Still Life with Fruit, Nuts and Cheese (1613) by Floris van Dyck (Wikimedia Commons)

The Medicine behind food – from starters to desserts 


Think of a traditional European meal. First, you’d have starters, maybe a soup, then your main dish, usually something with meat, then you might have dessert, or cheese – or even both! And, depending on what you’re eating, you might be advised to pair it with different wines, or ale. Of course, how people eat varies widely across time and space and is deeply connected to culture and history. Yet there’s another thing that, for centuries, was central in determining which foods should be eaten, what they should be eaten with, how they should be cooked, and in what order people should have them: medicine. Food has long been thought to be connected to health. “Let food be thy medicine and medicine be thy food”, a quote attributed to Hippocrates, highlights this connection. But that’s not all. If you were living in early modern Europe, the order in which you ate your food was believed to play a crucial role in digestion and your health. Centuries later, despite the fact that medicine has been completely transformed, we still eat in a similar way. You wouldn’t have a bowl of soup after your dessert, would you? So, let’s take a typical Tudor aristocratic dinner as an example and investigate the order in which food should be consumed. 

Humours and Food

It’s important to remember that the way people ate changed much from Henry VII to Elizabeth I – there was the Reformation, changes in medical thinking, and the introduction of ‘New World’ foods. In any case, between the 16th and 18th centuries in Europe, preventive medicine was central to how people thought about health. There was a real ‘culture of prevention’ in terms of medicine, with people trying to maintain good health. This was a time in which books like regimens – guides on how to stay healthy – were very popular, as well as dietary advice books. For those who could afford it, food – from what you ate to when, and how – was one of the best ways to attain the goal of a healthy body. Cookbooks were published as well, full of recipes and advice on how the food should be consumed. Having said that, we also need to keep in mind the way people thought about the body and, therefore, medicine at the time, and that means the humoral theory. 

This was based on traditional Greco-Roman medicine, which was still the basis of early modern understandings about health. The humoral theory has a long history, beginning with the Greek Hippocratic writers in the fifth century BC, being reinterpreted by the Roman physician Galen in the second century CE, and surviving thanks to its translations into Arabic and Latin in the medieval period and being taught in the newly founded universities. Later, the humoral theory was incorporated into vernacular medical texts in the early modern period, like cookery books and popular medical books. It remained the primary way to conceptualise medicine and the body until well into the nineteenth century. 

The humours were fluids or spirits concocted in the stomach in the heat of  digestion, which circulated in the body. There were four humours: blood, phlegm, yellow bile (choler), and black bile (melancholy). All bodies contained the four humours but in different proportions, which could vary according to gender, age, and the season of the year. Each person had a different combination of humours, which determined their temperament, personality, and physical health. But that’s not all. This ancient way of understanding the body was also applied to food. So foods could be characterised as hot/cold and dry/moist, to different degrees. And that’s where it gets interesting. Foods deemed hot, such as spices and red meat, could be used to treat an excess of phlegm or melancholy, heating the body. (For the same reason, they could act as aphrodisiacs.) On the other hand, cucumber and melon would be appropriate to counteract an excess of yellow bile. But even if you weren’t trying to treat an illness, the humoral theory understood health as a balance. So, food could be ‘corrected’: hot and dry spices such as black pepper and nutmeg could make salads less cold and moist. But herbs and spices, condiments and seasonings were not the only ways to correct potentially harmful food. Moist foods could be dried out by roasting, and dry foods could be made moister by being boiled. How you prepared and paired food mattered, as it could alter its qualities and make it healthier. (Read more about the humoral theory here.)

Spices could also preserve food, and many of the recipe books published in this period have recipes to make foods last longer to feed people during winter – just think of strawberry preserves or plum chutney, or even cured meat. Medical writers of the time, such as Hugh Plat, made a parallel between the preservation of food and preserving the body, keeping it healthy. These spices were believed to have medicinal properties and, as it turns out, many of them, like cinnamon, actually do. If food was meant to preserve health, people were advised to eat food that mirrored the quality of their bodily humours. Those who were ill required a different approach, to correct the imbalance in the body through foods with opposite humoral qualities. But you might be thinking – how did people determine these humoral qualities of food? Well, it was a mix of relying on tradition and the ancient authorities, such as Galen, Pliny the Elder, and Aristotle, and by observation, by what the food tasted like. For instance, cucumber being defined as cold and moist is hardly surprising. With the arrival of new foods from the New World, physicians characterised them based on the same humoral framework. And to make things easier, popular books of the time offered readers a humoral breakdown of different foods, along with advice on how to eat them. And here we finally get to the ideal order of eating. For people who could afford to serve many different dishes at each course, the humoral way of categorising food meant that individual people could choose what to eat according to their bodily constitution – which included, besides age and gender, their occupation, country, the weather, the season, and even their social class. And this was not only at court; if we think of the Jesuits, for instance, members of the colleges could choose among several dishes at each course what worked better for their bodies and needs, plus, their taste.

