Research in Japan concerning Florence Nightingale
– Status and Issues to Be Addressed –


Hitoe Kanai, Tokyo Ariake University of Medical and Health Sciences
Translated by: Reiko & Jeremy Pearson

 There are three types of research concerning Florence Nightingale. The first is biographical research to clarify Nightingale’s personality and the events that occurred around her life. The second is documentary research that undertakes bibliographic studies into the collection of Nightingale’s writings, including books, papers, reports, and letters. The third is philosophical research to elucidate Nightingale’s nursing philosophy and principles through studying Nightingale’s writings.
 The first two types of research are exhaustively undertaken and abundant documents are readily available. Therefore, it is difficult to gain a comprehensive picture of the results of this research. However, with regard to the third type of research, only a small amount number of studies has been undertaken, and the history of research concerning Nightingale’s “nursing philosophy,” which has been conducted particularly in Japan, is little known within the international nursing world. It is only recently that Nightingale’s philosophical research has come to international attention thanks to a collection of research studies on Nightingale as a “social scientist” and “social thinker” by Dr. Lynn McDonald, who is now visiting Japan.
 Although a number of English biographers have undertaken research on Nightingale’s life and times, and the people related to her, academic nursing study in the U.K. does not see Nightingale’s own work as a research subject for nursing studies. This is also true among the international nursing profession.
 On the other hand, the nursing world in Japan is keen to view Nightingale’s works as a subject for research into nursing principles rather than biographical study. This trend in Japanese Nightingale research has remained the same over the last 40 years. As a result, the “Principles of Nightingale’s Nursing Philosophy” has been extensively researched inside Japan, and her nursing philosophy is still influential in today’s frontline nursing. There is even a trend to revitalize nursing practice through a new understanding of her philosophy. This situation is very specific to Japan, but such research results and practices should be made widely known to the world.
 This lecture provides an overview of the entire range of Nightingale’s works and presents the current Nightingale research situation in Japan. Finally, I would also like to discuss some of the current and future issues to be addressed.


1. Biographical Research
 Even while Florence Nightingale was still alive, many articles and biographies were written about her. It was Sir Edward Cook, a biographer, who compiled and published a list of these works. In his work, The Life of Florence Nightingale Vols. I and II (1913), Sir Edward included a “List of Some Writings about Miss Florence Nightingale,” as Appendix B. The list covers 55 articles and biographical pieces concerning Nightingale between 1854, when the Crimean War broke out, and 1912, the year previous to the publication of his book. It can therefore be assumed that Nightingale was already a topical figure in Great Britain from the time of her service in the Crimean War between 1854 and 1856.
 W. J. Bishop continued the work begun by Sir Edward. He conducted formal in-depth research into the written works of Nightingale and other articles and books about her and organized them chronologically. Details of Bishop’s work will be discussed later. A Bio-Bibliography of Florence Nightingale was published in 1962, and its Chapter 10, Selected Writings about Florence Nightingale and Her Times, lists 240 documents published between 1854 and 1962. The documents covered here include documents published in countries outside the U.K. in their own languages.
 Nightingale’s articles and biography were introduced into Japan from early days. In 1890, a Japanese version of Florence Nightingale, translated by Hatsutaro Kitayama, was published (publisher unknown), and in 1901, a further book, Nightingale, Joshi-no-Tomo Press, Keirin-en Master’s Edition was published by Toyosha. The story of Nightingale’s distinguished service in the Crimean War was adopted in a state-required moral-education textbook in 1903 to promote the spirit of altruism and charity, and her story remained in the textbook for more than 40 years. Many different biographies of Nightingale have continued to be published—mainly for children—until today. Through this, the essence of Florence Nightingale’s contribution has spread widely through Japanese culture.
 At the same time, important works in the Bishop list were translated into Japanese as nursing references. The following three books are regarded as “official” biographies and were translated into Japanese:


 (1) The Life of Florence Nightingale Vols. I and II, Edward Cook, 1913.
 (2) Florence Nightingale 1820–1910, Cecil Woodham-Smith, 1950.
 (3) Florence Nightingale, Lucy Seymer, 1950.


 These three books are essential reading for Nightingale researchers in Japan. Other biographies translated into Japanese are as follows:


 (4) Florence Nightingale, Lytton Strachey, 1938.
 (5) Florence Nightingale, Elspeth Huxley, 1973.
 (6) Florence Nightingale, Pam Brown, 1988.
 (7) Florence Nightingale: Avenging Angel, Hugh Small, 1998.


