CHAPTER IV

ADVISER-GENERAL ON HOSPITALS AND NURSING (1868-1872) We are your Soldiers, and we look for the approval of our Chief.--MISS AGNES JONES (_Letter to Miss Nightingale_). From a correspondent in the North of England: "I have got a colliery proprietor here to co-operate with the workmen to build a Hospital for Accidents. Will you kindly give your opinion on the best kind of building?" From a correspondent in London: "We are proposing to form a British Nursing Association. May we ask for your advice and suggestions?" These letters are samples of hundreds which Miss Nightingale received, and to all such applications she readily replied. She constituted herself, or rather she was constituted by her fellow-countrymen, a Central Department for matters pertaining to hospitals and nurses. From all parts of the country, from British colonies and from some foreign countries, plans of proposed General Hospitals, Cottage Hospitals, Convalescent Homes were submitted to her. She criticised them carefully. When she was consulted at an earlier stage, she often submitted plans of her own. In all such cases, there were experts among her large circle of friends--architects, sanitary engineers, military engineers, hospital superintendents and matrons--to advise and assist her. And here a curiously interesting thing may be noticed. Miss Nightingale had begun her work as a Reformer with the military hospitals. So high was now their standard that she often went to them for models. Many plans for ideal hospitals were drawn for her at this time by Lieutenant W. F. Ommamney, R.E., at the War Office. The improvement of buildings and of nursing went on concurrently, and Miss Nightingale used her influence in each department to improve the other. If she were consulted only about buildings, she would answer: "These plans are all very well, as far as they go; but your Hospital will never be efficient without adequate provision for a supply of properly trained nurses." If she were asked to furnish a supply of nurses, she would say: "By all means; but you must satisfy me first that your buildings are sanitary." Thus, when she was asked to send nurses to the Sydney Infirmary, she stipulated that plans of the buildings should be submitted; and when the War Office was negotiating for a supply of nurses for Netley, there was a voluminous correspondence about the improvement of the wards and of the nurses' quarters. There was a great extension during these years of societies for the training of nurses, and of the introduction of trained nurses into infirmaries and other institutions. All this involved a large addition to Miss Nightingale's correspondence. As the nursing system extended, many questions arose with regard to the relation between the medical and the nursing staffs, and she was constantly referred to for suggestions and advice. She printed a code of "Suggestions" in 1868 dealing with such matters,[118] and three years later she and Dr. Sutherland drew up a Code for Infirmary Nursing which was approved by Mr. Stansfeld, the President of the newly-formed Local Government Board. Her correspondence was as extensive with individuals as with institutions. Hundreds of girls who thought of becoming nurses applied to her, and she generally answered their letters; but the supply of nurses barely kept pace with the demand. Miss Nightingale was impressed in particular by the lack of suitable applicants for the higher posts. There were many women anxious to take up nursing as a profession. There were few who possessed the social standing, the high character, trained intelligence, and personal devotion which were necessary to make them successful Lady Superintendents; and much of Miss Nightingale's correspondence during these years was to friends in various parts of the country who were begged to enlist promising recruits. [118] Bibliography A, No. 49 (note). II Among the women who sought out Miss Nightingale for advice were Queens and Princesses. She guarded very jealously, however, the seclusion which was necessary to enable her to do her chosen work, and she did not allow it to be invaded at will even by the most exalted personages. Her position as a chronic invalid gave her the advantage. She could pick and choose by feeling a little stronger or a little weaker. She made two rules which she communicated to her influential friends. She would not be well enough to see any Queen or Princess who did not take a personal and practical interest in hospitals or nursing; and she would never be well enough to receive any who did not come unattended by ladies or lords in waiting. Any interview must be entirely devoid of ceremonial; it must be simply between one woman interested in nursing and another. In 1867 the Queen of Prussia was paying a visit to the English court, and Queen Victoria asked Miss Nightingale through Sir James Clark to see Queen Augusta. Miss Nightingale was assured that the Queen had given much personal attention to hospitals. Miss Nightingale saw her (July 6) and found that the assurances were well founded:-- (_Miss Nightingale to Julius Mohl._) 35 SOUTH STREET, _July_ 28 [1867]. I am a little unhappy because the Queen of Prussia's Secretary told Mad. Mohl that I had seen the Queen. I liked her. I don't think the mixture of pietism and absolutism is much more attractive at the Court of Prussia than at the Court of Rome. Still, I am always struck, especially with our own Royal family, how superior they are in earnestness and education to other women. I know no two girls of any class, of any country, who take so much interest in things that are interesting, as the Crown Princess of Prussia and Princess Alice of Darmstadt--especially in theological matters and administration. The Queen of Holland, it will be remembered, had not been received; but at a later time Miss Nightingale saw her, in November 1868 and again in March 1870. "I think of you," wrote Queen Sophie (March 29, 1870), "as one of the highest and best I have met in this world." The Princess Alice asked for an interview in 1867 through Lady Herbert, who was able to inform Miss Nightingale that "the Princess has been to see most of the hospitals in London with a view to learn all about them so as to improve those in Darmstadt." Miss Nightingale saw the Princess in June, and in subsequent years there was much correspondence between them. But the royal lady who made the greatest impression on Miss Nightingale was the Crown Princess Victoria. It had been explained to Miss Nightingale by one of the Princess's ladies that "H.R.H. has always thought a life devoted to the comfort of fellow-beings