Proteins, Pathologies and Politics

Dietary Innovation and Disease from the Nineteenth Century

David Gentilcore, Matthew Smith

• Publisher: Bloomsbury Academic
• Year: 2018
• ISBN:
  9781350056879
• Edition: 1
• Topic: Politics & International Relations
• Subtopic: Agricultural Public Policy
• Index: Politics & International Relations

Proteins, Pathologies and Politics presents an international and historical approach to dietary change and health, contrasting current concerns with how issues such as diabetes, cancer, vitamins, sugar and fat, and food allergies were perceived in the 19th and 20th centuries. Though what we eat and what we shouldn't eat has become a topic of increased scrutiny in the current century, the link between dietary innovation and health/disease is not a new one. From new fads in foodstuffs, through developments in manufacturing and production processes, to the inclusion of additives and evolving agricultural practices changing diet, changes often promised better health only to become associated with the opposite. With contributors including Peter Scholliers, Francesco Buscemi, Clare Gordon Bettencourt, and Kirsten Gardner, this collection comprises the best scholarship on how we have perceived diet to affect health. The chapters consider: - the politics and economics of dietary change
- the historical actors involved in dietary innovation and the responses to it
- the extent that our dietary health itself a cultural construct, or even a product of history This is a fascinating and varied study of how our diets have been shaped and influenced by perceptions of health and will be of great value to students of history, food history, nutrition science, politics and sociology.

1

The Pre-History of the Paleo Diet: Cancer in Nineteenth-Century Britain

Agnes Arnold-Forster

Dr Loren Cordain describes himself as the ‘world’s foremost authority on the evolutionary basis of diet and disease’ and as ‘one of the world’s leading experts on the natural human diet of our Stone Age ancestors’.¹ He is the self-proclaimed founder of the Paleo Diet Movement and champions a way of eating that mimics that of our hunter-gatherer forbears. As its online advocates perform their commitment to this arcane way of eating through the very modern mediums of blogging, Twitter and Instagram, the popular Paleo diet and its cousins seem closely tied to the peculiarities of the twenty-first century. And yet, the Paleo premise is not new. In 2014, Cordain published an article on his website, titled ‘Breast Cancer and Other Cancers: Diseases of Western Civilization?’² In it, he claims that cancer was ‘rare or non-existent in historically studied hunter gatherers and other less westernized peoples’. In support of this, he quotes various early-twentieth-century authorities, including the Nobel prize-winning physician Dr Albert Schweitzer, who wrote on his arrival in Gabon in 1913, ‘I was astonished to encounter no case of cancer . . . This absence of cancer seemed to me due to the difference in nutrition of the natives as compared with the Europeans.’³

This quotation, which Cordain takes as near-irrefutable evidence, provokes him to insist at the end of the article, ‘Any way you look at it, the Paleo Diet is a good remedy to prevent cancer.’⁴ It is unusual for someone positioning themselves as a contemporary scientific authority to make use of, and directly quote, historical sources – not as errors to be refuted but as evidence for their claims. What are not unusual, however, are the assumptions that underlie the cancer-preventing claims of the Paleo diet. It is a well-known, if ill-supported, trope that cancer constitutes a ‘pathology of progress’ – an unintended consequence of modernity. Or, as Charles Rosenberg puts it, ‘The notion that the incidence of much late-20th-century chronic disease reflects a poor fit between modern styles of life and humankind’s genetic heritage.’⁵ His seminal article on ‘the idea of civilization as risk’ identifies a tendency on behalf of late-twentieth-century critics to point to the ‘structured asymmetry between a body evolved in Paleolithic conditions and the late-twentieth-century environment in which that body must maintain itself’. However, he suggests that the conventions of this argument – that the ‘change from savage to settled rural and then to urban life brought with it conditions increasingly inimical to the body’s requirement for diet, exercise, and stable emotional surroundings’ – were already established by the end of the eighteenth century.

