At Old St. Thomas's -- December 8

In anticipation of my Conversation to benefit the Old Operating Theatre and Herb Garret in London, which will take place in Zoom on December 8 at 7pm British time, I am posting here about the history of the old hospital and its time in Surrey Gardens. I will be talking about some of this during my presentation. This is a re-post from March of 2020, as I was starting to write the book. Enjoy!


St. Thomas’s Hospital at the Zoo

The cholera ward, of course, was in the giraffe house…

In my recent researches of St. Thomas’s Hospital, Southwark, I have discovered an unusual episode, a time when the hospital went to the zoo.

St. Thomas’s Hospital was located on Borough Street in Southwark from the medieval period until 1862. (What remains of it, the Old Operating Theatre Museum and Herb Garret, is my all-time favourite museum in London.) At that time, the railway was forcing itself through the area as companies competed with each other. The proposed railway went right through the heart of the hospital grounds. So in 1862 the hospital was sold to the railway company, for £296,000, according to this.

 

Guy’s and St. Thomas’ Hospitals shown on “Improved map of London for 1833, from Actual Survey. Engraved by W. Schmollinger, 27 Goswell Terrace”

‘St Thomas’s Hospital 1860’, aerial view. Credit: Wellcome Library, London. Wellcome Images, Roberts, G.Q., A brief history of St Thomas’s Hospital (1920)

 

A new hospital site was arranged to be built where most of it still stands, in Lambeth, across from the Houses of Parliament. But this site wasn’t complete until 1871.

 

View of St Thomas’s Hospital with plan taken from Henry Currey’s, St. Thomas’s Hospital, London. [London] : [Royal Institute of British Architects], 1871 [St Thomas’s Historical Books Collection PAMPH. BOX RA988.L8 T1 CUR]

Most sources skip over this gap. Where did the hospital go in the meantime, for nine years?

 

It went to Surrey Gardens, in Newington, Walworth, in September 1862. Surrey Gardens had been a pleasure garden, like Vauxhall. It had a zoo. But as business declined, the animals were sold off to build a huge music hall. The hall was gutted by fire in 1861, which coincidentally led to a court case that determined you cannot hold someone to a contract when it’s impossible to fulfill it (in this case, a concert reserved for a burnt-out hall).

St. Thomas’s Hospital decided to lease the whole property, repaired the building, and repurposed some of the zoo.

I’ve been looking for histories and records of St. Thomas’ Hospital to learn more about the situation at Surrey Gardens. The St Thomas’s Hospital Report of 1867 is available, for some reason, at Google Books. Amputation fatalities, I discovered, were lower at the new location.

[Aside: there were also some figures in the Report tables that seem odd to me. How could the average stay in hospital for an ankle sprain be 11 days (p602)? This made me wonder whether one had to stay in hospital to be allowed off work, or whether people really had no one at home to take care of them (or no home — quite possible in a poor neighborhood), or whether ankle sprains were for some reason more serious then? Four men and four women had sprained their ankle that year, and the average stay was 11 days? Perhaps they had more wrong with them than a sprained ankle.]

The giraffe house really was the cholera ward, and the old elephant house was used for dissections. That piece of information comes from a book about Florence Nightingale, who was a big part of all this. She had opened her first nursing school at Old St. Thomas’ only two years before the move, and helped provide for room and board for nurses at the hospital. She also helped design the new Lambeth hospital for maximum light, ventilation, and separation of patients into pavilions. [And she promoted hand-washing as the best anti-infective, as true now as it was in 1860.]

The Illustrated London News of December 1862 (copy available at HathiTrust) features a quick column on how the facilities at Surrey Gardens boasted the “rapid and complete conversion of the old buildings to their new and beneficent uses”, and imagined the gardens would provide a unique opportunity for medical students to stroll and contemplate. Nightingale, who believed in patient access to the outdoors, would have approved this. She wrote a letter to Henry Bonham Carter (her cousin and the Secretary of the Nightingale Fund) on the advantages of temporary buildings for hospitals, but it isn’t available online.

