In 1861, J.W. Randolph at 121 Main Street in Richmond, Virginia, printed a pamphlet that was prepared for the Army of Virginia by the order of Surgeon General Moore.

This pamphlet was not only given to the troops and hospitals ideas for cooking, it included two critical essays on “Taking Food” and “What Food” written by British nurse Florence Nightingale.

Ms. Nightingale’s first essay “Taking Food” was to be used by the Confederate medical corps to prevent starvation in the hospitals “in the midst of plenty.”

Weak patients usually find it impossible to take solid foods before 11:00 am in hospitals. Many patients are weak and/or feverous in the morning.

They have dry mouths.

These dry mouths usually prevent them from eating. She then suggests that they need to be given liquids.

A spoon of beef-tea, arrowroot and wine, or egg flip (a mixture of beer, rum, and sugar, heated with a red-hot iron) would be a good solution for patients.

Any soldier who can swallow can drink these liquids. It might be quite impossible to consume a mutton chop, fried egg, bacon, or other breakfast foods like gruel.

Delaying the food may result in a 2-3 hour delay by the staff. Punctuality and consistency are important in the hospital situation.

Leaving food for the patient is just as important not to do in the hospital.

Leaving food in hopes that the patient might eat it later, cold, should not be expected.

This could result in the soldier not taking food at all. She suggests that the food needs to come at the prescribed time and taken away (eaten or uneaten) at the prescribed time.

Sometimes that can distress the patient so much that they quit eating.

The flip side of this is to ask the soldier in the hospital what time they feel that they would eat the most food or the best.

When patients are unaware of their best eating time, observation by both the doctor and the nurses or matron need to be taken into account to develop a serving schedule.

Sometimes the smell of the food of others can affect the eating habits of a soldier, according to Ms. Nightingale. She suggests that, if possible, the patient should not see the food or smell the food of others.

She does state that, of course, this can be difficult in wards. A basic rule in the wards is never to clean or fuss in the wards during meals. This can counterbalance the effect of good food for the patient.

Some soldiers do need assistance in their feeding. This is especially true of new amputees or those with high fevers. Nurses should not talk to those who they are feeding. Other hospital personnel should not interrupt the feeding time of those in the hospital.

Nurses and hospital personnel need to observe the quality of the food that they are serving.

They should never “put before a patient milk that is sour, meat or soup that is turned, an egg that is bad, or vegetables that are undone.”

The goal in the food served is to do half the work of the poor patient’s weak digestive system. Poor food quality impairs that weak digestive process.

She suggests that the patient who refuses food should be brought a “bit of toast with his tea in the evening.”

Another option would be to serve the 2 pm dinner at 7 pm when the man may be hungry prior to bed.

It is also important to make sure that if the patient is given liquids using a cup and saucer, that the saucer is dry when giving it to the soldier so any spillage goes on the saucer and not on the soldier’s bed clothing or bed.

In Ms. Nightingale’s essay, “What Food” she recommends to the hospital staff what to serve those confined to the hospital. Beef tea is the primary food to serve the sick.

It is easy to prepare, easy to serve, and easy on the digestive system. Eggs, on the other hand, can be difficult for some patients to consume. Puddings, therefore, fall into that same category since they are all made with eggs. Milk and preparations with milk are thought to be the one food required of the sick.

Butter is considered the best fat for patients. Cream is another milk product that is very valuable.

In many long, chronic diseases it is irreplaceable. Nurses should think of it as similar to beef tea. Cream is considered easier to consume by the soldier and is considered “pure nourishment.” Buttermilk is thought to assist the body. especially when the man has a “high fever.”

Sweets are considered mixed in their hospital use. Those patients that did not like sweets when they are well. rarely desire them when they are sick. Sugar in tea or coffee, sweet puddings, and sweet drinks like lemonade are usually averted by the sick. Jellies, on the other hand, are very popular with nurses and the patient’s friends. Jellies are not considered nutritious for the sick. A spoonful is not considered desirable since it can cause diarrhea in the sick. Current medical thought does not have a reason why jellies are not nutritious, but until it is discovered, they should be given infrequently to the sick.

Breads that are homemade or brown breads are considered a most important article of diet for many patients. Breads are considered vital to keep the bowels of a patient open. Their use can reduce the number of drugs necessary to keep the bowels open like calomel. Coffee is felt to have the same effect upon the bowels and can be used in the same fashion.

The recipes provided to the Confederate Hospital are typical of this time period. Here are three examples that you would encounter being made in any hospital facility.


Put in a pan 4 oz. of arrow root, 3 oz of sugar, the peel of half a lemon, 1/4th teaspoon of salt, 2.5 pints of milk. Set it on the fire, stir gently, boil for ten minutes and serve. If no lemons are at hand, a little essence of any kind will do. When short of milk, use ½ water and ½ an ounce of butter as an alternative.

Many of you have also encountered the use of toast and water being served to the sick. Here is that recipe.


Cut a piece of crusty bread about 1/4th of pound. Toast gently and uniformly to a light yellow color. Place near the fire and when it looks “chocolate brown” put it in a pitcher and pour 3 pints of boiling water on the bread. Cover the pitcher until the water turns cold. Strain the bread out of the drink as it can ferment in a short time. A piece of apple that has been roasted black can be added to the drink.

Our final choice is Sago Jelly. Since many hospital personnel wanted to distribute jellies, here is a recipe for your use from the Army of Virginia.


Put in a pan with 3 pints of water and 3 oz. of Sago. Sago is a starch extracted from the spongy center, or pith, of various tropical palm stems. (A good substitute today might be cornstarch). Add 1.5 oz. of sugar, half a lemon peel cut very thin, 1/4th teaspoon of ground cinnamon and a little salt. Boil this for about 5 minutes stirring constantly. Add a little port wine or sherry to the mixture.

Until next time….

Your Obt. Servant,

Surgeon Trevor Steinbach

Army of Tennessee Field Hospital