However, while Rosenberg devotes considerable attention to the nineteenth-century origins of the ideas about the perceived health dangers of urban, industrial society, he focuses on infectious diseases and emotional disorders. Cancer and other chronic diseases, he argues, are instead assumed to be products of the last 50 years, ‘At the end of the twentieth century, many of the same themes and anxieties have recast themselves in rather different form. Our most invisible anxieties have surfaced in regard to chronic disease, not neurosis or hysteria.’⁶ Rosenberg is not alone in locating our preoccupation with cancer as a problem of civilization in the late twentieth century and neglecting its nineteenth-century genesis. While Roy Porter called cancer ‘the modern disease par excellence’ and Siddhartha Mukherjee described it as ‘the quintessential product of modernity’, they locate that modernity firmly in the post-war period.⁷ Thus, cancer in the nineteenth century – in general – also remains understudied.⁸ What work that has been produced on the disease’s history has predominantly focused on the twentieth century. This asymmetry can be partly explained by the ways in which cancer has been constrained by a version of periodization that serves to tie certain maladies – or malady-types – to specific epochs. Medical historians, epidemiologists and demographers have conceptualized the nineteenth century as the ‘epidemic century’, with infectious diseases and their control occupying the forefront of historical investigation. This periodization is most clearly articulated by Abdel Omran’s ‘citation classic’, published in 1971, on the theory of epidemiological transition.⁹ He posited three phases: ‘the age of pestilence and famine’ – roughly corresponding to medieval and early modern Europe; ‘the age of receding pandemics’ – the long nineteenth century; and ‘the age of degenerative and man-made diseases’ – intimately associated with civilization and the development of ‘modern’ healthcare and medicine.¹⁰ Diet is at the centre of this narrative. Civilized ways of living bring civilized ways of eating – which, in turn, bring civilized diseases.

Yet, and as Cordain has noticed, the idea that ‘civilized’ ways of eating made certain races more susceptible to cancer has its roots in the nineteenth century. The collection of vital statistics in Britain from the 1840s onwards suggested to troubled observers that cancer’s incidence was increasing exponentially. This perceived ‘cancer epidemic’ captured the medical and lay imagination, and provoked intense debate. Even the fashion magazine Vogue despaired, ‘It is sad news indeed that cancer is increasing at such a rate.’¹¹ This chapter thus explores fin-de-siècle debates about the relationship between industrialized or civilized life and cancer incidence to address this historiographical lacuna. Specifically, it argues that British discourse about the ‘cancer epidemic’ orbited around anxieties over social and economic progress and attendant dietary change. This discourse centred on two questions. First, had the broad chronological sweep of civilization – from hunter-gatherer to Western industrialization – made certain races more or less susceptible to cancer? ‘Negro’ communities (in nineteenth-century parlance) appeared to be immune to the disease, whereas Anglo-Saxon races – situated at the apex of Victorian conceptions of civilization – seemed particularly prone. Could the answer to this hierarchy be found in their food? Second, had more short-term shifts in diet dramatically effected the cancer incidence of certain countries? For example, had changes in diet following the Irish famine (increase in processed food and low-quality American meat) accelerated Ireland’s cancer susceptibility?

Various historians have observed that this period witnessed an increased awareness of food as a potential vector for disease.¹² Moreover, some scholars have recognized the close historical relationship between diet and cancer. For example, David Cantor has argued that for many early-twentieth-century Americans, cancer was a disease of nutrition and particularly a product of meat consumption.¹³ Similar ideas circulated in fin-de-siècle Britain. Like Cantor, I argue that the close connection between cancer and diet was in part a product of how practitioners and the public understood the disease’s pathology and character. However, while he suggests that this association proved troublesome for later-twentieth-century public health and awareness-raising campaigns, I contend that the causal relationship between food and malignancy appealed to, and was reassuring for, a professional community otherwise despairing at their impotence in the face of this ‘dread disease’.

This chapter is divided into two parts. Part One clarifies what cancer was in late-nineteenth-century Britain and delineates how Victorian practitioners and the public conceptualized its causes, characteristics, and cures. It also provides context to explain the broader connections made between food, diet and malignancy in this period. Part Two shows how fin-de-siècle medical men constructed expansive spatial and temporal hierarchies and argued that the broad chronological sweep of civilization – from the Stone Age to late-nineteenth-century modernity – had structured races’ susceptibility to cancer. Specifically, it looks at how, as diets moved further from ‘nature’, they were thought of as increasingly ‘cancer causing’. Finally, it zeroes in on a specific case study – Ireland after its famine – taken up by late-nineteenth-century observers as an example of how declining quality of food and the increase in the importing of foreign produce were undermining the cellular integrity of a population.

