CHAPTER II

SOWING THE SEED

(Nov. 1856-Aug. 1857)

You have sown the seed, and the harvest will come. God will give the increase.--SIR JOHN MCNEILL (_Letter to Florence Nightingale_, on her "Notes affecting the Health of the British Army").

The power of passive resistance wielded by a Department, and the reluctance or the inability of an easy-going Minister to withstand it, are unintelligible to those who are not themselves part of an administrative machine, and they are exasperating to those who are possessed of an impetuous temper and a resolute will. The Royal Commission on the health of the Army had been settled "in principle" between Lord Panmure and Miss Nightingale at their interview on Nov. 16, 1856, and a week later the Minister had received Mr. Herbert's conditional acceptance of the chairmanship. It was not till May 5, 1857, that the Royal Warrant actually setting up the Commission was issued. Throughout the six months of delay, Mr. Herbert and Miss Nightingale were busily employed in endeavours to persuade or coerce the Secretary of State into granting the Commission effective powers; the War Office and the Army Medical Department were as busily counter-working in the hope of so restricting its scope that any recommendations it might make would be of a "harmless" character.[244] There is no reason, I think, to suspect Lord Panmure of insincerity, but he was not the man to force the pace.

[244] See _Stanmore_, vol. ii. p. 124.

* * * * *

There were moments during the months of delay when Miss Nightingale's patience was exhausted, and there was one moment when her spirit for the fight quailed and she thought of taking service in a civil hospital. Lord Panmure from time to time was afflicted by the gout--"in the hands," Mr. Herbert said to Miss Nightingale, "and this explains his not writing." "His gout is always _handy_," she retorted. Then there was the call of the birds to be shot and the stags to be stalked. "But the Bison himself is bullyable, remember that." This was the word which she constantly passed round among her allies. At one time she pressed Mr. Herbert to issue an ultimatum. Let him renounce the chairmanship forthwith, unless Lord Panmure put an end peremptorily to the delays and gave a pledge that the recommendations of the Commission should be acted upon. Mr. Herbert and her other friends were for a more cautious policy, and she was overborne. "If you can get us out of the old, miry rut," wrote Sir John McNeill (Dec. 19, 1856), "and put us fairly on the rail, though the plant may be defective and the speed small, we shall go on improving. Do not allow yourself to be discouraged by delays." She was not in the end discouraged, but she was not the woman to sit still under the delays. She remembered her own _mot d'ordre_; and if she did not "bully the Bison," I imagine that she sometimes administered a feline stroke or two. In December Lord Panmure asked leave to come to her quiet room in Burlington Street for a talk. And the talk was quiet, too, I doubt not, for Miss Nightingale, sometimes biting in private letters, was never vehement in conversation. But she could be quietly emphatic. She was fully conscious of the strength of a weapon which she held in reserve. That weapon was her popularity, and the command, which she could use, if she chose, of the ear of the press and the public. Lord Panmure must have been conscious of this factor in the case also. It had been settled at Balmoral, again "in principle," that Miss Nightingale was to prepare a Report embodying the results of her experience and thought. If she and the Minister remained on good terms, if she felt assured that the Army in medical and sanitary matters would be reformed from within, her Report would remain confidential. But if she were not so persuaded, there was nothing to prevent her from heading a popular agitation for reform from without. This was her weapon for "bullying the Bison." In a note of self-communing, written during some moment of disappointment, she reproaches herself with having been "a bad mother" to the heroic dead, but pledges herself to continue the fight to the end. She had "begun at the highest, my Sovereign," and had proceeded to work through the politicians. If all else failed, she would make a last appeal, "like Cobden with the Corn Law," to the country. "Three months from this day," she wrote in one of her letters of incitement to Mr. Herbert, "I publish my experience of the Crimean Campaign, and my suggestions for improvement, unless there has been a fair and tangible pledge by that time for reform."

II

Miss Nightingale's exasperation was increased by the attitude of the Government towards the report of the "Chelsea Board." The McNeill-Tulloch _affaire_, which filled a large space in public attention at the time, requires only a brief notice here; the dramatic aspect of the now forgotten scene at Chelsea is admirably presented by Kinglake who, however, is not to be accepted as an unbiased authority on the merits of the dispute.[245] Sir John McNeill and Colonel Tulloch, it will be remembered,[246] had been sent out to the East in 1855 to inquire into the transport and commissariat arrangements of the campaign. Their Report, issued in January 1856, was the one official document among the pile produced by the Crimean War which brought responsibility directly home to specified individuals. Every one remembers the story of Lord Melbourne's protest when he had accidentally heard a rousing evangelical sermon with a direct "application": "Things have come to a pretty pass," he said, "when religion is allowed to invade the sphere of private life." Something of the same indignant remonstrance was rife when a Report on the Crimean muddle presumed to invade the sphere of personal responsibility. The impugned officers raised an outcry, and the Government appointed an examining Board of other officers to report on the Report which had reported them. This Board--called after the "Chelsea" Hospital where it sat--removed all blame from individuals, and found in July 1856 that the true cause of the Crimean muddle was the failure of the Treasury to send out, at the proper moment, a particular consignment of pressed hay. Miss Nightingale had many a gibe at this ridiculous mouse; and, many years later, Sir John McNeill rebuked "the levity" which referred "the fatal privations so heroically endured by the troops to so ludicrously inadequate a cause."[247] Some months were next occupied in the drafting, by the Treasury officials, of an explanation of the regrettable incident of the hay. The Government acquiesced, and the affair seemed to be over. And so it would have been, but for two factors--the press and public opinion. The _Times_ led a spirited attack upon the Chelsea Board, and public opinion espoused the cause of Sir John McNeill and Colonel Tulloch. Their Report had been set aside, and Lord Panmure had omitted even to thank them for their labours. Sir John remained contemptuously silent, but Colonel Tulloch, who was of a warmer temper, was vigorous in self-defence and rejoinder. In several large towns sympathy was expressed with the slighted Commissioners--a movement which Miss Nightingale and her family, through friends in various places, did something to advance. Complimentary addresses were sent to the Commissioners from the Mayor and Citizens of Bath, of Birmingham, of Liverpool, of Manchester and of Preston, as also from the Company of Merchants of the City of Edinburgh.[248] Noting this movement of public opinion, which was beginning to be reflected in the House of Commons, Lord Panmure bethought himself of doing something. His expedient was signally ill-judged. He had "the honour to acquaint" the Commissioners "that Her Majesty's Government have decided to mark the services rendered by you in the discharge of your duties in the Crimea, by tendering to each of you the sum of £1000." This pecuniary estimate of their services was promptly refused by each of them. "To accept it," wrote Mrs. Tulloch, "is almost the only thing I could not pardon in my husband, but, thank God, he feels as I do on the subject." Miss Nightingale was equally indignant, but her political instinct was not at fault. "I am _glad_," she wrote in reply to Mrs. Tulloch (Feb. 20), "that they have been such _fools_! I am sure the British Lion will sympathise in this insult, and if it does not, then it is a degraded beast." She proceeded to rouse the beast. She told Mr. Herbert about the Government's offer, and he concurred in her view. It was decided to raise the whole subject in the House of Commons. On March 12, 1857, Mr. Herbert moved a Humble Address to the Crown praying that Her Majesty might be pleased to confer some signal mark of favour upon Sir John McNeill and Colonel Tulloch. The Prime Minister, noting the course of the debate, accepted the motion, which was agreed to without a division. "Victory!" wrote Miss Nightingale in her diary; "Milnes came in to tell us." She thought she had lost in her round with Lord Panmure about Colonel Tulloch (above, p. 331); but she won after all. He was created K.C.B., and Sir John, who was already G.C.B., was sworn of the Privy Council. This episode, which in its initial stages exasperated Miss Nightingale so much that she was half inclined to throw up the fight, ended by giving her fresh spirit and encouragement. Her _mot d'ordre_ had come true: the "Bison" had proved bullyable--by parliamentary pressure. "I direct my letter," she wrote to the now Right Honourable Sir John McNeill (May 12), "with a great deal of pleasure. I consider that you and Sir Alexander Tulloch have been borne on the arms of the people--a much higher triumph than a mere gift of honours by the Crown. The poor Crown has been worsted. I am sorry for it. But it was not our fault."[249]

