18 August 2020

Important medicine chests at Florence Nightingale Museum, London

We know that medicine chests filled with bottles of herbal remedies and medicines were purchased by affluent families for domestic use from apothecaries in Britain in the C18th-C19th. These chests usually came equipped with a manual on how to use the medicines, what illnesses they could be us­ed for and the correct dosage for each. They were particularly useful when the families were travelling. Medicines that often feat­ured in those chests included 1] laudanum, an opioid that was widely available and usually used as pain relief and 2] med­icines needed for immediate first aid eg emetics, purgatives, stimulants and ant­icon­vulsants.

In larger chests, dressings and plasters were included for minor wounds, as were burns treatments. They also included a variety of instru­ments like a mortar and pestle, scales, meas­ures, spatula and lancet. Florence Nightingale had such a chest, as we will see.

Florence Nightingale's medicine chest, c1855
Bottles of medicine in the main compartment
Small instruments in the bottom drawer

From her late teens, Florence Nightingal(1820–1910) became capt­iv­ated by the idea of becoming a nurse; a passion that distressed her parents as nursing was viewed as an unfit profession for respect­able women. Florence studied nursing secretly, defying her parents and the ex­pec­t­ations of society, which, she believed, rendered middle class women unable to make full use of their energy and intel­ligence.

Nightingale had been working at a Harley St nursing home when she learned of the horrific conditions facing British army soldiers in their Crimean War hospital base. The British Secretary of State for War asked her to lead a team of 38 nurses to make urgent improve­ments in Scutari. She was told that with no understanding of the necessity for good hygiene in preventing disease, almost as many British soldiers were dying from illness and exposure as from wounds.

She became the best known name of the Crimean War (1853-56) when she and the nurses went out to Scutari hospital in Istanbul Turkey in Nov 1854, to run the soldiers' hospital. Faced with these appalling conditions and the hostility of army doctors, all the nurses worked tire­lessly, walking the hospital corridors to attend to thousands of cas­ualties, bringing organisation, new supplies and cleanliness, dedicated to reducing the spread of infection. Florence did indeed find that the young men were dying at an alarming rate, from diseases like dysentery caught in the hosp­it­al.

Back in UK, the rest of Nightingale’s life were dedicated to transforming healthcare, stressing the vital importance of hand wash­ing and cleanliness. Nightingale was passionate about using stats and research to physically change the design and structure of hospitals in ways relevant still - ward design, nurse training, hygiene, infection cont­rol and the compassionate treatment of patients. Meantime Florence was herself suffering from fever, insom­nia and exhaustion.

The Florence Nightingale Museum in Lambeth Palace Rd London opened in 1989. It is loc­ated in the grounds of St Thomas’ Hospital, close to the Houses of Parliament. The Nightingale in 200 Objects, People & Places Exhibition marked the 200th anniversary of her birth.

See a speech to the staff and trainees of The Nightingale Training School for Nurses showed her as a pioneer of evidence-based health care: gathering data to prove the importance of cleanliness and sanitation, her passion for data led to her being the first female member of the Royal Statistical Society.

Florence Nightingale's medicine chest
Bottles of medicine removed from the main compartment to read the labels clearly

The nurses and soldier’s wives cleaned shirts and sheets; bed pans & toilets were emptied; scrubbing brushes, buckets, blankets & operating tables were purchased from donations. Nightingale’s related writings, packed with advice, were put on display: You ought to use fresh water as freely for the skin ..as fresh air for the lungs (Notes on Nursing for the Labouring Classes, 1868).

Exhibition Display #28 was the medicine chest (c1855) that Florence took to the Crimean War. It contained medicines like quin­ine to treat malaria and carbonate of potassium for fever. It also contained a tiny set of scales, and a glass beaker for carefully measuring liquids. The chest was beautifully designed and crafted, making it transportable over distant and rugged travel.

Nightingale led her nurses to Scutari, to bring order, clean­liness and new supplies to the wards where the wounded were being treated. She took this medicine chest for her and her nurses to use,  most of the medicines being for upset stomachs or diarrhoea. But was it the only chest for all those sick men?? Could the medicine bottles be refilled in Turkey? The only comfort came from knowing that even when the men died in the nurses’ care, they died under loving conditions.

