Rumbles, page 15
Figure 21: The ‘Liver of Piacenza’, used in a lecture delivered by William Osler in 1913
The difference between modern anatomy and the soothsayers of old, of course, is that we no longer believe that examining the viscera can help us to predict the fate of powerful men or foretell the future of great nations. Yet something of the body’s prophetic potential remains with us in the science of the gut. According to a recent study carried out by the Harvard Medical School, our microbiome is a soothsayer capable not only of predicting if we will develop conditions like diabetes or IBS in the future, but also of forecasting our deaths.199 Having sequenced samples of gut bacteria taken from a wide range of participants, the researchers found that, in some cases, those microbes may prove more effective predictors of life course than genomes. Elsewhere, a Finnish study made of thousands of stool samples donated in 2002 found that those with a wealth of Enterobacteriaceae – the family of infectious bacteria that features salmonella and E. coli – were more likely to die within the next fifteen years.200 Tracking the lives of participants over this period, the researchers found that even when lifestyle factors were taken into consideration, such as smoking or poor diet, the peculiar composition of an individual’s microbiota did seem to exercise some influence on mortality. Our fate might even be sealed in the very early years of life, as the bacteria we acquire on our way out of the birth canal, from breastfeeding or even from the mouths of slobbery family pets, help to shape our immune system. The idea that the future course of your health and the possible date of your death might already be written in the body’s bacteria, viruses and fungi is somewhat unnerving, but, as we’ve seen, the stomach has long been famed for its prognostic powers.
Modern understandings of the gut owe an unacknowledged debt to centuries of ‘superstitious’ thinking, magic and folklore, which have insisted on the organ’s remarkable prophetic capacities. Haruspicy was also used by the Babylonians and the Ancient Greeks, where anthropomancy – the use of entrails from sacrificed men and women, often virgins – was employed to predict the outcome of major battles or chart the rise and fall of rulers. Less gruesome was the practice of gastromancy, taken up with enthusiasm in medieval Europe and in use well into the eighteenth century, which involved listening carefully to the gurgles and splutters of the stomach. Gastromancy was both a diagnostic tool used to identify illness in the body and a prognostic device that could divulge news of coming events in the world. It was advisable to treat the language of the belly with caution, however, as it was not always clear who or what was speaking. As Jan Purnis has uncovered, for most of history the practice of ventriloquism was associated not with the lips, but with the stomach. Derived from the Latin venter (belly) and loqui (speak), a ventriloquist was ‘someone who speaks out of or from the belly, stomach or abdomen’.201 Often treated as a religious authority, the ventriloquist was gifted with the ability to channel the voices of the dead through the stomach and foretell the future by interpreting its sounds. Throughout antiquity the gift of gastromancy commanded respect but, as we saw in a previous chapter, by the early modern period some had come to interpret the talkative gut as evidence of demonic possession. In 1656 the lexicographer Thomas Blount defined the ventriloquist as ‘one that has an evil spirit speaking in his belly, or one that by use and practice can speake as it were out of his belly, not moving his lips’,202 and elsewhere the practice was increasingly interpreted as a kind of trickery, as the author of A Perfect Discovery of Witches (1661) complained:
This imposture of speaking in the Belly hath been often practised in these latter days […] to draw many silly people to them, to stand wondering at them, so they by this imposture do make the people believe they are possessed by the devil, speaking within them, and tormenting them, and so do by that pretence move the people to charity.203
Only in the eighteenth century did the practice begin to resemble what we now think of as ventriloquism, as a deliberate performance intended to entertain rather than inform, and as one associated with the voice box rather than with the belly.
