Angela Georgina Burdett-Coutts.

Woman's mission; a series of congress papers on the philanthropic work of women, by eminent writers online

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visiting them constantly, and really know them intimately.
There is no lack of kindness and good-nature among them,
but one has frequently to deplore the willingness of the
neighbours to attend the sick, and to prescribe from their
own limited experience, in cases where trained skill and
sound knowledge are urgently required. More especially
does this apply to confinements, where a neighbour with no
knowledge or training will too frequently attend, with the
audacity of ignorance, both natural and abnormal cases, and
often sad, if not fatal, results to both mothers and infants
ensue from this practice. Terrible is the suffering, and the
lifelong injury, too often caused by these women !

As to ventilation, the villagers have no idea of it, and
alternate between the close and stuffy bedroom, with a window
never opened, and the chimney, if existing, carefully closed
or boarded up, and the thorough draught of the passage
between the back and front doors, which is the usual lounge
of any invalid and the children. We can wonder little, then,
at the mortality in villages after a mild epidemic of measles,
when the children die in numbers from bronchitis and other
chest affections. Besides this cause of mortality among
children is another, viz. the spread of infectious disorders
owing to the utter disregard of all precautions. The people
appear to be fatalists on this subject, and regard the most
ordinary prudence as flying in the face of Providence their
argument being, " If you are to have it, you will have it," and
they go about the surest way to take, and spread, whatever
the infection may be.

Sanitation is not even thought of. An open stagnant
ditch, or drain, is considered quite a suitable playground for
the children, and to throw all refuse just outside the door is
still a common practice.

The nasty compounds which are applied as poultices are
some of them too bad to describe to ears polite, and must
have a very pernicious effect, while even those of which the
ingredients are suitable, are prepared and applied in a very
different manner from what the doctor intended, or a nurse
would make.

212 Woman 's Mission.

How the village babies survive the very unwholesome
food on which they are brought up, must ever remain a
mystery to the mothers who carefully adapt their little ones'
diet to their age and powers of digestion. Biscuit soaked in
water is the most common of all, but cabbage and brown
sugar, and fat bacon to suck, are given at the age of a few
weeks only ; and at three or four months old, a little of any-
thing the elders are having is thought in many families good
for the baby ; wholesome food and regularity of meals are
really not considered at all. '

The doctor's visit, when he is not sent for too late for any
human aid to avail, is often of little use, from the misunder-
standing of his directions, or inability to carry them out.
There are still in many remote country villages old women
skilled in the use of herbs. One such who has cer-
tainly performed some remarkable cures, and who enjoys
the implicit confidence of her neighbours, avers that her father
could " cure all men and beasts," and that she inherits her
skill and her books from him. This aged crone believes in
the need of picking and collecting her herbs at particular times
of the moon's phases, and considers each plant to be under the
dominion of one of the planets. Truly a relic of heathen
superstition ! To quote a few of her prescriptions and de-
scriptions copied from labels she attached to the collection of
herbs, which she exhibited at a cottage garden flower show
about three years ago, will exemplify the state of credulity
and ignorance of the herbalist and her patients, better per-
haps than anything else :

" Hemlock. Saturn claims dominion over this herb.
Uses. Hemlock is very cold and very dangerous, especially
to be taken inwardly ; it may safely be applied to inflam-
mations, tumours, and swellings in any part of the body, as
also to St. Anthony's fire (= erysipelas), a local name, and
creeping ulcers, that arise of hot sharp humours by cooking
and repelling the heat.

"Balm. It is an herb of Jupiter and under Cancer. Uses.
The leaves with a little nitre are good against the surfeit of
mushrooms. It is also good for them that cannot fetch their

" Borage. It is an herb of Jupiter and under Leo. Uses.

Philanthropic Aspects of Nursing. 2 1 3

The leaves, flowers, and seeds are all of them good to expel
pensiveness and melancholy. It helpeth to clarify the blood
and mitigate heat in fevers.

" Elecampane, It is a plant under the dominion of
Mercury. The roots chewed in the mouth fasteneth loose
teeth and keepeth them from putrefaction. But wild tansy
is even more remarkable. It is said to be under Venus, and
the powder of the herb, boiled in vinegar with honey and
alum, easeth the toothache, fasteneth loose teeth, helpeth the
gums that are sore, and setteth the palate of the mouth when
it is fallen down.

