Meanwhile, Miss Nightingale, in the hope of completing the new Viceroy's education, had written an account of her interview to Lord Ripon, so that when they met he might know on what points his successor most needed indoctrinating. Lord Dufferin had not long been gone when an opportunity offered itself for another effort at evangelization. At the end of November Mr. Gladstone called upon Miss Nightingale. He had come without an appointment, and she was unable to see him; but assuming, for her purpose, that he had proposed to discuss Indian questions, she sent him a written statement of her views on various matters, and asked leave to write again with more special reference to Lord Ripon's splendid record. Mr. Gladstone thanked her (Dec. 6) for the valuable letter; said that the best use he could make of it would be to commend it to the attention of Lord Kimberley[211]; and added that he would be very glad to hear her views about Lord Ripon's administration. She had wanted to interest Mr. Gladstone, and was disappointed that he had only passed her letter on to Lord Kimberley, who, she thought, meant the India Council, a body not sympathetic to the Ripon policy. But, as she had been given the opening, she made another attempt. Mr. Gladstone was, of course, in general sympathy with Lord Ripon, but she wanted the Prime Minister to give greater prominence and emphasis to Indian internal reforms in his speeches. She did not succeed. “I wish I could hope,” wrote a friend who knew both India and Mr. Gladstone well (Jan. 4, 1885), “that you could make some real impression on him; but at his age and at this time, when his hands are so full, what can you expect? He has never given his mind to India, and it is too late now.” It was not only Mr. Gladstone who was preoccupied at this time with other things than the welfare of the Indian peoples. Miss Nightingale soon discovered this. Lord Ripon was nearly due in England. He ought, she said, to receive a popular welcome as enthusiastic as any accorded to a conquering General. As there were no signs of any preparation in that sort, she worked very hard, though with very little success, to organize a welcome in the form of laudatory articles in various newspapers and reviews.[212] She herself wrote an enthusiastic appreciation, but she was unwilling to sign it. The editors were willing to publish anything to which Miss Florence Nightingale would give her name, but for articles in praise of Lord Ripon's policy without that attraction there was no demand. As soon as it was disclosed that what was offered was only an unsigned article, or an article signed by some nominee of hers, the editors, with one consent, discovered that exigencies of space prevented its insertion. And this was not surprising; for Khartoum had fallen, and the Government was tottering. Miss Nightingale was as keenly interested as any one else in those things; but there were few beside herself to whom the standing problems of Indian administration were matters of “life and death,” no less passionately interesting than the fate of a hero or the fall of a ministry.

VIII

Lord Wolseley had been appointed to command a Gordon Relief Expedition in August 1884. There were already female nurses in Egypt. Some had been retained at Cairo after the Arabi Campaign of 1882. Others had been sent to Suakin during the “military operations” of 1883. More were now sent by the Government, and some were ordered up the Nile to Wady Halfa. Miss Nightingale felt this to be a great event. “Luther says,” she wrote to Miss Pringle (Claydon, Oct. 11, 1884), “that he looks and sees the firmament which God has made without pillars, and we wretched men are always afraid that it will tumble down unless we make our little pillars half a foot high. It is 34 years since I was at Wady Halfa. How little I could ever have thought that there would be trained nurses now there! O faithless me, that think God cannot make His firmament without pillars.” But Miss Nightingale's religion enjoined, as we know, “working with God.” The ultimate issue did not rest upon the little pillars; but they must be set up for what they are worth none the less, and Miss Nightingale threw herself, heart and soul, into forwarding the Egyptian nursing campaign. Presently more nurses were sent out on private initiative—some by the National Aid Society, others by a committee of ladies. On February 20, 1885, Lady Rosebery called at South Street. She and Mrs. Gladstone and Lady Salisbury, and other ladies, with the Princess of Wales, were proposing to establish a Committee of their own to send additional comforts for the sick and wounded, as well as additional nurses. In order to secure unity of administration, and in loyalty to Lord Wantage's Society, Miss Nightingale advised against any separate organization, and the Committee, which she then agreed to join, was reconstituted as “The Princess of Wales's Branch of the National Aid Society.” The Superintendent of the nurses sent out by the Government was one of Miss Nightingale's dearest pupils, Miss Rachel Williams, whose acquaintance we have made already under her pet-name of “The Goddess.” She had been in indifferent health and much worried. She stayed in South Street while arrangements were pending, and Miss Nightingale announced the departure to Miss Pringle (March 4): “Our darling has started this morning by the Navarino with seven nurses for Suez. If you had seen, as I did, how, the moment it was settled that she was to have this work, the cloud and the load were lifted off her, and she became again the Goddess and her youth returned, you would have felt, as she said, that Providential Goodness had opened and guided every step of her way. As soon as her appointment was made she looked as beautiful and bonny as ever.”

