New Light on the Lady with the Lamp: Susan-Mary Grant Looks at Florence Nightingale's Influence on Medical Care in the Crimea and the US Civil War

Article excerpt

`IT IS WITH FEELINGS OF surprise and anger,' announced The Times on October 12th, 1854, referring to the appalling conditions of the Crimean War, `that the public will learn that no sufficient medical preparations have been made for the proper care of the wounded. Not only are there insufficient surgeons ... not only are there no dressers and nurses,' but what, the paper asked rhetorically, `will be said when it is known that there is not even linen to make bandages for the wounded?' The Times continued its attack the following day with a critique of the `worn-out pensioners who were brought out as ambulance corps'. They were, the paper raged, `totally useless, and not only are surgeons not to be had, but there are no dressers or nurses to carry out the surgeon's directions and to attend on the sick during intervals between his visits.' The author of this diatribe was, not, as is commonly supposed, the famous war correspondent William Howard Russell, but The Times' Constantinople correspondent and future editor, Thomas Chenery. However, if the origin of these dispatches was quickly forgotten, their impact was not. Credited with inspiring, in part at least, Florence Nightingale's decision to take matters in hand as far as medical care in the Crimea was concerned, Chenery's revelations helped effect dramatic changes for soldiers fighting on both sides of the Atlantic in the mid-nineteenth century.

When the American Civil War broke out in April 1861, Nightingale was approached by the Federal Government for advice on organising medical care for troops in the field. By this time she was a well-known figure on both sides of the Atlantic. As early as December 1861, an article in the widely-read American periodical the Atlantic Monthly opened the debate over the appropriate treatment of the sick and wounded soldier. Here, the experience of the British at Scutari was recognised as indispensable. Nightingale's achievements, specifically, were regarded as crucial, in particular the stress she laid on `instant and silent obedience to medical and disciplinary orders.' In the journal's view, Nightingale's `practical hard work, personal reserve, and singular administrative power' had set new standards for the care of the wounded in wartime. `Through her, mainly,' it concluded:

   ... it is that every nation has already studied with some success the 
   all-important subject of Health in the Camp and in the Hospital. It now 
   lies in the way of American women to take up the office, and, we may trust, 
   to better the instruction. 

The last proved a false hope. Although Nightingale was cited frequently in articles on health care in the United States that appeared during the Civil War, learning from her experience and, more importantly, implementing her advice, proved no easy matter for the northern states during the Civil War. In July 1863, some two years into the war, one northern volunteer, Cornelia Hancock, was horrified at the conditions she witnessed in the aftermath of the battle of Gettysburg.

   ... The first day of my arrival, the sixth of July, and the third day after 
   the battle, was a time that taxed the ingenuity and fortitude of the living 
   as sorely as if we had been a party of shipwrecked mariners thrown upon a 
   desert island. 

`There was hardly a tent to be seen,' she wrote:

   Earth was the only available bed during those first hours after the battle. 
   A long table stood in this woods and around it gathered a number of 
   surgeons and attendants. This was the operating table, and for seven days 
   it literally ran blood. A wagon stood near rapidly filling with amputated 
   legs and arms; when wholly filled, this gruesome spectacle withdrew from 
   sight and returned as soon as possible for another load. 

Hancock came from a family of Quakers and, unlike Nightingale, never lacked familial backing, but she was almost felled at the first hurdle by Dorothea Dix, who had been appointed as superintendent of female nurses by the Union in June of 1861. …