In celebration of the bicentenary of nursing educator Florence Nightingale (12 May 1820 – 13 August 1910), we offer some Nightingaleiana from UCLA Library Special Collections.

The Elmer Belt Florence Nightingale Collection

In 1958, at a banquet celebrating the 10th anniversary of the founding of the UCLA School of Nursing and Dean Lulu Wolf Hassenplug’s decade of leadership, local urologist and book collector Dr. Elmer Belt gave his collection of works by and about Florence Nightingale to the Biomedical Library (later named for its own founder, Louise M. Darling). The introductory essay in the catalog of his donated collection explained Dr. Belt’s interest in the subject and described the footsteps in which Dean Hassenplug walked:

“Florence Nightingale takes her place as a possessor of one of the world’s most creative minds. From her earliest youth she sought out and stored up knowledge which served an original and single-minded purpose, the study of nursing and elevation into a science. … Florence Nightingale’s efforts in effecting military reorganization in the methods of troop sanitation, hospital construction, and care during war of sick and injured ultimately became the concern of the legislative bodies. When favorable action by these bodies seemed certain, she turned her attention to the creation of schools for the training of nurses. Her plan was to create schools of such caliber that their graduates could assume leadership in the formation and direction of additional schools for nurses. This is the plan of the U.C.L.A. Nursing School today.”

The Internet Archive is “a non-profit library of millions of free books, movies, software, music, websites, and more.” It includes 63 titles from Elmer Belt’s Florence Nightingale Collection, digitized in 2009. Click the “Collection” tab (https://archive.org/details/f_nightingale) to visit and view these works. The books and manuscripts themselves now are a component of UCLA Library Special Collections.

Nightingale’s Visual Display of Quantitative Information

Dr. Belt’s introductory essay described a prominent feature of Florence Nightingale’s talent and education: “A sound training in mathematics … had given her a taste for figures and a training which prepared her to understand the new science of statistics. … Columns of statistics were a tonic for her. Her knowledge of statistics enabled her to understand clearly problems which involved large numbers. Hence she was able to invent methods of showing her contemporaries factual data the significance of which was hitherto unknown to them. With this tool she demonstrated the deadly effect of disease which could have been prevented upon whole armies of men, of disease brought about by failure to understand the destructive effect upon health of poorly planned sanitation in the massing of men. She prepared charts for the visual demonstration of the weight of such statistics, the first of their kind, so that those lawmakers who were unaccustomed to figures could see and appreciate these visual displays.”

Following her hospital service in Scutari during the Crimean War, when she became known as the “Lady with the Lamp”, Nightingale gathered and studied mortality data. She paid for the printing of five hundred copies apiece of two massive reports to the Secretary of State for War.

Notes on Matters Affecting the Health, Efficiency, and Hospital administration of the British Army (London: Harrison and Sons, 1858) “was written in six months at ‘white-hot speed’ while Florence Nightingale worked on the Commission on Health of the Army. She uses the Crimean campaign as a test case in military hygiene. Great masses of detail, facts and figures illustrate the main theme: to improve conditions in hospitals which had proved more fatal than the battlefield” according to Belt. Her Subsidiary Notes as to the Introduction of Female Nursing into Military Hospitals in Peace and in War (London: Harrison and Sons, 1858) also was distributed through the government and was not issued to the public. Our copies at UCLA are not pristine, but show that they have been read or handled many times.

Nightingale’s dramatic summary “coxcomb” or “polar area” diagram about the deaths she saw in military hospitals is reproduced in a public domain entry for the nineteenth-century term, “Zymotic disease”. Her pie chart vividly shows that as time progressed (in months, read clockwise in 30-degree segments), hospital deaths in Scutari from wounds (pink areas) and some diseases (black areas) paled in comparison to mortality from “zymotic” or acute infectious diseases such as typhus, cholera, and dysentery (blue areas).