" Wild Marjoram, This is also under the dominion of
Mercury; the juice thereof being dropped into the ears helps
deafness, pains, and noise in the ears. Pimpernel is a gallant
and solar herb ; it helpeth the toothache, being dropped into
the ears the contrary side of the pain.

" Briony or Wild Vine. The root cleanseth the skin
wonderfully from all black and blue spots, freckles, morphew,
leprosy, foul scars, or other deformity whatsoever.

" Spearmint is an herb of Venus, and is a safe medicine
for the biting of a mad dog, being bruised with salt and laid
thereon, and Wood Betony is commended against the stinging
or biting of venomous serpents or mad dogs, being used
inwardly, and applied outwardly to the place.

"Balsam is under the dominion of Jupiter, and taken
fasting in the morning is very good for pains in the head
that are continual. It is also said to be an especial friend
and help to evil, weak, and cold livers ; and, lastly, Garden
Riie is an herb of the sun, and under Leo. The juice of it,
mixed with fennel with a little honey, helpeth the dimness
of the eyesight."

Many similar remedies could be named from the old
woman's collection, but these are sufficient for our purpose,
to show that the establishment of trained and skilled nurses
is greatly needed in country districts far away from the
influences of modern knowledge and science.

It would be well if landowners, and other benevolent
persons who wish to take up this branch of philanthropy,
and employ their energies in obtaining trained nursing for
the poor, would recognize from the outset what all such

2 1 4 Woman s Mission.

workers must see sooner or later that the scheme must be
a charity. Many start with the conviction that it must be, if
not a paying one, at least self-supporting, and though others
have failed to make it so, they will succeed. Our hospitals
exemplify the principle that the poor are utterly unable to
pay for skilled attention in serious illness, and this holds
good in district nursing both in towns and villages, more
especially in the latter, where the ignorance of the simplest
treatment of sickness, combined with the total absence of
even the ordinary comforts and appliances, make even a slight
ailment a burden that cannot be adequately borne without

Again, some workers wish to make their philanthropy as
cheap as they can by establishing, to work amongst the poor,
ignorant and common women made doubly dangerous by
a small amount of cheap and insufficient training. Such
women naturally cost less than a trained nurse, but it is
hardly necessary to point out that if by our philanthropy
we wish to raise and improve the condition of the poor, to
teach them by example to live healthy and more refined and
orderly lives if we want to save life and lifelong delicacy
and infirmity, no nurse is too good, too refined, and too high-
minded for the work.

Trained nurses cannot at once dispel the mists of ignorance,
or the ingrained bad habits and the prejudice of long custom,
but they may do much to lessen them, and mitigate the evils
which follow in their train. The comfort from a trained
nurse's visit is so great that it encourages people to follow
her advice. The village district nurse must be a kind, gentle-
mannered woman, endowed with great tact and patience to
deal with her patients, and their friends, and, if she possesses
these gifts, and is following the profession, not only as a
means of livelihood, but with sincere love for her heavenly
Master, and a desire to tread closely in His footsteps, she
will win the confidence and affection of all with whom she
comes in contact

Munificent gifts have been made to hospitals ; cottage
hospitals and infirmaries have been built and supported by
voluntary contributions, but none of these supply the same
need as trained sick nurses and certificated mid wives, living

Philanthropic Aspects of Nursing. 215

among the country people, ready and willing and capable of
attending them in all emergencies. The fees can never be
sufficient for their support ; there must always be a nurse fund
provided by those who have the means, and the will, to help
the poor and the suffering ones around them ; and those who
contribute to this fund may feel that they are obeying the
injunction of our Lord, who said, "The poor ye have always
with you, and whenever ye will ye can do them good," and
are following, in the way most suited to the present age and
the present needs, His example, Who went about doing good,
and healing the sick.

216 Woman's Mission.


To give a full statement of the entire range of this subject
would far exceed the possibilities of such a paper as the
present one ; but an attempt is here made to give a short
survey of the rise and actual condition of Nursing as a pro-
fession as it exists in England.

