Eminent Victorians

by Lytton Strachey

Who could face that?

And, if the need came, she meant to be as good as her word. For she had now determined, whatever might be the fate of the Commission, to draw up her own report upon the questions at issue. The labour involved was enormous; her health was almost desperate; but she did not flinch, and after six months of incredible industry she had put together and written with her own hand her Notes affecting the Health, Efficiency, and Hospital Administration of the British Army. This extraordinary composition, filling more than 800 closely printed pages, laying down vast principles of far-reaching reform, discussing the minutest details of a multitude of controversial subjects, containing an enormous mass of information of the most varied kinds—military, statistical, sanitary, architectural—was never given to the public, for the need never came; but it formed the basis of the Report of the Royal Commission; and it remains to this day the leading authority on the medical administration of armies.

Before it had been completed, the struggle over the powers of the Commission had been brought to a victorious close. Lord Panmure had given way once more; he had immediately hurried to the Queen to obtain her consent; and only then, when Her Majesty's initials had been irrevocably affixed to the fatal document, did he dare to tell Dr. Andrew Smith what he had done. The Commission met, and another immense load fell upon Miss Nightingale's shoulders. Today she would, of course, have been one of the Commission herself; but at that time the idea of a woman appearing in such a capacity was unheard of; and no one even suggested the possibility of Miss Nightingale's doing so. The result was that she was obliged to remain behind the scenes throughout, to coach Sidney Herbert in private at every important juncture, and to convey to him and to her other friends upon the Commission the vast funds of her expert knowledge—so essential in the examination of witnesses—by means of innumerable consultations, letters, and memoranda. It was even doubtful whether the proprieties would admit of her giving evidence; and at last, as a compromise, her modesty only allowed her to do so in the form of written answers to written questions. At length, the grand affair was finished. The Commission's Report, embodying almost word for word the suggestions of Miss Nightingale, was drawn up by Sidney Herbert. Only one question remained to be answered—would anything, after all, be done? Or would the Royal Commission, like so many other Royal Commissions before and since, turn out to have achieved nothing but the concoction of a very fat bluebook on a very high shelf?

And so the last and the deadliest struggle with the Bison began. Six months had been spent in coercing him into granting the Commission effective powers; six more months were occupied by the work of the Commission; and now yet another six were to pass in extorting from him the means whereby the recommendations of the Commission might be actually carried out. But, in the end, the thing was done. Miss Nightingale seemed, indeed, during these months, to be upon the very brink of death. Accompanied by the faithful Aunt Mai, she moved from place to place—to Hampstead, to Highgate, to Derbyshire, to Malvern—in what appeared to be a last desperate effort to find health somewhere; but she carried that with her which made health impossible. Her desire for work could now scarcely be distinguished from mania. At one moment she was writing a 'last letter' to Sidney Herbert; at the next she was offering to go out to India to nurse the sufferers in the Mutiny. When Dr. Sutherland wrote, imploring her to take a holiday, she raved. Rest!—

'I am lying without my head, without my claws, and you all peck at me. It is de rigueur, d'obligation, like the saying something to one's hat, when one goes into church, to say to me all that has been said to me 110 times a day during the last three months. It is the obbligato on the violin, and the twelve violins all practise it together, like the clocks striking twelve o'clock at night all over London, till I say like Xavier de Maistre, Assez, je sais, je ne le sais que trop. I am not a penitent; but you are like the R.C. confessor, who says what is de rigueur….'

Her wits began to turn, and there was no holding her. She worked like a slave in a mine. She began to believe, as she had begun to believe at Scutari, that none of her fellow-workers had their hearts in the business; if they had, why did they not work as she did? She could only see slackness and stupidity around her. Dr. Sutherland, of course, was grotesquely muddle-headed; and Arthur Clough incurably lazy. Even Sidney Herbert … oh yes, he had simplicity and candour and quickness of perception, no doubt; but he was an eclectic; and what could one hope for from a man who went away to fish in Ireland just when the Bison most needed bullying? As for the Bison himself, he had fled to Scotland where he remained buried for many months. The fate of the vital recommendation in the Commission's Report—the appointment of four Sub-Commissions charged with the duty of determining upon the details of the proposed reforms and of putting them into execution—still hung in the balance. The Bison consented to everything; and then, on a flying visit to London, withdrew his consent and hastily returned to Scotland. Then for many weeks all business was suspended; he had gout—gout in the hands—so that he could not write. 'His gout was always handy,' remarked Miss Nightingale. But eventually it was clear even to the Bison that the game was up, and the inevitable surrender came.

