The Doctor in the (Victorian) Kitchen

In the summer of 1880 at a house in Mayfair, London, a doctor by the name of Ernest Hart (1835-1898) delivered the fourth and last of a series of drawing room lectures sponsored by the National Health Society (NHS). The lecture supplied “many facts regarding food, and a number of suggestions respecting its preparation”. It was summarised in The Times on 2 June and in the British Medical Journal (BMJ) a few days later.

Hart, chairman of the NHS, was no ordinary medical practitioner. For over 30 years with a break in 1869-70, he edited the BMJ, the weekly periodical of the British Medical Association (BMA)--the UK equivalent and forerunner of the American Medical Association. Hart was the greatest of all BMJ’s editors, before or since; second perhaps only to Thomas Wakley, founder of the Lancet, in the entire field of medical journalism. With his dynamic and crusading approach to editorial work, coupled with a keen business brain, Hart transformed the BMJ from lacklustre institution to spectacular success. He was a colourful and controversial character whom some suspected of murdering his first wife. Although he probably was not a murderer, the first Mrs. Hart was fatally poisoned in suspicious circumstances. As for the break in his editorship, this was the result of Hart’s apparently forgivable embezzlement of BMA funds.

Hart has been described as ambitious, opinionated, egotistical, self confident and inclined to intolerance. Unsurprisingly, he acquired many enemies. Even during his last illness disgruntled leaders of the BMA were plotting ways of ejecting him from the editorial chair--not least because of some unashamed nepotism. Hart had many interests within and beyond medicine. His leisure activities ranged from dog and pigeon breeding to foreign travel and the collection of ancient Japanese art. One issue of medical and general interest on which he held strong views was diet, hence his Mayfair lecture. In it Hart deplored the British diet, especially its emphasis on meat and neglect of fish and “nitrogenous vegetables”. British bread alone came in for praise--far superior to the over-fermented and over-baked loaves found in France. He concluded with a plea for the use of seasonal ingredients. According to press accounts, probably written by Hart himself, the lecture elicited much interest on the part of its large audience. Many were particularly taken with the idea of varying “the monotony of the general dinner” (BMJ 5 June 1880, 861).

The NHS lecture was not the first occasion on which Hart had tackled the issue of diet. Between 20 September and 25 October 1879 he published a series of five leading articles in the BMJ under the heading: “The Doctor in the Kitchen”. These articles formed the basis of the lecture Hart gave some months later. The first piece was written in the context of “these hard times” and “the bad times yet to come during the winter of distress with which we are threatened”. In these circumstances, Hart believed, the “question of conveniently feeding our population” would loom large. He thought doctors well placed to offer opinions because of their status as “practical physiologists, physicians, and travelled men of the world”. He praised articles on food and diet in the Nineteenth Century (published in amended form as Food and Feeding in 1880 and in many subsequent editions). He then launched into his main themes: the use of more varied ingredients and employment of improved cooking techniques.

A good diet, Hart emphasised, was the key to good health. In his eyes a healthy diet involved the consumption of less meat and more beans, lentils, green vegetables, fish, rice, macaroni, cheese, and the hominy porridge “on which peasant and millionaire alike delight in America”, whether dwelling on New York’s Fifth Avenue or in a cottage in New England. Citing the example of strong and tireless labourers in Ireland and India, whose diets mainly comprised potatoes and rice respectively, Hart dismissed the popular English belief that meat alone could build bodily strength. But Hart had another objection to meat. A teetotaller himself, he maintained that excessive meat-eating led to excess alcohol consumption: “the digestion is fatigued by excess of nitrogenous food and then stimulated by alcohol to dispose of it”. Ingredients aside, the standard of culinary technique in English homes, rich and poor, was also wanting. Spit roasting meat over an open fire, the only cooking method recognised by many housewives, wasted food and fuel. Far better to make soup with a few bones, a crust of bread and half a cabbage; or a stew from a few scraps of meat, onion, carrot and bread crusts. Never one for false modesty, Hart soon noted the “extended welcome” accorded his words.

Hart’s second article, published on 27 September, returned to the theme of waste in the context of the anticipated “winter of much scarcity”. His theme was: “bad cooks waste food, fuel and health”. He thought that “with a few exceptions, English cooks are all bad cooks in one sense or another; unskilful in execution, or extravagant in selection, and destitute of sound and economical traditions”. Though scathing about the cooking standards of the rich, on this occasion Hart focused on the cuisine of the lower middle classes, along with curates, clerks and skilled artisans. For such people cooking was usually a matter of roasting, grilling or boiling joints of meat and serving them with a limited range of plain boiled vegetables. Few British cooks had much idea what to do with leftovers. They were even clueless, in most cases, about preparing fish and chips. Hart contrasted all this with the imagination and improvisation of other nations. Americans were commended for their pork and beans, but it was the French who received special praise. They knew what to do with the remnants of a previous day’s meal. They also knew how to turn such unregarded ingredients as dogfish, conger eel and tripe into splendid yet economical dishes. As a result French workers lived twice as well as their British counterparts notwithstanding that bread, butter, milk sugar and coffee were 20%-50% dearer in Paris than in London.

In his next essay Hart concentrated on vegetables. The English, he claimed, viewed vegetables as an insipid “adjunct to a solid mass of meat” of little nutritional value. Only the potato--to Hart’s bemusement--was prized. He thought the potato baked in its jacket “one of the few specialities of the English cuisine which is worthy of perpetuation”. Roasted beneath a joint it also had merit. Otherwise it was overrated and of scant nutritional value. The cabbages, peas, beans, Brussels sprouts, cauliflower and other vegetables that disgraced English dining tables were bad because they were served plain boiled. Again, Hart drew attention to the different way in which things were done in France.

