
MISS NIGHTINGALE, IN 1861, received a letter from a Mr. William Rathbone of Liverpool, who was the eldest son of a dynasty of Liverpool merchants and shipowners, and the sixth William Rathbone in succession to be senior partner in the family firm. He inherited a tradition of philanthropy and liberalism. His grandfather had been a prominent Abolitionist, and his father, though the Rathbones were originally Quakers, had taken a leading part in the struggle for Catholic emancipation. As a young man he was an honorary visitor for the District Provident Society in one of the poorest quarters in Liverpool, and witnessed the miseries endured by the poor who were ill in their own homes. In 1859 he founded district nursing, starting in his own district with one trained nurse. Since one nurse proved ludicrously inadequate, he decided to establish, at his own expense, a body of trained nurses to nurse the sick poor in their own homes. Finding that trained nurses of the type he required---responsible, trustworthy, and experienced---did not exist, he wrote to Miss Nightingale asking her advice.
Though she was overwhelmed with work on the Indian Sanitary Commission, she gave William Rathbone's scheme "as much consideration," he wrote, "as if she herself were going to be the Superintendent." She came to the conclusion that the only satisfactory solution was to train nurses specially, and suggested that the Royal Liverpool Infirmary should be approached to cooperate in opening a training school with the guarantee that a fixed percentage of nurses trained should be reserved for the Royal Infirmary. In the following year, at William Rathbone's expense, a Training School and Home for Nurses was opened in connection with the Royal Infirmary and proved an unqualified success.
William Rathbone, austere in spite of great wealth, unselfish, tenderhearted, devoid of sentimentality to the point of dryness, was a man Miss Nightingale could appreciate, and they became intimate friends. His admiration and affection for her was unbounded; he wrote that he was "proud to be one of her journey men workers," and when she moved into South Street he presented her with a stand filled with flowering plants, which he kept renewed weekly until his death.
While following up cases from his district he visited workhouse infirmaries and found that, though the sick in the slums were miserable, the paupers in the workhouse infirmaries were more miserable still. The Liverpool Workhouse Infirmary was, on the whole, well administered, but the condition of the sick was wretched beyond description. Twelve hundred sick paupers were accommodated. As in all workhouse infirmaries, such nursing as existed was done by able-bodied female paupers, and owing to the fact that Liverpool was a seaport and the city had large harbor slums, many of the women were drunken prostitutes. These women, wrote Miss Eleanor Rathbone in a memoir of her father, "were superintended by a very small number of paid, but untrained, parish officers, who were in the habit, it was said, of wearing kid gloves in the wards to protect their hands. All night a policeman patrolled some of the wards to keep order, while others, in which the inhabitants were too sick or infirm to make disturbance, were locked up and left unvisited all night."
On January 31, 1864, William Rathbone made the first move to reform workhouse nursing. He wrote to Miss Nightingale and suggested that a staff of trained nurses and a matron should be sent to the Liverpool Workhouse Infirmary; it was not possible to send nurses from the training school, as the full number trained there was already bespoken by the Royal Infirmary and the District Nursing scheme. If she could find nurses and a matron, he offered to guarantee the cost for whatever term of years she thought advisable. It would not be easy to obtain permission to introduce the nurses, and he asked her to draft a letter which he could send to the Vestry who controlled the Workhouse Infirmary, asking for their cooperation.
A long battle ensued. "There has been as much diplomacy and as many treaties and as much of people working against each other, as if we had been going to occupy a Kingdom instead of a Workhouse," Miss Nightingale wrote to Rev. Mother Bermondsey in September, 1864. Permission was not granted until March, 1865, and by then she had also become involved in the reform of workhouse nursing in London.
In December, 1864 a pauper named Timothy Daly died in the Holborn Workhouse. There was an inquest, and it was found that death had resulted from filthiness caused by gross neglect; the newspapers took the case up, and there was a public scandal. Miss Nightingale seized the opportunity to write a tactful letter to Mr. Charles Villiers, the President of the Poor Law Board. She ventured to write, she said, because Timothy Daly's case proved the overwhelming necessity for the improvement of nursing in workhouse infirmaries. He might perhaps be interested to hear what was going to be done in the Liverpool Workhouse Infirmary with a staff of trained nurses and a matron from the Nightingale Training School.
Mr. Villiers replied immediately; he was a friend of Lord Palmerston; he was a friend also of Miss Nightingale's ally, Sir Robert Rawlinson the engineer. A champion of the people's rights, Charles Villiers had devoted many years of his life to the repeal of the Corn Laws to reduce the price of bread. His appearance was romantically handsome, his manner was charming, and his powers of conversation were considered unequaled.
At the end of January he called and by the end of the interview they were firm friends. Her powers inspired him with intense admiration. Sir Edward Cook describes him bursting out to a friend after he had received one of her memoranda: "I delight to read the Nightingale's song about it all. If any one of them had a tenth part of her vigour of mind we might expect something."
More than the reform of workhouse nursing was discussed. She had realized that it was virtually impossible to reform workhouse nursing without reforming workhouse administration, and she urged Mr. Villiers to make use of the death of Timothy Daly to initiate an investigation into the whole question of the treatment of the sick poor.
"They are much more frightened by the death from the Holborn Union than they 'let on,'" she wrote to Sir John McNeill on February 7. "I was so much obliged to that poor man for dying. It was want of cleanliness. Mr. Villiers says that he shall never hear the last of it." Early in February, 1865 Mr. Villiers sent his principal assistant, Mr. H. B. Farnall, to see her. Mr. Farnall was Poor Law Inspector for the Metropolitan District. He had been working for Poor Law Reform all his life and knew the almost insuperable difficulties lying ahead, but she inspired him with an astonishing confidence. "From the first," he wrote in December, 1866, "I had a sort of fixed faith that Florence Nightingale could do anything."
It was decided to start the investigation in London, and with Mr. Farnall's assistance Miss Nightingale drew up a "Form of Enquiry" to be circulated to every workhouse infirmary and workhouse sick ward in the Metropolitan district. Mr. Villiers approved, and the forms were sent out in February, 1865.
In March permission was at last given for the Nightingale nurses to enter the Liverpool Workhouse Infirmary, and on May 16 twelve nurses and a matron, Miss Agnes Jones, arrived. "Mr. Rathbone puts down £1200," wrote Miss Nightingale. The experiment was at first to be confined to the male wards only.
Once more she was desperately anxious. Once more everything hung on the endurance, the good behavior, and the good sense of a band of young women. She had convinced Mr. Villiers of the possibility of employing trained nurses in workhouse infirmaries, but what if the nurses failed? The task which lay before them was fearful enough to daunt the boldest. Fortunately the matron was a young woman of remarkable character and qualifications who had already been selected by Miss Nightingale as the only woman capable of becoming her successor. Agnes Jones was the daughter of Colonel Jones of Londonderry and the niece of Sir John Lawrence. She was "pretty and young and rich and witty, ideal in her beauty as a Louis XIV shepherdess," Miss Nightingale wrote to Clarkey. But beneath the prettiness was the soul of a martyr. Miss Nightingale's work in the Crimea had inspired her to become a nurse, and, following in her footsteps, she persuaded her family to allow her to go to Kaiserswerth in 1860. After two years there she wrote to Miss Nightingale, who advised her to complete her training by a year at the Nightingale School at St. Thomas's. She entered in 1863 and was the best probationer Mrs. Wardroper had ever had and Miss Nightingale's "best and dearest pupil." On completing her training, she went to the Great Northern Hospital and was working there as a sister when she was offered the post of Matron of the Liverpool Workhouse Infirmary in August, 1864.
