It was to meet such a need that the first hospital was established in the United States on Manhattan Island in 1658. The "New Netherland Register" says "This hospital was established at the request of Surgeon Hendricksen Varrevauger for the reception of sick soldiers--who had been previously billeted on private families." In 1679 the hospital consisted of five houses. Early in the eighteenth century pest-houses were established at Salem, Massachusetts, at New York, and Charleston, and in 1717, a hospital for contagious diseases was built in Boston. The teachings and writings of Benjamin Franklin were of marked importance in promoting sanitary science and in securing the building of the first chartered hospital in the United States, which was erected in Philadelphia in 1755. The record shows four hundred and thirty-five patients treated in this hospital in the year 1775. That year was also marked by the building of the New York Hospital, which was destroyed by fire almost as soon as completed, and rebuilt in 1791. It owed its origin to two professors of King's College (now Columbia), which at that time was a church institution. The necessities of war have from early times had a marked effect upon the development of hospitals. Dr. James Tilton, in presenting recommendations to Congress in 1781, says of his experience in the Revolution: "It would be shocking to humanity to relate the history of our general hospitals in the years 1777 and 1779, when they swallowed up at least one-half of our army, owing to the system of placing nearly all the sick of the army in the general hospitals, where crowds and infection wrought a fearful mortality, and where more surgeons died in the American service in proportion to their number than officers of the line--a strong evidence that infection is more dangerous than weapons of war." The death rate of the English and French soldiers was so fearful, and the neglect and condition of the wounded men so appalling in the Crimean war (1854), that the entire English nation was aroused. It was a woman, Florence Nightingale, who was sent out by the nation and given full authority to act in the emergency upon which hung the fate of the armies. Not only did this noble woman, with her band of thirty-seven nurses, bring healing instead of death in those army hospitals, but she instituted reform in sanitation which was adopted by hospitals throughout the world. To her also humanity owes the inestimable boon of the trained nurse of education, refinement and ability. Before Florence Nightingale gave herself and initiated the movement for the training of young women of standing as nurses, such work had been left to the rough, uncouth, and often low-lived men and women, of whom the unspeakable Sairey Gamp, immortalized by Charles Dickens, is a fitting type. As the Christian church was the first to give healing to the needy, so it has carried this ministry wherever in the world its banners have been set up.