While some future seekers rooted around in the viscera, others have examined bodily waste for signs of what lay ahead. The practice of scatomancy, also known as copromancy or spatalamancy, transformed urine and faeces into remarkable divinatory tools. Throughout history and in cultures around the world, people have made careful observations as to the quantity, size and colour of human or animal excrement to read individual fortunes and glean glimpses of the world to come. In the late nineteenth century, John Gregory Bourke, a captain in the US Army stationed in the Territory of New Mexico, was inspired to investigate these prophetic customs after an odd evening spent in a local village. On 17 November 1881, Bourke was invited to attend a ceremonial dance held by the Nehue-Cue, a secret order of the Zuni people, a Native American tribe who trace their ancestry to farmers who settled in the valley of the Little Colorado River sometime in the last millennium BC. Bourke was an enthusiastic amateur ethnologist, who had already published several books documenting his travels in the Old West and encounters with Indigenous peoples, and jumped at the opportunity to observe the sacred rites. These turned out to be not quite what he expected. To begin with, the dancers were not attired in traditional costume; instead, several of them were wearing cast-off army uniforms and another appeared to be dressed as a priest. As he later recalled, ‘The dancers suddenly wheeled into line, threw themselves on their knees before my table, and with extravagant beatings of breast began an outlandish but faithful mockery of a Mexican Catholic congregation at vespers.’204 Next a feast was announced: women entered carrying dishes of tea, sugar and, to the captain’s disgust, a cooking pot filled with urine, from which the dancers took turns drinking. Unsettled by this strange communion, Bourke was determined to know more and so began a decade of research that culminated in the publication of Scatalogic Rites of All Nations in 1891. Running to almost five hundred pages, the book covers topics as diverse as ‘cow dung in religion’, ‘excrement gods of the Romans and Egyptians’, ‘urine in ceremonial ablutions’ and the ‘use of bladders in making excrement sausage’. This vast study of excrement also devotes a chapter to divination, omens and dreams that gathers examples collected by fellow ethnographers and anthropologists which seem to reveal the persistence of scatomancy across time and space. Alongside the Peruvian medicine men who tell fortunes using sheep dung, the reader learns that among the French peasantry it is considered good luck to dream of merde, that the Kamchatkans of Russia believe that wetting the bed portends the arrival of foreign guests and that sixth-century Europeans practised a form of augury that involved bird poo.
Though clearly fascinated by this wealth of feculent rites and excremental observances, Bourke was also keen to distance himself from such ‘primitive’ customs. The book begins by alluding to ‘difficulties surrounding the elucidation of this topic’ that arise, in part, because the ‘rites and practices herein spoken of are to be found only in communities isolated from the world’, but also because they are of such a shameful nature that ‘even savages would shrink from revealing [them] unnecessarily to strangers’.205 Positioning himself as an educated observer of cultures, religions and races other than his own, Bourke exemplified the ‘denial of coevalness’ described by Johannes Fabian in the previous chapter – by which colonised subjects are imagined as occupying a time other than that inhabited by white Europeans – by characterising the scatological as a phase of human development that the West has moved beyond. Though he cites the odd example from medieval Britain and occasionally notes the persistence of relevant superstitions among the poor of Europe, far more attention is paid to the ‘repugnant’ customs of ‘primitive peoples in all parts of the world’. Illustrating what the historian Alison Moore has described as the ‘universal relationship between excrement taboos and the civilising process’, Bourke invokes the ‘misuse’ of waste as evidence of barbarism.206 The strange mix of disgust and fascination that characterises Scatalogic Rites of All Nations may be bound up with the conditions of ethnographic study itself. As the literary historian Stephen Greenblatt has suggested, ethnography is a discipline whose ‘enabling condition is the otherness of the object of study’, so that negative emotions like revulsion and loathing sometimes come to play a role in the analysis; a role that is usually unacknowledged, but which becomes unavoidable in a lengthy study of excrement.207 What Bourke’s assured sense of superiority obscures, however, is that far from being the preserve of remote tribes and ‘savages’, scatology has informed the evolution of Western medicine and modern understandings of the body.
