The

origins and evolution of advice about

food and cookery for convalescents and
invalids

Peter Williams
BSc(Hons) DipNutrDiet MHP PhD FDAA

School of Medicine, University of Wollongong
Wollongong, NSW 2522, Australia

Tel: +61 02 61540003

Email: peterwilliams@ihug.com.au

24 September 2019

1
Funding: There was no funding for this study

Conflicts: The author declares no conflicts of interest

Keywords: Invalid cookery; convalescent food; cookbooks; history of food



Biographical Information:
Peter Williams is a Fellow of the Dietitians Association of Australia, an Honorary
Professorial Fellow in the School of Medicine at the University of Wollongong
and an Adjunct Professor of Nutrition and Dietetics at the University of
Canberra. He has been an active nutrition researcher with over 110 peer-
reviewed publications and an h-index of 36. He has served on National Health
and Medical Research Council working parties for reviews of the Dietary
Guidelines for Australia and on the Board of Food Standards Australia New
Zealand. He has conducted consultancy projects with the Agency for Clinical
Innovation to develop nutrition and therapeutic diet specifications for hospital
inpatients.


Abstract
This article examines the origins of ideas about the appropriate feeding of
invalids and convalescents in the Western culinary tradition. It traces the
evolution and development of ideas from early Greek and Roman writers
through the Middle Ages, Early Modern and Modern eras. Cookbooks in the first
half of the twentieth century very often carried separate sections on invalid
cookery but this feature has largely disappeared from cookbooks today. The
common ideas of convalescent food that have survived over many centuries
demonstrate the resilience of a culinary tradition based mostly on personal
experience rather than scientific research.

2
Introduction
There has been relatively little research on advice about the preparation of food
for convalescents and invalids. One paper concluded that recommendations
remained remarkably consistent across the 16th to 18th centuries in Europe,
despite radical changes in knowledge and theories of physiology at that time
(Albala 2012). Albala suggests that ideas have persisted to the present day,
passed down by non-professional carers rather than being informed by medical
research.

Until the 1950s, cookbooks were a common source of information about how to
feed sick patients. One bibliography which examined 889 Australian cookbooks
published between 1860 and 1950 found 25% included sections on food for
invalids and convalescents (Williams 2018). However that study found more
than half of the recipes were for beverages, desserts and soups of limited
nutritional value: beef-tea, barley water, gruel, broths, toast water, arrowroot
and apple water were among the most frequently cited (Williams 2019).

Common advice about feeding invalids in these cookbooks included serving
small frequent meals, never asking patients what they would like to eat,
minimising the use of fat or seasoning in foods, and avoiding foods regarded as
too rich or indigestible for invalids, such as pork, oily fish, pastry, full cream
milk, and cooked oysters. Few of the authors had any medical or nursing
expertise and it appeared that much of the advice was based on commonly held
ideas rather than any scientific evidence.

This paper aims to review the history of dietary advice for invalids and
convalescents in Western culinary traditions, and examines the origin of some of
the more common recommendations made for those preparing this food.

3
Definition of the terms invalid and convalescent
Convalescent care has rarely been addressed in the historiography of early
medicine. Newton suggests there has been an incorrect assumption that it was a
later nineteenth century invention (Newton 2018, 2015). However the concept,
if not the term, has its roots in Hippocratic-Galenic medical traditions and
discussion of the “neutral body” – a category of patients who were “neither sick
nor sound”(van der Lugt 2011). Early physicians envisaged three main bodily
states: healthful, neutral, or sick. The neutral category included those who were
born with weak constitutions, mothers after childbirth and the feeble elderly,
but also people recovering from illness. Convalescents were no longer sick, but
they functioned slowly and weakly.

Both words date from the mid seventeenth century and are based on the Latin
terms invalidus, meaning “not strong” and convalescere, “to grow strong”. An
invalid is defined as a person made weak or disabled by illness or injury
(Pearsall 2001). A convalescent is a person recovering from acute illness or
accident after the acute phase has subsided, until a complete recovery or
rehabilitation has been obtained (Alice 1947). In the nineteenth century it
became relatively common for some people to self-identify as invalids: long-
suffering individuals who regarded themselves as beyond the ability of medicine
to ensure recovery, and who required special care and attention (Frawley 2004).


History of ideas
Antiquity
Diet was important in ancient medicine, with much treatment being
preventative (eating correctly balanced foods) and corrective (restoring
harmony to the body), rather than therapeutic (curing disease) (Edelstein 1967).

The most ancient dietetic texts of any scope from antiquity are those contained
in the books of the so-called Hippocratic Collection. They consider human food
from three points of view: digestibility, nutritive value and physiological effects
(Trémolières 1975). Digestibility was assessed by subjective sensations and

4
especially appreciated were light foods that did not cause digestive difficulties.
Hard dry foods were suspect especially salt meat, hard cheese, lentils, roots and
unripe foods. Generally liquid foods were regarded as the most digestible.

From a nutritive point of view meat, wheat, milk and fresh cheese, beans and
sweet fruits were best; fatty substances, non-bread cereals, and fermented
cheeses were considered less nourishing; greens and acid fruits were thought to
give very little nourishment.

Of all the physiological properties, the most important for the sick was the
thermic effect of food: the ability to heat or cool the body. At one end were the
hot substances – spices, pungent and aromatic plants, salt, honey, strong wine,
wheat bread and the flesh of adult mammals. At the other end were cold and
cooling substances – slightly acid or sweet plants and watery drinks. In between
were more neutral substances: meat of young animals, poultry, fish, milk and
gruel made from non-bread cereals.

The theory of humours was influential, based on the writings of Hippocrates
(450-370BC). The human body, composed largely of liquids (“humours”)
depended for its good health on the right balance of four humours (blood,
phlegm, yellow bile and black bile) and on the right balance of the “qualities” of
these humours (hot, cool, moist and dry)(Wilkins 1996).

Since disease was thought to be caused by malignant alterations of the humours,
recovery was believed to involve the process of “concoction”, raising the natural
heat of the body to transform the humours. This could be by Nature itself (as in a
fever) or by the use of medicinal drinks that exhibited opposite qualities to the
offending humours (Newton 2015).

Galen (129-216AD) formulated what were to become the rules for healthy
eating that persisted into the Middle Ages and beyond. His dietetic writings
cover some 400 pages of Greek and were available in Latin translations from

5
1490. His main sources were the Hippocratic corpus, but also other Greek
writers from around 300BC (Nutton 1996).

In Galenic theory, the most nutritious foods were those substances that
resembled the human body, consequently animals were deemed more nutritious
than vegetables, and meat was superior to fish since humans bore a closer
resemblance to the former. In general Galen believed that eating fruit was
dangerous, although he did allow that apples allowed to ripen and then stored, if
baked or steamed, may benefit the sick. Vegetables were thought to offer little
nutrition, being cold and watery in consistency and also because they tended to
produce more undigested excrement, and therefore less was retained by the
body (Albala 2002). Natural philosophical ideas of the chain of being also
deemed birds nobler than land- and water-bound creatures because the heavens
were nearer to God; thus the most nutritious creatures were thought to be those
that could fly (Newton 2018).

