Florence Nightingale's Notes on Nursing, published in 1859, was the first book to address the specifics of patient care. It was written in a time when medical science was beginning to understand the importance of rules of hygiene. Hospitals were places where infections spread quickly, and caregivers were mainly untrained and impoverished. Nightingale spoke to these issues and gave specific directions to resolve concerns such as nourishment, ventilation, personal cleanliness, and patient observation.
