It was, however, behind the scenes that Miss Nightingale's activity as a reformer was most powerfully exercised. In accordance with Her Majesty's command, reports from Miss Nightingale were forwarded to the Queen, and by her were sent on to the Duke of Newcastle. The Duke, writing to the Queen on December 22, 1854, assured Her Majesty that the condition of the Hospitals at Scutari, and the entire want of all method and arrangement in everything which concerns the comfort of the army, were subjects of constant and most painful anxiety to him. “Nothing can be more just,” he added, “than all your Majesty's comments upon the state of facts exhibited by these letters, and the Duke of Newcastle has repeatedly, during the last two months, written in the strongest terms respecting them—but hitherto without avail, and with little other result than a denial of charges, the truth of which must now be considered to be substantiated.”[128] It remained for Ministers to do what was possible to remedy the evils.
Mr. Sidney Herbert, who (as already stated) had relieved the Duke of Newcastle of hospital matters, needed no compulsion to zeal, and Miss Nightingale's letters to him showed in what directions his zeal could most usefully be employed. The Government of Lord Aberdeen, defeated on the motion appointing the Roebuck Committee, resigned in January 1855, and Lord Palmerston became Prime Minister. The offices of Secretary for War and Secretary at War were amalgamated, and Lord Panmure became Secretary of State in place of the Duke of Newcastle. Mr. Herbert became for a short time Secretary of State for the Colonies, and then resigned. But Mr. Herbert begged Miss Nightingale to continue writing to him, promising to forward her representations to the proper quarters. Lord Palmerston knew her personally, and Lord Panmure paid deference to her wishes and opinions, so that the change of Government did not weaken her position. I have before me copies of a long series of letters addressed by Miss Nightingale to Mr. Herbert between November 1854 and May 1855. He had given her private instructions that she was to act as eye and ear for him in the East. Of her letters a few were printed by Lord Stanmore in his Memoir of Sidney Herbert, where also a series of Mr. Herbert's letters, both to her and to various officials concerned, is given. A comparison of the one set with the other shows very clearly how much of the improvements which the Government of Lord Aberdeen and its successor were able to effect was due to the suggestions, the remonstrances, the entreaties of Miss Nightingale. Her letters are written with complete freedom and often in great haste. It would be possible to make isolated extracts from them which would suggest that the writer was a censorious and uncharitable scold. But such a selection would convey a misleading impression. Miss Nightingale wrote unreservedly about individuals, because she saw, as Mr. Herbert himself saw also, that the personnel was at fault, and that the most admirable instructions from home would be useless unless there were men of some initiative and vigour to carry them out on the spot. She wrote in anger, because she saw, what Mr. Herbert soon came to know, that such men were not forthcoming. “I write all this savagery,” she said (March 5, 1855), “because of the non-success of your unwearied efforts for the good of these poor Hospitals.” And then something must be allowed to the caustic humour which, when Miss Nightingale had a pen in her hand, could not be denied. “I shall make no further remark about him,” she writes of a certain individual, “than that he is a fossil of the pure Old Red Sandstone.” “Some newspaper has said of me,” she writes on another occasion, “that I am the fourth woman (query, Old Woman) that has had to do with the war. Who are the other three?” And she goes on for Mr. Herbert's amusement to nominate three of his principal subordinates for the distinction. It would argue a lack of humour to take such epistolary diversions with no grain of salt. But I do not propose to follow the example of a previous writer, who has had access to these letters, in recording Miss Nightingale's remarks on individuals. I desire rather to illustrate from the letters, and from other sources, first, the practical contributions to reform which Miss Nightingale made in some matters of detail, and then her firm grasp of the large principles of sound administration.
III
Miss Nightingale performed the duties, as we have seen, of a Purveyor to the sick and wounded portion of the British army. The duty was assumed by her only because the home authorities had been deficient in foresight, or the authorities on the spot were inefficient and hampered by official restrictions. Hence her earlier letters to Mr. Herbert were largely filled with urgent suggestions for the sending of Government stores. She begs for “hair mattresses, or even flock, as cheaper.” The French hospitals were furnished throughout with hair mattresses; the British soldier was suffering terribly from bed-sores. She pleads for knives and forks: “the men have to tear their meat like wild beasts.” She suggests mops, plates, dishes, towelling, disinfectants, and so forth,—obvious requirements, no doubt, but, as Mr. Herbert said, the responsible authorities seem to have shrunk sometimes from making requisitions lest they should thereby confess the inadequacy of their preparations. It was Miss Nightingale, again, who suggested the need of carpenters to do odd jobs in the vast and imperfectly equipped Turkish buildings which served for the British hospitals. She expressed herself most gratefully for an “invaluable reinforcement” of them which Mr. Herbert had sent out; but their arrival necessitated a depletion in one department of her private stores. “These men,” she wrote (Feb. 19, 1855), “I had to find with knives, forks, and spoons, in default of the Purveyor, who besides would not provide them with rations unless the Officer of Engineers wrote ‘urgent’ and asked it ‘as a favour.’”