The rapidity of Miss Nightingale's decision, her memory for matters of detail, her thoughtfulness for others even in trivial things, her kindliness of heart interlacing the practical instinct, the mingled playfulness and gravity of her manner—these things are all illustrated in the reminiscences of another member of the party which sailed for Egypt in the Navarino:—

Sister Philippa was only one of the many war-nurses to whom their Chief showed this tender friendship. During their service abroad, she was constant in letters of encouragement and advice:—

Florence Nightingale was living her Crimean life again in the life of her pupils. Many a little incident recalled the old days to her. One of the nurses wrote that in her hospital the supply of soap had given out. “Send to Cairo,” Miss Nightingale answered, “for any quantity you like, and I'll pay, but only if you can do it without embroiling yourself with the authorities.” Another of her pupils was nursing in the Citadel Hospital at Cairo. “I am on night duty now,” she wrote, “and I don't dislike it at all: in fact I enjoy trotting about this weird old place all by myself in the solemnity of the night! and now and then hearing a low voice saying, ‘Sister, would you mind doing so and so,’ ‘Sister, can you give me something to ease my face,’ etc., etc., and then feeding the hungry enteric patients at stated times who open their mouths in turn like so many little birds!” The picture drawn in this letter, and the zest which it showed, pleased Miss Nightingale greatly, and she passed it on to old pupils at home. They were thrilled. Lucky Sybil! they said; she is doing work like the Chief's at Scutari! another Lady with the Lamp amid the glimmering gloom! And Miss Nightingale, who received from the medical authorities of the Army most satisfactory reports on the services rendered by her nurses, rejoiced in their successes and usefulness. She would have smiled upon any pupil “at the first stroke which passed what she could do.”

Yet with thankfulness that she had been able to show the way to others, there was mingled something of the wistful regrets of old age. There was much in the administrative conduct of the nursing service at the front which she could have ordered better. There was a paragraph in a newspaper about the attractions of “afternoon tea in the nurses' tent” which pained her (though the reference here was not, I think, to any of her own Nightingale nurses). Encouraging, cheery, helpful to others, she was in herself sad and almost sombre. It was in vain that Mr. Jowett still enjoined her to dwell upon all that she had been able to do, upon the many blessings which had attended her work. “You will have felt General Gordon's death,” he wrote (Feb. 22), “as much as any one. What poor creatures most of us seem in comparison with him! But not you, not you!” But the note which she struck in her next Address to the Probationers was all of humility. Old friends and comrades were dying. In 1882 a dear friend of her girlhood—Madame Mohl—died in Paris. In the same year Dr. Farr died—one of the founders in this country of her favourite science of statistics, and an associate of hers in work with Sidney Herbert. One of the most valued of her allies in later Indian work—Sir Bartle Frere—died in 1884. In the previous year a yet older friend, and one of her wisest counsellors—Sir John McNeill—had died. He had sent her a copy of the last piece he wrote; the preface to a new edition of Sir Alexander Tulloch's Reply to the Chelsea Board, in which Sir John in turn replied to the version of that affair given by Mr. Kinglake.[216] Her letter to him, sent “with the deepest affection and veneration,” was in a sombre vein. The correspondence recalled old days, but again “How little permanent progress had been made!” She only, she began to feel, was left; and she so unworthy! What opportunities she had been given! How little use she had been able to make of them! There were “dark nights of the soul” when such self-reproaches were grievous. But some years of life would perhaps still be granted to her. She would consecrate them the more devotedly to higher service. “To-day,” she wrote (Christmas Day, 1885), “let me dedicate this poor old crumbling woman to Thee. Behold the handmaid of the Lord. I was Thy handmaid as a girl. How have I back-slidden!”

CHAPTER VII

“THE NURSES' BATTLE”; AND HEALTH IN THE VILLAGE
(1885–1893)

The period of Miss Nightingale's life covered in this chapter includes the year of Queen Victoria's Jubilee; which was also what Miss Nightingale used to consider her Jubilee Year. She fixed her effectual call at February 7, 1837. In 1887 she had thus completed fifty years vowed to service. In August, a month of many memories to her, she looked back over the past and around her in the present, and was in a despondent mood:—

And in this month, too, Florence Nightingale was to die; but nearly a quarter of a century of life was first granted to her, and for the greater part of the time she remained in full possession of her faculties. Though she might be an “old lady” to young nurses, others remarked that she looked wonderfully fresh and youthful for her years. If old age had set in, her powers had by no means failed, and in many directions her work, though sometimes sore beset, continued to prosper. We will take first in our survey her work in the nursing world.