The 9-year relocation gets only a single-sentence mention in Wikipedia. That’s a shame. It seems like such an interesting interlude.

Never on Sunday

or at least not until the 1890s at the National Gallery.

Deeply embedded in the plot of Murder at an Exhibition (recently released) is the idea that the National Gallery in London was closed on Sundays. The murder victim has special permission to be there on Sundays, and is murdered there on the quiet. The action takes place in 1863.

As a fiction writer, I admit to keeping much rougher notes than I do as a historian. I had looked through a couple of guidebooks of the era, and had confirmed, to my satisfaction, that the gallery was open six days a week, with four for the public and two for students only (which two days differed by guidebook, strangely). No source mentioned Sundays, so I kept writing.

Then a wrench appeared in the works.

I love how many free lectures there have been during the pandemic, and I recently attended one about the Victorian art world. The speaker noted that in 1845, the National Gallery opened on Sundays to encourage working people, who worked six days a week. The speaker also said that the grubbiness of the working people caused problems, leading to a Select Committee meeting in 1850.

The speaker used this image:

This shows working men viewing pictures at the gallery in 1870. I know that the National Gallery offered many free days, so there’s no reason this had to be on a Sunday. But it made me uncomfortable. Her talk led me to believe that perhaps the National Gallery had been open on Sundays in 1863, ruining my story.

Members of the Facebook group for the Historical Novel Society helped me out, not just with their own information but their encouragement to contact the National Gallery, where a wonderful assistant actually sent me their record of opening hours for their whole history as they knew it. No Sundays in 1863.

But the speaker had been so sure. Could there have been a trial run? I researched through Hansard, which has the debates of the House of Commons, and found much arguing about opening both the National Gallery and the British Museum on Sundays, but no conclusion. So I posted at the Victoria listserv, a place where every Victorianist who’s anybody meets up. Several members helpfully responded with books and records. I’m now 99.9% sure the Gallery was closed.

Yes, I know, if it’s this much trouble for me to confirm, I should be comfortable just showing it was closed on Sundays. It’s a fictional work, not a research project. Except that all my fictional works are research projects. Whether it’s important to the reader or not, it is ridiculously important to me that the facts be accurate, and if they’re not accurate then I’d better have a damned good reason why, and an Author’s Note. That’s just how I roll.

On Victorian female painters

I have been notoriously lax in my advancement of the feminist cause. I just assume that women were far more active historically than they have been portrayed. Those who control the media control the message. But at the same time I do notice when women have important public roles to play, and in writing fiction I have made sure that my Victorian females have a great deal of agency.

That’s not wishful thinking. It’s simply that the ordinary academic practice of history tends to believe its sources, without looking at all of them. That’s human. So I just want to say up front, it takes quite a bit to get my feminist hackles up. I’m a humanist.

But as I look into the Pre-Raphaelites, I have found myself getting annoyed with the focus on the men. Rossetti, Burne-Jones, Millais — there are women who took their names, but they are seen as muses alone. No one says “Rossetti” and means Christina, Dante Gabriel’s highly published and respected poet sister. No one says Millais and means Lady Millais, or “Burne-Jones” and means Georgina, an accomplished artist, or “Morris” and means Jane, a talented embroiderer. Why, when most of them published or exhibited their own work? I’m not even sure the men themselves saw them as sidelines — there is much evidence of respect and collaboration. And yet in most of the books, the men’s work is emphasized, and the women’s downgraded. Most of the explorations of the women’s work are recent, like Jan Marsh’s Pre-Raphaelite Sisters, or the National Portrait Gallery exhibit.

For inspiration and amusement, I’ve been looking at the portrayal of the Pre-Raphaelites in cinema and television, so I’m watching Desperate Romantics. It was made in 2009, not exactly a bad time for feminism. But even there, little mention is made of anything the women themselves created or exhibited. I realize it’s set early (1850s), but the writer didn’t even imbue them with any ambition.

