nostalgia and civil war and symptoms of nostalgia and stages of nostalgia

By the beginning of the 19th century, then, nostalgia had been described by many European physicians. It was either a disorder of the imagination or a condition brought upon one by changes in altitude (though this latter theory was quickly losing its appeal). It was most common among armies and especially among those men either forcibly conscripted or far away from familiar circumstances.

Just as the 19th century supplemented the 18th century quest for system with a desire for development or stages of a phenomenon, so a 19th century French military surgeon, Dominique Jean Larray, wrote about the "stages" of nostalgia. In stage one the mental faculties underwent a change--an exaggeration of the imaginative faculty. People tended to exaggerate the pleasantness of the thing that they have left behind. The termperature of the head became elevated, the pulse sped up, rapid body movements followed and then, finally, the patient lost all energy, and stretched and sighed. In the second stage the patient had a fever and symptoms of gastritis. Finally, in the third stage he became greatly weakened with mental depression, indicated by weeping and groaning. In this last stage life often became a burden. Sometimes the patient was even known to commit suicide.

Though the physicians tried to break down the course of this illness as mentioned, their treatments weren't much more sophisticated than mentioned by Hofer in the 17th century. One authority mentioned the importance of "gymnastic amusements" and some mode of "useful instruction." Martial music was helpful to cheer the spirits, at least during hours of recreation. Whatever could serve to elevate the spirits of the soldier must be pursued. We can see from this description both the seriousness of the condition and the relative helplessness of the medical establishment to do anything about it.

Nostalgia Comes to America

American physicians of the 19th century surely couldn't go beyond their European counterparts either in diagnosing the condition or prescribing a treatment regimen. But the American experience of nostalgia in those days would primarily be manifest in two ways: among the "pioneers" who left all they had in the East to journey to the Middle West and West Coast and among soldiers in the Civil War. Of the former we know little, I believe. Or, to put it differently, I wonder if we have physician records from the pioneer period that diagnose people's homesick condition as nostalgia.

But we know more of the issue of nostalgia and the Civil War because the Surgeon-General's Office of the US War Department compiled a Medical and Surgical History of the War of the Rebellion 1861-65. In this official medical history of the war, 5,213 cases of nostalgia were reported among the white troops of the North during the first year of the war. This was a nostalgia-rate of 2.3 cases per 1,000 soldiers. In the second year the number was more alarming--3.3 cases per 1,000 soldiers. The Surgeon General, Dr. William A. Hammon, noted these numbers and had this to say:

"In regard to the age at which recruts are received into service, a change is imperatively demanded, both for the interests of the Army and the welfare of individuals. The minimum is now fixed at 18 years, and it is not uncommon to find soldiers of 16 years. Youths of this age are not developed, and are not fit to endure the fatigues and deprivations fo the military life. They soon break down, become sick and are thrown upon the hospitals. As a measure of economy, I recommend that the minimum age of recruits be fixed by law at 20 years" (quoted by Albert Deutsch in his account of military psychiatry during the Civil War in One Hundred Years of American Psychiatry, 373).

Another Army surgeon, J. T. Calhoun, commented on the problem of nostalgia in an 1864 paper read to the Medical Society of the second division, third Corps, Army of the Potomac. He observed that instances of nostalgia were so prevalent among northern troops because of four causes: (1) hasty enlistments; (2) a sense, betrayed by actual circumstances, that the war would be of short duration, (3) service far from home, especially deep in the South; and (4) the penchant among soldiers for writing letters when they were far away from home. That is, Calhoun asserted that the Union literary instinct, celebrated in such mini-series' as Ken Burns' epic Civil War, encouraged by officers as a means of keeping close to family, actually had the effect of further increasing the yearning for home. As a result, Calhoun encouraged a generous furlough system instead of the then-current arrangement where soldiers only got home leave for severe injury or emergencies at home. I don't know what happened to these recommendations; I would assume, however, in the rough and tumble days of 1864-65 that no one was going home for anything less than serious physical injury.

Conclusion

Nostalgia, the condition that had bulked so large in medical psychology of the preceding two centuries, then faded away remarkably quickly after the Civil War. Perhaps it was a greater sense of mobility in the European/American cultures. Perhaps it was the disappearance of large-scale wars until the 20th century. Most likely it was a result of the increased "scientific" emphasis in the medical profession late in the 19th century, which led to the abandonment of this kind of generic diagnosis in favor of more precise description and diagnosis. Rosen begins his excellent article by quoting a 1913 statement of Dr. S. Weir Mitchell in an address to the Physicians Club of Chicago on "The Medical Department in the Civil War." Mitchell says:

"Causes of nostalgia, homesickness, were serious additions to the peril of wounds and disease, and a disorder we rarely see nowadays...Today, aided by German perplexities, we would ask the victim a hundred and twenty-one questions, consult their subconscious mind and their dreams, as to why they wanted to go home and do no better than let them go as hopeless."

In other words, under the then-current influence of German psychology or psychiatry, the investigator would probe the symptoms of this homesickness more deeply. Weir was quite skeptical whether this led to more accurate or helpful diagnosis or treatment, but this was the brave new world in which he lived.

And so nostalgia as a medical condition disappeared from our collective speech. I kind of miss that...

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