and the alleviation of their sufferings the one most to be envied," and that "she knows your Notes on Hospitals and Notes on Nursing almost by heart." The Princess was in England at the end of 1868, and was full at the time of schemes for a new hospital at Berlin, for lying-in hospitals, for a training-school for nurses. She showed her practical purpose by sending to Miss Nightingale in advance her architect's plans. They had two long interviews in December, and Miss Nightingale had a very busy fortnight with Dr. Sutherland in collecting statistics about various lying-in hospitals and in preparing plans, with the assistance of the Army Medical Department and War Office Sanitary Committee, on the best model. Miss Nightingale was delighted with her visitor. "She took every point," she told Dr. Sutherland, "as quick as lightning." "I have a fresh neophyte," she wrote to Sir John McNeill (Dec. 25, 1868), "in the person of the Crown Princess of Prussia. She has a quick intelligence, and is cultivating herself in knowledge of sanitary (and female) administration for her future great career. She comes alone like a girl, pulls off her hat and jacket like a five-year-old, drags about a great portfolio of plans, and kneels by my bedside correcting them. She gives a great deal of trouble. But I believe it will bear fruit." That the inquiries of the Princess were searching, and her commissions exacting, appears from the correspondence:-- (_Miss Nightingale to the Crown Princess of Prussia._) 35 SOUTH STREET, _Dec._ 21 [1868]. MADAM--In grateful obedience to Your Royal Highness's command, directing me to forward to Osborne before the 24th the commissions with which you favoured me, I send (1) the Portfolio of plans for the Hospital near the Plotzen See, and, in this envelope, the criticism upon the plans. Also, in another envelope (2) a sketch of the Nursing "hierarchy" required to nurse this Hospital (with a Training School attached), even to ages desirable--as desired by Your Royal Highness. Also (3) the methods of continuous examination in use (with full-sized copies of the Forms) to test the progress of our Probationers (Probe-Schwestern). Also (4) lists of the clothing and underclothing (even to changes of linen) we give to and require from our Probationers and Nurses, and of the changes of sheets. Your Royal Highness having directed me to send patterns "in paper" of our Probationers' dress, I have thought it better to have a complete uniform dress such as our Probationers wear, for in-doors and out-doors, made for Your Royal Highness's inspection, even to bonnet, cap, and collar, which will arrive by this Messenger in a small box and parcel. I am afraid that the aspect of these papers will be quite alarming from their bulk. But I can only testify my gratitude for your Royal Highness's great kindness by fulfilling as closely as I can the spirit of your gracious will. I am sorry to say that I have not yet done encumbering your Royal Highness. The plans for Lying-in Cottages had to be completed at the War Office and are not quite ready. But they shall be forwarded "before the 24th." I think we have succeeded in producing a perfectly healthy and successful Lying-in Cottage, by means of great _sub-division_ and incessant cleanliness and ventilation, which includes the not having _any_ ward _constantly_ occupied. In one of these Huts we have had 600 Lyings-in consecutively without a single death or case of puerperal disease or casualty of any kind. (This experience is, I believe, without a fellow, but will, I trust, have many fellows before long.) Believe me, your Royal Highness's enquiry about these things does the greatest good, not only with regard to what is proposed in Prussia, but in stirring up the War Office, the Medical authorities, and other officials _here_ to consider these vital trifles more seriously. And thus thousands of lives of poor women, of poor patients of all kinds, will be saved, even in England, through your Royal Highness's means. Hitherto Lying-in Hospitals have been not to cure but to kill. As I have again to trouble your Royal Highness about these subjects, I will not now enter into two or three other little things with which I was commissioned. May I beg always to be considered, Madam, the most faithful, ready and devoted of Your Royal Highness's servants. (_The Crown Princess of Prussia to Miss Nightingale._) OSBORNE, _Dec._ 24 [1868]. I don't wish to lose a _minute_ in thanking you for your great kindness and for all the trouble you have taken for me. Your letter is so _excellent_, and all the information you give is _most_ valuable, and will be of untold use, not only to _me_ as a guide in my humble endeavours to promote a _serious_, _conscientious_, and _rational_ spirit in the treatment of sanitary matters, but to many others in Germany. Your precious time has _not_ been wasted while you were writing for me, I assure you. The dress I think _very_ neat and nice, and not clerical looking (which is, in my eyes, an advantage). I was so vexed that I forgot to tell you the other day how much I admired _Una and the Lion_. I read it this summer in Germany, and thought it touching and lovely in the extreme. I "colported" it right and left! After I have arrived at Berlin and had leisure thoroughly to go into every detail of the materials you have given me, I will write to you again. These few lines are only to express my earnest thanks. The Crown Prince wishes me to say how sorry he is never to have seen you. He shares my feelings when your name is mentioned. I trust that the next time I am in this country I shall see you again. I remain, dear Miss Nightingale, yours gratefully, VICTORIA. Negotiations with the Nightingale Fund were presently opened, and the Crown Princess sent Fräulein Fuhrmann, who afterwards superintended the Victoria Training School for Nurses in Berlin (p. 204), to receive her own training as a Nightingale Nurse at St. Thomas's. III The Nightingale Training School had for many years been extending the area of its influence, and Miss Nightingale herself, in spite of her incessant work in other fields, never lost general control and supervision of it. Year after year, she kept up correspondence, both voluminous and intimate, with Mrs. Wardroper, the Matron. Her brother-in-law, Sir Harry Verney, was now Chairman of the Council of the Nightingale Fund; her cousin, Mr. Henry Bonham Carter, had succeeded Mr. Clough as Secretary--a duty which he continues to discharge to this day. Sir Harry Verney saw Miss Nightingale frequently with regard to the business of the School. Between Mr. Bonham Carter