The “change of matrons” at St. Thomas's Hospital, caused by the retirement of Mrs. Wardroper, was hardly such a tragedy as it seemed to Miss Nightingale. Mrs. Wardroper had done her work, and there were younger women competent to fill the place. Mr. Jowett often begged Miss Nightingale to remember that “there is no necessary man—or woman”—“not even,” as, greatly daring, he once added, “yourself.” But in this case the Chief of the Nightingale School was not yet retiring, and she would still be able to supervise it—perhaps even more closely under a new Matron. For many years Miss Nightingale continued to maintain the intimate touch with her School that has been described in an earlier chapter: seeing the Sisters constantly, making the personal acquaintance of nurses, conferring with their medical instructors, reading their diaries and examination papers. Her heart was even more closely in the work when she secured the appointment, as Mrs. Wardroper's successor, of her dear friend, Miss Pringle. Presently, however, there came what was a heavy blow to Miss Nightingale. Miss Pringle joined the Roman communion, and it was necessary that she should retire from the Matronship of St. Thomas's. The months of unsettlement before the conversion was made were full of grief to Miss Nightingale. Indeed her notes and meditations suggest that the “loss” of her favourite pupil was one of the heaviest griefs of her life; but she loved her friend too well for the sorrow to leave any abiding bitterness. Over and over again in her meditations she wrote down lines from Clough's Qua Cursum Ventus. Miss Pringle was succeeded by Miss Gordon, an old pupil of the Nightingale School; she and Miss Nightingale speedily became the best of friends, and things went on much as before in the School. All these changes, with the delicate weighing of rival claims and sometimes with the worrying conflict of personal ambitions, caused Miss Nightingale heavy anxiety. Intensely conscientious, acutely sensitive, and seeing in every change a great potentiality of good or evil, she could not treat such things as mere matters of business. There have been Prime Ministers who could not sleep of nights under the sense of responsibility caused by ecclesiastical preferment; and to Miss Nightingale the selection of a Superintendent or a Home Sister was even as the appointment of a bishop.

II

The movement for District Nursing, which was always near to Miss Nightingale's heart, and which, in conjunction with Mr. Rathbone and others, she had done much to promote, received considerable extension by the action of Queen Victoria in 1887. The bulk of the sum presented as the “Women's Jubilee Gift” was devoted by the Queen to “the nursing the sick poor in their own homes by means of trained nurses.” She appointed the Duke of Westminster, Sir Rutherford Alcock, and Sir James Paget to be trustees of the Fund, and to advise upon its administration. Sir James Paget consulted Miss Nightingale, who, in several conversations, impressed upon him her view that the essential things were the training of nurses for the work, and the association of them in “Homes.” The lines of the “Metropolitan District Nursing Association,” which had for many years been largely supported by nurses trained in the Nightingale School and by grants from the Nightingale Fund, were adopted as the basis of the “Jubilee Institute for Nurses,” and the Association presently became affiliated to the Institute. In an introduction which she contributed in 1890 to a book giving account of these matters,[217] Miss Nightingale struck a warning note. “The tendency is now to make a formula of nursing; a sort of literary expression. Now, no living thing can less lend itself to a formula than nursing. Nursing has to nurse living bodies and spirits. It must be sympathetic. It cannot be tested by public examinations, though it may be tested by current supervision.” The Royal Jubilee Institute in some ways advanced Miss Nightingale's cause, but she had misgivings. “Vexilla regis prodeunt; yes, but of which King?” Was the oriflamme, which was now beginning to wave above the nursing sisterhood, “of heavenly fire, or of terrestrial tissue?” “We are becoming the fashion,” Miss Nightingale was fond of saying; “we must be on our guard. Royalty is smiling on us; we must have a care.” Such misgivings were speedily to be justified.

The nursing world was for some years rent in twain by a dispute about Royal Charters and Registration. The controversy lasted for seven years (1886–93); Miss Nightingale was in the thick of it, and during the more critical period of the dispute (1891, 1892) it was her main public preoccupation. In 1886 the Hospitals Association[218] appointed a Committee to inquire into the possibility of establishing a General Register of Nurses. The Committee violently disagreed; in 1887 the majority retired, and the minority founded the British Nurses Association with a view to carrying forward a scheme of Registration. In 1888 the Hospitals Association appointed a second committee which proceeded to collect opinions from the various Nurse Training Schools. These Schools were for the most part opposed to the idea of a General Register; but there was difference of opinion among leaders alike in the medical profession and in the nursing world. “I have a terror,” wrote Miss Nightingale to Mr. Bonham Carter (April 20, 1889), “lest the B.N.A.'s and the anti-B.N.A.'s should form two hostile camps, judging one another by that test chiefly or alone. This would be disastrous. The Unionists and the Home Rulers show us an example of what this is. They are two hostile camps, dividing families. It is like a craze. The test, e.g. even of a good doctor or of an acquaintance is, to which camp does he belong? Even a doctor, canvassing for an appointment, is asked whether he is Home Ruler or Unionist. I can remember nothing so distressing since the Reform Bill, which I remember very well, when the two sides would not meet each other at dinner.” I do not know that feeling between the pro-Registrationists and the anti-Registrationists went to the length of war-to-the-knife-and-fork; but the “Nurses' Battle” (as it was called in the newspapers) was hot and prolonged. From a fighting point of view, the two sides were fairly matched. On each side there were eminent doctors. The “anti's” had an advantage in that they included the greater number of those who had the longest and closest knowledge of nurse-training; but the “pro's” had a Princess at their head. The Princess Christian had accepted the presidency of the British Nurses Association; and when the time came for applying for a Charter, it was the Princess who petitioned the Queen. “This makes it awkward for us,” said Mr. Rathbone to Miss Nightingale; and undoubtedly it did. There were courtly personages even among Miss Nightingale's devoted adherents who were inclined to trim; and there were other persons, who, having never perhaps thought out the questions, were predisposed to do as the Princess did. Let each man in the battle have such credit as is due for his personal loyalty. “In any matter of nursing, Miss Nightingale is my Pope,” wrote Mr. Rathbone, “and I believe in her infallibility.” “Nothing can save us,” he said to Miss Nightingale herself, “except your intervention.” She was not slow to give it. Suggestions were made by intimate friends—Sir Henry Acland and Sir Harry Verney—that she should see the Princess Christian and endeavour to come to terms; and later on, in 1893, when the Empress Frederick visited Miss Nightingale, they renewed the suggestion. But the Princess Christian had made no overtures; she was committed to the particular scheme advocated by the Association of which she was President; and, to Miss Nightingale, opposition to that scheme was a matter of vital principle. She threw herself into the fray with an equipment of argumentative resource derived from her unequalled experience, and with a passionate conviction inspired by long brooding over a fixed ideal.