It seems needless here to recapitulate what the world
owes to the great pioneer of nursing, Miss Nightingale,
who, long before the Crimean War gave her a European
reputation, left the joys of home and the pleasures of the best
society, which she was in a position to command and adorn,
to undertake the care of a Home for Diseased Gentlewomen.
It was her great spiritual and moral force that convinced the
public that to leave helpless human beings in the hour of
suffering to ignorant, untrained supervision was a disgrace to
the intelligence of the nineteenth century. Simultaneously,
the inimitable works of Dickens presented the reverse of the
picture ; and, not without controversy and some misgiving in
head-quarters, Mr. Sidney Herbert succeeded in despatching,
for the first time in the world's history, a woman to take a
definite place in the operations of an army in the field. How
she sped is now a matter of universal knowledge, and nobly
have her pupils and sisters in the military services followed
her footsteps. On the return of Miss Nightingale after the
war, the gratitude of the English nation took expression in
a large contribution placed at her disposal. This was devoted
by her to the foundation of the Nightingale Training Insti-
tution for Nurses, in St. Thomas's Hospital, which, by intro-
ducing the best kind of nursing into hospitals, established a
right standard of practice, and led to the foundation of schools

On Nursing. 217

of nursing in connection with almost all the large hospitals
throughout the kingdom.

The military and naval services have been the great
nurseries and pioneers of good nursing, and in a return kindly
supplied to me by the War Office I find a list of no less
than thirty-four nurses, all decorated for good service, who
have been employed in the recent wars in India, Egypt,
Burmah, and elsewhere. Their distinction can only be equalled
by their modesty, and I have not found it easy to obtain any
details of the work done. But something is known of what
Miss Florence Lees, now Mrs. Dacre Craven, underwent in 1870
in the Franco- German War, when the Empress Frederick and
Princess Alice sent her to the front, and she spent eight weeks
in the hospital for typhus cases before Metz. There, in the
midst of the raging infection, she nursed a building containing
eighty beds, which on her arrival was destitute of every special
accommodation for patients. She found only the wards, the
beds, and the same rough food supplied as would be served
out to the same men in the field if in health. There were
absolutely no cups or vessels for use of any description, but
one pail. She had two other nurses with her, and they subse-
quently had to be repeatedly relieved ; but this heroic woman
went on with her life in her hand for the whole eight weeks,
more than once in additional danger from the poor fellows
when in violent delirium, who could only be restrained by the
assistance of convalescent inmates, trained by her into
hospital orderlies.

Before Miss Nightingale's school had quite developed, an
important move forward was made by religious sisterhoods ;
and for a considerable time the best nursing work then to be
had emanated from the St. John's House, Norfolk Street,
Strand, followed closely by the All Saints' Sisterhood in Mar-
garet Street, by the East Grinstead Sisters, and the Sisters of
St. Peter. I might append here a long list of sisterhoods, most
of which include some nursing of the poor among the different
objects of their work. Their devoted spirit has been invalu-
able in teaching the world how noble a thing good nursing
is. Though all did not attain to the highest standard of
professional training, the All Saints' and St. John's Sisterhoods
are still among the heads of the profession and in the first

218 Woman s Mission.

rank of those who give their services to the poor. These last-
named bodies provided nurses for hospitals (King's College
and Charing Cross), and also supplied nurses to private cases
that could pay for them. But the first attempt to supply
nurses to the poor was in Liverpool in 1859, where a be-
ginning was made with one single nurse, whose energy and
success rapidly led to the establishment of a nursing home,
and a place for training nurses to visit the sick poor in their
own homes, in Liverpool.

During the great cholera epidemic of 1866 in London
much admirable work was done by the sisters, and the
highest testimony to their efficiency and devotion was given
by Bishop (afterwards Archbishop) Tait, a.nd by Mrs. Glad-
stone, who daily visited the London Hospital during the
worst days of that awful scourge.

