TO THE BRITISH PEOPLE the invincibility of the British Army was an article of faith. Waterloo was a recent memory, and it was taken for granted that the nation which had beaten Napoleon could not be defeated. But since Waterloo forty years of economy had run their course, and the army which had won Wellington's victories had ceased to exist. In 1852 the artillery of the British Army consisted of forty field-pieces, many officially described as defective. In 1854, when the army was mobilizing for the Crimea, volunteers had to be drafted into the battalions selected for active service to raise their numbers to the regulation 850. The staff of the supply departments had been reduced to a few clerks, who were overwhelmed by the demands of mobilization. Before the Army sailed, the processes by which the troops were to receive food and clothing, to be maintained in health and cared for when wounded or sick, had already fallen into confusion.
An enormous amount of information exists on the Crimean War. While it was in progress, four Parliamentary Commissions of Inquiry investigated its disasters. Three of them went to the Crimea; the fourth, which sat in London, examined civil servants and officials in Government service as well as witnesses from the seat of war. The resulting mass of evidence fills a shelf of Blue Books in whose innumerable pages, from which the stench of misery and filth and despair seems palpably to rise, the Crimean War lies embalmed.
But in the spring of 1854, confidence was complete. The Guards were a magnificent body of fighting men as they marched through London to embark. The crowds which cheered them did not know that behind these splendid troops, the flower of the British Army, were no reserves. They were doomed to perish, and when they perished, their ranks were filled with raw recruits made "pretty perfect in drill in sixty days."
The first operation was not to be in the Crimea. The British Army was to relieve Silistria, in Roumania, then a Turkish province, where the Russians were besieging the Turks. A base was established at Scutari, a large village on the Asian shore of the Bosphorus, and in June, 1854 the British Army disembarked at Varna, in Bulgaria. Nothing was accomplished. A cholera epidemic broke out; the army became an army of invalids, and the Turks raised the siege of Silistria on their own account. The Allies then proceeded to the true objective of the war, the destruction of the great naval base recently constructed by the Russians at Sebastopol.
Though the plan of a descent on Sebastopol was an open secret and had been discussed in the Press, it had never been officially intimated to the supply departments; consequently no preparations had been made. When the British Army embarked at Varna for the Crimea, there were not enough transports to take both the army and its equipment across the Black Sea. Thirty thousand men were crammed in, but pack animals, tents, cooking equipment, hospital marquees, regimental medicine chests, bedding, and stores had all to be left behind. Twenty-one wagons only were brought for 30,000 men going into action. On September 14 the army disembarked at a cove with the sinister name of Calamita Bay. "My God," exclaimed Dr. Alexander, 1st class Staff Surgeon of the Light Division, "they have landed this army without any kind of hospital transport, litters or carts or anything." Cholera still raged, and over 1000 cholera cases were sent back to Scutari.
A week later, the British and the French won the hard-fought battle of the Alma, and the wounded paid the price of the abandonment of the army's hospital equipment. There were no bandages, no splints, no chloroform, no morphia. The wounded lay on the ground or on straw mixed with manure in a farmyard. Amputations were performed without anesthetics; the victims sat on tubs or lay on old doors; the surgeons worked by moonlight because there were no candles or lamps. And another 1000 cholera cases were sent back to Scutari.
Of this the British public knew nothing. Nor did they know what awaited the wounded and the sick when they reached the base at Scutari. At Scutari were enormous barracks, the headquarters of the Turkish artillery. These barracks and the hospital attached had been handed over to the British, and the British authorities assumed that the hospital, known as the General Hospital, would be adequate. The unexpected disaster of the cholera epidemic produced total disorganization. The first 1000 cholera cases sent back after the landing at Calamita Bay filled the hospital to overflowing; drugs, sanitary conveniences, bedding, doctors were insufficient. While Dr. Menzies, senior Medical Officer, was struggling with the crisis, he was notified that many hundreds of battle casualties from the Alma and another 1000 cholera cases were on their way. Since the General Hospital was filled, he was ordered to convert the artillery barracks into a hospital. It was an impossible task. The vast building was bare, filthy, and dilapidated. There was no labor to clean it; there was no hospital equipment to put in it.
Meanwhile the sick and wounded were enduring a ghastly journey across the Black Sea. They were conveyed in "hospital ships" which figured well on paper but in fact were ordinary transports equipped "with some medicines and medical appliances." They were packed far beyond their capacity. One, the Kangaroo, fitted to receive 250 sick, received between 1200 and 1500. Cholera cases, battle casualties, were crammed in together. Too weak to move, too weak to reach the sanitary conveniences, they fell on each other as the ship rolled and were soon lying in heaps of filth. Men with amputations were flung about the deck screaming with pain.
When the men arrived at the Barrack Hospital, there were no beds. They lay on the floor wrapped in the blankets saturated with blood and ordure in which they had been lying since they left the battlefield. No food could be given them because there was no kitchen. No one could attend to them because there were not sufficient doctors. Some of them lay without even a drink of water all that night and through the next day. There were no cups or buckets to bring water in. There were no chairs or tables. There was not an operating table. The men, half naked, lay in long lines on the bare filthy floors of the huge dilapidated rooms.
Such scenes of horror were nothing new in Britain's military annals: similar miseries had been endured by the British Army many times before. During the winter of 1759, outside Quebec, outside Havana in 1762, during the retreat to the Ems in 1797, worse miseries were endured than in the Crimea. In the disastrous Walcheren expedition of 1809 a whole army was lost through sickness. Men died in thousands in the general hospitals of the Peninsula; the Guards were so reduced by sickness that they had had to fall out of the campaign from November, 1812 to June, 1813.
But these horrors had remained unknown. England rang with the story of Scutari because with the British Army was the first war correspondent, William Howard Russell of The Times.
"By God, Sir, I'd as soon see the devil," said General Pennefather to Russell when they met in the Crimea; but Pennefather did not order Russell home. The Crimea was a casual war. Numbers of tourists, known to the army as "T.G.'s," "Travelling Gentlemen," camped with the troops. Private philanthropists came out at their own expense. Though Russell and his paper were abominated by the army authorities---The Times under the editorship of Delane was a Radical newspaper---he was never obstructed. The military aristocrats of the high command were content to ignore him. "Lord Raglan," wrote Russell, "never spoke to me in his life. . . . I was regarded as a mere camp follower, whom it would be impossible to take more notice of than you would of a crossing sweeper, without the gratuitous penny."
Russell was an Irishman with an Irishman's capacity for indignation, and in dispatches published on October 9, 12, and 13 he furiously described the sufferings of the sick and wounded. "It is with feelings of surprise and anger that the public will learn that no sufficient preparations have been made for the care of the wounded. Not only are there not sufficient surgeons . . . not only are there no dressers and nurses . . . there is not even linen to make bandages. . . . Can it be said that the battle of the Alma has been an event to take the world by surprise? Yet . . . there is no preparation for the commonest surgical operations! Not only are the men kept, in some cases for a week, without the hand of a medical man coming near their wounds. . . . but now . . . it is found that the commonest appliances of a workhouse sick ward are wanting, and that the men must die through the medical staff of the British Army having forgotten that old rags are necessary for the dressing of wounds."
