NightingaleStatistics for the Army in the East

Disease beat our army. Drains won it back.

Impact report, Scutari, 1854 to 1856. With a funding ask for the War Office and Parliament.

F. Nightingale, with W. Farr, General Register Office

The problem, in numbers

Disease killed eight of our soldiers for every one lost to wounds.

17,982 deaths in the Army in the East, April 1854 to March 1856

14,476 preventable disease

1,758 wounds

1,748 other causes

1,023 deaths from disease per 1,000 soldiers a year, January 1855

The baseline

At January's rate, disease kills the whole army in a year.

Army strength: 32,393
Died of disease: 2,761
Died of wounds: 83

What we did

We stopped treating the soldiers and started treating the building.

21 Oct 1854Sail for Scutari with 38 nurses
Nov 1854Arrive at the Barrack Hospital, Scutari
Mar 1855The Sanitary Commission lands: Sutherland, Gavin, Rawlinson. Sewers flushed, wards ventilated.

Hospital mortality after the work began, against the three weeks before

Outcome against the baseline

Next winter: a bigger army and a twentieth of the deaths.

First winterOct 1854 to Mar 1855

712 per 1,000 a year

Army 31,096 · Deaths 11,070

Second winterOct 1855 to Mar 1856

35 per 1,000 a year

Army 43,627 · Deaths 764

The one chart

The blue is every death we could have prevented.

January 1855

Army: 32,393
Disease: 2,761
Wounds: 83
Other: 324

Month

Each wedge's area is one month's death rate. April sits at nine o'clock; read it like a clock.

Cost, and what it bought

Three commissioners and 556 handcarts. The rest is arithmetic.

The bill, March 1855

Sanitary commissioners: 3
Handcarts of filth, Scutari: 556
Dead horses, Koulali: 24
Hospital sewers: Flushed
Wards: Ventilated

An army of42,000

At the first year's rate, 475 per 1,00019,937

At the second year's rate, 112 per 1,0004,696

15,241fewer deaths a year

What remains undone

In peacetime, our barracks at home still lose 1,100 men a year too many.

Army in England

17 to 20

Civil life

Deaths per 1,000 men a year

She told Sir John McNeill it was as criminal as marching 1,100 men onto Salisbury Plain each year and shooting them.

The ask

Fund four commissions, and let the numbers keep watch.

Barracks and hospitals

Drain, ventilate and rebuild every one at home

02Army Medical SchoolTeach army surgeons sanitation
03Army medical statisticsCount every death, every month, one way
04Army Medical DepartmentReorganize it, regulations and all

What it changesAn army that dies at the civil rate. 1,100 men a year, home.

F. NightingaleStatistical Society of London, 1858