[245] In chap. ix. of vol. vi. Kinglake accepts the finding of the Chelsea, Board as the last word on the dispute. For the other side, see Sir Alexander Tulloch's _Crimean Commission and the Chelsea Board_, 2nd ed., with preface by Sir John McNeill (1880).

[246] See above, p. 257.

[247] Preface to Tulloch's _Crimean Commission_, etc., 1880, p. xiii.

[248] For these addresses, see a pamphlet printed at Edinburgh in 1857, entitled _Addresses Presented to Sir John McNeill, G.C.B., and Colonel Tulloch, with their Answers_.

[249] Twenty years later another reparation was made. Sir Theodore Martin, in his _Life of the Prince Consort_, had taken an unfavourable view of the McNeill-Tulloch report. In the fifth edition he revised the passage. "It is almost more than we could have hoped," wrote Lady Tulloch, in telling Miss Nightingale of the revision; "I say _we_, knowing how much interest you took in the matter." "I give you joy," replied Miss Nightingale (Feb. 23, 1878); "I give you both joy, for this crowning recognition of one of the noblest labours ever, done on earth. You yourself cannot cling to it more than I do: hardly so much in one sense, for I saw how Sir John McNeill and Sir A. Tulloch's reporting was the salvation of the Army in the Crimea. Without them everything that happened would have been considered 'all right.' ... I look back upon those twenty years as if they were yesterday, but also as if they were a thousand years. Success be with us and the noble dead." A copy of this letter was sent to Sir John McNeill, who replied (March 25): "It was kind of you to copy it for me. There is no one, dead or alive, whose testimony I could value so highly with regard to the matters in question as I do Miss Florence Nightingale's. Her favourable opinion is very precious to me, not only because she knew more, and was intellectually more capable of forming a correct judgment than any one else who visited that strange scene, but because my regard and affection for her is such as would make it very painful to me to find that she had reason to think in any degree less favourably of our services than she did formerly. Her letter is very characteristic, and therefore to me very precious."

III

It was her friend Mr. Milnes who had suggested that Miss Nightingale should go a little outside her "Cabinet" and increase her influence by extending the range of her parliamentary acquaintances. "Before the Estimates come on," he had written (Feb. 1857), "you should surely have some people in the House who know what you want." And again: "You should know Lord Stanley; he is the best man you could get in the House in whatever you wish to be done. Come and dine with him here on Sunday." Mr. Milnes was right about Lord Stanley.[250] His public appreciation of Miss Nightingale has been mentioned already. He was not enthusiastic about many persons or things, but Miss Nightingale and her work were among the number. On now making her personal acquaintance, he sat, as it were, at her feet; he told her that he lived in hopes of being allowed to receive "future instructions" from her; he sent her early copies of papers and bills likely to interest her, and asked questions in the House of Commons which she suggested. When presently he became a Secretary for State they were to be associated in important work.

[250] Better known to the world as the 15th Earl of Derby; Secretary of State for India (1858-9); Foreign Secretary (1867-8); Foreign Secretary under Disraeli (1874-8); Colonial Secretary under Gladstone (1882-5).

Miss Nightingale, for all her impetuosity of spirit, had plenty of tact, and knew how to adjust the means to her several ends. In the spring of 1857, an expeditionary force was being dispatched to China, and she was very anxious that the health of her "children," the British troops, should be better cared for than it was, at sea or on land, in the Crimean Campaign. Her ally, Sir James Clark, was on friendly terms with her opponent, Dr. Andrew Smith. So she used her ally to coax her enemy. "I had a very satisfactory conversation with Dr. Smith," reported Sir James. "I find he has attended to almost everything I suggested--the ventilation of the ships, the diet of the troops; and they are to have fresh meat and vegetables during the whole voyage and while on the station when it is possible. Nothing seems to be forgotten or neglected on Smith's part, and the Duke of Cambridge backed our recommendations. So that the disasters of the Crimea are already telling for the benefit of the soldiers."

