Thoreau, Pulmonary Tuberculosis, and Dietary Deficiency

By Benjamin P. Sandler, MD

Summary: In this provocative letter to the editor of the medical journal Chest, Dr. Benjamin Sandler speculates whether the death of famous American author Henry David Thoreau, who died of tuberculosis at the age of 45, might have been the result of malnutrition he suffered during his years living on Walden Pond. Specifically, Dr. Sandler points to the lack of quality protein and excess of carbohydrate foods in Thoreau’s diet as probable causes behind his infection. From Chest, 1973.

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Thoreau, Pulmonary Tuberculosis and Dietary Deficiency[spacer height=”20px”]

To the Editor:

I wonder if Henry David Thoreau was responsible for his death from pulmonary tuberculosis in his prime at the age of 45? He lived the simple life, did not drink or smoke, and spent much time in outdoor activities. As far as we know, he had no contact with a tuberculous individual. During the two years of Spartan life at Walden pond, from July 4, 1845, to September 6, 1847, he tried to be self-sufficient in all aspects of living and wanted to prove that one could maintain health on a cheap, plain diet. His expenses for food for eight months was $8.74, for such staples as rice, molasses, rye meal, Indian meal, salt pork, flour, sugar, lard, apples, dried apple, sweet potatoes, one pumpkin, one watermelon, and salt. In addition to these foods, he ate potatoes, green corn, and peas, which he raised. He wrote, “I sometimes caught a mess of fish for my dinner, and once went so far as to slaughter a woodchuck which ravaged my bean field…It was fit that I should live on rice, mainly, who love so well the philosophy of India…The reader will perceive that I am treating the subject rather from an economic than a dietetic point of view.”

Thus, Thoreau lived on a quantitatively adequate diet from the caloric standpoint, but on a qualitatively poor diet because of the very small amount of protein-rich foods. For two years, he ate enough to appease hunger and rarely catered to appetite. “Yet men have come to such a pass that they frequently starve not for want of necessaries, but for want of luxuries,” he wrote. The essential and more expensive protein-rich foods such as meat, poultry, fish, pork, eggs, cheese, milk and butter, presumably were the luxuries referred to.

My purpose in this communication is to suggest that Thoreau’s diet during the two years at Walden consisted mainly of foods with high carbohydrate content, chiefly starch, and was woefully lacking in high-quality protein. Based on clinical research in the treatment of tuberculosis with a low-carbohydrate, high-protein diet,1,2 I concluded that the most important factor in susceptibility to tuberculosis was poor nutrition, and specifically a diet deficient in high-quality protein. Individuals who eat to excess to the point of obesity may develop tuberculosis because of deficient protein intake. Among my patients there were several who were obese and who had far advanced cavitary disease.

Faber,3 in an analysis of factors responsible for the increase in tuberculous mortality in Denmark, Sweden, and England during World War I, concluded that the reduced consumption of meat and fish was the most important nutritional factor. He found that “the total calories consumed was not diminished because there was sufficient bread and flour.”

Thus, it is possible that Thoreau developed a tuberculous lesion of minimal extent during the two years on his Walden Diet. The lesion probably became inactive after he left Walden and returned to Concord to live with his family where his diet improved. The lesion could have remained inactive or quiescent until he caught a severe cold in December, 1860. The cold persisted and developed into chronic bronchitis with cough, which lasted all through 1861. His condition gradually worsened and he died of “consumption” on May 6, 1862.

Benjamin P. Sandler, MD
Asheville, North Carolina


1. Sandler BP and Berke R. “Treatment of Tuberculosis with a Low Carbohydrate Diet.” Am. Rev. Tuberc., 46:238–261, 1942.
2. Sandler, BP. “Treatment of Tuberculosis with a Low Carbohydrate High Protein Diet.” Dis. Chest, 17:398–422, 1950.
3. Farber, K. “Tuberculosis and Nutrition.” Acta Tuberc. Scandinav. 12:287, 1938.

[Also cited:][spacer height=”20px”]

The Works of Thoreau. Selected and edited by Henry S. Canby, Boston: Houghton Mufflin Company, 1937.
Derleth, A. Concord Rebel. Philadelphia and New York: Chilton Company—Book Division, 1962.

By Dr. Benjamin Sandler. Chest, Vol. 63, No. 5, May 1973.


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