The Cooking Cauldron

Following the writings of physicians like Galen, people imagined the human stomach as a cauldron, which was fueled by the heat of the body. The food that was eaten was then ‘concocted’ or digested in the stomach and turned into a juice (chile), which went to the liver, where it was processed again, and then transformed into blood. From there, the blood went to the heart, and underwent a third concoction, producing bodily matter. But the stomach, just like a cooking vessel, would only work with the heat of the body, which would ‘cook’ or ‘concoct’ the food. Any undigested food would putrify and travel the body, and that was considered dangerous to health, as it would emit vapours, which could affect the brain.

However, from a medical perspective, everyone’s bodily composition was different. Gender, age, occupation, and individual humoral complexion all played a role. According to the humoral theory, men were thought to be hotter and drier than women, who were colder and moister – this was why they were ‘weaker’ than men, both mentally and physically. But that’s a whole other subject. In terms of lifestyle, if you exercised a lot, or had a very physically demanding occupation, such as a ploughman, that meant your bodily heat would be increased, whereas if you were a monk or a scholar peering over your books all day, your body would be much cooler and you would digest food differently. In the first case, a ploughman would have a ‘high heat’ under his cauldron, which meant he would be able to digest lots of heavy foods – just think of the ‘ploughman’s lunch’ you can still have in most UK pubs! A scholar’s stomach would do better with light foods that could be digested easily by their body’s ‘low fire’.

If you think this fire metaphor sounds weird, trust me, it gets weirder. Because things were much more literal than we might think for early modern physicians. This ‘fire’ that cooked the food in the stomach was believed to be underneath it, just like a fire under a cooking pot. That meant that the bottom of the stomach was its hottest part – and that’s where foods that needed the longest time to be digested should go. The foods that would go on top would be cooked much more slowly and gently. And here we get to the logic behind the order in which people who had multiple courses of food ate.

The Ideal Food Sequence

If you were living in 16th or 17th-century Britain, you would probably eat your dinner (or lunch) at around noon and your supper around 5 pm, roughly 5 hours after dinner. Supper tended to be simpler but, in wealthy households, it could be as elaborate as dinner. For medical writers of the time, this meant that the body had had enough time to digest the food and the stomach hadn’t been empty for too long. For most people, supper could mean porridge, made with water, milk, or whey. Still, the staple daily food for most people (95%) was pottage, with endless variations possible depending on the season, availability of ingredients, and, crucially, your budget. This was a stew cooked in a pot over the fire, made with cereals, vegetables, maybe herbs and flavoured by meat or fish if you could afford it, or even eggs and butter. Along with bread (and old bread could be used to thicken pottage), people would drink ale, which was often made at home.

However, for the lucky 5% who could afford it, both dinner and supper were an altogether different affair. And it’s from their habits that we have inherited the order in which we eat today, and which many restaurants follow – especially those with tasting menus. Supper for early modern Britons – at least the wealthy ones – was similar to dinner which they ate around midday: soups/pottage followed by boiled and then roasted meat, unless it was a fish day, tarts and sweets, and then cooked fruit, cheese, and nuts. In prosperous households, there would be two or three courses, each usually consisting of several different dishes. But sumptuary laws, which were created to enforce distinctions between social ranks, determined the way people ate. Sumptuary legislation aimed to control behaviour and maintain the social hierarchy, setting rules for how people should dress and eat. The Sumptuary Law of 31 May 1517, for instance, during the reign of Henry VIII, determined the number of dishes that could be served depending on rank. Cardinals were allowed nine, while archbishops could have eight, bishops were ‘only’ allowed seven, and so forth. The poor should avoid refined foods, as their ‘rustic stomachs’ wouldn’t digest them well – so you can see how medical advice reinforced the social hierarchy. Public officials were to enforce this by inspecting kitchens and dining chambers, although that was probably not easy. These dishes were organised into two or three different courses, and people ate the food in a specific order.

Thomas Muffet, a Tudor physician, wrote how ‘light food of liquid and thin substance and easie of concoction’ should be offered first. So, pottages and soups, which often contained peas, grains, and meat, should be eaten first, as they needed a long time to be digested. You shouldn’t be drinking much at this point, however, otherwise, you might cool down your stomach and make this process harder. Also, if we go back to the idea of the stomach as a pan over a fire, wet foods like these would prevent the others that would go on top of them from ‘catching’ on the bottom of the pan, the stomach.  If, instead, you ate something dry straight ahead, it might just burn, without being properly cooked. It sounds crazy, I know! But many of these ideas do make sense if you accept the premise of the stomach as a cauldron and the humoral theory. Along with the soup, you’d probably have bread, which would help its digestion. And then your stomach was ‘lined’, and you were ready for the next course.