As well as being nutritious, the convalescent’s food had to be easy to digest. A
classic example was the hen’s egg, a staple ingredient for the weak throughout
this period. The clue to digestibility was colour: white and pale tones signified
food that was light and could be digested easily (Albala 2012). For this reason
white meat such as chicken and partridges were thought best, whereas dark
coloured meats like beef and venison were not allowed because they were too
heavy and dense (Hart 1633). To make foods easier to digest, practitioners
recommended mashing or liquefying ingredients to spare the patient from any
mastication or chewing. The cooking process was also important and boiling was
the best method because it was seen as most similar to Nature’s own form of
digestion in the stomach. Rufus of Ephesus (who died around 100AD) also
advised against excessive seasonings since this burdens the stomach (Grant
1996).

In parallel with the Galenic ideas of this era, convalescent food
recommendations can also be found in the traditions of Indian Ayurveda
developed from 300BC to 700AD (Rastogi and Chaudhari 2014) and traditional

6
Chinese medicine from 206BC to 220AD (Porkert 1974). However there is little
evidence that they have had any direct influence on Western culinary traditions.

Middle Ages (5th-15th Centuries)

The ancient humoural theory became much elaborated in the Middle Ages,
particularly as physicians saw in it a rational means to define human health
(Scully 1995). Physicians believed that modification of temperaments was
fundamental to treating disease and modifications of foods (which each had its
own different temperament), could produce harmful or beneficial changes in a
person (Ottoson 1984).

The anonymous author of a Neapolitan recipe collection from the end of the 14th
century states that “some foods are appropriate for the sick and weak, such as
gruels of rice, oats or barley, and prepared with almond milk, chickpeas, pullet
broths; pomegranate wine, tisanes of pike, and figs and imported grapes” (Scully
1995). Among other dishes described as suitable for delicate stomachs are a
deep-fried doughnut dipped in a syrup of honey and sugar; teased chicken
cooked as a pancake with ginger, rice flour, sugar and egg yolk; spiced chicken
broth; pear or apple with egg yolk; a porridge of wheat, oats, rice or millet in
milk and egg yolks; and cheese slices and egg yolks boiled in water, wine herbs
and spices.

Whereas advice about the feeding convalescents in earlier times was found in
medical manuscripts, the first printed cookbooks date from the end of the
fifteenth century and often included recipes suitable for the sick (Willan and
Cherniavsky 2012). Sick-dishes can be easily distinguished in recipe collections,
primarily by the presence of sugar. Owing in part to the increased availability of
this previously exotic ingredient and in part to the nature that Arabic scholars
attached to it, sugar became during the fifteenth century one of the most valued
and common ingredient in sick dishes.

Amiczo Chiquart, a master cook to Duke Amadeus of Savoy, compiled a famous
culinary manuscript (Du fait de cuisine) published in 1420, which has a distinct

7
section of sick-dishes, designed for convalescents. Barley broths and porridges
appeared routinely in standard cookbooks of the time, and among the seventeen
sick-dishes in Chiquart’s collection were wheat precipitate, a semolina dish, an
oatmeal porridge, a barley porridge and a dish of chickpeas (Scully 1995).
Almond butter and puree are common ingredients; fruits are used in quince
turnovers and applesauce, and poultry appeared in strong broths of chicken or
partridge, and capon or partridge in white sauces.

In England, a collection of medical advice from the fifteenth century included the
following advice about the effect of food: “All bitter things comfort the stomach.
All sweet things enfeeble it. Roast things are dry. All raw things annoy the
stomach. Whoso will keep continual health [must] keep his stomach so that he
put not too much herein when he hath appetite, nor take anything into it when
he hath no need” (Dawson 1934).

Early Irish medicine also devoted much attention to the diet of the sick or
injured. The Bretha Crólige is a medico-legal text dating from 1468-74 and in one
passage it states that horse-flesh should not be given to any invalid as “it stirs up
sickness in the body”. Both meat cured with sea-salt and whale flesh are
similarly banned on the ground that “the produce of the sea impels one to
drink”. An invalid may only take beer under the direction of the physician (Kelly
2001).

In the same text, honey is forbidden when the invalid is suffering diarrhoea but
in general honey is regarded as especially healthy. Great emphasis is also placed
on the importance of herbs and vegetables in the invalid’s diet. The Bretha
Crólige speaks of “the great service given by garden plants in nursing” and
claims that the primary purpose of gardens is the care of the sick. There is
frequent mention of two particular vegetables cainnenn and imus, which are
probably onion and celery respectively. Sweet fruits are also recommended
(Kelly 2001).

8
The most revolutionary innovation of this era was the rehabilitation of green
plants and especially fresh fruits. These foods had been considered particularly
dangerous in ancient dietetics. All this changed in the sixteenth century when
northern doctors such as Forestus in Leyden and Ronsoeus in Antwerp noted
that fresh fruits and the juice of acid fruits were the best remedies for scurvy
(Trémolières 1975).

Early Modern (16th-18th Centuries)
There is a rich historiography on early modern theories of disease and treatment
(Stolberg 2011, Beier 1987). An article specifically on convalescent cookery in
early modern Europe, drawing on writings in cookbooks and medical texts,
notes that recipes thought to be both comforting and easy to digest would be
perpetuated from generation to generation (Albala 2012). Albala interprets this
continuity as a sign that convalescent care was “not inherently derived from any
theoretical structure” but reflected the relative stagnation of therapeutics
between the sixteenth and eighteenth centuries.

In the first half of the early modern period, humourally-based nutritional theory
offered dietary guidance for established illness. By contrast, advice for
convalescents was usually vague. While based on humourally “neutral” foods
such as bread cooked into gruel and meat broths, it seems have been drawn
from informal intuition about the need for food that is easy to digest and light in
colour and consistency so as not to tax the body excessively.

One central idea at this time was that convalescents need food that is extremely
nourishing yet with a texture and consistency that can be easily broken down by
a weakened digestive system. Recommendations therefore focused on foods that
appear to be pre-digested – cooked to softness or pounded to a smooth paste, to
replicate the action of the stomach and other digestive organs. Convalescent
dishes were normally boiled or gently poached, rarely roasted and never fried,
probably because boiling seemed closest to the action of the stomach with its
digestive heat.

9
The most common foods were long-cooked gruels, concentrated meat broths
and dairy products. Soups and purees were common along with white foods like
bread, chicken and almonds. Foods believed to be coarse such as meat or whole
vegetables, as well as anything prone to corruption, such as soft fruits, were
normally forbidden, as well as excessively dry foods like aged cheese, and salty,
highly spiced or preserved foods.

