The Life of Florence Nightingale, vol. 2 of 2 by Sir Edward Tyas Cook

CHAPTER II

8357 words  |  Chapter 26

THE PROVIDENCE OF THE INDIAN ARMY (1862, 1863) In this case you are doing much more than providing for the health of the Troops; for, to be effectual, the improvement must extend to the civil population, and thus another great element of Civilization will be introduced.--SIR CHARLES TREVELYAN (_Letter to Florence Nightingale_, Aug. 11, 1862). It is a commonplace that the British Empire in India was won and is held by British arms. And this, though not the whole truth of the tenure by which the Empire is held, is true. What is also true, but less generally known, is that there have been heavier sacrifices than those demanded in war and rendered glorious by British valour. The greater part of the British lives that were shed in India were lost, not in battle, but by disease. Burke said of British rule in India in his time: "England has built no bridges, made no high roads, cut no navigations. Were we driven out of India this day, nothing would remain to tell that it had been possessed, during the inglorious period of our dominion, by anything better than the ourang-outang or the tiger."[8] That was no longer true at the time with which we are here concerned. The era had begun in which it has been a song of the English to "drive the road and bridge the ford." But the land was not yet "cleared of evil." The British soldier was still sent out to India to die ingloriously by the neglect of sanitary laws. In 1859 it was found that the average annual death-rate among the British soldiers in India since the year 1817 had been 69 per 1000. To-day it is little over 5 per 1000. The changes in barracks and military sanitation in India, which are primarily accountable for this great saving of life, are directly traceable to the recommendations of the Royal Commission which was appointed by Lord Stanley in 1859, and which reported in 1863. Thus much the reader may find stated in any trustworthy book of reference or other standard authority. What he will not find generally stated is that the appointment of the Royal Commission is directly traceable to Miss Nightingale, that by her the greater part of its Report was written, and that the suggestions for reform founded upon it were also her work. At an International Congress held in London in 1860 a French delegate, as already related, spoke of Florence Nightingale as "the Providence of the English Army." She was no less the Providence of the Indian Army. To the British soldier in India, as at home, she was "a saviour." In introducing this subject, we must go back a little in point of time, for the Indian work had begun a few years before the death of Sidney Herbert. [8] Speech on Fox's East India Bill, Dec. 1, 1783 (_Burke's Speeches_, 1816, vol. ii. p. 430). * * * * * "I must tell you a secret," wrote Miss Nightingale to Harriet Martineau in 1859 (May 19), "because I think it will please you. For eight long months I have been 'importunate-widowing' my 'unjust judge,' viz. Lord Stanley, to give us a Royal Sanitary Commission to do exactly the same thing for the Armies in India which the last did for the Army at home. We have just won it. The Queen has signed the Warrant. So it is safe. Mr. Sidney Herbert is Chairman of course. Drs. Sutherland, Martin, Farr, and Alexander, whose names will be known to you, and Sir R. Vivian and Sir P. Cautley, of the India Council, are on it." Miss Nightingale had made up her mind two years before to do this thing. The Indian Mutiny, which filled some minds only with thoughts of vengeance and repression against the native soldiers, filled hers rather with thoughts of pity and reform on behalf of the British soldiers. She had gone into the figures of mortality in the Indian army at the time when she was analysing those in the army at home. There was "murder" committed not only by the Sepoys. It was murder also to doom British soldiers to death by neglect of sanitary precautions. At the end of her _Notes on the Army_ (1857), she inserted a fly-leaf, which foreshadowed her Indian campaign:-- While the sheets were passing through the press, those lamentable occurrences took place in India which have led to an universal conviction that this vast Empire must henceforth be held by British troops. If we were to be led by past experience of the presumed effect of Indian climates on European constitutions, our country might almost despair of being able to supply men enough.... The British race has carried with it into those regions of the sun its habits, its customs, and its vices, without considering that under a low temperature man may do with impunity what under a higher one is death. Our vast Indian Empire consists of many zones, of many regions, of many climates. On the mere question of climate, it is surely within human possibility, even in the great majority of instances, so to arrange the stations, and so to connect them, by railroads and telegraphs, that the troops would hardly be required to occupy unhealthy districts. Even