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 Regiments
in 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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