and her there is a great mass of correspondence extending over forty years and more; conducted sometimes by an exchange of letters through the post, sometimes by notes of question and answer at her house, as in the case of Dr. Sutherland. Mr. Bonham Carter, alike as Secretary of the Fund and as a cousin devoted to Miss Nightingale personally, gave his time and zeal without stint to the work; but he had independence of character. He was once asked how he contrived to do other things besides serve Miss Nightingale. "When it was getting late," he explained, "I used to say, Now I must go home to dinner." His devotion, good sense, and business-like habits contributed largely to the success of the undertaking, and saved Miss Nightingale much trouble in matters both of detail and of general administrative policy; but questions of what may be called the superior direction of the School were always referred to her, and there were many occasions on which her personal influence was felt to be indispensable. It was especially brought to bear whenever a contingent of Nightingale Nurses was sent from St. Thomas's to occupy new ground. The phrase quoted at the head of this chapter, from a letter by Miss Agnes Jones, when she was thus sent to pioneer work in the Liverpool Workhouse, exactly expresses one side of the relationship between the nurses and Miss Nightingale. But she was more to them than a Chief. She was not a distant and almost impersonal abstraction like "The Widow at Windsor." The Lady in South Street was not only the queen of the Nightingale Nurses, she was also their mother. The principal lieutenants who went out on important service, and many members of the rank and file, maintained constant correspondence with her--sending to her direct reports, consulting her in difficulties, looking to her, and never in vain, for counsel and encouragement. Miss Nightingale took especial pains to help and to influence the Lady Superintendents who went from St. Thomas's in command of nursing parties. Among her earlier papers containing thoughts about her future work, there is more than one reference to "Richelieu's 'Self-multiplication.'" She strove to extend her work by creating lieutenants in her own image. One of the most important of the missionary voyages of the Nightingale Nurses during these years was to New South Wales. Miss Nightingale had for some time been in correspondence with Sir Henry Parkes, then Colonial Secretary in New South Wales, about the nursing in the Sydney Infirmary, and in December 1867 Miss Osburn sailed with five nurses to take up the position of Lady Superintendent. The nurses arrived in time to nurse Prince Alfred, when he was shot during his visit to the Colony. There is a letter from Sir William Jenner to Miss Nightingale (July 4, 1868) saying, "I have received the Queen's commands to tell you how very useful they were. Her Majesty says, 'She is sure this information will give Miss Nightingale much pleasure.'" In one respect the nurses were more successful than Miss Nightingale desired. At first all went well. There were difficulties with the doctors and others, of course, but Sir Henry Parkes was always helpful. There was "no flirting," Miss Osburn reported (May 20), "and all the nurses cling round me in difficulties like true Britons." But they did not cling for long. Their services were too much appreciated. In a few years' time all the five had either married or received valuable appointments outside the Infirmary, and Miss Osburn had to recruit her staff from the Colony itself. Miss Nightingale thought that the expedition had thus "failed"; but there was something to be said on the other side, and the diffusion of the Nightingale band did much to promote the extension of trained nursing in the Colony. Another expedition of great importance was an extension of the Liverpool experiment to London. In 1868 Mr. (afterwards Sir) William Wyatt, the leader of a reform party in St. Pancras, had entered into correspondence with Miss Nightingale with regard to the new Infirmary (built under the Act of 1867) at Highgate; he submitted the plans of the building, and suggested the introduction of Nightingale Nurses. She approved the plans, encouraged him in his good work, and in the following year (1869) Miss Elizabeth Torrance was appointed matron, with nine nurses under her. The experiment was presently extended, and a training school for nurses was established at the Infirmary. There are about one hundred letters from Miss Torrance a year, a figure which will give some idea of the close touch which Miss Nightingale kept with important lieutenants. She considered Miss Torrance "the most capable Superintendent they had yet trained" (1870), and the letters bear out the estimate. They are those of a canny, capable and devoted woman--taking everything quietly as part of the day's work, with no fussiness or needless self-importance. "I have never seen such nurses," wrote the Medical Superintendent, when Miss Torrance and her staff had been at work for some months; "they are so thoroughly conversant with disease that one feels quite on one's mettle in practice. What strikes me most is the real interest they take in the work, and this is the secret of their success"--not attainable by the pauper nurses whom they displaced. Inspectors, Guardians, and other officials would have done well to feel quite on their mettle in Miss Torrance's presence also; for her letters show her to have been possessed of a humorous shrewdness which took the measure of men, by no means always at their own valuation. Miss Torrance amongst other reforms introduced useful work into the occupation of the inmates. "The achievement I am most proud of," she wrote (1871), "is getting the men's suits cut out and made. I found a tailor in No. 2 Ward who cut out some, and I sent them into Nos. 1 and 4 to be made, but there was a tailor in No. 1 who made difficulties, 'You see, ma'am, it's such a very old-fashioned cut.'" Once a week at least the Matron wrote reporting progress or difficulties to Miss Nightingale, who replied with advice, books, presents. Nurses, of whom the Matron reported well, came in batches to see Miss Nightingale. "They returned," wrote Miss Torrance, of one occasion of the kind, "beaming with delight, but as they all talked about it at once I did not gather very clearly what passed. Sister A., however, feared that Sister B. 