In the fight over the Netley Hospital, Miss Nightingale was defeated by Lord Panmure on the main issue; but she had some success in minor matters; and, though on the main issue she lost in the particular case, she won the day for the future. She was a pioneer in this country in advocating the "pavilion" system of hospital construction, which she had studied in France. Well-known examples of it are the Herbert Hospital at Woolwich, and St. Thomas's at Westminster. The plans for the Netley Hospital, which Lord Panmure sent her, were laid on the old "corridor" lines, and she instantly condemned the plans on that and other grounds. Into this cause, as into everything that she took up, she flung herself with full energy. She consulted all the best authorities, she collected information at home and abroad, she drew up memoranda, she prepared alternative plans. Lord Panmure did not dispute that her alternative might, in the abstract, be better, but pleaded that in this case the cost of alteration, now that the foundations were already laid, would be too great. Besides, there were susceptibilities--his own and other people's--to be considered. Miss Nightingale thereupon appealed to the Prime Minister. "If Miss Nightingale's suggestions are good," he wrote to Lord Panmure (Nov. 30, 1856), "it will be worth while to alter our intended arrangement of the building rather than have an imperfect Hospital."[251] Determining to press her advantage, Miss Nightingale went down to Embley in the Christmas vacation, and dined and slept at Broadlands. How great was the impression she made upon Lord Palmerston is shown by the peremptory letter which he next addressed to Lord Panmure (Jan. 17). It has been printed _in extenso_ elsewhere[252]; and a sentence or two will here suffice. "I am bound to say she has left on my mind at present a conviction that the plan is fundamentally wrong, and that it would be better to pull down and rebuild all that has been built. She brought hither the ground-plan and elevation of the proposed Netley Hospital, and the ground-plan of the last new Military Hospital at Paris, which she says has been adopted as the model for the Hospital at Aldershot." (The reader will note, I doubt not, Miss Nightingale's diplomatic touch; she only asked Lord Panmure to do at Netley what he himself was doing at Aldershot.) "It seems to me," continued Lord Palmerston most characteristically, "that at Netley all consideration of what would best tend to the comfort and recovery of the patients has been sacrificed to the vanity of the architect, whose sole object has been to make a building which should cut a dash when looked at from the Southampton River.... Pray, therefore, for the present, stop all further progress in the work till the matter can be duly considered." But even the most peremptory of Prime Ministers are not all-powerful. Lord Panmure immediately replied that the step ordered by his Chief "would involve us in great difficulties, as it would entail a rupture of all our extensive contracts, not to mention the reflections which it must cast on all concerned in the planning of those designs on which we have worked.... Many of Miss Nightingale's suggestions in the Report signed by herself and Dr. Sutherland can be carried out by alterations, but the total abandonment of the plan will be a most serious affair."[253] It appears from Miss Nightingale's papers that the War Office's estimate of the cost was £70,000; and these 70,000 reasons, combined with the argument from _amour propre_, caused Lord Panmure to win. Though ever reluctant to acknowledge defeat till she had fired her last shot, Miss Nightingale knew when she was finally beaten on one ground and she then made a stand on another. Foiled in her attempt to improve the Hospital root and branch, she used in good part the opportunities which Lord Panmure gave her of patching up "the patient," as she called it, so far as was still possible. The corridor was thrown more open; more window-space was given to the wards; borrowed lights and odd corners were abolished; the appurtenances were separated; and the ventilation was improved.[254] With regard to the future, Miss Nightingale in her private Report, and in almost identical words the Royal Commission in its public Report, recommended "that all plans for the original construction of Hospitals be submitted to competent sanitary authorities before such plans are finally approved," and "that all new Hospitals be constructed in separate pavilions, in order to prevent a large number of sick from being agglomerated under one roof." This recommendation was stoutly opposed by medical officers of the old school. "Poor Andrew Smith," wrote Mr. Herbert during a sitting of the Royal Commission, "swallowed some bitter pills to-day, including Pavilions." The bitter pill, administered by Miss Nightingale, is now the recognized prescription in the building of Hospitals.

[251] _Panmure Papers_, vol. ii. p. 321.

[252] _Ibid_. vol. ii. pp. 332-4.

[253] _Ibid_. vol. ii. p. 338.

[254] _Panmure Papers_, vol. ii. pp. 401, 405.

IV

This fight for the pavilion was only an incident in Miss Nightingale's work during the latter part of 1856 and earlier part of 1857. Her main work was preparation for the Royal Commission. This involved heavy correspondence, many travels, and close application. Until August 1857, she resided principally in London, at the Burlington Hotel; but in the spring she had spent some weeks, within easy distance of London, at Combe Hurst, the home of her uncle and aunt, Mr. and Mrs. Samuel Smith; and in April, a fortnight in Edinburgh, in order to confer with Sir John McNeill. She prepared for the Royal Commission by writing her own Report. The suggestion had been made at Balmoral in October 1856; but Lord Panmure, who seldom did to-day what could be put off till to-morrow, did not write his official instructions until February 1857. In asking her "further assistance and advice," he said: "Your personal experience and observation, during the late War, must have furnished you with much important information relating not only to the medical care and treatment of the sick and wounded, but also to the sanatory requirements of the Army generally." She had, it will be observed, carried her point, that the Report was to be of general scope. "I now have the honour to ask you," continued the letter, "to favour me with the results of that experience, on matters of so much importance to Her Majesty's Army. I need hardly add that, should you do so, they will meet with the most attentive consideration, and that I shall endeavour to further, so far as it lies in my power, the large and generous views which you entertain on this important subject."