The Sussex physician Thomas Twyne (1543-1613) recommended that in the
first few days of convalescence patients should retain the same diet they had
taken during illness, but consuming only liquid foods (Twyne 1576). Liquid
foods were the most advantageous because they could be quickly distributed
around the body despite being less nourishing than solid foods.

The first major cookbook to contain an entire chapter on convalescent cookery
is Bartolomeo Scappi’s Opera, published in 1570. Scappi was personal chef to
Pope Pius V and most of the dishes are regular recipes adapted for sick people
(Albala 2012). They include barley dishes, pastes and “acque cotte” (cooked
water): boiled or distilled drinks with cinnamon, anise, dried fruits, licorice,
mastic or barley. Panada was another dish in this section: it comprised
breadcrumbs soaked in lean broth, thickened with egg yolk or milk made from
melon seeds or almond. Sugar was optional. Milk, butter or almond oil could be
added before service.

Convalescent diets at this time have been briefly explored in Anne Stobart’s
book on English household medicine (Stobart 2016). She argues that throughout
the seventeenth century easily digestible broths remained the staple food for
recovering patients, though new exotic ingredients, such as sassafras and china
root, were introduced in the 1600s. Nonetheless some physicians were still
recommending fasting as an appropriate treatment for illness, rather than
attempting to nourish those recovering from illness. Everard Manywaringe
noted that “Physicians endeavor to raise up their weak Patients by
Restuaratives, Jellies, and nourishing Broths” but that was a mistake as “Foul

10
Bodies the more you feed them with high Nourishment, the worse you make
them” (Manywaringe 1696).

Convalescent care was part of a branch of medicine known as “analeptics”,
which meant “to cherish and renew the strength” (Newton 2018). A variety of
forms were recommended, including juleps and cordials (sweetened drinks and
spirits), and electuaries (powders mixed with honey or preserves). An example
is the surgeon Alexander Read’s restorative for weak convalescent persons,
made of pistachios, sugar and fragrant spices. Similar treatments were found in
domestic recipe books.

Another important consideration was the patient’s liking for a food and it was
vital to indulge the patients’ dietary predilections. The Manchester physician
Thomas Cogan justified this as follows: “Liking causeth good concoction [i.e.
digestion]. For what the stomacke liketh, it greedily desireth; and having
received it, closely incloseth it about until it bee duly concocted”(Cogan 1589).

Michael Stolberg has analysed over 2000 letters from patients in Germany from
this era to summarise their views about the experience of illness (Stolberg
2011). Most comments about convalescent food reflect those found in
cookbooks of the time. Too heavy a meal was to be avoided because it could
overburden the body. Easily digested food was conducive to health and wine
was often regarded as a welcome fortifier. Very spicy food, and smoked or salted
meats were avoided because it was suspected they caused “acrimonies” (morbid
impurities in the body), and patients had to avoid any food or drink that caused
increased inner heat.

The seventeenth century was the century of tea and coffee – drinks that were
adopted in Europe with uncanny rapidity, although doctors were not sure
“whether this exotic beverage (tea) is more palatable or more nutritious than
home-raised barley converted into broth” (Eden 1797).

11
The reputation of the English as meat-eaters had become established by the end
of the seventeenth century (Guerrini 2012). Tyron, in his much reprinted The
Way to Health, drew upon the concepts of Galen to advise simple meats and
drinks with minimal variety and ingredients (Tyron 1697). He ranked various
forms of meat by their healthful qualities: beef was high on his list; veal and pork
were deemed less wholesome; and wild fowl were healthier than domestic. At
the same time, some religious sectarians and radicals in the wake of the English
Civil War proposed a vegetarian diet among other attributes of an imitation of
Christ and a new, more egalitarian, England.

One example is George Cheyne, a popular physician among the elite of
eighteenth century London. Cheyne promoted a mainly vegetable-based diet,
with avoidance of alcohol. He believed that digestion was crucial to the proper
functioning of the body and gave special attention to the quantity and quality of
food and liquid, along with general comments on digestibility, including “the
larger and bigger the vegetable or animal …. the stronger and harder to digest is
the food made thereof”; “dry, fleshy fibrous substances” are more easily
concocted than “fatty, glutinous substances” and flesh which is white in colour is
generally kinder to the digestion (Cheyne 1724). Turner has summarised the
foods Cheyne believed were easy to digest (including poultry, whiting, asparagus
and strawberries) or those less easy to digest (including duck, salmon, apples
and pears) (Turner 1982). Some of these ideas seem very similar to those found
in later books of advice about convalescent feeding.

Empirical forms of medicine were developed in Paris in the 1790s that proved
more intent on understanding medical conditions and developing cures through
the physical observation of organs and tissues rather than theoretical
speculation, and this brought forward new ideas on convalescent foods in the
next century (Miller 2015).

Modern (19thCentury)
The nineteenth century can be considered the quantitative epoch of dietetics
and by the middle of the century great progress had been made in the chemistry

12
and physiology of food, chiefly as a result of the work of the German researchers.
By the 1870s the different nutritional constituents of food and their energy
value had been established, reflected in Pavy’s Treatise on Food and Dietetics,
one of the first books in which full nutritional analyses of foods are given (Pavy
1874).

In 1804, the English physician James Adair wrote an essay on diet and regimen,
especially aimed at “the indolent, studious, delicate and invalid” (Adair 1804).
His dietary regimen is largely based on his personal observations of the
digestibility of different foods and some comparative studies of the anatomy of
the stomach and bowels in different animals. He concludes that animal foods are
detained in the stomach longer than vegetable foods, and recommends a diet
largely based on vegetables and grains. He prefers root vegetables over
“cabbages, kails and salads [which] do not seem to be very digestible”, and
recommends oatmeal, and rye as more digestible than wheat. In his regimen for
invalids, meat is limited to no more than once a day but he admits lack of
information about the relative digestibility of different meats. His list of foods
that are not easily digested include cooked egg white, pork, nuts, onions and
warm bread. Finally he agrees with the standard recommendation of liquid
foods (including soup, broths, milk, cream, whey) as good foods for delicate
stomachs but cautions against coffee and tea as noxious foods that weaken and
undermine the constitution.

In 1835, another textbook on the care of invalids by an English physician
included 64 pages of advice about food, with the emphasis being on digestibility
(Robertson 1835). He provides comprehensive lists of the order of digestibility
of different foods (e.g., mutton > beef > lamb > veal > pork; whiting > haddock >
cod >flounder > salmon). This information appears to be based on a mixture of
personal clinical experience and some experiments observing the effects of
gastric juices. The book also includes several rules for eating: eat at regular
intervals, never fast for longer than five yours; make breakfast the principal
meal, drink as little as possible while eating; eat food slowly. Robertson agrees
with the use of wine and spirits in convalescence, especially ale, porter and port-

13
wine, claiming their chief purpose is to stimulate gastric secretion and cause
blood flow to increase.

