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Nightingale London, and, although she lived the retired life of an invalid, she was always busy with her pen or was offering verbally encouragement and direction. In 1857, after publishing a full report of the voluntary contributions which had passed through her hands in the Crimea, she issued an exhaustive and confidential report on the workings of the army medical departments in the Crimea. Next year she printed ‘Notes on Matters affecting the Health, Efficiency and Hospital Administration of the British Army.’ The commission appointed in 1857 to inquire into the sanitary condition of the army set a high value on her interesting evidence. With her approval an army medical college was opened in 1859 at Chatham; a first military hospital was established in Woolwich in 1861; and an army sanitary commission was established in permanence in 1862. Everywhere her expert reputation was paramount. During the American civil war of 1862–4 and the Franco-German war of 1870–1 her advice was sought by the foreign governments concerned.

In regard to civil hospitals, home nursing, care of poor women in childbirth, and sanitation, Miss Nightingale’s authority stood equally high. In 1862, in Liverpool Infirmary, a nursing home was founded with special reference to district nursing, and was placed under the care of Agnes Elizabeth Jones (1832–1868), who had been trained at Kaiserswerth. In 1867, at the request of the poor law board, she wrote a paper of ‘Suggestions for the improvement of the nursing service in hospitals and on the methods of training nurses for the sick poor.’ Miss Nightingale had a hand in establishing in 1868 the East London Nursing Society, in 1874 the Workhouse Nursing Association and the National Society for providing Trained Nurses for the Poor, and in 1890 the Queen’s Jubilee Nursing Institute.

In 1857, on the outbreak of the Indian Mutiny, Miss Nightingale had written from Malvern to her friend Lady Canning, wife of the governor-general, offering in spite of her bad health ‘to come out at twenty-four hours’ notice, if there were anything for her to do in her line of business’ (, op. cit.). She never went to India. But the sanitary condition of the army and people there became one of the chief interests of her later life. The government submitted to her the report of the royal commission on the sanitary state of the army in India in 1863, and she embodied her comments in a paper entitled ‘How People may live and not die in India,’ in which she urged the initiation of sanitary reform. She corresponded actively with Sir Bartle Frere, governor of Bombay, and in August 1867 was in constant communication with Sir Stafford Northcote, then secretary of state for India, as to the establishment of a sanitary department of the Indian government. With every side of Indian social life she made herself thoroughly familiar, exchanging views personally or by correspondence with natives, viceroys, and secretaries of state, and constantly writing on native education and village sanitation. She wrote to the ‘Poona Sarvajanik Sabha’ in 1889: ‘There must be as it were missionaries and preachers of health and cleansing, if any real progress is to be made.’ In other published papers and pamphlets she discussed the causes of famine, the need of irrigation, the poverty of the peasantry, and the domination of the money-lender. She urged native Indians to take part in the seventh international congress of hygiene and demography held in London in 1887, and to the eighth congress at Buda-Pesth in 1890 she contributed a paper on village sanitation in India, a subject which, as she wrote in a memorandum addressed to Lord Cross, secretary of state for India, in 1892, she regarded as especially her own.

Miss Nightingale wrote well, in a direct and intimate way, and her papers and pamphlets, which covered all the subjects of her activity, greatly extended her influence. Her most famous book, ‘Notes on Nursing,’ which first appeared in 1860, went through many editions in her lifetime.

Miss Nightingale, in spite of her withdrawal from society, was honoured until her death. Among the latest distinctions which she received was the Order of Merit in 1907, which was then for the first time bestowed on a woman, and in 1908 she was awarded the freedom of the City of London, which had hitherto only been bestowed on one woman, the [q. v. Suppl. II]. She had already received, among many similar honours, the German order of the Cross of Merit and the French gold medal of Secours aux blessés militaires. On 10 May 1910 she was presented with the badge of honour of the Norwegian Red Cross Society.

She died at her house in South Street, Park Lane, London, on 13 Aug. 1910, at the age of ninety. An offer of burial in Westminster Abbey was in accordance with her wishes refused by her relatives. She was buried in the burial place of her family at