The Report which Miss Nightingale wrote in response to this request--entitled _Notes affecting the Health, Efficiency, and Hospital Administration of the British Army_--is, I suppose, the least known, but it is the most remarkable, of her works. It is little known because it was never published. As in the end she extracted a Royal Commission from Lord Panmure, and as the Commission was followed by practical measures, she did not feel the necessity of appealing to the public. The War Office itself did not print her Report, and thus it never became generally known how much of the Report of the subsequent Royal Commission, and how many of the administrative reforms consequent upon it, were in fact the work of Miss Nightingale. But at her own expense she printed the _Notes_ for private circulation among influential people, and upon all who read it the work created, as well it might, a profound impression. Kinglake describes it as "a treasury of authentic statement and wise disquisition, affording a complete elucidation of the causes which had brought about failure, whilst also showing the means by which, in the wars of the future, our country might best hope to compass the truly sacred task of providing for the health of its troops."[255] Sir John McNeill, who read the proofs of the _Notes_ as they passed through the press, was impressed equally with the vigour of the style and the cogency of the reasoning. "Be assured," he wrote, "that the Report will detract nothing from your reputation but, on the contrary, that it will greatly add to it, and make it very plain why you have been placed where you stand in the estimation of the country. No other person could have written it." Of another batch of the proofs, he said: "It flows on so naturally, it gives so clearly the impression of being the genuine expression of earnest conviction, it has so much the character of good, sincere enlightened conversation on a subject which is thoroughly understood and appreciated, and so little the appearance of having been 'got up' or of pretension of any kind, literary or artistic, that you ought to be very cautious how you alter it in any respect that would at all detract from the unambitious and perfectly natural, but, at the same time, clear and vigorous, enunciation of important truths and wise propositions." And again: "It does not signify much what Lord Panmure thinks or proposes or objects to. You have set up a Landmark which neither he nor any other man or body of men can remove. Permanent progress has been made, though but small, and your ideas and plans will be pirated and claimed as their own by men who now disparage them." When the book was finally printed, and a copy of the volume sent to him, Sir John McNeill thought the same. "A few days ago," he wrote (Nov. 18, 1858), "I read a passage to one of the most admired essayists of our time[256] without telling him what I was reading from. When I had done he said, 'That is perfect, whose is that?' I bade him guess. He said, 'There are not many men in England who could have done it. I think I know them all, but I cannot quite bring it home with confidence to any of them. It may be some new writer.' I said it was, and then I told him who it was. So much for the manner of the thing, which you care little about. But for the matter: after a very careful study of the whole, I am fully satisfied that it is a mine of facts and inferences which will furnish materials for every scheme that is likely to be built up on that ground for several generations. No man or woman can henceforth pretend to deal with the subject without mastering these volumes and, if honest, without referring to them.... Regarded as a whole, I think it contains a body of information and instruction, such as no one else so far as I know has ever brought to bear upon any similar subject. I regard it as a gift to the Army, and to the country altogether priceless."

[255] Vol. vi. p. 367.

[256] Perhaps Abraham Hayward; see his opinion of Miss Nightingale's writing, quoted below, p. 408. The passage read out by Sir J. McNeill may have been that cited above, p. 242; or perhaps that cited on p. 317.

These estimates, given respectively by the literary historian of the Crimean War and by the man of affairs who had probed most deeply into the Crimean muddle, will be confirmed, I am confident, by any competent reader of Miss Nightingale's _Notes_.[257] The wide range of the book, and its mastery of detail on a great variety of subjects, are as remarkable as its firm and consistent grasp of general principles. The key-note is struck in the Preface. The question of Army Hospitals is shown to be part of wider questions involving the health and efficiency of the Army at large. Defects, similar to those which occasioned so high a rate of mortality among the sick in Hospital during the war, were the cause why so many healthy men came into Hospital at all. Those who fell before Sebastopol by disease were above seven times the number of those who fell by the enemy. A large number fell from preventable causes; but the causes could only be prevented in the future by the adoption of new systems. The bad health of the British Army in peace was shown to be hardly less appalling than was the mortality during the Crimean War. The only way to prevent a recurrence of such disasters was to improve the sanitary conditions of the soldier's life during peace, and during peace to organize and maintain General Hospitals in practical efficiency. The necessity of reorganization, and the application of sanitary science to the Army generally, are the two principles of which Miss Nightingale never loses sight in any of the branches of her subject. There is an Introductory Chapter giving the history of the health of the British armies in previous campaigns, and the book then contains twenty sections. The first six of these deal under different heads with the medical history of the Crimean War. Then come three sections dealing with the organization of Regimental and General Hospitals. The remainder of the book takes wider scope, discussing, in succession, the Need of Sanitary Officials in connection with the Army; the Necessity of a Statistical Department; the Education, Employment and Promotion of Medical Officers; Soldiers' Pay and Stoppages; the Dieting and Cooking of the Army; the Commissariat; Washing and Canteens; Soldiers' Wives; the Construction of Army Hospitals; and the Mortality of Armies in Peace and War. A twentieth section gives, after the manner of Royal Commissions, a summary of Defects and Suggestions. There are also various Appendices, Supplementary Notes, Diagrams and Illustrations. The first volume of the book consists of 830 octavo pages, some numbered in Roman numerals. The pages thus numbered were an after-thought. The main body of the book was ready for press in August 1857, but it was not desirable that the Nightingale Report should forestall, even in private circulation, the publication of the Royal Commission's Report. A final appendix to the latter Report contained a mass of official correspondence on the care of the sick and wounded during the Crimean War. Miss Nightingale pounced upon this, and prefixed to several of her sections a classified abstract of the principal documents. "A masterly analysis," wrote Sir John McNeill, when she sent him the proofs; "it is conclusive, because it is quite fair, and nothing could be more fatal to false pretension." Sometimes Miss Nightingale could not deny herself an ironical comment[258]; but the mere collocation of facts and utterances, as she arranged them, in deadly parallel, is more effective even than her sarcasm.

[257] This opinion is supported by an estimate of the _Notes_ in a paper which came into my hands as this book was going to press. "This work (the _Notes_) constitutes in my opinion one of the most valuable contributions ever made to hospital organization and administration in time of war. Had the conclusions which she reached been heeded in the Civil War in America or in the Boer War in South Africa, or in the Spanish-American War, hundreds of thousands of lives might have been saved" (_Hurd_, as cited in Bibliography B, No. 47, p. 76).

[258] See the passage quoted above, p. 288.

Lord Panmure's instructions to Miss Nightingale of February 1857 were afterwards supplemented by a request that she would submit a Confidential Report on "The Introduction of Female Nursing into Military Hospitals in Peace and in War." The request had an amusing sequel. "You directed me last week," she wrote to Lord Panmure (May 3), "to make suggestions to yourself as to the organization of Female Nursing in Army Hospitals. The Director-General, Army Medical Department, directed, last week, the expulsion of all female nurses but two from the Woolwich Artillery Hospitals.... I have a little pencil composition, to be 'dedicated, with permission, to your Lordship,' exhibiting the order emanating from the Secretary of State to introduce nurses, and a simultaneous order from the Army Medical Board to turn them out. I enclose a memorandum (merely tentative and experimental) as to the duties of nurses. I cannot expect the Secretary of State to enter into the details. Perhaps I may ask to hear his decision as to the ultimate steps to be taken."[259] The tentative memorandum was afterwards expanded into a treatise, forming the second volume (pp. 184) of the _Notes_. Its title--_Subsidiary Notes as to the Introduction of Female Nursing into Military Hospitals in Peace and War_--hardly describes the scope of the volume, which is, in fact almost a treatise on Nursing at large. "I read the _Subsidiary Notes_ first," wrote Mrs. Gaskell (Dec. 31, 1858). "It was so interesting I could not leave it. I finished it at one long morning sitting--hardly stirring between breakfast and dinner. I cannot tell you how much I like it, and for such numbers of reasons. First, because you know of a varnish which is as good or better than black-lead for grates[260] (only I wonder what it is). Next because of the little sentences of real deep wisdom which from their depth and true foundation may be real helps in every direction and to every person; and for the quiet continual devout references to God which make the book a holy one."