In 1526 the Renaissance polymath Heinrich Cornelius Agrippa published a searing critique of the state of scientific theory and practice. His Declamation Attacking the Uncertainty and Vanity of the Sciences and the Arts is particularly scathing of doctors and their diagnostic methods. Physicians are, he writes, the ‘most exquisite judges of the ordure of men’ who ‘behold obscene and beastly sights with their noses and ears to hear and smell the belches, farts, stinking breaths, steams and stenches of the sick, with their lips and tongues to taste the black and loathsome potions, with their fingers to search the dung and excrements’. No wonder, he concludes, that most sensible people forbid them from ‘coming to their table’, so as not to risk having to eat from the same dishes as ‘nasty physicians’.208 An occultist and theologian who was deeply sceptical of all worldly reason, Agrippa mocked the idea that any knowledge might be derived from the gassy gurgles and putrid emanations of the corrupt body. Physicians were, he insisted, little more than common swindlers making ‘divinations or prognostications’ by rooting around in the excrement of their easily duped patients. Agrippa was not alone in his distaste and, as a cartoon from c.1890 reveals, the suspicion that doctors took a rather unhealthy interest in the eliminations of the sick was not only a concern of the sixteenth century (Figure 22). In the cartoon, a physician is so pleased with his patient’s ‘superbe’ stools, that the cheeky maid asks if ‘Monsieur le docteur’ would like a fork? Blurring the line between scatology and coprophagy, the satirist points to something gleefully perverse in the medical profession’s obsession with excrement. While studies like the Scatalogic Rites of All Nations insisted that the civilised world had moved beyond such ‘primitive’ passions, popular depictions of the healing arts suggested otherwise. Scatology was an essential diagnostic tool, as the close examination of urine and faeces could elicit important clues as to the health of the patient. When physicians probed excreta, it was not for glimpses of events to come, but insights into the fate of their patients.
Figure 22: A Physician Examines a Patient’s Stools, lithograph by Gustave Frison, c.1890
For most of history, delving beyond the protective barrier of the skin was a very risky endeavour, so physicians made use of the body’s evacuations to judge its health. Early modern doctors were particularly invested in the divinatory potential of bodily waste. In this period a great deal of attention was paid to excretion because, according to the historian Michael Schoenfeldt, the ‘elaborate technology of digestion’ was considered to dictate the overall health of the body. This was imagined to be a three-stage process that began in the stomach, but also involved the liver and a vast network of veins that transported nourishment to where it was needed. From this perspective, as Schoenfeldt writes, human anatomy was simply a ‘giant stomach, a torus through which food passes’ where everything came to depend on digestion.209 The gut also played a pivotal role in humorism, the ancient system of medicine that we have encountered elsewhere in this book. Not only did the process of digestion help to generate yellow bile, black bile, phlegm and blood within the body, careful dietary management was also considered essential to maintaining humoral equilibrium. By eating certain foods and refraining from others it was possible to balance the humours – classified as hot or cold and wet or dry – a process that was fundamental to physical and mental health. If your humours were out of whack, perhaps an excess of black bile was making you melancholic or a lack of blood was sapping your energy, it would be obvious from your evacuations.
Figure 23: Urine chart dating from the end of the fourteenth century
Uroscopy was one of the most common diagnostic techniques employed by medieval doctors of all kinds and involved the close sensory analysis of a patient’s urine, using sight, smell and sometimes taste to determine the nature of their illness. Often the urine would be decanted into a glass flask – sometimes called a matula – which was designed to replicate the shape of the bladder to allow practitioners to observe the fluid in its natural habitat. Diagnosis would usually be made with reference to established diagrams that outlined possible colour and strata variations, their humoral significance, and disorders likely to arise from any potential imbalance (Figure 23). As historian Joseph Tate has uncovered, at their most ubiquitous, uroscopists were widely known as ‘pisse-prophets’, a derisive sobriquet that, nonetheless, goes some way to accounting for their sustained popularity as experts who were able to offer insight into the future health of their patients.210 While the Liver of Piacenza transformed an organ of the body into a tool for unravelling the mysteries of the universe, urine charts unveiled the secrets of the body by decoding its waste. Though not quite as common as uroscopy, early modern physicians also practised scatology. In his Praxis Medicinae (1639), for instance, Gualtherus Bruele instructed the reader on how to diagnose disease by reading the shape, texture and smell of faeces. We learn that a ‘hot distemper’ usually evidenced a rather dried-out specimen, while in a ‘cold distemper’ it tends to ‘waxeth thick and more tough’; that ‘weakness of the brain’ can be detected by the presence of half-digested matter; and that death is often foretold by the voiding of ‘black excrement’.211 Humoral medicine, with its faith in processes of letting and purging, hailed excrement as a kind of soothsayer, but it was not the only ancient system to do so. In Ayurveda, a tradition rooted in the Indian subcontinent that has been traced back as far as 6000 BC, similar attention is paid to the size, shape, smell and frequency of eliminations as valuable guides to mental and physical wellbeing. Ayurvedic medicine emphasises the need to manage the elemental forces in the body, known as vāta, pitta and kapha. Achieving balance or sāmyatva between the three results in health, while imbalance or viṣamatva results in disease. Waste management – of both sharirika mala (body wastes) and dhatu mala (metabolic wastes) – is thought be essential to maintaining bodily equilibrium, and stool analysis remains an essential tool for Ayurvedic doctors.