She knew how fearful would be the task, and she refused; but her conscience would not let her rest. Had she not received a call from God? After days spent in agony and prayer, she wrote again and accepted.
In 1868 Miss Nightingale wrote an account of Agnes Jones's work in Good Words under the title "Una and the Lion." The Lion symbolized the paupers Agnes Jones had to nurse, "far more untameable than any lion." She had nursed in great London hospitals, but, she said, until she came to Liverpool Workhouse Infirmary she did not know what sin and wickedness were. The wards were an inferno, the hordes of pauper patients more degraded than animals. Vicious habits, ignorance, idiocy, met her on every side. Drunkenness was universal---thirty-five of the pauper nurses had to be dismissed for drunkenness in the first month. Immorality was universal. Filth was universal. The patients wore the same shirts for seven weeks; bedding was only changed and washed once a month; food was at starvation level; spirits entered the infirmary freely. The number of patients was very large, 1350, rising at times to 1500.
There were administrative difficulties; her position and powers were not properly defined; the supply of food to the Workhouse Infirmary was done by contract, and the doctors had no control over it; the task of training the pauper nurses was hopeless. "It is like Scutari over again " Miss Nightingale told her.
At first it seemed that the experiment was failing. The governor of the Infirmary had supported the scheme, but Agnes Jones quarreled with him. She objected to his "want of refinement," and he thought her too strict and unpractical. There were several serious disagreements, described by Dr. Sutherland as "Hibernian Rows." Miss Nightingale intervened, smoothed things over, talked each side round. When affairs in Liverpool reached a deadlock, William Rathbone made a flying trip to London to consult her.
Gradually the scene changed. Agnes Jones, under Miss Nightingale's influence, became less rigid, and her genius as a nurse and as an administrator made itself felt. Old women visiting their husbands reported "wonderful changes in the House" since the London nurses came. Ladies who acted as charitable visitors began to sing her praises; the medical staff asked for more nurses. The results Miss Jones was achieving were so good that they intended to propose she should take over the female as well as the male wards. Most important of all, the cost of maintaining the sick in the Workhouse Infirmary under her regime was less, not more, than before. Agnes Jones, wrote Miss Nightingale, converted the Vestry to the conviction of the economy as well as the humanity of nursing pauper sick by trained nurses.
With this success behind her Miss Nightingale pressed for legislation.
It was impossible to correct the abuses which existed in workhouses and workhouse infirmaries until they were put on a new financial and administrative basis. To make the changes required, there must be an Act of Parliament. She did not try to establish a position for herself within the Poor Law Board as she had done with the War Office and the India Office. Mr. Villiers was over sixty. and, much as she liked him, she was forced to realize that he no longer possessed the energy to be her mouthpiece. The Poor Law Board would never produce the necessary legislation ---she must go over its head and approach Lord Palmerston. Once more she succeeded. He promised that if she would draft a Bill he would use his influence to get it through the Cabinet. Full of hope, she began work with Mr. Farnall, but another blow fell. It was the moment when Lord Palmerston was taken ill, and on October 18 he died; her hopes of influence in the Cabinet were at an end.
She must depend again on Mr. Villiers, but she was not left without hope. The answers to the "Form of Enquiry" sent out to London workhouses and workhouse infirmaries revealed facts so shameful that they could not be ignored.
Through the autumn of 1865 she worked on a scheme for the Metropolitan area which was intended to be extended later to other areas. The first necessity was to change the mental attitude which made the miseries of the hideous system possible. "So long," she wrote, "as a sick man, woman or child is considered administratively to be a pauper to be repressed and not a fellow creature to be nursed into health, so long will these shameful disclosures have to be made. The sick, infirm or mad pauper ceases to be a pauper when so afflicted." It was the conception on which she based her attitude toward the human race. Suffering lifts its victim above normal values. While suffering endures, there is neither good nor bad, valuable nor invaluable, enemy nor friend. The victim has passed to a region beyond human classification or moral judgments, and his suffering is a sufficient claim.
Administratively her scheme for reform was based on three essentials which she termed the A B C of workhouse reform.
(A) The sick, insane, incurable, and children must be dealt with separately in proper institutions and not mixed up together in infirmaries and sick wards as at present. "The care and government of the sick poor is a thing totally different from the government of paupers. Once acknowledge this principle and you must have suitable establishments for the cure of the sick and infirm."
(B) There must be a single central administration. "The entire Medical Relief of London should be under one central management which would know where vacant beds were to be found, and be able so to distribute the Sick etc., as to use all the establishments in the most economical way."
(C) "For the purpose of providing suitable establishments for the care and treatment of the Sick, Insane etc., Consolidation and a General Rate are essential." This point was vital; the future of workhouse nursing and administration turned on it. As long as the workhouses and infirmaries were paid for out of the parochial rates, and staff appointments were made by local authorities with absolute power, there would inevitably be jobbery. Moreover, "to provide suitable treatment in each Workhouse would involve an expenditure which even London could not bear." At the moment to be a sick or insane pauper in a poor parish was to be horribly penalized.
The memorandum reached Mr. Villiers in December. Her case was unanswerable, and he agreed to press at once for a new London Poor Law Bill. From day to day the situation improved. The Lancet sent a special commissioner to inquire into the state of London workhouse infirmaries, and, as a result, the "Association for the Improvement of the Infirmaries of London Workhouses" was formed. In April, 1866 the Association sent a deputation to the Poor Law Board pressing for immediate improvement, and Mr. Villiers gave an assurance that legislation might be expected almost immediately. Newspaper articles began to appear. Delane, editor of The Times, called to see Mr. Villiers, and journalists, including Edwin Chadwick, applied to Miss Nightingale for facts. In April the Metropolitan Workhouse Infirmary Bill seemed almost a certainty.
Yet once more everything vanished into thin air. It was the spring of 1866, and the Whig Government was tottering. Workhouse infirmary reform was a controversial subject, and as Lord de Grey delayed on the Indian Public Health Service so Mr. Villiers delayed on the Metropolitan Workhouse Infirmary Bill. "He was afraid," wrote Miss Nightingale to Harriet Martineau, on May 2, "of losing the Government one vote." On June 18 the Government fell, Mr. Villiers went out of office, and the Metropolitan Workhouse Infirmary Bill Was lost.
Though all the summer she was very ill, she would not accept defeat. Surely in some direction something could be done. "I had hopes for a time from a Committee of the House of Commons (on which serves John Stuart Mill) on the special Local Government of the Metropolis," she wrote to M. Mohl. on July 12. She sent John Stuart Mill a copy of her scheme; she approached Edwin Chadwick, who also served on the House of Commons Committee, offering "to express my conclusions more in detail in answer to written questions (as 1 have done to 2 Royal Commissions)." At first she seemed to be making an impression, and the Committee asked her for "a long letter," then hope faded as the whole question was postponed. "Because it is July and they are rather hot they give it up for this year," she wrote.
Early in July she had written to Mr. Gathorne Hardy, Mr. Villiers' successor, and on July 25 he replied in a complimentary and discouraging letter. She must not apologize for writing to him; she had "earned no common title to advise and suggest upon anything which affects the treatment of the sick." Sufficient compliments having been paid, he made it clear that he had no intention of becoming involved with her. He had "not advanced very far from want of time"; and he was "necessarily very much occupied with other business." In conclusion, he hastened to assure her he would "bear in mind the offer you have made and in all probability avail myself of it to the full."
He did not invite her to write to him again; he did not suggest calling on her. On the heels of the letter came further discouraging news. Mr. Gathorne Hardy removed Mr. Farnall from his post at Whitehall as Poor Law Inspector of the Metropolitan District and sent him to Yorkshire. There could be no plainer proof that Mr. Gathorne Hardy did not intend to be on the side of reform. Miss Nightingale was forced to admit she could do nothing further and went to Embley.