[259] _Panmure_, vol. ii. p. 381, where, in following pages, the Memorandum is also printed.

[260] "Even black-lead is unnecessary, as a varnish now obtainable looks better," _Subsidiary Notes_, p. 22.

As the work of a single hand, and that the hand of a woman in delicate health, the writing of Miss Nightingale's _Notes on the British Army_, in the space of six months, is an astonishing _tour de force_. Only the most intense application, assisted by great power of brain and will, could have accomplished it. She had no staff of secretaries. Mr. Arthur Hugh Clough, then employed in the Education Office, gave her some help, out of office hours, with the proofs; and her faithful Aunt Mai did some copying and correspondence. But for the most part everything was written in her own hand, and not for one moment did she allow herself any relaxation. Nor were the _Notes_ the only work of the same months. She prepared also (with some assistance from Mr. Bracebridge), and issued, in 1857, the masterly _Statement to Subscribers_ which has been quoted frequently in the foregoing Part of this Memoir. "Why do you do all this," wrote Mr. Herbert (Jan. 16), "with your own hands? I wish you could be turned into a cross-country squire like me for a few weeks."

V

One peculiar advantage Miss Nightingale enjoyed in the preparation of her _Notes_, which, however, added as greatly to her labour as to their effectiveness and authority. Experts of many kinds were willing and eager to help her. There were in all branches of the public service broad-minded men who knew alike the needs and the difficulties of reform, and who recognized in her an invaluable ally. Just as in the East, reformers in difficulty "went to Miss Nightingale," so now officials and officers--some openly, others with careful secrecy--approached her with hints and offers of assistance, or sometimes with petition that she would come and help them. Thus Sir John Liddell, Director-General of the Navy Medical Department, hearing what was on foot, begged her "to take up the sailors," and to "introduce female nurses into naval hospitals." She inspected Haslar Hospital at his request (Jan. 1857), and he consulted her on the plans for a Naval Hospital at Woolwich. "I return with many thanks," he wrote (Feb. 17), "your very clever Report on the Construction of Hospitals [a section of her _Notes_], from which I mean to profit largely in both our new and old buildings; but as you have only allowed me the privilege of reading your Report privately, I trust that when you see your notions carried out in our Hospitals you will not reproach me with being a plagiarist without conscience." Sir John in return supplied her with facts which she needed about naval stores, dietaries, and statistics. He also escorted her on a visit of inspection to Chatham, a military, as well as a naval, station. She was received on all sides with the utmost consideration, and a Military Medical Officer gave her free access to everything. Dr. Andrew Smith was exceeding wrath when he learnt that she had been prying into his domain there. The Medical Officer wrote to her explaining that he had misunderstood the case, imagining that her visit had official sanction on the military, as well as on the naval side, and begging her, in fear and trembling, to treat everything he had said and shown as strictly secret. The main object of her inspection of Barracks and Hospitals was to collect data for her Report, but sometimes she was able to effect a stroke of reform by the way and at once. She was invited to inspect Chelsea Military Hospital by Dr. McLachlan, the Principal Medical Officer. She went, marked many defects, and wrote to him on the subject. He concurred in what she said, explained that "reform moves slowly in old establishments, obstruction coming from sources least expected," and hoped that she might be able to exercise "a little pressure from without." The chairman of the Board was Mr. Robert Lowe, at that time Vice-President of the Board of Trade and Paymaster-General. She sought an introduction to Mr. Lowe, who "had much pleasure in calling upon her." The sequel is told in a letter from Dr. McLachlan: "If you have not already been made acquainted with it, I am sure you will be glad to learn that all the really important points mentioned in your letter to me some time ago have been conceded. Mr. Lowe's perseverance carried the Treasury. The men are to have flannel vests and drawers, knives, forks, spoons, plates, &c., &c." And Mr. Lowe himself, who could be soft sometimes, wrote to her with regard to "the improvements which you were good enough to suggest," that he was "happy to believe that the flannel is a very great comfort to the poor old men." Many Crimean veterans were afterwards Chelsea pensioners, and I have given some of their recollections of Miss Nightingale in an earlier chapter. They probably did not know that they owed their hospital comforts at home to the same woman's touch that had tended them at Scutari or in the Crimea. Miss Nightingale, during these months, inspected also the leading Civil Hospitals in London. Many of them had appointed her an Honorary Life Governor in recognition of her services during the war.

Military officers also tendered their assistance. "Ask questions," says a letter from Wellington Barracks addressed to a friend of Miss Nightingale, "until you arrive at what you want. It is a pleasure to assist that excellent lady in her noble work": "I was quite charmed," wrote an officer from Aldershot, "with the opportunity of again communicating with Miss Nightingale. She is the most single-minded and benevolent person I ever met, and is truly the wonder of her sex. Do, pray, convey to her my desire to place my humble services and experience at her disposal whenever and however she may desire." Within the War Office itself, she had influential friends. Sir Henry Storks was in frequent correspondence with her, and sent for her criticism drafts of new Regulations. Colonel Lefroy had, in accordance with her suggestion,[261] been instructed by Lord Panmure to draft a Scheme for a School of Military Medicine and Surgery. Miss Nightingale's notes on this Draft (Nov. 1856) include suggestions which might have come from some Royal Commission of our own day. She urges that the Board of Examiners should consist of the teachers. She suggests that the teachers in hospitals should not be doctors of eminence; "a man with an eminent practice rarely becomes an eminent teacher; many good men may be found to take the position of teachers at a moderate salary." She forestalled the idea of Imperial inter-change, of which the War Office of to-day says much. "A most important part of this School," she writes, would be to afford opportunities for study and comparison to Medical Officers from the Colonies. Like Dr. McLachlan at Chelsea, Colonel Lefroy at the War Office sometimes "came to Miss Nightingale." He told her of a certain military hospital which was very much overcrowded. The Principal Medical Officer had represented the case to Headquarters and demanded extra accommodation, but in vain: "a letter from Miss Nightingale might lead to better things." Colonel Lefroy was helpful in another matter. Miss Nightingale was a pioneer, as we have heard during the account of her work in the East, in devising means for encouraging the better employment of the private soldier's leisure, and for promoting his intelligent recreation. And this effort, commenced by her among the soldiers on service during the Crimean War, was continued upon her return to England. To the initiative and generosity of Florence Nightingale, the establishment of soldiers' reading-rooms is due. Her friend, Mr. Sabin, who had been the principal chaplain at Scutari, was now stationed at Aldershot, and Miss Nightingale concerted measures with him for continuing there the experiment which they had made in the East.[262] After much negotiation, permission was obtained from the military authorities to use one of the canteens as a reading-room, and on June 17, 1857, "Divisional Reading-Room, H Canteen, Aldershot Camp" was opened. The funds were provided by Miss Nightingale. The experiment was so much appreciated by the soldiers that she determined to enlarge it. She invoked the good offices of Colonel Lefroy, who wrote to her on August 19 as follows: "A propitious moment offered itself yesterday, and I asked the Chief whether I was at liberty to accept the offer of 'a private person' to contribute to the amusement of the Soldiers, and the improvement of their Reading-rooms. He laughed, having probably a shrewd suspicion of the identity of the unknown, and gave leave. I am now therefore quite at your service.... There will be no difficulty in finding means of applying any funds you will supply, and I have but one regret in the matter, viz. that a duty so essential to the moral improvement of the soldier should be left to private benevolence. I should like to print Milton's IXth Sonnet[263] on everything you give us." Miss Nightingale herself had no taste for publicity or praise. She loved to do good by stealth, and most of her influence was exerted behind the scenes.

