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venture； could only approve。 A pair of faithful friends offered
themselves as personal attendants； thirty…eight nurses were
collected； and within a week of the crossing of the letters Miss
Nightingale； amid a great burst of popular enthusiasm； left for
Constantinople。
Among the numerous letters which she received on her departure
was one from Dr。 Manning； who at that time was working in
comparative obscurity as a Catholic priest in Bayswater。 'God
will keep you；' he wrote； 'and my prayer for you will be that
your one object of worship； Pattern of Imitation； and source of
consolation and strength； may be the Sacred Heart of our Divine
Lord。'
To what extent Dr。 Manning's prayer was answered must remain a
matter of doubt； but this much is certain： that if ever a prayer
was needed； it was needed then for Florence Nightingale。 For dark
as had been the picture of the state of affairs at Scutari；
revealed to the English public in the dispatches of 〃The Times
Correspondent〃； and in a multitude of private letters； yet the
reality turned out to be darker still。 What had occurred was； in
brief； the complete breakdown of our medical arrangements at the
seat of war。 The origins of this awful failure were complex and
manifold； they stretched back through long years of peace and
carelessness in England； they could be traced through endless
ramifications of administrative incapacity from the inherent
faults of confused systems； to the petty bunglings of minor
officials； from the inevitable ignorance of Cabinet Ministers； to
the fatal exactitudes of narrow routine。
In the inquiries which followed； it was clearly shown that the
evil was in reality that worst of all evils one which has been
caused by nothing in particular and for which no one in
particular is to blame。 The whole organisation of the war machine
was incompetent and out of date。 The old Duke had sat for a
generation at the Horse Guards repressing innovations with an
iron hand。 There was an extraordinary overlapping of authorities
and an almost incredible shifting of responsibilities to and fro。
As for such a notion as the creation and the maintenance of a
really adequate medical service for the army in that atmosphere
of aged chaos； how could it have entered anybody's head？ Before
the war； the easygoing officials at Westminster were naturally
persuaded that all was well or at least as well as could be
expected； when someone； for instance； actually had the temerity
to suggest the formation of a corps of Army nurses； he was at
once laughed out of court。 When the war had begun； the gallant
British officers in control of affairs had other things to think
about than the petty details of medical organisation。 Who had
bothered with such trifles in the Peninsula？ And surely； on that
occasion； we had done pretty well。 Thus； the most obvious
precautions were neglected； and the most necessary preparations
were put off from day to day。 The principal medical officer of
the Army； Dr。 Hall； was summoned from India at a moment's notice；
and was unable to visit England before taking up his duties at
the front。 And it was not until after the battle of the Alma；
when we had been at war for many months； that we acquired
hospital accommodations at Scutari for more than a thousand men。
Errors； follies； and vices on the part of individuals there
doubtless were； but； in the general reckoning； they were of small
account insignificant symptoms of the deep disease of the body
politic to the enormous calamity of administrative collapse。
Miss Nightingale arrived at Scutari a suburb of Constantinople；
on the Asiatic side of the Bosphorus on November 4th； 1854； it
was ten days after the battle of Balaclava； and the day before
the battle of Inkerman。 The organisation of the hospitals； which
had already given way under the stress of the battle of the Alma；
was now to be subjected to the further pressure which these two
desperate and bloody engagements implied。 Great detachments of
wounded were already beginning to pour in。 The men； after
receiving such summary treatment as could be given them at the
smaller hospitals in the Crimea itself； were forthwith shipped in
batches of 200 across the Black Sea to Scutari。 This voyage was
in normal times one of four days and a half； but the times were
no longer normal； and now the transit often lasted for a
fortnight or three weeks。 It received； not without reason； the
name of the 'middle passage'。 Between； and sometimes on the
decks； the wounded； the sick； and the dying were crowded men
who had just undergone the amputation of limbs； men in the
clutches of fever or of frostbite； men in the last stages of
dysentry and cholera without beds； sometimes without blankets；
often hardly clothed。 The one or two surgeons on board did what
they could； but medical stores were lacking； and the only form of
nursing available was that provided by a handful of invalid
soldiers who were usually themselves prostrate by the end of the
voyage。 There was no other food beside the ordinary salt rations
of ship diet； and even the water was sometimes so stored that it
was out of reach of the weak。 For many months； the average of
deaths during these voyages was seventy…four in 1；000； the
corpses were shot out into the waters； and who shall say that
they were the most unfortunate？ At Scutari； the landing…stage；
constructed with all the perverseness of Oriental ingenuity；
could only be approached with great difficulty； and； in rough
weather； not at all。 When it was reached； what remained of the
men in the ships had first to be disembarked； and then conveyed
up a steep slope of a quarter of a mile to the nearest of the
hospitals。 The most serious cases might be put upon stretchers
for there were far too few for all； the rest were carried or
dragged up the hill by such convalescent soldiers as could be got
together； who were not too obviously infirm for the work。 At last
the journey was accomplished； slowly； one by one； living or
dying； the wounded were carried up into the hospital。 And in the
hospital what did they find？
Lasciate ogni speranza； voi ch'entrate： the delusive doors bore
no such inscription； and yet behind them Hell yawned。 Want；
neglect； confusion； misery in every shape and in every degree
of intensity filled the endless corridors and the vast
apartments of the gigantic barrack…house； which； without
forethought or preparation； had been hurriedly set aside as the
chief shelter for the victims of the war。 The very building
itself was radically defective。 Huge sewers underlay it； and
cesspools loaded with filth wafted their poison into the upper
rooms。 The floors were in so rotten a condition that many of them
could not be scrubbed； the walls were thick with dirt； incredible
multitudes of vermin swarmed everywhere。 And； enormous as the
building was； it was yet too small。 It contained four miles of
beds； crushed together so close that there was but just room to
pass between them。 Under such conditions； the most elaborate
system of ventilation might well have been at fault； but here
there was no ventilation。 The stench was indescribable。 'I have
been well acquainted；' said Miss Nightingale； 'with the dwellings
of the worst parts of most of the great cities in Europe； but
have never been in any atmosphere which I could compare with that
of the Barrack Hospital at night。' The structural defects were
equalled by the deficiencies in the commonest objects of hospital
use。 There were not enough bedsteads； the sheets were of canvas；
and so coarse that the wounded men recoiled from them； begging to
be left in their blankets； there was no bedroom furniture of any
kind； and empty beer bottles were used for candlesticks。 There
were no basins； no towels； no soap； no brooms； no mops； no trays；
no plates； there were neither slippers nor scissors； neither
shoe…brushes nor blacking； there were no knives or forks or
spoons。 The supply of fuel was constantly deficient。 The cooking
arrangements were preposterously inadequate； and the laundry was
a farce。 As for purely medical materials； the tale was no better。
Stretchers； splints； bandagesall were lacking； and so were the
most ordinary drugs。
To replace such wants； to struggle against such difficulties；
there was a handful of men overburdened by the strain of
ceaseless work； bound down by the traditions of official routine；
and enfeebled either by old age or inexperience or sheer
incompetence。 They had proved utterly unequal to their task。 The
principal doctor was lost in the imbecilities of a senile
optimism。 The wretched official whose business it was to provide
for the wants of the hospital was tied fast hand and foot by red
tape。 A few of the younger doctors struggled valiantly； but what
could they do？ Unprepared； disorganised； with such help only as
they could find among the miserable band of convalescent soldiers
draft