with regard to such districts the question arises to what extent the unhealthiness is inevitable, and to what extent it would be remediable.... As an illustration of the necessity of Government interference in this matter, it may be stated, on the very first authority, that, after a campaign perhaps one of the most arduous and successful on record, and when the smallness of the British force and the season of the year required every sanitary precaution to be taken for the preservation of the force, a certain earnest, energetic Officer appointed a sanitary inspector to attend to the cleansing of a captured city, and to the burial of some thousand dead bodies of men, horses, asses, bullocks, camels, and elephants, which were poisoning the air. The Bombay Government, to which the appointment was referred, "would not sanction it," "_because there was no precedent for it_"! In future, it ought to be the duty of the Indian Government to require no precedents for such procedure. The observance of Sanitary laws should be as much part of the future _régime_ of India as the holding of Military positions or as Civil government itself. It would be a noble beginning of the new order of things to use hygiene as the handmaid of civilization. Everything that Miss Nightingale thus said should be done, was done; and to the doing of it, she supplied, first, the propelling force, and, then, much of the detailed direction. First came the movement for getting the appointment of a Royal Commission agreed to in principle. Miss Nightingale's reference to Lord Stanley as her "unjust judge" need not be taken too seriously. He was her very good friend, as we know;[9] and it was when he was transferred from the Colonial to the India Office (1858) that she felt her time to have come. And Lord Stanley agreed at once to her suggestion of appointing _a_ Commission. It was when the consideration of _the_ Commission was reached that the delay began. Who should approach Lord Stanley on the details? And how should it be done? Miss Nightingale and what I have called her cabinet of reformers were equally interested in the Sub-Commissions still sitting on Army Sanitation at home. Lord Stanley wanted Mr. Herbert to undertake the chairmanship of the India Commission. Should he accept it, at risk of diverting some of his attention from these other reforms? Miss Nightingale and her friends hit upon a plan, as she hoped, for killing two birds with one stone. It was intimated to Lord Stanley that Mr. Herbert would accept the chairmanship on condition that the pending reforms at home were hastened. I do not know if the Indian Secretary came to terms with the War Secretary in that sense; if he did, I fear that General Peel interpreted "haste" as _festina lente_. Anyhow, Mr. Herbert accepted the chairmanship, and then some months were spent in arranging the membership and the terms of reference. There were to be three sanitary experts, a statistician, and two members of the India Council. Of the two latter, one (Sir R. Vivian) was a friend of Miss Nightingale's uncle, Mr. Smith; and of Sir Proby Cautley she had heard good reports. The sanitarians--Drs. Sutherland, Martin, and Alexander--and Dr. Farr, the statistician, were all of her inner circle. At the last moment there was a fresh delay. The list was submitted for the royal approval, and Her Majesty required that "a Queen's officer of acknowledged experience in India" should be added to the Commission. Mr. Herbert asked Miss Nightingale to supply a suitable man, by which he meant a man whose acknowledged experience included some belief in sanitary science. She took great pains, and employed some wile in obtaining the best opinions. She wrote, for one thing, to her uncle, telling him (May 19, 1859) to get at Sir John Lawrence, through his friend Sir R. Vivian, and ask for suggestions. "Vivian must be soaped," she added, "so as not to let him think that we undervalue _his_ opinion." Sir John Lawrence did not, however, on this occasion prove very resourceful; Miss Nightingale sent in the name of an officer, Colonel E. H. Greathed, who had been commended to her through another channel, and he was duly added to the Commission. At an earlier stage she had thrown out the interesting suggestion that John Stuart Mill, lately retired from the East India House, should be asked to serve, but this did not meet with favour. "Our business," wrote one of her circle, "is with spades and wheelbarrows," and he doubted whether "Compte" [sic] could be put to such purposes. Miss Nightingale always thought that this ally of hers, though invaluable in many ways, was a little wanting in soul. So then the Commission was appointed. The Warrant was issued on May 31, 1859. The Commission reported on May 19, 1863. There were some changes in its personnel from death and other causes. On the overthrow of the Derby Government, Mr. Herbert went to the War Office, and he presently resigned the chairmanship. Lord Stanley succeeded him. The members of the Commission on whom both Mr. Herbert and Lord Stanley most relied were