[261] See above, p. 330.

[262] See above, p. 281.

[263] _To a Virtuous Young Lady_:--

Lady, that in the prime of earliest youth Wisely hast shunned the broad way and the green, And with those few art eminently seen That labour up the hill of heavenly Truth, The better part with Mary and with Ruth Chosen thou hast, etc. etc.

Statisticians, sanitary engineers, architects, and other experts were all in correspondence or personal communication with Miss Nightingale during the preparation of her Report. Dr. William Farr, the first authority on the former subject, was at work with her in January and February 1857 upon comparisons of the mortality in the army and in civil life. "It will always give me the greatest pleasure," he wrote, "to render you any assistance I can in promoting the health of the Army. We shall ask your assistance in return in the attempts that are now being made to improve the health of the civil population. It is in the House and the Home that sound principles will work most salutarily." Later chapters will show how readily Miss Nightingale lent assistance in that field. When she had finished the statistical section of her Report, she sent the proofs with her illustrative diagrams for Dr. Farr's revision. He found nothing to alter. "This _speech_," he wrote, "is the best that ever was written on Diagrams or on the Army. I can only express my Opinion briefly in 'Demosthenes himself with the facts before him could not have written or thundered better.' The details appear to me to be quite correct." He specially commended her diagrams for the clearness with which they explained themselves. She was something of a pioneer in the graphic method of statistical presentation. In every branch of her inquiry she was equally thorough; consulting the best authorities, collecting the essential facts. She was in communication with Sir Robert Rawlinson and Sir Edwin Chadwick, and with Sir John Jebb, the architect of model prisons. She collected plans of all the best hospitals and infirmaries in Great Britain and on the Continent. She consulted Professor Christison on dietetics, and procured dietaries from foreign hospitals. She corresponded with Army Surgeons whom she had met in the East, and with Army chaplains and missionaries. The feeling which fellow-workers had for Miss Nightingale appears characteristically in a note from Sir Robert Rawlinson to her aunt (1858). "To have earned the good word of Miss N. is most gratifying. I trust I may deserve a continuance of it. I learn with sorrow that her health is so doubtful, but I have a full and abiding faith in the providence of God. She has sown seed that will give a full harvest, and mankind will be better for her practical labours to the end of time. Hospitals will be constructed according to her wise arrangements, and they will be managed in conformity with her humane rules. One man in the army will be more useful than two formerly, and reason will preside over comfort and health. So far as my weak means extend I will strive to work in the same field, and do that which in me lies to embody the lessons I have received." "It is very pretty," wrote her sister to Madame Mohl (May 2, '57), "to see these wise old men so profoundly convinced of her knowledge as well as of her disinterestedness, and looking up at her with such a mixture of reverence and tenderness, of desire that she should not overwork herself, and of desire that she should do the work which she alone can do so well." "You cannot think what it is," wrote her sister to another friend, "to watch a great mind like hers fully at work and fully equal to that great work. To see each emergency as it arises met and conquered, to see in her great plans for reform and improvement, how even each hindrance only seems to give a fresh impetus of power to overcome (if my heart was not in each move of the game it would be like watching a gigantic game of chess, whereof the pawns were men and the result the lives of thousands); how she collects the honey out of each man's information and binds it up into the whole that is to carry on the work." Miss Nightingale's _Notes_ were her own work in a peculiar degree and, as Sir John McNeill said, no one else could have done it. But it is also true that the book collects from many quarters the best that was known and thought at the time on the subjects with which it deals.

VI

Miss Nightingale's own Report was more than half finished when the long-promised and long-delayed Royal Commission on the same subject was appointed. The importunity of Mr. Herbert and Miss Nightingale had at last "brought the Bison to bay." On April 26 she received the welcome intimation that Lord Panmure would call at the Burlington Hotel on the following day with the Official Draft of the Instructions for the Commission. She suggested a few alterations, and these were accepted, and the documents were sent for the Royal approval. Miss Nightingale kept a copy of the manuscript, and sent it to her friend, Dr. Graham Balfour, the secretary of the Commission. "Every one of the members of the Commission," she explained to him (April 27), "was carried by force of will against Dr. Andrew Smith, and poor Pan has been the shuttlecock"; and with regard to the Instructions, "You will see curious traces of the struggle to exclude and to include all reform in the progress of the MS. I think I am not without merit for labouring at bullying Pan--a petty kind of warfare, very unpleasant."