But in October Mr. Gathorne Hardy made Mr. Villiers "frantically angry." On October 31 Miss Nightingale wrote to Douglas Galton that "Mr. Hardy told him, Mr. Villiers, twice, in the Ho: of C, that had he only known how to use, with dexterity and wisdom, the weapon of the law, he would have found it a very sufficient weapon." Fresh legislation, Mr. Hardy asserted, was quite unnecessary, provided the existing Acts were properly understood and applied. Since Mr. Villiers had devoted his term of office to framing new legislation, he took this as an attack on himself. He began to write to Miss Nightingale again, expressing his determination "not to sit down under this kind of thing"; he intended to "catch Mr. Gathome Hardy out" and show him that something more was needed to solve the problem of Poor Law Administration than "a touch of Mr. Gathorne Hardy's magic wand." On October 28 Miss Nightingale wrote to Edwin Chadwick: "I have had a great deal of clandestine correspondence with my old loves at the Poor Law Board this last two months. There is only one thing of which I am quite sure. And that is that Mr. Villiers will lead Mr. Gathome Hardy no easy life next February."
In October Mr. Gathorne Hardy appointed a committee of sanitary and medical experts to report "upon the requisite amount of space and other matters in relation to Workhouses and Workhouse Infirmaries." Among the other matters was included nursing. He did not consult Miss Nightingale, but she put her pride in her pocket and asked to be allowed to contribute. The committee invited her to submit a paper on nursing; this opening gave her the chance to put forward her scheme of workhouse reform, basing her argument on the obvious truth that the organization, construction, and administration of workhouse and workhouse infirmaries were of vital importance to the nursing system. She had her paper printed and sent a copy to Mr. Gathorne Hardy with a long, urgent letter. She was writing repeatedly to him, but with no effect. He neither consulted her nor informed her what he intended to do. It was a complete surprise when on February 8 he introduced a Bill which became law in the following month under the title of the Metropolitan Poor Act.
Miss Nightingale and her fellow workers felt they had been exploited. On February 11 William. Rathbone wrote: "I think Hardy's use of our experiment and of your name atrocious." On a draft copy Miss Nightingale scribbled angrily "Humbug ... .. No principles ... .. Beastly." She was especially angry that no direct provision was made for the improvement of workhouse nursing. For this, however, she herself was to blame. She had written a letter to Mr. Gathorne Hardy reporting the victory of the Liverpool Workhouse Infirmary nursing in which she gave a dramatic description of the opposition and difficulties encountered at the beginning. He took fright; either he was genuinely alarmed, or he was not sorry to find an excuse for postponing nursing reform; in any case, he publicly gave her letter as a reason for shelving the question for the present.
In fact, resentful though the Reformers might be, the Bill was a great advance. Miss Nightingale campaigned furiously in the hope of getting it amended, but Mr. Gathorne Hardy was both conciliatory and skillful. He put forward the Bill modestly as "only a beginning," freely admitting that criticism was justified but emphasizing he was doing everything that could be done at present. One by one her supporters became lukewarm. Mr. Villiers, who had begun by calling the Bill a seven months' child born in the Whitehall Workhouse, admitted that it would "set the ball rolling." Miss Nightingale herself did not suffer her usual torments of despair. After the Bill was passed, in March, 1867, she wrote to Rev. Mother Bermondsey almost with cheerfulness: "We have obtained some things, the removal of 2000 lunatics, so fever and smallpox cases and all the remaining children out of the Workhouses---(and the providing for them out of a common fund in order to relieve the rates) the paying of all salaries of Medical Officers, Matrons, Nurses etc., out of a Metropolitan (not parochial) rate. . . . Also;---the removing all other sick into separate buildings which are to be improved---and constituting fresh Boards of Guardians for these sick with nominees from the Poor Law Board. This is a beginning, we shall get more in time."
Another battle was over, but the pause which succeeded it brought her no rest. During the summer of 1867 she was forced to stay in London working desperately on Indian sanitary affairs. She was conscious of driving herself too hard; if Sidney Herbert or Clough had been alive, she wrote to Clarkey, one of them would have made her stop. But now there was no one to stop her. Indeed, far from being able to spare herself, she was forced, in June 1867, to undertake a new and laborious work.
Part of the money raised by the Nightingale Fund had been devoted. to establishing a training school for midwives in King's College Hospital. The school flourished and was considered by Miss Nightingale to be one of her most satisfactory achievements, when it was overtaken by disaster. Puerperal sepsis broke out in the lying-in wards following the delivery of a woman suffering from erysipelas and developed into an epidemic which closed the school. An investigation followed, in the course of which she discovered that no reliable statistics of mortality in childbirth existed. As harassed, and overdriven as she was, she set to work with Dr. Sutherland's assistance to collect facts and figures on which statistics could be based. It was a difficult task. Doctors were suspicious of interference and surprisingly ignorant---one doctor told her that ergot was a specific against puerperal sepsis. Institutions were unwilling to disclose their figures. However, working through hospitals and doctors to whom she was personally known, she collected preliminary facts which pointed to a startling conclusion. It seemed that in lying-in institutions and hospital wards the rate of mortality was much higher than when patients were delivered at home, however poor and unhygienic those homes might be. She determined that a great mass of further facts must be collected and began to correspond with doctors, matrons, sanitary experts, and engineers throughout the world.
The work involved was enormous. The analyzing and tabulating was done by her, and the majority of letters were written in her own hand. The inquiry took three years to complete, years during which the pressure of other work was crushing. At the end of the inquiry she had accumulated a mass of information but had neither time nor energy to work it up. A book was planned, but Dr. Sutherland had to put it into shape, and it was not until 1871 that a small volume was published under the rather apologetic title of Introductory Notes on Lying-in Institutions.
It is one of the most interesting of Miss Nightingale's works. She reached the conclusion that the use of small separate rooms was the answer to the high rate of mortality in maternity cases. The same conclusion was reached, independently, by Sir James Simpson, the pioneer of the use of chloroform in childbirth, With whom she corresponded. When she wrote, the great discoveries of bacteriology were still ten years ahead; Lister had only just made public his first experiments with carbolic acid, and the nature of infection was not understood. Miss Nightingale herself regarded "the fear of entering a cab in which a case of fever or small pox has been for half an hour" as "morbid" and wrote of "the myth of scarlet fever being carried in a bedside carpet." But she did establish, independently, the fact that, whenever a number of maternity cases were collected together, and whenever maternity cases were under the same roof as medical and surgical cases, the mortality rose. The lower mortality in cases delivered at home was due to the fact that "however grand, or however humble, a home may be in which the birth of a child takes place, there is only one delivery in the home at one time." In London workhouses the death-rate depended on the number of deliveries. Thirteen infirmaries which had no deaths at all in five years, had under sixteen deliveries per annum. "When Waterford Institution had 8 beds in 1 room the mortality was 8 per 1000. When the wards were moved and the number of beds reduced to 4, the mortality fell to 3.4 per 1000." In La Charité in Paris maternity cases were under the same roof as medical and surgical cases, and the mortality in 1861 was 193.7 per 1000, of which over 80 per cent were due to puerperal fever.
She pressed for midwifery as a career for educated women. In 1871 there was an agitation for women to be admitted to the medical profession, an ambition with which she had little sympathy: the crying need was for nurses and midwives. She added a letter to her book: "Dear Sisters," she wrote, "there is a better thing for women to be than 'medical men,' that is 'medical women.'" "It is a good thing you are at Lea Hurst," wrote Dr. Sutherland in July, 1871, "or your 'dear sisters' would infallibly break your head."