The objects of the British Nurses Association were “to unite all qualified British Nurses in membership of a recognized Profession”; “to provide for their Registration on terms satisfactory to physicians and surgeons as evidence of their having received systematic training”; “to associate them for mutual help and protection and for the advantage in every way of their professional work”; and “with a view to the attainment of these objects, to obtain a Royal Charter incorporating the Association and authorizing the formation of a Register.”[219] It was around the second and the fourth of these objects that the principal battle raged. The case of the Association was prima facie a strong one. A Register of Nurses, duly certified as competent, would, it was argued, be a protection against impostors. The certification was to be by a Board which would insist on a certain standard of professional proficiency. Three years' training in a hospital was suggested as the preliminary test. The case, on the other side, as developed by Miss Nightingale and her allies, was that the apparent advantages of a Register were deceptive. Who was to be protected? Not the hospitals: they protected themselves, without any general register, by their own methods. If any one was to be protected, it must be the public; but the Register would rather mislead than protect them. The placing of a name on a register would, at best, only certify that at a certain date the nurse had satisfied the required tests; but the date might be long ago, and the fact of registration would tell nothing of her subsequent conduct or competence. The registration of midwives stood on a different footing from that of nurses; for in the former case, a certain definite technical skill is of the essence of the matter: in the case of nursing, character is as much of its essence as any technical qualification. As for the three years' training in a hospital, there were hospitals and hospitals, training-schools and training-schools; and who was to guarantee the guarantors? The General Register would not raise the profession of nursing; it would do an injury to the better nurses by putting them on a level with the worse, and to the profession by stereotyping a minimum standard. The British Nurses Association had published a preliminary “register.” Miss Nightingale analysed it, and found that in the case of nurses “trained” at one hospital, the private Register of that Hospital excluded nearly one-third of those entered on the B.N.A.'s register; and that another Hospital's Register included, as “duly certificated,” only one-third of those entered on the B.N.A.'s register as trained thereat. “You cannot select the good from the inferior by any test or system of examination. But most of all, and first of all, must their moral qualifications be made to stand pre-eminent in estimation. All this can only be secured by the current supervision, tests, or examination which they receive in their training-school or hospital, not by any examination from a foreign body like that proposed by the British Nurses Association. Indeed, those who come best off in such would probably be the ready and forward, not the best nurses.”[220] The much vexed question of “internal” or “external” examination was, it will be seen, involved in this dispute. But to Miss Nightingale a larger and a more vital issue was at stake. It was a conflict between two ideals—or rather, as she would have said, between a high ideal and a material expediency. Mr. Jowett, though he agreed in her view “that nurses cannot be registered and examined any more than mothers,” was distressed that she was so greatly perturbed over what seemed to him so small a matter. “It is a comparative trifle,” he wrote (May 26, 1892), “among all the work which you have done, and you must not be over-anxious.” To Miss Nightingale it was not a trifle, but a trial—a possible parting of the ways. It was diverting attention from training-homes to examination-tests; it was sacrificing a high calling to professional advancement. “There comes a crisis,” she wrote to Mr. Jowett (May), “in the lives of all social movements, rough-hew them as you will, when the amateur and outward and certifying or registering spirit comes in on the one side, and the mercantile or buying-and-selling spirit on the other. This has come in the case of Nursing in about 30 years; for Nursing was born about 30 years ago. The present trial is not persecution but fashion; and this brings in all sorts of amateur alloy, and public life instead of the life of a calling, and registering instead of training. On the other hand, an extra mercantile spirit has come in—of forcing up wages, regardless of the truism that Nursing has been raised from the sink it was, not more by training, than by making the Hospital, Workhouse Infirmary, or District Home a place of moral and healthful safe-guards, inspiring a sense of duty and love of the calling.” The true way of “protecting the public” was “to extend Homes for Private Nurses on sound lines, aided by the Nurses' Training Schools and Hospitals”; not, by means of a Chartered Register, to encourage nurses “to flock to the Institutions which gave the easiest certificate at the least trouble of training.” Miss Nightingale could not, then, regard the dispute as a trifle. It caused her days and nights of grievous anxiety. Her meditations are full of despondency and searchings of heart both bitter and self-reproachful. The Princess Christian, with the best intentions, was giving her name to undermine Miss Nightingale's ideal. This could not justly be attributed in blame to the Princess; the fault must have been with her, Florence Nightingale, who had misused her opportunities, and had failed to impress her ideal on other minds. She was an unprofitable servant. But here, as in all things, the sensitive reproaches of the night-watches left no trace of themselves on the work of the day; or rather, they left their trace in greater activity and devotion.