'must have tried Miss Nightingale.'" Sister B., it seems, had the same fear about Sister A. Nurses and Matron alike regarded their reception by Miss Nightingale as a high privilege. "I always feel refreshed _for months_," wrote Mrs. Wardroper (March 1871), "after one of those affectionate receptions you accord me." None of Miss Nightingale's "soldiers" left her cabinet without feeling a better and a braver woman. Miss Torrance presently fell from grace in Miss Nightingale's eyes by becoming engaged to be married. At a critical period of the engagement, she failed to keep some appointments at South Street, and Miss Nightingale did not recover equanimity till she recalled to herself a saying of Mr. Clough's: "Persons in that case should be treated as if they had the scarlet fever." In November 1869 there were receptions in South Street such as a sovereign sometimes accords to warriors or statesmen on the eve of a great emprise. A Superintendent of Nurses (Mrs. Deeble) and a staff of six Ward Sisters were setting out from St. Thomas's to take charge of the War Office Hospital at Netley. Miss Nightingale received them all, gave them presents and addressed words of encouragement. "That I have 'seen Miss Nightingale'" wrote one of them, "will be one of the white mile-stones on my road, to which I shall often look back with feelings of gratitude and pleasure. I trust that I shall never forget some of the things you said to me, and that 'looking up' I may be enabled to show by my future life that your great kindness has not been thrown away." "The Netley sisters," wrote Mrs. Wardroper, "are overflowing with love and gratitude for all the interest and trouble you have so kindly taken for and in them. Your reception, pretty presents, and good advice have quite won their hearts. To know you, and to have heard from your own lips, that each one has your best wishes and prayer for success will do much to cheer and help them." "I have been preaching to them four hours a day," wrote Miss Nightingale to M. Mohl (Nov. 21), "and expounding Regulations. Some of them are very nice women. One was out with Dr. Livingstone and Bishop Mackenzie on the Zambesi Mission. One, a woman who would be distinguished in any society, accidentally read my little article on 'Una,' and wrote off to us the same night offering to go through our training (which she did) and join us." "Expounding Regulations" was always a part of Miss Nightingale's exhortation on such occasions. In this particular case she had a hand in making the Regulations. In other cases she often found them very stupid. They were generally made by men, who were incapable, she thought (as we have heard already), of devising suitable regulations for women. "Oh, how I wish there were no men," she wrote on one occasion when trying to compose a hospital quarrel. But even bad regulations must be observed, till they can be altered, and women did not always understand that some diplomacy was necessary to obtain the alteration. "Women," she said, "are unable to see that it requires wisdom as well as self-denial to establish any new work." As the work which the Nightingale Nurses had at this time to do was all new, there were many difficulties and most of them came up to Miss Nightingale for solution or advice. When a very long-winded letter arrived, she would often send it on unread to Dr. Sutherland, for him to digest and advise upon. It was her comfortable persuasion that he had nothing else to do, and she scolded him if there was any delay; but sooner or later he did the work for her, and his advice in such matters never failed in shrewd common sense. Sometimes he would say, "This letter shows a fit of temper on the nurse's part, and is a case for a little homily from you." In such homilies Miss Nightingale would mingle an appeal to higher motives with a reference to her own example and experience--as in the following letter:-- (_To a Discontented Nurse._) _April_ 22 [1869]. Do you think I should have succeeded in doing anything if I had kicked and resisted and resented? Is it our Master's command? Is it even common sense? I have been even shut out of hospitals into which I had been ordered to go by the Commander-in-Chief--obliged to stand outside the door in the snow till night--been refused rations for as much as 10 days at a time for the nurses I had brought by superior command.[119] And I have been as good friends the day after with the officials who did these things--have resolutely ignored these things _for the sake of the work_. What was I to my Master's work? When people offend, they offend the Master, before they do me. And who am I that I should not choose to bear what my Master chooses to bear? You have many high and noble points of character. Else I should not write to you as I do. But the spirit of opposition in which you are working (or rather _were_ at the time you wrote, for I am satisfied it was only an ebullition of the moment), and yet doing your work well and doing good, would, if it really were persisted in, materially increase the difficulties of that work to which, I am sure, you are devoted. [119] See Vol. I. p. 291. IV There was one failure in the work of the Nightingale Fund which led Miss Nightingale to write a new book, than which none ever cost her more labour. In 1867 the Midwifery School established in King's College Hospital[120] had to be closed owing to the high rate of mortality in the lying-in wards. As soon as the figures were brought to Miss Nightingale's notice, she set to work in examining the whole subject of mortality in lying-in wards. She soon found that no trustworthy statistics of mortality in child-bed had yet been collected. She searched for them throughout this country and from foreign hospitals and doctors. She discovered that in lying-in wards everywhere the death-rate was many times the amount of that which took place in home deliveries. This fact showed that public attention should at once be called to the subject, and at the same time it opened up larger questions. There was one school of medical opinion which held that the mortality must in the nature of things be large in lying-in wards; there was another which held that the high rate of mortality therein might be prevented. The inquiries which Miss Nightingale had made for the Crown Princess of Prussia[121] inclined her to the latter view, and she pursued her researches in all directions, collecting an immense mass of information and calling in the assistance of sanitary engineers and other authorities. It should be remembered in all this that the introduction of antiseptics has much altered the conditions since the time of Miss Nightingale's work now under consideration. Materials for a book accumulated, but time to put them into shape was wanting. Dr. Sutherland, on whose assistance she mainly relied, was