A bit of hospital history…

Eating in hospital: a little history

by Emily Collins (Museum Consultant/Curator, WCHN History and Heritage Group)

Hospital food – like airplane food, it does not have the best reputation of all cuisines! But what did patients eat in hospitals in the past, compared to now? How was food served to them? For History Month last May, the Women’s and Children’s Hospital Network ‘served’ up a display of objects from its History and Heritage Collection, inviting us to consider how the hospitality of hospitals has changed over time.

This mini exhibition, called Eating in hospital: a little history, will remain on display until September. On show are baby bottles and cups used to feed babies and small children milk and other foods, dating from the 1800s through to the present day. There are photos of children eating on the wards at the Adelaide Children’s Hospital in the 1940s, 50s and 60s, and nurses preparing milk bottles which they filled with formula such as those sold in old tins, which also feature in the display.

Nurse in Ernest Williamson kitchen measuring milk to pour into baby bottles (1959, ACH)
Nurse in Ernest Williamson kitchen measuring milk to pour into baby bottles (1959, ACH)
Children eating on ward
Children eating on ward

Of particular interest are menus from the former Queen Victoria Hospital (QVH) and the old Adelaide Children’s Hospital (ACH).  Imagine being a child at the ACH in 1890: you’d be enjoying a spartan meal of bread and butter for breakfast and lunch every single day, with the odd serving of beef tea or … raw meat juice. The QVH menu displayed (c1981) does not differ greatly from that offered to women in hospitals around Adelaide today. But if you had been a woman admitted to a maternity ward in that hospital in the winter of 1950, here’s hoping you were a fan of mutton. Mutton boiled, mutton roasted – whichever way it was dressed up!  

ACH diet table 1890s
ACH diet table 1890s

In researching this display, the WCHN History and Heritage Group uncovered some interesting tales on the general history of food and eating in hospitals.  A long time ago, hospital food was rather different to that as we know it now, and certainly has always varied depending on the location of hospitals around the world.

In Medieval times or the Middle Ages (5th to 15th Century AD), although medical treatment was not advanced, it has been claimed that patients were given better quality food than in hospitals today. This is because hospital food was often prepared by Monks, who planted courtyard gardens to grow fresh food such as herbs. On one Greek island in the 18th Century, a hospital for patients with leprosy served them almonds, grapes and figs from its garden. Freshly picked!

In 18th century Britain however, patients were reliant on their family and friends to bring fruits and vegetables for them, as hospitals only provided bread and beef. Interestingly, this ‘imported’ food was still cooked at the hospitals.

Jumping back in time to the 12th Century, the story in Jerusalem was different again. Often on the menu was chicken with saffron – now considered the world’s most expensive spice. According to one source, poor people in hospital were given so much bread and wine, they could sell the surplus to earn money while they were there. Yes – alcohol used to feature commonly in hospital diets around the world, even for children! A foundling hospital in London around 1835-1840 apparently allowed its young orphans a small amount of beer of a Sunday.  

In the past, patients were given food based on what was believed about diseases at the time in question.  In the 1700s, patients were allocated ‘high’ or ‘low’ diets depending on whether their illness was considered a consequence of depletion or overstimulation of the body’s systems. Another school of thought was that illnesses resulted from people having hot, cold, wet or dry bodies. By this reasoning, a patient diagnosed as having a hot and dry body was allowed to have cold fruit, but not hot soup, even in winter. Food was considered of great importance for healing illnesses, but this belief largely lost favour with more sophisticated scientific research.

From the 1900s, a new science gained ground: nutritional science. This science informed our understanding of what foods are good for our health today. Food is no longer a major part of the actual treatment for people’s illnesses while in hospital, however. As medical knowledge has advanced, pharmaceuticals have come to play the most dominant role. Some patients are still given a special diet prepared by the hospital, in the instance they cannot eat certain foods because of the impact on their health condition. Visitors to the Eating in Hospital display may observe the WCH has a current menu for diabetic patients.

Throughout history, food has been prepared and brought to patients in hospitals by kitchen staff and nurses (who sometimes happened to also be monks, or nuns).  But now, there is a new trend. One hospital in Bristol in the UK is using robots to heat and transport cold meals.

The new Royal Adelaide Hospital opening soon here in our city will also have robots, imported from Germany, to collect meals from the kitchen and bring them out to the wards. There will still be a personal touch at the end stage though, as hospital staff will offload the meals and allocate them to individual patients.

It has been argued that there is now more of a focus on technological initiatives than on the domestic. And yet having delicious, comforting food makes people happier, and happiness is one factor (among many) that may contribute to their healing.

Jokes about ‘hospital food’ aside, the catering departments of hospitals these days provide greater choice, and are charged with having to take into account more and more dietary restrictions, food allergies/intolerances, and diverse cultural backgrounds among patient populations than ever before. Hospitals are bigger, with more patients, and often located in built-up cities, with next to no land unaccounted for by buildings and parking spaces. I suspect the quaint kitchen garden of yore would struggle to service one modern ward.

And then there’s the bottom dollar! Hospitals in days long past used to spend most of their budget on patient food … but now we have MRI machines and so forth to fund. Advanced medical science and technology does not come cheap.

It must be concluded that serving food in hospital is already a complicated gig. People throughout time may have been difficult enough to please; but what of now, with the rise of foodie culture and our increasingly refined palates? The average patient is becoming quite the discerning consumer… and that’s just the adults. Junior Masterchef, anyone?

‘Eating in hospital: a little history’ is on display throughout July and August inside the side entrance of the WCH’s Samuel Way Building off Brougham Place – just follow the ramp by the frangipani tree.