It was in 1889 that the occasion came for resolute action. The British Nurses Association announced their intention of applying for a Charter, and proceeded to enlist public support. Miss Nightingale set to work on the other side. She made the acquaintance at this time of Miss Lückes, then, as now (1913), the Matron of the London Hospital, who was strongly opposed to the idea of registration. The acquaintance speedily ripened into friendship, and henceforth Miss Nightingale was looked to for support and sympathy by the Matron of the London, hardly less than by her of St. Thomas's. Other nurse-training schools came into line, and a manifesto was issued announcing their intention to oppose any petition for a Charter. There was desultory skirmishing for some time between the Registrationists and anti-Registrationists. There was a lively polemic in the newspapers. There were as many fly-sheets and pamphlets as if it were a theological dispute in a University.[221] In 1891 the British Nurses Association applied to the Board of Trade to be registered as a Public Company, without the addition of the word “Limited” to its name. The Memorandum and proposed Articles of Association were duly filed, and the foremost place was again given, among the declared objects, to a register of trained nurses, and to power to determine from time to time the test for registration. Miss Nightingale and her allies took up the challenge. Through Sir Harry Verney she approached the President of the Board of Trade (Sir Michael Hicks-Beach) with a statement of the case against the Association. A counter-petition was presented; and after full consideration the Board refused the application. The first engagement had thus resulted in a victory for Miss Nightingale. In the same year there was a Committee of the House of Lords to inquire into the London Hospitals. Mr. Rathbone, coached by Miss Nightingale, gave evidence on the question of the registration of nurses, and the Committee reported against it. A second victory! But the Registrationists now brought up their most formidable reserves. Permission was obtained from the Sovereign to use the title “Royal.” Thus strengthened by favour in the highest quarter, the Royal British Nurses Association petitioned the Queen for a Royal Charter. The petition was referred in the usual course to a special Committee of the Privy Council, and the two sides marshalled their forces. A campaign fund was raised by the anti-Registrationists. Miss Nightingale appealed privately to the Lord President of the Council and wrote various letters, Memoranda, Statements. She enlisted support from the medical profession. Her old pupils, now in charge of nurse-training schools throughout the country, rallied round her. Two petitions, of special weight, were presented to the Privy Council against the Charter. One was from the Council of the Nightingale Fund, the body which had been the pioneer in promoting the training of nurses. The other was the “Petition of Executive Officers, Matrons, Lady Superintendents, and Principal Assistants of the London and Provincial Hospitals and Nurse Training Schools, and of Members of the Medical Profession and Ladies directly connected with Nursing and the Training of Nurses.” The list of signatures, which occupies twenty-three folio pages, was headed by “Florence Nightingale.” In the preparation of these documents, Miss Nightingale had a large share, though much of the work—especially in the instruction of the lawyers, in consultations and so forth—was done by Mr. Bonham Carter.

The Committee of the Privy Council sat in November 1892 to hear the case.[222] Of the first day's proceedings Miss Nightingale wrote an account in which, as will be seen, she did not let the Registrationist dogs have the better of it, but which betrays at the same time serious anxiety about the result:—

The Committee took time to consider their advice to Her Majesty. In May 1893 the decision was announced. The Committee advised Her Majesty in Council to grant a Charter in accordance with a Draft revised by them. On June 6 the Charter was granted.

