Historically Speaking: Anorexia’s Ancient Roots And Present Toll

The deadly affliction, once called self-starvation, has become much more common during the confinement of the pandemic.

The Wall Street Journal

February 18, 2022

Two years ago, when countries suspended the routines of daily life in an attempt to halt the spread of Covid-19, the mental health of children plunged precipitously.

Two years ago, when countries suspended the routines of daily life in an attempt to halt the spread of Covid-19, the mental health of children took a plunge. One worrying piece of evidence for this was an extraordinary spike in hospitalizations for anorexia and other eating disorders among adolescents, especially girls between the ages of 12 and 18, and not just in the U.S. but around the world. U.S. hospitalizations for eating disorders doubled between March and May 2020. England’s National Health Service recorded a 46% increase in eating disorder referrals by 2021 compared with 2019. Perth Children’s hospital in Australia saw a 104% increase in hospitalizations and in Canada, the rate tripled.

Anorexia nervosa has a higher death rate than any other mental illness. According to the National Eating Disorders Association, 75% of its sufferers are female. And while the affliction might seem relatively new, it has ancient antecedents.

As early as the sixth century B.C., adherents of Jainism in India regarded “santhara,” fasting to death, as a purifying religious ritual, particularly for men. Emperor Chandragupta, founder of the Mauryan dynasty, died in this way in 297 B.C. St. Jerome, who lived in the fourth and fifth centuries A.D., portrayed extreme asceticism as an expression of Christian piety. In 384, one of his disciples, a young Roman woman named Blaesilla, died of starvation. Perhaps because she fits the contemporary stereotype of the middle-class, female anorexic, Blaesilla rather than Chandragupta is commonly cited as the first known case.

The label given to spiritual and ascetic self-starvation is anorexia mirabilis, or “holy anorexia,” to differentiate it from the modern diagnosis of anorexia nervosa. There were two major outbreaks in history. The first began around 1300 and was concentrated among nuns and deeply religious women, some of whom were later elevated to sainthood. The second took off during the 19th century. So-called “fasting girls” or “miraculous maids” in Europe and America won acclaim for appearing to survive without food. Some were exposed as fakes; others, tragically, were allowed to waste away.

But, confusingly, there are other historical examples of anorexic-like behavior that didn’t involve religion or women. The first medical description of anorexia, written by Dr. Richard Morton in 1689, concerned two patients—an adolescent boy and a young woman—who simply wouldn’t eat. Unable to find a physical cause, Morton called the condition “nervous consumption.”

A subject under study in the Minnesota Starvation Experiment, 1945. WALLACE KIRKLAND/THE LIFE PICTURE COLLECTION/SHUTTERSTOCK

Almost two centuries passed before French and English doctors accepted Morton’s suspicion that the malady had a psychological component. In 1873, Queen Victoria’s physician, Sir William Gull, coined the term “Anorexia Nervosa.”

Naming the disease was a huge step forward. But its treatment was guided by an ever-changing understanding of anorexia’s causes, which has spanned the gamut from the biological to the psychosexual, from bad parenting to societal misogyny.

The first breakthrough in anorexia treatment, however, came from an experiment involving men. The Minnesota Starvation Experiment, a World War II –era study on how to treat starving prisoners, found that the 36 male volunteers exhibited many of the same behaviors as anorexics, including food obsessions, excessive chewing, bingeing and purging. The study showed that the malnourished brain reacts in predictable ways regardless of race, class or gender.

Recent research now suggests that a genetic predisposition could count for as many as 60% of the risk factors behind the disease. If this knowledge leads to new specialized treatments, it will do so at a desperate time: At the start of the year, the Lancet medical journal called on governments to take action before mass anorexia cases become mass deaths. The lockdown is over. Now save the children.

A shorter version appeared in The Wall Street Journal

Historically Speaking: The Business and Pleasure of Dining Out

The food service industry will eventually overcome the pandemic, just as it bounced back from ancient Roman bans and Prohibition.

The Wall Street Journal

September 24, 2020

It remains anyone’s guess what America’s once-vibrant restaurant scene will look like in 2021. At the beginning of this year, there were 209 Michelin-starred restaurants in the U.S. This month, the editors of the Michelin Guide announced that just 29 had managed to reopen after the pandemic lockdown.

ILLUSTRATION: THOMAS FUCHS

The food-service industry has always had to struggle. In the Roman Empire, the typical eatery was the thermopolium, a commercial kitchen that sold mulled wine and a prepared meal—either to-go or, in larger establishments, to eat at the counter. They were extremely popular among the working poor—archaeologists have found over 150 in Pompeii alone—and therefore regarded with suspicion by the authorities. In 41 A.D., Emperor Claudius ordered a ban on thermopolia, but the setback was temporary at best.

In Europe during the Middle Ages, the “cook shop” served a similar function for the poor. For the wealthier sort, however, it was surprisingly difficult to find places to eat out. Only a few monasteries and taverns provided hospitality. In Geoffrey Chaucer’s 14th-century comic travelogue “The Canterbury Tales,” the pilgrims have to bring their own cook, Roger of Ware, who is said to be an expert at roasting, boiling, broiling and frying.