Hart’s fourth piece, which appeared in the BMJ on 11 October 1879, extolled the virtues of buttermilk, much neglected in many parts of England except for animal feed, as a nourishing food. He then returned to the subject of waste, enjoining the use of American cooking ranges in preference to the open fires employed in many British households. Aside from his regular injunctions in favour of the skilful use of leftovers and the consumption of one-pot stews and soups, he advocated the use of Indian corn (for breakfast), tomatoes (in soups) and haricot beans. Atypically, Hart had some praise for things English, notably roast mutton and beef, beefsteak puddings, thick soups, and the fruit puddings and tarts virtually unknown in France. But it was not long before he returned to the negatives:

“...our range is too limited, our selection falls too exclusively on the large and choice pieces of meat; we have neglected the art of stewing and of braising; we know nothing of the art of cooking vegetables except by boiling them in water; we are absurdly prejudiced against...pleasant, economical, and nutritious kinds of food.”

Hart wound up his series on 25 October. “The rapid accumulation of more serious demands upon space” he told readers, “warns me...to bring to a termination these short articles of holiday gossip about food and feeding”. A medical journal, he admitted, “was hardly the proper place to continue at length a series of articles on food, cooking, and cookery”. He had set out with the simple intention of supplying “a few desultory notes” on waste, but the favourable reception of these notes had persuaded him to continue the theme. In his final article Hart addressed issues raised in readers’ letters. These had raised questions about the nutritional value of soup, the correct preparation of hominy, the fuels used on American stoves and ranges, the deplorable absence of oil and fat in British cooking, the proper preparation of fish salads, mint sauce, and coarse fish such as pike and carp.

What are we to make of Hart’s foray into matters culinary? Hart professed that he wrote his articles for two quite different reasons: as “holiday gossip” and to impart practical advice at a time of hardship. It seems odd that he saw late September and October as vacation months so, perhaps, his other explanation has more merit. Conventionally the last quarter or so of the nineteenth century is seen as the time of Britain’s ‘Great Depression’ following the years of mid-Victorian boom. But historians have long since rejected the notion of unrelieved economic depression in this period. British agriculture had its problems, not least because of competition from American farmers, but unemployment did not surge and lower prices meant increased purchasing power for those in work. As John Burnett points out in Plenty and Want. A Social History of Diet in England from 1815 to the Present Day:

“...the lower cost of basic foods in particular left a bigger margin which could go towards providing a far more varied diet. There is a good case for selecting the 1880s as one of the decisive periods in the improvement of the standard of living of the working classes.” (Burnett 108)

Not a time for food riots after all.

So Hart’s advice probably was less timely than he claimed. Yet the arrival of New World agricultural products may have enabled the British consumer to locate the hominy Hart extolled. The late nineteenth century also saw the beginning of modern food technology and, as a result, greater variety in the British diet. But the average Briton’s preference for meat was not easily shaken. Foreign visitors had commented on this predilection as far back as the 17th century. As incomes rose from 1881 down to the First World War meat consumption rose by about one-third while potato consumption fell by the same amount (Burnett 131).

Hart can be judged brave to have devoted so much space in a leading medical journal to the subject of cooking. After all, the BMJ was best known for publishing scientific papers by such luminaries as Joseph Lister (aseptic medicine) and Charles Manson (malaria/mosquito theory). But Hart was never afraid take risks. At various times he devoted space in the journal to such subjects as masturbation and massage parlours. He took on patent medicine manufacturers and, unfashionably, had the temerity to champion women medical practitioners at a time when most male doctors regarded them with horror. Cooking was an unlikely subject for a medical journal, but food and drink did feature occasionally in the nineteenth century medical press, most famously in the Lancet’s campaign against adulteration in the 1850s. In the 1890s Thomas Oliver, who specialised in occupational medicine, wrote in the Lancet about “The Diet of Toil”, or “the alimentation of the labouring classes”. But the provision of recipes and cooking advice was another matter. The Lancet’s concerns about adulteration were partly medical, for some of the ingredients unscrupulous Victorian tradesmen added to food and drink were poisons. Oliver too wrote from a medical perspective. Hart’s concerns, though not unconnected with health, were broader. In today’s parlance he addressed the issue of lifestyle.

By modern standards scientific knowledge about diet was rudimentary in the 1870s. For example, discovery of the importance of “accessory food factors”, or vitamins as they came to be known, was decades away when Hart wrote his articles. To modern eyes some of Hart’s recommendations, for example in favour of the copious consumption of salt and butter, appear of doubtful value in health terms. Hart was also an enthusiast for deep fat frying, a technique, he claimed, the British had yet to espouse--even though the combination of fish and chips to make a complete meal supposedly originated in the town of Oldham in the 1860s. His denigration of the potato as a food lacking nutritional value also reads oddly. But he was writing primarily for doctors, many of whom were likely to encounter patients suffering from deficiency diseases rather than from the effects of a diet replete with sugar and fat. Furthermore, many of his tips, in favour of seasonal ingredients and for the avoidance of waste and improvement of taste, were soundly based and far-sighted. Today a good diet is routinely recognised as the basis of good health. But the Victorians were far less aware of the connection so Hart’s appreciation of the association also stands to his credit. Whether a recommendation to purchase a cooking range was really useful to someone struggling to fill empty stomachs is more debateable.