no more able than she herself to give undivided attention to the subject; but at last with his help the book was written. It was published in October 1871, with the title _Introductory Notes on Lying-in Institutions_. The book did for this special subject something of the same service which _Notes on Hospitals_ had done in the general sphere. Miss Nightingale showed by statistical evidence that many lying-in wards and institutions were pest-houses; she showed the importance of isolation and extreme cleanliness; and furnished model rules, plans and specifications for sanitary lying-in hospitals. In the latter pages, the book was an extension of the _Notes on Nursing_ to this special branch. She urged the importance of training-schools for midwives; described the ideal of an institution of the kind; and pleaded for "Midwifery as a Career for Educated Women." There was much agitation at the time for the admission of women to the medical profession. Miss Nightingale in a letter addressed "Dear Sisters," suggested that there was "a better thing for women to be than 'medical men,' and that is to be _medical women_." She was in the country when the book was passing through the press; and Dr. Sutherland, in sending a last revise with some suggestions of his own, said (July 22), "I return the proof corrected. Don't swear, but read the reasons on the accompanying paper. It is a good thing you are at Lea Hurst or your 'dear sisters' would infallibly break your head. They will probably break your windows. However, you are clearly right, and let them scream and stamp. The Book is a very good contribution to the subject, and will excite surprise and some opposition. But the facts are too strong." Miss Nightingale put out her book tentatively in a questioning spirit, as she explained in this characteristic dedication (which had received Mr. Jowett's imprimatur, but puzzled some of the reviewers):-- If I may dedicate, without permission, these small "Notes" to the shade of Socrates' Mother, may I likewise, without presumption, call to my help the questioning shade of her Son, that I who write may have the spirit of questioning aright and that those who read may learn not of me but of themselves? And further, has he not said: "The midwives are respectable women and have a character to lose."[122] [120] Vol. I. p. 464. [121] See above, p. 189. [122] _Theaetetus_, 150. V The preparation of this book had been delayed by the Franco-German War of 1870-71, which brought a great addition to Miss Nightingale's labours. There is a huge pile of documents on the subject amongst her Papers. A letter to an old friend gives an idea of one branch of the correspondence:-- (_Miss Nightingale to Harriet Martineau._) 35 SOUTH STREET, _Feb._ [1871]. Oh this year of desolation! The one gleam of comfort through it all was the rush of all English-speaking people, in all climates and in all longitudes,--not the rich and comfortable, but the whole mass of hard-working, honest, frugal, stupid people--who have contributed every penny they could so ill spare. Women have given the very shoes off their feet, the very suppers out of their children's mouths--not to those of their own creed, not to those of their own way of thinking at all, but--to those who _suffered most_. In this awful war, all, all have given--every man, woman, and child above pauperism. I have been so touched to receive from places I had never even heard of, but which it would take me a day to enumerate,--from congregations who had "seen my name in a stray London newspaper" as helping in the relief of the war sufferers--sums collected by halfpence (with a long letter to say how they wished the money spent)--from poor hard-working negro congregations in different islands of the West Indies--poor congregations of all kinds, Puritan chapels in my own dear hills, National Schools, Factories, London dissenting congregations without a single rich member, London ragged schools who having nothing to give, gave up their only feast in the year that the money might be sent to the orphans in the war "who want it more than we." Some of the letters from distant parts of the Empire show that Florence Nightingale had already become somewhat of a legendary figure. It was known that scenes of misery and horror were being enacted in Europe. It was assumed that she was ministering in the midst of them. In one of the letters there seems to be a confused idea that she was in two places at once--both directing the movement in London and nursing in some Red Cross hospital in France or Germany. And there is a sense in which this vague and legendary conception was true. Miss Nightingale played a busy part, though entirely behind the scenes, in the work of aid at the London headquarters; whilst among the devoted women who nursed the wounded or succoured other sufferers from the war, there were probably few who did not derive inspiration from the example of the Crimean heroine. The outbreak of the war had found English philanthropy unprepared. The British Government had been a party to the Geneva Convention, but nothing had been done to organize a Society under its rules until the alarm was sounded by Colonel Loyd Lindsay (Lord Wantage). A letter from him in the _Times_ of July 22, 1870, led to the formation of the National Society for Aid to the Sick and Wounded, which afterwards became the British Red Cross Aid Society. One of the first acts of the Committee, of which Colonel Loyd Lindsay was Chairman, was to consult Miss Nightingale, and a letter from her was read to the public meeting at which the Society was constituted. The words of stirring appeal were received with loud cheers. If she had not been confined to a sick bed, she would have volunteered to go out as a nurse. As it was, she must leave that work to others, and she gave the volunteers a characteristic note of caution: "Those who undertake such work must be not sentimental enthusiasts, but downright lovers of hard work. If there is any work which is simple, stern necessity, it is that of waiting upon the sick and wounded after a battle--serving in war-hospitals, attending to and managing the thousand-and-one hard dry practical details which nevertheless mainly determine the question as to whether your sick and wounded shall live or die. If there is any nonsense in people's ideas of what hospital nursing is, one day of real duty will root it out. There are things to be done and seen which at once separate the true metal from the tinkling brass both among men and women."