The Life of Florence Nightingale Volume II Part 12

Frere could not have known the exhausting labour he has put you all to; to produce that in four months must prove fatal to all your const.i.tutions! He is an ogre." Dr. Sutherland's Instructions are admirably exhaustive, and may well have taken some time to prepare. The remaining stages of the affair were quick, and the Secretary of State's dispatch went out to the Government of India on April 23, followed by private letters from Miss Nightingale. The Sanitary Blue-books of successive years contain copious reports and discussions upon this "Special Cholera Inquiry." It furnished much material for scientific discussion, by which Miss Nightingale sometimes feared that what she regarded as the essence of the matter was in danger of being overlaid.

She and the Army Sanitary Committee took occasion more than once to point out that "whatever may be the origin of cholera, or whatever may ultimately be found to be its laws of movement, there is nothing in any of the papers except what strengthens the evidence for the intimate relation which all previous experience has shown to exist between the intensity and fatality of cholera in any locality and the sanitary condition of the population inhabiting it."[106] The origin of cholera is now said to be a micro-organism identified by Koch, but the laws of its movement and activity remain inscrutable. Meanwhile, all subsequent experience has confirmed the doctrine which Miss Nightingale continually preached, that the one protection against cholera consists in a standing condition of good sanitation.

[106] Blue-book, 1870-71, p. 5; and see Bibliography A, No. 127.

IV

At the very time when Dr. Sutherland was hard at work upon the Cholera Instructions, Miss Nightingale heard a report (on good authority) which filled her with anger and consternation. Mr. Gladstone was engaged in cutting down the Army Estimates; the Army Medical Service was believed to be marked for retrenchment, and the War Office Sanitary Commission for destruction. When she told this to Dr. Sutherland, he took the matter with nonchalance and said (as men are sometimes apt to say in such cases, especially if there is a woman to rely upon) that he did not see that anything could be done. Very different was the view taken by Miss Nightingale, when she contemplated, not merely the interruption of Dr. Sutherland's useful work,[107] but the possibility of all Sidney Herbert's work being undermined. Nothing to be done indeed! There was everything to be done! She could write to the Prime Minister himself.

She could write to Lord de Grey (Lord President). She could get this friend to approach one Minister, and that friend to approach another.

She could even claim a slight acquaintance, and write to Mr. Cardwell (Secretary for War). She could write to all her friends among the Opposition and give them timely notice of the wicked things intended by their adversaries. She ultimately wrote to Lord de Grey, enclosing a letter which he was to hand or not, at his discretion, to Mr. Cardwell.

The intervention was successful, and Lord de Grey asked her for Memoranda to "post him up" in the work of the Army Sanitary Commission and in the Sanitary Progress in India. Lord de Grey interceded with Mr. Cardwell also on behalf of the Army Medical School and it was spared. The Army Sanitary Committee was not touched, and for nearly twenty years more (till 1888) Dr. Sutherland continued his work upon it.

Miss Nightingale's reports submitted to Lord de Grey are summarized in a letter to M. Mohl (Nov. 21, 1869):--"I am all in the arithmetical line now. Lately I have been making up our Returns in a popular form for one of the Cabinet Ministers (we are obliged to be very 'popular' for them--but hus.h.!.+ my abject respect for Cabinet Ministers prevails). I find that every year, taken upon the last four years for which we have returns (1864-7), there are, in the Home Army, 729 men alive every year who would have been dead but for Sidney Herbert's measures, and 5184 men always on active duty who would have been 'constantly sick' in bed. In India the difference is still more striking. Taken on the last two years, the death-rate of Bombay (civil, military and native) is lower than that of London, the healthiest city of Europe. And the death-rate of Calcutta is lower than that of Liverpool or Manchester![108] But this is not the greatest victory. The Munic.i.p.al Commissioner of Bombay writes[109] that the 'huddled native ma.s.ses clamorously invoke the aid of the Health Department' if but one death from cholera or small-pox occurs; whereas formerly half of them might be swept away and the other half think it all right. Now they attribute these deaths to dirty foul water and the like, and openly declare them preventable. No hope for future civilization among the 'ma.s.ses' like this!"

