photo #8912585

Hospital dietary records from 1800s show what doctors knew before dietary guidelines. Standard hospital diets for recovering patients: - Raw milk, 1-2 quarts daily - Butter, unlimited with meals - Cream in soups, drinks - Eggs, usually 2-4 daily - Meat broths - Some bread This was was standard practice across Europe and America. Florence Nightingale's nursing protocols, 1860: Specify milk, butter, eggs, and beef tea as essential for recovery. No mention of limiting these. The concern was ensuring adequate intake. Tuberculosis sanatoriums had specific protocols: Patients consumed maximum possible butter and cream. Half a pound of butter daily was not unusual for TB patients. The treatment was literally "fatten them up with dairy." Post-surgical recovery protocols: Immediately upon waking, patients given milk or cream to prevent wasting. Butter with every meal. The goal was rapid weight regain. Childhood hospitals treated failure-to-thrive with butter prescriptions. Children unable to gain weight were given butter at every meal until growth resumed. Convalescent homes - facilities specifically for recovery - had menus centered on dairy. Cream soups, buttered vegetables, whole milk drinks, cheese. The entire dietary plan was maximising dairy fat intake. The raw milk is particularly notable. Pasteurization wasn't mandatory until 1920s-1940s depending on region. Hospital milk was often raw, delivered fresh from farms. Nobody worried about bacterial contamination from quality sources. The concern was getting enough nutrition into patients. Wasting disease wards: The diagnosis covered various conditions where patients lost weight uncontrollably. The treatment was aggressive feeding with maximum fat. Butter, cream, eggs, fatty meat. Push calories from fat as high as possible. Medical textbooks from 1880s-1910s describe this explicitly. One 1893 text on hospital management states: "The provision of good butter in sufficient quantity is among the most important aspects of invalid feeding." Pregnancy wards had similar protocols. Women recovering from childbirth received butter and cream aggressively to prevent post-partum wasting. Mental hospitals used butter and eggs extensively. The theory was that good nutrition improved mental health outcomes. They weren't wrong - nutritional deficiencies do affect cognition. This continued until 1950s-1960s. Then dietary guidelines changed. Suddenly butter was dangerous. Hospitals switched to margarine. Patient recovery times increased but nobody connected it to the dietary change because new antibiotics and procedures received credit for everything. The institutional knowledge was lost. Modern hospital food is notoriously poor quality and low fat. But 19th century doctors knew: recovery requires fat. Butter and cream were medicine. They didn't understand the biochemistry. They observed outcomes. Butter-fed patients recovered better. Modern evidence-based medicine discarded this because it contradicted the new fat hypothesis. Observation was replaced by ideology. The 19th century approach worked better. We just forgot it.