Florence Nightingale

“ Good effects upon the health of gentleness, firmness, and cheerfulness. No child can be well who is not bright and merry, and brought up in fresh air and sunshine, and surrounded by love—the sunshine of the soul. ”

“ We have everything defined for us that can require a definition. We have "powers" given to everyone who can possibly wish to have them. We have duties imposed upon our officials in language that is as clear and precise as the best draftsmen in England could make it. We have awful threats launched against any and every dwelling-house which appears to a Medical Officer of Health "to be in a state
so dangerous or injurious to health as to be unfit for human habitation." ”

“ How shall we get the results of the Health Missioner's work fairly and completely tested? A question not at all easy to answer, because, in the first place, there can be no speedy results, the process is necessarily very slow; and because, in the second place, the results are often not on the surface, but in the intimate and private habits of life which a stranger who comes on a tour of inspection can hardly inquire about without giving offence. ”

“ The old cottage mother has no idea of responsibility for the health of her family. It is all the "will of God." But the young mother, who has had some education, is anxious to be taught. A very pregnant remark was made: "How superior the animal mother is to the human mother in intelligent care of her offspring; the cow never tries to teach her calf to eat grass, and the cat licks her kitten all over before it is half-an-hour old." As has been said of other people, may yet more truly be said of cottage mothers. ”

“ The real work is when, having made friends with the cottage mothers, and being invited by them to their own homes, every one of whom and every one of which differs from every other, the Health Missioner practically shows the cottage mother there, in the bedroom, in the kitchen and parlour, in the backyard and garden, in washing everybody's skin clean, in clothing and food—aided by the cottage mothers, who alone can tell her how to make what she has taught practicable. ”

“ Bedroom?—Is not what we want to get into a bedroom, fresh air, the most important thing of all, and sunshine, not merely light, but sunlight? What we want to get out of a bedroom, foul air? An unaired bedroom is a box of foul air. Opening of windows: but windows differ so much in their construction one from the other, that no general rule can be laid down, except that in all cases there must be ventilation near the ceiling; and the Health Missioner must see the kind of window and how it opens, in order to show the best way of airing the room. ”

“ Our Homes.—The Cottage Homes of England being, after all, the most important of the homes of any class, should be pure in every sense. Boys and girls must grow up healthy, with clean minds, and clean bodies, and clean skins. And the first teachings and impressions they have at home must all be pure, and gentle, and firm.
It is home that teaches the child after all, more than any other schooling. A child learns before it is three whether it shall obey its mother or not. ”

“ The Medical Officer chooses the candidates he deems qualified to be examined for Health Missioners. These qualifications must be—good character, good health, personal fitness for teaching, tact and power, so as to be "in touch" and in love with the village mothers—to be acceptable to them—growing in sympathy for them, to be their personal friend, and to make them her personal friends—not "prying about," as the village mothers might say. Not Bacteriology, but looking into the drains, is the thing needed. Even Medical Students do not learn much from lectures, unless with the objects before them. ”

“ You must "mother" the cottage mothers, and the girls. And don't think that the gain is all on their side. How much we learn from the poor—how much from our patients in hospital—when heart meets heart. It is a rule among the best District Nurse Societies not to give alms (money) .This also should be a rule of the Health Missioners. But without knowing the wants, the difficulties, temptations, fatigues, of their daily lives—without a serious study of their world—we cannot help them. Much fatigue is occasioned by their want of method. Their deplorable manners to their children have been noticed. ”

“ Our reply is that, for centuries there have been superstitions, for centuries the habits of dirt and neglect have been steadily and perseveringly learnt, and that, if we can transform by a few years' quiet persistent work the habits of centuries, the process will not have been slow, but amazingly rapid. What is "slow" in more senses than one is the eternal lecturing that is vox et præterea nihil—words that go in at one ear and out at the other. The only word that sticks is the word that follows work. ”

“ But there are great advantages in the Saturday's tub and plenty of soaping, and in friction of the skin. Not babies only, but men and women require daily washing. The body the source of defilement of the air.
The entire want of privacy in the bedrooms, the constant drive of the mother's occupations, make it a matter of difficulty when she can wash herself. [As a matter of fact, most women do not wash at all.] The Missioners should show the utmost sympathy—should, without giving offence, draw her out by careful questions, asking what plan the women would recommend rather than what they do. ”

“ His salary, which ought to be proportionate to his capital of knowledge ever accumulating, and his income of experience rolling up as years go on, which should give him an opportunity for sufficient leisure to work at public health as a scientific study, apart from his medical practice—his salary, which should be enough for this, is often hardly sufficient for his necessary travelling expenses as a public official—sometimes only a few pounds per annum. ”

“ In some cases the cost of hiring horse and cart—the amount depending on the distance of the allotment from the dwelling—is so serious a consideration that if bye-laws compelled the occupiers to remove their refuse to their allotments, say every month, either the value of the manure would be nothing, or the scavenging must be done at the expense of the Sanitary Authority. From the public health point of view, the Sanitary Authority should of course do the scavenging in all the villages.
The health Economy of the Community demands the most profitable use of manure for the land. ”

“ Water-supply almost entirely from shallow wells, often uncovered, mostly in the cottage garden, not far from a pervious privy pit, a pig-sty, or a huge collection of house refuse, polluted by the foulness soaking into it. The liquid manure from the pig-sty trickles through the ground into the well. Often after heavy rain the cottagers complain that their well-water becomes thick. ”