She wrote: “These pestilences, which are the scourge of camps and armies now, as plague and Black Death used to be in towns in the middle ages, gave rise to mortality in the Crimean Army represented by the blue wedges. … It was not by wounds, it was not by ordinary diseases that the army well nigh perished. But it was by these … mitigable and preventable pestilences that the British force before Sevastopol was all but swept away. Expunge the blue wedges, and within what insignificant bounds would not that great calamity have shrunk! These diagrams give the history of the whole disaster. In June 1854, the zymotic deaths from the diseases mentioned are all included in the small blue wedge for that month. What a different fate for the Army, had its mortality from zymotic disease alone never spread beyond those dimensions!”

Notes on Nursing

Most of Nightingale’s books looked like any other volume of their time. As a collector, Belt appreciated that: “The books have a characteristic mid-Victorian appearance. They are not beautiful either in typography or binding, but in their content, as a reflection of the influence of Florence Nightingale, they are immensely rich in human value.”

The most famous and still-reprinted Nightingale work was not even directed at professional nurses. Notes on Nursing: What It Is, and What It Is Not (London: Harrison, [December, 1859]) had a more general audience, the preface states, to provide “the knowledge one ought to have. … The following notes are by no means intended as a rule of thought by which nurses can teach themselves to nurse, still less as a manual to teach nurses to nurse. They are meant simply to give hints for thought to women who have personal charge of the health of others. ... Every day sanitary knowledge, or the knowledge of nursing, or in other words, of how to put the constitution in such a state as that it will have no disease, or that it can recover from disease, takes a higher place.”

Dr. Belt collected several editions of the book, to see what changes were made. He thought it “was utterly charming, as fresh and applicable today as the day it was written, reflecting that most solid and valuable of human possession, her depth of experience. Yet the notes are practical and intimate, full of good sense and are presented with brightness, gaiety and wit. Fifteen thousand copies were sold within a month.”

Preparing Nurses

In 1889 – twenty-nine years after she established a school for nurses at St. Thomas Hospital in London, Florence Nightingale replied to an inquiry from a Mrs. Cleveland, who had asked “if we have ‘a band of trained Nurses under’ us, ‘which we send out abroad’.” She recommended the correspondent write the Matron, Miss [Angelique Lucille] Pringle, or the Secretary, Mr. [Henry] Bonham Carter, or both, “giving the fullest particulars you are able.”

Nightingale explained, “Our Training School for Nurses is at St. Thomas’ Hospital, London. And other Training Schools have been formed in Hospitals & Workhouse Infirmaries, where we have sent a Matron & Staff of Trained Nurses, when requested. We have thus, where we are satisfied that the conditions exist which can alone enable the trained nurses to assume the responsibility & do their work satisfactorily, send a Staff of matron & Nurses to various places, & even ‘abroad’, & to the Seat of War where there has been War. But (except in the latter cases where it is impossible) it is desirable to give them from 6 to 12 months’ notice that such & such a Staff will be wanted, as Nurses cannot be kept ready like bottles on a shelf.”

Inspiring Nurses

We are offered many individual Florence Nightingale letters and signed items to purchase. However, we are not building a comprehensive research collection of them because there are several repositories which can justifiably make that claim. Ours is more of a teaching collection which has some unique highlights.

One of these highlights is a recent acquisition from a London bookseller that was too good to refuse. On the surface, Hoblyn’s A Dictionary of Terms Used in Medicine and the Collateral Sciences (London: Whittaker & Co., 1878) is an unpresupposing 10th edition of a standard reference work.

Our copy became special, and should give a reader a thrill to hold, because of the penciled inscription facing its title page: “For Nurse Sarah Smith: with Florence Nightingale’s very best wishes for her highest progress in this world & in the better world: & that she may never forget that who does not make progress every day in Nursing falls back. Easter 1880”.

Happy Birthday, Florence Nightingale!

For more information about worldwide bicentenary celebrations, visit the calendars maintained by the Florence Nightingale Museum and the “Florence Nightingale 2020” partnership.