Mary Seacole's medicines
Photo credit: Helen Rappaport

Note that Nigh­t­ingale’s contemp­orary, nurse Mary Seacole, also arrived at the Crimean War equip­ped with a medicine chest fil­l­ed with her herbal remed­ies. Pomegranate bark was ground to a paste, for example, to be used for the expulsion of tapeworms and as a purgat­ive. Seacole demonstrated that her home-grown Jamaican practice of hygiene, healthy food, natural rem­edies and kindness had as much to offer as traditional medicine. Thus she made her nursing practice a more holistic one. 

Florence Nightingale Museum reopened after the coronavirus lockdown from the 1st August 2020 onwards, with timed tickets Thurs-Sunday. Do visit.








14 comments:

Deb said...

The medicine chest was as carefully created as any other small pieces of furniture

Parnassus said...

Hello Hels, As wonderful as are modern medical discoveries, such as antibiotics and nano-medicines, it is amazing to think that most medical crises in history could be treated with simple hygiene. To be fair, there were people throughout history that advised cleanliness and good nutrition, but until about the 20th century this advice was largely ignored. In the U.S. Civil War, just a few years after Nightingale stocked her medicine chest, diseases such as dysentery were still the major cause of death, not battle injuries.
--Jim

Fun60 said...

What a determined individual. She had much to overcome to achieve her dream of becoming a nurse. I have yet to visit the Museum but I will one day.

Luiz Gomes said...

Boa tarde. A medicina é muito especial em nossos dias.

Joseph said...

I am not surprised that the army doctors were hostile to this group of compassionate nurses. The men had run the hospital perfectly well, according to their own perspective.

Hels said...

Deb

agreed. When the chest was kept in the home, it had to be as beautifully made as any other mahogany chest of drawers on display, only smaller. When the chest travelled by ship, it had to be so well designed to survive salty sea water and crashing waves.

Hels said...

Parnassus

depending on the geographical location of 19th century wars, it was absolutely true that more young men died from pneumonia, typhoid, malaria, dysentery-diarrhoea etc than from war wounds. Even in WW1, trench fever and rat bites were catastrophic.

Hels said...

Fun60

By the mid 19th century, nurses could only have been Catholic nuns or prostitutes. No wonder the wealthy, scholarly, Unit­arian Nightingale family were horrified when Florence wanted to become a nurse.

To understand Florence's struggle to study and practise nursing pre-Crimea, read
https://melbourneblogger.blogspot.com/2014/02/had-florence-nightingale-ever-been.html

Hels said...

Luiz

medicine is very effective now, as you say. But even so, there are still doctors who ban childhood inoculations because they "cause" autism etc etc. We still have a lot to learn, I believe.

Hels said...

Joseph

Male doctors, who had trained for years, were furious when "ignorant girls" insisted that hospital conditions were killing soldiers as fast as the enemy had. Even though they didn't know about antibiotics etc, Nightingale and the nurses knew the importance of clean bandages and bedding, fresh air, nourishing food and tender care.

mem said...

It would be fascinating to know if the contents of these boxes of remedies actually did anything other than Placebo effect . I wonder if anyone has looked at their scientific Objective effect on the illnesses they were supposedly treating .I know laudanum was responsible for a great deal of misery as was described by Jane Austin in Mansfield Park where Lady Bertram definitely has a drug problem . Often ladies were described as having a "delicate constitution" which was code fro prolapse caused by difficult childbirth and then of course treated by bed rest and laudanum . The bed rest was so that they could control their bladders.
Evidently Florence herself suffered a great deal , probably from PTSD after the war and apparently spent a great deal of time in bed and suffering from"emotional exhaustion " What a woman though . .

Hels said...

mem

even if some of the medicines had zero impact or worse, I think the nurses' contribution to the young soldiers' welfare was vast. Carefully cleaning and bathing the bodies really did reduce the spread of infection, and the fresh air and decent food helped repair their sad bodies. Ditto Florence opened a laundry so that sick soldiers would have clean linens.

While in Crimea, Florence had contracted the bacterial infection brucellosis, which was different from PTSD, and stayed largely in bed for life. But it didn't reduce her intellectual and political activities... which became more effective as time went on.

Anonymous said...

A very smart person. Didn't the Romans know about cleanliness for disease prevention yet along the centuries (dark ages?) it seemed to be forgotten and had to be relearnt, again and again including here in our own city in the 19th century.

Hels said...

Andrew

Roman doctors certainly knew enough to have swamps drained to prevent malaria spreading, and to send patients to public baths to cleanse their bodies. But they couldn't stop families using chamber pots inside their houses, and couldn't stop the faeces being tipped onto the streets. If only the learning went on in a linear pattern throughout the centuries that followed.