The spring of 1867 brought final victory in Liverpool. District nursing was rapidly developing. The city had been divided into eighteen districts, each provided with trained nurses. In the Liverpool Workhouse Infirmary the cost of the scheme which William Rathbone had borne was officially assumed by the Vestry, and all the wards in the Infirmary, male and female, were placed under the authority of Agnes Jones. It was triumph, but triumph was short-lived. The winter of 1867 was a time of unemployment and distress, Agnes Jones was already cruelly overworked, and the work entailed by the additional wards was more than any human being could accomplish. "All the winter," wrote Miss Nightingale to M. Mohl in February, 1868, "she has had 1350 patients and to fight for every necessary of life for them. She has never been in bed until 1.30 A.M. and always up at 5.30 A.M." An epidemic of typhus broke out, and Agnes Jones caught the infection. On February 19, 1868, she died. The last words she spoke to Miss Nightingale were: "You have no idea how I am overworked."
Her death was a catastrophe. There was no one to take her place. Personal loss Miss Nightingale could bear; on the third anniversary of Sidney Herbert's death she had written that the mere personal craving after a beloved presence she felt as nothing, a few years and it would be over-her bitter grief was for the work. After so much had been sacrificed, so much had been achieved, it seemed that the reform of nursing in workhouse infirmaries would collapse for want of someone to carry it on. She became frantic. Her bitterness against women, her distrust of women, her resentment of their pretensions flared up again. "I don't think," she wrote to Clarkey in April, 1868, "anything in the course of my long life ever struck me so much as the deadlock we have been placed in by the death of one pupil, combined you know, with the enormous Jaw, the infinite female ink which England pours forth on 'Woman's Work."
"The more chattering and noise there is about Woman's Mission the less of efficient women can we find," she wrote to Sir John McNeill on February 7, 1865. "It makes me mad to hear people talk about unemployed women. If they are unemployed it is because they won't work. The highest salaries given to women at all we can secure to women trained by us. But we can't find the women. They won't come." Those who did come gave enormous trouble, and there were moments when it seemed that everything she had achieved by her work in the Crimea would be lost through their unreasonableness and stupidity. "It is not money we want," she wrote to Harriet Martineau in February, 1865, "it is workers. . . . We don't aspire, altho' they are needed by the hundred and the thousand, to sending out nurses by the hundred and the thousand. What we want to do is to send a small staff of trained nurses and a trained training Matron, wherever we are asked. But the material, especially in the latter (the Matron) does not come to us. We have 73 nurses now in training at St. Thomas's, our largest number. 18 is the number we can entirely support at St. Thomas's but this is no difficulty at all, even at the moment some of our 23 are supported by others. We should never lack the money, but we want the workers. . . . Applications have no superfluity at all from any description or class of persons rushing to be trained. We can scarcely make up our number of the right sort. . . . We never have rejected one of the right sort for want of room. But really not many of any sort come to be rejected. . . . We have always 10 times as many situations offered as trained persons to fill them. Indeed I am sorry to say that nurses of ours have been made superintendents who were totally unfit for it, and whom we earnestly remonstrated with, as well as with their employers, to prevent them being made Superintendents but in vain---such is the lack of proper persons.
Many first-class nurses were prevented by lack of education from being able to attempt administrative work. Miss Nightingale considered that Mrs. Roberts, who had been her head nurse in the Crimea, was the best nurse she had ever met, but in 1857 she wrote: "She might be a first-class physician and surgeon, learnt by 23 years experience, but not by reading. She can't read! not literally." Too often the woman with some education who took up nursing did so only because she had proved herself too unreliable for other work. In 1871 visitors to the Poplar Sick Asylum found the matron in a "low dress with short sleeves, being merry"; she confided to them that she had successfully brought two actions for breach of promise. In military hospitals the difficulty was even greater. In July, 1871 Miss Nightingale gave Henry Bonham Carter, Hilary's brother, an account of an interview with the superintendent of a military hospital who had been reported for improper conduct. "She had nursed a Pole and he had left her all his money. Alternatively he had only given one small present to her little girl. Then she began raving about her social position, her poor husband, her character, her age. WHO might not take presents if she might not she screamed---she must have been heard all over Lord Lucan's next door---to frighten me. She began by declaring that she would not keep her superintendency a day, she would resign at once. Then it flashed, even over her, that her resignation might be accepted. "AND SHE SHOUTED "that she didn't care for the W.O.---not a fig---she snapped her fingers at them. She would stay where she was and nobody should turn her out, that if the W.O. asked her to resign she would defy them and they should find her a match for them and she should not resign. (Do you know I have the strong impression that there is a great deal to know which we do not know.) She told me she was a saint, she screamed this at least 40 times. She repeated (I am sure 80 times) that she had made the nurses a cake 'with her own hands' as proof of her being 'a mother to them.' She screamed 'You have made me miserable, miserable, miserable' (30 or 40 times). But she was quite evidently trying to practise on me. (1 have no doubt she has tried this practice on many, especially her husband.) And the cruelty of her eyes in saying this was frightful to see."
The obvious solution was for educated women of a good type to become nurses, but this path too was strewn with difficulties. The "ladies" and "nurses" controversy which had caused so much heart-burning in the Crimea was still raging. On September 13, 1866, Miss Nightingale wrote Dr. Farr a long letter protesting against statements made by a Dr. Stewart and a Miss Garret, who asserted that she had been "compelled to give up employing lady nurses, had been forced to abandon the introduction of educated women into the profession of nursing" and had "declared that educated women were unable to undergo the training necessary for the purpose." It was just possible, said Dr. Stewart and Miss Garret, that a middle-class woman might become a nurse but quite impossible for an upper-class lady.
The truth, wrote Miss Nightingale, was exactly opposite. "Be it known to Dr. Stewart who draws a painfully invidious distinction between 'upper' and 'middle class,' that the fact is exactly the contrary from what he represents it. It is far more difficult to induce a 'middleclass' woman than an 'upper class' one to go through as Head Nurse the incidental drudgery which must fall to the province of the Head Nurse-or be neglected.
"1. No nurses should do the work of 'scrubbers'---that therefore the Nurse whether she be upper, middle or lower class is equally able to go through the training of a nurse.
"2. No Lady Superintendent---be she upper, middle or lower class---is qualified to govern or to train nurses, if she has not herself gone through the training of a nurse.
"3. I don't exactly know what Dr. Stewart and Miss Garret mean by the 'upper' class. . . . Therefore I will wait to know before I mention many who have gone through the training of a nurse . . . are equally qualified to be Nurses, Head Nurses, to attend an operation or to be Supt---and yet are of what is usually called the 'upper' class."
Dr. Stewart and Miss Garret voiced views widely held by Miss Nightingale's contemporaries. The figure of the self-immolating sister of charity was fixed in the public mind, and few people could visualize the professional woman, trained, efficient, and highly paid whom she wished to call into existence. "To make the power of serving without pay a qualification is, I think, absurd," she wrote to Dr. Farr on September 13, 1866. "I WOULD FAR RATHER THAN ESTABLISH A RELIGIOUS ORDER, OPEN A CAREER, HIGHLY PAID. My principle has always been---that we should give the best training we could to any woman, of any class, of any sect, 'paid' or unpaid, who had the requisite qualifications, moral, intellectual and physical, for the vocation of a Nurse. Unquestionably the educated will be more likely to rise to the post of Superintendent, but not because they are ladies but because they are educated."