However, medical knowledge about convalescence was still quite rudimentary at
this time. In 1847, an American medical article on the management of
convalescence stated “after disease the sensibility of the stomach and intestines
is exalted and their tone diminished” and notes the difficulties of patient feeding
when the stomach is irritated or inflamed. The author offers no dietary
recommendations aside from the general advice to allow only as much food as
the stomach can digest, advise the patient to eat little and often, and submit the
food to effectual mastication (Parise 1847).

Despite this, medical advice could be quite strict about the need for dietary
prescriptions during convalescence. An article in The Hospital journal included
the advice:
“Never satisfy the cravings of a convalescent patient, especially after
fevers. The clearly expressed and persistently repeated wishes of the
patient himself on the subject of the diet suitable for him cannot always
be ignored; you must however report the expression of such longings to
the doctor. …. Unless you observe this rule unflinchingly you will be
guilty of some of the murders or very questionable forms of homicide
which are committed repeatedly with chops, steaks, pickles, cheese,
oranges, greens etc.” (Basil 1888).

In 1860 Florence published her Notes on Nursing, written to dispense “hints for
thought to women who have personal charge of the health of others”
(Nightingale 1860). She once described herself as an “incurable invalid, entirely
prisoner of my bed” (Frawley 2004). Although she did not record any recipes,
she held strong opinions about food. Feeding the sick, she claimed, was about
seduction. Patients often reject food, but it nonetheless must be consumed for
the body to regain its strength. The ingredients were to be the best and freshest
available, the dishes prepared with utmost skill. She warned “Remember that
sick cookery should do half the work of your patient’s weak digestion”.

14

Throughout the nineteenth century there were increasing publications with
advice about feeding invalids – both from medical professionals and from cooks.
Cookery for the sick was an area that started to move out of the exclusively
medical and nursing realm and into ideas regarding the rational management of
the domestic sphere (Santich 2013).

Textbooks of domestic economy and household science for school pupils started
to include advice on food for invalids. One such book for use in schools,
published in London, contained the advice that “the first step in preparation of
food in sickness is to arrange that as much effort and work, that are thrown
upon the stomach in health, are performed by the preliminary operations of
cooking. The employment of such readily digested foods as beef-tea, simple
broths, gruel, arrowroot, butter, cream and various lighter combinations of milk
and eggs with flour or bread, rests mainly upon this ground” (Mann 1878). The
author also notes that sweet things are neither suitable for, nor palatable to
invalids, and that water and tea are the best drinks, although barley water and
lemonade may be given at times.

Another example of a mid-nineteenth century book is Notes From the Sick Room
(Stephen 1883). It includes some limited advice of food, including several
methods for making beef-tea, advice on how to prepare milk, and comments
about the unpleasant smell of green vegetables, and the preference for cold food
for patients who are nauseous.

More comprehensive manuals of invalid cookery, with extensive lists of recipes
also appeared from this time. Some were still authored by physicians (Fothergill
1880, Neal 1861, Chase 1887), but increasingly these cookbooks were written
by women cooks (Pitkin 1880, Hooper 1876, Hamilton 1886, Earle 1897,
Heritage 1897, Boland 1898, Davies 1898, Ryan 1881).

Scientific studies on the relative digestibility of foods and their suitability for an
invalid diet appeared in the second half of the nineteenth century (Fraser 1886,

15
Beddoe 1865), and research on the role of enzymes led to a reconceptualisation
of digestion as an energy intensive process. This notion was supported by
empirical observations that sick patients often had no appetite; that is, their
powers of digestion were reduced as the body’s energy resources were
otherwise engaged (Haushofer 2018). As the physiologist William Darby
explained, in a publication announcing one of the first artificially digested foods,
they “relieve the enfeebled stomach of its main burden, and enable it to
complete the process of digestion without overtaxing its energies” (Darby 1870).

This concept soon found its way into popular advice for invalids: “In sickness the
whole of the body organs are weak, and cannot do the amount of work of which
they are capable during health. If much food is taken at once, the stomach will
make a violent effort to digest it, which effort will be a waste of energy, and will
have on the whole the same effect as if the patient had attempted manual toil
which his limbs were too weak to perform” (Stoker 1878).

In 1889 a professor of clinical therapeutics wrote, in a discussion on food for
invalids, “there is a general consent amongst all authorities that, owing to the
interruption of normal gastric digestion in fever, all food should be given in the
fluid form, that is, in a form that can be readily and immediately absorbed, that it
should be given in small quantities and at short intervals” (Yeo 1889). He
particularly recommended whey, milk, beef-tea, mutton, veal and chicken
broths, strained gruels, and vegetable and fruit juices.

Artificial digestion was originally developed as a research method to study the
mechanism of digestion. In the 1830s the German physiologist Theodor
Schwann characterized pepsin, a digestive enzyme secreted by the stomach, and
soon after German and French physicians trialled the use of pepsin as treatment
for patients with weak digestion. It entered the pharmacopoeias of Germany in
1861 and Britain in 1873. In Britain, the medical physiologist William Roberts,
championed the use of pancreatic extracts as therapeutic digestive agents and
the Benger company’s product “Liquor Panreaticus” was one of the first to be
commercially available in the 1880s. Later they added a range of food products,

16
including a peptonized beef jelly, and a peptonized milk gruel (marketed as
“pancreatised, farinaceous self-digestive food”) called Benger’s food (Haushofer
2018).

Digestion was a topic of great political and scientific interest during the second
half of the nineteenth century, with particular interest in how to feed people
most efficiently for least cost, especially in institutions such as hospitals
(Haushofer 2018). This led to the creation of a number of nutritional products
aiming to provide maximum nutrition with minimal cost. Justus Leibig’s meat
extract was the most well-known of such products but many others were also
marketed around the mid century (Finlay 1992).

In 1880 a professor of medicine in the US noted that the tendency of cows’ milk
to form a large and compact coagulum is a great source of inconvenience to
invalids and that various methods have been used to reduce size of the
coagulated casein in the stomach, including addition of various gums, starches,
gelatine, lime water, as well as the use of pepsin or rennet (Nunn 1880). He
advised that the use of peptonised milk is particularly useful for dyspeptic
invalids and consumptives with irritable stomach and bowels, and noted that
other preparations such as junket, whey and koumiss have been found
beneficial.

Nonetheless, as late as 1893 there was no precise scientific data available for
estimating the quantity of food appropriate and sufficient for the various classes
of invalids. The only reliable guide was the dietaries or rations provided in
various hospitals, which seem to have been suitable and sufficient. A summary of
these dietaries from ten English hospitals show a very limited range of foods
provided, generally limited to bread, butter, meat, potatoes, porter or beer, milk,
beef-tea, tea or coffee or cocoa, gruel, rice or bread pudding. Similarly a list of 82
hospital recipes suggested for invalids shows a quite limited range of items, of
which 42 are for beverages (including broths, soups and beef-tea) and virtually
none for vegetable or fruit dishes (Yeo 1893).

