"[Back in Italy] no one will know what you're asking for if you ask for fettuccine alfredo". Huff Post

To be honest I can't quite remember why I'm writing about Fettuccine Alfredo, but anyway it's a little bit interesting so here I go.
Fettuccine Alfredo - it does almost always seem to be fettuccine and certainly the original was - was created back in 1907/8 by a restauranteur named Alfredo de Lelio. His wife had just given birth to their son Armando and was not that well, so Alfredo cooked her some plain pasta and tarted it up with butter and cheese and pasta water. She liked it so much that she suggested adding it to the menu in their restaurant and before too long it became famous particularly with Hollywood royalty such as Douglas Fairbanks and Mary Pickford. It is said that this particular Hollywood couple were so enamoured of the dish that they gave Alfredo a gift of a solid gold spoon and fork with which to toss his pasta.

For a part, maybe a large part of the popularity of the dish with the Americans was the performance that accompanied its presentation. It was a 'finished at the table' dish - like Caesar salad and all those flambé things. By 1967 Alfredo's son was in charge and his performance was described by one Francesco Simoncini - a restaurant critic I believe.

"[The fettuccine] are seasoned with plenty of butter and fat parmesan, not aged, so that, in a ritual of extraordinary theatricality, the owner mixes the pasta and lifts it high to serve it, the white threads of cheese gilded with butter and the bright yellow of the ribbons of egg pasta offering an eyeful for the customer; at the end of the ceremony, the guest of honor is presented the golden cutlery and the serving dish, where the blond fettuccine roll around in the pale gold of the seasonings. It's worth seeing the whole ceremony. The owner, son of old Alfredo and looking exactly like him, ... bends over the great skein of fettuccine, fixes it intensely, his eyes half-closed, and dives into mixing it, waving the golden cutlery with grand gestures, like an orchestra conductor, with his sinister upwards-pointing twirled moustache dancing up and down, pinkies in the air, a rapt gaze, flailing elbows."
Perhaps it's just as well that Alberto was given the golden spoon and fork, because most of the photographs I found of it being served in the restaurant back then had both Alberto's diving in with their hands, and almost stuffing it into the open mouths of their guests. Not very hygienic.
So even though the fettuccine may well have been delicious it really became more of a tourist dish and attraction than anything else. A fairly crude one at that really, and one which panders to American taste and clichéd ideas about what Italians are like. Which leads to that quote at the top of the page, because although there are now two 'genuine' Alfredo restaurants in Rome, the rest of Italy does not know this dish - they call it Pasta al burro.
Before I get to how you make it, just a little more about the Alfredo story. He had to close his first restaurant because of civic rebuilding, and eventually sold his new version to two of his waiters. This restaurant is one of the two remaining. The original Alberto then opened a new restaurant with his son, who then took over, and passed it to his son and his niece who now runs it as Il Vero Alberto.
Suffice to say that the Americans loved it and took it back to America - and thence to the rest of the world - leading to the Fettuccine Alfredo we know today, which is not really the same as the original.
"Naturally, we Americans couldn’t leave well enough alone, and always seem to want to add to just about everything. So eventually, when Alfredo’s preparation made its way across the Atlantic, someone thought extra butter just wasn’t enough. How about some cream?" Life and Thyme

So much so that today you will find it hard to find a recipe that does not have cream. Nigel Slater has one that he calls 'classic' but it certainly has cream. And it doesn't stop there.
"The Olive Garden has published instructions on its website that include both milk and heavy cream, two kinds of grated cheese, and flour. Ironically, this sort of thing is intended to make it simpler to execute at scale and at home ...
Nutmeg is also a common addition in modern executions, as are pepper and/or garlic; sometimes lemon makes an appearance, and certain versions even call upon egg yolk for an extra creamy, luxurious element to the already decadent sauce." Life and Thyme

Actually Lemon and Thyme are being generous. Most of the recipes I found had all manner of other additions. This one, for example, from Taste which is sort of a yardstick for 'majority' Australia has all manner of other stuff in it - most notably, bacon, herbs and zucchini. Now it might be delicious but it's definitely not Fettuccine Alfredo.
And Fettuccine Alfredo is not the original Fettuccine al burro either because Alfredo tripled the amount of butter he put into the dish, which is why it is sometimes called al triple burro. But that is the only difference. And while Pasta al burro may well be a classic Italian dish that dates back to the 15th century, it is notably absent from virtually all of my Italian cookbooks. Maybe it's because it's really just too simple. In fact Elizabeth David was the only one I could find:
"Fettuccine is the Roman name of home-made egg tagliatelle, or noodles. When cooked, very generous helpings of butter and grated cheese are stirred into the pasta and left a minute or two to melt. More butter, more cheese, on the table. With good unsalted country butter this is a dish worth eating."
But I notice that even she does not include the pasta water, which many say is crucial in emulsifying the cheese and the butter into a creamy sauce. Two 'pure' versions that I found online were from Serious Eats and Bon Appétit both of which are favourite 'go to' online sources for me.
It is interesting though isn't it how a dish evolves? Particularly in the modern era. An ancient dish is picked up by a canny operator and turned into a performance. It is tweaked and fiddled with to pander to American, British, whatever taste until it becomes unrecognisable. Not necessarily awful but something completely different. And then the 'purists' step in and back we go to the roots. Simple is classy these days.
It wouldn't be 'pure' or that other dread word 'authentic' but it would be a good lunch dish to whip up with some leftover pasta you have lurking in the fridge. Indeed I realise that one of my own favourites of this type is actually a sort of Alfredo - with the addition of chilli. And no pasta water. And I do think you need the pasta water to emulsify the sauce, because when I do it with my leftovers, so that I obviously don't have any pasta water, it's just melted butter, and not creamy.