![]() ![]() She herself used the word “coxcomb” to refer not to this sort of chart but to the short reprints of an annex containing diagrams, text and tables abstracted from the Royal Commission report, of which 2000 copies were printed and distributed to important people. The chart shown here 1 comes from one of her own monographs 2 and is of a type now commonly known as “Nightingale's rose” or “Nightingale's coxcomb”. A fact that does not receive a mention in my son's Ladybird book is that in 1858 Nightingale became the first woman to be elected a Fellow of the Statistical Society of London, as the Royal Statistical Society was then known. Nightingale also sent a letter to the 1860 International Statistical Congress advocating the uniform collection of hospital statistics-the proposal was adopted by the congress-and tried, unsuccessfully, to get questions on health and housing added to the census. The pair were instrumental in setting up a royal commission of inquiry into sanitary conditions during the Crimean war. By showing that even in peacetime a soldier faced twice the risk of dying in a given year as a civilian, she campaigned successfully for better conditions in barracks. He was the first to compile “mortality tables”, listing causes of death in the general population she later compared his numbers with her own on the deaths of soldiers to great effect. Just a few months after her return from the Crimea Nightingale met William Farr, the Compiler of Abstracts in the General Registry Office, at a dinner party. (Charles Dickens's portrait of the inebriated and awful nurse Sarah Gamp in Martin Chuzzlewit was not too much of an exaggeration.) But she is perhaps better understood as one of the social and health reformers of the time who appreciated the value of data in working out what to do and persuading others of the rightness of one's cause. Nightingale truly is the mother of modern nursing: she created the first training programme for nurses and changed the image of nursing from that of a low-class job for, not to put too fine a point on it, drunks to that of a noble vocation. What killed far more of them was what she called “Preventible or Mitigable Zymotic Diseases”-and what we would call infections. This meant that when she returned to London she was able to prove to those who believed that dying was just what soldiers did during wars that in fact wounds had killed rather few of the soldiers. When she arrived she discovered that no one was keeping track of admissions, deaths or causes of death she started to do so. What she did do, however, was to keep meticulous records. ![]() All of that was no doubt true but beside the point considering that cholera and dysentery were rife and neither she nor anyone else knew how these diseases were transmitted. Nightingale knew, by and large, that it was not their wounds that were killing the soldiers in Scutari, but she thought they were dying because they were ill-fed, ill-clothed and had been overworked. And his use of carbolic acid as a disinfectant failed to catch on for another decade at least-and more slowly in Britain than in many other places. It was not until the 1860s that James Lister started his pioneering work on antisepsis at Glasgow Infirmary-and it was not until 1865, when he read of Louis Pasteur's hypothesis that sepsis was caused by tiny airborne particles, that he actually succeeded in cutting post-operative deaths previously, around half of his patients had died from infection after operations. ![]() #Who was florence nightingale free#Wounds were to be kept free of infection by stopping air coming into contact with them-sepsis was thought to be a kind of combustion. ![]() The generally accepted theory of the day was that diseases like cholera were caused by bad air-“miasma” or “effluxions” or somesuch. And Nightingale did not “disinfect” the wards because the very idea had not been invented. The reason those contemptible doctors did not practise antiseptic medicine is that they did not know why it mattered-or even what it was. And, looking at it again, I am rather taken by its feminist message: those dreadful doctors apparently had no chance against “one of the most determined women who ever lived”. Now that I come to think of it, it may even be the same book. That is pretty much the same Florence Nightingale story I read myself as a child. © National Portrait Gallery, London, with thanks. Florence Nightingale, photo by William Edward Kilburn circa 1856. ![]()
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