In May 1857 a Commission to study the whole question of the army medical service began to sit. But the price was quite high. Florence Nightingale was doing this grueling work because it was vital， not because she had chosen it. From then she began to change. She became more brilliant in argument than ever， more efficient， more knowledgeable， more persistent and penetrating in her reasoning， scrupulously① just， mathematically accurate—but she was pushing herself to the very limits of her capacity at the expense of all joy.
That summer of 1857 was a nightmare for Nightingale—not only was she working day and night to instruct the politicians sitting on the Commission， she was writing her own confidential report about her experiences.
It took Florence only six months to complete her own one-thousand-page Confidential Report， Notes on Matters Affecting the Health， Efficiency and Hospital Administration of the British Army. It was an incredibly② clear， deeply-considered volume. Every single thing she had learned from the Crimea was there； every statement she made was backed by hard evidence.
Florence Nightingale was basically arguing for prevention rather than cure. It was a new idea then and many politicians and army medical men felt it was revolutionary and positively cranky. They grimly opposed Florence and her allies.
So she was forced to prove that the soldiers were dying because of their basic living conditions. She inspected dozens of hospitals and barracks and exposed them as damp， filthy and unventilated③， with dirty drains and infected water supplies. She showed that the soldiers’diet was poor. She collected statistics which proved that the death rate for young soldiers in peacetime was double that of the normal population.
She showed that， though the army took only the fittest young men， every year 1，500 were killed by neglect， poor food and disease. She declared “Our soldiers enlist to death in the barracks”， and this became the battle cry of her supporters.
The public， too， was on her side. The more the anti-reformers dragged their feet， the greater the reform pressure became.
Nightingale did not win an outright④ victory against her opponents， but many changes came through. Soon some barracks⑤ were rebuilt and within three years the death rate would halve.
The intense work on the Commission was now over， but Florence was to continue studying， planning and pressing for army medical reform for the next thirty years.
People began to demand that Nightingale apply her knowledge to civilian hospitals， which she found to be “just as bad or worse” than military hospitals. In 1859 she published a book called Notes on Hospitals. It showed the world why people feared to be taken into hospitals and how matters could be remedied.
Florence set forth the then revolutionary theory that simply by improving the construction and physical maintenance， hospital deaths could be greatly reduced. More windows， better ventilation， improved drainage， less cramped conditions， and regular scrubbing of the floors， walls and bed frames were basic measures that every hospital could take.
Florence soon became an expert on the building of hospitals and all over the world hospitals were established according to her specifications. She wrote hundreds and hundreds of letters from her sofa in London inquiring about sinks and saucepans， locks and laundry rooms. No detail was too small for her considered attention. She worked out ideas for the most efficient way to distribute clean linen， the best method of keeping food hot， the correct number of inches between beds. She intended to change the administration of hospitals from top to toe. Lives depended upon detail.
Florence Nightingale finally succeeded. All over the world Nightingale-style hospitals would be built. Today’s hospitals with their flowers and bright， clean and cheerful wards are a direct result of her work.
① scrupulouslyadv. 小心翼翼地，多顾虑地
② incrediblyadv. 难以置信地，很，极为
③ unventilatedadj. 不通风的
④ outrightadj. 全部的，彻底的
⑤ barrackn. 营房，兵营
只为病房鲜花盛开
1857年5月，一个研究军队医务各方面问题的小组委员会成立了。但是，因此而付出的代价也是相当巨大的。因为它的异常关键，所以交由弗洛伦斯·南丁格尔来负责，并不是她自己的选择。从那时候起她开始改变自己。与从前相比，她变得更加能言善辩，更加讲究效率，更加知识渊博，同时在理论方面也更加坚定和深刻，谨小慎微，精益求精，她将自己推上了一个能力方面的极至，而这所有的一切都是她用牺牲了所有娱乐活动而换取的。
对南丁格尔来说，1857年的夏天简直就是一个梦魇，她，不但要日以继夜地指导在委员会工作的政客家们，而且还要就她的个人经历撰写一份机密报告。
弗洛伦斯仅仅花费了6个月的时间，就完成了她自己长达1000页的一份机密报告，名为：《关于英国军队健康、效率和医院督导事项的纪录》。这份报告思路清晰，深思熟虑，简直令人难以置信。从克里米亚她所学到的点点滴滴都跃然于纸上，每项陈述见解都论据充足。
弗洛伦斯·南丁格尔基本的主张是提前预防，而不是治疗。在当时的条件下，这是一个非常标新立异的观念，许多政客和军医都觉得这有些不合乎常规，又有点胡思乱想。他们坚定地反对着弗洛伦斯以及她的同盟者们。
因此，她只好努力地去证明：士兵们之所以会死亡，那是因为恶劣的基本生活条件所致。她调查了数十家医院和兵营，最终发现这些地方非常地潮湿、充满污浊而且通风不畅，排水管肮脏而且供水管道遭到了严重的污染。她指出那些伤员士兵们的饭菜极其的差。她收集了大量统计数据，这些证明：在和平时期年轻士兵的死亡率相当于普通人口的两倍。
她指出：虽然军队仅仅招募那些身体最强健的年轻人，但是每一年还是有1500人由于照顾不周、营养匮乏和疾病折磨而死去。她大声呐喊说“我们的士兵们在军营里被死神召唤而去”，而这成为了她的支持者们的战斗号角。
同时，大众也站在了她的一面。因此，那些反对改革者们越是拖后腿，改革的压力变得就越大。
南丁格尔和反对派的斗争，虽然没有取得彻底的胜利，但是许多变化由此发生。之后不久，就有一些兵营被重新修建，这样3年内死亡率就会从预计的减少一半。
委员会的紧张工作至此基本结束，但是弗洛伦斯还要继续钻研，设计及监督今后30年内，军队医疗的改革。
人们开始希冀南丁格尔可以将自己的知识用于民用医院上，她发现这些医院的情况与军队医院相比，简直是有过之而无不及。1859年，她出版了一本名为《医院纪要》的书。书中指出：为什么世界上的人们恐惧到医院治疗，而这些问题又要如何进行补救。
弗洛伦斯提出通过改进医疗设施可以使医院的死亡率大幅降低，而这种说法在当时，还是一种非常具有是革命性的理论。多设窗户，保持良好的通风，改进排污设备，减少拥挤和定期清洗地板、墙壁和床架都是每一家医院应该采取的基本措施。
不久以后，弗洛伦斯就成为了医院设施方面的专家，全世界的医院都根据她制定的制度规则来建立。她坐在伦敦自家的沙发上面，写了成百上千封信件来询问有关洗涤槽和平底锅、门锁和洗衣房等方面的事情。对于她那种体贴入微的品格来说，每一件细微的小事都是她关怀的对象。对于最有效地来发放干净被褥，最好地来保持食物的温度等方法，床与床之间最佳的摆放尺寸，她都费尽心思想出各种办法。她计划要彻底改革医院的监管制度。生命赖于细节。
弗洛伦斯·南丁格尔最终取得了成功。南丁格尔式的医院在全世界建立。今天，医院里面鲜花盛开，明亮清爽，充满欢乐，而这所有的一切，都源于她的心血与努力。