Nineteenth-century cancer

Cancer in the nineteenth century was identified and diagnosed according to its observed adherence to a set of characteristics. It was, like today, defined by its long duration and its irreversible capacity for growth and spread. Those surgeons who felt surface cancer with their hands were well aware that these masses could be later-stage manifestations of an internal disease; or that breast cancer, for example, could spread to the liver or lungs. Crucially, too, it was a material entity – an ‘object’ that could be identified by hand or eye.¹⁴ Cancer was evidenced by the presence of a tumour, accompanied by pain, physical degeneration and disability, and marked by its inexorably increasing magnitude.¹⁵ These identifying characteristics were codified following cancer patients’ admission to the nineteenth-century hospital, after two cancer-specific institutions were set up in 1792 and 1802.¹⁶ The context of the clinic allowed medical men to trace cancer through its life course, making possible extended observations of its duration and its tendency to grow and metastasize. Then, practitioners watched their subjects die with depressing regularity. Thus, the hospital confirmed cancer as an incurable disease that was distinct from other maladies. Early-nineteenth-century surgeon Thomas Denman insisted, ‘Of all diseases deemed incurable, that which is denominated Cancer has been most generally allowed to be so.’¹⁷

While many of these identifying features of the disease might be alien to us today, we can nonetheless meaningfully speak of ‘cancer’ as a broadly coherent and stable disease category in the nineteenth century and before. Historian Alanna Skuse argues that while cancer in the early modern period was predicated on an entirely different way of interpreting the human body and its afflictions, it nonetheless had much in common with our twenty-first-century malady: cancer then is recognizable to us now. She claims that ‘cancerous disease “existed” in the early modern period, in the sense of there being a distinctive malady known as “cancer” which was broadly contiguous with the illness sharing that name today’.¹⁸ In the nineteenth century, too, cancer was a distinct pathological entity that shared physical characteristics with the malady in both the sixteenth century and the twenty-first. This stable profile over time, at least in terms of its meaning if not its experience, only makes cancer’s relative absence from the historical literature more surprising.

While many other diseases ended in death in the nineteenth century, cancer was articulated as superlative – as the most extreme case on a spectrum. The language used by medical men and the laity alike repeatedly reinscribed this special status. Cancer was synonymous with ‘malignancy’ – an evocative term that meant both the ability to metastasize and a being with malevolent intention. Cancer was positioned as a disease that was not only deadly, but also cruel. It was a ‘pernicious’ malady, synonymous with death and decline and feared by doctor and patient.¹⁹ It was, ‘of all the ills to which the human frame is liable’, the ‘most poignant’.²⁰ It was repeatedly designated the ‘crudele opprobrium medicorum’ – the cruellest challenge to the medical profession.

The terms here have a moral inflection, and it was common for commentaries on cancer – or commentaries that used...

Table of contents

• Cover
• Half Title
• Series Information
• Title Page
• Contents
• Illustrations
• Contributors
• Introduction
• 1 The Pre-History of the Paleo Diet: Cancer in Nineteenth-Century Britain
• 2 Nutrition, Starvation and Diabetic Diets: A Century of Change in the United States
• 3 Allergic to Innovation? Dietary Change and Debate about Food Allergy in the United States
• 4 Dietary Change and Epidemic Disease: Fame, Fashion and Expediency in the Italian Pellagra Disputes, 1852–1902
• 5 Conceptualizing the Vitamin and Pellagra as an Avitaminosis: A Case-Study Analysis of the Sedimentation Process of Medical Knowledge
• 6 Food and Diet as Risk: The Role of the Framingham Heart Study
• 7 From John Yudkin to Jamie Oliver: A Short but Sweet History on the War against Sugar
• 8 The Popularization of a New Nutritional Concept: The Calorie in Belgium, 1914–1918
• 9 Nutritional Reform and Public Feeding in Britain, 1917–1919
• 10 The Sin of Eating Meat: Fascism, Nazism and the Construction of Sacred Vegetarianism
• 11 ‘Milk Is Life’: Nutritional Interventions and Child Welfare: The Italian Case and Post-War International Aid
• 12 Like Oil and Water: Food Additives and America’s Food Identity Standards in the Mid-Twentieth Century
• Index
• Copyright Page