Author: Gravedigger Page 1 of 20

In 1853 the Ottoman Empire was in decline and Russian expansion threatened the balance of power. British and French armies united with the Turks fighting the Russians in Crimea. WH Russell’s journalism, Roger Fenton’s photography, Tennyson’s poetry, and the paintings of Elizabeth Butler, Robert Gibb and Harry Payne fostered a jingoistic enthusiasm for the war in Britain such that Alma, Balaklava, and Inkerman still feature as street names today.

Against this background Florence Nightingale emerged as a national heroine, venerated by Victorians as The Lady with the Lamp.

Nightingale (1820-1910) was born into a wealthy British family. She believed, as significant numbers of Victorians did, that she was called by god to serve others. Her decision to realise this through nursing was strongly, and unsurprisingly, opposed by her family. “Nurses” at this time were not far removed from the caricature of Sarah Gamp presented by Dickens in Martin Chuzzlewit: untrained, incompetent, negligent and often drunk. Hospitals were filthy places with straw spread on the floors, as it might be in an old butcher’s shop, to soak up blood.

Nightingale however managed to acquire some medical training at a Lutheran religious community in Germany where the deaconesses worked with the sick. In 1853, through social connections, she was appointed Superintendent of the Institute for the Care of Sick Gentlewomen in Upper Harley Street.

In 1854 Sidney Herbert, the Secretary of State for War, who knew Nightingale well, appointed her to lead a staff of thirty-eight women volunteer nurses at the military hospital in Scutari. Here she found the wounded being treated in horrific conditions with shortage of medicines, hygiene neglected, overworked staff, overcrowding, lack of ventilation, poor nutrition, and rampant infections. Ten times as many soldiers were dying from typhus, typhoid, cholera, and dysentery as from battle wounds.

Five days after her arrival the injured from the battles of Balaklava and Inkerman appeared at the hospital. Nightingale instituted practical measures: cleaning, hand washing, bathing patients, improved nutrition.

The improved hygiene may have reduced the death rate, but the latter remained high until the British Government set out a sanitary commission. Realising that the hospital was built over defective sewers and patients were drinking contaminated water, they flushed out the sewers and improved ventilation. The mortality rate then fell substantially, but not as dramatically as reported at the time since the government concealed accurate figures to avoid criticism.

Meanwhile the media of the day romanticised and arguably exaggerated Nightingale’s achievements. William Russell in The Times:

She is a “ministering angel” without any exaggeration in these hospitals, and as her slender form glides quietly along each corridor, every poor fellow’s face softens with gratitude at the sight of her. When all the medical officers have retired for the night and silence and darkness have settled down upon those miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds.

A portrait of her with her lamp appeared in The Illustrated London News and Henry Wordsworth Longfellow immortalised her in Santa Filomena, a sentimental and moralising poem which enjoyed great popularity:

Lo! In that house of misery

A lady with a lamp I see

              Pass through the glimmering of the gloom

              And flit from room to room.

Lytton Strachey, a man not given to hyperbole, nor to bad poetry, nonetheless praised Nightingale in his book Eminent Victorians which debunked other nineteenth century heroes. His more judicious reasoning suggesting that her achievements were as admirable as her personality was intolerable. The Lady with the Lamp was stubborn and opinionated, he claimed, but these qualities were needed to realise improvements at Scutari.

Although she is most remembered for her time in the Crimea, Nightingale’s achievements when she returned home after the war were greater. In 1860 she set up the first secular training school for nurses at St. Thomas’ Hospital in London. She insisted on autonomous nursing leadership with matrons having full control of their staff, to the chagrin of doctors who saw their authority threatened. The hierarchical structure which she instituted, influenced by her contact with the army, undoubtedly alienated some potential nurses. Yet the teaching hospitals transformed nursing into a respectable, and respected, profession.

Nightingale turned her attention not only to the sanitary design of hospitals but also to working class homes. Working with the sanitary reformer Edwin Chadwick she produced statistical models highlighting the causes of mortality. Their mutual commitment to adequate drainage reduced the death rate. A pioneer statistician, Nightingale produced the so called rose diagrams, a type of pie chart, summarising their research in a form which could be quickly understood and used to put pressure on government to introduce reforms.

Nightingale was lauded by the press, received awards and decorations including the Order of Merit, and offered a burial in Westminster Abbey which in accordance with her prior request her family declined. She is buried in St. Margaret’s churchyard, East Wellow, Hampshire near her family home.