 The book by Hugh Small is an unusual work focusing on a supposed darker side of Nightingale from his own perspective. It is still questionable whether the book is a true documentary or mere speculation by the author. I believe that Dr. McDonald will clarify this point for us in her lecture as an invited speaker.
 When we look at original works in Japanese, again there are a number of people who published biographies of Nightingale, and their number is still increasing. However, these tend to be recompilations of one or more of the above books according to the taste of the author, rather than the author’s original research. Thus, it is fair to say that biographical research by the Japanese does not truly exist. Yet the sheer volume of publications indicates that Nightingale’s personality and her achievements have always been of great interest to Japanese people.


2. Bibliographic Research
 There is also a large number of documents written by the hand of Nightingale herself. Nightingale’s works were first described by Sir Edward Cook. He wrote a detailed biography of Nightingale directly after her death (1913), and the book chronologically lists Nightingale’s 147 works as Appendix A. However, it was only in 1993 that Sir Edward’s biography was first translated into Japanese, therefore very limited attention has been paid to this list in Japan until now.
 Today we can find some of the original works by Nightingale in Japan, thanks mainly to the efforts of Lucy Seymer. Seymer’s Selected Writings of Florence Nightingale (1954) covers nine works of Nightingale concerning “nursing.”
 This book was discovered by a Japanese editor, and a chapter of the book, Notes on Nursing, was translated into Japanese and introduced in a quarterly nursing magazine, Sogo Kango (Comprehensive Nursing), in 1967. This was the beginning of the translation of Nightingale’s works into Japanese. Until Bishop’s serious research results were published in Japanese and made more easily accessible to Japanese researchers, Nightingale’s bibliographic research and philosophical research solely relied on Lucy Seymer’s book.
 W. J. Bishop conducted painstaking research on Nightingale’s writings and created a detailed bibliography of her works after a keen reading of many of the documents. Unfortunately, Bishop died before he could publish his research, and his secretary, Sue Goldie, took over the research and published his work. His research results were published as A Bio-Bibliography of Florence Nightingale in 1962 with the support of the International Council of Nurses.
 Bishop numbered Nightingale’s 150 works and categorized them into nine groups. Then he added a summary and comments on each work. This provides a clear and accessible overview of Nightingale’s works. The nine categories Bishop used are as follows:


 (1) Nursing: 47 items
 (2) The Army: 11 items
 (3) Indian and Colonial Welfare: 39 items
 (4) Hospitals: 8 items
 (5) Statistics: 3 items
 (6) Sociology: 9 items
 (7) Memoirs and Tributes: 8 items
 (8) Religion and Philosophy: 4 items
 (9) Miscellaneous Works: 21 items


 Just by looking at this list shows us what a prolific writer Nightingale actually was.
 In my own investigations, I found that 47 of these 150 works had already been translated into Japanese. I also found that the Japanese nursing world has not simply translated Nightingale’s works from the first (Nursing) category, but more generally across all of Bishop’s nine categories.
 The number of Japanese translations in each category is as follows:


 (1) Nursing: 28 out 47
 (2) The Army: 4 out of 11
 (3) Indian and Colonial Welfare: 1 out of 39
 (4) Hospitals: 2 out of 8
 (5) Statistics: 0 out of 3
 (6) Sociology: 5 out of 9
 (7) Memoirs and Tributes: 1 out of 8
 (8) Religion and Philosophy: 1 out of 4
 (9) Miscellaneous Works: 5 out of 21


 These numbers indicate that Nightingale’s documents have been translated evenly across all categories from the 1960s to the 1990s. This in turn suggests that the Japanese nursing world has already established a good foundation for bibliographic research into Nightingale’s works. (Please note that although the number of works from the Statistics category is none, many of the statistical works overlap with the works in the Hospitals category. Nightingale’s contribution to statistics is already known to the Japanese through the translation of works in the Hospitals category. Therefore, we can assume that these translations cover the statistical area.)
 Dr. Lynn McDonald has established a new mainstream in Nightingale bibliographic research. Dr. McDonald has gone beyond Bishop’s research by thoroughly covering almost all the existing handwritten documents of Nightingale, while Bishop covered only her published works. Dr. McDonald’s Collected Works of Florence Nightingale Vols. 1 to 16 published between 2001 and 2011 represents a complete coverage of Nightingale bibliographic research. This area of research will advance significantly thanks to Dr.McDonald’s excellent achievement.


