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Reviewed by:
  • Florence Nightingale and the Health of the Raj
  • Lynn McDonald
Jharna Gourlay . Florence Nightingale and the Health of the Raj. The History of Medicine in Context. Aldershot, U.K.: Ashgate, 2003. xii + 305 pp. Ill. $114.95, £60.00 (0-7546-3364-0).

This is the first book-length study of Florence Nightingale's forty years of work on India—on public health, famine prevention, economic development, and better government. The material is fascinating, and the tale well told. Of the ten chapters, the first two give introductory material on Nightingale and India; the other eight describe her major areas of contribution. Secondary sources are well used to flesh out the story. Thus we find out what Nightingale was trying to do, with whom, against what obstacles, and with what success or failure. Often the author explains that a measure proposed by Nightingale was not implemented for another twenty or more years. The book contains a useful chronology, a glossary, biographical data on collaborators, and a small number of illustrations.

Good as it is, however, this volume is not quite all its author claims for it. Jharna Gourlay states in her preface that "the book is based on primary sources in archives in Britain and India" (p. ix)—true, but only partially, for it depends largely on the British Library and the India Office (now the Asia, Pacific and Africa Collections, also at the British Library), and a small number of original letters from the author's research in India; print sources are then much used. Oddly ignored are such major county archives as Wiltshire, with a vast correspondence with Sidney Herbert, and Liverpool, with 148 letters to Lord Stanley. From British university archives a large set of letters to Sir Louis Mallet at Balliol College was missed (Gourlay used the smaller collection at the British Library), as was a sizable set of letters to Sir Charles Trevelyan at Newcastle. American and Canadian university archives (notably those of Columbia, Boston University, and the Woodward Biomedical Library at the University of British Columbia) are missed entirely. Gourlay is undoubtedly correct that Indian correspondence "is difficult to find" (p. x), especially that with Indian nationals, but she missed much correspondence with officials and experts that could have been used. We have material from more than two hundred archives worldwide for the Collected Works of Florence Nightingale generally, using twenty-plus in the two India volumes (edited by Gérard Vallée).

The author uses her secondary sources well to provide background and explanation. "The Zemindar, the Sun and the Watering Pot" deals with the complicated issues of poverty and famine and shows how Nightingale's initial focus on public health had to be broadened: people must first live. Gourlay explains how Nightingale's own working style changed from trying to persuade officials to bring in reforms to encouraging Indian nationals and promoting self-government.

Gourlay explores the core issue of the British government's responsibility for the massive famines that occurred under its rule—for India had had famines before. This is complicated, because population data did not exist before British rule. She makes the case, using recent scholarship, for significant blame, Indians having to pay for their occupation and Britain's border wars, and British officials not investing in but taking resources out of the country. [End Page 373]

The chapter "The Ryot's Faithful Servant" is an excellent consideration of Nightingale's work on land tenure. Perhaps the best chapter is that about her collaboration with Lord Ripon, governor general in 1880–84 (a topic for which British Library sources are adequate).

The author's decision to call Nightingale by her first name, with the occasional "Miss Nightingale," was an irritant for this reviewer—men of course always got surnames and titles. Why not simply "Nightingale," as one would refer to an author or expert, which surely she was? Chapter titles like "Florence and the Zenana Force" similarly grate, although the material—Nightingale's work on women's issues—is informative. Finally, I would quibble with the "health of the raj" title: the health of the government was surely only a means to an end—better institutions to...


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