When the right type of woman had been secured and there were no religious objections, difficulties remained. The Nightingale nurses, carefully selected, trained under Miss Nightingale's own eye, were efficient, professional, educated, but they suffered from a feeling of their superiority. "Intolerable conceit is one of our nurses' chief defects," she wrote in 1871. One of the Nightingale probationers---"a good girl," wrote Miss Nightingale, "but using the lowest kind of High Church slang"---refused to sit at meals with an old-style sister from St. Thomas's on the ground that the sister was "low." When Nightingale nurses were sent to work under matrons who were not Nightingale-trained, they were patronizing. On one or two occasions Miss Nightingale was asked to recall her nurses because they were too difficult to manage.
There were difficulties inherent in the very fervor which inspired the new nurse. The woman who was neither frivolous nor in financial difficulties, who was prepared to undergo a rigorous training and subsequently endure the conditions of work in the wards of a hospital or infirmary of the period, was likely to be animated with a fanatic's spirit. Miss Nightingale did not want fanatics; she did not want warfare, especially holy warfare. No one knew better that almost everything was wrong with the conditions and technique of contemporary nursing. But the way to improvement did not lie through rebellion; she had never been a rebel, and she did not mean to send out parties of rebel nurses. Authority must not be flouted but converted. Regulations must be observed because regulations were essential to organization. If regulations were bad, they must certainly be changed, but until they were changed they must be observed. In a private note of 1866 she wrote: "Women are unable to see that it requires wisdom as well as self denial to establish a new work."
It was a difficult lesson to teach. Women who had trained as nurses inspired by a spirit of devotion found themselves sent to posts where their good intentions were frustrated and their skill wasted. Unhappy and rebellious, they appealed to Miss Nightingale, and when she preached patience, yielding, moderation, their disappointment was great. Many lost faith in her, and she frequently mentions having received letters of abuse from unhappy and disappointed nurses. But she would not change her policy. "Do you think," she wrote to a rebellious nurse on April 22, 18695 "I should have succeeded in doing anything if I had kicked and resisted and resented? . . . I have been shut out of hospitals into which I had been ordered by the Commander-in-Chief, obliged to stand outside the door in the snow until night, have been refused rations for as much as 10 days at a time for the nurses 1 had brought by superior command. And I have been as good friends the day after with the officials who did these things---have resolutely ignored these things FOR THE SAKE OF THE WORK."
The want of women to train as nurses, the difficulties perpetually arising from their unreasonableness and instability affected Miss Nightingale's attitude toward the feminist question. The movement for the higher education and emancipation of women was gathering strength, and between 1860 and 1870 the first organized efforts were made to enable women to enter the learned professions and to give them the vote. In September, 1860 John Stuart Mill asked Miss Nightingale to support the movement to enable women to qualify as doctors on the same terms as men. But she was unsympathetic; her difficulties had left her with the conviction that women already had more opportunities than, at the moment, they were capable of using. She was impatient with "female missionaries," with the "enormous jaw about Woman's Work." She was convinced that her attitude was based on hard facts derived from her experience, but in fact the truth lay in her own nature.
Her outlook was aristocratic. Equality meant little to her, equality of the sexes, the goal of the early pioneers of feminism, least of all. She had never felt handicapped by her sex or wished to be a man. In all the long history of frustration recorded in her private notes, she never suggests she was frustrated by men because she was a woman. Stupidity frustrated her, not sex. She had been made aware that in the world of affairs suggestions from a woman were accepted less readily than suggestions from a man, but by using the right tactics she had been able to overcome that drawback. Statesmen, Cabinet ministers, public servants had willingly sat at her feet, and she assumed that any woman who chose to take the trouble could achieve the same position. In spite of the extraordinary power of her mind, she was a woman of intensely feminine nature whom men admired and spoiled. She preferred men to women, and sex antagonism, sex rivalry were foreign to her. Nothing exasperated her more than a desire on the part of women to imitate and emulate men. "To do things just because men do them!" she wrote contemptuously. The exaggerated praise lavished on female achievement infuriated her---why should what was normal for a man be considered exceptional for a woman? Why should it be hailed as remarkable when a woman qualified as a doctor---not because she qualified brilliantly but because she succeeded merely in qualifying?
Dr. Elizabeth Blackwell was the first woman to qualify as a doctor. She had studied in Paris and qualified in America, and was now a celebrity. On January 19, 1862, Miss Nightingale wrote that she would be "inferior as a 3rd rate apothecary of 30 years ago." "Female M.D.'s have taken up the worst part of a male M.D. ship of 50 years ago," she wrote to John Stuart Mill on September 12, 1860. "The women have made no improvement, they have only tried to be 'men' and they have succeeded only in being third rate men. Let all women try . . . these women have in my opinion failed but this is no prior conclusion against the reasoning."
On September 23 John Stuart Mill replied, pointing out the limitations of her argument. "When we consider how rare first rate minds are, was it to be expected on the doctrine of chances that the first two or three women who take up medicine should be more than you say these are---third rate. It is to be expected that they will be pupils at first, not masters. . . . Neither does the moral right of women of admission into the profession depend at all upon the likelihood of their being the first to reform it."
She remained unconvinced. The moral right did not interest her. The all-important consideration was the work waiting to be done in the world. Women made third-rate doctors and first-rate nurses: there were plenty of first-rate doctors; there was a shortage of first-rate nurses; what could be plainer than the conclusion that women ought to become nurses, not doctors? In July, 1867 John Stuart Mill asked her to become a member of the first committee of the London National Society for Women's Suffrage. "A Society has been formed for the purpose of obtaining the Suffrage for Women. The honour of your name as a member of the General Committee is earnestly requested." She refused. Again, the moral right of women to have a voice in the government of the country meant little to her. Her objections were practical---"that women should have the suffrage," she wrote on August 11, 1867, "I think no one can be more deeply convinced than I. It is so important for a woman to be a 'person' as you say. . . . But it will be years before you obtain the suffrage for women. And in the meantime there are evils which press much more hardly on women than the want of the suffrage. . . . Till a married woman can be in possession of her own property there can be no love or justice. But there are many other evils, as I need not tell you." John Stuart Mill answered that he deplored on moral grounds the "indirect influence" to which women were restricted owing to their want of political power. But Miss Nightingale, whose immense influence was all indirect, was devoid of moral qualms and influenced only by practical considerations. "I have thought I could work better, even for other women, off the stage than on it," she wrote simply. She declined to believe in the vote as a universal panacea for the wrongs of women. "If women were to get the vote immediately Mr. Mill would he disappointed with the result," she wrote in a rough draft of a letter to Jowett. The greater part of female misery was due to economics---not to the economic situation of women specifically but the economic situation of the whole nation. She instanced the "frightful burden of pauperism, the overflowing workhouses . . . The wives and daughters of all these people are starving, does Mr. Mill really believe that the giving of any woman a vote will lead to the removal of even the least of these evils?" In a sentence which she used again in writing to John Stuart Mill, she spoke of her own position. "In the 11 years I have passed in Government offices I have never felt the want of a vote, because, if 1 had been a Borough returning two members to Parliament, I should have had less administrative influence." Her arrogance was unconscious; her modesty was genuine. She insisted that the only difference between herself and other women was that she worked and they did not. She never could be brought to admit there was anything else.
In later life she was conscious she had been unsympathetic, and in 1896 she wrote to Sir William Wedderburn asking him to tell her what the vote would do for the ordinary woman. "I am afraid I have been too much enraged by vociferous ladies talking on things they know nothing at all about to think of the rank and file."
Miss Nightingale was now forty-eight, and she thought of herself as old. Writing to Clarkey in 1868, she spoke of "the course of my long life." Jowett implored her to change her way of living. It was inconceivable that she could intend to spend the rest of her days shut up in one room in London. Early in 1868 fate intervened. Another change of Government destroyed much of her remaining influence in official departments. In March the Tories went out, the Liberals came in, and Mr. Gladstone became Prime Minister.