The revelation burst on the nation like a thunderclap, and on October 13 Sir Robert Peel, the third baronet, opened "The Times Fund" for supplying the sick and wounded with comforts. The same day The Times published another dispatch from Russell. "The manner in which the sick and wounded are treated is worthy only of the savages of Dahomey. . . . There are no dressers or nurses to carry out the surgeons' directions, and to attend on the sick during the intervals between his visits. Here the French are greatly our superiors. Their medical arrangements are extremely good, their surgeons more numerous and they have also the help of the Sisters of Charity. . . these devoted women are excellent nurses."
The country seethed with rage. Russell's statement that British arrangements compared unfavorably with those of the French was intolerable, and the next day a letter in The Times demanded angrily, "Why have we no Sisters of Charity?"
It was read by Sidney Herbert, who in December, 1852 had been appointed Secretary at War, and was now responsible for the treatment of the sick and wounded. The administration of the British Army was then divided between two Ministers, the Secretary for War and the Secretary at War. The Secretary at War was responsible for the financial administration of the army, and since the cheese-paring, the callous economies, the criminally inadequate arrangements had been executed in his name, the blame must lie at the door of Sidney Herbert. His political position was now extremely delicate. His mother had been Russian, daughter of the Russian Ambassador, and the famous Woronzoff road which was to be of such overwhelming importance to the British Army in the Crimea led to the Woronzoff palace at Yalta which belonged to his uncle. Suspicion was inevitable; and a storm of national fury burst on his head. The military authorities, enraged by the interference of The Times, refused to admit that anything was wrong. Sidney Herbert was not convinced and acted on his own responsibility. He wrote to the British Ambassador at Constantinople, Lord Stratford de Redcliffe giving him carte blanche to purchase anything he considered necessary for the hospitals, and on October 15 he wrote to Miss Nightingale inviting her to go to Scutari in command of a party of nurses. She would go with the Government's sanction and at the Government's expense.
She had already acted on her own account and, without consulting the Herberts, had arranged to sail for Constantinople with a party of nurses in three days' time. She had hesitated to approach them, embarrassed by the attacks being made on Sidney Herbert; but when her plans were completed, she called at 49 Belgrave Square on the morning of Saturday, October 14. The Herberts had gone to Bournemouth for the week-end.
On Saturday afternoon Miss Nightingale wrote to Liz Herbert: "My dearest I went to Belgrave Square this morning for the chance of catching you, or Mr. Herbert even, had he been in Town. A small private expedition of nurses has been organized for Scutari and I have been asked to command it. I take myself out and one nurse. . . . I do not mean that I believe the Times accounts, but I do believe we may be of use to the poor wounded wretches." She asked Liz to negotiate her release from her engagement with the Harley Street committee---unless the committee thoroughly approved she could not honorably break her engagement; and, would Sidney approve? "What does Mr. Herbert say to the scheme itself? Does he think it would be objected to by the authorities? Would he give us any advice or letters of recommendation? And are there any stores for the Hospital he would advise us to take out." Finally, would Liz write to the Ambassadress, Lady Stratford de Redcliffe, and say: "This is not a Lady but a real Hospital Nurse . . . and she has had experience." This letter crossed one written by Sidney Herbert at Bournemouth on the Sunday, in which he formally asked her to take charge of an official scheme for introducing female nurses into the hospitals of the British Army:
DEAR MISS NIGHTINGALE,
You will have seen in the papers that there is a great deficiency of nurses at the Hospital at Scutari.
The other alleged deficiencies, namely of medical men, lint, sheets, etc., must, if they have really ever existed, have been remedied ere this, as the number of medical officers with the Army amounted to one to every 95 men in the whole force, being nearly double what we have ever had before, and 30 more surgeons went out 3 weeks ago, and would by this time, therefore, be at Constantinople. A further supply went on Thursday, and a fresh batch sail next week.
As to medical stores, they have been sent out in profusion; lint by the ton weight, 15,000 pairs of sheets, medicine, wine, arrowroot in the same proportion; and the only way of accounting for the deficiency at Scutari, if it exists, is that the mass of stores went to Varna, and was not sent back when the Army left for the Crimea; but four days would have remedied this. In the meanwhile fresh stores are arriving.
But the deficiency of female nurses is undoubted, none but male nurses having ever been admitted to military hospitals.
It would be impossible to carry about a large staff of female nurses with the Army in the field. But at Scutari, having now a fixed hospital, no military reason exists against their introduction, and I am confident they might be introduced with great benefit, for hospital orderlies must be very rough hands, and most of them, on such an occasion as this, very inexperienced ones.
I receive numbers of offers from ladies to go out, but they are ladies who have no conception of what an hospital is, nor of the nature of its duties; and they would, when the time came, either recoil from the work or be entirely useless, and consequently---what is worse---entirely in the way. Nor would these ladies probably ever understand the necessity, especially in a military hospital, of strict obedience to rule. . . .
There is but one person in England that I know of who would be capable of organising and superintending such a scheme; and I have been several times on the point of asking you hypothetically if, supposing the attempt were made, you would undertake to direct it.
The selection of the rank and file of nurses will be very difficult: no one knows it better than yourself. The difficulty of finding women equal to a task, after all, full of horrors, and requiring, besides knowledge and goodwill, great energy and great courage, will be great. The task of ruling them and introducing system among them, great; and not the least will be the difficulty of making the whole work smoothly with the medical and military authorities out there. This it is which makes it so important that the experiment should be carried out by one with a capacity for administration and experience. A number of sentimental enthusiastic ladies turned loose into the Hospital at Scutari would probably, after a few days, be mises à la porte by those whose business they would interrupt, and whose authority they would dispute.
My question simply is, Would you listen to the request to go and superintend the whole thing? You would of course have plenary authority over all the nurses, and I think I could secure you the fullest assistance and co-operation from the medical staff, and you would also have an unlimited power of drawing on the Government for whatever you thought requisite for the success of your mission. On this part of the subject the details are too many for a letter, and I reserve it for our meeting; for whatever decision you take, I know you will give me every assistance and advice.
I do not say one word to press you. You are the only person who can judge for yourself which of conflicting or incompatible duties is the first, or the highest; but I must not conceal from you that I think upon your decision will depend the ultimate success or failure of the plan. Your own personal qualities, your knowledge and your power of administration, and among greater things your rank and position in Society give you advantages in such a work which no other person possesses.
If this succeeds, an enormous amount of good will be done now, and to persons deserving everything at our hands; and a prejudice will have been broken through, and a precedent established, which will multiply the good to all time.
I hardly like to be sanguine as to your answer. If it were "yes," I am certain the Bracebridges would go with you and give you all the comfort you would require, and which their society and sympathy only could give you. I have written very long, for the subject is very near to my heart. Liz is writing to Mrs. Bracebridge to tell her what I am doing. I go back to town tomorrow morning. Shall I come to you between 3 and 5? Will you let me have a line at the War Office to let me know?
There is one point which I have hardly a right to touch upon, but I know you will pardon me. If you were inclined to undertake this great work, would Mr. and Mrs. Nightingale give their consent?
The work would be so national, and the request made to you proceeding from the Government who represent the nation comes at such a moment, that I do not despair of their consent. Deriving your authority from the Government, your position would secure the respect and consideration of every one, especially in a service where official rank carries so much weight. This would secure to you every attention and comfort on your way and there, together with a complete submission to your orders. I know these things are a matter of indifference to you except so far as they may further the great objects you have in view; but they are of importance in themselves, and of every importance to those who have a right to take an interest in your personal position and comfort.
