Florence Nightingale

Florence Nightingale was born on 12 May 1820 during her parents' long honeymoon tour of Italy. Her father William had inherited a fortune from lead mines, her mother Frances came from a family of merchants and politicians that had campaigned for the abolition of the slave trade. The family was Unitarian in background, liberal and fond of travel, and divided the year between two country houses and London.

Her father himself gave his two daughters an education at university level, exceptional for girls at the time. Florence had a gift for mathematics and as a teenager was already keeping tables of what she saw. A woman of her class was expected to make a good marriage; after years she turned down a proposal from the politician Richard Monckton Milnes. On journeys through Egypt and Germany she visited hospitals and institutions and laid the foundation for her later knowledge.

At Scutari Nightingale found a hospital above blocked sewers, with thousands of wounded and sick men on the floor, without enough beds, soap or bandages. Against the resistance of army doctors she used money from a newspaper fund to set up kitchens, a laundry and a storehouse, and recorded every admission and every death. At night she walked the miles of wards with a lamp, which made her a national heroine in the British press.

After the war she worked, often from her sickbed, as a researcher and lobbyist. With the statistician William Farr she calculated that by far the most British deaths in the East had been from typhus, cholera and dysentery and not from wounds. To convince ministers and the Queen she drew circular diagrams with wedges for each month. After that she turned to hospital design with air and light, to the training of nurses and midwives and to public health in India.

In Victorian Britain hospitals were used by those who could not afford a doctor at home, and nursing was regarded as unskilled work with a bad name. There was no agreement about the cause of infectious diseases: most reformers, Nightingale included, believed that disease arose from foul air ('miasma'). The bacteriology of Pasteur and Koch came only later, but the emphasis on hygiene and ventilation worked even without the right explanation.

The Crimean War (1853–1856) was the first war of which the public at home received almost daily reports by telegraph and from war correspondents. William Howard Russell's dispatches in The Times about the fate of sick soldiers caused a scandal and contributed to the fall of the government. At the same time statistics was growing into an instrument of government: states began to count births, deaths and diseases systematically.

The Royal Commission of 1857 led to better barracks, an army medical school and a statistical service of its own; mortality among soldiers in peacetime fell sharply in the years that followed. In 1858 Nightingale became the first woman admitted to the Statistical Society in London. Her 'Notes on Nursing' was translated into many languages and gave ordinary households, too, rules for caring for the sick.

The school at St Thomas' Hospital produced trained nurses who went as matrons to hospitals in Britain, the colonies and the United States. Henri Dunant called her work an inspiration for the founding of the Red Cross. The profession offered middle-class women one of the first recognised careers outside the home, although in Nightingale's own view it remained subordinate to that of the doctor.

After 1857 Nightingale lived largely withdrawn in her house in London, probably because of the chronic effects of brucellosis, the 'Crimean fever' she had contracted in 1855. She wrote an estimated fourteen thousand letters and dozens of reports. In her last years she was blind and confused. She died on 13 August 1910, aged ninety; burial in Westminster Abbey was declined in accordance with her wishes, and she lies in the churchyard of East Wellow in Hampshire.

Her image has been revised repeatedly since. The legend of the gentle angel gave way to that of the tough administrator and gifted statistician. Researchers such as Hugh Small pointed out that mortality in her own hospital in the first winter was higher than elsewhere and that this realisation explains her later zeal for reform. More attention has also been paid to contemporaries such as the Jamaican Mary Seacole, who cared for soldiers in the Crimea at her own expense.