The Life of Florence Nightingale Volume II Part 2

[12] A true prediction: see Sir Bartle Frere's saying, below, p. 158.

[13] The inscription is: "To Miss Florence Nightingale in recollection of the greatest and best of Princes from the beloved Prince's broken-hearted Widow, Victoria R. Osborne, Jan. 13, 1863."

[14] He had been recalled from Madras in 1860.

[15] "It will be remembered that Miss Florence Nightingale came to this country and was impressed with the idea that if India needed anything it was village sanitation. She collected a ma.s.s of facts and has since been agitating in England": _Amrita Bazar Patrika_ (Calcutta), June 29, 1892, reprinted in the _Indian Spectator_, July 10.

Miss Nightingale's "Observations" form a synopsis of the whole subject.

Giving chapter and verse from the Stational reports for each of her statements, she shows, first, that the prevailing diseases were camp diseases such as she had seen in the Crimean War--largely due to the selection of unsuitable sites. Among the causes were Bad Water, Bad Drainage, Filthy Bazaars, Want of Ventilation, and Surface Overcrowding in barrack-huts and sick-wards. Her remarks under these several heads are often characteristically racy. "Where tests have been used, the composition of the water reads like a very intricate prescription, containing nearly all the chlorides, sulphates, nitrates, and carbonates in the pharmacopoeia, besides silica and quant.i.ties of animal and vegetable matter, which the reports apparently consider nutritive." "If the facilities for was.h.i.+ng were as great as those for drink, our Indian army would be the cleanest body of men in the world." "There is no drainage, in any sense in which we understand the word. The reports speak of cesspits as if they were dressingrooms." "Except where the two Lawrences have been--there one can always recognize their traces--the bazaars are simply in the first savage stage of social savage life."

Under the head of "Overcrowding," she brings together various instances with figures and woodcuts; she quotes one report which said that the men (300 men per room!) "are generally accommodated in the barrack without inconvenient overcrowding," and she asks, "What is _convenient_ overcrowding?" "At some stations the floors are of earth, varnished over periodically with cow-dung: a practice borrowed from the natives. Like Mahomet and the mountain, if men won't go to the dunghill, the dunghill, it appears, comes to them." Her next section, on "Intemperance," is scathing. In India, as at home,[16] it was a current opinion of the time that the soldier is by nature a drunken animal; the only question seemed to be as to how he had better get drunk. At one station, though the men were reported as "mostly temperate," she found that on a ten years'

average one man in three was admitted into hospital directly from drink.

"The men are killed by liver disease on canteen spirits to save them from being killed by liver disease on bazaar spirits. May there not be some middle course whereby the men may be killed by neither?" Under "Diet," she notes the absurdity of a uniform ration, in amount and quality, in all seasons and climates; and ventures to doubt whether cesspits are desirable adjuncts of kitchens. Her next head is "Want of Occupation and Exercise"--a fruitful source of vice and disease. It is a most interesting chapter, full of valuable hints and ill.u.s.trated by an amusing drawing, sent to her by Colonel Young, of "Daily Means of Occupation and Amus.e.m.e.nt _pa.s.sim_." Here, as in much else of Miss Nightingale's work, she collected all the better opinions; she picked out from the returns before her any hopeful experiments; enlarged upon them, and drove the moral home. Her chapter on "Indian Hospitals" is naturally very full and detailed. She discusses the prevalent structural defects; suggests improvements in the internal arrangements; and notes that there were "neither trained orderlies nor female nurses." On the subject of "Hill Stations," Miss Nightingale's "Observations" show a fear lest too much reliance should be placed upon their superior salubrity. She quotes instances of terrible sanitary defects on hill stations, and enforces the moral that "the salvation of the Indian army must be brought about by sanitary measures everywhere." After discussing "Native Towns," "Soldiers' Wives," and "Statistics," Miss Nightingale insisted generally on the importance of inst.i.tuting a proper system of sanitary service in India. Henceforth, to the end almost of her long life, she regarded herself, and in large measure was able to act, as a sanitary servant to the army and peoples of India.

[16] See Vol. I. p. 277.