[107] Captain Galton took occasion in 1876 to render a tribute to Dr. Sutherland's services. "Possessed of high general culture, of remarkably acute perception, of a very wide experience, and of a perfectly balanced judgment, he has been the moving mind in the proceedings of the Army Sanitary Commission since its formation."

(_Journal of the Society of Arts_, vol. xxiv. p. 520).

[108] According to the Sanitary Blue-book for 1869-70, the death-rates per 1000 were: Bombay 19.2, London 23.3, Calcutta 31.9, Liverpool 36.4. In 1910 the order was very different: London 12.7, Liverpool 17.7, Calcutta 23.0, Bombay 35.7. In four years (1864-8) the death-rate in Bombay had fallen from 31.3 to 19.2; the rise in modern times is due to the industrialization of the town.

[109] To Miss Nightingale; in the Blue-book (p. 186) it is similarly stated that "in three years the ma.s.ses have begun to learn that such scourges as cholera, fever and the like can be prevented by the ordinary processes of sanitation."

V

In December 1869 Miss Nightingale made a new friend. Lord Napier of Magdala[110] was pa.s.sing through London, and wrote to Sir Bartle Frere saying that it "would make him very happy if he could have the privilege of paying his respects to Miss Nightingale before he left." Sir Bartle begged Miss Nightingale to grant the favour, as Lord Napier was devoted to their cause and was likely to be employed in India again--as quickly came to pa.s.s, for in the following month he was appointed Commander-in-Chief.[111] Lord Napier called on December 14, in order (as he wrote to her in making the appointment) "to have an opportunity of saying how much I have felt indebted to you for the a.s.sistance that your precepts and example gave to all who have been concerned with the care of soldiers and their families." He spent some hours with her, and she was charmed with him. "I felt sure," wrote Sir Bartle Frere (Dec. 23), "that you would like Lord Napier of Magdala. He always seemed to me one of the few men fit for the Round Table." A long note which she recorded of the conversation shows how congenial it must have been to her, for Lord Napier talked with strong feeling of the importance and the practicability of improving the moral health of the British soldier. The administrators and the men of action always appealed to her more than the politicians, and Lord Napier of Magdala was now added to her list of heroes. "When I look at these three men (tho' strangely different[112])--Lord Lawrence, Lord Napier of Magdala and Sir Bartle Frere--for practical ability, for statesmanlike perception of where the truth lies and what is to be done and who is to do it, for high aim, for n.o.ble disinterestedness, I feel that there is not a Minister we have in England fit to tie their shoes--since Sidney Herbert. There is a simplicity, a largeness of view and character about these three men, as about Sidney Herbert, that does not exist in the present Ministers. They are party men; these three are statesmen. S. Herbert made enemies by not being a party man; it gave him such an advantage over them." Lord Napier of Magdala came to see Miss Nightingale again in the following year (March 18, 1870), spending in conversation with her his last hours before leaving London to take up his appointment in India. She and Sir Bartle Frere attached high importance to this interview. Lord Napier was a convinced sanitarian. He was bent upon introducing many reforms in the treatment of the soldiers. He believed in the possibility of improving both their moral and physical condition, by means of rational recreation and suitable employment. Sir Bartle Frere suggested to Miss Nightingale that after seeing the Commander-in-Chief she should write to the Viceroy so as to prepare his mind for what Lord Napier would propose. Lord Napier himself begged her to do so. "Everything in India," he said to her, "depends on what is thought in England, and it was you who raised public opinion in England on these subjects." Preparation of the Viceroy's mind was held to be the more necessary because a letter, lately received by Miss Nightingale from him, seemed to show that his sanitary education was by no means complete. So Mr. Jowett's "Governess of the Governors of India" took her pupil again by the hand, and, with Dr. Sutherland's a.s.sistance, drew up a further Memorandum on the Indian sanitary question at large. Referring him to the Royal Commission's Report, she pointed out that the causes of ill-health among the troops were many, and that there was no single panacea; that if other causes were not concurrently removed, the erection of new barracks could not suffice; that fever may lurk beneath and around "costly palaces" (for so Lord Mayo had called some of the new barracks) even as around hovels; that expense incurred in all-round sanitary improvement can never be costly in the sense of extravagant, because it is essentially saving and reproductive expenditure; and so forth, and so forth.[113] Miss Nightingale, before sending her letter, submitted it to Sir Bartle Frere (March 25). "I have nothing to suggest," he said, "in the way of alteration, and only wish that its words of wisdom were in print, and that thousands besides Lord Mayo could profit by them. They are in fact exactly what we want to have said to every one connected with the question from the Viceroy down to the Village Elder." Sir Bartle begged her to consider whether she could not write something to the same effect which would reach the latter cla.s.s. Mr. Jowett had suggested something of the sort a few years before. "Did it ever occur to you," he had written (March 1867), "that you might write a short pamphlet or tract for the natives in India and get it translated? That would be a curious and interesting thing to do. When I saw the other day the account of Miss Carpenter in India, I felt half sorry that it was not you. They would have wors.h.i.+pped you like a divinity. A pretty reason! you will say. But then you might have gently rebuked the adoring natives as St.

