Women can experience intense food cravings in pregnancy. They plough through pickles, gorge on eggs, fantasise about mustard, and devour entire tubs of ice cream. And if early modern writers and medical practitioners are to be believed, some have been known to hanker after human flesh.
Our predecessors in the 16th, 17th and 18th centuries were keenly aware of the link between pregnancy and food cravings, and devoted a great deal of time to analysing these urges – whether they were for traditional sources of sustenance or something altogether more unusual.
It was widely accepted that, in the words of the popular medical writer Nicholas Culpeper, cravings were one of the “chiefest sign[s] of conception”, and that what followed, according to the author John Sadler, would be “a longing desire for strange meats” (“meats” being a term to describe a range of foodstuffs).
The author of a satirical piece published in 1682, entitled The Ten Pleasures of Marriage, suggested that cravings were so common that “all women when they are with child; do fall commonly from one longing to another”. He complained to his readers – whom he assumed included the husbands of such women – that in the summer their wives would crave “China oranges, sivil lemmons, the largest asparagus, strawberries with wine and sugar, cherries of all sorts, and… plums”. These extravagant appetites were no cause for concern for the pregnant woman themselves, the author wrote. But, he bemoaned, it was a different story for the long-suffering husbands and servants who were required to “trot out” long after dark to procure such delicacies.
In John Webster’s play The Duchess of Malfi, first performed around 1613–14, Daniel de Bosola attempts to discover if the eponymous duchess is pregnant by presenting her with a bowl of apricots, which were known to be a favourite of pregnant women. When she greedily devoured the gift, his suspicions were confirmed and made plain for all to see, as the apricots subsequently brought on the duchess’s labour pains.
An unfulfilled longing
As well as describing (often in great detail) women’s pregnancy cravings, early modern writers spent a great deal of time theorising about what they meant for both mother and child. Some concluded that denying such cravings could have negative consequences for the unborn baby. For example, they believed that an unfulfilled desire for strawberries or red wine could cause the appearance of red birthmarks, what we would now perhaps call a strawberry nevus or strawberry haemangioma. “The woman must not lose her longing, for the child might get a blemish by it,” opined the author of The Ten Pleasures.
Yet, according to some contemporaries, failing to acknowledge and appease pregnancy cravings potentially posed far greater dangers than birthmarks. The 18th-century midwife Sarah Stone, who worked in Taunton and Bristol, described a woman who at eight months pregnant experienced a great “flooding” (loss of blood). Stone believed this was caused by an unfulfilled longing, but her patient staunchly denied that she had wanted for anything. Stone warned the mother-to-be rather emphatically that “both she and the child would doubtless lose their lives, unless she speedily had what she had an inclination for”. At this, the expectant mother finally replied that she longed for nothing “except a Peasecod [pea pod], that she saw a boy hold up against the sun”, after which she started to experience pain.
Stone reported that she had a local gentleman send some pea pods from his garden. Happily, as soon as the woman had eaten them, her bleeding stopped, and she went on to give birth to a healthy son. This might be the only example of an unsated craving causing serious ill health to appear in Stone’s collection of case notes, A Complete Practice of Midwifery, but she was confident that “such things as these frequently happen”.
Unrequited longings weren’t the only craving-related phenomenon to cause concern to medical practitioners in the 16th, 17th and 18th centuries. Early modern authors noted that some women displayed an excessive desire for nutritious foods – a condition they described as malacia. A translation of a German text, Etmullerus Abridg’d: or, A Compleat System of the Theory and Practice of Physic, written by the Leipzig physician Michael Ettmüller, stated that this entailed a “violent and insatiable longing for usual food, as Herrins, and such like”.
But what if the pregnancy cravings became even more unorthodox? What if they drove the woman to consume materials that we don’t typically classify as food? We know that reports of such cravings reached the ears of early modern writers and that they called the condition ‘pica’. The term ‘pica’ is derived from the Latin for magpie, presumably because those with the affliction collected all manner of bizarre items to eat.
Contemporaries report that women suffering from pica consumed everything from earth and ashes to coals and shells. Yet perhaps most unusually of all, some also apparently developed an appetite for human flesh. Jane Sharp wrote in her 1671 midwifery guide, The Midwives Book, that the seventh sign that a woman was with child was that “she hath a preternatural desire to something not fit to eat nor drink, as some women with child have longed to bite off a piece of their Husbands’ Buttocks”. Daniel Sennert’s Practical Physick (1664) even claimed that one woman, “though she loved him [her husband] very well, [had] killed him, eat part, and powdered the rest” to satisfy her desire for his flesh.