Dr. Sutherland and Dr. Farr, and a third, who was yet not a member--Miss Nightingale. And among these three the lion's share of the work was done by her. [9] See Vol. I. p. 339. II She had not waited for the actual appointment of the Commission to begin collecting, preparing, and digesting evidence for it. Her first concern was to draft a circular of inquiry which should be sent to all the Stations in India. It lacked nothing, as will be supposed, in requiring fulness of statistical detail. When she had prepared it, she sent it in proof to Sir John McNeill for his suggestions, asking him also (May 9, 1859) "kindly to give an opinion as to the general direction which the Enquiry should take." In cases where she was personally acquainted with Governors or high military or medical officers in India, she wrote soliciting their good offices. Sir Charles Trevelyan, then Governor of Madras, promised cordial co-operation. Then she and Dr. Farr set to work on such statistical records as were obtainable from the East India House. There is a bundle of correspondence amongst her Papers relating to the difficulties she encountered, and surmounted, in obtaining official sanction for clerical work in this regard. Dr. Farr's appetite for statistics was as insatiable as hers, and she had taken means to lay in ample supplies:-- (_Miss Nightingale to Dr. Farr._) HIGHGATE, _June_ 2, [1859]. Your Commission was gazetted on May 31 and Mr. Herbert is in town. As it will be necessary to obtain the Statistics of Sickness, Mortality, and Invaliding of the Indian Army from the Medical Boards there, would not some of the proposed forms for the Army Medical Dep. be better than any other, filled up for each station with the Diseases annually for a period say of 10 years? Or would it be necessary to provide others? We must, of course, have the most minute Statistics--both for Soldiers and Officers in the Queen's, Company's and native troops. And these we should get by this method for 10 years. I suppose the Medical Boards have the Presidency Medical Book Records. Would it be necessary to get the Returns for each Corps separately? Would it not be important to get the ages--age and time of service at Death or Invaliding? HAMPSTEAD, _Dec._ 6 [1859]. In consequence of your intemperate desire to have the Indian Medical Service Regulations, we have applied at the Great House for copies. And the answer is that they have only one Office copy, and if we want any we must send to India. Knowing their weakness, we had (in our "Queries") previously sent to two hundred Stations in India for copies of all "Regulations," and we hope the result will satisfy your literary appetite. Dr. Farr, then, was being fed with statistics. Officials in India were being kept busy with forms to be filled up, and with the preparation of other written evidence. In November 1859 the Commission began taking oral evidence in London, but this was a comparatively minor part of its labours, and during 1860 no public sittings were held. They were resumed in 1861. Lord Stanley had then succeeded Mr. Herbert in the chair, but Miss Nightingale's grip upon the Commission was not relaxed. Two of the Commissioners, Dr. Sutherland and Dr. Farr, were in close touch with her. The former was with her almost every day; the latter asked her to send him questions which he should put to witnesses. As in the case of the former Royal Commission, so now Miss Nightingale saw some of the witnesses before they gave their evidence. Among her visitors in this sort was Sir John Lawrence, as already mentioned, and a friendship began which had important consequences. Seeing that everything was thus in good train, Miss Nightingale was able during the years 1859-60-61 to devote her main work to those other matters with which we have been concerned in preceding Parts. In 1862, her main interest was in the Indian Commission, and the amount of work which she gave to it during 1862-1863 was enormous. Her manner of life during these years was similar to that described in a previous chapter. Work for the Commission required her constant attendance in London or within easy distance of it. In 1862 she lived either in a hotel (Peary's, 31 Dover Street), a hired house (9 Chesterfield Street), or Sir Harry Verney's house in South Street. During August and September she took a house in Oak Hill Park, Hampstead. In 1863 she divided her time between Hampstead, hired houses in Cleveland Row, and Sir Harry Verney's. Her affectionate friend, Mrs. Sutherland, did all the house-hunting for her. Cleveland Row was selected for its nearness to the War Office; and the convenience of the site so far constrained Dr. Sutherland's sanitary conscience that he declared Cleveland Row to be "the airiest place in London." III Few of my readers have come to close quarters, I suppose, with the _Indian Sanitary Commission's Report_. It is a very formidable thing, consisting of two bulky volumes, containing respectively 1069 and 959 pages--in all 2028 pages, mostly in small print. Of this mountainous mass, the greater part bears