Appetite and its Discontents: Science, Medicine, and the Urge to Eat, 1750–1950 by Elizabeth A. Williams (review)

Appetite and its Discontents is a fascinating and ambitious book that traces a twohundred-year medical interest in the nature and function of appetite. The book is a welcome addition to historical literature on food and consumption, as it explores how the object of appetite was imagined, debated, and approached by western orthodox physicians and scientists, and how their ideas changed over time. The focus on medicine helps to address a limitation in the historiography regarding how shifting theories about appetite affected treatment and how individuals imagined their relationship with food.

Williams, a cultural historian and professor emerita at Oklahoma State University, brings to this subject a wealth of expertise in the history of gender, medical education, and food. Williams is not only interested in charting advancements in scientific knowledge in this book, but also the effects of bias, misunderstanding, and failure. Drawing on an impressive range of archival records, encyclopedias, and dictionaries, the author convincingly argues that those who studied appetite did so within rigid disciplinary boundaries, which separated the human actor from the science and ultimately delayed the reconciliation of allied knowledge.

The book is organized chronologically and grouped into four thematic sections, chronicling major changes in medical understandings of appetite. In the first section, "Anxieties of Appetite: Created Needs in the Enlightenment, 1750–1800," the author reveals how Hippocratic doctrines informed physicians' interest in medical dietetics and the idea of appetite as an individual experience. However, she also shows that some investigators, inspired by Enlightenment ideals, began to pursue new experiments informed by the scientific method, which challenged long held precepts. The result of this research is the focus of the next section, "The Elusiveness of Appetite: Laboratory and Clinic, 1800–1850." She finds that while ancient principles were slowly supplanted by knowledge generated through experimentation, many physicians remained committed to the individuality of appetite and the influence of the mind on ingestion. The third section, "Intelligent or 'Blind and Unconscious'? Appetite, 1850–1900," explores how some investigators used special instruments to ascertain the somatic source of appetite, while others, influenced by Darwinism and the discipline of psychology, considered the possible effect of animal instinct. The final section, "Appetite as a Scientific Object, 1900–1950," examines the impact of scientific medicine and increasing professionalization on understandings of appetite. Williams shows that somatic explanations for appetite continued to grow alongside psychological explanations, so that by 1950 there was no clear resolution. The author reasonably concludes her analysis in 1950, since the study of appetite diverged into several specialties and sub-disciplines at that time. The Epilogue sets out a useful roadmap for historians to examine the subsequent multiple strands of inquiry.

There are many strengths to Appetite and its Discontents. It is meticulously researched, cogently argued, and thoughtfully presented. Perhaps one of the most interesting case studies explored by Williams is the influence of French physiologist Xavier Bichat and English physician Erasmus Darwin. Williams shows how Bichat's concept of appetite as a fundamental need clashed with Darwin's idea of appetite as a voluntary action. These differing theories forced investigators in various directions and set the stage for deeper inquiries into the nature of appetite. Moreover, Williams effectively demonstrates how class and gender shaped the first medical descriptions of certain eating disorders, such as anorexia nervosa, and the corresponding treatment decisions. These case studies collectively chart the gradual professionalization of medicine and its wider influence on western society.

Appetite and its Discontents will appeal to a wide academic audience. Medical historians will find the author's attention to conceptual frameworks and shifting ideas of appetite especially useful as a reference. In turn, historians studying food and consumption will find the shifting and conflicting theories of appetite valuable for comparative studies. Academics researching eating disorders will benefit from the book's historical grounding and contextualization of key theories. Finally, the author...