Jane Morris embroidery

by Georgiana Burne-Jones

Clerk Saunders, by Elizabeth Siddall

I thought perhaps I’d look into their lives a bit, see whether they would make good characters in my book, or whether the tale I’ll tell could be through their eyes, instead of the men’s. I don’t know much about the art history of this period, so I’m investigating. My book is set in 1863, so I thought I’d see what the Royal Academy of Arts was doing then. I found The Royal Summer Exhibition: A Chronicle, a great resource that for 1863 discussed several of the key works including Millais, comparing his dark work in The Eve of St Anges to the lightness of a painting by Edward Matthew Ward. And then I saw in the Context section:

For some critics, Henrietta Ward’s picture of Mary Queen of Scots surpassed her husband’s efforts, and the Mutrie sisters were described as “still supreme among flower-painters”.

Who’s Henrietta Ward? I tried to search her by name and “Mary Queen of Scots”. I found an engraving from the Illustrated London News of it, but not the painting. So then I found the Royal Academy of Arts catalogue for that exhibition on HathiTrust. I wondered whether she’d be listed like the male painters, as “H. Ward”. I found the work, and her name as “Mrs. E. M. Ward”, and she had half a dozen works in the exhibition. I looked her up at the NPG, but there’s not a lot there. I found a review in the Athaeneum, which said:

They used “Mrs.” but referred to the artist as a male. How strange.

I thought I’d pick at random another female, since they are so clever indicated with “Miss” and “Mrs.” Item 571, Always welcome, by Mrs. J. F. Pasmore. Started searching on Google. “Mrs. J. F. Passmore painting 1863”. Very frustrating. I had spelled the name wrong. Then I stumbled on this at an antiques dealer site:

And here’s the description:


Middle initial and last name spelling confusion aside, she “also exhibited paintings”? Hers is in the Royal Academy exhibition, but I can’t find a copy of Always welcome online (there are plenty of paintings around by John F., mostly for sale). And this website attributes the above painting to him anyway, not her. So now I don’t know what to think. Maybe this is just a picture of her.

I don’t like to class everyone together: all women, all men. Some women had extraordinary power, both in the home and out of it. Others were taken advantage of. This sort of problem makes one wonder whether it’s the sources or the perception. Looking at the sources, I find more and more evidence of women’s agency. But finding those sources seems inordinately difficult.

 

 

Mystery tropes

I watch quite a few British/Canadian/Australian mysteries on television, so much so that I’ve been keeping a list of tropes. A lot of mystery programs (Midsomer Murders, Death in Paradise, Father Brown, Murder She Hoped, even the Kiwi series Brokenwood Mysteries) have similar settings for murder.

For example, there’s the one at the flying school, the one at the dance competition, the one with chefs in a restaurant, the one with the amateur theatre group. People get murdered when checking into health spas, joining hunting parties, and (gulp) attending author book signings. Sometimes there’s an unusual arrangement assumed to be a motive: the breakup of the band, the tontine (where whoever hasn’t died inherits everything), the dinner to which everyone was invited individually.

Back in the fourth grade, I gave up cursive writing and pens, only using either when it was required. I am trying now to revive both, with a fountain pen, a lovely journal given me by a friend, and mystery plots and ideas. Here’s the first page of tropes (please bear with my handwriting, obviously):

What this creates is a treasure trove of settings and/or a list of what to either imitate or avoid when writing a story. For me, it’s helpful to see the patterns. Many of these seem designed to limit the number of possible suspects. For example, if you have a murder at a music festival, there could be thousands of suspects. How does your detective narrow down? If one of the organizers is killed, they will tend to cast their gaze on the other organizers rather than attendees. This may or may not work, but it allows a lot of people to go home.

Since this is not how I write my mysteries, which sort of grow organically, it’s interesting to see how mysteries can be mass-produced through the recycling of settings.

Luckily, I don’t think that boarded-up operating theatre, the National Gallery, or pneumatic railway are likely to appear on the list any time soon. But about those 19th century health spas . . .

Forthcoming: H.G. Wells on Science Education

Amidst my Victorian mysteries is the book I’ve spent five years putting together: a collection of the writings of H. G. Wells on the subject of science teaching.