If it was a fasting day – Wednesday, Friday, or Saturday – you would probably have fish. And if it was Lent, you would definitely be eating fish. However, medical writers tended to believe that fish wasn’t as healthy as beef or other kinds of meat. It was too cold and moist, and the humour that predominated in it was phlegm – the same one that was predominant in women. Naturally, then, too much fish could be detrimental to male virility and make men effeminate. If religion allowed you to eat red meat, that was preferable. The main humour in meat would be blood, which was closer to human flesh in its nature and, especially, closer to men’s bodily composition. Not only would meat make for excellent blood, but because it was so similar to flesh, it wouldn’t need to be altered as much in the body to become human bodily matter. This quality of meat meant that, for those who needed extra strength, it was the best nourishment. Soldiers or pregnant people should definitely eat meat. Of course, the kind of meat you ate, if you could afford it in the first place, varied depending on where you were. Greek physicians believed pork to be the healthiest, but British physicians argued that beef was superior. If you were really wealthy, however, you would probably have several kinds of meat on your table. You should eat boiled meat first, as it required more time to be digested. Roast meats had already been exposed to much heat, and so, were already more ‘cooked’. Just think of a restaurant menu: have you ever seen roast meat as a starter? I definitely haven’t. In any case, you weren’t supposed to eat too much of the heavy meat course, otherwise, they would pile in your stomach and the top layers wouldn’t cook properly.

After this main course of meat, you should eat lighter foods, such as vegetables, small pies, tarts and sweets like custards with fruits, and sweets. In terms of vegetables, that meant leeks, onions, carrots, and cabbage, for instance, with oil or vinegar. Root vegetables were believed to be healthier even though pulses like peas and beans were considered the best options in terms of vegetables. This was the best moment to stop and have a drink, probably ale or wine. All the food on top of the soup layer would be making things too dry in your stomach,  so a liquid was required to moisten the whole concoction. If you were a ploughman or had any physical occupation that made your body even hotter, ale was advised, as it was believed to be the most ‘cooling’ beverage. If you were planning on eating vegetables or salads after your meat course, on the other hand, wine was better, as it was a ‘heating’ beverage that would keep the body’s heat up and counteract the effects of something like salad.

The same went for fruits which, like salads, were watery and cooling.  So you should eat them in moderation, lest they make your blood too thin. There were always ways around this though, if you were a fruit lover. Cooked fruits were believed to be more nourishing, especially if cooked with wine. Just think of pears poached in wine, a very popular dish at the time, or baked apples. Fruits preserved in honey or sugar were very popular, too.  Along with the sweets and fruits, you might drink spiced wine or hippocras which, as the name evoking Hippocrates suggests, was believed to improve health. Thomas Muffet wrote that sweets (sweetmeats) were of ‘temperate heat and delight the stomach and the liver, fatten the body, and are digested quickly’.

For this final course of fruits, spiced wine, sweets, fritters, jellies, and cheese, people could leave the table and withdraw to a different room or to the gardens. This was called a ‘banquet’. So, banquet at the time was not a synonym for feast as it it today. Rather, it came from the Italian word banchetto, meaning a bench, over which sugary foods would be served. They became very fashionable among the aristocracy, but the habit eventually spread to wealthy families in general.  These desserts were cold and eaten by hand, standing up and socialising, often in a banqueting house or garden, away from where the main meal, the feast, had been served. As for the cheese, sometimes eaten with nuts, it was thought to ‘close’ the stomach after a meal. And I mean this literally. Cheese would act as a lid ‘sealing’ the cooking cauldron, the stomach, for the food to be cooked properly and to prevent vapours from the watery foods you had (such as from fruits) from rising up and causing issues. You could then have another glass of wine to finish off your meal. 

The thing with cheese – just because I find this topic fascinating – is that it wasn’t popular among the elite in the beginning of the 16th century, as it was often considered ‘poor’ people’s food, but it became increasingly popular. Even then, the nobility had a way of differentiating themselves from the masses: they were fond of hard cheeses, which took longer to prepare, while the populace mostly ate cheaper, soft cheeses. Of course, there were exceptions, but many of these cheeses were imported. That was the case of Parmesan, and the French Angelot. According to Thomas Muffet, a good cheese is ‘neither too soft nor too hard, too close, nor yet spongy, too clammy, nor yet crumbling, too salty, nor yet unsavoury, too dry, nor yet weeping, pleasantly, not strongly smelling, easily melting in the mouth and never burning as it is toasted at the fire’. I love that description!