Some building operations, Miss Nightingale, as we have seen, took it upon herself to carry out; and some sanitary reforms she was able, by her personal influence with the orderlies, to effect.[129] “The instruction of the Orderlies in their business was,” she said,[130] “one of the main uses of us in the War Hospitals.” Other sanitary engineering works, on a larger scale, were ultimately carried out, thanks in part to her urgent and detailed representations to the authorities at home. She had pointed out repeatedly to them that the mere issuing of orders was insufficient; it was essential that executive powers should be placed in the hands of officials directly responsible for immediate action. When the Government was reconstituted after the fall of Lord Aberdeen, with Lord Panmure as Secretary for War, this lesson was taken faithfully to heart, and a Commission of Three—Dr. John Sutherland, Dr. Hector Gavin, and Mr. Robert Rawlinson, C.E.—was sent out to the East with full executive powers. They received their instructions on February 19, 1855, and within three days they sailed. “The tone of the instructions,” says Kinglake, “is peculiar, and such as to make one believe that they owed much to feminine impulsion. The diction of the orders is such that, in housekeeper's language, it may be said to have ‘bustled the servants.’” The credit for the bustling at home belongs, however, to Lord Shaftesbury, who had pressed the appointment of the Commissioners upon Lord Panmure, and who was employed to draft their instructions.[131] The duties of these Sanitary Commissioners were laid down with a minuteness of detail which Miss Nightingale herself could not have excelled; and they were then told that “the utmost expedition must be used in the execution of all that is necessary at the place of your destination. It is important that you be deeply impressed with the necessity of not resting content with an order, but that you see instantly, by yourselves or your agents, to the commencement of the work and to its superintendence day by day until it is finished.”[132] It is from the Report of the Sanitary Commissioners that I drew many of the statements about the condition of the hospitals given in an earlier chapter. They set about the work of sanitary engineering with great dispatch, and the death-rate in the hospitals fell, as the result of their reforms, with remarkable rapidity.[133] “The sanitary conditions of the hospitals of Scutari,” Miss Nightingale told the Royal Commission of 1857, “were inferior in point of crowding, ventilation, drainage, and cleanliness, up to the middle of March 1855, to any civil hospital, or to the poorest homes of the worst parts of the civil population of any large town that I have ever seen. After the sanitary works undertaken at that date were executed (June), I know no buildings in the world which I could compare with them in these points, the original defects of construction of course excepted.” It was this Commission, as Miss Nightingale said afterwards to Lord Shaftesbury, that “saved the British Army.” In Dr. Sutherland, the head of the Sanitary Commission, Miss Nightingale found a warm admirer and a stout supporter. During his stay at Scutari he acted as her physician. On her return to England she was on terms of intimate friendship with him and his wife; and Dr. Sutherland was, as we shall hear, one of her close allies in the battle for reform in army hygiene. With Mr. (afterwards Sir Robert) Rawlinson she also formed a friendship which lasted to the end of his life. Dr. Gavin died in the Crimea during the work of the Commission.
