Bauer, Axel W.

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Peter Voswinckel. "Der schwarze Urin: Vom Schrecknis zum ... Bauer, Axel Bulletin of the History of Medicine; Spring 1994; 68, 1; ProQuest pg. 193BOOK REVIEWS Bull. Rist. Med., 1994, 68 193 Peter Voswinckel. Der schwarze Urin: Vom Schrecknis zum Laborparameter. Urina Nigra. Alkaptonurie, Hämoglobinurie, Myoglobinurie, Porphyrinurie, Melanurie. Berlin: Blackwell Wissenschaft, 1993. xiii + 281 pp. Ill. DM 98.00. The title of the book under review already indicates that a fascinating chapter of medical "problem history" has been chosen as a central theme. This is not at all an obsolete field of research, if only it can be fruitfully combined with new approaches from the French "history of mentalities." Peter Voswinckel, who is not only a medical historian but also an experienced dinical hematologist, has succeeded in accomplishing this difficult task. What's Der schwarze Urin about? Physicians of all tim es have recognized and even described black urine (urina nigra) as a rare but always dangerous phenomenon (significans) . Of interest for medical history is the variation in thc meaning (significatum) of this clinical sign in different times. Voswincke1 begins his investigation with a brief explanation of linguistic metaphors, sensorial impressions, connotations, and visual icons; he describes-in historical terms-the relatively static syntax of black urine as an object of perception in the five human sensory channe1s. The evolution pro-ceeded much more dynamically, however, on the semantic level. With regard to its diverse pathophysiological genesis, the symptom of black urine is a very complex term, a sometimes rational, sometimes mystical cipher of illness and death. The author is right when he avoids making modern diagnoses with the use of old descriptions, because such an action would ignore the linguistic incompat-ibility of the observations encoded in those historical texts, which invariably contain interpretations. Voswinckel's empirical evidence consists of approximate1y sixty case reports ranging in age from the Corpus Hippocraticum to areport dating from 1831 and, furthermore, of twenty-nine hundred cases published within the last 150 years. This enormous collection of source material is skillfully unfolded by the author in section D ofhis book. Throughout this process he makes the reader aware ofa panorama rich in variety: black urine occurs as a bad prognostic sign (symbol) in the writings of Hippocrates and Galen, in the Byzantines' late Greek uroscopia, in Galenistic Humanism, and in the curiosity of the baroque period. Voswinckel discusses the possible connection between urina nigra and black bile, which was one of the four classic humors (see section E). The meaning of urina nigra changed around 1800, when the symbol-influenced by the modern dinic and the dominance ofvisual perception (see Michel Foucault, Naissance de La clinique: une archeoLogie du regard midicaL [1963] )-was converted, with the use of new methods of clinical chemistry, into a symptom, a sign of disease which should be explained according to the laws of nature. Voswinckel organizes the remain-ing chapters of his work in accordance with this change. Each chapter corre-sponds to one of the five entities of disease into which urina nigra was divided during the age of scientific medicine: hemoglobinuria, alcaptonuria, me1anogenuria, porphyrinuria, and myoglobinuria. Voswinckel discusses the first ten publications on each disease (this is a new method). The wide range of topics referred to is impressive: poisoning with AsH3 , wh ich was proved by animal experimentation in 1853; urine as a criterion of success in blood transfusion; Copyright (c) 2004 ProQuest Information and Learning Company Copyright (c) Johns Hopkins University Press 194 BOOK REVIEWS Bull. Hist. Med., 1994, 68 European colonialism and its problems with blackwater fever at the end of the nineteenth century; the beginnings of modern human genetics; death by acute intermittent porphyria triggered by the hypnotic Sulfonal Bayer (1889-1892) or by modern pesticides such as hexachlorinebenzol (Turkey, 1957-64); observa-tions of myoglobinuria made by surgeons during World War land by internists during World War 11 (crush syndrome); and the denial of the results of research by Jewish scientists in National Socialist Germany and their bclated vindication in the Federal Republic of Germany after 1945. The reader learns about all of this and much more from this meticulously investigated but nevertheless vividly written work. Eight hundred bibliographie referenees, and indexes of authors, plaees, and subjeets, also make the book a valuable and user-friendly guide. Peter Voswinekel 's postdoetoral thesis should be available in every specialized library for the history of science. His work proves once more that even today sound medical knowledge is an indispensable requirement for meaningful re-search activity in medieal history. Axel Bauer Rupreeht-Karls-U niversi tät Heidelberg RolfWinau, ed. Technik und Medizin. Technik und Kultur, no. 4. Dusseldorf: VDI Verlag, 1993. xviii + 340 pp. Ill. DM 168.00. Rolf Winau, the editor of this book, contributed all of the chapters except the one on eleetrieity and medieine. This volume is number 4 in aseries of ten designed to explain technology and culture to general readers; the series also includes monographs on topics linking technology with philosophy, religion, scienee, nature, and art. The topies of the chapters in this monograph range from antisepsis and asepsis, anesthetics, imaging of the body, microscopie studies of the body, and pharmacy, to civilization and disease. As an introduction for the generalist the volume fulfills its mission, if the reader is primarily interested in the German literature and illustrations of examples of related medieal teehnol-ogy developed in Germany. Readers versed in American and British teehnology and medieine will be familiar with the discussion provided but may not have seen some of the instruments shown in the photographs. American readers will be surprised to find no mention of Stanley Reiser's influential volume Medicine and the Reign 01 Technology (1978) and other familiar English-language sources, but the German generalist reader probably would not find English-Ianguage publications accessible or, perhaps comfortable to read. Reiser's objeetive, to demonstrate that with the introduetion of diagnostic instru-ments medicine beeame less of a humane and interpersonal endeavor, is men-tioned on the first page as a well-known idea; however, the reader is left to deeide throughout the rest of the book where and how this might have oecurred. Indeed, magie, religion, and empiricism are more aeeepted parts of medieal care than is Western teehnology worldwide. This topie and industrial medicine are Copyright (c) 2004 ProQuest Information and Learning Company Copyright (c) Johns Hopkins University Press 

Peter Voswinckel: Der schwarze Urin: Vom Schrecknis zum Laborparameter. Urina Nigra. Alkaptonurie, Hämoglobinurie, Myoglobinurie, Porphyrinurie, Melanurie.

Peter Voswinckel: Der schwarze Urin: Vom Schrecknis zum Laborparameter. Urina Nigra. Alkaptonurie, Hämoglobinurie, Myoglobinurie, Porphyrinurie, Melanurie.

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