But Nightingale was not the only woman whose fame rested largely on her activities in the Crimea. Mary Seacole (1805-1881) was born in Jamaica where her mother ran a boarding house and convalescent home for military and naval staff. She was also a “doctress”: a woman who treated the sick with traditional Caribbean and African herbal medicines. Seacole worked alongside her mother, sometimes providing nursing assistance at the British Army Hospital.

In 1851 while visiting her brother in Panama she helped to treat victims of an outbreak of cholera. Spotting a business opportunity in Panama, where gold prospectors were passing to and from California, she opened the British Hotel and Restaurant to cater for them.

Seacole travelled to England initially to deal with investments which she had acquired in gold mining businesses. She then applied to the War Office to join the second contingent of nurses going to the Crimea, but the full complement had already been secured. She appealed to the trustees of the Crimea Fund, established to support the wounded in Crimea, for sponsorship to travel there but was refused. Seacole suspected a lack of appreciation of her skills as a doctress and an element of racism in this refusal:

In my country, where people know our use, it would have been different; but here it was natural enough…that they should laugh, good-naturedly enough, at my offer….Was it possible that American prejudices against colour had some root here? Did these ladies shrink from accepting my aid because my blood flowed beneath a somewhat duskier skin than theirs? (1)

Seacole used her own resources to travel to Crimea where she opened the New British Hotel at Balaclava in 1855 aiming to provide food and accommodation for sick and convalescent officers. The French chef, Alexis Soyer, who had come to Crimea to help improve the diet of British soldiers, advised her to concentrate on a food and beverage service as the officers slept on their ships or in camp.

For the duration of the war, Seacole combined a successful catering business with medical aid to the wounded. She served officers in the British Hotel and sold provisions near the British camp. After supplying food and drink to spectators who came to view the battles from Cathcart’s Hill, she would head for the battlefield to nurse the casualties.

WH Russell wrote:

She was a warm and successful physician, who doctors and cures all manner of men with extraordinary success. She is always in attendance near the battlefield to aid the wounded and has earned many a poor fellow’s blessing. (2)

“Mother Seacole” as she became known to the soldiers.

out of the goodness of her heart and at her own expense, supplied hot tea to the poor sufferers (wounded men being transported from the peninsula to the hospital at Scutari) while they are waiting to be lifted into the boats…She did not spare herself if she could do any good to the suffering soldiers. In rain and snow, in storm and tempest, day after day she was at her self-chosen post with her stove and kettle, in any shelter she could find, brewing tea for all who wanted it, and there were many. (3)

But Seacole did much more than provide tea; equipped with lint, bandages, needles, and thread she tended to the wounds of soldiers, prepared medicines, and performed minor surgery. (4)

When the war ended and the soldiers left Crimea, Seacole faced financial difficulties with provisions she could no longer sell and creditors demanding payment. But such was her celebrity and popularity that when she returned to England a fund supported by many military men was set up on her behalf.

Mary Seacole continued to travel and in 1857 published her autobiography, The Wonderful Adventures of Mrs. Seacole in Many Lands.

In 1860 she had converted to Catholicism, and when she died, she was buried in St. Margaret’s Roman Catholic Cemetery in Kensal Green.

But while Nightingale’s fame endured after her death, Seacole was all but forgotten for a century, until in 1973 her grave was rediscovered and restored by the Jamaican Nurses Association. A memorial service was held on the centenary of her death in 1981.

 In the 21^st century Seacole has achieved more prominence, and since 2007 she has featured on the national curriculum alongside Florence Nightingale.

And then there is Mary Anne Bulkley (1789-1865), more commonly known as James Barry, army surgeon and Inspector General of Military Hospitals, whose passion for improved sanitation rivalled that of Nightingale, and whose emphasis on the importance of good diet surpassed that of Seacole.

Barry was born in Cork and assumed male identity in 1809 when she entered the medical faculty of Edinburgh university, where she would not at that time have been admitted as a woman. She came close to being banned from taking her final exams, not on the suspicion that she was a woman but that her delicate appearance indicated that she was underage. Only the intervention of an influential family friend secured her graduation.

She went on to qualify in surgery at St Thomas’ and Guy’s Hospital and became an army surgeon. Her career was marked by remarkable success and frequent promotions with postings all over the empire, interspersed with violent clashes with fellow surgeons, military officers and officials leading on one occasion to a duel, followed by arrest and demotion.

In Cape Town she became the Colonial Medical Inspector, and it was there that she performed one of the first successful Caesarean sections.

Throughout her career she was concerned with the welfare of the poor and underprivileged, and of rank-and-file soldiers. And from this sprang her obsession with clean water, spotless wards, sterile instruments, improved sanitation, and healthy diet.