Paul did on a similar occasion, and a.s.sured them that you were only a Washerwoman and not a Divine at all; that would have had an excellent effect." Presently she found an opportunity of doing something in the kind that Mr. Jowett and Sir Bartle Frere had suggested.

[110] Robert Cornelius Napier (1810-90), created Baron Napier of Magdala, 1868. Miss Nightingale's other friend, the Governor of Madras, Baron Napier (in the Scottish peerage), was created Baron Ettrick in the United Kingdom peerage, 1872. In first signing himself "Napier and Ettrick" in a letter to Miss Nightingale, he begged "the high priestess of irrigation" to observe that his new t.i.tle was "watery."

[111] In succession to Sir William Mansfield (Lord Sandhurst). On his return from India Lord Sandhurst came to see Miss Nightingale (July 8, 1870), and they corresponded afterwards.

[112] Of Lord Lawrence and Sir Bartle Frere, Miss Nightingale wrote to Madame Mohl (March 26, 1869): "You can ask Sir Bartle Frere about Sir John Lawrence if you like. But they are so unlike, yet each so roundly perfect in his own way, that they can never understand each other--never touch at any point, not thro' eternity. I love and admire them both with all my mind and with all my heart, but have long since given up the slightest attempt to make either understand the other. But each is too much of a man, too n.o.ble, too chivalrous, to denigrate the other."

[113] The substance of much of her Memorandum to Lord Mayo was embodied in the "Observations" which she contributed to the Indian Sanitary Blue-book, 1869-70; see especially p. 43.

Meanwhile, Lord Mayo had introduced Dr. J. W. Cunningham to Miss Nightingale, and they became great allies. When he returned to resume his duties as "Sanitary Commissioner with the Government of India," he corresponded with Miss Nightingale regularly, telling her where things were backward and where a word in season from her would be helpful. In every question she took the keenest interest, sparing no pains to forward, so far as she could, every good scheme that was laid before her. In 1872 Mr. W. Clark, engineer to the munic.i.p.ality of Calcutta, came to see her about great schemes of water-supply and drainage. She obtained an introduction to Sir George Campbell, the Lieutenant-Governor of Bengal, in order to commend to his notice Mr. Clark's plans. For many years she was thus engaged in correspondence with sanitary reformers and officials in various parts of India, sending them words of encouragement when they seemed to desire and deserve it, words of advice when, as was frequently the case, they invited it. When such officials came home on furlough, most of them came also to Miss Nightingale. Dr. Sutherland, in his official capacity on the War Office Sanitary Committee, would often see them first; he would then pa.s.s them on to her, dividing them into two cla.s.ses: those "whom you must simply lecture" and those "whose education you had better conduct by innocently putting searching questions to them." Miss Nightingale was never backward in filling the part of governess to those who in sanitary matters governed India.