This tendency towards cannibalism was also mentioned in an English edition of Felix Platter’s medical text A Golden Practice of Physick, which warned that “some love raw flesh like meneaters, some have been like beasts and bitten peoples arms by violence”.
Pica was evidently the cause of some consternation in early modern England. But medical experts disagreed as to how damaging the condition was to the sufferer herself. A number of books argued that the very cause of the problem – a build-up of vicious (or diseased) humours in the stomach – allowed women to digest these items safely. According to scientific thought at the time, the body was comprised of a balance of humours – blood, phlegm, yellow bile and black bile – but these humours would corrupt if someone suffered from disease, or consumed too much food or drink that couldn’t be properly digested. One author described how the stomachs of women suffering from pica could “digest without any trouble or harm, a great many noxious and offensive objects”, provided that they didn’t eat in such vast quantities that their bodies were overwhelmed.
However, John Sadler offered a harsher warning about the condition, writing that the “eating of corrupt meates, as in the disordinate longing called pica, unto which breeding women are often subject” could cause a “schirrositie” (hard growths or fibrosis) or hardness to develop in the womb. Jane Sharp was similarly explicit that pregnant women had to be reasoned with, for if they couldn’t be dissuaded from eating such things then they would miscarry.
The idea that pica posed a serious threat to pregnant women endured over the decades, and a 1741 edition of Aristotle’s Works Completed copied Sadler’s sentiment verbatim. A posthumous edition of Michael Ettmüller’s medical treatise likewise offered stark warning about the dangers of this condition. It claimed that though eating “absurd and uncommon things” caused no “visible disturbance” in the short term, over time such a diet caused a build-up of “deprav’d humours in the body”. This could lead to dropsy, cachexies (malnutrition and wasting), and other unpleasant symptoms.
For pregnant women, then, the dire effects of indulging their cravings had to be weighed against the dangers inherent in denying them, which could lead to “bad consequences happening to the child in the belly”. This posed a medical conundrum, one in which women were damned if they did and damned if they didn’t.
But medical practitioners did offer some consolation to pica sufferers. According to the Scottish obstetrician and male midwife William Smellie, the dangers that the condition posed to the baby faded in the fourth month of pregnancy. And, in a bid to reduce the likelihood of pica leading to miscarriage, Culpeper’s Directory for Midwives offered a remedy that “keeps the child from suffering by the mothers appetite”, made from the juice of vine leaves and syrup of quinces.
A taste for chalk and ashes
Pregnant women were not alone in being prone to pica. Medical writers frequently listed the condition as a symptom of green-sickness, which is no longer a recognised condition. Known as ‘chlorosis’ in the 19th century, greensickness was peculiar to adolescent girls and was thought to be caused by the obstruction of menstruation or the retention of ‘seed’ within the body. This excess menstrual blood, it was believed, travelled to the digestive tract where it triggered the desire to consume unnatural foods.
Jane Sharp wrote of greensickness sufferers that they “will be always eating oatmeal, scrapings of the wall, earth, or ashes, or chalk, and will drink vinegar”. Likewise, Robert Johnson’s Manual of Physic reported that they ate “coals, ashes, clay, turfs, leather and I know not what”.
The popular reproduction manual Aristoteles Master-piece (1684) claimed, rather unusually, that it was the eating of chalk, oatmeal, tobacco-pipes, loam, starch, nutmegs, and drinking vinegar that caused the build up of undigested humours in the bowels, which then made the disease difficult to shake off. Consuming such foods, noted Sharp, would lead to girls’ bodies becoming “loose and spongy, and they grow lazy, and idle, and will hardly stir”.
Curing the condition in both unmarried and pregnant women necessitated emptying the stomach of the harmful matter that provoked the cravings. To this end, medical authors recommended that women were purged and made to vomit. Some writers suggested that when the patient was pregnant, ‘gentle’ purges and emetics should be employed. They also advised that the stomach be strengthened with cinnamon water, orange pills and remedies made from coral.
Robert Johnson warned that women who suffered from greensickness for a long time might find themselves infertile. Yet there was a potential cure – one that would relieve their greensickness and, presumably, also their pica, too – and that was to get married and engage in sexual activity. In other words, greensickness sufferers should take their chances with another cause of intense food cravings: pregnancy. Once again, for the young women of early modern England, it was a case of damned if you do, damned if you don’t.
Jennifer Evans is senior lecturer in history at the University of Hertfordshire. Her book Men’s Sexual Health in Early Modern England is set to be published by Amsterdam University Press in 2021
WATCH: Episode four of the seventh series of BBC One drama Call the Midwife addressed the issue of unusual pregnancy cravings. You’ll find it at bbc.co.uk/iplayer