THE ACCESSION OF MR. Gladstone to power was a severe blow to Miss Nightingale. They had never been in sympathy; administration did not interest Mr. Gladstone. He disliked soldiers, regarded an army as an undesirable and unchristian institution which, as the world progressed, every civilized nation would discard, and consistently opposed increased expenditure on the welfare of the British soldier. A standing army, he had said, can never be turned into a moral institution.
In Miss Nightingale's opinion the effect of Mr. Gladstone was disastrous. "The administrative state of things here is to me unimaginable," she wrote to M. Mohl on June 10, 1869. The War Office is drifting back to what it was before the Crimean War. Pauperism which concerns hundreds of thousands is just let alone. . . . One must be as miserably behind the scenes as I am to know how miserably our affairs go on." "What would Jesus have done," she wrote in a private note, "if He had had to work through Pontius Pilate?"
The tide had turned against her. Very far off were the days when she wrote "Alexander whom I made Director General." There were no longer men in the departments who spoke the words she put into their mouths and were instruments in her hand. In the War Office her influence was almost at an end; in 1869 Douglas Galton, her last remaining friend, resigned and took an appointment at the Office of Works, retaining out of his War Office appointments only his seat on the Army Sanitary Committee.
India alone was left. In Indian affairs, in spite of disappointments and unrealized hopes, she had achieved a personal position of very great authority, and it happened that the number of men holding important offices in India who were her intimate friends steadily increased.
At the end of 1865 her old admirer, Lord Napier, was appointed Governor of Madras, and he wrote asking her to receive him, assuring her that he was "at your orders for any day or hour," and reminding her that he had had "the happiness and honour of having seen you at the greatest moment of your life, in the little parlour of the hospital at Scutari." She was ill, but "managed to scramble up to see him" on January 1, 1866, and made not only an enthusiast for the cause of sanitation in India but a personal friend. He signed his letters "ever your faithful grateful and devoted servant;" he told her "I think 1 am attached to you irrespective of sanitation;" he promised her "You shall have the little labour that is left in me." In Madras his governorship was marked by solid achievements. Roads and schools were built, drainage and irrigation undertaken, wells sunk, jails remodeled, and hospitals reconstructed. Under the direction of Lady Napier the experimental scheme for gradually introducing female nurses into Indian hospitals, which had been mishandled and subsequently abandoned by Sir John Lawrence, was put into practice in Madras. Miss Nightingale wrote that Lady Napier was one of the most efficient women she had ever met.
In 1868 Sir John Lawrence's term of office as Viceroy ended. On November 23, a few days before he sailed, he wrote to Miss Nightingale: "I think we have done all we can do at present in furtherance of Sanitary Improvement and that the best thing is to leave the Local Governments themselves to work out their own arrangements. If we take this course we shall keep them in a good humour." Far from having done all that could be done, she considered that almost nothing had been accomplished; and as for the local governments being in a good humor, he forwarded by the same mail an official memorandum from Mr. John Strachey sharply criticizing the Sanitary Department at the India Office. The instructions they sent out, he asserted, were written from an English point of view, old discussions were "hashed up," no credit was given the Government for the fact that 2 million pounds sterling a year was being spent on sanitary works, and the department's latest scheme for "a system of sanitary experts sending in reports" was "politically foolish, and indeed absolutely dangerous . . ." The memorandum was, Miss Nightingale scribbled to Dr. Sutherland, "the nastiest pill we have swallowed yet." However, she restrained her irritation and wrote Sir John Lawrence a final letter "to bless and not to curse."
And yet when, in April, 1869, he called on her with a present of "a small shawl of the fine hair of the Thibetan goat" she succumbed once more to his personal beauty and charm. "When I see that man again," she wrote to M. Mohl on June 10, 1869, "all the statesmen of the moment in England whether 'in' or 'out' seem to me like rats and weazels." Nevertheless, her heart never quite ran away with her head, and she added, "but when I see him I understand he will not do much in England."
She had already established her influence over Sir John Lawrence's successor, Lord Mayo. On the morning of October 28, 1868, Dr. Sutherland, arriving at South Street after a day's holiday, sent up a message that he hoped "there was nothing much on to-day." "There is a 'something' which most people would think a very big 'Thing' indeed," she replied. "And that is seeing the Viceroy or Sacred Animal of India. I made him go to Shoeburyness yesterday and come to me this afternoon because I could not see him until you give me some kind of general idea what to state."
Lord Mayo came and stayed the whole afternoon. Though she liked him personally, his attitude toward the responsibility he had undertaken provoked her wrath. He said "quite calmly" that he had not been able to free himself from his previous office as Irish Secretary until October 6, he was not going to be able to see Sir Stafford Northcote, the Secretary of State for India, at all because Sir Stafford would be busy first electioneering and then staying with the Queen, and he was proposing to go out to India as Viceroy on November 6 "completely uninstructed." "He came to me to be coached and with Sir Bartle Frere I gave him his Indian education." Jowett wrote that she had earned a new title, "Governess of the Governor of India," but Miss Nightingale replied that her correct title was "Maid of all (Dirty) Work."
Lord Mayo was, however, a willing pupil. "He asked me," she wrote to Dr. Sutherland immediately after the interview, "(over and over again) that we should now, at once before he goes, write down something (he said) that would 'guide me upon the Sanitary Administration as soon as 1 arrive.' "
In Lord Mayo's guide to sanitary administration, Miss Nightingale showed a new purpose. Once more she took a step forward and passed from advocating engineering works to laying down an economic policy. Nothing could be done in India until India was fed; before sanitation must come irrigation---"famine is the constant condition of the people." Health was impossible, justice was impossible, organization was impossible, as long as the great mass of the people of India was vitiated and corrupted by being semi-starved from birth to death. Agricultural development, which implied irrigation, must come first of all. Before education, before any of the blessings of Western civilization were offered to them, the people of India must be fed, and henceforward irrigation works became Miss Nightingale's first aim for India.
A year later she added the Commander-in-Chief to her circle. In December, 1869 she received a note from Lord Napier of Magdala asking if he might call. He came on the afternoon of December 14 and was instantly elected to a leading position in her gallery of heroes. "Ah there is a man," she wrote to M. Mohl on April 1, 1870. "We were like a brace of lovers on our Indian objects."
Robert Cornelis Napier had gained his title as a reward for his brilliant military feat of storming the supposedly impregnable fortress of Magdala in Abyssinia. He was tall, extremely handsome and was described by Sir Bartle Frere as "one of the few men fit for the Round Table." He had begun his career in the Bengal Engineers of the East India Company and risen to be head of the Public Works Department of the Punjab. One of his achievements was the construction of the Bari-Doab canal, 250 miles long, said to have turned a desert into a garden. He was humane, based his discipline on confidence not fear, and devoted himself to the welfare of his troops.
In March, 1870 he came for a final conference. "Make no ceremony with me, as an old Père de famille and do not think of getting up and thus fatiguing yourself," he wrote to Miss Nightingale on March 18.
"He actually spent his last morning in England with me, starting from this house," she told M. Mohl on April 1, 1870. "And I sent away the C.I.C. to India without anything to eat! He said he had too much to talk about to waste his time in eating." Between them they put on paper a complete scheme of Indian Army reform to be begun at once, ranging from barrack and hospital reorganization to the provision of education and physical training. Lord Napier asked her to write to Lord Mayo to prepare his mind for the proposals---"a letter from you would have great weight as it was you who raised public opinion in England on these subjects," he told her.
