In 1650 the physician Thomas Willis was called to the Falkam household in Oxfordshire on an urgent call. Mrs Falkam, a ‘woman of good family, aged about 20’, was six months pregnant when she ‘fell into an exquisite tertian fever’. The fever, Willis quickly ascertained, was caused by Mrs Falkam’s ‘gulping down uncooked liquid [perhaps vinegar] on account of an insistent pica’. Willis prescribed a vomit and ordered his patient to keep to a ‘strict diet’, forgoing her strange cravings.
The definition of pica has changed very little since Willis’ day, classified today by the American Psychiatric Association as an eating disorder involving the ‘persistent eating of non-nutritive substances’. In 1651 the popular medical writer Nicholas Culpeper differentiated pica from regular pregnancy cravings by defining it as a ‘depraved’ and ‘evil appetite’, the ‘desire to eat absurd things’ including ‘raw corn, chalk, ashes, lime, earth, clay’. Physicians described the archetypal pica patients as pregnant women and girls suffering from menstrual disturbances. In Culpeper’s 1655 translation of Lazare Rivière’s Practice of Physick, pica was depicted as ‘proper and peculiar’ to women due to their ‘weakness of mind, and tenderness’, ‘seldom’ impacting men.
In early modern society the pregnant body stood in an ambiguous relationship to marriage and motherhood. Neither fully mother nor fully wife, it defied the control of both husband and doctor as the invisible child grew in the womb. Before modern medical testing, neither the viability of a pregnancy nor the all-important identity of the father could be fully confirmed, creating anxiety for husbands and doctors.
In this context, pica served as an important – if ambiguous – sign of pregnancy. Following the ancient authority of Hippocrates and Galen, who in his second-century On the Causes of Symptoms had described how pica ‘occurs especially in women affected by bad humours, whenever they are pregnant’, early modern physicians suggested that pregnancy pica was caused by blood diverting to the foetus. Because this refined blood nurtured the child, the natural purgative of menstruation paused, and any remaining ‘impure’ blood could not leave the body. Early modern medical texts therefore consistently blamed pregnancy pica on the corrupted female interior, filled with impurities which threatened the growing child. The French obstetrician Jacques Guillemeau argued in 1612 that pregnant women are ‘stuffed with divers excrements, and ill humours; and according to the qualitie they have, the Woman with child, longeth after the like’.
The secrets of the womb could be hard to interpret, even for trained physicians. While Culpeper considered pica one of the ‘chiefest sign[s] of conception’, it could also indicate or even cause a miscarriage and was occasionally seen as a marker of virginity. This could produce difficulties for both practitioners and sufferers. In The Sicke Womans Private Looking-Glasse, a 1635 text aimed at women, the physician John Sadler acknowledged that ‘the signes of a breeding woman, and of one that beareth a mole [a false pregnancy] are all one’, including her ‘disordinate longing called Pica’. Rivière asserted that even if they did not miscarry, pica sufferers risked bearing ‘diseased, and weak’ children.
Given these risks, physicians writing on the appropriate regimen for pregnant women, including their diet, exercise, and sexual activity, debated extensively about whether women should be allowed to indulge their longings. Asserting that women ‘must master’ their cravings, Guillemeau connected pica to women’s moral as well as physiological weakness. Women were believed to be less rational and more sexually voracious than men, with the Bible teaching that ‘three things are never satisfied: hell, a woman’s womb, and the earth’. The story of Eve eating the apple of the Tree of Knowledge also provided a template for women’s susceptibility to both dietary and moral transgression, fostering a deep cultural suspicion about women’s appetites which can be seen in descriptions of pica sufferers. The 1684 gynaecological treatise Aristotle’s Masterpiece, for example, described pregnant women who ‘covet, and greedily long for things contrary to the Nutriment, as Coals, Rubbish, Chalk, Lime, Starch, Oat-meal, raw Flesh and Fish, or the like’.
The lurid language used to describe pica sometimes tipped into horror; the Golden Practice of Physick (1664) called pica a ‘vicious Appetite’ in which ‘some love raw flesh like Meneaters, some have been like beasts and bitten peoples Arms by violence’, while the term ‘ravenous’ was often applied to sufferers. Some went so far as to suggest that women with pica might engage in cannibalism. Culpeper reported the disturbing case of a pregnant woman ‘that longed for her husbands flesh, and though she loved him very well; she killed him, eat part, and poudered up the rest’.
Culpeper’s cannibal wife was not a one-off anecdote. In Guillemeau’s words, pica in its most extreme form caused women to ‘long after Mans flesh’, and William Salmon’s 1694 translation of Isbrand van Diemerbroeck’s Anatomy of Human Bodies suggested that women with pica sometimes desire ‘the fleshy and brawny part of the Members of a living Man’. Yet while pica was diagnosed and treated in practice, there is no evidence that the cannibalism anecdote was based on a real case. This was a medical moral panic, mapped atop a disorder which impacted real women.
Another factor fuelling this panic might be contemporary concern around cannibalism. Culpeper’s disturbing anecdote evokes the so-called barbarians newly discovered on the borders of European consciousness. At least one work, the dietitian Thomas Muffet’s Health’s Improvement (1655), made this explicit: ‘What is more unpleasant to most mens natures, then the taste of humane flesh? Yet not onely some women with child have longed for it, but also the whole nation of Canibals account it the sweetest meat of all others’.
Seventeenth-century women such as Mrs Falkam really did suffer from pica, and from the few case notes that survive it seems doctors such as Willis were largely sympathetic to their patients. Nonetheless, the moral panic over pica in medical texts says much about early modern attitudes towards the reproductive body, suggesting a deep concern with the power of the pregnant woman: the power over life itself.
Helena C. Aeberli is a PhD researcher in early modern eating disorders at Magdalen College, Oxford.