Each side claimed the victory. The Nursing Record (June 15)—an organ of the Registrationists—claimed that they had won all, and even more than all, that they asked, and declared proudly that henceforth “members of the Royal Chartered Association will hold a higher position than any others.” The Hospital, on the other side, argued that all this was ill-founded, but if the “British Nurses” wanted to be congratulated on nothing, “we are willing to congratulate them” (June 24). The fight before the Privy Council now became a fight in the press on the meaning of the verdict. The anti-Registrationists, headed by Miss Nightingale and the Duke of Westminster, put their interpretation in a quiet letter to the Times (July 3), which the Royal British Nurses Association hotly denounced as “untrue in fact and injurious in intention” (July 6). The fact was that the Lords of the Council had steered a middle course. They granted the Charter; but in it for the words “the maintenance of a list or register of nurses, showing as to each nurse registered,” etc., they substituted the words “the maintenance of a list of persons who may have applied to have their names entered therein as nurses,” etc. There was nothing in the Charter which gave any nurse the right to call herself “chartered” or “registered.” What the promoters hoped we need not discuss; what the opponents feared was a Charter in such terms as would give the Corporation an authoritative, and perhaps ultimately, an exclusive right to register nurses, and thereby would give it also indirect control over nurse-training. No such Charter was obtained; and in this sense the opposition of Miss Nightingale and her friends had prevailed. The controversy is not dead; but, so far, her view has continued to prevail,[223] and the official registration of nurses is still a pious hope to its supporters, a heresy to its opponents. Miss Nightingale greatly deplored the feud, but sought to bring good out of evil. “Forty years hence,” she wrote to Mr. Rathbone (Feb. 26, 1891), “such a scheme might not be preposterous, provided the intermediate time be diligently and successfully employed in levelling up, that is, in making all nurses at least equal to the best trained nurses of this day, and in levelling up Training Schools in like manner.” “Great good may be done,” she wrote to Mr. Jowett (May 1892), “by rousing our side to an increased earnestness about (1) providing Homes for Nurses while engaged in their work of nursing, and (2) full private Hospital Registers, tracing the careers of nurses trained by them.” There were no years in which Miss Nightingale herself gave more thought and trouble, than in 1891–3, to personal care for the affairs of the Nightingale School.

In a Paper which Miss Nightingale was invited to contribute to a Congress on Women's Work, held at Chicago in 1893, she treated the whole subject of nursing.[224] This paper embodies in a methodical form her characteristic views, and in it she takes occasion in several places to touch obliquely upon the controversy described in preceding pages. “A new art, and a new science, has been created since and within the last forty years. And with it a new profession—so they say; we say, calling.” She dwells on the conditions necessary to make a good training school for nurses. She dilates upon the dangers to which nursing is subject. These are “Fashion on the one side, and a consequent want of earnestness; mere money-getting on the other side; and a mechanical view of nursing.” “Can it be possible that a testimonial or certificate of three years' so-called training or service from a hospital—any hospital with a certain number of beds—can be accepted as sufficient to certify a nurse for a place in a public register? As well might we not take a certificate from any garden of a certain number of acres, that plants are certified valuable if they have been three years in the garden?” Then there was “imminent danger of stereotyping instead of progressing. No system can endure that does not march. Objects of registration not capable of being gained by a public register!” The whole paper is written with a good deal of gusto. The volume in which it appeared was dedicated to Princess Christian.

In the following year Miss Nightingale had some correspondence with the Princess, who, as President of the Royal British Nurses Association, had made a scheme for enrolling a “War Nursing Reserve” through the Hospitals, and had written to consult Miss Nightingale about it. The Hospital Sisters were according to this scheme to be placed “in subordination to the Army Sisters”—nurses with the larger experience under those with the smaller. This seemed to Miss Nightingale a mistake; and she noted other details in which the scheme appeared to her inadequately considered. She pointed these things out faithfully to the Princess, but the correspondence on both sides was cordial. The letters from the Princess made Miss Nightingale exclaim, “How gracefully Royalty can do things!” And on her part she desired to be conciliatory. “We should, I think, be earnestly anxious,” she wrote, “to do what we can for Princess Christian as she holds out the flag of truce, in order to put an end as far as we can to all this bickering, which does such harm to the cause.”

There were thoughts in Miss Nightingale's mind throughout this controversy still deeper than any which have yet been noticed. She had an esoteric conception of Nursing which made her regard the view of it as a registrable business in the light almost of sacrilege. “A profession, so they say; we say, calling.” And not only a calling, but a form through which religious satisfaction might be found. Her view comes out in a letter which she wrote to Mr. Jowett in 1889 in the course of a discussion with him upon the necessity of external forms for the religious life: “You say that ‘mystical or spiritual religion is not enough for most people without outward form.’ And I may say I can never remember a time when it was not the question of my life. Not so much for myself as for others. For myself the mystical or spiritual religion as laid down by St. John's Gospel, however imperfectly I have lived up to it, was and is enough. But the two thoughts which God has given me all my whole life have been—First, to infuse the mystical religion into the forms of others (always thinking they would show it forth much better than I), especially among women, to make them the ‘handmaids of the Lord.’ Secondly, to give them an organization for their activity in which they could be trained to be the ‘handmaids of the Lord.’ (Training for women was then unknown, unwished for, and is the discovery of the last thirty years. One could have taken up the school education of the poor, but one was specially called then to hospitals and nursing—both sanitation and nursing proper.) This was then the ‘organization’ which we had to begin with, to attract respectable women and give religious women a ‘form’ for their activity.… When very many years ago I planned a future, my one idea was not organizing a Hospital, but organizing a Religion.” Now, “handmaids of the Lord” cannot be certified by external examiners, nor can a religious service be guaranteed by registers.

