Letter to Charles Shrimpton, M.D.
1862-05-19

[Page 1 of 5]
9 Chesterfield St.
W.
May 19/62
My dear Sir
You entirely understood
my meaning.
Pyaemia is an
indigenous disease in
Paris, as it is elsewhere,
altogether independently
of Surgical conditions.
This has been observed
by one person at least
through a period of
35 years. And now
on enquiry it is found
still to exist; and
to a greater extent
[Page 2 of 5]
than in London or
other English towns.
Those who know
the construction of
Paris dwellings know
full well the reason.
Given a Surgical
Patient admitted into
a Paris Hospital: -
there is strong ground
for believing that that
Patient labours under
Pyaemia to begin with.
As regards the
general practical
result, Patients die
more frequently in
Paris where the previous
[Page 3 of 5]
pyaemic condition is
more manifest than
in London where it is
less manifest. And
generally the need of
many serious surgical
operations presupposes
the existence of
Pyaemia.
The question is
one quite distinct
from Pyaemia after
operations, where the
additional shock
may perhaps have
led to the disease.
Even this is doubtful,
unless we add to it
bad sanitary conditions
[Page 4 of 5]
of wards & houses.
You yourself have
probably often delayed
operations because the
"Patient could not
bear" them. Why?
Is it not often from
Pyaemia in some
form or other, already
existing?
Nosology is always
ready with a name
which means nothing.
Fact & observation
determine the real
cause of the evil.
It would be a
fine thing indeed
if I were to enter
[Page 5 of 5]
into a controversy
with you. It would
be as if I were to
contend with the
Speaker of the Ho: of
Commons on a point
of parliamentary
precedent.
But you know I
don't do it for that
Yours sincerely
F. Nightingale