17
Modern (20th Century)
In the 20th century, knowledge of the physiology of convalescence became more
sophisticated, and four phases of convalescence after physical injury were
recognised (Moore 1958):
1) Injury – with loss of lean tissue and fat and loss of nitrogen from the
body. The patient is weak and listless, with little appetite or desire for
food.
2) The turning point – when patients take renewed interest in their
surroundings and there is an increase in gastrointestinal function.
3) Strength – a long period of anabolism, muscle regrowth and wound
healing, which cannot proceed normally without adequate food intake.
4) Fat redeposition – the patient continues to gain weight for several more
months.
There was a particular emphasis on feeding that provided adequate energy and
protein intake in stages 3 and 4, to overcome the negative nitrogen balance that
occurs in the first two stages.

Increasingly the preparation of food for invalids became one of the roles of
nurses in hospitals, and training in invalid cookery was part of the nursing
curriculum. Nursing journals commonly contained articles on the service of food
to invalids, with an emphasis on small dainty serves, the value of liquid foods
and strictly following physician orders for food (Irwell 1912, Sargent 1915,
Fewell 1920b, a).

Invalid cooking also became part of the teaching in schools of cookery and
domestic science from the beginning of the 20th century. Examples of such
publications include Invalid Recipes published in the UK (Mann 1901), Sick Room
Cookery and Advice on Sick Nursing, published in Ireland (Ferguson 1903), Food
and Cookery for the Sick and Convalescent, published in the USA (Farmer 1904),
and the Australian text Cookery for Invalids (Schauer and Schauer 1912).
They contain general advice that is found in many similar books from this time
(Williams 2019), including:
• Never consult a patient as to the menu

18
 • Fat must be rigorously excluded from an invalid’s diet
• Extreme care should be taken to season food lightly, using no herbs and
spices
• Only the best and freshest ingredients should be used, and everything
prepared with scrupulous cleanliness.

These books reflect the maintenance of a traditional set of invalid recipes into
the twentieth century. Attempts to reform them in keeping with new discoveries
in chemical analysis and physiology seem to have had little impact (Adelman
2018). In a speech to the British Medical Association in 1889, Charles Jessop
endeavoured to show that beef-tea, had no value to the invalid. He cited medical
literature and physiological experiments to support his ideas, but noted that
“Nurses, cooks and patients all clamour for clear beef-tea” (Jessop 1889).

By the 1930s and 1940s, with the development of nutrition science and the
discovery of new vitamins, medicine was coming to a more scientific
understanding of the physiology of convalescence and the specific nutritional
requirements of recovery (Bull 1935, Woodruff 1940, Anon 1945b, Cuthbertson
1945, Ivy and Grossman 1944). There was increasing awareness of the potential
problem of malnutrition during convalescence with traditional dietary
restrictions, and a greater emphasis on adequate energy and protein intakes to
assist recovery from illness. In the 1950s the importance of adequate vitamin C
and calcium was also recognised in addition to the emphasis on reversing
negative nitrogen balance (Meikelejohn 1954, Moore 1958).

However while this understanding became the basis of diet planning manuals in
hospital settings (Chima 2007, Rynbergen 1963), cookery books for the general
public from this time continued to offer the same sort of culinary advice that
could have been found fifty years earlier. Getting Better – a handbook for
convalescents, published in London in 1943 still included traditional recipes for
calf’s feet jelly, beef-tea, sweetbreads and wine whey (Pim 1943). The same
convalescent dishes could also be found in a textbook on cooking for the sick and

19
convalescent co-authored in 1951 by a Professor of Physiology and a cookery
writer (Heaton and Mottram 1951).


Some specific foods
The evolution of advice about the foods suitable for convalescence can be
considered with a few examples.

Barley
Even in the times of Greek physicians barley was regarded as an ideal food for
anyone who was out of sorts. Because barley was understood to possess a
temperament that was cool and dry, a moist broth was seen as ideal for the
treatment of those recuperating from fever (Scully 1995). In Hippocratic
writings, barley water was the first item of food to be introduced after a fast
(King 1996). The Romans made flour from barley into a gruel (much used as a
restorative) and a highly nutritious barley-water (White 1996).

In his Canon of Medicine, the influential Arab physician Avincenna (980-
1037AD) had recommended barley water for the feverish and its use was
depicted in Tacuinum sanitatis, an Italian manuscript from the end of the
fourteenth century, and described as “Nutritious and easy to digest, it is given
with favourable results to feverish patients to slake their thirst; it alleviates
coughs and cleanses the lungs” (Adamson 2004). The privileged place of barley
and barley water continued in nineteenth and twentieth century texts (Adair
1804, Williams 2018), presumably based on this antiquarian advice.

Chicken
Chicken turns up very frequently in sick-dish recipes in the Middle Ages.
Aldobrandino of Sienna (a 13th century professor of medicine at Bologna) stated:
“You should know that chicks have a flesh that is more temperate, that
digests more easily and that engenders better blood, that gives more
strength, and is more closely aligned to human nature than domestic
fowl. For these reasons they are well eaten by those who have wasted,

20
 or whose stomach is weak, or who are just recuperating from
illness”(Aldobrandino of Sienna 1911).

Of all the domestic meats, chicken enjoyed a reputation for possessing, with veal,
the most moderately moist and moderately warm qualities – those most closely
approximating those of healthy humans and hence categorised as ideal by
physicians. Scully suggests that the overwhelming preference for chicken,
compared to other meats, as the basis of a sick dish may also have been due to
its universal availability and low cost (Scully 1995).

Interestingly, in the highly elaborated humoural theory of food in traditional
Chinese medicine chicken is also regarded as a warming food. A woman after
childbirth is understood to be very weak because her “beneficial hotness” has
become depleted and she is advised to eat chicken every day (Pillsbury 1978).

Oysters
In ancient Greece and Rome oysters were regarded as delicacies and their
physicians approved their dietetic properties. Both Celsus and Pliny agreed that
oysters are an excellent tonic for the stomach, and several Greek physicians
recommend them as strengthening and useful in cases of dysentery (Andrews
1948). However, some nineteenth century medical writers disagreed, especially
in relation to cooked oysters (Robertson 1835). Early twentieth century medical
advice was still that oysters are more readily digested when raw than when
cooked, but owing to the possible danger of typhoid infection it is better not to
give them to patients who are convalescing from acute disease (Saundby 1908).