VI

Sanitary improvement depended, however, on the governed as well as on the governors; and Miss Nightingale had for some time been extending her influence in India by making the personal acquaintance of Indian gentlemen. "I have been quite beset by Pa.r.s.ees," she wrote to M. Mohl (Feb. 16, 1868); "and after all I saw your Manochjee Cursetjee, that is, the 'Byron of the East.' Sir B. Frere says that few men have done so much for the education of their own race. He talked a good deal of Philosophy to me, while my head was entirely in Midwifery! He is (by his own proposal), if I can send out the Midwives, to take them in at the house of his daughters, of whom one married a Cama, and the other is the first Pa.r.s.ee lady who ever lived as an English single lady might do."

Many other Indian ladies and gentlemen were introduced to Miss Nightingale personally or in correspondence by Miss Carpenter. In 1870 Miss Nightingale was elected an Honorary Member of the Bengal Social Science a.s.sociation, the Council of which body was mainly composed of Indian gentlemen. She wrote a cordial letter of thanks (May 25). "For eleven years," she said, "what little I could do for India, for the conditions on which the Eternal has made to depend the lives and healths and social happiness of men, as well Native as European, has been the constant object of my thoughts by day and my thoughts by night." She eulogized the work that had been done by many private gentlemen of India; she put before them a vision of vast schemes of drainage and irrigation; she sent a subscription to the funds of the a.s.sociation, and promised a contribution to its Proceedings. In this contribution,[114]

sent in June 1870, Miss Nightingale did what Sir Bartle Frere desired: she addressed the Village Elder. "I think," said Dr. Sutherland, who had submitted a draft for Miss Nightingale to rewrite in her own language, "that this is the most important contribution you have made to the question." In simple and terse language, she described the sanitary reforms which might be carried out by the people themselves--pointing out in detail the nature of the evils, and the appropriate remedies for them, and then appealing to simple motives for sanitary improvement. "As we find in all history and true fable that the meanest causes universally multiplied produce the greatest effects, let us not think it other than a fitting sacrifice to the Eternal and Perfect One to look into the lowest habits of great peoples, in order, if we may, to awaken them to a sense of the injury they are doing themselves and the good they might do themselves. Much of the willingness for education is due to the fact, appreciated by them, that education makes money. But would not the same appreciation, if enlightened, show them that loss of health, loss of strength, loss of life, is loss of money, the greatest loss of money we know? And we may truly say that every sanitary improvement which saves health and life is worth its weight in gold."

This address to the Peoples of India was the most widely distributed of all Miss Nightingale's missionary efforts. The a.s.sociation translated it into Bengali. Sir Bartle Frere had it translated into other Indian languages.

[114] Bibliography A, No. 56.