There was, however, one point in which he triumphed over Miss Nightingale: the building of Netley Hospital had been begun under his orders, before her return to England. Soon after her arrival she examined the plans, and found that they reproduced all the worst faults of an out-of-date and mischievous system of hospital construction. She therefore urged that the matter should be reconsidered, and in the meantime the building stopped. But the Bison was obdurate; it would be very expensive, and in any case it was too late. Unable to make any impression on him, and convinced of the extreme importance of the question, she determined to appeal to a higher authority. Lord Palmerston was Prime Minister; she had known him from her childhood; he was a near neighbour of her father's in the New Forest. She went down to the New Forest, armed with the plan of the proposed hospital and all the relevant information, stayed the night at Lord Palmerston's house, and convinced him of the necessity of rebuilding Netley.

'It seems to me,' Lord Palmerston wrote to Lord Panmure, 'that at Netley all consideration of what would best tend to the comfort and recovery of the patients has been sacrificed to the vanity of the architect, whose sole object has been to make a building which should cut a dash when looked at from the Southampton river … Pray, therefore, stop all further progress in the work until the matter can be duly considered.' But the Bison was not to be moved by one peremptory letter, even if it was from the Prime Minister. He put forth all his powers of procrastination, Lord Palmerston lost interest in the subject, and so the chief military hospital in England was triumphantly completed on insanitary principles, with unventilated rooms, and with all the patients' windows facing northeast.

But now the time had come when the Bison was to trouble and to be troubled no more. A vote in the House of Commons brought about the fall of Lord Palmerston's Government, and, Lord Panmure found himself at liberty to devote the rest of his life to the Free Church of Scotland. After a brief interval, Sidney Herbert became Secretary of State for War. Great was the jubilation in the Nightingale Cabinet: the day of achievement had dawned at last. The next two and a half years (1859-61) saw the introduction of the whole system of reforms for which Miss Nightingale had been struggling so fiercely—reforms which make Sidney Herbert's tenure of power at the War Office an important epoch in the history of the British Army. The four Sub-Commissions, firmly established under the immediate control of the Minister, and urged forward by the relentless perseverance of Miss Nightingale, set to work with a will. The barracks and the hospitals were remodelled; they were properly ventilated and warmed and lighted for the first time; they were given a water supply which actually supplied water, and kitchens where, strange to say, it was possible to cook. Then the great question of the Purveyor—that portentous functionary whose powers and whose lack of powers had weighed like a nightmare upon Scutari—was taken in hand, and new regulations were laid down, accurately defining his responsibilities and his duties. One Sub-Commission reorganised the medical statistics of the Army; another established in spite of the last convulsive efforts of the Department an Army Medical School. Finally, the Army Medical Department itself was completely reorganised; an administrative code was drawn up; and the great and novel principle was established that it was as much a part of the duty of the authorities to look after the soldier's health as to look after his sickness. Besides this, it was at last officially admitted that he had a moral and intellectual side. Coffee-rooms and reading-rooms, gymnasiums and workshops were instituted. A new era did in truth appear to have begun. Already by 1861 the mortality in the Army had decreased by one-half since the days of the Crimea. It was no wonder that even vaster possibilities began now to open out before Miss Nightingale. One thing was still needed to complete and to assure her triumphs. The Army Medical Department was indeed reorganised; but the great central machine was still untouched. The War Office itself—! If she could remould that nearer to her heart's desire—there indeed would be a victory! And until that final act was accomplished, how could she be certain that all the rest of her achievements might not, by some capricious turn of Fortune's wheel—a change of Ministry, perhaps, replacing Sidney Herbert by some puppet of the permanent official gang—be swept to limbo in a moment?

Meanwhile, still ravenous for yet more and more work, her activities had branched out into new directions. The Army in India claimed her attention. A Sanitary Commission, appointed at her suggestion, and working under her auspices, did for our troops there what the four Sub-Commissions were doing for those at home. At the same time, these very years which saw her laying the foundations of the whole modern system of medical work in the Army, saw her also beginning to bring her knowledge, her influence, and her activity into the service of the country at large. Her "Notes on Hospitals" (1859) revolutionised the theory of hospital construction and hospital management. She was immediately recognised as the leading expert upon all the questions involved; her advice flowed unceasingly and in all directions, so that there is no great hospital today which does not bear upon it the impress of her mind. Nor was this all. With the opening of the Nightingale Training School for Nurses at St. Thomas's Hospital (1860), she became the founder of modern nursing.