Chapter XX

_William Rathbone—Agnes Jones—Infirmaries—Nursing in the homes
of the poor—Municipal work—Homely power of Miss Nightingale’s
writings—Lord Herbert’s death._

A word must here be said of Mr. William Rathbone’s work in Liverpool. After the death of his first wife, realizing the comfort and help that had been given during her last illness by a trained nurse, he determined to do what he could to bring aid of the same kind into the homes of the poor, where the need was often so much more terrible. This brought him into touch with Miss Nightingale, who advised him to start a school of nursing in connection with the Liverpool Hospital. These two friends—for they soon became trusted and valued friends, each to each—were both people of prompt and efficient action, and one step led to another, until Liverpool had not only an important school of nurses for the sick poor, but also led the way throughout the country in the reform of the hitherto scandalous nursing in workhouse infirmaries. Mr. Rathbone set his mind on securing the services of Miss Agnes Elizabeth Jones to help him in his work, a woman of character as saintly as his own, and the difference in their religious outlook only made more beautiful their mutual relations in this great work.

Miss Agnes Jones, who has already been mentioned more than once in these pages, left an undying record on England’s roll of honour. It was of her that in 1868 Miss Nightingale wrote[17]:—

“A woman attractive and rich, and young and witty; yet a veiled
and silent woman, distinguished by no other genius but the
divine genius—working hard to train herself in order to train
others to walk in the footsteps of Him who went about doing
good.... She died, as she had lived, at her post in one of
the largest workhouse infirmaries in this kingdom—the first
in which trained nursing has been introduced.... When her
whole life and image rise before me, so far from thinking the
story of Una and her lion a myth, I say here is Una in real
flesh and blood—Una and her paupers far more untamable than
lions. In less than three years she had reduced one of the
most disorderly hospital populations in the world to something
like Christian discipline, and had converted a vestry to the
conviction of the economy as well as humanity of nursing pauper
sick by trained nurses.”

And it was in introducing a book about the Liverpool Home and School for Nurses that she wrote:—

“Nursing, especially that most important of all its
branches—nursing of the sick poor at home—is no amateur work.
To do it as it ought to be done requires knowledge, practice,
self-abnegation, and, as is so well said here, direct obedience
to and activity under the highest of all masters and from the
highest of all motives. It is an essential part of the daily
service of the Christian Church. It has never been otherwise.
It has proved itself superior to all religious divisions,
and is destined, by God’s blessing, to supply an opening the
great value of which, in our densely populated towns, has been
unaccountably overlooked until within these few years.”

As early as 1858 Miss Nightingale published “Notes on Matters affecting the Health, Efficiency, and Hospital Administration of the British Army,” and the commission on this subject appointed in 1857 set a high value on her evidence.

Something of the development that followed along both these lines—that of army reform and of nursing among the submerged—may be gleaned from the following clear statement of fact which appeared during the South African War, on May 21, 1900, in a great London daily:—

“In the forty and more years that have elapsed since her
return, Miss Nightingale has seen the whole system of army
nursing and hospitals transformed. Netley, which has been
visited by the Queen again this week, was designed by her, and
for the next largest, namely, the Herbert Hospital, Woolwich,
she assisted and advised Sir Douglas Galton in his plans.

“There is not a naval or military hospital on any of the
foreign stations or depôts on which she has not been consulted,
and matters concerning the health and well-being of both
services have been constantly brought before her. District
nursing owes much to her, and in this connection may be cited
a few lines from a letter which she wrote when Princess
Louise, Duchess of Argyll, was initiating a movement to
establish a home for the Queen’s Jubilee Nurses in Chiswick and
Hammersmith. ‘I look upon district nursing,’ she wrote, ‘as
one of the most hopeful of the agencies for raising the poor,
physically as well as morally, its province being not only
nursing the patient, but nursing the room, showing the family
and neighbours how to second the nurse, and eminently how to
nurse health as well as disease.’”

“Everywhere,” we read in Mr. Stephen Paget’s contribution to
the “Dictionary of National Biography,” “her expert reputation
was paramount,” and “during the American Civil War of 1862-4,
and the Franco-German War of 1870-1, her advice was eagerly
sought by the governments concerned.” The “Dictionary of
National Biography” also assures us that “in regard to civil
hospitals, home nursing, care of poor women in childbirth, and
sanitation, Miss Nightingale’s authority stood equally high.”

In what she wrote there was a homely directness, a complete absence of anything like pose or affectation, which more than doubled her power, and was the more charming in a woman of such brilliant acquirements and—to quote once more Dean Stanley’s words—such “commanding genius”; but, then, genius is of its nature opposed to all that is sentimental or artificial.

I believe it is in her “Notes on Nursing for the Labouring Classes” that she writes to those who are “minding baby”: “One-half of all the nurses in service are girls of from five to twenty years old. You see you are very important little people. Then there are all the girls who are nursing mother’s baby at home; and in all these cases it seems pretty nearly to come to this, that baby’s health for its whole life depends upon you, girls, more than upon anything else.” Simple rules, such as a girl of six could understand, are given for the feeding, washing, dressing, nursing, and even amusement of that important person, “baby.”

