's urine flask in this 17th century print by Isaac Sarrabat. i i

A physician examines a patient's urine flask in this 17th century print by Isaac Sarrabat. CollectionImages from the History of Medicine (NLM) hide caption

itoggle caption CollectionImages from the History of Medicine (NLM)
A physician examines a patient's urine flask in this 17th century print by Isaac Sarrabat.

A physician examines a patient's urine flask in this 17th century print by Isaac Sarrabat.

CollectionImages from the History of Medicine (NLM)

Naturally, we wondered if doctors have any use for urine wheels today.

"Color is still used on a day to day basis to monitor how a patient is doing, if we're concerned about bleeding," urologist Eric Wallen at the University of North Carolina School of Medicine tells Shots.

The medieval wheel details 20 shades of pee, including orange, red, brown and even green. Wallen says urologists often describe urine using wine terms, "like a rose, Cabernet or chardonnay." Which is interesting, given that the urine wheel is somewhat reminiscent of a wine aroma wheel.

"If you eat too many vegetables, your urine can have a greenish tinge," Wallen says. "Some medicines for the bladder can also turn pee green or bright orange."

Medieval doctors used urine to diagnose diabetes: The sheer volume of liquid and a sweet taste were both tell-tale signs. And they knew that an infection makes pee cloudy and smell bad.

With the advent of the printing press, the urine wheels eventually fell into the hands of charlatans, who aggressively diagnosed and treated any ailment based on the color and smell of pee alone. Medical societies condemned them as "pisse prophets," according to a 2007 paper in Kidney International, and the backlash destroyed the credibility of urine analysis, at least for a while.

But modern medicine still relies on toilet visuals. One useful guide is the Bristol stool chart, or scale, because let's face it: Not all bowel movements are created equal. And inconsistencies can be a clue that something's not right.

The Bristol stool chart was developed by Dr. Ken Heaton at the University of Bristol and first published in 1997.

The Bristol stool chart was developed by Dr. Ken Heaton at the University of Bristol and first published in 1997. Wikimedia Commons hide caption

itoggle caption Wikimedia Commons

Ken Heaton, a doctor at the University of Bristol in the U.K., first published the chart in the Scandinavian Journal of Gastroenterology in 1997. It classifies stool into seven types, using familiar shapes like snakes and sausages, and is used by doctors to diagnose irritable bowel syndrome. Type 4 and Type 5 are generally considered ideal forms.

For real, you might ask? Yes — even the Food and Drug Administration's Center for Drug Evaluation and Research recommends the chart for tracking stool consistency in irritable bowel syndrome trials.

Apparently, there's a layman market for the chart as well: You can buy Bristol stool chart mugs and business card cases should you want to refer to it on a regular basis.

Comments

 

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.