Liquid foods
Before the advent of intravenous therapy, hospitals and home caregivers were
often confronted with the challenge of providing adequate oral fluids and
nutrition to invalids and the infirm. From as early as the seventeenth century
until the turn of the twentieth century pap boats – open of half-covered pear
shaped vessels with a spout at one end – were used to serve pap or panada to
patients (Herrman and Sanchez 1997). Pap was bread boiled with milk and

21
sugar; panada was more substantial, usually a sieved liquid based on ground
cooked chicken combined with bread and broth. Liquefied food was used
because it was believed to be the “most easily digested, and in cases of severe
illness [could] be entirely relied upon” (Weeks-Shaw 1892).

In 1885, a comprehensive article on feeding the sick with liquid food
summarised the limited scientific understanding of this topic in relation to
invalid feeding (Roberts 1885). The author supports the use of milk, egg drinks
and fortified gruels, but notes that beef-tea and other meat decoctions should
rank only as stimulants rather than nutrients, despite widespread
misapprehension about this among the public.

Nonetheless most modern books on convalescent cookery contain recipes for
beef-tea, sometimes with up to four different methods of production. Once
regarded as highly nourishing for patients, several of the authors note that it is
best regarded as a stimulant rather than a food (Beeton 1923, Butler 1930-5).
Nonetheless a commercial peptonised version (Beefine) was still being sold in
1945 and promoted as “proved for invalids … invaluable for convalescents,
affords relief to sufferers from indigestion and nerves … tones up the system,
enriches the blood, is appetising, delicious, refreshing and wholesome” (Anon
1945a).

Alcohol
Debates about the suitability of alcoholic beverages were still unsettled in the
nineteenth century. In 1865 Dr John Beddoe noted that at St Bartholomew’s
Hospital every patient received two pint of beer daily, while this was not the
case in Scottish and Irish hospitals. Partly on moral grounds supporting
temperance among the working classes, he prefers to limit beer only to extra
portions on medical order (Beddoe 1865).

In his book Food in Health and Disease, Professor Burney Yeo noted that brandy
and whisky diluted with water are commonly prescribed in England while
lighter wines are more commonly used in Continental countries. His own

22
preference is to allow port wine or champagne during convalescence, or “if the
patient prefers a good claret or Burgundy at this time, there is no objection to his
having the equivalent quantity of these wines” (Yeo 1893).

Brandy and whiskey were advertised in medical journals in the early twentieth
century. The British Pharmacopoeia of 1907 noted the value of alcohol as a
cardiac stimulant and in acute fever it was recommended “as an admirable food
because it requires no digestion and is easily absorbed” (White 1920). However
it was also recognised as a depressant and its use in convalescent feeding
became much more limited (Guly 2011). Nonetheless in the 1950s writers still
advised that “if an invalid is used to consuming alcohol he may often be allowed
it in his diet, despite its untoward effects, because he would be miserable
without it and the misery would produce a more deleterious effect than the
alcohol” (Heaton and Mottram 1951).


Conclusion
Table 1 summarises the historical information presented here to show the
evolution of ideas about convalescent feeding over several millennia. Many of
the ideas in twentieth century books had their origins in early Greek and Roman
writing, and many do not seem to have been based on clear scientific evidence.

Beyond 1950 very few cookbooks included a separate section on convalescent
food and the provision of dietary advice for invalids seems to have become more
medicalised, with the development of the dietetic allied health profession
(Williams 2019). However, advice about eating while recovering from illness is
still prevalent today on the Internet and in magazines. While some seems
founded on reasonable scientific evidence, encouraging adequate protein, fruits
and vegetables, vitamin C, probiotics and hydration (Haris 2018), others still
republish traditional ideas that could have been found a century earlier (van
Straten 2018, Zandonella-Stannard 2013).

23
Although some advice about light diets for postoperative recovery can still be
found in evidence-based clinical guides (Agency for Clinical Innovation 2011),
the common ideas of convalescent food that have survived over many centuries
mostly demonstrate the resilience of a culinary tradition that was based on
personal experience rather than scientific research.

24
 Table 1. Key beliefs about cooking for convalescents and invalids

Era Theoretical concepts Recommendations Sources
Antiquity Humoural theories of Animal foods Medical texts
(3000BC – 4th century) health Barley
No excessive seasoning
Middle Ages Humoural theories Sugar Aristocratic cookbooks
(5th-15th centuries) Arabic medicine Chicken
Eggs
Almonds
Early Modern Digestibility of food Liquid foods Popular cookbooks
(16th – 18th centuries) Patient acceptance Some spices Medical advice
Tea
Fruit
Vegetarianism
Modern Scientific Artificially digested foods Professional cooks
(19th – 20th centuries) understanding of Meat extracts and beef–tea Nursing and medical
digestion and nutrition Adequate protein and publications
energy sources

25
References

Adair, James Makittrick. 1804. Essay on Diet and Regimen, as indispensable to
recovery and preservation of firm health especially to the indolent, studious,
delicate and invalid, with appropriate cases. London: James Ridgway.
Adamson, Melitta Weiss. 2004. Food in Medieval Times. Westport, CT:
Greenwood Press.
Adelman, Juliana. 2018. "Invalid cookery, nursing and domestic medicine in
Ireland, c. 1900." Journal of the History of Medicine and Allied Sciences 73
(2):188-204.
Agency for Clinical Innovation. 2011. "Therapeutic diet specifications for adult
inpatients." NSW Agency for Clinical Innovation, accessed 11 July 2013.
http://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0006/160557/
ACI_AdultDietSpecs.pdf.
Albala, Ken. 2002. Eating Right in the Renaissance. Berkley, CA: University of
California Press.
Albala, Ken. 2012. "Food for healing: Convalescent cookery in the early modern
era." Studies in History and Philosophy of Biological and Biomedical
Sciences 43:323-328.
Aldobrandino of Sienna. 1911. Le regime du corps de maitre Aldebrandin de
Sienne. (Edited by Louis Landouzy and Roger Pepin). Paris: Champion.
Alice, Mother M. 1947. "Special nursing service for convalescents." Hospital
Progress 28 (10):332-335.
Andrews, Alfred C. 1948. "Oysters as a food in Greece and Rome." The Classical
Journal 43 (5):299-303.
Anon. 1945a. The Beefine Way: A range of tested recipes. Melbourne: Beefine Pty
Ltd.
Anon. 1945b. "Malnutrition during convalescence." Nutrition Reviews 3 (2):40-
42.
Basil, Minas Manook. 1888. "Aids to Nursing: Food and Feeding." The Hospital 4
(80):5-6.
Beddoe, John. 1865. "On hospital dietaries." The Dublin Quarterly Journal of
Medical Science 40 (1):46-72.
Beeton, Isabella Mary. 1923. Mrs. Beeton's All-About Cookery with over 2000
Practical Recipes. New ed. Melbourne: Ward, Lock & Co Ltd.
Beier, Lucinda McCray. 1987. Sufferers and Healers: The experience of illness in
Seventeenth-Centrury England. London: Routledge & Kegan Paul.
Boland, Mary A. 1898. A Handbook of Invalid Cooking: For the nurses in training-
schools, nurses in private practice, and others who care for the sick. New
York: The Century Co.
Bull, Cecil. 1935. "Diet for the convalescent and the aged." Postgraduate Medical
Journal 11:77-82.
Butler, Ella E. 1930-5. Invalid and Convalescent Cookery for Hospital Trainees. A
text book containing lecture notes and recipes required by the ATNA. Perth:
Brokensha & Shaw Ltd.

