With the French the _chef d'administration_, the Commissary, as we should call him, is the master of the Orderlies. And the Medical Men just come in and prescribe, as London physicians do, and go away again. With us the Medical Officers are everything, and have to do everything, however heterogeneous. The French system is bad, because, though there may be twenty things down on the Carte for the Medical Man to choose his patient's diet from, _nominally_, the Chef d'Administration may have provided only two, and the Patient has no redress.
Whether, in any new plan, the House Stewards have the command of the Orderlies, or the Medical Man, which I am incompetent to determine, whichever it be let us have a Governor of the Hospital. As it is a Military Hospital, a Military Head is probably necessary as Governor.
On September 20, 1855, a Royal Warrant was issued, reorganizing the Medical Staff Corps, "for the better care of the sick and wounded," revising the duties of the several officers, and improving their pay. Any one who cares to refer to this Warrant, and to compare it with Miss Nightingale's letters just given, will see that in large measure her suggestions were adopted by the War Department.
Miss Nightingale was careful, as we have seen, not to interfere with the doctors, and, though she thought that as administrators some of them were ineffective, she bore willing testimony to their skill and devotion (with some few exceptions) in their proper work. But she could not abstain from deploring one great omission, and she offered to subscribe largely towards repairing it:--
"One thing which we much require," she wrote to Mr. Herbert (Feb. 22, 1855), "might easily be done. This is the formation of a Medical School at Scutari. We have lost the finest opportunity for advancing the cause of Medicine and erecting it into a Science which will probably ever be afforded. There is here no operating room, no dissecting room; post-mortem examinations are seldom made, and then in the dead-house (the ablest Staff Surgeon here told me that he considered that he had killed hundreds of men owing to the absence of these) no statistics are kept as to between what ages most deaths occur, as to modes of treatment, appearances of the body after death, etc., etc., etc., and all the innumerable and most important points which contribute to making Therapeutics a means of saving life, and not, as it is here, a formal duty. Our registration generally is so lamentably defective that often the only record kept is--_a man died_ on such a day. There is a kiosk on the Esplanade before the Barrack Hospital, rejected by the Quarter-Master for his stores, which I have asked for and obtained as a School of Medicine. It is not used now for any purpose--£300 or £400 (which I would willingly give) would put it in a state of repair. It is not overlooked and is in every way calculated for the purpose I have named. The Medical teaching duties could not be carried on efficiently with a less staff than two lecturers on Physiology and Pathology, and one lecturer on Anatomy, who will be employed in preparing the subject for demonstration, and performing operations for the information of the Juniors."