It was that same visitation which led to the formation of
the East London Nursing Society, the first of the London
societies organized for the sole benefit of the poor. That
society places a trained nurse in each parish, obtains her
lodging from the local funds, and supplies fully trained
nursing superintendence from matrons living in the imme-
diate neighbourhood. There are twenty-nine nurses now
established, one residing in each parish, under four matrons ;
and they have an efficient plan for the supply of necessary
diet and comforts for the patients. The value of these
services in the deep poverty of the East End is incalculable.

Development followed quickly in the form of a really
grand scheme for training and giving the highest form of
nursing to the poor, initiated by the Duke of Westminster,
who in 1870 founded the Metropolitan and National Nursing
Association, with a central training-home in Bloomsbury
Square. It is composed almost entirely of ladies, who are
trained by Mrs. Dacre Craven ; whose exploits have already
been referred to. This institution is now divided into a
great number of branches, and the central training-home in
Bloomsbury continues to stand out as the highest for com-
pleteness and efficiency. But among the efforts to comfort
poor people few exceed in value the Association for Providing
Trained Nurses to Workhouses, which followed closely after
the kindred institutions for the poor in their own homes.

On Nursing. 219

The establishment of schools for trained nurses in almost
every large hospital is now an accomplished fact. The
nurses to private cases who receive full payment greatly
benefit the institutions to which they belong ; among the
earliest was the Westminster training-school founded by
the late Lady Augusta Stanley. Our space makes a mention
of all impossible, but they are usually all on the same system,
viz. to train nurses for private cases, reserving a few for
the poor.

The movement recently instituted by H.R.H. the Princess
Christian, to consolidate the general nursing profession by
giving a certificate under Royal Charter to all who have
received three years' full training, is expected to assist the
value of their work by consolidating their social status. But
her Majesty Queen Victoria stands pre-eminent among the
supporters of this great duty of providing nurses for the sick
poor, and by her action has made this movement a national
one. By her appointment the Duke of Westminster, Sir
Rutherford Alcock, and Sir James Paget were made trustees ;
and, from information obtained by them, it appears that
beside the work done in London and Liverpool, there are
district nursing organizations in Derby, Bristol, Brighton,
Manchester, Worcester, Leeds, Oxford, Newcastle, Maidstone,
Edinburgh, Glasgow, Belfast, Dublin, and many other towns.
These nursing organizations are exclusive of the institutions
for providing nurses to the rich, and are far more effectual
for the poor than those on the mixed system ; though it
cannot be denied that the latter are very beneficial. In
January, 1888, the trustees recommended that the bulk of
the Jubilee Fund, amounting to ^70,000, should be applied
for the training of nurses for the poor. Her Majesty finally
approved a scheme for uniting this fund with the ancient
charity of St. Katherine's Hospital, founded in 1 148 by
Queen Matilda, wife of King Stephen, chartered in 1273 by
Queen Eleanor, widow of Henry III., and again in 1351
by Queen Philippa, queen of Edward III., when the duty of
visitation of the sick poor was expressly imposed. As soon
as the necessary arrangements for the adjustment of its
revenues are completed, this ancient foundation will have
increased funds at its disposal.

22O Woman s Mission.

The committee made it its first duty to develop training-
schools in London, Edinburgh, and Dublin ; and in Edinburgh
the energy of the late Lady Rosebery rapidly formed a centre,
extending to Glasgow, Aberdeen, and other important places.
In Dublin a commencement has been made ; and throughout
England associations have come forward to accept the con-
ditions of affiliation. A noble gift from Mr. Tate has greatly
assisted the work, of which the reports, rules, and all details
may be seen in the Nursing Section. But although the
positions occupied by the above foundations are the first in
importance, both by intrinsic merit and official sanction, full
justice cannot be done to the interest felt in the subject of
nursing, especially on behalf of the poor in Great Britain,
without mentioning some very leading institutions which
have made this work an integral portion of their plan.
Among these, the institution founded by the late Mrs.
Ranyard to send " Bible women " to the poor is doing good
nursing work, and has nearly one hundred nurses employed
in various poor parishes in London. The nursing branch is
under the direction of Mrs. Selfe-Leonard, and the institution
gives its nurses three months' hospital training. These nurses
are selected with extreme care, and, though they could not
be certificated as fully trained nurses, have done very
valuable work.

