Hektoen International

A Journal of Medical Humanities

“Uncertain disease”: the science of nostalgia

Kevis Goodman
Berkeley, California, USA


Nosology, 1800
William Cullen

William Cullen, the well-esteemed Edinburgh physician and professor of medicine at Glasgow and later Edinburgh, shared the “love of system” praised by no less than Adam Smith, who—not coincidentally—happened to be Cullen’s patient and friend.1 Cullen set out to gather all existing medical nosologies (the disease classifications that imitated Linnaean botanical taxonomies), to provide a synopsis of each and supply his own system to surpass them all. First published in 1769, revised continuously until its author’s death in 1790, and reprinted without interruption well into the nineteenth century, Cullen’s work bore a title that testified to its aspirations to be the key to all nosologies: Nosology, or a Systematic Arrangement of Diseases, By Classes, Orders, Genera, and Species, with the Distinguishing Characters of Each, and the Outlines of the Systems of Sauvages, Linnaeus, Vogel, Sagar, and Macbride.

There was, however, an obstruction encumbering the system, and it bore the name of “nostalgia.” Unlike his predecessors, who had classified nostalgia with melancholia and mania among the mental illnesses, Cullen placed nostalgia in a category that he labeled the “false or defective appetites” (Dysorexiae). There it stood alongside other appetites and desires deemed pathological: bulimia (“appetite for a greater quantity of food than can be digested”), polydispsia (“preternatural thirst”), pica (“a desire of eating what is not food”); satyriasis (“excessive desire of venery, in men”); nymphomania (“uncontrolable [sic] desire of venery, in women”); nostalgia (“in persons absent from their native country, a vehement desire of revisiting it”); anorexia (“want of appetite for food”), and more.3 As if aware that something was awry, however, Cullen added a footnote at the bottom of the page that included the first of the Dysorexiae, acknowledging that “Nostalgia alone, if it be really a disease, cannot properly come under this class, but I could not well separate this uncertain disease from the other Dysorexiae.”4

What was nostalgia at the moment that it snagged Cullen’s system? The word had been coined in 1688, from the Greek nostos (homecoming) and algia (pain or suffering), by a Swiss physician, Johannes Hofer, who sought to give the German vernacular expression for homesickness (Heimweh) international prestige and a place in contemporary medical writing.5 It soon became the widely used medical term for a wasting illness prevalent in wartime, maritime travel, and global expansion, sometimes so acute as to be thought a cause, direct or indirect, of death. During the century and a half following Hofer’s description, the topic had a substantial presence in the manuals and narratives of physicians and officers from many nations, traveling aboard ships, in armies, and on voyages of exploration. It was simultaneously a matter of great concern in the medical centers of Europe, Britain, and America. In France, it often went by the name of maladie du pays; in Britain it sometimes merged with other seafaring illnesses, such as calenture and scurvy, to form composite illnesses such as “scorbutic nostalgia.”6 Because the eighteenth-century life sciences, profoundly influenced by Newton’s physics and materialist in emphasis, did not separate diseases of the body from those of the mind, and psychology was not yet a separate field of study, nostalgia acquired an extremely detailed physiological profile of symptoms. With a fitting symmetry between the historical conditions of the disease and the language of concurrent medical writing, nostalgia was said to consist of disordered internal—neural and muscular—“motions.” It was thus motion sickness in a double sense: the corollary of a radical increase in the mobility of persons and populations, in turn represented as the decreased or irregular motions within bodies.

Of course, longing for homecoming existed before Hofer and 1688—we have The Odyssey to prove it. However, its pathologization as a disease with a developed medical profile was new, signaling that this longing for return had become a problem, in need of a remedy, as it had not been before. Nostalgia was a disability of modern mobility, and, in a world order increasingly premised on mobility, it did indeed seem a “false appetite” to many. For political or economic leaders of the several nations and their military or naval personnel, it seemed a serious practical impediment to empire and expansion, especially since its sufferers were not primarily nobility (like Odysseus) or scholars (associated with melancholia) but the dislocated and the dispossessed, many more in number: peasants, soldiers, sailors, the newly urban poor, and the homeless everywhere. Cases of the disease reached epidemic proportions during the French Revolution and Napoleonic wars, partly because of the movements of massive armies across nations, followed by the refugees they dislocated, and also, in part, because of the sense of radical discontinuity that attended the political overthrow of the French monarchy and the regime changes unfolding across Europe.7 Military generals and surgeon-generals complained that their men were not dying on the battlefield for their country but, instead, either deserting or dying off the field from their desire to return to it. British navy captains and ship doctors reported that nostalgic sailors at sea, watching for their absent home, saw its green fields in the waters beneath them and threw themselves in. The scene became a popular topos, picked up by literary authors and poets, as in William Cowper’s popular verse narrative, The Task, where a sailor dreams of home:

            his blood inflam’d
With acrid salts; his very heart athirst
To gaze at Nature in her green array.
Upon the ship’s tall side he stands, possess’d
With visions prompted by intense desire;
Fair fields appear below, such as he left
Far distant, such as he would die to find—
He seeks them headlong, and is seen no more.8

