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.
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]
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.”