[123] There were those amongst her entourage who wished that she could lay all other work aside and take control of the organization. The state of her health made this impossible, but she was closely connected with the Society's work throughout. Her brother-in-law, Sir Harry Verney, and her cousin's husband, Captain Galton, were active members of the Executive Committee. Sir Harry's daughter, Miss Emily Verney, was an active member of the Ladies' Executive Committee.[124] Captain Galton and her cousin, Mr. Henry Bonham Carter, were sent early in the war to visit the hospitals of France and Germany; and when the war was over, the task of reporting upon the correspondence of the Society's agents and of the English doctors was entrusted to Dr. Sutherland.[125] Through all these personal connections, Miss Nightingale kept close touch with the Society's work. She thought that there was a lack of vigour at the start. Why, she wanted to know, did not the Society advertise itself more? "If it had been in hiding from its creditors instead of being an Aid Society, it could not have had a more complete success; if it had been sick and wounded itself, what could it have done less?" Its advertisement ought to appear every day "immediately above the Theatrical Announcements--with a list of articles wanted, and an acknowledgement of those received. It makes me mad to see advertisements only of the 'Voysey Defence Fund' and the 'Derby Memorial Fund.' What _does_ it matter whether Voysey is defended or not, and whether Lord Derby has a memorial or not?"[126] The Committee in reply hoped to do more presently; as it did--it collected nearly £300,000 and rendered a great deal of aid, both in France and in Germany. From the moment that the war was seen to be inevitable, Miss Nightingale had been deluged with correspondence. The French authorities applied to her for plans of temporary field hospitals. The Crown Princess of Prussia applied for assistance and advice in all sorts. "The dreaded letter has come," she wrote to Dr. Sutherland; "what _am_ I to answer; how to express sympathy with Prussia without alienating France?" Miss Nightingale's personal sympathies were rather on the French side. "I think," she wrote (Dec. 20), "that if the conduct of the French for the last three months had been shown by any other nation it would have been called _as it is_ sublime. The uncomplaining endurance, the sad and severe self-restraint of Paris under a siege now of three months would have rendered immortal a city of ancient Rome. The Army of the Loire fighting seven days out of nine barefoot, cold and frozen, yet unsubdued, is worthy of Henry V. and Agincourt. And all for what? To save Alsace and Lorraine, of which Paris scarcely knows." In writing to the Crown Princess on hospital matters she put in a plea for clemency in the hour of final victory. "Prussia would remember," she was sure, "the future wars and misery always brought about by trampling too violently on a fallen foe, and Germany will show to an astonished Europe that moderation of which victorious nations have hitherto shown themselves incapable." Miss Nightingale, here as in other matters, hoped more of human perfectibility than she was to find; the immediate future was to belie her picture alike of the severe self-restraint of Paris, and of the unexampled moderation of Prussia. In rendering aid to the sick and wounded she was, however, consistently impartial. Wherever she heard of good work being done, whether in France or in Germany, she was ready to help, and she gave disinterested advice to the nursing service in both armies. Throughout the war, she had a large correspondence both at home and with all sorts and conditions of people in France and Germany. [123] The letter is printed in the _Times_ of August 5, 1870. It was dated August 2, "the day," as Miss Nightingale noted in the letter, "of Sidney Herbert's death nine years ago." [124] She died in 1872--"such a genius for working for men," Miss Nightingale wrote of her, "so lovely, so loving, and so beloved." [125] _Report of the British National Society for Aid to the Sick and Wounded during the Franco-German War, 1871_, pp. 149-177. [126] Letters to Captain Galton, August 1870. At home, she was diligent in collecting money and gifts in kind for the Aid Society. She wrote constant letters and memoranda to members of the Executive Society; advising on all matters, from the general administration of field ambulances to the pattern of hospital suits, vetoing (when she could) impracticable suggestions, sending lists of the things most urgently needed. She received and answered a constant stream of applications from persons inquiring what to send, and from doctors and nurses wanting to volunteer for service. Abroad, her correspondence was on a similar scale. Distributing agents of the Society, nurses, workers of all kinds wrote, consulting her in cases of perplexity or giving information on points that they thought likely to interest her. The private reports preserved among Miss Nightingale's papers contain a mass of information about the treatment of the sick and wounded, of which she expressed the opinion that it far surpassed in horror, as of course it vastly exceeded in scale, anything that she had witnessed in the Crimea. Self-devotion on the part of volunteers, though it could not remedy the evils, was conspicuous in relieving them, and many letters to Miss Nightingale are eloquent of the inspiration which was derived from her example in the Crimea and from the messages of sympathy, encouragement and advice which she now sent. "Tell Miss Nightingale," said the warm-hearted Grand Duchess of Baden, "that I have endeavoured to follow implicitly everything she has recommended, and that I love and respect her more than any one in the world." There are letters, too, from English and German nurses and workers in which Miss Nightingale is addressed as "dearest of all friends" or "beloved mistress" and "queen." Her services to both of the belligerents were recognized by decorations. The French Société de Secours aux Blessés conferred its bronze cross upon her (July 1871), and from H.M. the Emperor and King she received the Prussian Cross of Merit (Sept.). But there was more significance in what she gave than in what she received. Among the English ladies who rendered most devoted service during the war was the wife of an officer (Colonel Cox) who had known Miss Nightingale in the Crimea; among the German ladies who had done the like was Madame Werckner of Breslau. When the war was over, both ladies asked the favour of an interview with Miss Nightingale. Madame Werckner became her personal friend, and wrote with enthusiastic gratitude when she