In the spring of 1838, French novelist and playwright Honoré de Balzac wrote a letter from Milan to his muse and future wife, Lady Hańska: “Dear, I have home-sickness! … I go and come without soul, without life, without the power to say what the matter is; and if I stay thus two weeks longer, I shall be dead.”

Balzac wasn’t being melodramatic. From the Enlightenment through the early twentieth century, homesickness was considered a serious physical condition that could lead to death if not properly treated.

Swiss Missing Home

In 1688 Johannes Hofer, a Swiss medical student, became the first person to pathologize the experience of missing home. As Susan Matt, a historian of emotions, recounts in Homesickness: An American History, Hofer studied the case of a man from Berne who had left home to pursue studies in Basel. The man became despondent, developed a high fever, and seemed inches from death. He was ordered to return home, and by the time he arrived back in Berne, he had completely recovered.

What explained the man’s strange ailment? Doctors of the time believed that “vital spirits” flowed through the body. Hofer theorized that in homesick patients the spirits are so fixated on homey thoughts that they become “exhausted” and can’t help the rest of the body function. The ailment has “no remedy other than a return to the homeland,” wrote Hofer.

Hofer needed a label for this newly discovered illness. The German heimweh and the French la maladie du pays were already in use, but there was no official medical term to describe the painful pining for home. Hofer invented the word nostalgia by fusing the two Greek words, nostos, “homecoming,” and algia, “pain.” Today we think of nostalgia as the wistful longing for a lost time, but originally it meant the acute yearning for a specific place. (Other contenders: nosomania, philopatridomania, and pothopatridalgia.)

The Homesickness Pandemic

At first, Matt writes, nostalgia was considered a uniquely Swiss disease. According to Jean Starobinski, the first historian to critically study nostalgia, one doctor blamed the condition on changes in atmospheric pressure. The doctor theorized that when a Swiss person descended from his alpine home, his blood thinned and flowed less freely to his heart, resulting in depression, loss of appetite, and a deadly fever. If he couldn’t return to the mountains, “the most logical treatment consists in quartering him on a hill or in a tower, where he can breathe lighter air.”

The English word homesickness came on the scene around the 1750s. We don’t know who coined it, but the Oxford English Dictionary indicates that the word appeared as early as 1748, in a Moravian church hymnal. Like nostalgia, homesickness could provoke a rash of unpleasant symptoms, including fever, lesions, trouble sleeping, heart palpitations, emaciation, organ failure, incontinence, and dysentery.

Soldiers seemed to be particularly susceptible to homesickness, and many men deserted in part because they missed home too much. During the Civil War, Union army bands were sometimes forbidden from playing the popular song “Home, Sweet Home”—and perhaps for good reason. According to Matt, more than 5,000 Union soldiers were diagnosed with nostalgia, including 74 who died. One doctor deemed the illness a fate worse than syphilis.

In extreme cases, homesickness drove people to suicide. A headline from 1899 read: “Fatal Nostalgia: Woman Died Because She Could Not Live Away From New York.” The article went on to describe how the woman, in a fit of despair, downed a quart of whiskey and slashed her wrists. And in 1915, an article headlined “Homesickness Kills: Many Soldiers, Especially Wounded or in Prison, Die From That Cause” stated:

"Homesickness, or nostalgia, as the doctors call it, has long been recognized as a specific military disease which is especially liable to attack recruits. It leads to desertions, sickness and death; and, although it never claims as many victims as the bullet or the typhoid germ, it is quite capable of enough harm to impair seriously an army’s efficiency."

Finding a Cure

Homesickness emerged during a time of mass migration, and in the 18th and 19th centuries, it was not to be trifled with. In the early 20th century, people started to take it less seriously—though Matt notes that as late as World War II, homesickness was listed as a condition in the Surgeon General’s manual.

Homesickness is no longer classified as a disease, but considered more of an emotional woe or adjustment problem. Recent psychological studies define homesickness as “the distress or impairment caused by an actual or anticipated separation from home.” In small doses, homesickness is a sign of our healthy attachment to loved ones. In more chronic cases, it may be associated with depression, anxiety, and loneliness.

So what’s the cure? Psychologists say we’re less likely to feel homesick when we feel connected, socially and geographically. In other words, wherever you are, make yourself at home.