Early nursing

Both of the items presented today are going to be of the more modern kind – early twentieth century – which is not to say that nursing only began around then. Nursing care has probably existed for as long, if not earlier, than medicine has. However, it was formalised much later than medicine, possibly because nursing care was seen mostly as a woman’s work – and women did not, for a long time, have access to universities or formalised higher education.

Helmstadter and Godden [1] see the early revolution in nursing care as a direct result of the advances in medicine. The early nineteenth century saw revolutions in surgery, requiring more post-operative care, and in ‘supportive therapeutics’, which put more responsibility on nurses. To provide nurses with appropriate training, sisterhoods began early forms of nursing schools – such as the Diakoniewerk of Kaiserswerth, established 1836 and visited by Florence Nightingale in 1850.

Plate 1, Miss Florence Nightingale [bust of Florence Nighingale wearing cape and bonnet].

It is obviously impossible to speak about nursing without mentioning ‘the lady with the lamp’. Florence Nightingale made history for reforming the profession of nurse, and establishing one of the first non-religious schools of nursing in Europe in 1860 – only pre-dated by the École de la Source in Lausanne, Switzerland (1859) [2]. It is in schools like this that you may have found The Science and Art of Nursing.

STORE 106:21

Made of four volumes enriched with many illustrations, The Science and Art of Nursing summarises everything a nurse-in-training would have needed for her studies – despite the fact that, at the time, nurses had yet to have a professional registry in the United Kingdom.

This edition which has been specially prepared for Subscribers, is not obtainable through the general booksellers.

This item would not have been printed for general use, as the label at the beginning warns the reader. Published in 1909, our copy seems to have belonged to the Royal British Nurses Association. This association was founded in 1887 by Ethel Bedford-Fenwick (1857-1947) [3], who would later become the first president of the International Council of Nurses (1899-1904). The late 1890s and early 1900s proved particularly important for the nursing profession. They saw the passing of both the Cape Medical act of 1891 (see Hadfield [4]), which made mention of nurses, and the Nurses Registration Act 1901 in New Zealand. 1900 also had one of the very first studies on nurses, with Hamilton’s thesis comparing hospital and non-hospital personnel [5].

It would not be until 1919 that the United Kingdom would get its own registration act, thanks to the campaigning of both the Royal British Nurses Association and Bedford-Fenwick.

STORE 106:34

Ashdown’s Complete system of nursing was first published in 1917, however we only hold the 1923 and 1933 printings – see the two table of contents below; can you spot any differences? It was revised no less than ten times, proving fairly popular with – now professionally registered – nurses.  The last revision (in 1935) occurred shortly before the publication of Ashdown’s new book, Anatomy, physiology and hygiene : a textbook for nurses (1937).

Some records indicate that Ashdown may have based her writings on Morten’s Nurse’s Dictionary of Medical Terms and Nursing Treatment (1892). We know very little of Ashdown, however Violet Honnor Morten (1861-1913) became famous enough to gain an entry into the Oxford dictionary of National Biography [6].

Although she trained as a nurse and midwife, gaining her diploma in 1896, Morten is better remembered for her written contributions to nursing and women’s rights. She also served as member of the London school board, using her position to push for equal pay for men and women – among other causes. As Bedford-Fenwick, Morten advocated for women to have a voice in what was, for a long time, seen as ‘their’ job.

The year following the publication of our copy, Ashdown published another Complete System of Nursing, aimed at male nurses – showing yet another shift in the profession.

For more Whipple Library Special Collections books related to nurses and nursing, head over to our past exhibition The steel hand in the velvet glove: Books used for the teaching and training of nurses.

Blog post by Raphaëlle Goyeau, Library Assistant


STORE 106:21: The science and art of nursing : a guide to the various branches of nursing, theoretical and practical, by medical and nursing authorities. London: Cassel and Co. 1909.

STORE 106:28 and 34: A. Millicent Ashdown. A complete system of nursing. London: J.M. Dent & Sons. 1917. 1924 and 1933 printings.

References and further readings

[1] Carol Helmstadter & Judith Godden. Nursing before Nightingale, 1815-1899. Farnham: Routledge. 2011.

[2] Deborah Dolan Hunt. Fast facts about the nursing profession: historical perspectives in a nutshell. New York: Springer Publishing Company. 2017.

[3] Susan McGann. “Fenwick [née Manson; known as Mrs Bedford Fenwick], Ethel Gordon (1857-1947)”, Oxford Dictionary of National Biography. Available online from https://doi.org/10.1093/ref:odnb/33106

[4] Leslie Anne Hadfield. A bold profession: African nurses in rural Apartheid South Africa. Madison: University of Wisconsin Press. 2021.

[5] Anna Hamilton. Considérations sur les infirmières des hopitaux : these présentée et publiquement soutenue à la Faculté de médecine de Montpellier le 15 juin 1900. Montpellier : Imprimerie Centrale du Midi (Hamelin Frères). 1900. Available online from https://gallica.bnf.fr/ark:/12148/bpt6k854187n/f1.item

[6] Ellen Ross. “Morten, (Violet) Honnor (1861-1913)”, Oxford Dictionary of National Biography. Available online from https://doi.org/10.1093/ref:odnb/62035