was asked to visit Embley: "the home of your childhood." And Mrs. Cox wrote (July 15): "How can I ever thank you for the loving reception you gave me? I can only say that never whilst I live can it be forgotten." To Mrs. Cox's work the English Committee referred in their Report. Of Madame Werckner Miss Nightingale told something in an address to the Probationers at St. Thomas's. "At a large German station, which almost all the prisoners' trains passed through, a lady went every night during all that long, long dreadful winter, and for the whole night, to feed and warm and comfort and often to receive the last dying words of the miserable French prisoners, as they arrived in open trucks, some frozen, some as dead, others to die in the station, all half-clad and starving. Night after night, as these long, terrible trainsfull dragged their slow length into the station, she kneeled on its pavement, supporting the dying heads, receiving their last messages to their mothers; pouring wine or hot milk down the throats of the sick; dressing the frost-bitten limbs; and, thank God, saving many. Many were carried to the prisoners' hospital in the town, of whom about two-thirds recovered. Every bit of linen she had went in this way. She herself contracted incurable ill-health during these fearful nights. But thousands were saved by her means. She is my friend. She came and saw me, and it is from her lips I heard the story." The Crown Princess of Prussia also came to South Street, and "she let me tell her," wrote Miss Nightingale,[127] "a good deal of behind the scenes of Prussian Ambulance work. I do like her so very much and twice as much now that she is really worn and ripened by genuine hard work and anxiety." This visit was productive of large results. The Princess and Miss Nightingale had been in communication throughout the war--partly by direct correspondence, and partly through an English lady, Miss Florence Lees, who was serving in German hospitals. At the beginning of the war the Princess had telegraphed and written to Miss Nightingale begging her to recommend a thoroughly competent English lady for such duty. Miss Lees (Mrs. Dacre Craven) had been sent; she was one of the ablest of the ladies who received training at the Nightingale School, and was presently to play an important part in the development of trained nursing in London. Miss Lees was placed by the Crown Princess in charge of the nursing at a war hospital which she had arranged at Homburg; Miss Lees was also employed to visit and report upon the war hospitals at Metz and other places. She was in constant correspondence with Miss Nightingale, who from this and many other sources of information had formed a very poor opinion of the Prussian nursing, medical and ambulance service. After collating various reports with Dr. Sutherland, Miss Nightingale said to him that "the abnormally bad among the Crimean hospitals were luxurious compared with the normal Prussian hospitals." "The only Prussian hospitals up to the present standard of sanitary experience," she added, "are those of the Princess herself, and in them it was H.R.H. who taught the doctors, and not the doctors who taught her." I do not know whether she communicated to the Princess the further opinion that the root of the evil was the bureaucracy; "it shows what it means to be without the free play of public opinion, through Parliament and press, which calls every Public Office, and almost every Society, to account." But upon the facts Miss Nightingale spoke freely, as she was requested to do, and the Princess asked her to send documents:-- (_The Crown Princess of Germany to Miss Nightingale._) OSBORNE, _July_ 28 [1871]. I return the deeply interesting and important papers which the Crown Prince and myself have read _most_ attentively and word for word. The Crown Prince wishes me to thank you particularly for your having let him see these papers. Much was not new to him. You _know_ how much interest he takes in sanitary matters, how anxious he is for reforms wherever needed. Every remark offered is therefore always gratefully received by us. Let me repeat, dear Miss Nightingale, how great a happiness it was to me to see you again. Ever yours, with sincerest admiration and respect, VICTORIA, CROWN PRINCESS OF GERMANY. [127] Letter to Harriet Martineau, Sept. 20, 1870. Of the great and practical interest which the Princess already took in hospitals, we have heard above. The experiences of the Franco-Prussian War quickened it yet more, and in 1872 she drafted a report on hospital organization. Subsequently a Home and Nursing School, named after her, was established in Berlin, and the "Victoria Sisters," following the lead of the Nightingale Nurses, undertook the nursing in municipal hospitals. The success of the Victoria Training School led in its turn to the establishment of similar institutions throughout Germany. And thus Miss Nightingale's words came true, that the trouble which she took to inform and inspire the Crown Princess "will bear fruit." The experience of the Franco-German War bore fruit in the better organization of the Red Cross movement, especially in this country, and the inspiration here too may be traced back to Miss Nightingale. The "Red Cross" owes its inception, as already stated, to a Swiss physician, M. Henri Dunant. He had witnessed the horrors of war on the bloody field of Solferino, and he devoted his life thenceforward to the promotion, and then to the extension, of the Geneva Convention. In 1872 M. Dunant read a paper in London upon the movement. His first words were these: "Though I am known as the founder of the Red Cross and the originator of the Convention of Geneva, it is to an Englishwoman that all the honour of that Convention is due. What inspired me to go to Italy during the war of 1859 was the work of Miss Florence Nightingale in the Crimea."