I know you will come to a wise decision. God grant it may be in accordance with my hopes!
Believe me, dear Miss Nightingale,
ever yours,
SIDNEY HERBERT.
The terms of this letter were accepted by Miss Nightingale and considered by her to be her charter. They make it clear that from the inception of her mission she was to be an administrator.
It was not as an angel of mercy that she was asked to go to Scutari--- relieving the sufferings of the troops was scarcely mentioned. The consideration of overwhelming importance was the opportunity offered to advance the cause of nursing. Were nurses capable of being employed with success to nurse men under such conditions? The eyes of the nation were fixed on Scutari. If the nurses acquitted themselves creditably, never again would they be despised. "If this succeeds," Sidney Herbert had written, "an enormous amount of good will have been done now . . . a prejudice will have been broken through and a precedent established which will multiply the good to all time."
Before she had time to write a reply, he had received her letter, and on the Monday afternoon he called on her at Harley Street, bringing a letter from Liz: "My own dearest noblest Flo. I knew you would do it. . . . God be thanked. Sid longed to go to you last week . . . I will write a 'cut and dry' letter to the committee in Harley Street and bear all the blame if any can possibly attach itself to such a work! Go then at once, and God prosper it and you. Your own loving E. H. Would that I could come to town to you at once. But my nurse is ill and away and I cannot leave my children. . . ."
Sidney Herbert warned Miss Nightingale that he was by no means satisfied with the assurances he was receiving from the army authorities, and that he was sending out immediately a "Commission of Enquiry into the State of the Hospitals and the Condition of the Sick and Wounded." The Commission had three members, a well-known barrister, Mr. Benson Maxwell, and two doctors, Dr. Cumming and Dr. Spence. Its purpose was to establish the facts, but it was not empowered to take action and could not alter existing arrangements. She was to work with the Hospitals Commission, send in official reports, and in addition write privately to him telling him confidentially what she could not write officially.
The number of nurses in the party was fixed at forty. She was doubtful of her ability to control more than twenty, but Sidney Herbert insisted that twenty would not be a sufficiently large number to make the experiment impressive. He would have preferred an even larger number than forty. On Wednesday, October 18, Sidney Herbert, supported by the Duke of Newcastle, placed Miss Nightingale's appointment before the Cabinet. The appointment was unanimously approved, and next day she received a formal confirmation written and signed by Sidney Herbert as Secretary at War. She was appointed "Superintendent of the Female Nursing Establishment of the English General Hospitals in Turkey," and her authority was defined: "Everything relating to the distribution of the nurses, the hours of their attendance, their allotment to particular duties is placed in your hands, subject of course to the sanction and approval of the chief medical officer; but the selection of the nurses in the first instance is placed solely under your control." Precise as these instructions appeared, they contained a flaw. The words "Superintendent of the Female Nursing Establishment of the English General Military Hospitals in Turkey" were subsequently contended to limit her authority to Turkey and to exclude her from the Crimea.
Her appointment caused a sensation. The story of the Cabinet meeting, the official instructions, the letter to the Commander-in-Chief flew from mouth to mouth. No woman had ever been so distinguished before, and Fanny and Parthe were ecstatic. Forgetting they had brought her to the verge of insanity by their opposition, they congratulated themselves on the scope of the experience which qualified her for her mission. "It is a great and noble work," wrote Parthe to a favorite cousin. "One cannot but believe she was intended for it. None of her previous life has been wasted, her experience all tells, all the gathered stores of so many years, her Kaiserswerth, her sympathy with the R. Catholic system of work, her travels, her search into the hospital question, her knowledge of so many different minds and classes. . . ."
Parthe and Fanny hastened from Embley to London to share in the excitement, and, in the haste of packing, the owl Athena was left shut in an attic, where she was found later dead; she required constant attention and was subject to fits. When the lifeless body was put into Miss Nightingale's hands, she burst into tears. "Poor little beastie," she said, "it was odd how much I loved you." It was the only sign of emotion she showed on the eve of departure. Otherwise she was, wrote Parthe, "as calm and composed as if she was going for a walk."
She had made up her mind to start on Saturday, October 21, four clear days only after she had received Sidney Herbert's letter. Nurses had to be engaged; she was determined they should wear uniform, which must be made; tickets and berths must be reserved. S and her husband had agreed to accompany her, and Mr. Bracebridge took over the finances of the expedition and made the traveling arrangements, adding to the prevailing excitement by hiring one of the new fast hansom cabs and driving about London at ten miles an hour.
The headquarters of the expedition were at the Herberts' London house, 49 Belgrave Square. Mary Stanley, Mrs. Bracebridge, Lady Canning, and Lady Cranworth sat all day in the dining-room prepared to receive a rush of applicants---but few came. It had been intended to engage forty, but in the end only thirty-eight women who could conceivably be considered suitable presented themselves. "I wish people who may hereafter complain of the women selected could have seen the set we had to choose from," wrote Mary Stanley to Liz Herbert in October 1854. "All London was scoured for them. . . . We felt ashamed to have in the house such women as came. One alone expressed a wish to go from a good motive. Money was the only inducement." "As to that stuff about the 'enthusiasm' of the nursing in the Crimean campaign'---that is all bosh," wrote Miss Nightingale to Sir John McNeill in 1867; "we had, unfortunately for us, scarcely one woman sent out who was even up to the level of a head nurse." The nurses were to receive 12s. to 14s. a week with board, lodging, and uniform. After three months' good conduct they received 16s. to 18s. , and after a year's good conduct 18s. to 20s. The average wage of a nurse in a London hospital was 7s. to 10s. Each nurse signed an agreement submitting herself absolutely to Miss Nightingale's orders. Misconduct with the troops was to be punished by instant dismissal. A nurse invalided home was to have her expenses paid first class, but one sent home for misconduct must travel third class on salt rations. No young women were accepted, the majority being stout elderly old bodies. Miss Nightingale wrote later from Scutari that in future "fat drunken old dames of fourteen stone and over must be barred, the provision of bedsteads is not strong enough." A uniform dress was provided, but each nurse brought with her underclothing, four cotton night-caps, one cotton umbrella and a carpet-bag. No colored ribbons or flowers were allowed. No nurse in any circumstances was to go out alone or with only one other nurse. She must either be with the housekeeper from Harley Street, Mrs. Clark, or with three other nurses. In no circumstances was any nurse to go out without leave. Strong liquor was permitted in moderate quantities. At dinner each nurse was to be allowed one pint of porter or one pint of ale, at supper half a pint of porter, or half a pint of ale, or one glass of Marsala or one ounce of brandy.
Lady Canning and Lady Cranworth kept a "large and melancholy" book in which they recorded the particulars of each applicant. Candidates came from the humblest class---"Maid-of-all work," "Very poor," "Has been for a few days in St. George's Hospital." Subordinate clerks in Government service signed testimonials recklessly. "Many," wrote Miss Nightingale, "were (undisguisedly) sent out as paupers to be provided for, who could not otherwise gain their living."
Fourteen professional nurses who had experience of serving in hospitals were engaged; the remaining twenty-four were all members of religious institutions. The party was non-sectarian; nurses, insisted Miss Nightingale, were to be selected "with a view to fitness and without any reference to religious creed whether Roman Catholic nuns, Dissenting Deaconesses, Protestant Hospital nurses or Anglican sisters."