Scatology is having something of a renaissance, as a chorus of alternative practitioners, wellness gurus and innovative health start-ups encourage us to pay more attention to our poo. Writing for the Guardian in 2021, Hannah Marriott described how the ‘rise of stool-gazing’ has been fuelled by campaigns like The Gut Stuff – whose adverts, posted on bus stops around London, asked commuters whether ‘smooth criminal, the smashed avo [or] the poonami’ best described their evacuations – by apps like the Moxie Poop Scanner, which promises to help the user to correctly categorise their stools, and by companies like Seed, which has set up a database onto which it is possible to upload pictures of your poo that will help train artificial intelligence to distinguish between healthy and unhealthy excrement.212 These commercial ventures are all based on appropriating and redeploying a clinical assessment tool called the Bristol Stool Chart. Developed in 1997 by doctors based at the Bristol Royal Infirmary, the scale organises human faeces into categories ranging from the hard lumps of Type 1, past the smooth healthfulness of Type 4 and on to the watery formlessness of Type 7. Now widely used in the diagnosis of gastrointestinal disorders, it has proved especially successful in the early detection of IBS and has been taken up as a tool for measuring the effectiveness of a range of ongoing medical treatments. The invention of the Bristol Stool Chart was not, however, the first time that modern medicine had attempted to schematise faeces. Published in 1921, René Goiffon’s Manuel de coprologie clinique could be read as a precursor of sorts. In his coprology, the French doctor proposed that the quality of the patient’s faeces had little to do with the food consumed and was rather determined by the peculiarities of the course it plotted down the oesophagus, into the stomach and through the intestinal coils. While his early modern forebears relied only on the information of their senses to map this journey, Goiffon was able to observe the action of bacteria at different stages in the digestive process and to identify the complex structural components of faeces using microscopic analysis.213 Today the emergence of ‘stool-gazing’ as a popular pursuit speaks to a similar fascination with how waste might make our innermost workings visible and, in some new way, comprehensible.
Wonderful as such knowledge might be, it does not really compare to the nation-shaking prophecies and terrifying visions of the future that were once attributed to the gut. It is possible to read the history of medicine as a story of disenchantment in which the magical potential of the body – as something that might transform or transcend the conditions of the everyday – was slowly erased by the rise of scientific rationalism. On first inspection, this seems to have been the fate of the oracle stomach, imbued by the ancients with powers capable of bringing down civilisations and then reduced by the modern world to commenting on minor digestive upsets. Yet the relationship between time, medicine and the gut remained more complicated than this apparent demotion allows for. One area that this becomes apparent is in the long history of dissection and the story of the modern autopsy. In 1531 the translation and republication of Galen’s On Anatomical Procedures reignited interest in the procedures and possibilities of dissection by making practical instruction widely available for the first time. This revival was also aided by a shift in the kind of bodies that it was deemed acceptable to use in the teaching of medicine. Because the use of human bodies was largely forbidden in Ancient Greece and Rome, classical works based their knowledge of anatomy on the observation of different animals. But by the time of the European Renaissance, anatomists were granted access to a ready supply of cadavers – usually executed criminals – and were able to accurately map the inner structures of the body for the first time.