It throws an interesting side-light on the relation of Ministers to their subordinates to know, as appears from Miss Nightingale's papers, that Lord Panmure was careful to have the documents initialled by the Queen before submitting them to Dr. Smith. To those who have delved into the history of the Crimean muddle, few things are more curious at first sight than the long ascendancy of Dr. Smith. Perhaps no one was to blame, but only the system; but if any individuals were to blame for the medical defects, then surely the Medical Director-General must have been one. Lord Grey sent to Miss Nightingale a very long and elaborate Memorandum on her _Notes_. He admired the skill with which she marshalled the facts; but maintained that the true conclusion to be drawn from them was not that radical reform was needed, but that several persons (including Dr. Smith) should have been court-martialled. I doubt if Miss Nightingale differed from the latter proposition. But in fact Dr. Smith was decorated, and when the war was over he was allowed for many months to obstruct the course of reform. The explanation, however, is simple. The permanent head of a Department is a master of its detail, and if he be a man of any ability, this fact often gives him an ascendancy over his political chief. If the Minister be indolent, or incapable of detail, or for any other reason disposed to the line of least resistance, he becomes as clay in the hands of his permanent subordinate, whenever a matter comes down from generals to particulars. So Lord Panmure, at the final stage of this affair, took the precaution of barring out details. Dr. Smith, who was a pertinacious man, had, I dare say, many criticisms to offer when the Instructions for the Commission were shown to him. But, if so, Lord Panmure had a general and a conclusive answer. What the Queen had signed must not be altered.

The Royal Warrant, instructing the Commission, was in very wide and comprehensive terms, and Mr. Herbert and his colleagues set to work without a day's delay. Six months had elapsed between his acceptance of the Chairmanship and the issue of the Royal Warrant. The Report of the Commission was prepared in precisely three months. To appreciate fully the industry which such a result involved, one must have looked into the mountainous mass of detail which the Commission accumulated and sifted. No praise can be too high for the unremitting attention, the incessant hard work which Mr. Herbert, as Chairman, threw into the task. But even so, such speed in the preparation of the Commission's Report would have been impossible, but that much of the ground had been already explored, and most of it exhaustively covered, by Miss Nightingale. In all Royal Commissions, as also in more august bodies, there is an Inner Cabinet, and sometimes an Innermost Cabinet as well. In the present case there was an Innermost Cabinet of three, and one of the three was not a member of the Commission--Mr. Herbert, Dr. Sutherland, and Miss Nightingale. There was no man so closely associated with Miss Nightingale's work for so many years, and in so many different directions, as Dr. John Sutherland. He was recognized as one of the leading sanitarians of the day. He had been an Inspector under the first Board of Health (1848), and had been employed by the Government in many special inquiries. As head of the Sanitary Commission sent to the Crimea in 1855, he had, as already stated, made Miss Nightingale's acquaintance, and from that time forth they were close colleagues. He served on almost every Commission, Sub-Commission, and Committee with which she had anything to do. If he was not nominated in the first list, she always insisted on his inclusion. He sometimes exasperated her, as we shall hear in later chapters, but they worked together in constant comradeship. He was, as it were, her Chief-of-the-Staff; and also in large measure her Private Secretary for official matters. Upon Dr. Sutherland and Miss Nightingale the Chairman of the Royal Commission mainly relied. I have already quoted Mr. Herbert's general tribute to her assistance (p. 312). It is fully borne out by the evidence contained in her papers.

Throughout the proceedings of the Commission, Miss Nightingale was in daily communication--personal, or by letter--with Mr. Herbert or Dr. Sutherland, or with both. I have before me, of this date, fifty letters from each of them to her. She was an unremitting task-master. "My dear Lady," wrote Dr. Sutherland one Friday (May 22), "do not be unreasonable. I fear your sex is much given to being so. I would have been with you yesterday, had I been able, but alas! my will was stronger than my legs. I have been at the Commission to-day, and as yet there is nothing to fear. I was too much fatigued and too stupid to see you afterwards, but I intend coming to-morrow about 12 o'clock, and we can then prepare for the campaign of the coming week. There won't be much to do, as the Commission is going to the Derby, except your humble servant and Alexander, who, for the sake of example, are going to see Portsmouth and Haslar to give evidence on both. We shall meet on Monday and Friday only. The Sanitary arguing goes on on both these days, and I hope to-morrow to be able to perform the coaching operation you desiderate, and as you don't go to church you can coach Mr. Herbert on Sunday. I have now sent you a Roland for your Oliver, and am ever yours faithfully." Of the letters from Mr. Herbert, written after the Commission was appointed, the first defines the position: "We must meet and agree our course." A few other brief extracts will fill in the sketch. "I am getting up the examinations; does anything occur to you?" "I send you Hall's correspondence. You know the matters treated with all the dates which I do not, and will see in them what I should not." He consults her about the order in which to call the witnesses, "or we shall seem to be always examining one another." He asks her to look into a comparison of the mortality among marines and sailors respectively. She secured on another subject some damning documents. "I return your stolen goods," he writes. "Pray keep them carefully. If ever we have to besiege the Army Medical Department, no Lancaster gun could be more formidable than this document; it is really almost unbelievable." "I should very much like to have a Cabinet Council with you to-day. Shall I come to you at 5 o'c., or would you come here?" And so forth, and so forth, almost daily. But I can perhaps best convey an idea of the co-operation in terms of legal procedure. Miss Nightingale was the solicitor who gave instructions in the case to Mr. Herbert. As each branch of the inquiry came up, she sent him a memorandum upon it; often, no doubt, a copy of her own Report on the same subject. She suggested the witnesses, and often saw them before they gave their evidence, in order, as it were, to take their proof. In the case of some important witnesses, she prepared the briefs for cross-examination, as well as examination. In June, Sir John Hall, whom the reader will remember as Principal Medical Officer in the Crimea, was to be in the box. "I have been asked," she wrote to Sir John McNeill (June 12), "to request you to give us some hints as to his examination, founded upon what you saw of him when in your hands. My own belief is that Hall is a much cleverer fellow than they take him for, almost as clever as Airey,[264] and that he will consult his reputation in like manner, and perhaps give us very useful evidence, no thanks to him.... I would only recall to your memory the long series of proofs of his incredible apathy, beginning with the fatal letter approving of Scutari, Oct. '54,[265] continuing with all the negative errors of non-obtaining of Lime Juice, Fresh Bread, Quinine, etc., up to his _not_ denouncing the effects of salt meat before you.... We do not want to badger the old man in his examination, which would do us no good and him harm. But we want to make the best out of him for our case. Please help us. I understand that Dr. Smith says he was much afraid of 'the Commission' at first, and 'thought it would do harm.' But now 'thinks it is taking a good turn.' Is this for us or against us?" Sir John McNeill thought "for us," and advised that Dr. Hall should "not be put too much on the defensive," but should be led in examination "to slip quietly into the current of reform as Dr. A. Smith seems from what you say to have done." Still, if he proved obdurate he must of course "be put in a corner"; and so Sir John McNeill assisted the lady-solicitor to prepare posers for a possibly refractory witness. It was difficult, however, to be refractory with Mr. Herbert. "He was a man of the quickest and most accurate perception," she wrote of him in later years, "that I have ever known. Also he was the most sympathetic. His very manner engaged the most sulky and the most recalcitrant of witnesses. He never made an enemy or a quarrel in the Commission. He used to say, 'There takes two to be a quarrel, and I won't be one.'" Then, again, Miss Nightingale was always at Mr. Herbert's call to supply details, missing dates, and references. Every one familiar with the courts knows how even the ablest counsel will sometimes stumble over a date or fumble among his papers for a particular document, till a junior behind him or the solicitor in front of him comes to his rescue. That was another rôle played by Miss Nightingale, though behind the scenes. "Sidney is again in despair for you," wrote Mrs. Herbert; "can you come? You will say, _Bless_ that man, why can't he leave me in peace? But I am only obeying orders in begging for you."