Nostalgia was thus about the uncertain present before it was about the past. Modernity’s “unwelcome double,” as Peter Fritzsche has called it, it represented a form of protest, a refusal to accommodate “things as they are” (the title of a 1794 novel by William Godwin) or to move on.9 No one, perhaps, knew this better than the physician J. G. Zimmerman. Writing in a 1778 treatise entitled Experience in Physic, and arguing against the premise that nostalgia is specifically a Swiss sickness, Zimmerman unexpectedly swerved from his argument, with the following comment: “Every Swiss feels, as I do, the Nostalgia, under a different name, tho’ at home, whenever he thinks he should live better in any other country.”10 Zimmerman was not an especially radical thinker; he was, after all, the chief physician in Hanover to the British King George III – a hopeless task, that. But he opens up the counterfactual and utopian possibilities of nostalgia, its hope for things not as they are, its critical stance that they might be otherwise.

Medical writing on nostalgia as a life-threatening pathology peaked during the Napoleonic wars and the decade following, then gradually began to subside, although it was some time before it completely disappeared. During World War II, the journals War Medicine and the United States Naval Bulletin still warned about the need for early detection among enlisted men.11 However, during the nineteenth century, nostalgia, understood as a physical mobility disability, was increasingly separated from general usage, because of the growing specialization of medicine from other areas of culture and, within medicine, between psychology and other medical specialties. At the same time, in everyday popular parlance, unmoored from its original context, the word began to pick up very different associations, such as the longing for a simpler or simply departed time. This process produced the later, now familiar idea of nostalgia as a sentimental relation to a partly fabricated past or as an escape from the present. Yet it has frequently made us lose sight of the longing, the element of resistance and real pain—the very algia in nostalgia—that the original phenomenon represented.

Why is it worth remembering? There are several answers to this question, depending on the perspective from which it is asked: modern medicine, the history of medicine, or the humanities. Because one of them bears on the meeting of these disciplines, I focus on it here.

In the medical humanities and related new fields, we strive to be interdisciplinary. This was not always necessary. Before the nineteenth century, “science” still meant general knowledge, rather than a subject or subset thereof. Medicine and the life sciences in particular developed in the same matrix as the new discipline then describing itself as the “science of sensuous perception” (aisthesis)—namely, aesthetics, or in Britain (wary of foreign terms) “criticism.” William Wordsworth’s epithet for “Poetry” in 1800, “the science of feelings,” might have been Cullen’s for physiology.12 Authors of belles-lettres and criticism worked in the same circles as medical writers and practitioners and drew on shared principles of association. Sometimes they were the same person. Friedrich Schiller was a medical student at the Military Academy of Stuttgart—attending to cadets suffering from nostalgia!—before writing On Naïve and Sentimental Poetry and On the Aesthetic Education of Man.13 Albrecht von Haller, Oliver Goldsmith, Tobias Smollett, Erasmus Darwin, J. W. von Goethe, John Keats, and Novalis were poets or novelists with variously active careers in medicine, biology, or natural history.

In their literary theory and practice, these and other figures were just as interested in what moves people, of course, even if they posed and answered the question differently. Medical science’s explorations of the causes and effects of mobility were crucially absorbed into the developing ground of aesthetic theory, persisting there in questions about the means and ends of producing emotion, ethical action, or political movement, or in debates about the role of form in the spatial and temporal movement of reading. The very term nostos (“homecoming”) was a term in poetics, designating the end of a poem. At times, working in intellectual and geographical proximity to medical science, poets, novelists, and critics shared the physicians’ therapeutic mandate and regarded their writing as a form of cure. At the start of the nineteenth century, John Keats’s poem, The Fall of Hyperion, could still wonder: “Sure a poet is a sage, / A humanist, physician to all men . . .”?14 But a note of doubt has crept in, tilting the declaration into the interrogative. Increasingly, literary figures, while continuing to respond to the dis-ease or unease of modernity, sought other ends. Are disciplines shaped in part by the ways in which they respond to disturbances in the delicate ecology between bodies and their worlds? For this, at root, was what nostalgia was.

This is, of course, too large a question, if an interesting one. The point, however, is that we are now working to bring together kinds of knowledge that were not always apart. In that endeavor, we would be well-served by understanding the ground they once shared, the complex interchanges between them, their points of divergence, as well as the reasons why they began to separate to begin with.