With the assistance of Manning it was arranged that ten Roman Catholic nuns, five from a convent in Bermondsey and five from an orphanage in Norwood, should join the party, and it was conceded that they should be completely under Miss Nightingale's control. If she were to weld this heterogenous, undisciplined collection of women into an efficient instrument, she must have absolute and unquestioned authority; her word must be law; a nun or a sister nursing for Miss Nightingale must take her nursing orders from Miss Nightingale and not from her mother superior; and the mother superior must take her nursing orders from Miss Nightingale and not from the bishop.
It was an extraordinary concession for Manning to have obtained, and, as far as the original nuns were concerned, it worked with perfect smoothness. The five Norwood nuns, though amiable, proved inexperienced, but the five from Bermondsey were very nearly the most valuable members of the party. Their superior, known as Rev. Mother Bermondsey, became one of Miss Nightingale's dearest friends.
Three other religious bodies were approached for nurses. St. John's House, a High Church sisterhood in Blandford Square, Miss Sellon's Anglican sisterhood, known as the Sellonites, in Devonport, and an Evangelical body, the Protestant Institution for Nurses, in Devonshire Square.
The Sellonites agreed to accept Miss Nightingale's authority and sent eight sisters who were especially valuable as they had had experience in nursing cholera in the slums of Plymouth and Devonport during the cholera epidemic of 1853. The authorities of St. John's House demurred, but after being visited first by Sidney Herbert and then by the Chaplain-General of the Forces allowed themselves to be persuaded and sent six sisters. The Protestant Institution flatly refused---their nurses were to be controlled only by their own committee. The refusal was unfortunate. As a result, the party contained a preponderance of Roman Catholics and members of the High Church. Out of the thirty-eight nurses, twenty-four were either professed nuns or Anglican sisters. The remaining fourteen, the hospital nurses, were, as Clarkey observed, of no particular religion unless the worship of Bacchus should be revived.
But religious differences were not the only difficulty. Amongst women who were prepared to devote themselves to the sick, there were two totally different conceptions of the functions of a nurse. The hospital nurse, drunken, promiscuous, and troublesome, considered that her function was to tend her patient's sick body and restore him to physical health by carrying out the doctor's orders. The religious orders, sisters and nuns, were neither drunken nor promiscuous, but were apt to be more concerned with the souls of their patients than with their bodies.
Since the middle of the eighteenth century the great medieval tradition of nursing among religious orders had decayed. Physical and spiritual were thought incompatible; at one point the sisters of St. Vincent de Paul had been forbidden to put diapers on boy babies. Lofty sentiments were encouraged but cleanliness was ignored. "Excellent self devoted women," wrote Miss Nightingale of certain nuns, "fit more for heaven than a hospital, they flit about like angels without hinds among the patients and soothe their souls while they leave their bodies dirty and neglected." This conception was not held only by religious orders. It was shared by a number of educated women who spent much of their time among the sick, but described themselves not as nurses but "ladies."
Miss Nightingale refused to admit "ladies," as such, into her party. All must be nurses; all must eat the same food, have the same accommodation, wear the same uniform, except the nuns and sisters, who were allowed to wear their habits. And the uniform was extremely ugly. It consisted of a gray tweed dress, called a "wrapper," a gray worsted jacket, a plain white cap, and a short woollen cloak. Over the shoulders was worn a holland scarf described as "frightful," on which was embroidered in red the words "Scutari Hospital." There was no time to fit individual wearers; various sizes were made up and issued as they came in, with unhappy results. Small women got large sizes; tall women got small. That a "lady" could be induced to appear in such a get-up was certainly a triumph of grace over nature, wrote one of the nuns. The uniform had not been designed to make the wearer look attractive. Scutari was a disorderly camp, teeming with drink-shops, prostitutes, and idle troops, and a distinguishing dress was necessary for the nurses' protection. A Crimean veteran told Sir Edward Cook that he saw a nurse seized by a soldier in the street of Scutari, but the man's mate recognized the uniform. "Let her alone," he said, "don't you see she's one of Miss Nightingale's women."
Before Miss Nightingale left England, she called again on Dr. Andrew Smith. He was jocose. The ladies, he assured her, would undoubtedly be a comfort to the men. Ladies had finer instincts; they might, for instance, see a spot on a sheet where a mere man might easily overlook it. As for medical duties---well, he did not think Miss Nightingale and her nurses could possibly go wrong in administering a nice soothing drink of capillary syrup to any man who seemed uncomfortable. She contemplated taking a quantity of stores, but he assured her stores were unnecessary. There was now a positive profusion of every kind of medical comfort at Scutari.
On Saturday morning, October 21, 1854, the party left London Bridge to travel via Boulogne to Paris. One night was to be spent in Paris and four nights in Marseilles, where in spite of the assurances of Sidney Herbert and Dr. Andrew Smith Miss Nightingale intended to buy a large quantity of miscellaneous provisions and stores. Uncle Sam was to go as far as Marseilles to assist her. From Marseilles the party were to proceed to Constantinople in a fast mail boat, the Vectis.
Among the Nightingale papers is preserved a small oblong black notebook, fastened with an elastic band and covered with American cloth. It contains three letters, the only personal papers Miss Nightingale took with her to Scutari. One from Fanny bestowed on her the maternal blessing she had so long sought in vain; one from Manning commended her to the Protection, Worship and Imitation of the Sacred Heart; the third was from Richard, Monckton Milnes---"I hear you are going to the East," he wrote ". . .you can undertake that, when you could not undertake me."
The party reached Boulogne at dinner-time and were given an ovation. Many of the fisherwives of Boulogne had sons and brothers in the French Army, and they seized and shouldered the baggage and carried it in triumph to the hotel, refusing to accept payment. The landlord placed his establishment at the disposal of the party, desired them to order what they would for dinner, and refused to be paid.
The ladies would not sit with the nurses at dinner, though the nurses were in difficulty, as they knew no French. Miss Nightingale waited on the nurses and ate with them herself. "We never had so much care taken of our comforts before," one of them said to her. "It is not people's way with us."
The party arrived at the Gare du Nord, Paris, at 10 P.M., and was welcomed by an enthusiastic crowd and cheered on the way to the hotel where M. Mohl had arranged rooms and supper. Uncle Sam, writing to Embley, described Florence and Mrs. Bracebridge going from room to room trying to fit the party in, followed by Mr. Bracebridge, who, carrying a large box with all the cash in it under his arm, was highly excited, constantly interrupting Florence with exclamations and irrelevant reminiscences, and reproaching her for being so confoundedly silent. Mr. Bracebridge was followed in turn by M. Mohl, who implored him to come downstairs and eat his supper like a good boy.
Miss Nightingale had hoped to add to her party some Sisters of Charity of British nationality from the convent of St. Vincent de Paul, but permission was refused.
The next day the party left for Marseilles. In Marseilles Miss Nightingale set about purchasing stores. In her bedroom, but NOT, explained Uncle Sam, at bedtime, she received a motley crowd of merchants, shopkeepers, dealers, officials from the French Government and the British Consulate, army officers, The Times correspondent, and a Queen's Messenger "with the same serenity as in a drawing-room." She was looking handsomer than ever, he noted, and the impression she created was extraordinary.