in one way or another the impress of Miss Nightingale. It was she, in the first place, as already stated, who drafted the questions which were sent to every military station in India. The replies, signed in each case by the commanding officer, the engineer officer, and the medical officer, occupy the whole of the second volume. The replies, as they came in from India, were sent to her to analyse. There were van-loads of them, she said, which cost her £4:10s. to move whenever she changed houses. With the analysis made by her and Dr. Sutherland, these replies anticipated, as she afterwards noted,[10] the Statistical Survey of India which Lord Mayo ordered ten years later. It was said at the time that such a complete picture of life in India, both British and native, was contained in no other book in existence. In October 1861 she was formally requested by the Commission to submit remarks on these Stational Reports. She had completed the task by August 1862. The "Observations by Miss Nightingale," which occupy twenty-three pages of the Report, are among the most remarkable of her Works, and in their results among the most beneficent. They are also extremely readable; and to make them more instructive, she included a number of woodcuts illustrating, not only Indian hospitals and barracks, but native customs in connection with water-supply and drainage.[11] The Treasury--horrified perhaps at the idea of popularizing a Blue-book--made some demur to the cost, but Miss Nightingale was allowed to solve the difficulty by paying for the printing, as well as for the illustrations, out of her private purse. [10] In her _marginalia_ to Sir William Hunter's _Earl of Mayo_ (1891). [11] Indian officers (and especially Colonel Young) supplied her with sketches, some of which were touched up by her cousin, Miss Hilary Bonham Carter. She made full use of the opening which the niggardliness of the Treasury gave her. She hurried the printers, and had a large number of her "Observations" struck off for private use. "I have looked once more," wrote Lord Stanley (Nov. 21), "through your Remarks, and like them better the oftener I read them. The style alone (apart from the authority which your name carries with it) will ensure their being studied by many who know nothing of the subject. They will admirably relieve the dryness of our official Report. I hope every Indian and English newspaper will reprint them, in extracts at least. They must be circulated with our Report, separately from the too voluminous mass of evidence which we can't help appending. You have added one more to your many and invaluable services in the cause." "Miss Nightingale's Paper," wrote Dr. Farr to Dr. Sutherland (Dec. 1), "is a masterpiece, in her best style; and will rile the enemy very considerable--all for his good, poor creature."[12] But it was not only among the Commissioners that she circulated her Paper. She sent it confidentially to many of her influential friends. "The picture is terrible," wrote Sir John McNeill (Aug. 9), "but it is all true. There is no one statement from beginning to end that I feel disposed to question, and there are many which my own observation and experience enable me to confirm." A copy went to John Stuart Mill, who was much pleased with the "Observations," and was certain that "the publication of them would do vast good." Miss Nightingale had a copy bound for the Queen, and sent it--as also a copy of her Paper on Sidney Herbert--through Sir James Clark, who marked passages for the Queen to read. Her Majesty, he found from conversation, had not confined her reading to those passages. The Queen in return sent a copy of her Collection of Prince Albert's Speeches. "The Queen," wrote Miss Nightingale to M. Mohl (Feb. 14, 1863), "has sent me her book with such a touching inscription. She always reminds me of the Greek chorus with her hands clasped above her head wailing out her irrepressible despair."[13] Miss Nightingale sent her "Observations" also to Sir John Lawrence, who studied them closely, and corresponded with her on the subject. Another copy went to Sir Charles Trevelyan.[14] "Having," he wrote (Oct. 31, 1862), "undertaken the duties of Financial Member of the Council of India, I may now be able to give some help in carrying the recommendations of your Commission into practical effect. You must not expect from me as much as Sidney Herbert did, for my power will not be the same. The Governor-General and the local Governors will alone be in that position. But I shall do _what I can_. Perhaps you will send me a copy of your Abstract of the Evidence, and direct my attention to the points of more immediate importance. I shall be obliged for any hints." Miss Nightingale responded by sending him papers enough to occupy all his time on the voyage. She seems at this time to have entertained some hope that her health would permit her, when the Report was out, to visit India in person; for one of Sir Charles's letters refers to such a visit, and expresses the pleasure which it would give to Lady Trevelyan and himself to receive her as their guest, and in every way to assist her mission. But this was not to be. Her knowledge of India and Indian questions was already great, and presently it became so minute as to encourage a legend that she herself had once been there.