Sally Metzler
Chicago, Illinois, United States

For years, physicians and pundits have deliberated the merits of starving or feeding a fever. Even the novel Tom Jones by Henry Fielding (published in 1749) presents a lengthy discourse on the recommended treatment of fever in regard to nutrition.¹ As the heroic foundling Jones languishes in bed from a head wound, the landlady of the boarding house in which Jones is recovering avers to the doctor that Jones had “an eating fever…for he hath devoured two swinging buttered toasts this morning for breakfast.”² The doctor then proceeds to detail the scientific principles of nourishment and fever:

I have known, people eat in a fever; and it is very easily accounted for; because the acidity occasioned by the febrile matter may stimulate the nerves of the diaphragm, and thereby occasion a craving which will not be easily distinguishable from a natural appetite; but the aliment will not be concreted, nor assimilated into chyle, and so will corrode the vascular orifices, and thus will aggravate the febric symptoms. Indeed, I think the gentleman in a very dangerous way, and if he is not blooded, I am afraid will die.³

Contrary to the doctor’s advice, once Jones regains consciousness, he wisely and adamantly refuses to be bled.

The origin of the adage feed a cold, starve a fever most often credits John Withals, who in 1574 wrote A Short Dictionarie most profitable for Yong [sic] Beginners. Therein he noted that “fasting is a great remedy of fever.”⁴ Yet delving deeper, references—albeit vague—to the medical maxim date back at least as far as Socrates and Hippocrates: “for oftentimes what is good for hunger is bad for a fever, and what is good for a fever is bad for hunger.”⁵ According to Stuart Gallacher, Hippocrates alluded to the debate in his asseveration “As the soil is to trees, so is the stomach to animals. It nourishes, it warms, it cools; as it empties it cools, as it fills it warms.” Further, Hippocrates prescribed a regimen for eating during different seasons, recommending copious food in the winter to keep warm and less fare in the summer to keep cool.⁶ Through the years, opinion vacillated as to the benefits of feeding or starving a fever, and surprisingly today it remains equivocal. At one point, the pendulum swayed to feeding a fever, the most famous example expounded by Irish physician Dr. V. Robert Graves (1796–1853), who during morning rounds instructed his students that a patient with typhus fever had recovered on account of his copious intake of food.⁷

Circling back to Tom Jones, aside from the discourse advancing the merits of feeding or starving a fever, a wealth of other medical inferences enlivens the pages of this magnificently crafted and entertaining novel.⁸ Moreover, anyone embarking today on the journey of travails and triumphs of the dashing foundling will feast at a literary banquet of eloquence, humor, and rare insights into the medical practice of days gone past.

End notes

1. Henry Fielding, The History of Tom Jones, A Foundling (New York: The Modern Library, 1950). All references and citations herewith refer to this edition. The novel was first published in 1749.
2. Fielding, 343.
3. Fielding, 343-4.
4. Mark Fischetti, “Fact or Fiction?: Feed a Cold, Starve a Fever,” Scientific American, January 3, 2014, https://www.scientificamerican.com/article/fact-or-fiction-feed-a-cold/; According to John Sidney Lee, “Withals’s Short Dictionarie became a standard school book. After being reissued by Wykes in 1562 and 1568, it was reprinted for the first of many times by Thomas Purfoot in 1572 with an appendix of phrases by Lewis Evans (fl. 1574) [q. v.]. The volume now bore the title A Short Dictionarie most profitable for Yong Beginners. See Dictionary of National Biography, 1885-1900/Withals, John, entry by Sidney Lee, https://en.wikisource.org/wiki/Dictionary_of_National_Biography,_1885-1900/Withals,_John.
5. Socrates in Memorabilia, III, viii. 7—THE MEMORABILIA, Recollections of Socrates By Xenophon. Socratic Discourses by Plato and Xenophon, translated by J.S. Watson (London: Everyman’s Library, Dent & Sons, 1910), 95.
6. Stuart Gallacher, “Stuff a Cold and Starve a Fever,” Bulletin of the History of Medicine vol 2, no. 5 (May 9, 1942): 576-81. See esp. 579-80; Socrates (Memorabilia, III, viii. 7) [for oftentimes what is good for hunger is bad for a fever, and what is good for a fever is bad for hunger].
7. See Eoin O’Brien, “Dublin Masters of Clinical Expression, V. Robert Graves (1796-1853)” p. 163 in Journal of the Irish Colleges of Physicians and Surgeons vol. 4, no. 4 (April 1975): 161-3.
8. George Dunea, “Tom Jones Medical,” Hektoen International (Summer 2015), https://hekint.org/2017/02/01/tom-jones-medical/