3. Philosophical Research
 Very little research has been conducted anywhere in the world in terms of Nightingale’s philosophy.
Her life and achievements were regarded as a historic event and highly revered in many countries; however, as far as I am aware, it is only in Japan that philosophical research on her has been carried out.
 In the U.S, Nightingale used to be regarded as one of the world’s nursing theorists, and I had the opportunity to read about her nursing philosophy. However, those articles tended to be rather superficial, some claiming that “Nightingale did not have a clear definition of ‘health.”It was clear that the authors of these articles had not studied the entire canon of Nightingale’s work. These researchers must have only studied Notes on Nursing (probably the initial edition) and assumed the entire characteristics of her philosophy from this limited source.
 To understand Nightingale’s nursing philosophy systematically, it is necessary to study all of her 150 works, particularly her later work. There is no other country but Japan that has elucidated an outline of Nightingale’s philosophy that penetrates the entire range of her output. As mentioned earlier, 47 works out of Nightingale’s 150 works have been translated and a comprehensive study of her philosophical approach has been made through these translations. It may not be an exaggeration to say that Nightingale’s comprehensive nursing philosophy has been clarified here in Japan.
 The foundation of Nightingale’s philosophy is her “scientific approach.” She revered the rules of nature, and pursued the principles underlying social phenomena. Nightingale’s ideas were very close to that of modern science and it can be said that she was a scientist who was capable of lecturing on nursing and sociology in an academic context.
 From the viewpoint of practical nursing, Nightingale’s academic and practical ideas are particularly prominent in Notes on Nursing among her works. However, to the eyes of academic researchers of nursing, this book appears to have been insignificant and simply regarded as “a book for maintaining home health.” They failed to seek Nightingale as a scientist or a philosopher in this book.
 However, in Japan, Notes on Nursing became almost a bible for nurses and is regarded as a special document that presents the essence of nursing and much useful advice on nursing practice. Books explaining Notes on Nursing were also written and these books further promoted Nightingale’s work. Notes on Nursing (revised second edition, 1860) is still designated as a textbook in more than 70% of the 1,300 nursing schools across Japan (including both those for registered nurses and for licensed practical nurses). This fact shows just how deeply Japan developed an understanding of Nightingale—more than any other country.
 Further, there was an academic movement to understand Nightingale’s philosophy based on her documents in the 1970s and onwards. In 1978, the Nightingale Research Association was established, and the KOMI Theory Research Group, which is the predecessor of the Nightingale KOMI Care Society, was established in 1996. Academic associations such as these have been leading Nightingale philosophical research in Japan.
Within this movement, the Japanese Nursing Association Publishing Company published Hiroko Usui’s Kagaku-teki Kango-ron (Scientific Nursing Theory) in 1972. This was a systematic formulation of nursing study based on Nightingale’s principles. This theory has been leading Japanese nursing education to the present day.
 In 1993, I published Nightingale Kango-ron, Nyumon (Introduction to Nightingale’s Nursing Theory), and KOMI Riron (KOMI Theory) in 2004. I believe that these books have contributed to spreading Nightingale’s philosophy in Japan, as well as accelerating establishment of nursing studies based on Nightingale’s philosophy.
 Today, the number of Japanese papers concerning Nightingale’s philosophy is extensive. This means that the philosophical study of Nightingale by the Japanese has substantially advanced. The quality of studies being undertaken into Nightingale’s philosophy by Japanese researchers is higher than any other research and has succeeded in redefining her as a rare “philosopher,” rather than simply as an important historical figure.


Issues to Be Addressed
 As mentioned earlier, there are three types of research concerning Florence Nightingale.
 For Japanese researchers, like me, we have to find the original documents available for Nightingale research, then translate them into our own language, and finally identify the characteristics of her philosophy. We have been following this method to the present day. I believe that this, rather long-winded approach, has actually helped us to identify the essence of her work—particularly in the area of philosophical studies based on her own texts.
 In contrast, in English-speaking countries, due to the abundance of reference materials, the focus has been on collecting historical details about Nightingale, as well as organizing the huge number of documents and artifacts. This helped realize the great achievements made in biographical research on Nightingale. However, I have a doubt that overly focusing on the minutiae of Nightingale’s life and character may actually lead us further away from her nursing philosophy. Personality analysis is not essential for philosophical research.
 For the future nursing world, we need to deepen and crystallize Nightingale’s philosophy. I hope that collaborative research work on Nightingale’s philosophy will commence in the near future, and the “nursing principles” suggested by Nightingale will become the common language of the nursing world across the globe.