Most of the 80 articles in this book have not been republished since they originally appeared in places like The Journal of Education, The University Correspondent, and The Saturday Review. Most of them were written before Wells published The Time Machine and became a well-known author of scientific romances, then later more polemical works and a history of the world. Many of the articles had to be rounded up in different British libraries, including the Bromley Library, the Bodleian in Oxford, the Cambridge University Library, and the British Library in both London and Wetherby.

Herbert George Wells originally wanted to be a science teacher, a difficult goal considering his lower middle class origins. Through independent study, he was able to win grants and scholarships and attend the Normal School of Science (now Imperial College) to study biology under T.H. Huxley. His first published book was not science fiction; it was The Text-book of Biology, volumes one and two, written for the University Correspondence College, where he was a tutor for William Briggs, a pioneer of distance education.

From the time he started at the Normal School until his success as a fiction author over ten years later, Wells was both subject to and wrote critiques about the vagaries of science education. He abhorred cramming for exams instead of gaining knowledge, railed against the continued emphasis on classics over science in the schools, and worried about British educational weakness as compared to other nations. His remarks will seem familiar to many in education today, and of interest to Wells fans, science teachers, students, and Victorianists. They appear in this book transcribed, annotated, and footnoted.

Publication date was September 21, Wells’s birthday. It is my first hard-cover release.

    Buy

At a cost to the economy, 1862

Murder at Old St. Thomas’s is set in London in 1862, which was the year of an Exhibition. Although it was not as beloved as the 1851 Crystal Palace Exhibition, the Great Exhibition of 1862 in London was extraordinary, as I noted in a previous post.

In addition to celebrating industrial and artistic achievement, the Exhibition also hosted meetings of several international groups. This included the International Congress of Charities, Correction and Philanthropy. On June 13, the speaker was Sarah Parker Remond.

A free person of color born in Massachusetts, Remond was anti-slavery from an early age. It is reputed that she made her first speech against the practice when she was 16. Her parents were successful business people. They were active in anti-slavery societies, and made sure their children got a good education, despite the lack of good schools for non-white children.

Sarah was already known as a lecturer for the American Anti-Slavery Society (founded by William Lloyd Garrison) before she was asked to go to London in 1858. Her intention was to get a better education, and she enrolled at the Bedford College for Women while continuing to lecture. While she was there, the American Civil War began.

Her speech at the Exhibition in 1862 emphasized support for emancipation, and by implication the Union blockade against the Confederacy. Britain had declared itself neutral in the conflict, and British ships continued to bring in products to northern ports. She pointed out how the British cotton industry used the products of slaves, although Britain itself had outlawed slavery in 1824. The British Parliament had further passed the Slavery Trade Act of 1873 and were actively involved in confiscating slave ships, but were continuing to benefit from the manufacture of cotton grown by slaves in America. She said,

Let no diplomacy of statesmen, no intimidation of slaveholders, no scarcity of cotton, no fear of slave insurrections, prevent the people of Great Britain from maintaining their position as the friend of the oppressed negro, which they deservedly occupied previous to the disastrous civil war.

This was despite the fact that she recognized that:

Thousands among the commercial, manufacturing, and working classes, on both sides of the Atlantic, are dependent upon cotton for all material prosperity. . .

As the result of the efforts of Remond and others like her, Britain respected the Union blockade of the Southern states. But the result of the decline in raw cotton importation was mill closures and starvation in places like Lancashire. There it’s become known as the Lancashire Cotton Famine.

In 1862, as now, the problem was not just that economic strain had thrown people out of work. It was that there was not enough of a social safety net to provide for them when they lost their jobs. The British government engaged in some compensation experiments, including minor funds distributed directly (similar to today’s stimulus checks), but it was minimal and in many cases never reached the people who needed it. The new Poor Laws had funded workhouses rather than “outdoor” relief to help people at home. Ultimately, some relief occurred when the government provided money to local councils, who then created new opportunities for employment in public works. But that wasn’t until 1864. Before that any efforts were supported primarily by private charity (similar to today’s GoFundMe), partly out of a suspicion of increased government activity*.