[128] [128] M. Dunant's Paper is reported in the _Times_ of August 7, 1872. He sent a copy of it to Miss Nightingale: see Bibliography B, No. 31. VI It will have been seen that during the years treated in the foregoing chapters (1867-1871) Miss Nightingale did an enormous amount of work. Her health during the same period had been no better. Country air did not bring any accession of strength; there is evidence of sleepless nights in numbers of her letters dated in the small hours of the morning; and during 1870 and 1871 especially her letters and diaries speak of great weakness. She was able to do as much as she did only by the devotion of the same friend, Dr. Sutherland, whose relations with his task-mistress have been described in an earlier chapter. More and more, indeed, she seems to have fallen into the habit, which had become almost a necessity, of saying nothing, doing nothing, writing nothing (her letters to Mr. Jowett and a few other intimate friends alone excepted) without first consulting Dr. Sutherland. I have illustrated this point incidentally in previous pages, but such occasional references give an inadequate account of the extent to which she relied upon him. "The only way I can work now," she wrote to him in 1870, "is by receiving written notes from you, and working them up into my own language, then printing and showing you the work." Her Papers, with hundreds upon hundreds of drafts and memoranda in Dr. Sutherland's hand, show that such was in fact the way in which the work was done, and the process was applied not only to things ultimately printed, but almost to the whole range of her correspondence. He was sometimes called upon to draft even the most delicate family letters. She was asked to suggest an inscription for a memorial to Agnes Jones at Liverpool. Dr. Sutherland had first to try his hand at it. She was put out by an unwarranted liberty which a publisher had taken with her name. The case was sent to Dr. Sutherland, with a pressing appeal, "What _shall_ I do? I have no one to act for me." He acted for her. He had artistic tastes, and served as eyes for her at the International Exhibition of 1871, when he selected some French bronzes for her to give to Mr. Jowett. Whenever she was asked to join a Society, or subscribe to a new institution, Dr. Sutherland had first to advise and report. Sometimes she accompanied her references to him with amusing comments, as to Uncle Sam in earlier days. Did Dr. Sutherland advise her to join a new "Central Philanthropic Agency"? She was inclined against it, remembering that "When Crosse invented a new insect, my grandmother was heard to exclaim, 'Are there not enough insects already?'" Sometimes a reference may have been made only, or mainly, for the fun of the thing; as when the Census Paper was left at South Street in 1871 and she sent it off by special messenger to Dr. Sutherland at the War Office to know how she was to fill it up. "Am I the head of this household?" Dr. Sutherland forbore to say that no doubt was conceivable about _that_. "Occupation column: as I think that _every_ body ought to have a defined occupation, I should like to put what mine is, but I don't know how to define it." "Oh," replied Dr. Sutherland, "say, Occupation, None." The last column inquired whether the householder was "Deaf-and-dumb, blind, imbecile, or lunatic?" "I shall return," said she, "Imbecile and Blind, and if everybody did the same now, it would be true." "Don't," replied he; "you are the exception." But for the most part her references to him were on matters which either called for some quick application of worldly wisdom or involved considerable drudgery. His shrewd good sense never failed; and the drudgery, though it may have been delayed, was always done in the end. She is asked to express an opinion on some Indian Health Reports, and is tired. Off they go to Dr. Sutherland, who replies: "I have been through them all; you may safely say they are very well done." Or, pamphlets, memorials, prospectuses, are sent to her, and she is in no mood to master them. They are consigned to him; and in course of time neat little digests are returned, and she is advised what to do or say. Every important letter is similarly sent to him with a note saying, "What am I to answer?" or "What does all this come to?" or "Please advise." "You _must_ come to-morrow to see my letter before it goes." "I want to ask you some questions, and you must be good." In years when Miss Nightingale was much in the country (as in 1870 and 1871), Dr. Sutherland's daily work for her was the heavier, because all communications were through the post. There was fret and jar between them in personal intercourse, as we have heard, and opportunity for misunderstanding was increased when two busy people were exchanging ideas by letter. This was especially the case when any work was on hand of which the scope had not been precisely defined, and Miss Nightingale was often impatient. "I could do work," she wrote on one occasion, "if it were real work, done at the least expenditure to myself. But to do a minimum of work at the greatest expenditure to myself (by driving, pumping, etc.) is now physically impossible to me." Such complaints and such references to her weakness were frequent. To the latter Dr. Sutherland always referred in terms of sympathy--"I know you are very ill," "I beg you to let me help as much as I can," and so forth. With regard to the complaints, he sometimes laughed them aside: "Thanks for your parting kick, which is always pleasant to receive by them as likes it." "You are a true Paddy, you like to trail your coat, but I won't tread on it." Sometimes he defended himself--"If you knew what I have had to do, I am quite sure you would not have written about the proof as you have done"; and sometimes he refrained from defence other than simple denial--"I scarcely know how otherwise to reply to your attack than simply to state that it is groundless. Am I such a fool, I ask myself, as to do what she says I have done?" But this admirable man never lost his temper, and never made her reproaches an occasion for declining to help her any more. "All I can say is, I am ready to help." "I am at your orders in this as in all things." Such is the continual note of his messages. In private meditations often, and in letters occasionally, Miss Nightingale spoke of herself as a "vampyre." When she wrote in some such sense to Mr. Jowett, he told her to put such talk aside as idle, for "that way madness lies." Yet in a sense there was an element of truth in what she said. She was terribly exacting. She accepted no excuses, made few allowances, and sometimes assumed that those who worked with her had nothing else to do. Dr. Sutherland was a hard worker, but allowed himself diversions. At Norwood he had a garden, and Miss Nightingale was sarcastic about his fondness for digging ponds. But he had also, besides a strong interest in their common work, an abiding admiration for the gifts, the character, and the self-devotion of his friend. In addition to his own bread-winning work, he gave an immense amount of time and labour to Miss Nightingale. In any estimate of her services to great public causes, and especially in connection with sanitation in India, an honourable place is due to the collaborator who helped her through many years with unfailing devotion.