Popular Science Monthly/Volume 5/June 1874/Nostalgia

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THOSE great changes of place, temporarily, by masses of people, which were brought about by the late war, have drawn the attention of physicians again to a very singular malady, nostalgia, or homesickness, some extremely noteworthy cases of which appeared, particularly among the mobiles collected at Paris during the siege. Indeed, homesickness is a real disease, occasioning a group of symptoms and disturbances of very definite character—a disease the more real, inasmuch as it often ends in death. An eminent physician, who had earlier opportunities as a health-officer in the navy, and lately again as chief of one of the great Paris ambulances, to study nostalgia very closely, Dr. Benoist de la Grandière, has published an essay on the subject which will give us some interesting facts.

Sauvage describes nostalgia by four words—morositas, pervigilio, anorexia, asthenia—which signify sadness, sleeplessness, want of appetite, and exhaustion. The patient very early loses his cheerfulness and vigor, and courts in solitude a surrender to the fixed idea that haunts him, the thought of his country. He dwells in charmed repetition upon the memories connected with the places where his early life was spent, and paints them with a world of dreams in which his imagination shuts itself so obstinately that nothing can call him away from it. He shuns the persons once loved best, rejects all diversions, and is angered by any attempt to console him. The conviction cherished by fancy that he shall never see his country again, and the grief it inspires, bring on disturbances of function which at last affect the whole natural system. His features change, his eyes grow set and dull, his countenance wears a look of stupor, his motions then grow languid, and betray painful indecision of will. Anæmia follows, the skin becomes dry and clammy, the mucous tissues lose color, the secretions decrease, the pulse sinks, and disturbance of the circulation appears. With regard to the digestive functions, the disorder is not less serious; as the patient eats little or nothing, gastric difficulties ensue. In women, chlorosis occurs, with its usual train of varied nervous affections; they neglect their dress and all their interests of emotion, including coquetry; then follow intermitting chills and night-sweats, making what Broussais called the hectic fever, and Larry the dry consumption of the melancholy-mad. At length the intellect and the patient perish together, with a last sigh for the country never again to be seen. The chief and peculiar mark of this neurosis is that the sufferer knows he must die. It often happens that nostalgic patients voluntarily starve to death or commit suicide.

Nostalgia attacks by preference young people and those just entering youth, affecting all temperaments without distinction. It is oftenest remarked among soldiers. During the great wars of the Revolution and the Empire it often prevailed as an epidemic, and scourged our armies with severity. Desgenettes relates that at St.-Jean-d'Acre it added a new complication and a more fatal horror to the plague. On the pontoons at Cadiz and Plymouth, that served as prisons for the soldiers of General Dupont, after the capitulation of Baylen, it killed as many French as died from yellow fever. In Poland and in Russia it intensified all other epidemic disorders. Michel Lévy says that in 1831 the Twenty-first regiment of light infantry, then in the Morea, received a large number of young Corsican recruits, many of whom fell victims to nostalgia, in the hospital at Navarino.

During the last war nostalgia carried off many sufferers among our unhappy prisoners dispersed throughout Germany. It attacked the soldiers and mobiles during the siege of Paris, especially toward the close of it, when privations and successive defeats began to reduce the most robust organizations. Many of the cases of nostalgia then observed in the hospitals and ambulances presented a really piteous sight. One instance we personally saw. The 4th of January, 1871, the young Marquis R——, aged twenty-four, a mobile from Finisterre, entered the Bicêtre military hospital. He had a slight varioloid and a bronchial complaint, which were certain to be cured, and actually were so. Yet this illness gave him slight concern; he was the victim of other anxieties. He ate hardly any thing, and spent his time in tears and prayers, refusing all efforts to distract or console him. On the 10th of January all symptoms of disease had disappeared, but his emaciation had so increased, and the sinking of his moral force was so alarming, that the house-physician thought it his duty to remonstrate kindly with him. Two soldiers and a nurse were placed in attendance on him, who talked with him constantly in the Breton dialect, about his country and his family. All these methods failed. On the 16th, when examined again by the physician, the young patient sighed sadly, and, with tears in his eyes, expressed himself nearly in these words: "It is all over; I am very sure of it; I am going to die, and you will not succeed in preventing it. I had never left Brittany; I was satisfied, rich, and happy; my father died without ever having been severe with me, leaving me always to do as I chose. I refused to go to college, and was educated at home; I grew up under the cure's training and instruction, and led the careless, pure, and honorable life of a Breton gentleman. Who would have told me that I should ever leave Finisterre, and come to die in a hospital-bed at the gates of Paris! I was sure of it, the day I left Brittany, that it was all over with me. I was at Villiers, at Champigny—I fought there, doing as the rest did, but God refused to take me. He chose to try me yet more, and I bow to his holy will. If you knew how I suffer! Never to see my mansion again, nor the forests, nor my flocks, my horse, and my dogs! May God shorten my misery, and pardon my weakness! How loud the guns sound this morning!—the building will be battered down—do not stay here—my last hour is near, and I wish to make ready for death as a good Christian." The 23d of January the patient's pulse was at 110, his skin dry, his eye brilliant, his mind wandering, and on the 28th, at ten in the morning, he died.