In 1862 the issue was the moral culpability involved in profiting from slave labor. Now it is the moral culpability of forcing workers into plague conditions. Jobs that take place indoors have the greatest risk of infection, while those outdoors have the least. Safer jobs could include massive infrastructure repair on America’s roads, bridges, and parks. Designs could be implemented to move commercial, educational, and political enterprises into better ventilated conditions.

Perhaps public works, and a bit of advice from Miss Nightingale (see previous post), might be an answer beyond 1864.

 

____

* Hall, Rosalind. “A Poor Cotton Weyver: Poverty and the Cotton Famine in Clitheroe.” Social History 28, no. 2 (2003): 233.

Editing hours

Editing ones own work is always difficult, but even more so whether there are decisions to be made and things to look up, rather than just errors to fix, in the final pass. For example, in one recent three-hour session, even though I’d already had two professional edits of the novel, I spent time:

  • finding out how I spelled “moustache” in the first book
  • looking up greetings appropriate for an afternoon tea party / art exhibit
  • learning how to force an em-dash to stay with a quotation mark on the same line in Word (you can’t)
  • deciding whether it should be M.P. or MP
  • removing the word “so” everywhere because I use it too much
  • looking up whether they would have called it a comforter in 1863 (yes)
  • changing colloquial phrases (“gone up” to “been increased”)
  • realizing the appalling necessity of a thesaurus

All of which make for a better book. It’s a little different than grabbing a red pen and making some marks, and really shouldn’t be done by someone else. And I admit to some frustration that I missed things, as in “how could I not have caught that on the first four reads?” But it’s all part of the journey.

Was the first female doctor in England a man?

Whenever historians discuss the “first” of anything, they use qualifiers. In the case of the first female doctor in the UK, there might be several candidates, depending on how one qualifies the word “doctor.” The innumerable wise women and healers who made diagnoses and prescribed treatment for centuries may be unknown to history. So we define “doctor” in terms of official qualification and credentials.

The honor of being the first female doctor in the UK thus goes to an extraordinary person, Elizabeth Garrett Anderson. Although she had been refused admissions to the College of Surgeons and Physicians because of her sex, she was admitted to the Worshipful Society of Apothecaries because their rules stated nothing forbidding women (an oversight they remedied shortly afterward). The University of Paris then admitted her to the examination necessary to certify her as a medical doctor in the 1860s.

Before her, one might argue, was Elizabeth Blackwell, the first woman on the UK Medical Register as a practicing physician. She would not have been able to obtain a medical degree but was grandfathered into the Medical Act of 1858.

But there is an even more startling possibility. Dr. James Barry was a famous figure in nineteenth-century military circles. He obtained his medical degree from the University of Edinburgh and might have been prevented from sitting his exams due to his youthful appearance but for the intervention of the Earl of Buchan, who was friends with his tutor.

Portrait of James Barry, Wellcome Collection

Dr. Barry was a good physician, known for an excellent bedside manner, and he became a talented surgeon in the army. He served in South Africa and the Caribbean and performed the first successful European caesarean section in Africa. He became Inspector General in 1857 and traveled the British Empire enforcing sanitation in hospitals.

There is much evidence of Dr. Barry’s personality. He was known for his squeaky voice and violent temper. Florence Nightingale, whom he met in the Crimea, hated him, even though his emphasis on hygiene was as energetic as her own. Others reported that he was quarrelsome in the extreme.

He also never undressed in front of other people. This, and his clean-shaven face, curly hair, and short stature do not appear to have caused much comment among most of his colleagues. Later, however, there were rumors of duels caused by insults about his appearance and the expected posthumous claims that “I always suspected” or “I always knew.”

