What the Dictionary of National Biography should say about Nightingale

There have been many calls for revision of the entry on Florence Nightingale in the UK’s most frequently consulted biographical source, because of new information and analysis that has become available since its biography of Nightingale was written in 1998. The source in question is the publicly-funded Oxford Dictionary of National Biography (ODNB). I have written to the editors of the ODNB to give them some notes which could be useful when the time comes around for a revision. This article summarises the revisions that I have suggested to them.

Biographies in the ODNB are attributed to specific authors, and the current biography of Nightingale is attributed to Monica Baly and Colin Matthew (former editor of the ODNB). Both died several years before the ODNB was published in 2004; Baly’s papers in the archives of the Royal College of Nursing show that she was initially commissioned to write the biography but had not completed the changes to her draft called for by the editors when she died in 1998. It is not clear therefore to what extent she would agree with all of the ODNB entry that bears her name, but she did set the tone in her first sentence which summarises the wide-ranging polymath Nightingale only as ‘Reformer of Army medical services and nursing organisation’. The limitations of this summary are not surprising given that Baly was a former army hospital nurse and nursing organiser. A wider historical perspective is needed.

Political sanitarian work

The most pressing need is to mention Nightingale’s long and successful campaign for public expenditure on sanitation (reduction in overcrowding, running sewers, and clean water), and her high-profile conflict with the Chief Medical Officer of Health John Simon on the subject between 1858 and 1871. The only authors to have referred to this conflict are me, F. B. Smith, and John Simon’s 1963 biographer Royston Lambert. Lambert says that Nightingale induced Stansfeld (the cabinet minister responsible for overseeing Simon) to visit her couch side where she played on Stansfeld’s vanity and persuaded him to deprive Simon of his power and thus radically change the national public health strategy. Even if one accepts Lambert’s old-fashioned view that feminine wiles were at work rather than Nightingale’s and Edwin Chadwick’s combined reasoning powers, it would be a feat worthy of mention in ODNB. Mark Bostridge in his 2008 biography agrees that sanitation became Nightingale’s highest priority after the Crimean War. The ODNB should mention it, and should preferably refer to her conflict with Simon as a crossroads in the history of public health.

Whistleblowing

The ODNB could mention that the government suppressed Nightingale’s key evidence to the post-war Royal Commission, and that she leaked it in strict confidence to several hundred eminent people, alerting them to the government’s censorship and culpability. For nearly 100 years, until whistleblowing became a reputable activity, biographers ignored both suppression and leak. Again, Bostridge has endorsed these discoveries, first published in 1998. The ODNB entry should mention them even if it doesn’t quote my interpretation that her possession of a ‘smoking gun’ – the suppressed evidence – gave Nightingale real political power.

Germ Theory

I don’t think anyone now agrees with the ODNB’s statement, unsupported by evidence  (in Baly’s writings or elsewhere), that Nightingale “continued to disregard the germ theory of infection”. It has subsequently been discovered that when the London teaching hospitals first began teaching germ theory, Nightingale was in the forefront. I pointed out as long ago as 2000 (in the Times Literary Supplement) that she wrote an article for Quain’s Dictionary of Medicine, published in the early 1880s,  in which she approvingly cited a surgeon’s advice to nurses to wash their hands to kill germs. This is not compatible with disregarding germ theory, continuously or otherwise. It seems that the idea that Nightingale opposed germ theory was promoted by those who favour public spending on medical intervention rather than sanitarian reform and convinced themselves that all sanitarians are opponents of germ theory. This conflict of priorities is still in evidence today, particularly in the developing world.

Contextualisation

Nightingale studies have always been too Nightingale-centric for a subject who was connected to many mainstream political currents. The ODNB should mention William Farr and Edwin Chadwick, Victorian figures of national standing with whom she collaborated. At present the ODNB mentions provincial nursing collaborators like Rathbone who are much less important. There should also be mention of Lord Palmerston’s 1855 accession to power as Prime Minister, his struggle to persuade Queen Victoria to let Nightingale speak out, and of his landslide re-election in 1857, all of which were crucial to Nightingale’s entry into politics.

A recently revealed context is the edgy status of her family as parvenu alleged revolutionaries invading the Duke of Wellington’s territory in Hampshire. Nightingale’s father was not quite the dilettante would-be politician and unworldly country squire portrayed by his family and by biographers, but rather a thorn in the side of the local Tory political establishment. The situation has been documented by Dr. Russ Foster (see the later post on William Edward Nightingale for his article) and goes some way to explain Nightingale’s inherited appetite for political controversy and her robust attitude in dealing with social discrimination. It deserves a mention.

Historiography – the misrepresentation

The current Historiography section of the ODNB entry highlights the manipulation of her nursing record and could usefully mention the outright censorship of her political activity accomplished by her biographers Cook and Woodham Smith and the wide acceptance of the erroneous ‘research’ of F. B. Smith.  This section of ODNB should show Florence Nightingale to be a contender for the title of the most misrepresented famous person in history.

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