To experience restaurant-style dining with separate tables, waiters and a menu, one had to follow in the footsteps of the Venetian merchant Marco Polo to the Far East. The earliest prototype of the modern restaurant developed in Kaifeng, the last capital of the Song Dynasty (960-1279), to accommodate its vast transient population of merchants and officials. The accumulation of so many rich and homesick men led to a boom in sophisticated eateries offering meals cooked to order.

Europe had nothing similar until the French began to experiment with different forms of public catering in the 1760s. These new places advertised themselves as a healthy alternative to the tavern, offering restorative soups and broths—hence their name, the restaurant.

In 1782, this rather humble start inspired Antoine Beauvilliers to open the first modern restaurant, La Grande Taverne de Londres, which unashamedly replicated the luxury of royal dining. By the 1800s, the term “restaurant” in any language meant a superior establishment serving refined French cuisine.

In 1830, two Swiss brothers, John and Peter Delmonico, opened the first restaurant in the U.S., Delmonico’s in New York. It was a temple of haute cuisine, with uniformed waiters, imported linens and produce grown on a dedicated farm. What’s more, diners could make reservations ahead of time and order either a la carte or prix fixe—all novel concepts in 19th century America.

Delmonico’s reign lasted until Prohibition, which forced thousands of U.S. restaurants out of business, unable to survive without alcohol sales. During that time, the only growth in the restaurant trade was in illegal speakeasies and family-friendly diners. Yet in 1934, just one year after Prohibition’s repeal, the art deco-themed Rainbow Room opened its doors at Rockefeller Plaza in New York. Out of the ashes of the old, a new age of elegance had begun.

Historically Speaking: Pets and the Humans Who Loved Them

From prehistoric times to the age of Covid-19, people have looked to animals for companionship.

May 7, 2020

The Wall Street Journal

Americans have been adopting pets at a record pace since the pandemic began. It’s as if the crisis has intensified our need for animal companionship, which goes back a long way. Scientists agree that dogs were the first species to form a relationship with humans: Inside Chauvet Cave, a Paleolithic site in southern France, archaeologists recently found 26,000-year-old canine paw prints alongside those of a human child.

John Steinbeck with his dog Charley.
PHOTO: BETTMANN ARCHIVE/GETTY IMAGES

Humans kept animals as companions long before we domesticated livestock like sheep, goats and cattle, some 10,000 years ago. By contrast, horses were only tamed in Eurasia around 6,000 years ago. Though they weren’t household pets, they inspired passionate feelings in their owners, as the equine imagery of ancient art and poetry so beautifully attests.

One of the first pet dogs whose name is known to us is Abutiu, who belonged to an Egyptian pharaoh in the early third millennium B.C. After Abutiu’s death, his heartbroken owner gave him a royal burial. The inscription on the tomb explained, ‘His Majesty did this for him in order that he might be honored before the great god, Anubis.’

By around 1000 B.C., the Egyptians’ love affair with dogs had given way to an obsession with cats, which they revered as semi-divine creatures. It was illegal to kill a cat or take one out of Egypt. The ancient Greeks were baffled by Egyptian felinophilia; they were more taken by the loyalty of canines. In Homer’s Odyssey, the old dog Argos waits 20 years for Odysseus to return, then dies content once he has seen his master.

The Romans made pets of cats, dogs, snakes, insects and birds—indeed, almost anything that breathed, except for goldfish. Those didn’t become household companions until 1369, when China’s Hongwu Emperor ordered the creation of the first fishbowl.

Pet ownership was a status symbol in early modern Europe, like having a carriage. Cardinal Richelieu, an adviser to the French King Louis XIII, shared his rooms with 12 cats, while Madame du Barry, the mistress of Louis XV, kept an orangutan and a parrot. Almost no one bothered to house-train their pets, much to the chagrin of unwary visitors to Versailles.

During the French Revolution, pedigree pets suffered by association with their aristocratic owners. The future Empress Josephine was incarcerated in Paris along with her pet pug Fortuné. Always protective of its mistress, the dog reacted badly on her wedding night to Napoleon in 1796, sinking its teeth into his leg.

As the cult of Romanticism swept through Europe in the 19th century, a pet became more than just a companion. It was an alter ego and “loving friend,” as Elizabeth Barrett Browning wrote in her poem “To Flush, My Dog.” Many authors felt the same way about their pets: Charles Dickens had his pet raven Grip, Ernest Hemingway had his six-toed cat Uncle Willie, and of course John Steinbeck had his poodle Charley, whom he immortalized in his 1962 book “Travels with Charley.”

They aren’t alone; a 2018 meta-review of mental health studies by researchers at Liverpool University confirmed the emotional benefits of pet ownership. Steinbeck once admitted to his publisher: “I need a dog pretty badly. I dreamed of dogs last night. They sat in a circle and looked at me and I wanted all of them.”