Anne Summers. Angels and Citizens: British Women as Military Nurses 1854-1914. London: Routledge & Kegan Paul, 1988. 371 pp. illus.

If you are interested in reading nursing history this book is for you. If you particularly want to understand Canadian nursing history within the context of the British empire then the sections on the Boer War, the birth of the VAD and the relationship of the British Red Cross with the Order of St. John of Jerusalem will be of some help. Lest we forget, Canada had at least 7,300 Registered Nurses in its army medical service during World War I and II; other nurses went overseas with the British, French and United States services and before this, some served in the Boer War and others nursed in the Riel Rebellion. We, too, have a history that needs to be re-written.

Summers has brought to life, by names and deeds, nurses who, went to wars in the Crimea, India, Egypt, South Africa and Europe and, between wars, sought to organize military nursing as a career. As editor of the History Workshop Journal and a Wellcome Research Fellow in the University of Oxford she brings a scholarly interest in medical labour history. Her thesis is supported with maps, photographs and references. This happy combination of enthusiasm and data may be the result of the research having been originally conceived outside the framework of academe and then written as a doctoral thesis for the Open University in Britain. The result is a readable book which I found hard to put down until finished.

When she began this study Summers had planned to inquire "into the origins of the First World War" but as she proceeded she realized that her investigation was about the attitudes of women to war. She believes that it is the image of the military nurses' uniform which "takes us a long way towards understanding the capacity of that whole European generation [of women] to tolerate" war and its massive destruction of life. Summers concludes that as military nursing became feminized, the war nurse came to symbolize "motherhood and domesticity." This image was one of "healing" in a policy of collaborative slaughter; and "service and self-abnegation" while responding "to challenge and responsibility." Thus the military nurse embodied "all the contradictions of the social position of women in the Victorian and Edwardian eras."

A major theme is that women were able to encroach on male territory as wars began to require the militarization of all civilians. Summers states that women who entered military nursing found, "an outlet for religious compassion and political sympathies," even though they never questioned the political rationale for war; they gained freedom from domestic ties and comforts; they could travel abroad; and they could be at "the heart of the action on a world stage" with the men. She supports this with an untangling of the conflicts faced by the women who sought to develop military nursing as a career for female nurses. It is these which make up the argument of the book.

In ten chapters Summers dramatizes the "painful, long drawn-out process" of women becoming accepted as army nurses. The friction at one moment could be class-motivated between women who had to work for pay (nurses) and Ladies who volunteered to serve without re-imbursement; or gender based between men who held traditional expectations of women's place in society and women who wanted a more innovative role; or professional jealousies between Matrons-in-Chiefs and Medical Officers, between Trained Nurses and amateur nurses, between anti-suffragist nurses and suffragist nurses; between the unranked nurse and the ranked orderly; and between associations such as the Red Cross and the Order of St. John. At times the struggles included combinations of these. For us in Canadian nursing, her interpretation sheds some light on the difficulties we have had in achieving recognition and status within the health care system.

The first three chapters place Florence Nightingale's contribution within the context of the work of other nurses prior to and during her lifetime. For example, there were religious sisters, soldiers' wives, hospital nurses, and widows of medical officers and other military personnel. Credit is given to Jane Shaw Stewart and Nightingale for inaugurating the first female service of the Victorian army. But during Stewart's time and the period of her successor, Mrs. Jane Deebles, the army sisters remained "`in but not of' the army." As Summers points out Nightingale played a part but there were other women who also fought for improvements in army nursing.

The two chapters in the second part of the book focus on the increasing involvement of civilians in the battlefield as soldiers or in organizations such as the Order of St. John, which began in the 1840s, and the Red Cross in 1863. Here we see the beginning of activities which we have experienced as part of our own health care organization. The teaching of home nursing, suggested by Lady Emily Strangford in 1874 when she advocated part-time hospital training for women who wanted to learn more about health care, was implemented in 1879 by the St. John's Ambulance Association. It gave instruction in nursing to women on a part-time basis.

Finally, in the remaining four chapters Summers look at the acceptance of military nursing as a female responsibility. She moves through the political turmoil of the Boer War to World War I. We learn that the trained nurses, who had served in South Africa, were angry because the Royal Red Cross Medal was awarded not only to nurses who had earned it but to Ladies who they felt had not. There is political discontent between the personnel of volunteer organizations such as the Queen Alexandra's Imperial Military Nursing Service, the Princess Christina Army Nursing Reserve and civilian nursing. This would be added to, in 1909, when the associations were joined by the Voluntary Aid Detachments, an idea which originated in Japan.