Miss Nightingale's "Observations" were only part of her share in the labours of the Commission. They were followed in the Report by an Abstract, arranged under Presidencies, of the Returns on which the "Observations" were founded. This a.n.a.lysis, occupying nearly a hundred pages, was drawn up, as already stated, by Miss Nightingale and Dr.

Sutherland. The ma.n.u.script of it, preserved amongst her papers, is mainly in her handwriting. And she did much more, as will presently be related.

IV

When the Commission of the Army in India was nearing the end of its labours, an event happened which seemed to Miss Nightingale of crucial importance. On April 14, 1863, she heard from Sir Harry Verney that Sir George Lewis, the Secretary for War, had died suddenly on the previous day. Sir Harry added that at the Service Clubs, Lord de Grey was talked of as a probable successor, but that Lord Panmure's name was also mentioned. From another and a better-informed source she heard that Lord de Grey hoped to get the appointment, but that there were believed to be two difficulties in the way. The Queen might object to the War Office being given to a Minister who had not yet been in the Cabinet, and pressure might be put upon Lord Palmerston from other quarters not to appoint a Peer. Should either or both of these factors prevail, Mr. Cardwell was believed to be the most probable successor. Now it seemed to Miss Nightingale all-important that, when the Report on the health of the army in India came out, the Secretary of State for War should be a proved sanitarian. She did not want to have once more to "bully the Bison," and she did not know much of Mr. Cardwell. She did know Lord de Grey, and she knew him as a sympathiser in her cause.

Without a moment's delay she set herself to bring to bear in his favour such influence as she might possess, either on her own account or as the public legatee, as it were, of Sidney Herbert. A telegram written _en clair_ and preserved by the recipient shows how a good press was secured for Lord de Grey's appointment:--

_From_ Florence Nightingale to Harriet Martineau.--Agitate, agitate, for Lord de Grey to succeed Sir George Lewis.

The world was duly informed next day (April 17) through the columns of the _Daily News_ that public opinion expected the appointment of Lord de Grey. But Miss Nightingale took other measures. She wrote a letter to Lord Palmerston, and to his princ.i.p.al colleague, Mr. Gladstone, she sent a copy of it. Mr. Gladstone, in reply, did not doubt that Lord Palmerston had a very high opinion of Lord de Grey, but added on his own part that he saw great difficulty in not having the head of the War Office, with its vast expenditure, in the House of Commons. The letter to Lord Palmerston, meanwhile, was delivered by a special messenger, who had been strictly charged to make sure that the Minister read it at once. The sequel, describing a somewhat curious scene, had better be given in Sir Harry Verney's own words:--

CLEVELAND ROW, _Ap._ 15 [2.30]. From Hampstead I returned to South Street, and found your letter. Thence to Cambridge House. Lord Palmerston was so good as to admit me. I said that I had seen you this morning, and that by your desire I requested him to allow me to read a letter to him from you. He said, "Certainly"; and I read it to him rather slowly. Having read it, I said that you had mentioned this morning that within a fortnight of Lord Herbert's death, he had said to you more than once that he hoped Lord de Grey might be his successor. I then added, "I have not to request any reply or observations on Miss Nightingale's letter. I have only to thank you for your kindness in allowing me to read it." He took the letter and put it in his pocket. He then asked how you are, and where, and I told him. There is a Cabinet at 5.30 this afternoon. I think that if Gladstone has your note before going to it, it might be well.

She had antic.i.p.ated Sir Harry's suggestion, as we have seen. The Prime Minister put her letter into his pocket, but it did not stay there. He took it with him to Windsor and read it to the Queen. On April 22 it was announced that Her Majesty had been pleased to approve the appointment of Lord de Grey as Secretary of State for War.

V

Miss Nightingale thus felt a.s.sured that when the Indian Report came out she would have a sympathetic chief at the War Office, and she turned with the greater zest to the next stage in her labours; namely, the preparation of the Report by the Commissioners. The ma.n.u.script of the first page or two (explaining the delay in issuing the Report and the procedure of the Commission) is in Lord Stanley's handwriting (preserved among Miss Nightingale's papers). He entrusted the preparation of the first draft of the rest of the Report, for statistics to Dr. Farr, and for the rest to Miss Nightingale and Dr. Sutherland. She had written a first draft of the greater part of her sections of the Report as early as April 1862. By August it was in type and corrected by Lord Stanley, who "pledged himself to carry it through the Commission next month."[17]

But Dr. Farr's section was not so far advanced, and there were other delays at which Miss Nightingale chafed not a little. In May 1863 the last stage was reached. "I have done and shall do all in my power," Lord Stanley wrote to her (July 10), "to make it public that to Dr.