Though her professional skill was never in doubt, she earned a reputation for being tactless, impatient, argumentative, imperious, and opinionated.

During the Crimean war she ran a hospital for convalescent soldiers in Corfu, as always putting emphasis on the paramount importance of hygiene, clean hands, and instruments. The hospital had some of the highest recovery rates of the conflict.

Soon after, in 1859, Barry was forcefully retired on the grounds of old age and ill health.

She had left instructions that there should be no examination of her body after death, that she should not be washed, but buried in the clothes she died in wrapped in her bedsheets. Nonetheless her landlady summoned a woman to lay out the body. On discovering that Barry was a woman the latter approached DR McKinnon, Barry’s own physician, hoping to be paid for her silence. When McKinnon refused saying that Barry’s sex was none of his business, she took her story to the press.

There resulted the prurient speculation which McKinnon, and others who had known of Barry’s sex, had sought to avoid. Fortunately, as McKinnon pointed out, there was no family to be distressed by this.

Barry was buried in Kensal Green but when I visited recently the grave looked a little forlorn and forgotten. It features in the cemetery guide produced by the Friends of Kensal Green but is not easy to find and was more overgrown than I remembered from earlier visits.

Barry does not feature on the national curriculum.

And Did The Three Ladies of the Crimea Ever Meet?

Nightingale and Seacole did meet in Scutari, when Seacole was en route to Crimea, and sought a bed for the night. Seacole recorded that one of Nightingale’s colleagues had rebuffed her thinking she sought to join their group, and she inferred that racism was at the root of the rebuttal. But later when Seacole was packing up to leave Crimea she told Soyer,

You must know, M Soyer, that Miss Nightingale is very fond of me. When I passed through Scutari, she very kindly gave me board and lodging.

When Soyer related this to Nightingale, she replied,

I should like to see her before she leaves, as I hear she has done a deal of good work for the poor soldiers. (5)

And yet, Nightingale did not want her nurses associating with Seacole, as she wrote to her brother-in-law, that although

She was very kind to the men and, what is more, to the Officers -and did some good, (she) made many drunk.

She added that Seacole kept “a bad house” in Crimea and that,

I had the greatest difficulty in repelling Mrs. Seacole’s advances, and in preventing association between her and my nurses (absolutely out of the question!). Anyone who employs Mrs. Seacole will introduce much kindness – also much drunkenness and improper conduct. (6)

Relations between Nightingale and Barry were even more fraught during their one recorded meeting. When Barry visited the hospital at Scutari in her role as Inspector General of Army Hospitals she was not impressed by the standards of hygiene and lectured Nightingale on the subject in the presence of her subordinates. For Nightingale who prided herself so much on the improvements which she had made in hygiene at Scutari this must have been particularly galling. After Barry’s death Nightingale wrote, in a letter fairly dripping with rage, and with a wild assortment of personal pronouns in parentheses,

I never had such a blackguard rating in all my life – I who have done more than any woman – from this Barry sitting on (her) horse, while I was crossing the Hospital Square, with only my cap on, in the sun. (He) kept me standing in the mist of quite a crowd of soldiers, commissariat servants, camp followers, etc etc, every one of whom behaved like a gentleman, during the scolding I received, while (she) behaved like a brute. After (she) was dead, I was told (he) was a woman. I should say (she) was the most hardened creature I ever met. (6)

There is no record of Seacole and Barry ever meeting.

And Today?

There are arguments that Seacole’s knowledge of medicine, her skills and her contribution to nursing surpassed those of Nightingale (7) whose work has been more critically reviewed in recent times. Yet others defend Nightingale’s achievements passionately, regarding Seacole as little more than a kind-hearted businesswoman. (8). The erection of a bronze statue of Seacole outside St. Thomas’ Hospital in 2016 proved controversial since the hospital is associated particularly with Nightingale.

What is certain is that soldiers in the Crimea had reason to be grateful to both The Lady with the Lamp and to Mother Seacole – and to James Barry too.

1. Mary Seacole, The Wonderful Adventures of Mrs. Seacole in Many Lands
2. The Times, 20 September 1855
3. National Library of Jamaica, Mary Seacole
4. Mark Bostridge, Ministering on Distant Shores in The Guardian, 14 February 2004
5. Alexis Soyer, Soyer’s Culinary Campaign, Routledge 1857
6. Letters in Wellcome Institute
7. Jane Robinson, Mary Seacole: The Black Woman who Invented Modern Nursing. Mark Bostridge, Ministering on Distant Shores
8. Lynn McDonald, cofounder Nightingale Society