It was not Miss Nightingale's nature to console herself; yet some progress had been made in the ten years since the Indian Sanitary Commission began its work. Her enormous energy, her extraordinary history, her capacity to inspire boundless faith, were producing astonishing results. Mr. John Strachey criticized her sharply more than once, but he told Sir Bartle Frere: "Of the sanitary improvements in India three-fourths are due to Miss Nightingale." Her fellow workers regarded her as exercising an almost supernatural influence. "I have often known a scrap of paper on which you had written a few words---or even your words printed---work miraculously," wrote Sir Bartle Frere in 1868.
Man after man who came to see her in the bright austere drawing-room in South Street fell under her spell. Many began with concealed hostility: she was a thorn in the side of bureaucracy, an interfering aggressive woman to be visited only because it was good policy. Few were not converted. Her sincerity, her disinterestedness, her astounding knowledge were irresistible. Honest men, able men, men who had the good of India and its peoples at heart, became her friends.
But her record was not one of uninterrupted success. She had never been to India, her knowledge was a paper knowledge, and her persistence had its drawbacks. She owed her success to her ability to persist in the face of opposition. Again and again she proved to be right. When she proved to be wrong, she paid the penalty. In 1867 she came to the conclusion that the barracks and hospitals of the army in India were not adequately ventilated. In the hot weather, when infection and disease were most rife, it was the invariable custom to keep the windows shut and only open the doors.(1) In the Crimea, in the hospitals of London, she had proved the supreme importance of fresh air. In the Crimea she had been told that if the windows of the men's huts were opened during the winter the huts would become so cold that the men would die of pneumonia. She had forced the windows to be opened, and the men had not died. Their health had improved, and they had contracted less pneumonia. Therefore, when she wrote a memorandum to the Government of India advising that the windows of barracks and hospitals should be kept open through the hot weather and was told the men would be made ill with heat, she would not be convinced. She persisted in pressing for a general order to open the windows, writing to doctors, to the secretaries of the Presidential Sanitary Commissions, to Commanding Officers, to the Viceroy himself, until Sir John Lawrence told her bluntly that nothing on earth, even a direct order from the Government at home, would induce him to issue instructions for windows to be kept open in hot weather.
A laugh went up throughout the length and breadth of India. Her supporters were forced to realize that she might be betrayed into ludicrous mistakes, and even today Miss Nightingale's attempt to open windows in the hot weather is not forgotten.
A more serious failure followed. The report of the Indian Sanitary Commission had urgently recommended improvement in barrack accommodation, and during 1864 an enormous amount of work was done by Miss Nightingale and Douglas Galton on a model barrack plan. She was aware from the beginning that no single standard plan could be laid down and applied throughout India. Her object was to define the essential features which every barrack must possess and to leave the local authorities to adapt them to local conditions. The scheme was approved by the Government of India and the War Office, and in 1865 she wrote that she had got a grant of seven millions for "my Indian barracks." Work began at once, and the plans were passed to the Royal Engineers.
Presently disturbing news reached her. The Royal Engineers were acting "in a high handed manner." They were determined to erect barracks for the army without civilian interference or advice. By the end of 1869 it was evident that the scheme had gone fatally wrong. On December 4 Miss Nightingale wrote to Sir Bartle Frere: "We begged and prayed to be allowed to put up in Poona and the Deccan where the winds are terrific and the ground rocky, one storied barracks---we were ordered to wait. Sir Robert Napier [Lord Napier of Magdala, the Commander-in-Chief] was ordered to wait until a 3rd class engineer colonel, an ordinary man such as you can find anywhere, sent us 'standard plans,' which we were to use and no other and which were extravagantly expensive."
She was in despair. Not a single one of the new barracks, she wrote to Sir John McNeill in 1869, was erected in accordance with the recommendations. Everything had been sacrificed for the sake of an imposing façade of European design totally unsuited to the climate. Good water, drainage, shade, space, all had been neglected.
The troops moved in, and disaster followed. Cholera broke out at several stations, and early in 1870 there was an outcry in The Times against the senseless extravagance of erecting palatial buildings in which the troops died.
The cause of sanitary reform had received a serious set-back. The money had been forthcoming, the work had been promptly done, and the result was complete failure. That the reformers were in no way responsible, that what had been done was a complete contradiction of every essential laid down, was impossible to explain. Military secrecy, military etiquette veiled the issue in hopeless obscurity, and not only the public but officials within the War Office who had been in favor of sanitary improvements now associated them with sentimental extravagance.
She was losing ground on all sides. She was already shut out of the War Office and the Poor Law Board, and in India the barrack failure must weaken her hold on Lord Mayo. Yet she hardly rebelled. In the last two years she had changed. "I assure you 1 don't let these things corrode into me now," she told Clarkey in 1868. She had worn herself out. Her last collapse, in December 1867, had weakened her not only in body but in mind. Some of her energy, some of her power of fierce feeling had gone. "I am becoming quite a tame beast---fit for a lady to ride or drive---as horse dealers say of their most vicious brutes," she wrote to M. Mohl in September, 1868.
In the summer of that year she went to Lea Hurst for three months. She had not been there since 1856, and the visit marked a change in her way of life. While she was at Lea Hurst, she read the novels of Jane Austen, who, she told Clarkey in September, 1868, in her opinion, "ranked second to Shakespeare in the English language for dramatic power," and the plays of Shakespeare---"I don't know whether Hamlet was mad, he would certainly have driven me mad."
Jowett spent a week at Lea Hurst; Parthe stayed away: Miss Nightingale had refused to go there unless "Parthe and her governessing are excluded." She had long talks with W. E. N. on metaphysics. Her mother, she wrote, was "more cheerful, more gentle than I ever remember her tho' of course she is much aged. Her memory is nearly gone but to me she is far dearer, far more respectable than ever before." Fanny was now eighty, W. E. N. seventy-four.
By the end of September she was bored. She wrote on September 27 imploring M. Mohl to stay on at South Street "until I come which will be, please God, on Friday or Saturday." Family life, books, friends were not sufficient; she needed an outlet. For some time Jowett had been urging her to write and in the summer of 1868 she began a "Treatise on the Reform of the Poor Law." Her loss of power was at once apparent. Jowett had to send her a draft before she could start, and even then she found composition an intolerable strain. The treatise was shortened to an article, but even so she could not complete it.
In September, 1869 she wrote a letter to Dr. Sutherland enclosing a large mass of notes on the subject, asking him to expand them into a book after her death, and to do the same for Notes on Lying-In Institutions. But she herself, though she worked on for more than twenty years, never touched either again. The days of her great achievements, when she had written the huge volume of Notes on Matters affecting the Health, Efficiency and Hospital Administration of the British Army with her own hand in six months, were over. She was no longer capable of the sustained effort necessary to write a book.
The energy with which she had once sprung on opportunity like a tiger had also left her. Her life was growing calmer. It had been, she wrote to Jowett in 1865, "a fever and not a fitful one. Neck or nothing has been all my public life. . . . Could I help in the two Royal Commissions I have served, in the 9 years I have served in the W.O. [War Office] exclusive of the Crimea my whole life being in a hurry? If the thing were not done to the day, it were not done at all."
Not only were the demands of the work less frenzied, but she herself was working in a less frenzied atmosphere. A new influence for reasonableness had come into her life. Clough had been succeeded as secretary of the Nightingale Fund by Hilary Bonham Carter's brother, Henry. Henry Bonham Carter was devoted to Miss Nightingale; he gave up more than forty years of his life to her service, but he would not become a slave. When it was getting late, says Sir Edward Cook, he used to say, "Now I must go home to dinner"; he was an excellent man of business and invaluable to Miss Nightingale, but his soul remained his own.
In 1870 some of the urgency of old days returned. War was declared between Germany and France in June, and in July the "National Society for Aid to the Sick and Wounded," subsequently called the "British Red Cross Aid Society," was founded at a public meeting in London.