Sutherland and you we mainly owe it that the Report has a.s.sumed its present shape." Among her papers is a collection of proofs of the Report in various stages; some corrected by Dr. Farr and Dr. Sutherland, others corrected and re-corrected by her. The descriptive portion of the Report is in substance a repet.i.tion of her "Observations," in the colder language which is held to add weight and dignity to such doc.u.ments; though here and there Miss Nightingale's touch may be felt. The magnitude of the evils which needed to be remedied is put in an arresting way. "Besides deaths from natural causes [9 per 1000], 60 head per 1000 of our troops perish annually in India. It is at that expense that we have held dominion there for a century; a company out of every regiment has been sacrificed every twenty months. These companies fade away in the prime of life; leave few children; and have to be replaced, at great cost, by successive s.h.i.+ploads of recruits." The cost of preventable sickness in the Indian army was calculated at 388,000 a year. The list of Recommendations with which the Report concludes may be described as a Sanitary Charter for the Army in India--a Charter which during many successive years was gradually put into force.

[17] Letter to Sir J. McNeill, Aug. 8, 1862.

Last of all came what Miss Nightingale considered the most vital point of all--namely, the suggestion of practical machinery by which, if the Government adopted it, the recommendations of the Commission might be carried out. At this crucial point, she had a very stiff fight. The machinery, as she had devised it, was to be twofold. First, there were to be Sanitary Commissions appointed for each Presidency in India. On this point, all the Commissioners seem to have been agreed; but it was different with Miss Nightingale's second point. The reports which she had read and marked from the Indian stations filled her with a fear that if the whole of the initiative were left to India the work would in some cases be negligently or unintelligently done. There had not yet been in that country the same education of public opinion amongst the governing cla.s.s in the science of sanitation that had been in progress in England.

She deemed it essential that the machinery recommended by the Commission should in one way or another include provision to secure for India the experience already obtained in dealing with all kinds of sanitary questions in England. She had formulated her own plans to this end at an early stage of the Commission. What she first suggested was a Sanitary Department at the India Office, and this, as we shall hear in a later chapter (p. 153), was ultimately established. It had been well if the suggestion had been accepted from the beginning, for the compromise which was subst.i.tuted led to some confused friction between the War Office and the India Office. As the second-best plan, Miss Nightingale wanted the standing Sanitary Committee at the War Office,[18] reinforced by one or two representatives of India, to be invested with authority over Indian sanitation, and she wanted, secondly, a Sanitary Code to be issued for India by the Home Government. She had named the two Indian officials, and had urged the addition of Mr. Rawlinson, at that time the leading sanitary engineer in England.[19] But on all this there was some difference of opinion. She was kept informed from day to day of the currents of thought among the Commissioners, and of the course of the discussions. The letters, minutes, memoranda in which she urged her views are many. She had first to persuade Lord Stanley, and this in personal interviews she succeeded in doing. She begged him to open the subject to Sir Charles Wood, the Secretary for India, who did not take the suggestion amiss. There were still, however, some contrary opinions, but ultimately her policy prevailed. "I cannot help telling you, in the joy of my heart," she wrote to Harriet Martineau (May 19), "that the final meeting of the Indian Sanitary Commission was held to-day--that the Report was signed--and that after a very tough battle, lasting three days, to convince these people that a Report was not self-executive, our Working Commission was carried, not quite in the original form proposed, but in what may prove a better working form because grafted on what exists. This is the dawn of a new day for India in sanitary things, not only as regards our Army, but as regards the native population." But Miss Nightingale was never content to let the light steal in gradually; she wanted to secure for the Report of the Commission the fullest possible glare of publicity.

[18] The Barrack and Hospital Commission, re-named the Army Sanitary Committee in 1865; see p. 65.

[19] Her nominations were, in the end, all approved. The Indian representatives were Sir Proby Cautley and Sir James Ra.n.a.ld Martin.

