A fried-brain sandwich is generally a sandwich with sliced calves' brains on sliced bread. Thinly sliced fried slabs on white toast became ubiquitous on menus in St. Louis, Missouri, after the rise of the city's stockyards in the late 1880s, although demand there has so dwindled that only a handful of restaurants still offer them. But they remain popular in the Ohio River valley, where they are served heavily battered on hamburger buns. In Evansville, Indiana, they are still offered at a couple of "mom and pop" eateries, specifically the Hilltop Inn, and remain a favorite dish, featured at the city's annual West Side Nut Club Fall Festival. Kissner's, a traditional workman's taproom in Defiance, Ohio still owned by the founding family, has offered what their menu now calls their "infamous" brain sandwich since 1928; for years, one instructor at Defiance College would famously hold the last meeting of each class at Kissner's where they would drink beer and he would offer to buy a brain sandwich for any student who would care to try one.
Increased incidence of bovine spongiform encephalopathy (BSE), otherwise known as mad cow disease, since the late 20th century will likely further diminish the remaining appeal of this curious regional dish. Brains from cows over 30 months old at slaughter are no longer permitted in human food in the United States (Hefling, 2004). Some restaurants have taken to serving pigs' brains instead of cows' brains due to BSE concerns. But as pigs' brains are substantially smaller than cows' brains, the amount of preparation required for each sandwich increases. Each brain must be cleaned before being sliced and pigs' brains produce fewer slices.