On October 27 the party sailed in the Vectis. She was a horrible ship, built for carrying fast mails from Marseilles to Malta, infested with huge cockroaches and so notorious for her discomfort that the Government had difficulty in manning her. Miss Nightingale, a wretchedly bad sailor, was prostrated by sea sickness. On the second day out the Vectis ran into a gale. The guns with which she was armed had to be jettisoned; the stewards' cabin and the galley were washed overboard. Miss Nightingale suffered so severely that when Malta was reached she was too weak to go ashore.
The rest of the party went sightseeing in the charge of a major of militia. The party was made up partly of Anglican sisters in black serge habits, partly of Roman Catholic nuns in white habits, and partly of hospital nurses. The hospital nurses were placed in the middle where they would have no chance to misbehave, and the major marched the party from point to point in military formation. The major would shout, "Forward black sisters," and the Anglican sisters in their black serge habits got into motion; but the white nuns would straggle, and there came a shout, "Halt! Those damned white sisters have gone again." Malta was full of idle troops, and soon the party was followed by a crowd of soldiers. One of the Anglican sisters heard a sergeant remark that he should think "them ancient Amazons we read about took a deal of drilling."
On November 3, still in atrocious weather, the Vectis, "blustering, storming, shrieking," wrote Miss Nightingale, rushed up the Bosphorus, and anchored off Seraglio Point next day. Constantinople, in the pouring rain, looked like a washed-out daguerreotype. On the opposite shore stood the enormous Barrack Hospital. Everyone was on deck eager to see their goal. "Oh, Miss Nightingale," said one of the party, "when we land don't let there be any red tape delays, let us get straight to nursing the poor fellows! " Miss Nightingale, gazing at the gigantic pile, replied: "The strongest will be wanted at the wash tub."
At breakfast-time the Vectis anchored, and during the morning Lord Stratford, the British Ambassador at Constantinople, sent across Lord Napier, the Secretary of the Embassy. Lord Napier found Miss Nightingale, exhausted from the effects of prolonged sea sickness, stretched on a sofa. Fourteen years later he recalled their first meeting: ". . . I was sent by Lord Stratford to salute and welcome you on your first arrival at Scutari . . . and found you stretched on the sofa where I believe you never lay down again. I thought then that it would be a great happiness to serve you."
The nurses were to go to the hospital at once, for wounded were expected from the battle of Balaclava, fought on October 25. Painted caïques, the gondola-like boats of the Bosphorus, were procured, the nurses were lowered into them with their carpet-bags and umbrellas, and the party was rowed across to Scutari. The rain having ceased, a few fitful gleams of sunshine lit up the Asian shore, which, as it grew clearer, lost its beauty. The steep slopes to the Barrack Hospital were a sea of mud littered with refuse; there was no firm road, merely a rutted, neglected track. As the caïques approached a rickety landing-stage, the nurses shrank at the sight of the bloated carcass of a large gray horse, washing backward and forward on the tide and pursued by a pack of starving dogs, who howled and fought among themselves. A few men, limping and ragged, were helping each other up the steep slope to the hospital, and groups of soldiers stood listlessly watching the dead horse and the starving dogs. A cold wind blew. Some wretched-looking women shivered in tawdry finery.
The nurses disembarked, climbed the slope, and passed through the enormous gateway of the Barrack Hospital, that gateway over which Miss Nightingale said should have been written "Abandon hope all ye who enter here." Dr. Menzies and Major Sillery, the Military Commandant, were waiting to receive them. That night Lord Stratford wrote to the Duke of Newcastle: "Miss Nightingale and her brigade of nurses are actually established at Scutari under the same roof with the gallant and suffering objects of their compassion."
FROM THE EUROPEAN shore of the Bosphorus, from the magnificent house where the British Ambassador lived, the great quadrangle of the Turkish Barracks glimmered golden, magnificent as a giant's palace, but at close quarters romance vanished. Vast echoing corridors with floors of broken tiles and walls streaming damp, empty of any kind of furniture, stretched for miles. Later Miss Nightingale calculated there were four miles of beds. Everything was filthy; everything was dilapidated. The form of the building was a hollow square with towers at each corner. One side had been gutted in a fire and could not be used. The courtyard in the center was a sea of mud littered with refuse. Within the vast ramifications of the barracks were a depot for troops, a canteen where spirits were sold, and a stable for cavalry horses. Deep in the cellars were dark and noisome dens where more than 200 women, who had been allowed by an oversight to accompany the army, drank, starved, gave birth to infants, carried on their trade as prostitutes, and died of cholera. "But it is not a building, it's a town!" exclaimed a new arrival.
To reach the Barrack Hospital meant martyrdom for wounded men. Their was no pier, and the rickety landing-stage could only be used by small boats. The men were taken out of the sick transports and lowered into caïques or rowing-boats; after landing they were jolted on stretchers over rough ground up a precipitous slope.
Although so near Constantinople the situation was isolated. The only communication with Constantinople was by boat, and the Bosphorus was swept by sudden storms which cut off all communication for three or four days at a time. At Scutari were the principal cemeteries of Constantinople, but no markets or shops, only a "profusion of tombs, fountains and weeping willows"---and ample opportunities for drunkenness and vice. As soon as the British Army occupied Scutari, a horde of Jews, Greeks, and Armenians descended. Tents, booths, ramshackle sheds used as drinking-shops and brothels sprang up round the barracks, and spirits of the worst quality were drunk by the troops in enormous quantities. Regiments sent to Scutari rapidly deteriorated, and on one night, out of 2400 troops stationed in the barracks, 1400 were reported drunk.
These were obvious drawbacks, but the vast building hid a more fatal secret. Sanitary defects made it a pest house, and the majority of the men who died there died not of the wounds or sickness with which they arrived but of disease they contracted as a result of being in the hospital.
The catastrophe which destroyed the British Army was a catastrophe of sickness, not of losses in battle. There were two different sicknesses. The troops on the heights before Sebastopol fell sick of diseases resulting from starvation and exposure. When they were brought down to Scutari and entered the Barrack Hospital, they died of fevers resulting from the unsanitary construction of the Barrack Hospital assisted by insufficient food, filth, and overcrowding. The second sickness was the more fatal. When the war was over, it was found that the mortality in each regiment depended on the number of men which that regiment had been able to send to Scutari.
When Miss Nightingale entered the Barrack Hospital on November 5, 1854, there were ominous signs of approaching disaster, but the catastrophe had not yet occurred. Food, drugs, medical necessities had already run short, the Barrack Hospital was without equipment, and in the Crimea supply was breaking down. Winter was swiftly advancing, and each week the number of sick sent to Scutari steadily increased.
There were men in the Crimea, there were men in Scutari, there were men at home in England who saw the tragedy approach. They were powerless. The system under which the health of the British Army was administered defeated them. The exactions, the imbecilities of the system killed energy and efficiency, crushed initiative, removed responsibility, and were the death of common sense.
Three departments were responsible for maintaining the health of the British Army and for the organization of its hospitals. The Commissariat, the Purveyor's Department, and the Medical Department. They were departments which during forty years of economy had been cut down nearer and still nearer the bone. In 1853, Dr. Andrew Smith, the Director-General of the British Army Medical Service, received 1200 pounds sterling a year and had only twelve clerks to execute the entire administration of his department. The Purveyor's Department had been reduced to a staff of four, and at the outbreak of war it was extremely difficult to find anyone with sufficient experience to send out as a Purveyor-in-Chief. Mr. Ward, "poor old Ward," the Purveyor at Scutari, was over seventy years of age, a veteran not only of the Peninsula but of Walcheren. His staff consisted of two inexperienced clerks and three boys who also acted as messengers. Mr. Filder, the Commissary-General, a Peninsula veteran, complained in 1855 that he was expected with three incompetent clerks to conduct and record the whole business of supplying the British Army in the Crimea.
