Florence Nightingale on Women, Medicine, Midwifery, and Prostitution

Article excerpt

Florence Nightingale on Women, Medicine, Midwifery, and Prostitution Edited by Lynn McDonald (Waterloo, ON: Wilfred Laurier University Press, 2005) (1,085 pages; $150 cloth)

Florence Nightingale on Women, Medicine, Midwifery, and Prostitution is the eighth volume of the Collected Works of Florence Nightingale, and it follows the format of the earlier volumes in the series. There is a brief summary of Nightingale's life with particular reference to the content of the book and how it relates to other volumes. An editing key for the series helps readers to find references. All adult women in the volume are addressed by surname, a favor frequently accorded primarily to male subjects, as the editor emphasizes.

The book logically falls into two halves. The first half addresses substantive political themes related to women, while the second half primarily consists of Nightingale's correspondence with other women. Each of the substantive theme areas has its own introduction, which includes the editor's evaluation and judgment of Nightingale's work and concerns. Earlier volumes included Nightingale's views on women in relation to different topics such as home and family. Major nursing correspondents will be covered in future volumes.

The first theme, women's place in the Victorian era, deals with roles for women in medicine, nursing, and midwifery; income security and management of money; marriage and gender; social class; and education. A draft version, one seldom seen, of Nightingale's novel Cassandra completes the section on women, with the editor wanting "to bring out Nightingale's views on women, their place in life and God's intentions for them, as she developed them" (p. 112). The final printed version of the novel will be included in a later volume. Perhaps it will demonstrate refinement in Nightingale's thinking on this important subject.

The second substantive theme is Nightingale's work on midwifery. McDonald, a social scientist, clearly identifies Nightingale's general lack of success in this area. The editor brings an authoritative understanding to the problems existing at the time and the major persons involved. She covers material from several countries as well as personages such as Ignaz Semmelweiss, Léon LeFort, and numerous others. The correspondence and editorial comments also cover a midwifery school's establishment, operation, and closing. It began in October 1861 and closed in December 1867. The discussion of the status of puerperal sepsis in the 1860s at the time of Nightingale's midwifery training at King's College is perhaps the most outstanding part of this volume. Between 1862 and 1866, puerperal fever occurred; in 1867 there were nine deaths out of 125 deliveries. Although, according to McDonald, the statistics for puerperal sepsis deaths did not exceed those in many other lying-in institutions, even so the school was closed. Nightingale's book, Introductory Notes on Lying-In Institutions, reprinted in this volume with a good editorial commentary, illustrates Nightingale's use of a statistical problem-solving approach to "ascertain the 'normal death rate of lying-in women' and the great question whether a training school for midwifery nurses can safely be conducted in such a building"(p. 294). The lengthy coverage of Nightingale's experience with midwifery ends: "Evidently the answer remained 'No' " (pp. 407-8).

Prostitution and the Contagious Disease Act plus treatment for syphilitic prostitutes comprise the third, and last, substantive issue of the first half of the book. The editor's brief introduction covers the growing problem of venereal/sexually transmitted disease in the 1860s among the British military, the corresponding loss of service and resources, and the Continental system of compulsory inspection and treatment of prostitutes that the British government proposed to implement. Nightingale's progressive position that vice or prostitution was the problem rather than the resulting diseases of gonorrhea and syphilis differed from the position of the prevailing majority. …