The institution known as the Mildmay Deaconesses also
has a branch for nurses, and employs them in the homes of
the poor. The Sisters of St. John the Divine, formerly a
part of the Norfolk Street Institution, have now established
themselves in Poplar, and give efficient help to the poor.

It is difficult to decide whether maternity work should be
classed as nursing, and therefore included among the under-
takings described in this paper or classed among the strictly
medical charities. If it is regarded as women's work for
women, we may mark its progress with approbation. A very
decided effort is now being made to provide well-trained
midwives for the poor ; and though inadequate to the wants
of the ever-growing population of London, there is a nucleus
of excellent work in the East End Mothers' Home, which
trains midwives ; and a very remarkable effort to promote
good work of this kind should be noticed in the Maternity

On Nursing. 221

Hospital at Clapham, in which there is a school for midwives,
and the whole machinery of the medical and nursing staff
is entirely composed of women.

The institutions here indicated mostly concern London
only, or have their centres there ; but there is a very active
general movement to supply nurses throughout the country
districts in England, which is taking form in various ways.

The Cottage Nursing Association, of which the centre is
in Gloucestershire, is fully described in this Section by a very
able paper from the pen of Lady Victoria Lambton and Mrs.
Malleson ; it gives the best nursing by fully trained nurses
and midwives, and deserves the highest praise. The same or
a kindred plan, also supplying highly trained nurses, is estab-
lished at West Mailing, in Kent. All the institutions named
previously as having centres in towns, of course also supply
fully trained nurses. A very large number of single nurses,
with different degrees of training, is employed by ladies ; one
or perhaps two nurses being placed in a parish, though in
some cases they come from the organization provided for
cottage hospitals. But in the remote country districts those
who wish thus to assist poor people find themselves much
hindered by the unwillingness of the peasant poor to admit
very highly trained nurses into their houses. Their remote-
ness makes daily visits of a single hour or more (without
residence) unattainable ; and they will not accept the services
of any nursing attendant who does not undertake to assist, or
even to fulfil, all the necessary household duties, and supply
whatever is wanted for the general comfort of the family as
well as care of the patient. Now it does seem an injustice to
compel fully-trained nurses, who have sacrificed much time
and money to the attainment of the delicacy of touch needed
for the highest surgical work, to undergo the risk of spoiling
their hands by housework. And it is very unusual that the
severest surgical cases are ever attended at home. These
(mostly accidents) are usually removed at once to the great
hospitals in the nearest towns. I am far from intending to
imply that fully-trained nurses are not always the most
valuable ; but the difficulty above indicated is a very real
one, and can only be met by supplying a nurse of less
ambitious quality. Another difficulty arises from the fact

222 Woman s Mission.

that a fully-trained nurse placed alone in a remote country
parish often finds that there is not work enough to employ
her time. These impediments have been best overcome by
the Ockley system, suggested by Miss Broadwood, a lady
residing near Horsham, in Surrey. The plan here is to
employ well-selected women from the district, and give them
three or four months' training at the hospital at Plaistow.
They are distributed as asked for by the different parishes
belonging to groups arranged in various neighbourhoods.
By a very excellent adoption of the " benefit " principle,
funds for these nurses are provided by a settled contribution
from each parish calculated in proportion to the amount of
its population. It is found that a subscription at the rate
of twenty-five or twenty-seven shillings for every hundred
persons annually will, if there is a large group of parishes,
supply the wages of the nurses. The patients pay a weekly
fee on a graduated scale according to their social position, viz.
two shillings weekly for the poor of the neighbourhood ; five
shillings for artisans and small farmers ; seven and sixpence
for substantial tradesmen ; and one pound for the gentry and
wealthy inhabitants. An annual subscription is expected, of
the same amount as their weekly fee. Evidently the plan
suited the wishes of the poor ; for it was rapidly adopted in
twenty parishes round Horsham, and, with various modifica-
tions, is being established in many other places, such as
Battle, Rye, the neighbourhood of Grantham, etc. These
nurses, though not fully trained, have learned the primitive

Online LibraryAngela Georgina Burdett-CouttsWoman's mission; a series of congress papers on the philanthropic work of women, by eminent writers → online text (page 21 of 49)