When he died in 1865 of dysentery, a charwoman named Sophia Bishop laid out his body. This action was against Barry’s known wishes that under no circumstances should his body be disrobed in death. The woman claimed that his body had full female genitalia and stretch marks, indicating a possible pregnancy. Barry’s own doctor, Major D.R. McKinnon, simply refused to care about his patient’s sex, having been called upon to identify the body and sign the death certificate. He had written the sex as male on the certificate. When Bishop told him her observations and tried to get him to pay for her silence, McKinnon famously reported to George Graham of the General Register Office:

The woman seems to think that she had become acquainted with a great secret and wished to be paid for keeping it. I informed her that all Dr Barry’s relatives were dead, and that it was no secret of mine, and that my own impression was that Dr Barry was a Hermaphrodite. But whether Dr Barry was a male, female, or hermaphrodite I do not know, nor had I any purpose in making the discovery as I could positively swear to the identity of the body as being that of a person whom I had been acquainted with as Inspector-General of Hospitals for a period of years.

The army sealed the records, supposedly for a hundred years. Isobel Rae’s 1958 book The Strange Story of Dr. James Barry, based on access to those papers, broke the story in the subtitle: Army Surgeon, Inspector General of Hospitals, discovered on death to be a woman. The only evidence, despite the new batch of papers, was the word of the woman preparing the body.

James Barry qualified as a doctor in 1812, so if one says he was female, then he would be the first woman doctor by several decades. The story has fascinated many, and more documents have since been uncovered demonstrating that Barry was Margaret Ann Bulkley in his earlier life. (This includes items like a letter from young Barry to a family solicitor where the recipient wrote “Miss Bulkley” on the outside of the envelope.*) The current wisdom that James Barry was, in fact, a woman, is happily disseminated in more recent books, both for adults and children.

It is natural that current discussions of gender would play into how we interpret James Barry today. Did he simply dress as a man to have a career not open to women? Is it right to call him the “first female medical doctor” if we believe he identified as male? Should we call him a transgender man? Or is it best to respect his own view of himself?

Even if we accept the report of the avaricious charwoman and the handwriting analysis of Margaret Bulkley, we have no way of knowing whether Dr. Barry actually identified as male or would simply be labeled a cross-dresser hiding his female identity. His last wish that he not be undressed for burial seems to speak to something deeper. But here, we are certainly engaging in supposition unsupported by the sources. Instead, it might be best to celebrate an extraordinary career, acknowledge the good he did with his medical skills, and enjoy critiques of his explosive personality from a safe distance.

*see Pain, Stephanie. “The Extraordinary Dr. James Barry.” New Scientist, vol. 197, no. 2646, Mar. 2008, pp. 46–47.

Also published in Medium: Frame of Reference

Visiting 1862: The International Exhibition

Murder at Old St. Thomas’s is set in 1862, so I did quite a bit of research. For me, this was stepping back 25 years from my usual research area, so I found a lot of surprises, in addition to this novel technique for social distancing:


The first thing to do after putting on my crinoline was to find good maps of London, big maps where you can see street names and even buildings:

Guide to the what? The International Exhibition of 1862. Although the Great Exhibition of 1851, with its Crystal Palace, is more famous, this one was supposed to be even bigger. You can see the catalogue here. It took place in South Kensington, on Cromwell Road, where the Natural History Museum would be later.

The Victorianist blog has some good information, and points out that the death of Prince Albert in December 1861 put a damper on the whole proceedings from the start. And it says the building, above, cost £300,000 but the cost was covered by the profits from the Great Exhibition of 1851. My studies of Victorian science education claim that the entire system of British science education was basically financed by the same pool. Which makes me think that the money from the Great Exhibition of 1851 is like pieces of the cross. There is no possible way that they made enough profit in 1851 to fund everything that’s been claimed.

Another page with information is here.

And look, they even had cameras then:

The Exhibition caused a lot of traffic snarls, especially in west London. And it really was international, with exhibitors and visitors coming from all over the globe. More in my next post…

 

Home health tips from Florence Nightingale

While she was not writing about people quarantined in their homes, Florence Nightingale’s Notes on Nursing (1859) were about caring for people in their homes, and doing it well.

Nightingale is known, of course, for her service during the Crimean War and her active reform of nursing and hospital hygiene in the mid-Victorian era. She’s the one who realized that many deaths in military hospitals were unnecessary, caused by unhygenic conditions rather than wounds or injury. And she came to this conclusion when aneasthetics were in early days, and antiseptics as yet unknown (Joseph Lister would start his famous work after the war).