26
Chase, Alvin Wood. 1887. Dr Chase's Third Last and Complete Receipt Book and
Household Physician. Sydney: Malcolm & Grigg.
Cheyne, George. 1724. An Essay of Health and Long Life. London: G. Strahan and J.
Leake.
Chima, Cinda S. 2007. "Diet manuals to practice manuals: the evolution of
nutrition care." Nutrition in Clinical Practice 22 (1):89-100.
Cogan, Thomas. 1589. The haven of health. London Thomas Orwin.
Cuthbertson, DP. 1945. "The Physiology of Convalescence after Injury." British
Medical Bulletin 3:96-102.
Darby, Stephen. 1870. On Fluid Meat: A new preparation of meat especially
adapted to weak stomachs and for invalids generally with remarks on food.
London: John Churchill and Sons.
Davies, Mary. 1898. Weldon's Invalid Cookery. London: Weldon & Co.
Dawson, Warren R. 1934. A Leechbook or Collection of Medical Recipes of the
Fifteenth Century. London: Macmillan and Co Ltd.
Earle, Maude. 1897. Sickroom Cookery and Hospital Diet, with special recipes for
convalescent and diabetic patients. London: Spottiswoode & Co.
Edelstein, Ludwig. 1967. "The Dietetics of Antiquity." In Ancient Medicine.
Selected papers of Ludwig Edelstein, edited by Owsei Temkin and C. Lilian
Temkin, 303-316. Baltimore: The Johns Hopkins Press.
Eden, Frederick Morton. 1797. The State of the Poor; Or, An History of the
Labouring Classes in England, from the Conquest to the Present Period.
London: J Davis (printer).
Farmer, Fannie Merritt. 1904. Food and Cookery for the Sick and Convalescent.
Boston: Little, Brown, and Company.
Ferguson, Kathleen. 1903. Sick room cookery and advice on sick nursing. Athlone:
Westmeath Independent Office.
Fewell, Alice Urquhart. 1920a. "Soups for the sick." The American Journal of
Nursing 20 (8):621-624.
Fewell, Alice Urquhart. 1920b. "The value of fruit in invalid diet." The American
Journal of Nursing 20 (6):467-470.
Finlay, Mark R. 1992. "Quackery and cookery: Justus von Liebig's extract of meat
and the theory of nutrition in the Victorian age." Bulletin of the History of
Medicine 66:404-418.
Fothergill, J Milner. 1880. Food for the Invalid; the Convalescent; the Dyspeptic;
and the Gouty. London: Macmillan and Co.
Fraser, James W. 1886. "Notes on the relative digestibility of the chief
albuminoid proximate principles, with remarks on its bearing on invalid
diet." The Lancet 128(3304):1215-1219.
Frawley, Maira H. 2004. Invalidism and Identity in Nineteenth-Century Britain.
Chicago: The University of Chicago Press.
Grant, Mark. 1996. "Oribasios and medical dietetics or the three Ps." In Food in
Antiquity, edited by John Wilkins, David Harvey and Mike Dobson, 371-
379. Exeter: University of Exeter Press.

27
Guerrini, Anita. 2012. "Health, national character and the English diet in 1700."
Studies in History and Philosophy of Biological and Biomedical Sciences
43:349-356.
Guly, Henry. 2011. "Medicinal brandy." Resucitation 82:951-954.
Hamilton, Miss. 1886. A Course of Four Lectures delivered to the Members of the
Clunes Girls' Friendly Society on Sick Nursing. Clunes: Guardian and
Gazette.
Haris, Nadia. 2018. "The Best Foods to Eat While Recovering from Illness."
Livestrong Foundation, accessed 8 January 2010.
https://www.livestrong.com/article/342656-the-best-foods-to-eat-
while-recovering-from-illness/.
Hart, James. 1633. Klinike, or The diet of the diseased. London: Ione Beale.
Haushofer, Lisa. 2018. "Between food and medicine: artificial digestion, sickness,
and the case of Benger's Food." Journal of the History of Medicine and
Allied Sciences 73 (2):168-187.
Heaton, Nell, and Vernon Henry Mottram. 1951. Cooking for the Sick and
Convalescent. London: Faber and Faber Ltd.
Heritage, Lizzie. 1897. Cookery for Invalids and Others. London: John Hogg.
Herrman, Eleanor Krohn, and Diane Sanchez. 1997. "Feeding infants, invalids,
and the infirm." Western Journal of Nursing Research 19 (4):536-541.
Hooper, Mary. 1876. Cookery for Invalids, Persons of Delicate Digestion, and for
Children. London: Henry S King & Co.
Irwell, Celia K. 1912. "Suggestions for the serving of food to invalids." The
American Journal of Nursing 12 (9):727-729.
Ivy, AC, and MI Grossman. 1944. "Gastro-intestinal function during
convalescence." Federation Proceedings: Federation of American Societies
for Experimental Biology 3:236-239.
Jessop, Charles. 1889. "The physiological value of meat food for invalids, and
waste in methods of preparation." British Medical Journal 31:462-464.
Kelly, F. 2001. "Medicine and early Irish law." Irish Journal of Medical Science
170 (1):73-76.
King, Helen. 1996. "Food and blood in Hippokratic gynaecology." In Food in
Antiquity, edited by John Wilkins, David Harvey and Mike Dobson, 351-
358. Exeter: University of Exeter Press.
Mann, Ellen E. 1901. Invalid Recipes. London: Longman, Green and Co.
Mann, Robert James. 1878. Domestic Economy and Household Science. For home
education; and for school mistresses and pupil teachers. London: Edward
Stanford.
Manywaringe, Everard. 1696. The Efficacy and Extent of True Purgation. London:
Printed for D Browne and R Clavel.
Meikelejohn, AP. 1954. "Feeding convalescent patients: nutritional needs and
present costs." The Lancet 263 (6825):1284-1286.
Miller, Ian. 2015. "Food, Medicine and Institutional Life in the British Isles,
c1790-1900." In The Routledge History of Food, edited by Carol Helstosky,
200-219. Abingdon: Routledge.

