It was observed in early hospitals that patients tended to get better more quickly if they were well nourished. It was also noted that patients with certain illnesses sometimes needed more of particular foods while others could not tolerate some foods at all.
According to the British Dietetic Association website, the earliest dietary observations were at St Bartholomew’s Hospital in 1687 and the first recorded therapeutic diet was at Radcliffe Infirmary, Oxford in 1837. It was not until the late 19th century and early 20th century, however that the science of dietetics was developed, first in the United States of America. In 1920 a report was commissioned by the Board of Managers of the Royal Infirmary of Edinburgh (RIE) to investigate dietetic arrangements and the Dietetic Department opened in 1924, the first hospital known to have developed such a department. Sister Ruth Pybus was appointed dietician and obtained a Rockefeller Scholarship to study dietetics in American hospitals. In 1928, the Rockefeller Foundation also generously gave the hospital a grant towards the building of facilities for the Dietetic Department which included a metabolic unit, two wards, a diet kitchen and laboratory. The image shows the diet kitchen in 1950.
Staff working in the dietetic kitchen, ward 21 RIE, 1950 (P/PL1/S/395)
Much ingenuity was exercised in the creation of recipes in the early days. The ‘liver diet’ and the ‘spleen diet’ were created for patients with pernicious anaemia and great effort was made in producing bran wafers for diabetics, made from bran with the starch removed put into a jelly of agar-agar or carragheen moss. The consistency was described as being like fairy toast with the appearance of thin firelighters, but they were much in demand by patients! LHSA holds a set of tasty recipes from the Dietetic Department from the 1950s, which includes this one for chicken in jelly (LHB1/89/4/1).
Recipe for chicken in jelly, 1950s (LHB1/89/4/1)
References: The Growth and Development of the Dietetic Department: 4 The Royal Infirmary of Edinburgh by Anna Buchan, International Journal of Food and Nutrition vol. VII, no. 2, Summer 1954.