An Analysis of Urinalysis: A Sample from Claude Carr Cody at Battle Creek Sanitarium

The Special Collections of Southwestern University has many different primary sources linked directly to Claude Carr Cody, an individual who was influential at Southwestern University. Primary sources related to Cody include multiple records from the Battle Creek Sanitarium in Michigan. These include items such as his bills from the Battle Creek Sanitarium, an exercise regimen, diet prescription cards exercise regiments, and finally, his urine examination card. One particular primary source, a urine examination card, is the focus of this paper. The urine examination card was completed as part of an examination performed by Dr. Mortensen of the Battle Creek Sanitarium on September 14, 1914. The data on the card includes information such as the chemical and physical components commonly found in urine. Components of urine that were accounted for on the card include the color, the odor, and the various chemical components such as urea and nitrogen. This paper examines the urine examination card as a primary source of information about an individual and as an example of historical methods for determining an individual’s health.

            Claude Carr Cody was born in Georgia on November 5, 1854. He was instrumental in the development of Southwestern University where he served as a distinguished professor of mathematics for the majority of his career.[1] Importantly, he also filled several leadership roles within the university including serving as its first dean, a dorm manager, a secretary, the university treasurer, a librarian and president.[2] Cody was pivotal in the movement to keep Southwestern University in Georgetown, Texas instead of moving the school to Dallas, Texas. For the roles he played as a faculty member and leader at Southwestern University, Cody has been referred to as the “Grand Old Man of Southwestern.” [3] Cody died in 1923 leaving a number of personal artifacts in the possession of Southwestern University.[4] The documents held at Southwestern University in relation to his visit to the Battle Creek Sanitarium provide insight into his life.

The Battle Creek Sanitarium was a Western health reform institute based on ideas from the Seventh-Day Adventist church.[5] Dr. John Harvey Kellogg was director of the sanitarium until his death. The institution was known for practicing new techniques for health care and healing.[6] Some of those techniques included an emphasis on diet, as demonstrated in the diet prescriptions among Cody’s records. Patients at the sanitarium were encouraged to heal themselves through diet, exercise, and other methods.[7] Cody was a frequent visitor of the sanitarium and was cared for by Dr. Mortenson, whose name is included on the urine examination card within Cody’s records.[8]

The methods used to preform urine examinations in 1914 differ from methods used today. During the early twentieth century, the urine examination was conducted through visual inspection and smell.[9] As such, physical properties of the urine, such as color and odor, were documented on the card. Cody’s card also included information about the chemical properties of his urine. The chemical analysis examined components such as urea, nitrogen, ammonia, uric acid, creatinine, chlorides, phosphates, inorganic sulfates, sugar, diacetic acid, acetone, albumin, bile, urobilinogen, indican, indolacetic acid, and blood.[10] Today, however, the examination of urine is more complex. A modern urine test includes a visual inspection to assess color and clarity. Importantly, modern technology is used to examine the microscopic properties of the urine so as to detect chemical properties, bacteria, yeast, and parasites to assist medical professionals in the diagnoses of illnesses.[11]  Thus, some similarities remain in the urine examinations conducted in 1914 and those conducted today. However, urine examinations conducted today utilize modern techniques and technology to discern more information about the individual. Modern techniques are objective and accomplished through the use of technology. Historical techniques relied more on the examiner’s senses and subsequent judgments of his or her perceptions of the urine.[12]

            Although Cody’s urine examination card did not include information about the microscopic properties of his urine, there were additional details on the card. Specifically, Cody’s card noted the average measurements for males and females listed next to the patient’s measurements. This information allowed Cody and his doctor to determine if the basic chemical and physical properties of his urine differed from average specimens for men. Cody’s sample was generally normal when comparing to the averages listed in the column next to his measurements. Only a few of his measurements were slightly different than the average for a male during that time. For example, Cody’s sample contained 4.77 grams of nitrogen; however, the average for a male, as listed on the card, is 7.43 grams of nitrogen. Therefore, Cody had more nitrogen in his urine than the average male. According to the urine examination card, Cody’s urea content was below average.  His sample contained 8.68 grams of urea while the male average is listed on the card as 13.29 grams.  Nitrogen and urea are important chemical components in urine because their levels correlate to kidney function. Urea is the waste product excreted by the kidney upon urination and also relays the amount of protein that is broken down in the kidneys.[13] These chemical properties were commonly known diagnostic markers at the time Cody lived.

C. C. Cody’s diet prescription card was issued the same day as his urine examination, September 14, 1914. In it we learn that he was asked to eat lima bean puree and vegetable soup. However, no protein consumption is indicated in the record.[14]  This information leads to the conclusion that the diet prescriptions from the Battle Creek Sanitarium may have lowered Cody’s protein levels,[15] as reflected by the urea and nitrogen levels in his urine sample. We do not have evidence that shows that Battle Creek doctors were causally relating the diet prescription data and urine card data the way I do it here. Modern urinalysis, however, considers causes of changes in the properties of urine as part of the diagnostic process.

At the beginning of the twentieth century, physicians were learning how to effectively further investigate the components of urine.[16] An interest in the components of urine marked the beginning of the importance of urinalysis to diagnose diseases. Early urine tests and Cody’s results may indicate that doctors at the Battle Creek Sanitarium were seeking to determine whether he had a disease. [17] However, the practice of examining urine in 1914 limited the diagnostic information provided by the test. Modern technologies allow physicians to test and analyze chemicals and microorganisms in urine so as to support the diagnosis of diseases. The urine serves as a barometer for the functioning of the body.  

            The urine examination card offers insight into Cody’s health, which in turn may offer explanations for his visit to the Sanitarium. Such examinations have been used throughout history to gauge health.[18]  The card is somewhat detailed for the time period in which it was used due to the inclusion of averages for the male and female patients. This information may have assisted Cody and Dr. Mortenson in determining whether the chemical properties of his urine were different from the average male. Similarly, the diet prescriptions suggest that Cody was provided with advice to improve his health.[19] However, with the help of a physician who has a greater understanding of the contents of urine and using technology that allows analysis of microorganisms within urine, modern urinalysis can serve a more detailed diagnostic purpose for individuals. Urinalyses are a common part of a basic physical examination and help discern kidney functioning and metabolic disorders.[20]  

By Katherine Rynearson