Her first concern was to get early notices of the Report in the newspapers. The daring, the celerity, the energy of her moves might excite the admiration even of the greatest experts in this sort of our own day. The gist of the Report, so far as its statement of the facts was concerned, was contained in her own "Observations"; and, as explained above, she had already circulated these both in India and at home. Having thus, as it were, salted the ground, she prepared for the official publication. As one of the princ.i.p.al authors of the Report, she was obviously ent.i.tled to some copies. She obtained a note from Lord Stanley, the Chairman, to that effect. The Queen's printer, Mr. Spottiswoode, was her very good friend, having been a.s.sociated with her in more than one philanthropic enterprise, and, after seeing Lord Stanley's note, he promised to use every expedition and to let Miss Nightingale have some of the very earliest copies. She sent them off immediately; to various influential friends (Sir John Lawrence among the number), but princ.i.p.ally to writers for the press; and with regard to these latter, there was no reason why she should tell each recipient of the special early copy that he was not the only individual so favoured.

A Blue-book of 2028 pages is not mastered in a minute, and people wondered how so many of the newspapers and magazines were able to notice the Report so fully on the instant. "Mr. Baker [the Clerk to the Commission] has regained his equanimity," wrote the printer (July 23); "but for three days he could not recover the shock of your rapid action." Miss Nightingale's celerity may well have seemed indecent to the leisurely official mind; for six months were allowed to pa.s.s before the Government of India was officially provided with copies of the Report! This delay may seem incredible to those not well versed in such affairs, but it is recorded in a Government Dispatch,[20] and an investigation made by Miss Nightingale into another delay of a like kind may perhaps afford an explanation.[21] Meanwhile, in July 1863, she had, for some days previous to the issue of the Report, been arranging for reviews in newspapers and magazines, in Edinburgh and Dublin as well as in London. Mr. W. R. Greg was especially helpful; he contributed notices to three important periodicals--the _Economist_, the _National Review_, and the _Spectator_. Miss Nightingale was diligent also in coaching Harriet Martineau, writing at great length to explain the points on which public opinion might most usefully declare itself. Miss Martineau wrote on the Report in the _Daily News_, _Macmillan's Magazine_, and _Once a Week_; and on her own part she had a contribution to make to the cause. She was an old friend of Lord and Lady Elgin.

Should she write to them? The indefatigable Miss Nightingale at once sent her the heads of a letter on the subject which should go immediately to the Viceroy.

[20] "On the 5th February 1864, the Government of India informed the Secretary of State that, in consequence of the non-arrival of the Report of the Royal Commission, it had not been possible to carry out the measures indicated in the despatch of the 15th August, but that having just received a few copies, &c., &c." (_Memorandum on Measures adopted for Sanitary Improvements in India up to the end of 1867_, p. 2).

[21] See below, p. 49 _n._

Though Miss Nightingale attached importance to notices in the press, she was equally eager that the Report itself should attract the attention of influential individuals in and out of Parliament. And here at the outset she met with a severe check which, however, by her energy and resource was turned to the greater advantage of the cause. The Blue-books were of enormous bulk, and a smaller edition had been prepared, apparently by the Clerk. Owing to what was officially described as "a mistake," it was this smaller edition that was "presented to both Houses of Parliament by command." It alone was placed on sale to the public; the 1000 copies of the complete work (of which the printer had been ordered to break up the type) were reserved for the press and for official purposes. They could be obtained (on application) by members of Parliament, but were not accessible to the public. The smaller edition, which the officials designed for public use, did not contain Miss Nightingale's "Observations" (though these were referred to in the Report) and did not contain the evidence from the Indian Stations. It gave instead a "precis of evidence" made by the Clerk. This, as Miss Nightingale thought, was badly done, and, moreover, referred in the margin to pa.s.sages which again were not accessible to the public. Miss Nightingale was naturally and justly indignant at a proceeding which thus left the recommendations of the Commission unsupported, so far as the public were concerned, by the essential facts. She set herself with characteristic energy to rectify the official "mistake," or, as she suspected, to circ.u.mvent the design. If indeed there were any intention to withhold from the public eye the full extent of the terrible state of things in India, the authors of the design had counted without the formidable Lady-in-Chief. As for the partial suppression of her own "Observations,"

that was easily rectified. Dr. Sutherland and Dr. Farr, incensed at the treatment which she had received, promptly made arrangements with a publisher for the separate issue of her "Observations."[22] This little "red book" had a large sale, and was widely reviewed in the press.

