II
Before the International Congress at London in 1860 separated, Miss Nightingale addressed a letter to Lord Shaftesbury (President of the Second Section), which was read to the whole Congress, and adopted by it as a resolution. The point of it was to impress upon Governments the importance of publishing more numerous abstracts of the large amount of statistical information in their possession. She gave various instances in which useful lessons might thus be enforced upon the public mind, and cited Guizot's words: “Valuable reports, replete with facts and suggestions drawn up by committees, inspectors, directors, and prefects, remain unknown to the public. Government ought to take care to make itself acquainted with, and promote the diffusion of all good methods, to watch all endeavours, to encourage every improvement. With our habits and institutions, there is but one instrument endowed with energy and power sufficient to secure this salutary influence—that instrument is the press.” With Miss Nightingale statistics were a passion and not merely a hobby. They did, indeed, please her, as congenial to the nature of her mind. Her correspondence with Dr. Balfour and Dr. Farr shows how she revelled in them. “I have a New Year's Gift for you,” wrote Dr. Farr (Jan. 1860); “it is in the shape of Tables, as you will conjecture.” “I am exceedingly anxious,” she replied, “as you may suppose, to see your charming Gift, especially those Returns showing the deaths, admissions, diseases,” etc., etc. But she loved statistics, not for their own sake, but for their practical uses. It was by the statistical method that she had driven home the lessons of the Crimean hospitals. It was the study of statistics that had opened her eyes to the preventable mortality among the Army at home, and that had thus enabled her to work for the health of the British soldier. She was already engaged on similar studies in relation to India. She was in very serious, and even in bitter, earnest a “passionate statistician.” And the passion, as will appear in a later chapter,[316] was even a religious passion.
Miss Nightingale made a valiant attempt to extend the scope of the Census of 1861 in the interest of collecting statistical data for sanitary improvements. There were two directions in which she desired to extend the questions. One was to enumerate the numbers of sick and infirm on the Census day. For sanitary purposes it would be extremely useful to determine the proportion of sick in the different parts of the country. To those who said that it could not be done, because the people would not give the information, the answer was that it had been done in Ireland. The other point was to obtain full information about house accommodation; facts which, as would now be considered obvious, have a vital bearing on the sanitary and social conditions of the people. This point also had been covered in the Irish Census. Dr. Farr entirely agreed with Miss Nightingale, but he could not persuade Sir George Lewis, the Home Secretary, to include these provisions in the Census Bill (1860). Miss Nightingale thereupon drew up a memorandum on the subject, and, through Mr. Lowe (Vice-President of the Council), submitted it to the Home Secretary. Mr. Lowe may have agreed with her, but he failed to persuade his colleague. “Whenever I have power,” wrote Mr. Lowe (May 9), “you can always command me, but official omnipotence is circumscribed in the narrow limits of its own department.” Sir George Lewis replied that “both of Miss Nightingale's points had been duly considered before the Census Bill was introduced. It was thought that the question of health or sickness was too indeterminate.” “With regard to an enumeration of houses, it was thought that this is not a proper subject to be included in a Census of population.” A very official answer! But Sir George added that he did not see how the result of such enumeration could be “peculiarly instructive”—an avowal which he also made in the House of Commons. The cleverest of men are sometimes dense; and this remark of Sir George Lewis, added to his subsequent conduct of the War Office, earned for him, in Miss Nightingale's familiar correspondence, the sobriquet of “The Muff.” In communicating the result of her first attempt to Dr. Farr, she said, “If you think that anything more can be done, pray say so. I'm your man.” But she had not waited to be spurred on. She had already bethought herself of a second string in the House of Lords. Lord Shaftesbury, to whom she had appealed, promised to do all he could. Lord Grey did the same, and asked her to send Dr. Farr to coach him. She began to “thank God we have a House of Lords”:—
(Miss Nightingale to Robert Lowe.) Old Burlington St., May 10 [1860]. I cannot forbear thanking you for your letter and for your exertions in our favour. Sir George Lewis's letter, being interpreted, means: “Mr. Waddington does not choose to take the trouble.” It is a letter such as I have scores of in my possession, from Airey, Filder, and alas! from Lord Raglan, from Sir John Hall (the doctor) and from Andrew Smith. It is a true “Horse Guards” letter.
They are the very same arguments that Lord John used against the feasibility of registering the “cause of death” in '37—which has now been the law of the land for 23 years. He was beaten in the Lords. And we are now going to fight Sir George Lewis in the Lords. And we hope to beat him too. It is mere child's play to tell us that what every man of the millions who belong to Friendly Societies does every day of his life, as to registering himself sick or well, cannot be done in the Census. It is mere childishness to tell us that it is not important to know what houses the people live in. The French Census does it. The Irish Census tells us of the great diminution of mud cabins between '41 and '51. The connection between the health and the dwellings of the population is one of the most important that exists. The “diseases” can be obtained approximately also. In all the more important—such as smallpox, fevers, measles, heart-disease, etc.—all those which affect the national health, there will be very little error. (About ladies' nervous diseases there will be a great deal.) Where there is error in these things, the error is uniform, as is proved by the Friendly Societies; and corrects itself.…
The passionate statisticians were, however, hopelessly out-voted in the House of Commons. Mr. Caird moved in her sense on the subject of fuller detail about house-accommodation, and in sending her the printed notice of his amendment, said that “his position would be greatly strengthened with the House if he could obtain Miss Nightingale's permission to quote her name in favour of the usefulness of such an inquiry.” I do not know whether she gave permission; the debate is reported very briefly in Hansard. But in any case Mr. Caird's amendment was promptly negatived. As for the House of Lords, Miss Nightingale's reliance upon a better love of statistics in that assembly was cruelly falsified. The Census Bill came up late in the session, and I do not find that either Lord Grey or Lord Shaftesbury said a word upon the subject. The only critical contribution made to the debate proceeded from Lord Ellenborough, who, so far from wanting the Census Bill to include provision for more statistical data, proposed to exclude most of those that were already in. He could not for the life of him see what was the use of asking people so many questions.[317] Here, then, Miss Nightingale was in advance of the time; in one case, by a generation, in the other, by two generations. Recent Censuses have included more particulars of the housing of the people, though still not so many as she wanted. Official statistics of the local distribution of sickness will presently be obtained, I suppose, in a different way, through the machinery of the National Health Insurance Act.
Deprived by the recalcitrance of the Home Secretary and Parliament of a fuller feast of statistics at home, Miss Nightingale turned to the Colonies and Dependencies. The Secretary for the Colonies gave her facilities for collecting much curious and instructive information; and the Secretary for India accepted her aid in collecting and tabulating facts and figures which were the foundation of some of the most notable and beneficent of her labours. But, though she was already (1860–1) engaged in these inquiries, they belong in the main to a later period; and we must now turn to another side of Miss Nightingale's work for the improvement of the National Health.