VII

Miss Nightingale's third sphere of missionary work was in the Sanitary Department at the India Office, to which, through her alliance with Sir Bartle Frere, she was a confidential adviser. Her action, in making suggestions and in seeking to influence officials in India, has been ill.u.s.trated already. Her constant work was in helping to edit and in contributing to the Annual Blue-book containing reports of "measures adopted for sanitary improvements in India." The importance which Miss Nightingale attached to the publication of such an annual has been explained in general terms already (p. 145). She saw in it two useful purposes. First, the fact that reports from India were required and published each year acted as a spur to the authorities in that country; and, secondly, the introductory memorandum, and the inclusion of reports on Indian matters by the War Office Sanitary Committee, gave opportunity, year by year, for making suggestions and criticisms. The Annual was issued by the Sanitary Department at the India Office and edited by Mr. C. C. Plowden, a zealous clerk in that office with whom Miss Nightingale made friends; Sir Bartle Frere, as head of the Department, instructed him to submit all the reports to Miss Nightingale who in fact was a.s.sistant-editor, or perhaps rather (for her will seems to have been law) editor-in-chief. It was she who had prepared for the Royal Commission the a.n.a.lysis of sanitary defects in the several Indian Stations; who had written the "Observations" on them; who had taken a princ.i.p.al part in drafting the "Suggestions" for their reform. It was natural that she should be asked to report on the measures actually taken to that end. She was a very critical reporter. "Sir Bartle Frere hesitates a little," she was told on one occasion (1869), "as to the omission of all terms of praise, and says that the Indian Jupiter is a G.o.d of suns.h.i.+ne as well as thunder and should dispense both; he, however, sanctions the omission in the present case." Miss Nightingale's papers show that during the years 1869-74 she devoted great labour to the Annual. She read and criticised the abstracts of the local reports prepared by Mr. Plowden; she discussed all the points that they suggested with Dr. Sutherland; she wrote, or suggested, the introductory memorandum. She did this work with the greater zeal because it kept her informed of every detail; and the knowledge thus acquired gave the greater force to her private correspondence with Viceroys, Governors, Commanders-in-Chief, and Sanitary Commissioners. Her share in the first number of the Annual has been already described (p. 155). In the following year Mr. Plowden wrote (May 22, 1869): "I forward a sketch of the Introductory Memorandum to the Sanitary volume. You will see that the greater part of it is copied verbatim from a memorandum of your own that Sir Bartle Frere handed over to me for this purpose." "I can never thank you sufficiently," wrote Sir Bartle himself (July 5), "for all the kind help you have given to Mr. Plowden's Annual, at the cost of an amount of trouble to yourself which I hardly like to think of. But I feel sure it will leave its mark on India." She took good care that it should at any rate have a chance of doing so. She had discovered that the 1868 Report, though sent to India in October of that year, had not been distributed in the several Presidencies till June 1869. She now saw to it that copies of the 1869 Report were sent separately to the various stations by book-post. She continued to contribute in one way or another to successive volumes[115]; and that for 1874 included a long and important paper by her.

[115] See Bibliography A, Nos. 57, 62.

VIII

Ten years before Miss Nightingale had popularized the Report of her Royal Commission in a paper ent.i.tled "How People may Live and Not Die in India." The Paper was read to the Social Science Congress in 1863. In 1873 she was again requested to contribute a Paper to the Congress. She chose for her t.i.tle "How some People have Lived, and Not Died in India."

It was a summary in popular form of ten years' progress, and this was the Paper which the India Office reprinted in its Blue-book of 1874.

Miss Nightingale glanced in rapid detail at the improvements in various parts of India; took occasion to give credit to particularly zealous officials; and noticed incidentally some of the common objections. One objection was that caste prejudice must ever be an insuperable obstacle to sanitary improvement. She gave "a curious and cheerful" instance to the contrary. Calcutta had "found the fabled virtues of the Ganges in the pure water-tap." When the water-supply was first introduced, the high-caste Hindoos still desired their water-carriers to bring them the _sacred_ water from the _river_; but these functionaries, finding it much easier to take the water from the new taps, just rubbed in a little (vulgar, not sacred) mud and presented it as Ganges water. When at last the healthy fraud was discovered, public opinion, founded on experience, had already gone too far to return to dirty water. And the new water-supply was, at public meetings, adjudged to be "theologically as well as physically safe." Then there was the objection of expense, but she a.n.a.lysed the result of sanitary improvements in statistics of the army. The death-rate had been brought down from 69 per 1000 to 18. Only 18 men died where 69 died before. A sum of 285,000 was the money saving on recruits in a single year.

The course of sanitary improvement, and the results of it, among the civil population cannot be brought to any such definite test; no Indian census was taken till 1872, registration of births and deaths was only beginning and was very imperfect; and India is a country as large as the whole of Europe (without Russia). It was the opinion of a competent authority that the sanitary progress which had been made in India during the years covered by Miss Nightingale's review "had no parallel in the history of the world";[116] but the progress was relative of course to the almost incredibly insanitary condition of the country when she began her crusade. The progress had been made along many different lines.