Miss Nightingale was pressed to give up all other work and take control. The need was very great and heartrending reports of the sufferings of the troops on both sides were being received. But she refused; one laborious memorandum on sanitation in India affected the lives of millions on whom, even if her health allowed, she could never turn her back to become the Lady with the Lamp once more.
Though she had declined to be in charge of the National Society, its activities were under her direction. Sir Harry Verney, Douglas Galton and Miss Emily Verney, Sir Harry's daughter by his first wife, were on the executive committee. Henry Bonham Carter and Dr. Sutherland were sent by the Society to visit both the French and German hospitals during the war, and after it the report on the Society's work was written by Dr. Sutherland under her supervision.
She advised the executive committee on organization and administration. "Those who undertake the work of aiding the sick and wounded must not be sentimental enthusiasts but downright lovers of hard work . . . .. attending to and managing the thousand and one hard practical details which never the less plainly determine the question as to whether your sick and wounded shall live or die," she wrote on August 2, 1870. It was nine years to the day, she noted, since Sidney Herbert died. She advised on practical matters from the administration of field ambulances to the pattern of hospital suits and cooking utensils. She wrote to workers at the seat of war; she interviewed volunteers for service; she directed and supervised the purchase and despatch of supplies. She collected money from her friends which was used chiefly for the relief of prisoners of war and recorded sending out £5000 in one week. Once again in scenes of horror and confusion it was found that the quickest way to get things done was to go to Miss Nightingale. The amount of correspondence involved was a strain. "Every man and woman in the world seems to have come into it with the express purpose of writing to me," she told Madame Mohl in 1870. "Would I could go to the seat of War instead of all this writing, writing, writing."
At first her sympathies were with Germany. She considered Napoleon III a tyrant and disliked and despised the Empress Eugénie, whom she described as "the Empress who was born to be a dressmaker." Germany was the home of liberal thinking, music, and philosophy. M. Mohl, whom she loved dearly, was a German; she herself had been trained at Kaiserswerth on the Rhine; Prince Albert, for whom she had a profound admiration, had been a German. Germany stood for music, folk-songs, simplicity, and thought. She had to discover that since her girlhood a startling change had taken place, and that in place of Germany had risen Prussia.
Through her influence a War Office ambulance had been equipped and sent out to the German Army with the double purpose of assisting the German wounded and of observing and noting the treatment and requirements of wounded in a large-scale modern war. The Germans would not allow it to be used. In November, 1870 she wrote to Douglas Galton that she had heard that the War Office ambulance was "cold shouldered" by the Prussians. On December 12 he wrote: "Every foreign ambulance has a Prussian N.C.O. in it. Ours is the only exception because it has only one patient in it---a casual."
On November 4, 1870, she wrote to M. Mohl: "Is it not quite unknown in history that a philosophical, a deep thinking, the most highly and widely educated and in some respects the most civilised nation of Europe---the Germans, should plunge head foremost into this abyss called Military Despotism? That they should not see that that (soi-disant) German Unity means only Prussian aggrandisement." The alacrity with which German philosophy and culture hastened to prostrate themselves before the Prussian war machine left her bewildered. "Now if you take all the greatest names in science, in literature, or metaphysical and religious philosophy, in art, of the last 70 or 80 years in all Germany, . will you tell me how many of these came out of Berlin," she wrote in a private note. "Yet the higher civilisation is to be subjected to the lower." "The free translation of German nationality is Prussian military supremacy."
German behavior after the defeat of the French finally alienated her. "After the fighting," she wrote to M. Mohl in February, 1871, "come the miseries of the poor people. Correspondents known and unknown write to me by every post." She deplored Bismarck's "rapaciousness," his "want of delicacy or of any nobility." She had loved the German language, the German mind, and the German way of life. All that had perished. There had been a death, but the death was of Germany, not France. Worst of all, she realized that a new age had dawned for Europe. "Prussia," she wrote in a private note of 1871, "openly says she does these things because the first Napoleon did them 64 years ago. And France will say, long before 64 years hence, she will do them because the Corporal Emperor King did them so many years ago. Horrible as is the account of wounds and grief and starving people, it is as nothing compared with the principles which this War has put forth and brought to life."
In 1872 Jean Henry Dunant, a Swiss banker, Paid a visit to London. He had succeeded in turning what the world assured him was a Utopian dream into hard fact---he had brought about the Geneva Convention and founded the International Committee of the Red Cross. In 1872, after the Franco-Prussian war, Dunant visited London and read a paper on the work of the Society. His first words were these: "Though I am known as the founder of the Red Cross and the originator of the Convention of Geneva, it is to an Englishwoman that all the honour of that Convention is due. What inspired me ... was the work of Miss Florence Nightingale in the Crimea."
She had legendary prestige and enormous popular appeal, and while she had these she could not be without power. Throughout 1870 and 1871 she debated the possibility that she might "seek office" again. If she pursued Ministers, she might make her way into the departments once more. But such a course was contrary to the policy of her life. She had succeeded because she had made herself an instrument in the hands of Ministers, because she had been sought out, not seeking. Mr. Gladstone's Government had no place for her. She despised his Ministers; she called them contemptuously "Gladstone's secretaries," and though they treated her with deference she felt they were antagonistic. "Here is a note from Mr. Cardwell," she wrote to Sir Bartle Frere in 1870, "which seems to me, I don't know why, a nasty one." Her powers of working and concentrating had declined, and she had come to depend entirely on Dr. Sutherland. "The only way I can work now," she wrote to him in 1870, "is by receiving written notes from you, and working them up into my own language, then printing and showing you the work."
Loss of influence in Indian affairs finally decided her. Her hopes of Lord Mayo were not being fulfilled. It was not that he wished to do too little, but that he wished to do too much. "He got," wrote Sir Bartle Frere in 1874, "into the hands of men who were like the Fisherman's Wife who never would make the best of what the Enchanted Fish gave her but always wanted something better." With Sir Bartle Frere's help Miss Nightingale ale had preached irrigation to him. To her dismay in 1871 he sent home what Sir Bartle Frere described as a "wild and visionary project" for providing every ryot in India with water at once. When it was pointed out that the money to pay for the enormous works involved could not be raised by tax until after the water had been provided Lord Mayo "sulked."
Miss Nightingale was profoundly discouraged. She had lost Lord Mayo and with him her influence in the Government of India; under the present Government her influence in the War Office and at the Poor Law Board was at an end; she was wretchedly ill and overwhelmed with other and vitally important work. She decided she would struggle no more with Government departments. As 1871 passed into 1872 she wrote on a sheet of paper: "1872. This year I go out of office."
Almost immediately she had proof that her term of office had already ended. In February Lord Mayo, while inspecting a penal settlement, was assassinated by a convict. He was succeeded by Lord Northbrook. She knew Lord Northbrook personally; he had been a friend of Sidney Herbert, but he did not consult her or call to see her before he sailed.
She was deeply wounded. "Why should you be troubled at the Governor General not coming to see you (as he most certainly ought to have done)," wrote Jowett on April 3, 1872. "Put not your trust in Princes, or Princesses or in the War Office or in the India Office; all that kind of thing necessarily rests on a sandy foundation. I wonder that you have been able to carry on so long with them."
It was sixteen years since she had returned from the Crimea to instigate the Royal Army Sanitary Commission of 1857. For sixteen years she had labored in Government departments, sacrificing health, pleasure, friends. She had done the work of a Secretary of State, she had "made the appointments." Now all that was over. Henceforward she must lead a new life. What kind of life should it be?
1. It had long been established in India that it was only by keeping the windows and shutters closed as far as possible during the hours when the sun was up, that the lower temperature of the night could be partly retained to make the day endurable.