These departments had no standing. Dr. Andrew Smith told the Roebuck Committee that it would have been considered impertinence on his part to approach the Commander-in-Chief with suggestions as to the health of the army. A commissary officer did not rank as a gentleman, while the purveyor was despised even by the commissary. Ill paid, despised, not highly qualified and painfully anxious for promotion, their fear of their superior officers, especially of the military authorities, was abject. It was something, wrote Miss Nightingale, which no one outside the army had any idea of; it was absolutely Chinese. Men of courage, of determination, and of character might have risen above the system, as Dr. Alexander, the ablest man in the medical service rose above it, but such men did not usually choose to become commissariat officers, purveyors, or army surgeons.
The method by which the hospitals were supplied was confused. The Commissariat were the caterers, bankers, carriers, and store-keepers of the army. They bought and delivered the standard daily rations of the men whether they were on duty or in hospital. The bread and the meat used in the hospitals, the fuel burned there were supplied by the Commissariat. But the Commissariat did not supply food for men too ill to eat their normal rations. At this point the Purveyor stepped in. All invalid foods, known as "medical comforts," sago, rice, milk, arrowroot, port wine, were supplied by the Purveyor. But though these comforts were supplied to the hospital by the Purveyor, he did not obtain them: all the Purveyor's contracts were made by the Commissariat. The Purveyor never dealt directly with his merchant and had no power over him. If goods were unsatisfactory, the Purveyor could only complain to the Commissariat. Though the standard daily rations of the men in hospital were bought and delivered by the Commissariat, it was the Purveyor who cooked and distributed them. Yet he had no authority over their price, suitability, or quality, having to accept what the Commissariat sent unless he could claim the consignment was unfit for human consumption. Mr. Filder, the Commissary-General, cross-examined by the Roebuck Committee, said with heat that for his part he never had understood where the duties of the Commissariat ended and the duties of the Purveyor began. Mr. Benson Maxwell, an eminent lawyer and a member of the Hospitals Commission, declared that though he had spent some weeks in the hospitals he was perfectly unable to disentangle the respective duties of Commissariat and Purveyor.
Relations between the doctors and the Purveyor were even more obscure. A doctor might order a man a special diet, but it depended on the Purveyor whether the patient received it or not. Having made a requisition on the Purveyor, the doctor was powerless. Dr. Andrew Smith stated before the Roebuck Committee that he could not say what his position was with regard to the Purveying Department. If he made a complaint, the Purveyor told him it was not his province. "Then," said Dr. Smith, "I must go to the War Office and get them to carry out what 1 ought to have the power to carry out." He was asked: "Has this uncertainty with regard to the power of providing necessaries and comforts in the hospitals been in existence ever since you have been at the Medical Board?" "Yes, and long before that."
Though the system placed executive power in the hands of the Commissariat and the Purveyor, it was only a limited power. Certain goods only might be supplied. Each department had a series of "warrants" naming definite articles. "The Purveyor," wrote Miss Nightingale, "only gives such amounts of articles as are justifiable under his 'warrants,' by which he is governed, and is not responsible for those wants of the soldier in hospital which are in excess of the warrants, whatever may be the evidence before him, either in the requisition of the medical officer or the personal observation which, it would appear, he was bound to make of what was close under his eyes."
The result was the extraordinary shortages. When the sick and wounded came down to Scutari from the Crimea, they were in the majority of cases without forks, spoons, knives, or shirts. The regulations of the British Army laid down that each soldier should bring his pack into hospital with him, and his pack contained a change of clothing and utensils for eating. These articles were consequently not on the Purveyor's warrant. But most of the men who came down to Scutari had abandoned their packs after Calamita Bay, or on the march from the Alma to Balaclava, at the orders of their officers. Nevertheless, the Purveyor refused to consider any requisitions on him for these articles.
Officials were trained not to make trouble, not to spend money, never to risk responsibility; and at Scutari, grossly overworked as they were, they were placed in a situation which demanded courage and resource. The system, while it discouraged action, was enormously prolific of forms, requisitions, dockets, cross-checks, authorizations, and reports.
In the hospitals at Scutari every requisition, however trifling, had to be checked and counter-signed by two doctors, one of them a senior officer. No medical officer was permitted to use his discretion. The surgeon on duty had to make as many as six different daily records of the "Diet Roll," the particulars of food and comforts to be consumed by each patient. As soon as a man attained proficiency in his profession and became a first-class surgeon, he spent so much time filling in forms and drawing up reports that the care of the patients was left to inexperienced juniors. Dr. Menzies, Senior Medical Officer at the Barrack Hospital, stated that he was so inundated with office work that he had no time to go into the wards. "It must be admitted," the Roebuck Committee agreed, "that he had no time left for what should have been his principal duty, the proper superintendence of these hospitals."
The Barrack Hospital was the fatal fruit of the system. When the General Hospital was unexpectedly filled with cholera cases and Dr. Menzies was abruptly notified that the casualties from the Alma and a further large number of cholera cases were on their way, he was instructed to turn the Turkish Barracks into a hospital. The preparation and equipment of a hospital formed no part of his duties, his task being to instruct the Purveyor. He sent for "poor old Ward" and told him to prepare the Turkish Barracks for the reception of wounded. He had then, in accordance with the rules of the service, performed his duty. How Mr. Ward was to conjure hospital, equipment at a moment's notice out of the drink-shops, brothels, and tombs of Scutari, how he was to collect labor to clean the vast filthy building when no labor existed nearer than Constantinople, was not Dr. Menzies's concern. Mr. Ward also knew the correct procedure. He had no authority to expend sums of money in purchasing goods in the open market, and in any case many of the articles required were not on his warrant. He requisitioned the Commissariat on the proper forms, the Commissariat wrote on the forms "None in store," and the matter was closed. The wounded arrived and were placed in the building without food, bedding, or medical attention. At a later date Dr. Menzies instructed the Purveyor to issue the men shirts. This was not done, and the men continued to lie naked. Dr. Menzies was asked by the Roebuck Committee why he had not seen to it that his order was carried out. He replied that it was no part of his duty to see that an order was executed. Having issued the instruction correctly and placed it on record, his duty was done. "Their heads," wrote Miss Nightingale in 1855, "are so flattened between the boards of Army discipline that they remain old children all their lives."
The destruction of the British Army in the Crimean campaign was materially assisted by the attitude of his officer to the private soldier. Savage physical suffering was endured by officers and men alike, and the officers were courageous, stoical, physically tough---Sir George Brown, who commanded the Light Division, had had his arm cut off in the Peninsula and had been thrown on some straw in the bottom of a cart; Lord Raglan had had his arm amputated without an anesthetic after Waterloo and had called out: "Here, bring that arm back, there is a ring my wife gave me on the finger." But officers regarded the men they commanded as denizens of a different world.
