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Looking at the records of food supplied to medieval and early modern hospitals across Europe and the Middle East might make a modern NHS patient envious. Last year, at a conference on the history of hospital food, I learned that patients in 8th century Islamic hospitals (Bimaristans) could expect fresh fruit from a courtyard garden, and that patients in the 12th Century Hospital of St John of Jerusalem were served chicken with saffron. Some of the poor sick seem to have been given such vast quantities of bread and wine that they may have been able to sell the spare food to earn a bit of money while in hospital. And this review of leper hospitals in the 18th century says that the lepers at Scio (the Greek island Chios) had their own gardens supply them with “almonds, pot-herbs, and delicious figs and grapes”.
This sounds fantastic, so what’s gone wrong with hospital food?
First of all, we can’t take all these accounts at face value – they’re examples of the two biggest challenges historians face: our evidence and its biases. The reports and records of hospital food in the 8th century are in very poor shape compared to today’s records, and it’s not all accurate. A traveller reporting on fantastic food in a Bimaristan might be trying to put pressure on Christian hospitals to do better, or he might just be misled by one unrepresentative experience (or even a language difficulty). Even when we get our hands on the historic records of a hospital they can usually only tell us what was spent on food, not how much the patients got, or what they actually ate.
Fruit: bitter medicine?
Since most patients have left no records for the historian about their diet, we have to try to reconstruct their experience based on our knowledge of the past. Even if the diet in a medieval hospital looks delicious to us, we are not medieval patients, and so we need to be wary of assuming they’d like to eat the same things we do.
It’s important to remember that for most patients in the past there was much less division between “medicine” and “food” than is the case now. The dominant humoral understanding of the body explained disease as an imbalance of the major fluids of the body, of hot, cold, wet and dry “qualities”. These imbalances could be cured by altering diet, environment, exercise patterns and sleeping habits, as well as with medicines and bloodletting – so a personalised diet might be part of a course of medical therapy.
Because the food of a patient might be part of their cure, it may have been quite different to the food they were used to – food for sickness was not the same as food for health. Someone who was too hot and dry (perhaps with a dry fever or sunburn) would have to eat something cold and wet, whether they wanted to or not! That might include uncooked fruit – delicious for us, and one of Jeremy Hunt’s “must haves” in the new NHS diet. But fruit was roundly condemned by many early modern physicians as full of cold watery humours and unsafe for most people. If you’d been brought up to believe that fruit was unhealthy, or might even make you go blind, then being presented with a plate of raw figs and grapes might not be much of a treat!
Grow your own therapy?
Even if hospital patients have always hated their food, whether it’s microwaved meals, over-salted vegetables, or fresh fruit, there are still things we can learn from the past. One obvious change in food provision is the loss of the hospital garden. Until the 19th century many hospitals had outdoor space, part of the therapy for recuperating patients, a place for apothecaries to grow healing herbs, and a site for kitchen gardens to feed the staff and patients. Outdoor space was lost in the 19th century as giant hospitals were built in crowded urban areas, and as convalescent and elderly patients were moved to homes and hospices elsewhere. There’s quite a trend for “urban farming” in the 21st century – perhaps that could extend to give hospitals back their gardens too?
The other lesson is that, at least until very recently, food was part of the healing process. Whether it was formal humoral rebalancing or just “nutritious” beef stew to “build up” a sick child’s constitution, food and medicine were not two separate categories. Given the huge role played by emotional and psychological well being in health and disease, perhaps it’s time to properly recognise the medical properties, as well as the health benefits, of a pleasant meal.
If you’re interested in the intersection between food and medicine (and magic!) you should check out The Recipes Project Blog. They tweet @historecipes; Vanessa tweets @HPS_Vanessa
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