The Secret Report Found

In August 1856 Florence Nightingale printed her Confidential Report to the British Government in which she claimed that bad hygiene in the hospitals (particularly hers) was the main cause of death during the Crimean War.  She was also finalising the public report of her Royal Commission on the same subject.  She asked the Minister of War to allow her to include in the public report the evidence that she had printed in her Confidential Report (called Notes on Matters Affecting the Health of the British Army).  The Minister and his colleagues refused to allow publication.  Her statistical analysis proving that the death rate in her hospitals was much higher than in other hospitals, despite the superior standard of nursing and medical care, has therefore never been published.  Her statistics were the product of an official government investigation, but they do not appear in any Government archive and nobody has ever reprinted them or even referred to their existence before 1998.  The only reason they still exist is that after she recovered from her breakdown Florence Nightingale printed a number of copies of her secret report and “leaked” them to leading citizens throughout the country to show that the anti-public health attitudes of the previous Government had caused the death of 16,000 soldiers.  Her “leak” also showed that she had given evidence of this to Ministers but they had not published it despite their commitment to exposing the truth.   She wanted to shame the Government into passing public health legislation at home in Britain, and she succeeded.

Part of the key chapter from her Confidential Report follows, first as originally printed in 1858, then as first published on this web page in 1998:

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“FURTHER REMARKS ON THE GREATER MORTALITY IN CERTAIN CORPS,
WITH STATISTICS OF THE NUMBER CONSTANTLY SICK

It has already appeared, in the preceding note, that the mortality in certain Corps was in excess of the general rate.  In the 46th, 95th, 63rd, 44th, 28th, and 50th Regiments it averaged 73 per cent during the seven winter months from October 1854 till April 1855, a rate of mortality which would have extinguished the whole of those Regimentsin ten months, or, in other words, a mortality of 125 per cent. per annum.

[Table A is ommitted here.  It shows the estimated total mortality of eight regiments,  from wounds and from disease respectively.]

The next Table, not the least remarkable, explains itself.  It shows, Regiment by Regiment, what the admissions into Hospital were, and what the Deaths, during those fatal seven months.  This has been shown before; but it has not been shown before how much of that mortality was due to the frightful state of the Hospitals at Scutari; how much it depended upon the number which each Regiment was unfortunately enabled to send to those pest-houses.

The eight Regiments, above mentioned, which were almost annihilated, and the three Regiments of Guards, have been distinguished by the letter S in the column of “Died at Scutari;” the preponderance of Deaths in that terrible column showing how much Scutari contributed to swell the mortality by which these unfortunate Corps were thus swept away.

TABLE B.

GENERAL ABSTRACT, showing the total number of Admissions into Hospital and Deaths, together with the Numbers Invalided, of the Troops serving in the Crimea, for the whole period of Seven Months, commencing 1st October, 1854, and terminating 30th April, 1855; and including those under treatment at Scutari.