[264] Richard, Lord Airey, Quartermaster-General to Crimean Army, 1854-5, one of the officers vindicated by the Chelsea Board; Quarter-master-General, 1855-65.

[265] Dr. Hall had reported to Dr. Smith from Scutari (Oct. 20, 1854), with "much satisfaction," that "the whole Hospital establishment has now been put on a very creditable footing," etc. See _Notes_, p. 52.

A difficulty arose upon the question whether Miss Nightingale should or should not give evidence herself. She was averse from doing so, and Sir John McNeill strongly supported her. In his paternal way he did not like the idea of her exposing herself to such a strain, and indeed her physical weakness at the time was great. In the present day she would of course, in like circumstances, have been made a member of the Royal Commission. In those days the idea of calling a woman as a witness caused some qualms. Her own objection was founded rather on regard for Mr. Herbert's susceptibilities. She could not tell the truth, the whole truth, and nothing but the truth without going into the past, and such evidence might seem to cast reflections on the conduct of her friend as Minister during the earlier part of the war. Mr. Herbert, however, brushed this point aside, and urged her to come and tell the whole truth. Her friend Mr. Stafford was yet more emphatic. "Let me entreat you," he wrote (June 11), "to reconsider your determination. You have done so much, you ought to do all. This is our last effort for the soldier. No one can aid us so well as you, and you can aid us so well in no other manner; even if your opinions should offend some few individuals, the fault is theirs, not yours. The absence of your name from our list of witnesses will diminish the weight of our Report, and will give rise to unfounded rumours; it will be said either that we were afraid of your evidence, and did not invite you to tender it, or that you made suggestions, the responsibility of which you were reluctant to incur in public." There was obvious force in Mr. Stafford's arguments, and it was decided that Miss Nightingale should give evidence in the form of written answers to written questions. Her evidence, which occupies thirty-three pages of the Blue-book, is in effect a condensed summary of her confidential Report. None of the evidence given to the Commission was more direct and cogent. "It may surprise many persons," wrote an army doctor at the time, "to find, from Miss Nightingale's evidence that, added to feminine graces, she possesses, not only the gift of acute perception, but that, on all the points submitted to her, she reasons with a strong, acute, most logical, and, if we may say so, masculine intellect, that may well shame some of the other witnesses. They maunder through their subjects as if they had by no means made up their minds on any one point--they would and they would not; and they seem almost to think that two parallel roads may sometimes be made to meet, by dint of courtesy and good feeling, amiable motives that should never be trusted to in matters of duty. When you have to encounter uncouth, hydra-headed monsters of officialism and ineptitude, straight hitting is the best mode of attack. Miss Nightingale shows that she not only knows her subject, but feels it thoroughly. There is, in all that she says, a clearness, a logical coherence, a pungency and abruptness, a ring as of true metal, that is altogether admirable."[266] "I have perused with the greatest interest," wrote a member of the Commission (Sir J. R. Martin) to her, "your most conclusive evidence now in circulation for the perusal of the Commissioners. It contains an assemblage of facts and circumstances which, taken throughout their entire extent, must prove of the most vital importance to the British soldier for ages to come."

[266] _The Army in its Medico-Sanitary Relations_, p. 26. Edinburgh, 1859. Reprinted from the _Edinburgh Medical Journal_. The writer was Dr. Combe, R.A.

VII

The Report of the Commission was written by Mr. Herbert in August 1857, with much assistance from Miss Nightingale. "A thousand thanks," he wrote to her (Aug. 5). "The list of recommendations and defects is very clear and good. I have noted one or two additions." A comparison of the Recommendations at the end of Miss Nightingale's Report with those at the end of the Royal Commission's Report shows how closely the latter document followed the earlier. The Report was not issued to the public until January 1858. The reason for the delay is intimately connected with the story of Miss Nightingale's life during the latter half of 1857. The salient feature of the Report was its adoption and confirmation of the appalling figures which she had first tabulated many months before. "It is of infinite importance to the success of all you have still to accomplish," wrote Sir John McNeill (Nov. 9) when she sent him a proof of Mr. Herbert's Report, "that the accuracy of your statements as to the condition of the Barracks has been established beyond question. It deprives interested cavillers of all right to be listened to when they desire to question your other propositions." It was shown conclusively by the Royal Commission that, as Miss Nightingale had said, the rate of mortality in the Army at home in time of peace was double that of the civil population. A comparison of the civil and military mortality in certain London parishes was yet more startling. In St. Pancras the civil rate was 2·2; the rate in the barracks of the 2nd Life Guards was 10·4. In Kensington the civil rate was 3·3; the rate in the Knightsbridge barracks was 17·5. Every one who knew the contents of the Report perceived that this was the point which would cause a sensation. The Crimean War and its muddles were beginning to fade into the past, especially in view of the Indian Mutiny; and reorganization of a department of the Army would never be likely to arrest popular attention. But the case was different with facts and figures showing that the health of the Army, even when at home and in peace, was shamefully sacrificed by official neglect. There was to be a sitting of Parliament in December, and nasty questions would assuredly be asked unless something were done. There was a masterful and importunate woman behind the scenes who was firmly resolved that something should be done. Without a moment's rest, without thought of recess or relaxation, Miss Nightingale flung herself into a new campaign.