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, bandages--all 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 drafted off to tend their sick comrades, they were faced with disease, mutilation, and death in all their most appalling forms, crowded multitudinously about them in an ever-increasing mass.
They were like men in a shipwreck, fighting, not for safety, but for the next moment's bare existence-- to gain, by yet another frenzied effort, some brief respite from the waters of destruction.