Does this view of the matter seem a little transcendental? It was in accord, at any rate, with another of Miss Nightingale's fundamental doctrines, which in its application to the controversy had a severely practical force. Nursing, she held, is a progressive art, in which to stand still is to go back. No note is more often struck in her Addresses to Nurses. She held, as may already have been gathered from the foregoing summary of her case, that the Registrationists, consciously or unconsciously, had lost hold of that essential truth about nursing. It was right that precautions should be taken against impostors, and that the fullest inquiries should be made. Miss Nightingale's objection was not to the precautions, but to their misleading nature; not to the tests, but to their inadequacy. The only real and sufficient guarantee, in the case of an art in which the training, both technical and moral, is a continuous process, was, she held, that the public should be able to obtain a recent recommendation of the nurse, who was to be passed on from one doctor, hospital, or superintendent to another with something of the same elaborate record of work and character that she herself required in the case of Nightingale Probationers and Nurses.

III

The fate of Miss Nightingale's work in the cause of Public Health both in India and at home was chequered during these years, even as was that in the cause of trained nursing, but here again substantial advance was made in several directions. There was once a Secretary of State who entered the India Office possessed by a strong and personal interest in sanitation. There was some excitement in the Office. There were one or two men around the Minister who heartily approved; there were more who shook their heads. The Minister must have been listening, they thought, directly or indirectly, to a certain lady's “beautiful nonsense.” He was too impressionable. He was anxious to do things, in spite of the claims of economy. He was too much in a hurry. They took him in hand in order to quiet him down. They thought to have succeeded in making him satisfied to leave things as they were. The other side became conscious of a change. “It is essential,” wrote one of them to a certain lady, “that you should see him at once.” The lady, who was the hope of one side and the fear of the other, was Miss Nightingale. The Minister need not be identified; for these things, though true also of a particular case and time, are here given as a general allegory. For thirty years and more, through all changes and chances in the political world, Miss Nightingale was a permanent force, importuning, indoctrinating, inspiring, in the interests of better sanitary administration.

For some time after the early months of 1885 the political situation was very unsettled. The Government formed by Lord Salisbury after the defeat of Mr. Gladstone in June was only a “Cabinet of Caretakers,” and it was not worth Miss Nightingale's while to approach any of them. Besides, she instinctively recognized the Secretary of State for India as a hopeless subject. She was right. Lord Randolph Churchill was all against Lord Ripon, and all for economy. When Lord Salisbury's Government was in turn overthrown, after the general election in December, Miss Nightingale, through various channels, approached Mr. Gladstone, and begged him to send Lord Ripon to the India Office. He returned polite but evasive answers, and so controversial an appointment was obviously improbable. Lord Ripon went to the Admiralty. The excitement of the first Home Rule Bill followed; the Government was defeated; another general election was necessary, and all was in confusion. Dr. Sutherland, anxious to retire from the public service (for he was now nearly 80), was pressing Miss Nightingale to devise measures for safeguarding his department after he was gone. She pressed him to stay on yet a while. “During the political earthquakes of the last 8 months, still continuing, no permanent interest can be expected,” she wrote to him (July 20, 1886), “in those who are so little permanent. The subject excruciates me.” Lord Ripon, who came to see her ten days later, thought that the times were unpropitious generally for good causes—an opinion which defeated Ministers are apt to hold. “There are waves in these matters,” he said. “The thing is to come in upon the crest of the waves. You would have done nothing for the Army and Sanitation if it had not been for the crash in the Crimea. Now, the wave is against India.”

Miss Nightingale, however, did not allow herself to be tempted into inactivity by this wave-theory. For the moment, indeed, there was nothing to be done with Ministers at home; but she had not been neglectful of cultivating relations with Anglo-Indians and Indians in positions of influence. In 1885 she had added Sir Neville Chamberlain and Sir Peter Lumsden to her list of Anglo-Indian acquaintances. Lord Reay had called upon her (March 1885) before leaving to take up the governorship of Bombay, and she corresponded with him frequently on sanitary subjects. In October, Lord Roberts came before going out to India as Commander-in-Chief. Miss Nightingale took great pains with this interview, Dr. Sutherland having furnished her in advance with an admirable synopsis of what might still be done to improve the health and welfare of the troops. Lord Roberts's command was fruitful of some reforms in which Miss Nightingale had been a pioneer. He established a club or institute in every British regiment and battery in India. He closed canteens. He opened coffee-stalls. He established an Army Temperance Association.[225] No letter which Miss Nightingale received in her Jubilee Year can have pleased her more than one which the Commander-in-Chief in India sent her from Simla on August 6. In this letter Lord Roberts told her that the Government of India had sanctioned the employment of female nurses in the Military Hospitals. A commencement was to be made at the two large military centres of Umballa and Rawalpindi, and 18 nurses, with lady superintendents in each case, were to be sent out from England at once. The selection of nurses was entrusted to Surgeon-General Arthur Payne, who in the following month had several interviews with Miss Nightingale. Thus, after twenty-two years, was the scheme which she had put before Sir John Lawrence brought to fruition. Miss Nightingale saw the Superintendents before they went out, and letters from them were now added to the pile of those which she received from hospitals throughout the world, reporting progress or asking advice. Miss C. G. Loch wrote from Rawalpindi (April 12, 1888) describing how she had found that, as Miss Nightingale always said, the education of the Orderlies was the most important thing for the nurses to do.

