Hospitals for the poor and sick have existed since ancient times; the modem hospital is a relatively recent institution. If two factors can be said to define it, they are the presence of round-the-clock skilled nurses and the ability to undertake major surgery. Neither of these was a general feature of American hospitals until at least the 1880s. The first professional nursing schools, based on Florence Nightingale’s precepts, were established in 1873 at Bellevue Hospital in New York, the New Haven Hospital, and the Massachusetts General Hospital. Others followed rapidly in the next decade. Many, if not most, of the new hospitals springing up in the burgeoning towns and cities of the late nineteenth century were predicated from the beginning on the integral development of the nursing schools. Through changes in nursing alone the hospital was transformed from the often filthy, disorganized, and terrifying older institutions of the early 1870s into a monument to hope, science, and efficiency.