In her last chapter Summers questions the myth that women gained the franchise because of the war service of the military nurse during World War I. She argues that if this was true the vote should not have been limited to women over the age of thirty. Her challenge to the readers is that the "conventional explanation in terms of the political recognition of women's war service needs to be reassessed in the context of unspoken issues, as yet relatively unexplored by historians, of national and internal party politics."

I can only fault this book on two items. Summers writes that Jane Shaw Stewart, who was appointed Superintendent-General of Female Nurses at the General Hospital at Netley on March 6, 1863 was the first woman to appear "on the British Army List." According to Paul Kopperman (whose 1979 article is not listed in her bibliography) Charlotte Browne, who was with her apothecary brother at Louisbourg and may have assisted him there as a nurse from 1746-1748, was entered, as matron, in the British Army Lists in the 1700s.

Secondly, each time I pick up this book I am confronted by its cover--a photograph of two female World War I nurses who are smoking. Can you imagine what the leaders of nursing in World War 1 would have thought? What comes to mind is that in 1918 Jean Gunn, then president of the Canadian National Association of Trained Nurses, was asked by its members to write a letter objecting to the illustration of a Canadian soldier "with his arm around a nursing sister." On their behalf she wrote to the publisher that the picture was

"to say the least, undignified and did not in any way represent the wonderful spirit of service with which our nurses had met the difficulties of overseas work." The picture on Summers' book begs the same reaction. What is the purpose of showing two women, with a red cross on their bib, enjoying a cigarette? If the image of a nurse is often a metaphor, what is the publisher saying? Despite this questionable choice Summers has done a tremendous job in unravelling the complexities of sixty years of military nursing in Britain.

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ARTICLES:

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BOOKS:

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ARCHIVES/MUSEUMS:

Midwest Nursing Resource Center,

College of Nursing,

University of Illinois,

Chicago Campus.

Monday-Friday, 9-4, Mary T. Whalen, Curator, 312/996-0740

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EXHIBITIONS:

September 20, 1989-August 12, 1990,

Dolls and Duty: Martha Chase and the Progressive Agenda 1889-1925. (Includes early Chase hospital mannequins. Manufacturer of Mrs. Chase dolls.)

The Rhode Island Historical Society,

110 Benevolent St., Providence, RI 02906,

401/331-8575,

Admission is charged.

Hours: Monday-Friday, 9-5,

Saturday, 11-4,

Sunday, 1-4.

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NEWS ITEMS:

The more than 120 posters of the First and Second World War include Red Cross posters of nurses. The museum plans to have the posters appraised and repaired before exhibiting them publicly.

FELLOWSHIPS:

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CONFERENCES/UP-AND-COMING:

First Annual Penn Nursing History Assembly. April 20--21, 1990. Contact Joan E. Lynaugh, Director, Center for the Study of the History of Nursing, University of Pennsylvania, School of Nursing, Nursing Education Building, Philadelphia, PA 19104-6096.

Canadian Association for the History of Nursing/Association Canadienne Pour L'Histoire Du Nursing. June 27-28, 1990 in Calgary, Alberta. Contact, Diana Mansell, Vice-President, CAHN/ACHN, 430 Hendon Dr. N.W. Calgary, Alberta T2K 1Z7.

American Association for the History of Nursing. Seventh Annual Conference. September 22-24, 1990 in Galveston, Texas. Contact Rosemary McCarthy, Executive Director, AAHN, Inc., P.O. Box 90803, Washington, DC 20090-0803.

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VIDEOS:

ORGANIZATIONS:

Ontario Women's History Network.

Margaret Kellow, Department of History, University of Western Ontario, has brought to my attention the organizing of the above association to "promote women's history in Ontario in three areas --teaching, research and public accessibility." Because of the timing of this publication you may have missed the first meeting on February 3, 1990. If you are interested in being part of a network of over four dozen teachers, librarians, historians and others across Ontario contact Margaret Kellow, Faculty of Social Science, Department of History, University of Western Ontario, London, Ontario N6A 5C2.

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CLOSING QUOTATION:

`The writings of our own patriotic dead should be brought back from oblivion. The generation which went to battle from among our Race was the generation of sacrifice, . . . who voluntarily laid themselves on the altar of the highest ideal which has ever been upheld in war. . . .

They could not attain all they aimed at, nor can we in this present day, but they did not "lose their souls!"

Mabel Clint, A.R.R.C., Our Bit, 1933