			Total.
Division and Corps	AverageStrength	Admittedinto   Hospital	Died in the Crimea, &c.	Sent to Scutari, &c.	Died at Scutari, &c.	Invalided to England, &c.	Remarks
2nd	30th Foot	522	934	108	308	93	99
Division	55th “	695	1,462	61	265	96	100
	62nd “	430	949	96	135	42	24
	95th “	417	1,250	199	345	155s	114
	41st “	684	1,323	104	320	94	81
	47th “	637	1,223	91	280	71	102
	49th “	655	1,071	66	274	90	89
3rd	1st “	771	1,048	229	354	118	63
Division	14th “	423	878	8	42	2	6	a)
	38th “	689	1,728	149	319	118	73
	39th “	401	623	23	32	16	48	a)
	50th “	520	1,033	231	278	96s	84
	89th “	433	993	111	129	59	38	b)
	4th “	508	1,044	96	354	95	46
	9th “	309	754	117	217	56	52
	18th “	475	636	29	95	18	18	a)
	28th “	522	1,209	175	373	101s	77
	44th “	598	1,140	204	394	112s	65
4th	17th “	561	846	59	47	23	9	b)
Division	20th “	532	1,438	132	370	122	116
	21st “	582	1,388	145	294	113	86
	57th “	715	975	66	189	53	65
	46th “	378	1,573	259	431	146s	84
	68th “	503	2,042	73	229	79	53
	68th Detachment	154	371	3	22
	Rifle Brig., 1st Bat.	601	1,311	124	397	281	176	c)
Light	7th Foot	562	783	105	347	125	129
Division	23rd “	579	949	219	331	140s	115
	33rd “	424	1,194	189	345	135s	144
	34th “	504	652	54	86	30	21	b)
	97th “	646	695	172	224	86	41
	19th “	548	837	132	276	112	118
	77th “	736	1,147	124	286	96	84
	88th “	624	1,603	81	319	101	105
	90th “	419	642	95	207	61	25	b)
	Rifle Brig.2nd Bt. R.W.	449	1,114	43	272			d)
1st	42nd Foot	704	775	72	135	51	30
Division	63rd “	448	602	183	383	170s	96	h)
	71st “	330	348	12	43	5	3	a)
	79th “	714	932	156	241	65	39
	93rd “	727	797	87	71	53	62	e)
	Rifle Brig.2nd Bt. L.W.	192	271	8	43	..	..
	Grenadier Guards	487	716	63	271	238s	189	f) g)
	Coldstream Guards	478	1,234	115	441	166s	98	f) g)
	Scots Fusilier Guards	553	904	95	353	169s	147	f) g)
	TOTAL INFANTRY	23,775	45,437	4,963	11,167	4,052	3,214
Cavalry	1st Dragoons	247	226	7	100	23	18
Div.	2nd “	205	480	15	126	23	16
	4th Dragoon Guards	250	490	11	63	8	18
	6th Dragoons	241	483	20	42	18	23
	5th Dragoon Guards	172	370	9	73	14	39
	4th Dragoons	163	427	12	75	19	29
	8th “	155	301	3	78	16	25
	11th “	143	314	13	70	21	24
	13th “	185	256	7	67	15	29
	17th “	154	312	6	75	20	25
	TOTAL CAVALRY	1,915	3,659	103	779	177	246
Royal	Right Attack	575	600	70	179
Artillery	Left “	587	517	45	…
	A Battery	155	137	12	29
	H “	146	121	6	24
	F “	161	418	16	45	Artillery Total:
	B and G Batteries	268	385	42	71	258	379
	E Battery	150	169	12	51
	C “	193	447	8	…
	P “	138	239	12	42
	W “	254	331	15	29
	I       “	189	317	9	21
SAPPERS (Right andMINERS      Left Attack)
433	1,136	28	91	35	42
TOTAL ARTILLERY ANDENGINEERS
3,249	4,817	275	582	293	421
Genl. Hospital, Balaclava		2,114	190

Notes:

a) Each of the four Corps marked a) having been in the Crimea for four months only, the
Strength has been reduced in a corresponding proportion.

b) Ditto ditto marked b), ditto ditto for five months only the Strength has been reduced

c) The Deaths at Scutari include those of both Battalions, as we have no means of
separating them

d) Deaths at Scutari included with 1st Battalion

e) Ditto ditto

f) Half the strength only included, the Returns being only available for four months

g) The Guards Brigade was serving in front up to the end of February, but has been
included here with the Force at Balaclava, as it was there at the time the Returns were
made up.

h) The 63rd was also with the 4th Division, in front, till the end of January, and has
been included here with the Force at Balaclava, for the same reason.

It may, from the data here presented, be probably inferred that to the excessive mortality (described above) of certain corps, the condition of the Hospitals at Scutari contributed quite as largely as the amount of military labour.  In the extracts presented in the last note too large a share in the calamitous result has most likely been assigned to the severe pressure of the soldier’s duties.”

[The chapter continues with statistics on the variations in the number of men sick at any one time.]

[For a full discussion of the origin and significance of  Table A, see Florence Nightingale, Avenging Angel, by Hugh Small.]