Thereby the subject received a second series of notices. "It is not a book," said one of the reviewers, "but a great action." But Miss Nightingale herself was more concerned with the wide circulation of the Blue-books themselves. First, she wrote round to every member of Parliament whom she knew, informing them of the facts and begging them to apply for the unmutilated edition. One of the answers she received was from Lord Shaftesbury (Aug. 22): "I will immediately apply for the copy of evidence you mention, but ought we not to insist when Parliament meets that it be fully circulated like any other doc.u.ment? Sir C. Wood may have made a 'mistake,' but a far greater mistake would be to bury this important matter in the 'tomb of all the Capulets.' ... You have achieved very grand things; and you must thank G.o.d that He has called you to such a work, and has so blessed it. I have much to talk to you about."[23] Secondly, she extracted a promise that inquirers at Hansard's office should be informed that copies of the unmutilated edition could be obtained by the public on application at the Burial Board Office.[24] She took very good care that they should not be buried there. She prompted all sorts and conditions of persons among her acquaintances to apply, and there was a run on the book. Next, and chiefly, she was anxious that the essential parts of the Report should come under the notice of every officer and every official in India who was in any degree responsible for the health of the army and who might be brought by a knowledge of the facts to further the cause of sanitary reform. The way in which she achieved her purpose was characteristic.

Miss Nightingale had a personal grievance in this matter; and she used it, as on a previous occasion she had used her personal prestige, to gain a public end. To an intimate friend in the War Office, she was downright: "Done in some way or other, I am determined it shall be." But to the great men above him, she was suave--insidiously and dangerously suave. She entirely agreed that it would be expensive to reprint, and absurd to circulate widely, two enormous Blue-books of 2028 pages.

n.o.body would read them. But on the other hand was it not a little unfair to her to circulate an abridged edition, from which was excluded all the material upon which, at the request of the Commission, she had spent years of labour? But what was to be done? She knew how busy all Government officials were; but she would willingly undertake the task of putting together an amended edition of the smaller issue. Would the Treasury object to the cost? If so, she would bear it. In one way and another, she said, she had spent 700 in connection with the former Report on the British Army; the cost of similar work in connection with India would be less, and she would gladly defray it. Lord de Grey authorized her to proceed on August 26, and for the next three months she was busy in preparing the Report in the form in which it was to be circulated among military and medical officers.[25] But she was not quite satisfied yet. She had provided means for bringing her horses to water, but who was to make them drink? Her amended report was to be circulated amongst the Army in India, but would it be read? She was afraid not, unless the Secretary of State specially commended it to the attention of his subordinates. Did the War Office shrink from taking initiative in a matter which also concerned the India Office? "But surely Sir Charles Wood will be very grateful to you for remedying his mistake." The Minister a.s.sented, and a preface was added to Miss Nightingale's edition of the Report, in which the Secretary for War explained that it was circulated "with a view of affording information on the subject to Commanding, Engineering, and Medical Officers." Of course there were official delays, and this edition of the Report was not issued till August 1864, but it gave Miss Nightingale opportunity of organizing yet another press crusade. Through Sidney Herbert's friend, Count Strzelechi, who was also a friend of Delane, she was able to secure a series of articles in the _Times_ on the sanitary needs of India.[26] The Count was very proud of what he had been able to do for her. None of Miss Nightingale's official works obtained a wider circulation than the "Observations"; nor, I suppose, did any Blue-book on such a subject ever attain a greater amount of publicity.

[22] Bibliography A, No. 34.

[23] Miss Nightingale's letter to Lord Shaftesbury is printed in his _Life_, p. 581.

[24] This was not designedly a practical joke. The Clerk to the Commission held a post in the Board.

[25] See Bibliography A, No, 33 (3).

[26] A leading article appeared on August 23, introducing a series of "special articles" which began on the following day.

VI

But all this was only a preliminary. Public attention had been aroused, and every one said vaguely that something must be done. It remained for Government to do it. The steps which Miss Nightingale took to this end, the obstacles which she encountered, the measure of success which she attained, will be described in the next chapter.