And it is in her best known book of all that she says: “The healthiest, happiest, liveliest, most beautiful baby I ever saw was the only child of a busy laundress. She washed all day in a room with the door open upon a larger room, where she put the child. It sat or crawled upon the floor all day with no other playfellow than a kitten, which it used to hug. Its mother kept it beautifully clean, and fed it with perfect regularity. The child was never frightened at anything. The room where it sat was the house-place; and it always gave notice to its mother when anybody came in, not by a cry, but by a crow. I lived for many months within hearing of that child, and never heard it cry day or night. I think there is a great deal too much of amusing children now, and not enough of letting them amuse themselves.”

What, again, could be more useful in its simplicity than the following, addressed to working mothers:—

“DEAR HARD-WORKING FRIENDS,—I am a hard-working woman too. May
I speak to you? And will you excuse me, though not a mother?

“You feel with me that every mother who brings a child into the
world has the duty laid upon her of bringing up the child in
such health as will enable him to do the work of his life.

“But though you toil all day for your children, and are so
devoted to them, this is not at all an easy task.

“We should not attempt to practise dressmaking, or any other
trade, without any training for it; but it is generally
impossible for a woman to get any teaching about the management
of health; yet health is to be learnt....

“The cottage homes of England are, after all, the most
important of the homes of any class; they should be pure in
every sense, pure in body and mind.

“Boys and girls must grow up healthy, with clean minds and
clean bodies and clean skins.

“And for this to be possible, the air, the earth, and the water
that they grow up in and have around them must be clean. Fresh
air, not bad air; clean earth, not foul earth; pure water,
not dirty water; and the first teachings and impressions that
they have at home must all be pure, and gentle, and firm. It
is home that teaches the child, after all, more than any other
schooling. A child learns before it is three whether it shall
obey its mother or not; and before it is seven, wise men tell
us that its character is formed.

“There is, too, another thing—orderliness. We know your daily
toil and love. May not the busiest and hardest life be somewhat
lightened, the day mapped out, so that each duty has the same
hours?...

“Think what enormous extra trouble it entails on mothers when
there is sickness. It is worth while to try to keep the family
in health, to prevent the sorrow, the anxiety, the trouble of
illness in the house, of which so much can be prevented.

“When a child has lost its health, how often the mother says,
‘Oh, if I had only known! but there was no one to tell me. And
after all, it is health and not sickness that is our natural
state—the state that God intends for us. There are more people
to pick us up when we fall than to enable us to stand upon
our feet. God did not intend all mothers to be accompanied by
doctors, but He meant all children to be cared for by mothers.
God bless your work and labour of love.”

Dec 16/96 10 South Street Park Lane W

Dear Duke of Westminster

Good speed to your noble effort in favour of District Nurses for town “& Country”; and in Commemoration of our Queen who cares for all.

We look upon the District Nurse, if she is what she should be, & if we give her the training she should have, as the great civilizer of the poor, training as well as nursing them out of ill health into good health (Health Missioness), out of drink into self control but all without preaching, without patronizing—as friends in sympathy.

But let them hold the standard high as Nurses.

Pray be sure I will try to help all I can, tho’ that be small, here I will with your leave let you know.

Pray believe me your Grace’s faithful servant

Florence Nightingale]

Or in a widely different field, in that fight against one of the most important causes of consumption, in which she was so far ahead of her time, what could be more clear and convincing, both in knowledge and in reasoning, than the following analysis with regard to army barracks:—

“The cavalry barracks, as a whole, are the least overcrowded,
and have the freest external movement of air. Next come
the infantry; and the most crowded and the least ventilated
externally are the Guards’ barracks; _so that the mortality
from consumption, which follows the same order of increase in
the different arms, augments with increase of crowding and
difficulty of ventilation_.”[18]

Her own well-trained mind was in extreme contrast with the type of mind which she describes in the following story:—

“I remember, when a child, hearing the story of an accident,
related by some one who sent two girls to fetch a ‘bottle of
sal volatile from her room.’ ‘Mary could not stir,’ she said;
‘Fanny ran and fetched a bottle that was not sal volatile, and
that was not in my room.’”

All her teaching, so far as I know it, is clearly at first-hand and carefully sifted. It is as far as possible from that useless kind of doctrine which is a mere echo of unthinking hearsay. For instance, how many sufferers she must have saved from unnecessary irritation by the following reminder to nurses:—

“Of all parts of the body, the face is perhaps the one which
tells the least to the common observer or the casual visitor.

“I have known patients dying of sheer pain, exhaustion, and
want of sleep, from one of the most lingering and painful
diseases known, preserve, till within a few days of death,
not only the healthy colour of the cheek, but the mottled
appearance of a robust child. And scores of times have I heard
these unfortunate creatures assailed with, ‘I am glad to see
you looking so well.’ ‘I see no reason why you should not live
till ninety years of age.’ ‘Why don’t you take a little more
exercise and amusement?’—with all the other commonplaces with
which we are so familiar.”

And then, again, how like her it is to remind those who are nursing that “a patient is not merely a piece of furniture, to be kept clean and arranged against the wall, and saved from injury or breakage.”

