Food To Cure What Ails You: When Cookbooks Treated Meals As Medicine

Browse through some turn-of-the-century American cookbooks, and it's obvious that popular tastes have changed (such as the presence of fried cornmeal mush and the absence of cilantro). But more striking than the shift in flavors and ingredients is the focus on feeding those who are sick — or, to use the parlance of the time, "cooking for invalids."

Whether you're looking at The Settlement Cook Book (1901), Jennie June's American Cookery Book (1870) or The Woman Suffrage Cook Book (1890), sections on nourishing the sick are all somewhat similar in approach.

First, there are a lot of fluids. Teas and lemonades, but also barley water, and something unappetizingly called "beef tea." (Think of it as a barely seasoned bouillon.) And there are a surprising number of recipes for "toast water" — basically consisting of the former infused with the latter (a drink evidently so commonplace that a recipe for toast-water lemonade in The Woman Suffrage Cook Book begins by instructing the reader to "make toast water in the usual way.")

The books also spell out simple puddings and porridges using thickeners that have fallen out of favor in today's home kitchen (arrowroot, Irish moss). And there are a fair number of jellies, which were popular at the time. Finally, a widespread belief in the healing power of a wee bit of wine or brandy. (Some books, like Mrs. Lincoln's Boston Cook Book (1884), warn against wine or liquor without the advice of a physician.)

Almost without fail, these cookbooks outline how to create an environment for optimal healing. It's not just what you serve, but how you serve it. Providing ample dining options (presented in small servings and whisked away when finished), speaking in hushed tones, ensuring proper ventilation and choosing pleasant conversation topics are all recommended, with the attractiveness of the serving bowl given equal weight as the broth it contains.

According to culinary historian Anne Mendelson, who has written about the Joy of Cooking (which featured its own recommendations for sickroom care and cooking through the 1943 edition), the presence of these meals amidst the roasts and desserts makes a great deal of sense, given the landscape of the time.

"You have to realize that until the early 20th century — World War I — the professionalization of medicine and nursing was just much less advanced," Mendelson explains, "and most people's access to professional care was spotty."

Which means a lot of recuperation took place in the home. And, Mendelson notes, in an era when people died in their own beds rather than in the hospital, average Americans had a lot more contact with the sick.

"There were extended families living in one home — this was a very common thing 100 years ago ... much more common than it is now. Women had to spend much more time in the home nursing sick children and frail old people. And at that point, childhood illness and childhood mortality were a bigger part of life."

Journalist and culinary historian Laura Shapiro has written about American women and cooking during the turn of the century in her book Perfection Salad (including a section on Fannie Farmer, who wrote an entire tome on Food and Cookery for the Sick and Convalescent). Shapiro notes that while published cookbooks of the time formalized the process, guidelines on cooking for invalids appeared in cookbooks long before.

"It goes back to Britain, and then back to the Middle Ages. And why not?" Shapiro asks. "Women were not just the cooks, they were also the caretakers of the sick at home."

But while the general guidelines on cooking for the sick has long roots, Shapiro says that their manifestation in early American cookbooks reflects the rise of "scientific cookery" rooted in the Industrial Revolution and Progressive Era — when science was overhauling everything from charity to motherhood to food.

"The home itself was a site for the reform movement, and the role of a woman was to raise up a new American family," Shapiro explains. "And you do it in great part through sanitation, hygiene and proper nutrition."

But as for the actual science of this scientific approach?

Well, they were working off a somewhat limited playbook. "Fats, carbohydrates and proteins were known by the mid 1800s," explains Patty Keane, president of the New Mexico Academy of Nutrition and Dietetics, "but vitamins and minerals really weren't discovered until the early 1900s."

As New York University nutrition professor Marion Nestle notes, these bland, liquid-like diets were considered easier to digest by people who were too sick to eat — an idea that is still popular. And, Nestle argues, one that should be abandoned. "If people feel like eating and have a functioning intestinal tract, they are better off with real food."

But, as dietitian and nutritionist Patty Keane says, while getting foods with the proper nutrient profile can help with everything from healing wounds to bolstering immunity, that's not the whole picture. We can now tailor meals to specific medical conditions, but having them prepared and delivered with care, as outlined in these early manuals, is an equally important part of healing — even in modern practice.

"While the nutrition science may have changed a tremendous amount," acknowledges Keane, "we know that there is much more to the provision of meals to promote wellness and healing than the food itself."

And while formulating recipes for optimal healing has become the provenance of health professionals rather than home cookbooks, caring and concern is still very much on the menu.

Deena Prichep is a freelance print and radio journalist based in Portland, Ore.

Copyright 2017 NPR. To see more, visit http://www.npr.org/.