  1. Adam Smith, The Theory of Moral Sentiments, ed. D. D. Raphael and A. L. Macfie, The Glasgow Edition of the Works and Correspondence of Adam Smith (Oxford: Clarendon, 1976), 1:185.
  2.  Until 1792, the title appeared in Latin. This is part of the title as it appeared in the third edition of the English translation, published in Edinburgh in 1800. In fact, the full title is longer: Nosology: or, a systematic arrangement of diseases, by classes, orders, genera, and species; With The Distinguishing Characters Of Each, and outlines of the systems of Sauvages, Linnæus, Vogel, Sagar, and Macbride. Translated from the Latin of William Cullen, M. D. Late Professor Of The Practice Of Physic In The University Of Edinburgh (Edinburgh, 1800). Available via Eighteenth Century Collections on Line (Gale), accessed University of California, 27 February, 2013.
  3. Cullen, Nosology, 162-164.
  4. Ibid., 162.
  5. Johannes Hofer, Dissertatio Medica de Nostalgia, trans. Carolyn Kiser Anspach, Bulletin of the History of Medicine 2 (1934): 376-391. Other accounts of the history of nostalgia include Jean Starobinski, “The Idea of Nostalgia,” Diogenes 54 (1966): 81-103; George Rosen, “Nostalgia: A ‘Forgotten Psychological Disorder,” Clio Medica 10 (1975) 29-52; Michael Roth, “Dying of the Past: Medical Studies of Nostalgia in Nineteenth-Century France,” History and Memory 3 (1991): 5-29; Nicholas Dames, Amnesiac Selves: Nostalgia, Forgetting, and British Fiction, 1810-1870 (New York: Oxford University Press, 2001); Linda M. Austin, Nostalgia in Transition, 1780-1917 (Charlottesville: University of Virginia Press, 2007); and Helmut Illbruck, Nostalgia: Origins and Ends of an Unenlightened Disease (Evanston: Northwestern University Press, 2012). With the exception of Starobinski and Illbruck, these tend to focus on the nineteenth century or later, when nostalgia had been redefined to look more like the phenomenon we now associate with the term. Both literary medical-historical and literary-historical accounts of nostalgia display a teleological drive, building developmental narratives whose end is the scholar’s own moment. Unlike them, I am more interested in recovering the earlier writings on the disease formerly known as nostalgia, in order to understand what it did in its original context. My subtitle, “The Science of Nostalgia,” is therefore intended in a double sense: it refers to the medical-scientific background of the illness, and it also poses the question of what nostalgia knew – i.e., nostalgia’s “science,” in the older sense of that word as “knowledge.”
  6. See, for example, Thomas Trotter, Observations on the Scurvy, with a Review of the Opinions Lately Advanced on that Disease, 2d ed. (London, 1792), 44-45.
  7. See the long discussion of the disease under “Nostalgie,” in the Dictionnaire des sciences médicales (Paris: Panckoucke, 1819), 36: 269-285.
  8. William Cowper, The Task 1.447-54, in The Task and Other Poems, ed. James Sambrook (New York: Longman, 1994).
  9. Peter Fritzsche, “How Nostalgia Narrates Modernity,” in The Work of Memory: New Directions in the Study of German Society and Culture, ed. Alan Confino and Peter Fritzsche (Urbana and Chicago: University of Illinois Press, 2002), 62.
  10. Johann Georg Zimmerman, A Treatise on Experience in Physic, 2 vols. (London, 1788) 2:285.
  11. See Nauman Naqvi, “The Nostalgic Subject: A Genealogy of the ‘Critique of Nostalgia,’” C.I.R.S.D.G.(Centro Interuniversitario per le ricerche sulla Sociologia del Diritto e delle Istituzioni Giuridich) Working Paper n. 23 (September, 2007): 23-29.
  12. William Wordsworth, Lyrical Ballads, 2d ed., ed. R. L. Brett and A. R. Jones (London and New York: Routledge, 1991), 288.
  13. See Kenneth Dewhurst and Nigel Reeves, Friedrich Schiller: Medicine, Psychology and Literature (Berkeley and Los Angeles: University of California Press, 1978), 177-201.
  14. John Keats, “The Fall of Hyperion,” 1:189-90, in Complete Poems, ed. Jack Stillinger (Cambridge, MA: Harvard University Press/Belknap Press, 1982).



KEVIS GOODMAN, PhD, teaches in the Department of English at the University of California, Berkeley, where she specializes in the study of literature and the sciences from the later 17th century through the Romantic era in Britain. She is the author of one book (Georgic Modernity: Poetry and the Mediation of History [Cambridge University Press, 2004, 2008]) and numerous articles and reviews in scholarly journals. Her current project is a second book on the poetics and sciences of mobility during the 18th and early 19th centuries.


Highlighted in Frontispiece Fall 2013 – Volume 5, Issue 4
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