“ They don't know what us wants." Sympathy with, interest in the poor so as to help them, can only be got by long and close intercourse with each in her own house—not patronising—not "talking down" to them—not "prying about;" sympathy which will grow in insight and love with every visit; which will enable you to show the cottage mother on the spot how to give air to the bedroom, &c. You could not get through the daily work of the cottage mother—the washing, cooking, cleaning, mending, making. ”

“ The gain is a double one—safety in the matter of health—increase in the matter of food, besides the untold gain, moral as well as material, which results from the successful cultivation of land.
There are some villages without any gardens—barely room for a privy and ashpit. But even in these cases the occupiers generally have allotments.
Plenty of bye-laws may be imposed, but bye-laws are not in themselves active agents. And in many, perhaps in most, cases they are impossible of execution, and remain a dead letter. ”

“ We wait to see whether the filth will really trickle into the well, and whether the foul water really will poison the family, and how many will die of it. And then, when enough have died, we think it time to spend some money and some trouble to stop the murders going further, and we enter the results of our "masterly inactivity" neatly in tables ”

“ Let not England lag behind—especially not in the conviction that nothing can be done without personal friendship with the women to be taught. It is a truism to say that the women who teach in India must know the languages, the religions, superstitions, and customs of the women to be taught in India. ”

“ Medical Officer of Health: generally a busy man with a private practice covering a very large area, who earns a pittance for doing a most important public duty; a man appointed to his office and maintained in it by those whom he ought to criticise fearlessly and openly, when they are careless about the health of those dependent on them. ”

“ The eye and hand must be trained to see and deal with dangers to health. "No practical knowledge is possible on any subject without the meeting of the senses with the material."
(8) After a Health Missioner has become settled in a district, she will then be able to receive a Probationer, who, while attending the Medical Officer's lectures and classes, will find time to accompany the Health Missioner in her round of visiting. [It will depend on the tact of the two ladies if this is acceptable or not to the cottage mother; if unacceptable, it must, of course, cease.] ”

“ We want independent Medical Officers of Health—appointed by the County Council, and removable only by them—men trained up for this as a profession; we want Sanitary Inspectors, with a proper qualification, appointed with the Medical Officer's approval; we want that each Medical Officer should be informed as to all approaches of dangerous disease, and bound in his turn to supply the information for other neighbouring districts ”

“ Gardens [4] near houses, and allotments where refuse and privy contents are used for manure [5] ; Cottage-owners made amenable to sanitary laws, compelling the landlord to give his cottages the essentials for health as far as construction is concerned; School teaching of health rules, made interesting and clear by diagrams showing dangers of foul drains and so forth. [But we must not expect too much practical result from this. It has failed, except as a book or lesson, where it has been tried in India. The school-master himself should be a health apostle.] ”

“ You cannot know the points through which they can be influenced and influence others. They certainly cannot be managed or influenced in a lump—rather less than anybody else. You must know each and her individuality, separately at home, if you are to do any good. ”

“ When our water is poisoned, we want to know it; then we shall avoid it. But it is far more difficult to get people to avoid poisoned air, for they drink it in by the gallon all night in their bedrooms, and too often in the day. ”

“ Then comes the question of hair and hair-brushes. Mothers should encourage their girls' natural wish to look nice, make them proud of beautifully brushed and well-plaited hair, rather than of the smart hat above it. ”

“ Now the most profitable use is that which permits of least waste, and if we could only regard economy in this matter in its true and broad sense, we should acknowledge that the Community is advantaged by the frequent removal of sewage refuse from the houses, where it is dangerous, to the land, where it is an essential. ”

“ Often the garden is large enough for the utilisation of ashes and house refuse too. But occupiers almost always take both privy and ashpit contents to their allotments. Thus hoarding-up of refuse matters occurs. ”

“ We must not talk to them, or at them, but with them.
A great man who has just passed away from us used to advise his young men, when they entered life, to make personal acquaintance with the poor, whether they took or not to "works of philanthropy." ”

“ Uses of animal and of vegetable food. Danger of all ill-cooked and half-cooked food. Nourishing value of vegetables and whole-meal bread. Danger of too little food and too much at the wrong times. Dangers of uncooked meat, specially pork, diseased meat, decaying fish, unripe and over-ripe fruit, and stewed tea. ”

“ Earth closets are the exception, cess-pit privies the rule. [In another place 109 cess-pit privies were counted to 120 cottages. And, as might be expected, there was hardly a pure well in the place.]
In one, a market town, there are water-closets, so called from being without water.
Storage of Refuse and Ashes.—Ashpits are conspicuous by their absence. Huge heaps of accumulated refuse are found piled up near the house, sometimes under the windows, or near the well, into which these refuse heaps soak. Where there are ashpits, they are piled up and overflowing. ”

“ So as we read such an account as this we seem to be watching, not robbery, but murder going on, and to be waiting for the rates of mortality to go up before we interfere; we wait to see how many of the children playing round the houses shall be stricken down. ”

“ Then speak very plainly of the offensive condition of an unwashed body, the smell of the feet, the horrible state of the hair, the decay and pain in the teeth, &c.; the consequent poisoning of the air of the room, &c. It is the human body that pollutes the air. ”

“ They teach her as much as she teaches them. The mothers should help her by asking questions and by relating their own experiences. And, in a lecture, the Missioner should welcome such questions, even if asked rudely. If she snubs them, it is all over with her usefulness. ”

“ Made foods not wholesome. Head-ache often caused by bad eyesight. Symptoms of overwork at school—head-ache, worry, talking in the sleep. Danger to babies and little children of any violence, jerks and sudden movements, loud voices, slaps, box on the ear. ”