First, in connection with the health of military stations, the Government of India established committees of military, civil, medical and engineering officers, of local magistrates and village authorities to regulate the sanitary arrangements of the neighbourhood. Sanitary oases for British troops were thus established in the midst of insanitary deserts. Then, sanitary regulations were issued for fairs and pilgrimages--each of these a focus of Indian disease. Inst.i.tutions in India--hospitals, jails, asylums--had been greatly improved; and the munic.i.p.alities of the great cities had made some sanitary progress. Ten years before, Miss Nightingale had reported to the Royal Commission that no one of the seats of Presidencies in India had as yet arrived at the degree of sanitary civilization shown in the worst parts of the worst English towns. Now, Calcutta had a pure-water supply and the main drainage of most of the town was complete. Bombay had done less by munic.i.p.al action, but thanks to a specially vigorous Health Officer, Dr.

Hewlett, sanitation had been improved. Madras had improved its water-supply and was successfully applying a part of its sewage to agriculture. The condition of the vast regions of rural India showed that the teaching of the Sanitary Commissioners was beginning to take some effect. Hollows and excavations near villages were being filled up; brushwood and jungle, removed; wells, cleaned. Surface refuse was being removed; and tanks were being provided for sewage, to prevent it going into the drinking-tanks. From reports of particular places, Miss Nightingale drew her favourite moral. There was a village in South India which had suffered very badly from cholera and fever. It was in a foul and wretched state, and had polluted water. Then wells were dug and properly protected; the surface drainage was improved; cleanliness was enforced; trees were planted. The village escaped the next visitation of the scourge. Miss Nightingale had many hours of depression, and many occasions of disappointment, as Health Missionary for India; but in her Paper of 1874 she bore "emphatic witness how great are the sanitary deeds already achieved, or in the course of being achieved, by the gallant Anglo-Indians, as formerly she bore emphatic witness against the then existing neglects." Only the fringe of the evil had been touched; but at any rate enough had been done to show that the old bogey, "the hopeless Indian climate," might in course of time be laid by wise precautions. "There is a vast work going on in India," said Dr.

Sutherland; and in this work Miss Nightingale had throughout played a princ.i.p.al, and the inspiring, part. It was the opinion of an unprejudiced expert who, though he admired her devotion, did not always agree with her views or methods, that "of the sanitary improvements in India three-fourths are due to Miss Nightingale."[117]

[116] Captain Galton, "On Sanitary Progress in India," 1876 (_Journal of the Society of Arts_, vol. xxiv. pp. 519-534.) This is the best _short_ account of the matter that I have come across. It is more detailed than Miss Nightingale's Paper of 1874. For further particulars, a reader should, of course, refer to the Annual Sanitary Blue-books.

[117] So Sir Bartle Frere reported to Miss Nightingale that Sir John Strachey had said to him; and Sir John wrote in much the same sense to Miss Nightingale herself.

But here, as in all things, her gaze was fixed upon the path to perfection. In her own mind she counted less the past advance than the future way. There was an Appendix to her Paper in which she preached the supreme importance of Irrigation--of irrigation, that is, combined with scientific drainage. Only by that means, she held, could yet more people "live and not die in India," and could the country be raised to its full productive power. A letter which Sir Stafford Northcote sent her (April 29, 1874), in acknowledgment of her Paper on "Life or Death in India,"

exactly expressed her own feelings. "How much," he said, "you have done!

and how little you think you have done! After all, the measure of our work depends upon whether we take it by looking backwards or by looking forwards, by looking on what has been accomplished or on what has revealed itself as still to be accomplished. When we have got to the top of the mountain, are we much nearer the stars or not?"

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 a.s.sociation. 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 const.i.tuted herself, or rather she was const.i.tuted 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 a.s.sist 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 inst.i.tutions. 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 inst.i.tutions. 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.