[15] But she never saw the country. It is not always either the "life-long resident," or, on the other hand, "Padgett, M.P.," who is better qualified than the student to perceive and serve a country's need. [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 mass 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 quantities of animal and vegetable matter, which the reports apparently consider nutritive." "If the facilities for washing 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 illustrated by an amusing drawing, sent to her by Colonel Young, of "Daily Means of Occupation and Amusement _passim_." 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 instituting 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 analysis, occupying nearly a hundred pages, was drawn up, as already stated, by Miss Nightingale and Dr. Sutherland. The manuscript 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 principal 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 anticipated 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 assured 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 manuscript 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 assumed 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 repetition of her "Observations," in the colder language which is held to add weight and dignity to such documents; 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 shiploads 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 class 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 substituted 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 Ranald 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 principal authors of the Report, she was obviously entitled 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 associated 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 principally 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 pass 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 "précis of evidence" made by the Clerk. This, as Miss Nightingale thought, was badly done, and, moreover, referred in the margin to passages 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 circumvent 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 document? 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 God 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. Nobody 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 assented, 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 Saturday 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 principally by passionate devotion to her cause. And there was another feeling which gave her strength, as appears from many a passage 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 shore, 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 shore, 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 shore who are shouting to cheer me."

Chapters

1. Chapter 1 2. PART V 3. CHAPTER I 4. CHAPTER II 5. CHAPTER III 6. CHAPTER IV 7. CHAPTER V 8. CHAPTER VI 9. PART VI 10. CHAPTER I 11. CHAPTER II 12. CHAPTER III 13. CHAPTER IV 14. PART VII 15. CHAPTER I 16. CHAPTER II 17. CHAPTER III 18. CHAPTER IV 19. CHAPTER V 20. CHAPTER VI 21. CHAPTER VII 22. CHAPTER VIII 23. CHAPTER IX 24. PART V 25. CHAPTER I 26. CHAPTER II 27. CHAPTER III 28. 1000. The rate in 1911 was, as already stated, 5.04. 29. CHAPTER IV 30. 1864. Miss Nightingale's good offices were asked by the War Office 31. CHAPTER V 32. CHAPTER VI 33. introduction to new masters at the India Office and the Poor Law 34. 25. You owe me no apology for calling my attention to material 35. PART VI 36. CHAPTER I 37. CHAPTER II 38. CHAPTER III 39. CHAPTER IV 40. PART VII 41. CHAPTER I 42. Introduction dwells too much on the _form_ of the _Gorgias_ and does 43. CHAPTER II 44. CHAPTER III 45. 1895. "Nearly 600 nurses completed their probationary course under 46. CHAPTER IV 47. 1878. Sir James Knowles's magazine was then in the early days of its 48. CHAPTER V 49. 1869. She was one of the many women who revered the name of Florence 50. CHAPTER VI 51. CHAPTER VII 52. CHAPTER VIII 53. CHAPTER IX 54. 1893. Thirty-nine years ago arrival at Scutari. The immense blessings I 55. 1851. Octavo, paper wrappers, pp. 32. 56. Introduction par M. Daremberg._ Paris: Didier. Crown 8vo, 57. Introduction (as is shown by a MS. amongst Miss Nightingale's Papers) 58. introduction of conflicting disease-theories into sanitary reports, 59. 1872. Contributed by request to the _Report on Measures adopted for 60. Part II. Ch. VIII. Miss N. was denounced as "a semi-Romish Nun," an 61. Chapter vii., "The Providence of the Barrack Hospital," gives an 62. Chapter vii. gives a full account of the mission of the Bermondsey 63. Chapter xi. is mainly devoted to an account of "The Lady-in-Chief"

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