Livermush is such a part of the North Carolina culture that there's an entire festival devoted to it. "Livermush Expo" is generally held in October in the town of Shelby (but you'll also find smaller livermush festivals in the towns of Drexel and Marion).
What is livermush?
Primarily consisting of pig liver and cornmeal, and generally seasoned with sage and black pepper, it's all formed together in a rectangular loaf. Livermush is made up of pretty much what's left of the pig after the good parts are taken. It's not far from scrapple you find in Mid-Atlantic states like Pennsylvania and Delaware. The only difference is scrapple has a little less cornmeal, and a different amount of liver. Scrapple could have more, less, or even no liver at all. As the name implies, liver is a required part of livermush. You'll pretty much only find livermush in North Carolina, and a little of South Carolina and Virginia.
Where did livermush come from?
If the question is where does livermush come from, just take a look at a few of the ingredients listed above: head parts and pork liver. I think the specifics are best left unsaid. But if you're asking where did it come from, as in the history of it, that's an easier answer. There are a few different theories as to how this regional dish was born. The first is that it became popular in rural North Carolina during the Civil War. Simply out of desperation, and not wanting to waste anything edible, locals took generally unusable pig parts into a ground mix. Another theory claims that the meat became a staple during the Great Depression, because it's cheap to make, and can prepared in a variety of ways for breakfast, lunch and dinner. Both of those theories hinge on the fact that livermush is fairly inexpensive and can be prepared in a variety of ways. While both of those stories probably hold true, ultimately, historians think that the mixture was probably brought to the Appalachian mountains by German settlers who came down from the Pennsylvania region, which explains why you find scrapple a little further north.
How to make livermush
Livermush isn't something you usually "make" on your own. There are a few recipes online, but that's generally left to the professionals. Nevertheless, if you do want to try your hand at it, there are a few recipes here and here. The most common way to prepare livermush is to cut a slice off of a block, and fry it until it's golden brown. It's then served for breakfast, alongside eggs or grits. It's also popular as a sandwich meat for lunch or dinner, and plenty of people swear by putting a slice on a bun with grape jelly. You'll sometimes find it as an ingredient in omelettes and as a pizza topping.