She was one of the rare people who realized that truth of word is partly a question of education, and that many people are quite unconscious of their lack of that difficult virtue. “I know I fibbs dreadful,” said a poor little servant girl to her once. “But believe me, miss, I never finds out I have fibbed until they tell me so!” And her comment suggests that in this matter that poor little servant girl by no means stood alone.

She worked very hard. Her books and pamphlets[19] were important, and her correspondence, ever dealing with the reforms she had at heart all over the world, was of itself an immense output.

Those who have had to write much from bed or sofa know only too well the abnormal fatigue it involves, and her labours of this kind seem to have been unlimited.

How strongly she sympathized with all municipal efforts, we see in many such letters as the one to General Evatt, given him for electioneering purposes, but not hitherto included in any biography, which we are allowed to reproduce here:—

“Strenuously desiring, as we all of us must, that
_Administration_ as well as Politics should be well represented
in Parliament, and that vital matters of social, sanitary,
and general interest should find their voice, we could desire
no better representative and advocate of these essential
matters—matters of life and death—than a man who, like
yourself, unites with almost exhaustless energy and public
spirit, sympathy with the wronged and enthusiasm with the
right, a persevering acuteness in unravelling the causes of the
evil and the good, large and varied experience and practical
power, limited only by the nature of the object for which it is
exerted.

“It is important beyond measure that such a man’s thoughtful
and well-considered opinions and energetic voice should be
heard in the House of Commons.

“You have my warmest sympathy in your candidature for Woolwich,
my best wishes that you should succeed, even less for your
own sake than for that of Administration and of England.—Pray
believe me, ever your faithful servant,

“FLORENCE NIGHTINGALE.”

And also the following letter written to the Buckinghamshire County Council in 1892, begging them to appoint a sanitary committee:—

“We must create a public opinion which will drive the
Government, instead of the Government having to drive us—an
enlightened public opinion, wise in principles, wise in
details. We hail the County Council as being or becoming one
of the strongest engines in our favour, at once fathering and
obeying the great impulse for national health against national
and local disease. For we have learned that we have national
health in our own hands—local sanitation, national health.
But we have to contend against centuries of superstition and
generations of indifference. Let the County Council take the
lead.”

And how justly, how clearly, she was able to weigh the work of those who had borne the brunt of sanitary inquiry in the Crimea, with but little except kicks for their pains, may be judged by the following sentences from a letter to Lady Tulloch in 1878:—

“MY DEAR LADY TULLOCH,—I give you joy, I give you both joy, for
this crowning recognition of one of the noblest labours ever
done on earth. You yourself cannot cling to it more than I do;
hardly so much, in one sense, for I saw how Sir John MacNeill’s
and Sir A. Tulloch’s reporting was the salvation of the army in
the Crimea. Without them everything that happened would have
been considered ‘all right.’

“Mr. Martin’s note is perfect, for it does not look like an
afterthought, nor as prompted by others, but as the flow of a
generous and able man’s own reflection, and careful search into
authentic documents. Thank you again and again for sending it
to me. It is the greatest consolation I could have had. Will
you remember me gratefully to Mr. Paget, also to Dr. Balfour?
_I look back upon these twenty years as if they were yesterday,
but also as if they were a thousand years._ Success be with us
and the noble dead—and it has been success.—Yours ever,

“FLORENCE NIGHTINGALE.”

We see from this letter how warmly the old memories dwelt with her, even while her hands were full of good work for the future.

The death of Lord Herbert in 1868 had been a blow that struck very deeply at her health and spirits.

In all her work of army reform she had looked up to him as her “Chief,” hardly realizing, perhaps, how much of the initiating had been her own. Their friendship, too, had been almost lifelong, and in every way ideal. The whole nation mourned his loss, but only the little intimate group which centred in his wife and children and those dearest friends, of whom Miss Nightingale was one, knew fully all that the country had lost in him.

It may be worth while for a double reason to quote here from Mr. Gladstone’s tribute at a meeting held to decide on a memorial.

“To him,” said Gladstone, “we owe the commission for inquiry
into barracks and hospitals; to him we are indebted for the
reorganization of the medical department of the army. To him
we owe the commission of inquiry into, and remodelling the
medical education of, the army. And, lastly, we owe him the
commission for presenting to the public the vital statistics of
the army in such a form, from time to time, that the great and
living facts of the subject are brought to view.”

Lord Herbert had toiled with ever-deepening zeal to reform the unhealthy conditions to which, even in times of peace, our soldiers had been exposed—so unhealthy that, while the mortality lists showed a death of eight in every thousand for civilians, for soldiers the number of deaths was seventeen per thousand. And of every two deaths in the army it was asserted that one was preventable. Lord Herbert was the heart and soul of the Royal Commission to inquire into these preventable causes, and through his working ardour the work branched forth into four supplementary commissions concerning hospitals and barracks. When he died, Miss Nightingale not only felt the pang of parting from one of her oldest and most valued friends, but she also felt that in this cause, so specially dear to her heart, she had lost a helper who could never be replaced, though she dauntlessly stood to her task and helped to carry on his work.