In the matter of stores, whatever suggestions or requisitions Miss Nightingale sent home were complied with by Government. But it was one thing to send stores out, and quite another to secure that they should arrive when and where they were wanted. “Sidney,” wrote Mrs. Herbert to Mrs. Bracebridge (Nov. 17, '54), “has sent heaps of armchairs, etnas, and other comforts, but is in terrible fear that they may have been carried on with the troops to Balaclava from some blunder.” Miss Nightingale's unerring eye for detail and perception of the point saw where the evil lay. First, there was no co-ordination among the departments at home in packing the things. The Prince (the wreck of which in the famous hurricane of November 14 was disastrous to the welfare of the soldiers) “had on board,” she wrote, “a quantity of medical comforts for us, which were so packed under shot and shell as that it was found impossible to disembark them here, and they went to Balaclava and were lost.” But there was a second obstacle. The army had encamped at Scutari as early as May 1854, but it had occurred to nobody to establish either there or at Constantinople an office for the reception and delivery of goods. Packages, intended for the army or the hospitals, if they arrived in merchant vessels, were detained in the Turkish Custom House, from which they were never extracted without much delay, difficulty, and confusion; many were partially or entirely destroyed; and many abstracted and totally lost. “The Custom House,” said Miss Nightingale, “was a bottomless pit, whence nothing ever issued of all that was thrown in.” In the case of ships chartered by the Government, great masses of goods were necessarily landed together and stowed away promiscuously for want of time and space for sorting, and were often delayed by an unnecessary trip to Balaclava and back again. There were occasions in which vessels containing hospital stores, as well as munitions of war, made three voyages to and fro before the former were landed at Scutari. Sometimes when Miss Nightingale happened to hear of an incoming vessel betimes, she was able, by special petition to the military authorities, to intercept hospital stores; but she saw (what no one else seems to have done) that the whole system was at fault. “It is absolutely necessary,” she wrote, “that there should be a Government Store House, in the shape of a hulk, where stores for the British, from whatever ships, could be received at once from them, and be delivered on the ship-store-keeper's receipt. There are no store-houses to be had by the water's-edge, and porterage is very expensive and slow.” In March 1855 Miss Nightingale's solution was adopted.[134]
As Purveyor, Miss Nightingale was directly concerned only with the sick and wounded; but the condition in which the men arrived at Scutari enabled her to learn the state of things at the front, and she urged upon Mr. Herbert the necessity of sending out warm clothing to the army in the Crimea. “The state of the troops who return here, particularly those 500 who were admitted on the 19th, is frost-bitten, demi-nude, starved, ragged. If the troops who work in the trenches are not supplied with warm clothing, Napoleon's Russian campaign will be repeated here.” The terrible experiences of the British army before Sebastopol during the winter of 1854–55 were some fulfilment of her prediction. When opportunity offered she similarly sent suggestions to Lord Panmure; then, in reply to a letter of kind inquiries from him about her health (Aug. 1855), she called attention to the disproportionate number of patients which came from the Artillery, and threw out hints for economizing the men's labour.[135] On a matter of the soldiers' pay, she was the means of remedying a hardship which had struck her at Scutari. She pressed earnestly upon Mr. Herbert that hospital stoppages against the daily pay of the sick soldier (9d.) should be made equal to the hospital stoppage against the wounded soldier (4½.), provided that the sickness be incurred while on duty before the enemy. She made this representation in December 1854, not only to Mr. Herbert, but to the Queen. On February 1, 1855, she heard with great satisfaction that her suggestion had been adopted, and that the soldiers' accounts were to be rectified in that sense as from the Battle of the Alma.
IV
The Queen had asked Miss Nightingale to make suggestions as to what Her Majesty could do “to testify her sense of the courage and endurance so abundantly shown by her sick soldiers.” One of the suggestions submitted was the rectification just mentioned. Another suggestion was that a Firman should be immediately asked of the Sultan granting the military cemetery at Scutari to the British, and that Her Majesty should have it enclosed by a stone wall. “There are already, alas!” wrote Miss Nightingale, “about a thousand lying in this cemetery. Nine hundred were reported last week. We have buried one hundred in the last two days only. The spot is beautiful, overlooking the Sea of Marmora, and occupies the space between the General Hospital wall and the edge of the sea-cliff.” The suggestion must have gone straight to the Queen's heart, for Miss Nightingale was informed that Her Majesty had written on the subject both to Lord Clarendon, the Secretary of State for Foreign Affairs, and to the British Ambassador to the Porte. The Firman was obtained in due course, and the well-kept British enclosure attracts the attention of travellers to this day by contrast with the Oriental burial-places. It was again at Miss Nightingale's suggestion that a memorial obelisk, far seen in lonely splendour, was erected “by Queen Victoria and her people.”[136]
But I must not linger further over points of detail. Miss Nightingale's eye for detail did not prevent her from taking comprehensive views, and from time to time she sent to Mr. Herbert schemes of reorganization. In the following letter, of January 8, 1855, she exposed the extent and nature of the evil in the hospitals, and the kind of reform which was needed to remedy them:—