Her Secret Report

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:

“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 and
MINERS      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.]

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