Early nursing reform in nineteenth-century London: a doctor-driven phenomenon.

Florence Nightingale's status as a national heroine, her charisma and her excellent sense of public relations led to the popular belief that she and her lady nurses in the Crimea, and later, her school at St Thomas's, miraculously transformed nursing almost overnight. Aside from the fact that this is hardly the way historical processes work, and despite the very convincing studies of revisionists such as Monica Baly and Christopher Maggs, this interpretation has shown remarkable persistence.' From a twenty-first century perspective it is obvious that nineteenth-century nursing reforms were complex and multiform, reflecting many of the major trends of their time such as the efforts of women to break into the public sphere, the rising standard of living, the religious revival with its emphasis on good works and its violent denominational controversies, the reformation of manners, and, most important, the rapid development of clinical medicine. In this article I shall argue that the very important contributions of Nightingale and the new lady nurses have overshadowed the significant reforms which doctors in the twelve London teaching hospitals made in the earlier part of the nineteenth century. Indeed, it was the new "scientific" doctors, as they called themselves, in the teaching hospitals who created the demand for better nursing.2 The new medicine in London developed in the voluntary hospitals in the first part of the nineteenth century. Based on clinico-pathological correlation, localism and hospital-based statistics, pioneered in large part by the Paris school of medicine, it was to make these hospitals the centre of medical education and prestige. More important than these