Final Thoughts… and Cheese

So, because through digestion food ultimately became blood and flesh, it was believed to be central to good health and so eating well was one of the main ways of preventing illness. But, as we all know from watching nutrition advice change constantly today, ‘eating well’ can mean different things. Renaissance medical advice was not homogenous or consistent, as physicians often disagreed among themselves, even though most agreed on certain things, such as bread being the ‘staff of life’, as Thomas Muffet wrote. This was because bread was indispensable to the ‘concoction’ that happened in the stomach. Without bread ‘all other meats [foods] would either quickly putrifie in our stomachs, or sooner pass through them than they should’, which would cause ‘crudities, belly-worms and fluxes’. Very unpleasant!

To eat well, the first thing you needed was to understand the nature and the quality of the food you would eat. Of course, eating this way presupposes the material possibility of making choices; a certain amount of wealth is implied. The knowledge to make these choices was partly based on ancient Galenic and Hippocratic medicine, and partly inherited from medieval writers such as Ibn Sina and Hildegaard von Bingen and, although these texts were either in Latin, Greek, or Arabic, they were starting to be translated into the vernacular languages, such as English, and becoming part of an oral, ‘popular’ culture. Plus, because literacy tended to be connected to social status and wealth at the time, those who could afford to eat such a complete meal – a feast, really – were also the ones who would be able to read all these books that were being published on how to live a healthy life, such as regimens of health, full of dietary advice. In a 1599 manual by Henry Buttes, for instance, there were lists of plants, meat and fish, with their composition according to the humoral theory (things such as their degree of heat and moisture) along with medical advice on their consumption. As medicine changed, this humoral understanding of digestion was challenged, as was the whole idea of the stomach as a cauldron.

Anyway, ‘eating well’ in this period wasn’t just about what you ate; but when and how you ate, and in which order. This deeply shaped social and cultural practices and, although the medical reasons for eating this way have long faded away, along with humoral theory, many of these practices have remained with us. Just think of having cheese at the end of a meal, especially in places like France. Having eaten this way for most of your life, if you grew up in a Western household and went to European restaurants, it becomes so ingrained and natural that we don’t even question it. And yet, like everything, there’s a lot of history behind it, hiding underneath all the pretentious tasting menus that you might expect at a Michelin-starred restaurant.

Early modern physicians believed that a specific order of foods was important, even if in the 17th century there was a shift from more preventive medicine, with curative medicine gaining in importance. And, although naturally many of these recommendations were ignored, medicine lays at the basis of many European cooking practices. Many people took this advice seriously though, as we can see the order in which food was served in menus of the time. In a period in which there was no cure or treatment for many conditions, taking care of your body and trying to preserve health was in many people’s minds, maybe in an effort to control the uncontrollable, which I find very relatable and human.

Still, despite medical advice, there were those who just ate foods that tasted nice, even if they were themselves ‘experts’. One of my favourite surgeons of the time, the Bolognese Leonardo Fioravanti, when writing about Parmesan cheese, admitted how ‘there is no group of people in the world who believes less in medicine than do we doctors, and in the towns, there are no men more unregulated than us, because the things which we forbid the ill we ourselves eat without fear’. In the end, who could resist cheese? Just make sure to eat it at the end of your meal, and let the stomach do its cooking job. 

Primary Sources:

Andrew Boorde, Dyetary of Health (1542).
Alvise Cornaro, Della vita sobria (1558).
A. W., Book of Cookrye (c.1591).
Anonymous, A Noble Boke of Festes Ryall and Cokery (1500).
Anonymous, A Proper Newe Booke of Cokerye (c. 1545).
Henry Buttes, Diets Drie Dinner (1599).
Girolamo Cardano, De sanitate tuenda (1560).
Thomas Cogan, The Haven of Health (1584).
Thomas Dawson, The Good Huswifes Jewell (c. 1596)
Thomas Dawson, The Good Huswifes Handmaide for the Kitchin (1588).
Castore Durante, Il tesoro della sanita (1586).
Elinor Fettiplace, Receipt Book (1604).
Leonardo Fioravanti, Il tesoro della vita humana (1570).
William Harrison, Description of England (1588).
Gervase Markham, The English Huswife (1615).
Thomas Muffet, Healths Improvement (1655).
Baldassare Pisanelli, Trattato della natura de’ cibi e del bere (1586).

Further Reading:

Ken Albala, A Cultural History of Food in the Renaissance (2014).
Noga Arikha, Passions and Tempers: A History of the Humours (2007).
Peter Brears, Cooking & Dining in Tudor & Early Stuart England (2015).
Terry Breverton, The Tudor Cookbook (2016).
Ruth Goodman, How to be a Tudor (2015).
Paul Lloyd, Dietary Advice and Fruit-Eating in Late Tudor and Early Stuart England, Journal of the History of Medicine and Allied Sciences 67(4), pp. 553-586.
Alison Sim, Food and Feast in Tudor England (1997).
Brigitte Webster, Eating with the Tudors (2023).


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