The official introduction of female nursing into the Indian military hospitals was by no means the only satisfaction which Miss Nightingale received during Lord Dufferin's Viceroyalty. He had declared himself ignorant of Indian sanitary things, but had promised to learn; and not only was he as good as his word, but Lady Dufferin was keenly interested also. She founded the “National Association for Supplying Medical Aid to the Women of India.” Miss Nightingale had long been interested in the subject, and Lady Dufferin consulted her at every stage. One of the first things needful, Lady Dufferin had written (Sept. 19, 1885), was a supply of Sanitary Tracts. “In using the word tract, I am thinking of some little books in Hindustani written by A.L.O.E. which I am obliged to read as part of my studies in the language. They are stories with a moral, and I don't see why something of the kind might not be published with health as a moral.” Miss Nightingale took great pains in collecting suitable raw material, and during the remainder of Lord Dufferin's Viceroyalty wrote to her by almost every mail.

IV

Yet more was to be “fired,” during Lord Dufferin's Viceroyalty, of sanitary “shot” supplied, as he had requested, by Miss Nightingale; but we must now turn back to London, where, partly from circumstances and partly of necessity, Miss Nightingale was presently engaged in a vigorous campaign. There is a large bundle of correspondence during these years upon a matter which is referred to in some of the letters as “The Sutherland Succession.” Now, Dr. Sutherland was in Miss Nightingale's eyes the indispensable man. Not any longer in the personal sense, as described in an earlier chapter; for he was now a very old man, and was only able to help her on rare occasions. She had already found a successor in this personal sense, or rather she had put Dr. Sutherland's place into commission. Sir William Wedderburn was during these later years her most constant collaborator in Indian matters, and for the rest she relied upon Sir Douglas Galton.[226] She had often chafed at Dr. Sutherland's delays, but I expect that when Sir Douglas succeeded to him she may in one respect have parodied to herself the well-known Cambridge epigram, and said, “Poor Dr. Sutherland! we never felt his loss before.” For Sir Douglas Galton, though devoted also to Miss Nightingale's service, was an exceedingly busy and much-travelling man, and she had to be content with the crumbs of his time. “As it was some time in the dark ages,” she wrote (May 13, 1887), “since I saw you last—my memory impaired by years cannot fix the date within a decade—I seize the first day you kindly offer.” And again (Dec. 3, 1889): “I must take your leavings, as beggars must not be choosers. Yes, please, your dog will see you to-morrow on your way from Euston for as long as you can stop.” Miss Nightingale relied greatly on Sir Douglas Galton's advice; she had a very high opinion, not only of his thorough knowledge of all sanitary subjects, but of his sound judgment generally. From the personal point of view, then, Dr. Sutherland was gone already; but in his official capacity he was still indispensable. He was the mainspring of the system of sanitary administration, both for the home Army and for India, which Miss Nightingale had built up. He was the one paid working member, and he was also the working brain, of the Army Sanitary Committee, and it was to that Committee that Indian sanitary reports were referred. But he was impatient to retire. At any moment his health might become worse, and he might send in his resignation before arrangements had been made for the appointment of a successor. So long as he remained at his post, no changes were likely to be made; but if he retired, it was very probable that no successor would be appointed, and that the whole system would collapse. That the heads of the Army were ignorant of Dr. Sutherland's services, had been burnt in upon Miss Nightingale's mind a few years before. In discussing some matter of army nursing with the minister of the day, she had suggested the reference of it to Dr. Sutherland. “Who is he?” said the minister; “I have never heard of him.” At the India Office it was much the same. “I don't think,” wrote a friend (Sept. 8, 1886), “that this office in general appreciates the importance of those reviews of Indian sanitary matters of which Dr. Sutherland has been the real author hitherto.” The whole system would lapse, he feared, unless she was able to do something.

Nor was this all. The sanitary service in India itself was in danger. The annexation of Burma had made retrenchment necessary; a Finance Committee was at work in recommending economies; and Miss Nightingale received private information that the Sanitary Commissioners were marked down by the Committee for destruction. The whole edifice thus seemed to be crumbling. This was what she had in her mind when, in the Jubilee retrospect quoted at the beginning of the chapter, she said that the work of thirty years had all to be done again.

She turned with all her old energy to efforts commensurate to the threatened calamity. In accordance with her usual method, she first consulted many influential friends (Lord Ripon amongst others), and then acted with great energy. She wrote a long statement to Lord Dufferin (Nov. 5). “I have sent your letter in extenso,” he replied (Jan. 18, 1887), “to the head of the Finance Committee. You should understand that it does not at all follow, because the Committee recommend a thing, that their recommendation will, as a matter of course, be accepted by the Government. On the contrary, I will go most carefully into this question in which you naturally take so deep an interest, and will be careful to have it thoroughly discussed in Council by my colleagues with the advantage of having had your views placed before them.” A few months later came welcome news:—