Dear Sir David [Cannadine: Professor; director, ODNB]

Monica Baly was undoubtedly the best person to write the entry when it was commissioned, but she was past her best work, and in fact died before the final version was settled. There are some errors and peculiarities in her original text but, Worse, Colin Matthew added many points of his own. He and the advisors considered the entry to have been “too defensive,” meaning not critical enough. We consider the problem to have been undue reliance on F.B. Smith as a reliable source. Matthew added 14 Smith references to Baly’s text (she had one).

Lawrence Goldman, your predecessor, explained to one of us (Professor McDonald) that history graduate students were thrilled when Smith’s Reputation and Power book came out in 1982, delighted to see an icon tumble. Baly had already done her doctoral research when it appeared, and was not immediately influenced by it. She, however, increasingly accepted his views. The evolution of her ideas would make an excellent graduate seminar in history: the first edition of her 2 books on Nightingale were very favourable; in the second edition the superlatives are removed; in the third, there are negatives. Not all of the references Matthew added to Smith were wrong, but why quote him at all when he is such an unreliable source?

The (revised) entry praises Reputation and Power as “striking.” It warns of the errors and limitations of Woodham-Smith’s biography (agreed), but F.B. Smith is worse. Yet the (revised) entry credits him with examining “the remarkable network of manipulation (mostly by letter) by which she sought to impose her will and achieve her objectives” (911). It stated, without primary source evidence, that she “often used relatives ruthlessly to help her with her with various projects” and that she “coerced” others into acting as secretaries or guardians in her house (908).

Numerous errors in the entry have already been sent in (see correspondence from McDonald 20 December 2006 and 29 December 2009 and from Goldman 12 February 2007 and 19 February 2010). Corrections were made only on (most of) the incorrect names and dates, so that serious bloopers remain, such as that Nightingale “continued to disregard the germ theory of infection.” No, germ theory is not in her early books – how could it be, when they predate Lister’s antiseptic surgery (1867) and Koch’s definitive paper of 1879? Her school taught a rudimentary version of it in 1873, the first nursing school to do so (she approved the syllabus). How she came to accept germ theory is set out in Cook’s biography. She made references to germs and germ theory in late papers, notably in one for an Indian journal. She urged that slides be presented in lectures in Indian villages, to demonstrate the bacilli and encourage people to clean up the local water supply (“Sanitation in India, Quarterly Journal of the Poona Sarvajanik Sabha). Baly and Matthew are wrong.

We are concerned about the disproportionate space given to Nightingale’s family relations, and the sexist terms used: she is referred to by her first name, even as an adult; her mother is nicknamed “Fanny,” while her father is not nicknamed (he was “Night”). Nightingale’s Suggestions for Thought is discussed, but without any realization of its history, a composite of two draft novels and dialogue among a range of religious thinkers. The Crimean War coverage is heavy on the “lady with the lamp” imagery, light on the reforms she made.

The coverage of family relations and her suitor in general was not faulty, but out of proportion; her important health care and social reforms are glossed over or omitted. For example:

1. No discussion of her Notes on Hospitals, a work used worldwide; indeed scant mention of her work on hospital reform. Only the briefest mention, no discussion, of her Introductory Notes on Lying-in Institutions, a pioneering study of maternal mortality post-childbirth.
2. No list of her major writings!
3. No coverage of her study of mortality and morbidity in colonial schools and hospitals or the disappearance of aboriginal races, nor of a proposal for providing employment in times of distress, nor her critique of the harm of voluntary relief in war.
4. No discussion of Nightingale’s important late writing: (1) 2 articles on nursing for Quain’s Dictionary of Medicine, 1883, updated in 1890 and 1894, with the latest information on aseptic procedures for operating theatres; (2) 1884 a letter to the editor of the New York Herald on cholera prevention, “Scavenge Scavenge Scavenge” reprinted in both British and American journals, books and shorter works, reprinted in 1892; (3) 1890 a short article on hospitals in Chambers’s Encyclopedia; (4) 1893 a major paper for a Chicago world congress.

The section heads are unhelpful, when not misleading, especially “Out of office 1870-1880,” from an offhand remark cited from Cook 2:240 that the new viceroy, Lord Northbrook, did not visit her in 1872 (they did correspond). Lord Lytton, the next viceroy, did not visit either, but their differences were so great that she was glad that he did not ask her to do anything for him. The three Liberal viceroys that followed were keen to collaborate, and visited (Lords Ripon 1880-84, Dufferin 1884-88 and Lansdowne, 1888-94), also numerous governors of presidencies.

She had excellent government connections, notably with Lord de Grey (later Ripon) and Lord Hartington; Gladstone had a high opinion of her, which is badly misrepresented in the brief reference to him. During the 1870s she did a great deal to establish district nursing (in the entry briefly noted in 1867, when most of her work was in the late 1870s and late 1880s). She did a massive amount on India then, and the Franco-Prussian War (nowhere discussed!).

“Religion and attitude to women” makes no sense as a section, quite apart from the fact that it is wrong on her and her family’s religious views and practices. The error on germ theory oddly is in Religion and attitude to women.

The heading “Old age, 1880-1910″ is faulty; Nightingale effectively retired in 1900, but was enormously productive 1880 to at least 1893 (see the late papers). This included more work on India, the Egyptian campaigns and Anglo-Zulu Wars (nowhere discussed); she helped to launch new projects in health visiting; worked on establishing female medical care for women in India (with Lady Dufferin, the vicereine): mentored nurses going to India to nurse in plague: advised on new pavilion hospitals for (Montreal, Derby, Liverpool and Berlin are examples); assisted on establishing nurse training in Germany, and, in the 1890s, Italy and France.

She also took on new subjects in this late period, such as the Rukhmabai case, defending an Indian woman who refused to consummate her (child) marriage; she wrote a campaign letter for Dadabhai Naoroji, the first Indian to be elected to the British Parliament, and did further work on famine prevention and relief, with attention to land ownership, tenancy, credit and taxes.

The statement that Nightingale “tried to keep up with public health matters but she was increasingly out of touch” is badly mistaken; see those later writings and correspondence with experts who sought her advice.

The entry is wrong also that “in 1889 St Thomas’ appointed a matron without consulting her or the council”; she was consulted for the appointment made in 1890, via the secretary of her Council, Henry Bonham Carter (see the Minute Book and Add Mss 47722 and 47737); she was consulted on appointments as late as 1897.

What grounds are there for the conclusion that “she failed to achieve a credible training for nurses” in her school, for which further references are given to F.B. Smith. Sources which credit her with significant accomplishments in nursing are simply omitted: Lucy Seymer, Florence Nightingale’s Nurses: The Nightingale Training School 1860-1960, and Brian Abel-Smith, A History of the Nursing Profession). For a chronology of Nightingale’s influence establishing nursing throughout Britain and the world, see McDonald, Florence Nightingale: Extending Nursing, pp. 12-22 and for a list of the hospitals which got matrons from her school, see McDonald, The Nightingale School, Appendix C.

No information is given as to what training schools did a better job; indeed significant advances in training occurred only much later, e.g. with Isabel Hampton Robb at Johns Hopkins University Hospital (Nightingale mentored her). Nightingale’s influence can be seen as well in the writing of the next two generations of nursing leaders.

Given that the bicentenary of Nightingale’s birth will be celebrated in 2020, we are keen to see adequate coverage of her work in the ODNB, an influential source, which will undoubtedly be consulted in the preparation of speeches, papers, etc. We are all too aware of the ODNB entry on Mary Seacole being used as justification for errors elsewhere, notably by English Heritage.

(Signed by 20 members of the Nightingale Society)