Book excerpt: Nursing Before Nightingale is a study of the transformation of nursing in England from the beginning of the nineteenth century until the emergence of the Nightingale nurse as the standard model in the 1890s. From the nineteenth century on historians have considered Florence Nightingale, with her training school established at St. Thomas's Hospital in 1860, the founder of modern nursing. This book investigates two major earlier reforms in nursing: a doctor-driven reform which came to be called the 'ward system,' and the reforms of the Anglican Sisters, known as the 'central system' of nursing. Rather than being the beginning of nursing reform, Nightingale nursing was the culmination of these two earlier reforms.