Hospitals for Incurables: the former Longmore Hospital, Edinburgh

geograph-1315422-by-kim-traynor
Historic Scotland Offices in the former Longmore Hospital which closed in 1991 ©Copyright kim traynor and licensed for reuse under this Creative Commons Licence

Separate hospitals for incurables began to be established in Britain in the mid-nineteenth century and were welcomed by some, condemned by others. Andrew Reed, who founded the hospital for incurables in Putney in 1854 (which eventually became the Royal Hospital for Neuro-disability) firmly believed in the need to offer relief to such unfortunates, and had a few years earlier founded Royal Earlswood Asylum, for those with incurable mental disorders. While the Poor Law provided care for those who had been rendered destitute by their chronic illness, there was little provision for those above the poverty line, whose physical or mental condition was often made worse by their living conditions. Cancer, tuberculosis, rheumatism, paralysis, deformity and spinal disease or injury, were chief amongst the illnesses that were unwelcome in general hospitals because of the length of time a patient suffering from chronic disease occupied a place on the ward. The Middlesex Hospital in London was rare in having a cancer ward, established in 1792.

The first specialist cancer hospital in Britain was in London, opening in 1852 in a converted house in Fulham Road. Its founder was William Marsden, and his Free Cancer Hospital became known as the Royal Marsden in 1954. Other early cancer hospitals were established in Leeds (around 1858), Liverpool (1862) and Manchester (1871), although these did not just treat cancer. The first specialist cancer hospital in Scotland opened in 1890 in Glasgow (later the Beatson Memorial Hospital). The discovery of X-rays, radioactivity and radium in the late nineteenth century introduced new treatments and radical surgery.

By the late nineteenth century hospitals for incurables had become an established type.  Henry Burdett, the great chronicler of hospital planning and design in this period,  provided advice on what form such hospitals should take, reproducing plans of the Jaffray Hospital in Birmingham by way of an exemplar. This was a distinct hospital plan type, more analogous to a convalescent home where patients similarly might not be confined to bed all day. Day-rooms, sitting-rooms, libraries and smoking-rooms, with easy access to the open air, whether a balcony, verandah or garden, were considered desirable in hospitals for incurables. Wide corridors to accommodate wheelchairs, and a lift to access upper floors helped patients get about, and, Burdett urged, there should be  ‘an absence of everything which will tend to promote waste of energy of every kind’

In Scotland the first hospital for incurables was founded in Aberdeen in 1857, opening in a private house in Morningfield the following year. In 1874 the Scottish National Institution for the Relief of Incurables was established and this lead to a number of hospitals being founded. That in Edinburgh first opened in 1875 with accommodation for 22 patients, the Edinburgh Association for Incurables having purchased a house for the purpose at 3 Salisbury Place which was enlarged and altered at a cost of £3,265 142d, plus another £300 or so for furniture and fittings. Within a year of its opening, the management committee was already hoping to add separate wards for cancer cases.

Town Plans 1877
Extract from the OS Large Scale Town Plans, 1877. Reproduced by permission of the National Library of Scotland. The Longmore Hospital is the building on the north side of Salisbury Place set furthest back from the road, with two rear wings. 

The inadequacy of the original house lead to the acquisition of adjoining properties and rebuilding on the site. The patients were evacuated to a house in Fisher Row until the new hospital was completed at the end of 1880. Most of the cost was met by the trustees of J. A. Longmore, and the name of the hospital changed to honour this generosity.

Efforts to expand continued, Nos 6 and 7 Salisbury Place were purchased and fitted up for patients in 1886.

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A visit from the Lord High Commissioner from RCAHMS

The Lord High Commissioner made more than one visit to the hospital, so it is hard to date the photograph. In May 1890 he paid a long visit with Lady Tweeddale, and in June 1894 The Lancet reported that the Lord High Commissioner and the Marchioness of Breadalbane had paid their ‘usual visits to the various hospitals in Edinburgh’ on which occasion the Marchioness opened a bazaar at the Longmore.

In 1891 plans for enlarging the hospital were approved which involved pulling down the old east wing of the building. This was to make way for a ‘more suitable wing’ which was intended to provide accommodation for 34 additional patients, with two 14-bed wards, nurses’ rooms, lavatories, kitchens, but no mention of where the other six patients were to be fitted in.

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Women’s ward from the ‘old East wing, now demolished’, from RCAHMS

The OS map below from 1893 shows how much the hospital had evolved in the relatively short time since it first opened.

large town plans 1893
Extract from the OS Large Scale Town Plans, 1893. Reproduced by permission of the National Library of Scotland.

Princess May and the Duke of York opened the new East Wing in 1891.

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Princess May Ward. From RCAHMS

The west wing was added in 1899, along with a new laundry, kitchen, chapel and mortuary, and electric lighting was installed. The new wing, of two storeys over a basement, was attached to the main building by a ‘wide corridor of iron and glass’. The ground floor was set apart for phthisical (TB) patients, the upper floor for cancer.

The map below from 1905 shows this later phase of the development.

1905 revised OS
Extract from the 2nd edition OS map, revised 1905. Reproduced by permission of the National Library of Scotland. 

A series of photographs of the interior of the hospital has been preserved in the National Monuments Record of Scotland, and provide a glimpse of what life was like there for patients and staff. The photographs seem to have been taken in the 1890s as a record of the new additions to the hospital, though as we have seen, they include at least one photograph of older parts of the hospital prior to demolition.

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Interior of a ward for female cancer patients. The cancer wards along with the TB wards were probably in the 1899 addition which comprised a two-storey and basement wing connected to the main building by a broad glazed corridor. From RCAHMS
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And its counterpart for male cancer patients. From RCAHMS
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Interior of a ward for male TB patients, from RCAHMS
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A private ward, from RCAHMS
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It is particularly poignant to see children in hospital, but even more so in a hospital for incurables. From RCAHMS
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Not all patients were confined to bed, here is a ‘recreation room’ for male patients. From RCAHMS
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Probationer Nurses’ drawing room. From RCAHMS
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The main hospital kitchen, rebuilt in 1899. From RCAHMS
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A ward kitchen. From RCAHMS

References: H. C. Burdett, Hospitals and Asylums of the World, vol.3, 1893, pp.303-5: The Lancet, 4 July 1891, p.47; 6 Feb 1892, p.336, 9 June 1894, p.1476; 14 Jan 1899, pp.125-6: Edinburgh Evening News, 4 Feb 1876; 11 Nov 1880; 15 June 1886, p.2

see also: Lothian Health Services Archive blogspot and Building up our Health pp. 92-3

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