Mental health in the 19th century, when soldiers died of homesickness

Abner R Small, a commissioned officer in the 16th Maine Volunteers, was captured by Confederate forces in August 1864 and spent several months as a prisoner of war. In his diary, Small recorded the effects of imprisonment upon his fellow inmates. “They became homesick and disheartened,” he noted. “They … were dying of nostalgia.”

Nostalgia, once regarded as a condition of homesickness, was widespread during the American Civil War. Wartime letters and diaries, as well as post-war memoirs and reminiscences, reveal much about the emotional sensitivity of Civil War fighting men towards their homes.

For the most part, Union and Confederate armies were comprised of young volunteers who were away from their homes and families for the first time. The majority of recruits came from an agricultural or rural background.

While Civil War-era preventative medicine lacked the knowledge to care satisfactorily for those stricken with homesickness, medical experts of the time debated how to manage and alleviate the emotional suffering of their patients.

Nostalgia ain’t what it used to be

The term “nostalgia” was created in a 1688 dissertation by Johannes Hofer, a Swiss medical student at the University of Basel. According to Hofer, Swiss mercenaries serving abroad were particularly susceptible to bouts of nostalgia, especially when reminded of the sights, sounds and tastes of home. These youthful conscripts became anxious, lost sleep and appetite, and suffered from heart palpitations. Though frequently fatal, nostalgia was treatable. The most effective remedy for homesick patients was to be sent home to the Alps.

By the 18th century, nostalgia was no longer a provincial disease. Physicians across Europe studied the nostalgic condition, often advancing different theories on evolving forms of homesickness. Nostalgia became an established pathology, a mental disorder that continued to afflict soldiers separated from home or peoples displaced by the onset of modernity.

Over time, nostalgia became less an acute homesickness for a specific place, and more a sentimental longing for the past. Often partially recalled, nostalgic memories usually invoke pleasant associations and simultaneous regret at the passing of time.

Absence makes the heart grow fonder

The definition of nostalgia as a mental disease, however, persisted. Civil War fighting men attached much importance to home and its associations; a domestic ideal was at the very heart of family life and society. Many soldiers believed they were fighting to protect their homes and communities. Soldiers missed their wives, sweethearts, and mothers.

John Preston Sheffey’s “incurable blues” were exacerbated by the fact that his wife wrote to him only sporadically. By the summer of 1863, Sheffey, a Confederate cavalry officer, admitted he was feeling “intensely homesick”.

“You must write to me ever so often,” he instructed his wife. “If I were to get a letter from you today, I would look for another tomorrow as anxiously as if I had not received one for a month.”

With the outbreak of the war in 1861, many American males were forced to confront extraordinary social and political upheaval as the security and certainty of home life dissolved. It is no coincidence that extensive debate on the subject of homesickness in America was articulated at this time.

Nostalgia was all too familiar to Union and Confederate army doctors and surgeons during the Civil War and they recognised the condition as a legitimate mental disease. The death of Frederic D Whipple, a volunteer from Vermont, was put down to “a clear case of nostalgia”. Doctors asked the recently married recruit about his strange behaviour. He was sent to the infirmary “where, refusing to be nursed, after a few days he died, moaning … all the time, ‘I want to go home, I want to go home’.”

No place like home

Statistics recorded in the multi-volume Medical and Surgical History of the War of Rebellion (1888), show the malaise “developed to a morbid degree” among white Union soldiers over the course of the war with some 5,213 cases identified, resulting in 58 deaths – the statistics also reveal 334 cases and 16 deaths among the Union’s black soldiers.

Unfortunately, no statistics are available for Confederate soldiers stricken with homesickness. Confederate medical regulations published early in the war list nostalgia among “all other diseases”. Given limited scientific understanding, this was perhaps understandable; there were no experts during the Civil War era that specialised in the diagnosis and treatment of mental disorders.

American medical handbooks from the mid-19th century offered broad and wide-ranging definitions of nostalgia, combining both psychological and physiological effects of the malady. A medical report from 1864 in the Confederate States Medical and Surgical Journal, the only journal of its kind published under the Confederacy, noted many Confederate soldiers convalescing in Virginia hospitals were “oppressed with nostalgia”.

Civil War-era doctors and surgeons determined to meet the challenge of the circumstances by facing them head-on. While many homesick soldiers were hospitalised in the short term, only in the most severe cases might a full discharge from the army be considered. Occasionally, doctors assured patients that they would be returned home on a furlough if symptoms persisted. For example, the South Carolina physician and medical essayist Francis P Porcher noted “the promise of a furlough … would literally rescue a sick or wounded soldier from the jaws of death”. A Civil War veteran writing in 1907 recalled the granting of furloughs as a perfect antidote to offset “the gloom of homesickness”. For some soldiers, though, the cure was worse than the disease; the return home was more disappointing, not less.

The importance that 19th-century Americans attached to homesickness reminds us how powerful this emotion can be. If homesickness today is dismissed as a sign of immaturity, we would do well to remember that for earlier generations the significance of home ties offered an important lesson.

This article first appeared on The Conversation (theconversation.com). David Anderson is senior lecturer in American history at Swansea University