The first modern recipe for the dish was included in cookery writer Elizabeth Raffald's 1769 book The Experienced French Housekeeper.
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In the Canton of Uri, the potatoes are traditionally omitted, and in some regions, bacon or ham is added.
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Similar recipes for macaroni and cheese occur in the 1852 Hand-book of Useful Arts, and the 1861 Godey's Lady's Book.
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In Scotland, a macaroni pie is an open pie containing macaroni and cheese, often derided for being characteristic of the stodginess of much Scottish cuisine.