Analysis Christmas 2008: Great Britons

Reappraising Florence Nightingale

BMJ 2008; 337 doi: (Published 16 December 2008) Cite this as: BMJ 2008;337:a2889
  1. Keith Williams, researcher
  1. 1Wellcome Trust Centre for the History of Medicine at UCL, London NW1 2BE
  1. kcwilliams{at}

    Keith Williams takes a closer look at the nurse’s influence on military medicine

    Revisionism has hardly touched Florence Nightingale, and she remains one of the great icons of the Victorian age. Despite some hostile comment, in particular from F B Smith,1 the popular image of her remains that of the angel of Scutari and the genius behind much medical reform and the development of nursing. However, an examination of primary sources shows that much of this reputation is based on the myths created by the popular press at the time of the Crimean war and subsequently by Cook’s biography of her.2 This was commissioned by Nightingale’s family after her death and can therefore hardly be regarded as unbiased. The Nightingale myth was given a considerable boost by Woodham-Smith’s book,3 written in the aftermath of the second world war, a time when Britain desperately needed heroic figures. Indeed, such was the acclaim with which this book was greeted that Nightingale’s reputation was largely unimpeachable for the next few decades.

    One reason this situation remained unchallenged is that historians generally have not undertaken the breadth of primary research necessary to objectively re-evaluate Nightingale’s work, her achievements, and her role in the movement for medical reform in the 19th century. This is particularly true in regard to military medicine, and it may fairly be argued that Nightingale, far from guiding the reform and development of military medicine, actually impeded its progress as a result of her class based hostility to military doctors.

    Class wars

    It is often forgotten, or overlooked, that Nightingale was born into a wealthy and well connected family. Indeed, at a time when influence was often determined by social standing, the Nightingales could exercise considerable influence. Lord Palmerston, who was prime minister during much of the Crimean war, was …

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