The doctor had a serious problem. And he had a pretty good idea why it was happening.
Diarrhea was running rampant among Union Civil War soldiers. It was more than the temporary discomfort we know today. Treating it was a major challenge. Pepto-Bismol and similar drugs wouldn’t hit the market for decades. But the disease wasn’t waiting.
Some 1.6 million cases were reported in the Union army alone. It claimed the lives of 50,000 soldiers. That was the same strength as 10 brigades, or two full divisions. Not to mention the tens of thousands of other soldiers hospitalized with the ailment. Diarrhea was seriously depleting Union ranks.
The good doctor had a hunch about why so many guys were getting sick. It was because of what they were eating. And he knew a thing or two about diet and its effect on health.
Just 38 when the war broke out, the New York state native had started his career as a chemist. He went on to earn his medical degree in 1850, topping it off with a master’s degree (a major accomplishment at the time) two years later. Along the way, he developed a fascination with dietary habits and how the food one ate helped determine how one felt.
When the Civil War commenced, he put on a blue uniform and served as an army surgeon. That was when the widespread diarrhea crisis caught his attention. It didn’t take long to pinpoint the culprit.
Hardtack was the foundation of the enlisted man’s diet. It was shaped like a modern soda cracker, though it was much larger and quite thicker. A flour, water, and salt concoction was baked rock hard to prevent spoiling. It was so hard, in fact, soldiers often boiled it in water just to make it edible. Men with dental issues even broke their teeth biting it. Nevertheless, Washington shipped tons of it to feed the guys at the front.
Hardtack was very high in carbohydrates, and that was the problem. The doctor was a strong proponent of a high-protein diet (he was Paleo when Paleo wasn’t cool) and thought fruits, vegetables and cereals should be strictly limited. He believed if you wanted to be healthy you should eat meat — and plenty of it.
To treat patients with diarrhea, the doctor had beef ground up, shaped into patties, and broiled. He fed it to them three times a day and had them wash it down with hot water or coffee, which he was certain cleansed the digestive system. Sure enough, many patients became regular again. The doctor knew he was on to something.
He continued studying the connection between good eating and good health after the war. In 1888, he even started a national health fad when he published “The Relation of Alimentation and Disease.” (Note: The book is filled with scatological descriptions from cover to cover and is not for the faint of heart.) Though it included other health-friendly recipes, his boiled ground beef patties were the star of the show. They became wildly popular. Over time, Americans jazzed them up with gravy, minced onion, pepper, and even a dash of Worcestershire sauce.
When the United States entered World War I in 1917, any food with a Germanic name was suddenly out of favor. Sauerkraut, for instance, became “liberty cabbage” for the duration. So it was the broiled beef patties. “Hamburger” had too much of a German ring to it and a new handle was needed. Thus, the creator’s name was called into service. The doctor was James Henry Salisbury and almost overnight his creation became “Salisbury steak.”
The entrée went on to become a reliable TV dinner staple with millions upon millions of servings consumed by Baby Boomers throughout the second half of the 20th century.
Salisbury steak has fallen on hard times in recent years as Millennials and Gen Zers turn up their noses at the dish their parents and grandparents once enjoyed. But you can still find it in the frozen food section of the grocery store, a forgotten legacy from the time soldiers ate it to prevent mad dashes to the privy.