28
Moore, Francis D. 1958. "Getting well: the biology of surgical convalescence."
Annals of the New York Academy of Sciences 73 (2):387-400.
Neal, Ebenezer. 1861. Diet for the Sick and Convalescent. Philadelphia: James
Challen and Son.
Newton, Hannah. 2015. "'Nature Concocts & Expels': The agents and processes of
recovery from disease in Early Modern England." Social History of
Medicine 28 (3):465-486.
Newton, Hannah. 2018. Misery to Mirth: Recovery from Illness in Early Modern
England. 1st ed. Oxford: Oxford University Press.
Nightingale, Florence. 1860. Notes on Nursing. What It is and What It Is Not.
London: Harrison.
Nunn, RJ. 1880. "Peptonized milk as food for infants and invalids." American
Journal of Obstetrics and Diseases of Women and Children 13 (3):722-738.
Nutton, Vivian. 1996. "Galen and the traveller's fare." In Food in Antiquity, edited
by John Wilkins, David Harvey and Mike Dobson, 359-370. Exeter:
University of Exeter Press.
Ottoson, Per-Gunnar. 1984. Scholastic Medicine and Philosophy. A Study of
Commentaries on Galen's Tegni (ca. 1300-1450). Naples: Bibliopolis.
Parise, M Reveille. 1847. "On the Mangaement of Convalescence from Acute
Disease." The Western Journal of Medicine and Surgery 7 (5):445.
Pavy, Frederick, Williams. 1874. A treatise on food and dietetics, physiologically
and therapeutically considered. Philadelphia: Henry C Lea.
Pearsall, Judy, ed. 2001. The New Oxford Dictionary of English. Oxford: Oxford
University Press.
Pillsbury, Barbara LK. 1978. "'Doing the Month': Confinement and convalescence
of Chinese women after childbirth." Social Science & Medicine 12:11-22.
Pim, Sheila. 1943. Getting Better: A handbook for convalescents. London: Faber
and Faber Ltd.
Pitkin, Eliza A. 1880. Invalid Cookery: A manual of the sick and convalescent to
which is added a chapter of practical suggestions for the sick-room.
Chicago: Knight and Leonard.
Porkert, Manfred. 1974. The Theoretical Foundations of Chinese Medicine.
Cambridge MA: Massachussetts Institute of Technology Press.
Rastogi, Sanjeev, and Priyanka Chaudhari. 2014. "Convalescent food practices in
Ayurveda." In Ayurvedic Science of Food and Nutrition, edited by Sanjeev
Rastogi, 67-80. New York: Springer.
Roberts, William. 1885. "On feeding the sick: feeding the sick with liquid food."
Medical Record 29 (5):115-120.
Robertson, William Henry. 1835. Popular Treatise on Diet and Regimen;
Intendeed as a text book for the invalid and the dyspeptic. London: Charles
Tilt.
Ryan, Catherine. 1881. Convalescent Cookery: A family handbook. London: Chatto
& Windus.
Rynbergen, Henderika J. 1963. "In gastrointestinal disease fewer diet
restrictions." The American Journal of Nursing 63 (1):86-89.

29
Santich, Barbara. 2013. "History Through the Lens of Food." In Eat History: Food
and Drink in Australia and Beyond, edited by Sofia Eriksson, Madeleine
Hastie and Tom Roberts. Newcastle on Tyne: Cambridge Scholars
Publishing.
Sargent, Cora McCabe. 1915. "Creamed dishes for the convalescent." American
Journal of Nursing 15 (9):722-725.
Saundby, Robert. 1908. "Sick-Room Cookery." The Hospital 44 (1146):491-493.
Schauer, A, and M Schauer. 1912. Cookery for Invalids: For hospital and home,
nurses in training schools, in private practice, and others who tend the sick.
2nd ed. Brisbane: Edwards, Dunlop & Co Ltd.
Scully, Terence. 1995. The Art of Cookery in the Middle Ages. Woodbridge, UK:
The Boydell Press.
Stephen, Leslie. 1883. Notes From Sick Rooms. London: Smith, Elder & Co.
Stobart, Anne. 2016. Household Medicine in Seventeenth-Century England
London: Bloomsbury Academic.
Stoker, Jane. 1878. "Domestic Economy for Pupil Teachers." In The Teachers'
Assistant and Pupil Teachers' Guide, edited by Anon, p33. London: W
Stewart.
Stolberg, Michael. 2011. Experiencing Illness and the Sick Body in Early Modern
Europe. Basingstoke UK: Palgrave Macmillan.
Trémolières, Jean. 1975. "A history of dietetics." Progress in Food and Nutrition
Science 1 (2):65-114.
Turner, Bryan S. 1982. "The government of the body: medical regimens and the
rationalization of the diet." The British Journal of Sociology 33 (2):254-
269.
Twyne, Thomas. 1576. The schoolemaster, or teacher of table philosophie.
London: Richarde Iones.
Tyron, Thomas. 1697. The Way to Health, Long Life and Happiness. Or, a discourse
on temperance. 3rd ed. London: H. Newman.
van der Lugt, Maaike. 2011. "Neither Ill nor Healthy: The intermediate state
between health and disease in medieval medicine." Quaderni Storici
136:13-46.
van Straten, Michael. 2018. "The Convalescing Diet." accessed 9 January 2019.
http://www.michaelvanstraten.com/diet.php?id=23.
Weeks-Shaw, Clara S. 1892. A text-book of nursing. New York: Appleton and Co.
White, KD. 1996. "Cereals, bread and milling in the Roman world." In Food in
Antiquity, edited by John Wilkins, David Harvey and Mike Dobson, 38-43.
Exeter: University of Exeter Press.
White, WH. 1920. "Discussion on the value of alcohol as a therapeutic agent."
Proceedings of the Royal Society for Medicine 13:47-49.
Wilkins, John. 1996. "Food and medicine." In Food in Antiquity, edited by John
Wilkins, David Harvey and Mike Dobson, 337-350. Exeter: University of
Exeter Press.

30
Willan, Anne, and Mark Cherniavsky. 2012. The Cookbook Library. Four centuries
of the cooks, writers and recipes that made the modern cookbook.
Berkerley, CA: University of California Press.
Williams, Peter G. 2018. An Annotated Bibliography of Invalid Cookery Advice and
Recipes in Australian Cookbooks 1860-1950. Canberra: Willard Publishing.
Williams, PG. 2019. "Advice and recipes for invalid and convalescent cookery in
Australian cookbooks 1860-1950." Nutrition and Dietetics (In press early
view) http://dx.doi.org/10.1111/1747-0080.12468.
Woodruff, I Ogen. 1940. "Present day concepts of convalescent care." JAMA 114
(6):461-467.
Yeo, I Burney. 1889. "A discussion on food for invalids and infants." British
Medical Journal 2 (1510):1261-1266.
Yeo, I Burney. 1893. Food in Health and Disease. London: Cassell & Company Ltd.
Zandonella-Stannard, Drew. 2013. "Ghosts of Fevers Past." Saveur magazine,
accessed 9 January 2019.
https://www.saveur.com/article/Kitchen/Victorian-Invalid-Cookery.

31