The work, which has been described in foregoing pages and which Miss Nightingale continued during the following year, was very heavy, and it was all done under grievous physical disability. In 1857-58, when she was doing like work in connection with the Royal Commission on the Home Army, though she was in very delicate health, she had yet been able to move about. When Sidney Herbert could not come to see her, she could go to see him. But now in 1863, when work for the Commission on the Indian Army was at its height, she was bedridden. When she invited a nursing friend to her house, the formula was "Will you come and spend Sat.u.r.day to Monday in bed with me?" She could only receive her visitors, if at all, in her own room, and all her writing was done in bed. She was sustained through these disabilities partly, it may be, by the consciousness of power and by satisfaction in its exercise, but princ.i.p.ally by pa.s.sionate devotion to her cause. And there was another feeling which gave her strength, as appears from many a pa.s.sage in her private letters. She was carrying out, as best she could alone, the "joint work" which had been left "unfinished" at Sidney Herbert's death.

"There is no feeling more sustaining," Sir John McNeill had said to her, when Arthur Clough was also taken from her, "than that of being alone."

So, in some sort, I think, she found it. And sometimes, as to one who stretches out his hands in yearning for the further sh.o.r.e, there seemed to come to her voices of encouragement. "I heard the other day," she said in 1863, "of two Englishmen who were nearly lost by being caught by the tide on the coast of France, and a little French fisher-girl ran all along the wet sands to show them the only rock, half a mile from the sh.o.r.e, which the tide did not cover, where of course she was obliged to stay with them. It got quite dark, the water rose above their knees, but presently they heard a sound, faint and far off, and the little girl said, 'They think the tide is turning, they are shouting to cheer us!' I often think I hear those on the far-off sh.o.r.e who are shouting to cheer me."

CHAPTER III

SETTING REFORMERS TO WORK

(1863-1865)

I am more hopeful than you appear to be in regard to the good likely to be effected by the Report. Although our Indian administration has great difficulties to contend with owing to the nature of the country and the people, it is both honest and able; and I never knew a public measure, the advantage of which was generally admitted, which ultimately was not properly taken in hand.--SIR CHARLES TREVELYAN (_Letter to Florence Nightingale_, Aug. 24, 1862).

In the last chapter we traced Miss Nightingale's hand throughout the famous Report of the Indian Sanitary Commission. We saw how she worked for the inclusion, in the Commissioners' recommendations, of machinery for getting the other recommendations adopted; we saw, too, how cleverly she man[oe]uvred to obtain wide publicity and discussion for the whole subject. But this was not enough for her. She had created a favourable atmosphere; she had provided suitable machinery; it remained to set the wheels going round. "Reports are not self-executive": she applied her words in this fresh direction; and, as in the case of the Home Commission five years before, so now she gave not a moment's rest to herself or to anybody else whom she could influence until reforms, recommended by the Report, were set on foot.

Miss Nightingale was as eager, in as great a hurry to begin, as determined to have her way, as before; but the difficulties were now greater. In the case of the Home Army, only one department (though that, to be sure, was a dual one) was concerned; in the case of Sanitary measures for the Army in India, there were the India Office and the Government of India to be considered as well as the War Office. And everybody, who knows anything about public affairs, knows what it means to the cause of prompt efficiency if departments begin wrangling with each other. And then Miss Nightingale had no longer her "dear master."

Lord Stanley, the Chairman of the Indian Commission, was friendly, and sincerely desirous to see things done; but he was not an enthusiast. His temperament was cool; his judgment, critical. But, as I have already said, he had a great belief in Miss Nightingale, and though she did not always find him an easy man to drive, she did it. The moment the Report was signed she was up and at him. He must do as Sidney Herbert did; that is, go at once to Ministers and insist on immediate steps being taken to put the recommendations of the Report into operation. Otherwise, all their labour might dissolve in air. Lord Stanley proposed to wait and see:--

(_Lord Stanley to Miss Nightingale._) _July_ 10, 1863. ... Do not fear that Lord Herbert's work will be left unfinished: sanitary ideas have taken root in the public mind, and they cannot be treated as visionary. The test of experience is conclusive. The ground that has been gained cannot be lost again.----_July_ 12....