The private soldier of 1854 did not bear a good character. The young man who was the disgrace of his village, the black sheep of the family, enlisted. The Duke of Wellington described his army, the army which won the victories of the Peninsula and Waterloo, as "the scum of the earth enlisted for drink." Officers had no feeling of responsibility toward their men. "During the time I have been in the Crimea, that is since the landing . . . no general officer has visited my hospital nor, to my knowledge, in any way interested himself about the sick," Dr. Brush of the Scots Greys wrote to the Hospitals Commission. When it became evident that the army would have to winter before Sebastopol under conditions of appalling severity, a large number of officers threw up their commissions and went home. Many of these, like Lord George Paget, who had taken part in the Charge of the Light Brigade, were men of unquestioned personal courage. They were astounded when they were cut in their clubs.
Miss Nightingale was told: "You will spoil the brutes"; she heard the troops described by their officers as "animals," "blackguards," "scum." And the medical authorities were enraged by what they considered unreasonable demands---clean bedding, soup, hospital clothing were "preposterous luxuries." "Poor old Ward." cross-examined as to the state of the Barrack Hospital by the Hospitals Commission in December, 1854, said: "I served through the whole of the Peninsula War. The patients never were nearly so comfortable as they are here. . . . In general the men were without bedsteads. Even when we returned to our own country from Walcheren and Corunna the comforts they got were by no means equal to what they have here."
The doctors at Scutari received the news of Miss Nightingale's appointment with disgust. They were understaffed, overworked; it was the last straw that a youngish Society lady should be foisted on them with a pack of nurses. Of all Government follies, this was the worst. However, they had no choice but to submit; open opposition would be dangerous, for Miss Nightingale was known to have powerful backing, to be the intimate friend of Sidney Herbert and on friendly terms with half the Cabinet. Opinion was divided as to whether she would turn out a well-meaning, well-bred nuisance or a Government spy. For their part, regimental officers received the news with an indulgent smile. Colonel Anthony Sterling, attached to the Highland Brigade, wrote in November, 1854: "The ladies seem to be on a new scheme, bless their hearts. . . . I do not wish to see, neither do I approve of, ladies doing the drudgery of nursing."
However, on November 5 Miss Nightingale and her party were welcomed into the Barrack Hospital with every appearance of flattering attention and escorted into the hospital with compliments and expressions of goodwill. When they saw their quarters, the picture abruptly changed. Six rooms, one of which was a kitchen and another a closet ten feet square, had been allotted to a party of forty persons. The same space had previously been allotted to three doctors and, in another part of the hospital, was occupied solely by a major. The rooms were damp, filthy and unfurnished except for a few chairs. There were no tables; there was no food. Miss Nightingale made no comment, and the officials withdrew. It was a warning, a caution against placing reliance on the flowery promises, the resounding compliments of Stratford Canning, first Viscount Stratford de Redcliffe.
Lord Stratford had been British Ambassador to Constantinople three times and associated with Turkey since 1807. His influence was immense; he was virtually a dictator; his latest "reign" at Constantinople had lasted, with a two years' intermission, for sixteen years. The Turks called him "the great Elchi," the great ambassador. Physically he was extremely handsome, and he prided himself on his presence---"the thin rigid lips, the majesty of brow of a Canning." He lived magnificently and traveled with twenty-five servants and seventy tons of plate.
Miss Nightingale described Lord Stratford as bad-tempered, heartless, pompous, and lazy. He loved to consort with kings and emperors; he loved to write bad poems in majestic rhythms and keep his attachés up until the small hours while he read them aloud. He was jealous of his inferiors. "The Elchi," wrote Lord Napier, "would never employ anyone on serious work who was at all near himself, so I spent the best years of my life at a momentous crisis doing nothing." He was not the man to interest himself in a hospital for common soldiers. In his magnificent palace on the Bosphorus he lived for two years with, said Miss Nightingale, "the British Army perishing within sight of his windows," and during those two years he visited the hospitals only once, when she "dragged" him there for a visit of only one and a half hours.
After receiving Sidney Herbert's letter, Lord Stratford informed Dr. Menzies that if anything was required for the hospitals both The Times fund and public money were available. Dr. Menzies was thoroughly alarmed; the suggestion that civilian funds should be used to make good deficiencies in army administration struck him with horror. He refused to admit anything was wrong: as far as present wants extended, the hospitals were satisfactorily supplied, and as for future needs he referred once more to the stores expected from Varna. The Ambassador accepted this assurance. He did not go across and see the hospitals for himself, nor did he send anyone else to inspect them or ask for details. He wrote to Sidney Herbert that there did not appear to be anything required and passed on to a project very near his heart: the subscriptions to The Times fund would be difficult to return, and he pressed that they should be devoted to the building of a Protestant Church in Constantinople. Though he was strongly Protestant in sympathies, the project was by no means a religious one. It would be a diplomatic triumph. To have procured permission from the Sultan to build a church of a rival religion in Constantinople, a Mohammedan city, was a mark of extraordinary favor, and the building of the church would immensely increase British prestige.
That night, as Miss Nightingale was calculating how she could cram her party of forty into five small rooms and a kitchen, Lord Stratford wrote a flowery letter to the Duke of Newcastle complimenting her on the "accomplishments" she brought into the field of charity and venturing to hope that "much comfort may be derived by the sick and wounded from that attractive source."
Fourteen nurses were to sleep in one room, ten nuns in another; Miss Nightingale and Mrs. Bracebridge shared the closet; Mr. Bracebridge and the courier-interpreter slept in the office; Mrs. Clark, who was to be cook, and her assistant must go to bed in the kitchen. There was one more room upstairs, and the eight Sellonites must sleep there. They went upstairs, and hurried back. The room was still occupied---by the dead body of a Russian general. Mr. Bracebridge fetched two men to remove the. corpse while the sisters waited. The room was not cleaned, and there was nothing to clean it with; it was days before they could get a broom, and meanwhile the deceased general's white hairs littered the floor. There was no furniture, no food, no means of cooking food, no beds. Most of the party prepared to sleep on so-called Turkish "divans," raised wooden platforms running round the rooms on which the Turks placed bedding; there was, however, no bedding. While the nurses and sisters unpacked, Miss Nightingale went down into the hospital and managed to procure tin basins of milkless tea. As the party drank it, she told them what she had discovered.
The hospital was totally lacking in equipment. It was hopeless to ask for furniture. There was no furniture. There was not even an operating table. There were no medical supplies. There were not even the ordinary necessities of life. For the present the nurses must use their tin basins for everything, washing, eating, and drinking.
They must be prepared to go short of water. The allowance was limited to a pint a head a day for washing and drinking, including tea, and it was necessary to line up in one of the corridors where there was a fountain to obtain it. Tomorrow the situation would become worse; a battle at Balaclava had been fought on October 25, and transports loaded with sick and wounded were expected.
The party had to go to bed in darkness, for the shortage of lamps and candles was acute. Sisters and nurses lying on the hard divans tried to console themselves by thinking how much greater were the sufferings of the wounded in the sick transports. The rooms were alive with fleas, and rats scurried beneath the divans all night long. The spirits of all, wrote Sister Margaret Goodman, one of the Sellonites, sank.
The doctors ignored Miss Nightingale. She was to be frozen out, and only one doctor would use her nurses and her supplies. Mr. Macdonald told the Hospitals Commission: "Nurses were offered by Miss Nightingale and not accepted"; and he experienced similar difficulty himself. He had The Times fund to spend; the urgency of the need for supplies was tragically evident, but he had the greatest difficulty in "squeezing out" of the doctors an admission of what was needed. The medical authorities drew together in a close defensive phalanx. Admit failure! Accept help for the army from civilians, from The Times under whose attacks the army authorities were smarting! From a high Society miss who happened to be on dining terms with the Cabinet! Their experience of army methods, of confidential reports, told them that the man who consorted with Miss Nightingale or who supplied his wards through The Times fund would be a marked man.