Benoist de la Grandière gives some curious details about nostalgia in different nations. The French, precisely because they are more attached to their country than any others, and feel a passionate aversion to expatriation, are the very ones whom nostalgia most readily attacks. The inhabitants of the western departments, particularly the Bretons, and next to them those of the southern provinces and of Corsica, are remarkably predisposed to it. The very religious life, the manners so unchanging and the customs so characteristic which have continued so long in Brittany, create bonds not to be severed without danger between the soil of ancient Armorica and its inhabitants. The Swiss, too, love their country warmly, and never quit it but with regret. Nostalgia is not uncommon in Italy, particularly since the transfer of conscripts from one end of the kingdom to the other has become the practice. Between 1867 and 1870, the Italian Army showed a total of 203 cases of positive nostalgia, eight of which were fatal. The English and the Germans leave their country with less reluctance. The English, above all, are spared nostalgia through their adventurous spirit, and it may be said that their country is wherever the British flag floats. The cosmopolitan character of the Germans is less positive. During the late war, nostalgia found quite a number of victims among the soldiers of the Landwehr; and, on a late journey to Alsatia, I satisfied myself that it affected the soldiers from Silesia and Pomerania.

Sagar says that love of country is strongest with those who are nearest to a state of nature. This is quite correct. Savages, men living under the rudest forms of civilization, in the most uninviting climates, grieve when they quit them. Foissar relates that a Lapp, brought to Poland, where every kindness was shown him, was seized with incurable sadness, and at last escaped and returned to his inhospitable country. Greenlanders who had been taken across to Denmark, risked certain death by trusting themselves to slight canoes to cross the ocean separating them from their own land. Similar facts have been observed among the North American Indians. Albert mentions the story of a young squaw, Couramé, a foundling in the forest, adopted by a rich family. "Take me back," she exclaimed, "take me back to the land where I was born. O mother! have you quite forgotten me?" Couramé fell ill, and wasted away. One day, falling in with some Indians of her tribe, she made her escape with them. Strange affinity! that unconquerable attachment of man to the soil, the climate, the aspect of the narrow-bounded region in which his childhood had been spent! What an argument to oppose to our international and humanitarian philosophers!

What, then, is this strange disease? Most physicians class it as a variety, one form, of insanity, a sort of mania or melancholy. Benoist de la Grandière does not so regard it; he discovers in it a nervous affection of the organs through which imagination and memory act. The very clear distinctions which he points out between nostalgia and other kinds of mental derangement justify his way of viewing it. Indeed, the nostalgic patient has no such senseless or extravagant notions as madmen have. He never fancies himself possessed of a devil, or changed to a wolf or a dog. He is not swayed, as are the melancholy-mad, by the dread or terror of some imagined ill. On the other hand, the subjects of mania, or hypochondria, are usually in good health; in spite of their deranged intellects, they retain their strength and good condition. The deep sadness of the nostalgic patient, on the contrary, produces its first effect by changing the functions of nutrition in him, and causing disturbances that are often fatal to life. The various conditions of insanity are hereditary, while nostalgia never is so. Besides, the especial characteristic of this disorder is that it may be cured with absolute certainty, when the troubles it has brought about have not yet endangered the health; restoring the patient to his family effects a complete cure. On the contrary, the attempt to satisfy an ambitious madman's dreams of greatness or of wealth, far from lessening his mental derangement, will only give it new violence.

Whatever the nature of it, there is but one way to cure the unhappy creature whom love of his country consumes and destroys, and that is to send him back to his own land. Where that remedy is not possible, and fortunately that is not often the case, the medical treatment of nostalgia is limited merely to moral and hygienic palliatives. The very first duty of physicians, whenever the causes of nostalgia seem threatening, is to adopt preventives of its fatal influence. With this object, it is essential to employ actively and to divert in all possible ways soldiers and sailors who are taken to a distance from their country. It seems to be settled, moreover, that nostalgia is far less common in the navy than among the land-forces, and the fact probably depends upon the careful attention with which officers of the navy exert themselves to provide for the amusement of sailors, and to guard them against ennui. Nothing is so gay as a vessel's crew. Discipline does not suffer by it, and obedience is only the more prompt. "A ship without singing aboard," says Foussagrives, "always leads us to suspect the moral government it is kept under." During the Chinese campaign, on board the Forbin, whose crew was entirely made up of Bretons, all important manœuvres were gone through with to the accompaniment of the national biniou.

In the case of nostalgic patients whose illness results from the isolation they are reduced to by the language they speak, association with people who speak the same tongue is often one of the most effectual remedies. Esquirol, remarking that all the Bretons placed in one of the halls of the Salpêtrière showed more serious symptoms than patients occupying beds in the other wards of the hospital, directed students from Brittany to be stationed in that hall, requesting them to talk in a friendly way in their native dialect with their compatriots. No other treatment was needed for the cure of nostalgic cases. During the siege of Paris similar facts often occurred. In the ambulances, countrymen, particularly Bretons, were remarked growing perceptibly thinner and weaker. The physicians questioned them but got no answers, as they understood only their provincial dialect. Some one was found at length who could talk with them in that dialect, console them, and cheer them up, and the poor wretches visibly regained strength and hope. When all expedients have failed, and circumstances forbid the patient's return to his own country, there are still devices of stratagem that may improve his case. During the investment of Mayence the physicians sent word to the soldiers swept off by typhus and nostalgia that the general-in-chief had obtained from the besiegers a free passage for convalescents. The hope revived the courage of many among these unfortunates. Marceray cured a monk employed in a military hospital by making him read a fictitious letter containing permission from his superior to return before long to his convent. The case is the same with nostalgia as with other nervous affections, in which drugs are almost wholly powerless, and no improvement can be expected from other means than from skillful and judicious moral intervention on the physician's part.—Revue des Deux Mondes.

Note, by the Editor of the Revue.—Circumstances have prevented the earlier publication of the foregoing sketch, which has been for some time in our possession. It is the last one sent us by one of our most sympathetic fellow-laborers, whom death removed suddenly and prematurely from his friends, the 2d of January, at the age of twenty-six.

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