Contrary to her “lady with the lamp” image, Nightingale was a no-nonsense, if not actually abrasive, person. She was once even cussed out by a doctor who might have been the first woman to get a medical degree in Britain, except that s/he identified as a man (more on this person in a future post).

I have had a copy of Nightingale’s Notes on Nursing for awhile. I don’t even recall why I bought it. I assumed it was a book for teaching nurses, since Nightingale founded her school of nursing at St. Thomas’s Hospital. But it’s a book about nursing, not just in hospitals, but in the home. And her emphasis, not surprisingly, in on creating healthy conditions.

It is also not surprising that this was considered a job for women, and in my opinion this book should reside on a shelf alongside Mrs. Beeton’s Book of Household Management, published in series at the same time, and printed as a book only two years later. Most people know that Ms. Nightingale was a big advocate of fresh air. In fact, the odd configuration of the new St. Thomas’s Hospital, opened in 1867, was the result of her promotion of cross-ventilation.

Have you ever opened a window for fresh air, and it became so chilly you wished you could leave the heat on? Nightingale recommends this, or at least keeping the fire going with a window open, so that an ill person can have fresh air. She points out that you can keep the patient warm with blankets, and safely allow fresh cold air into the room.

Her book also notes that opening doors and windows is to no avail if the air that comes in isn’t fresh. If your room opens onto a utility closet, or you leave your chamber pot open under the bed (oh those master bathrooms!), or your window overlooks a refuse heap, you are not doing any good with air. Ill people really should be taken out into the garden to get a little sun and air, which I see done all too seldom. I’ve been in elder nursing homes where the windows don’t open and the only outside is a little paving of cement in a courtyard. Nightingale was not a fan of courtyards — the air isn’t fresh enough, going round and round.

Too much bedding, too many visitors

All of her advice was based not only on her experience, but on research and statistics. Her faith in scientific endeavor was firm. In the early 1860s, when the plot was being hatched for passing the Contagious Diseases Act, she argued against it based on statistics. The idea was that preliminary arrest and examination of prostitutes would prevent venereal disease in the military. The act would give the police power to arrest any woman they suspected of being a prostitute. Many who were against the idea argued on the basis of feminine modesty, or the inappropriateness of making a private disease a public issue, or the likely abuses by the police. Nightingale argued on facts: everywhere that harsh measures arresting and examining prostitutes had been enforced by a state, the V.D. numbers had actually increased rather than decreased.

Her household nursing advice seems so common-sense, and yet is often ignored, then and now. She had to recommend that damp towels be spread out to dry, that one not chit-chat inanely with someone who wasn’t feeling well, and that one should always sit beside the sickbed rather than hovering over it, forcing the ill person to crane their neck. And here’s more:

  • Reading the patient the funny bits of a book you’re reading (update: bits and memes off the internet) is extremely annoying to the ill person.
  • Quiet is important, because when someone is ill certain sounds can be distressing or even intolerable.
  • A bedroom, where one sleeps, is not the same as a sickroom. A person in bed because they are ill needs not only air but light, and should be able to see out an open window.
  • The bed needs to be aired daily — in fact Nightingale suggests two different beds so the sheets of one can always be aired. Not doing this, or using too much bedding and thick mattresses, leaves the patient essentially in their own waste of sweat and their own breathed air. (The current metal hospital bed is likely based on the iron ones she recommended.)
  • Cleaning must be thorough. Damp cloths, not dusters that just raise the dust into the air. Carpets are horrible even if lifted and beaten 3 times a year (I can just imagine what she’d think of wall-to-wall carpeting). Bad smells indicate organic matter is stuck to things, and it shouldn’t be.

See why I want this filed next to Mrs. Beeton? It’s far less about medical nursing than about good housekeeping. The medical advice reminded me of Hippocrates, especially when it came to diet (“The diet which will keep the well man healthy may kill the sick one”). But at this time, when there is more than the usual concern about people being ill at home, it’s still good advice.