untitled

wards [with particular configurations of environ-
mental circumstances determining which]”
(Rosenberg, 1979).
Anticontagionism reached its peak prior to the
political revolutions of 1848; the resulting wave of
conservatism and reaction brought contagionism
back into dominance, where it remained until its
reformulation into the germ theory in the 1870s.
Leaders of the contagionists were primarily high-
ranking military physicians, politically united.
These divergent worldviews accounted in some part
for Nightingale’s clashes with the military physi-
cians she encountered during the Crimean War.
Given the intellectual and social milieu in which
Nightingale was raised and educated, her stance on
contagionism seems preordained and logically con-
sistent. Likewise, the eclectic religious philosophy
she evolved contained attributes of the philosophy
of Unitarianism with the fervor of Evangelicalism,
all based on an organic view of humans as part of
nature. The treatment of disease and dysfunction
was inseparable from the nature of man as a whole,
and likewise, the environment. And all were linked
to God.
The emphasis on “atmosphere” (or “environ-
ment”) in the Nightingale model is consistent with
the views of the “anticontagionists” of her time.
This worldview was reinforced by Nightingale’s
Crimean experiences, as well as her liberal and pro-
gressive political thought. Additionally, she viewed
all ideas as being distilled through a distinctly moral
lens (Rosenberg, 1979). As such, Nightingale was
typical of a number of her generation’s intellectu-
als. These thinkers struggled to come to grips with
an increasingly complex and changing world order
and frequently combined a language of two dis-
parate realms of authority: the moral realm and the
emerging scientific paradigm that has assumed
dominance in the twentieth century. Traditional re-
ligious and moral assumptions were garbed in a
mantle of “scientific objectivity,” often spurious at
best, but more in keeping with the increasingly ra-
tionalized and bureaucratic society accompanying
the growth of science.

The Feminist Context of

Nightingale’s Caring

I have an intellectual nature which requires satisfac-
tion and that would find it in him. I have a passion-

ate nature which requires satisfaction and that would

find it in him. I have a moral, an active nature which

requires satisfaction and that would not find it in his

life.

—Florence Nightingale, private note, 1849, cited

in Woodham-Smith (1983, p. 51)

Florence Nightingale wrote the following tor-

tured note upon her final refusal of Richard

Monckton Milnes’s proposal of marriage: “I know I

could not bear his life,” she wrote, “that to be nailed

to a continuation, an exaggeration of my present

life without hope of another would be intolerable

to me—that voluntarily to put it out of my power

ever to be able to seize the chance of forming

for myself a true and rich life would seem to

be like suicide” (Nightingale, personal note cited

in Woodham-Smith, 1983, p. 52). For Miss

Nightingale there was no compromise. Marriage

and pursuit of her “mission” were not compatible.

She chose the mission, a clear repudiation of the

mores of her time, which were rooted in the time-

honored role of family and “female duty.”

The census of 1851 revealed that there were

365,159 “excess women” in England, meaning

women who were not married. These women were

viewed as redundant, as described in an essay about

the census entitled, “Why Are Women Redundant?”

(Widerquist, 1992, p. 52). Many of these women

had no acceptable means of support, and

Nightingale’s development of a suitable occupation

for women, that of nursing, was a significant his-

torical development and a major contribution by

Nightingale to women’s plight in the nineteenth

century. However, in other ways, her views on

women and the question of women’s rights were

quite mixed.

Notes on Nursing: What It Is and What It Is Not

(1859/1969) was written not as a manual to teach

Notes on Nursing: What It Is and What It

Is Not (1859/1969) was written not as a

manual to teach nurses to nurse, but

rather to help all women to learn how to

nurse.

nurses to nurse, but rather to help all women to

learn how to nurse. Nightingale believed all women

required this knowledge in order to take proper

care of their families during times of sickness and

CHAPTER 5 Florence Nightingale’s Legacy of Caring and Its Applications 47