She realized that before she could accomplish anything she must win the confidence of the doctors. She determined not to offer her nurses and her stores again, but to wait until the doctors asked her for help. She would demonstrate that she and her party wished neither to interfere nor attract attention, that they were prepared to be completely subservient to the authority of the doctors.
It was a policy which demanded self-control; the party were to stand by, see troops suffer, and do nothing until officially instructed. Though Miss Nightingale could accept the hard fact that the experiment on which she had embarked could never succeed against official opposition, yet she inevitably came into conflict with her nurses.
A day passed, and some stores arrived. She made them sort old linen, count packages of provisions. The hardships of life continued. They stood in the corridor to get their pint of water. They ate out of the tin bowls, wiped them with paper, washed their faces and hands in them, wiped them again and drank tea from them. Discomfort would have been ignored if the sufferings of the wounded had been relieved, but they were not relieved. The cries of the men were unanswered while old linen was counted and mended---this was not what they had left England to accomplish. They blamed Miss Nightingale.
On Sunday, November 6, the ships bringing the wounded from Balaclava began to unload at Scutari. As on other occasions the arrangements were inadequate, and the men suffered frightfully; they were brought up to the hospital on stretchers carried by Turks, who rolled their bleeding burdens about, put the stretchers down with a bump when they needed a rest, and on several occasions threw the patient off. Screams of pain were the accompaniment to the unhappy procession, and Sister Margaret Goodman recorded the case of a soldier who died as a result.
Still Miss Nightingale would not allow her nurses to throw themselves into the work of attending on these miserable victims. She allocated twenty-eight nurses to the Barrack Hospital and ten to the General Hospital a quarter of a mile away. All were to sleep in the Barrack Hospital, and all were to wait. No nurse was to enter a ward except at the invitation of a doctor. However piteous the state of the wounded, the doctor must give the order for attention. She sent her nurses to church to sit through an admirable sermon by the chief Chaplain, Mr. Sabin. If the doctors did not choose to employ the nurses, then the nurses must remain idle.
She was also determined to send no nurse into the wards until she knew that nurse could be relied on. The reliability of the nurse was as important to the success of the experiment as the cooperation of the doctors, and for nearly a week the party were kept shut up in their detestable quarters making shirts, pillows, stump-rests, and slings and being observed by her penetrating eye. The time, sighed one of the English Sisters of Mercy, seemed extremely long.
In any case, no directions had been issued governing the employment of nurses. They were entirely in the hands of the doctors. "No general order," wrote Miss Nightingale in 1856, "ever existed defining the duties of the nurses in the various hospitals to which they were respectively attached. . . . The number admitted into each division depended on the medical officer of that Division, who sometimes accepted them, sometimes refused them, sometimes accepted them after they had been refused."
Miss Nightingale herself rigidly obeyed regulations. On a later occasion she was sitting by the bedside of a man critically ill and found his feet stone cold. She told an orderly to fetch a hot-water bottle. The man refused, saying he had been told to do nothing for a patient without directions from a medical officer. She accepted the correction, found a doctor, and obtained a requisition in proper form. For weeks she stood by in silence while the skill of highly efficient nurses was wasted.
"Our senior medical officer here," she wrote to Sidney Herbert in January, 1855, "volunteered to say that my best nurse, Mrs. Roberts, dressed wounds and fractures more skillfully than any of the dressers or assistant surgeons. But that it was not a question of efficiency, nor of the comfort of the patients, but of the 'regulations of the service.' "
She was first able to get a footing in the hospital through the kitchen. A state of starvation existed in the Barrack Hospital. According to regulations a private soldier in hospital was placed on what was known as a whole diet, a half-diet, or a spoon diet, the first representing the man's ordinary rations cooked for him by the hospital, the second about half his rations, and the third liquid food. In addition he was supposed to receive "extra diet," wine, milk, butter, arrowroot, jelly, milk puddings, egg', etc., as prescribed by the surgeon attending him and procured through the Purveyor.
But to cook anything at the Barrack Hospital was practically impossible. The sole provision for cooking was thirteen Turkish coppers each holding about 450 pints. There was only one kitchen. There were no kettles, no saucepans; the only fuel was green wood. The tea was made in the coppers in which the meat had just been boiled, water was short, the coppers were not cleaned, and the tea was undrinkable. The meat for each ward was issued to the orderly for the ward, who stood in line to receive it from the Purveyor's Department. The Purveyor was understaffed, and when the hospital had 2500 patients one clerk did all the issues, and the orderlies had to wait an hour or more. When the orderly had the meat, he tied it up, put some distinguishing marks on it, and dropped it into the pot. Some of the articles used by the orderlies to distinguish their meat included red rags, buttons, old nails, reeking pairs of surgical scissors, and odd bits of uniform. The water did not generally boil; the fires smoked abominably. When the cook considered that sufficient time had been taken up in cooking, the orderlies threw buckets of water on the fires to put them out, and the contents of the coppers were distributed, the cook standing by to see that each man got his own joint; the joints which had been dropped in last were sometimes almost raw. The orderly then carried the meat into the ward and divided it up, usually on his bed, and never less than twenty minutes could elapse between taking it out of the pot and serving it. Not only were the dinners always cold, but the meat was issued with bone and gristle weighed in, and some men got portions which were all bone. Those who could eat meat usually tore it with their fingers---there were almost no forks, spoons, or knives. Men on a spoon diet got the water in which the meat had been cooked, as soup. There were no vegetables only, sometimes, dried peas.
Orderlies cooked extras over fires of sticks in the wards and the courtyard. One of them, Edward Jennings, told the Hospitals Commissions on December 14, 1854: "I boil chickens in an old tin in the ward. I also cook the sago and other things as well as 1 can . . . the doctor does not give me any directions. I cook all the extras and give them to the man at once and he can do what he likes with them. . . . I never did anything in the way of cooking until I became an orderly." The administration of medicines was left to the orderlies, and it was their practice to give the day's medicine in one draught. When wine was ordered, the orderlies drank it themselves. They also ate the rations of men who were ill or asleep. One of the Sellonite sisters saw a young orderly eat up eight dinners.
The food was almost uneatable by men in rude health; as a diet for cholera and dysentery cases it produced agonies. The torture endured by the men when the pangs of hunger were superimposed on diarrhea was frightful. "I have never seen suffering greater," wrote one observer.
The day after Miss Nightingale arrived she began to cook "extras." She had bought arrowroot, wine and beef essences, and portable stoves in Marseilles. On the 6 of November, with the doctors' permission, she provided pails of hot arrowroot and port wine for the Balaclava survivors, and within a week the kitchen belonging to her quarters had become an extra diet kitchen, where food from her own stores was cooked. For five months this kitchen was the only means of supplying invalid food in the Barrack Hospital. She strictly observed official routine, nothing being supplied from the kitchen without a requisition signed by a doctor. No nurse was permitted to give a patient any nourishment without a doctor's written directions.
Cooking was all she had managed to accomplish when, on November 9, the situation completely changed. A flood of sick poured into Scutari on such a scale that a crisis of terrible urgency arose, and prejudices and resentments were for the moment forgotten.