King Edward VII Estate: Midhurst Sanatorium

Following on from the post featuring Midhurst Sanatorium chapel, I wanted to look at the main Sanatorium building. It is one of the most important former sanatoria in England and one of the most attractive. Latterly the King Edward VII Hospital, it closed in 2006 and remained empty for some years after. The sanatorium building and chapel were listed Grade II* and the gardens registered, conferring a degree of protection for these important buildings and imposing restrictions on the re-use and redevelopment of the site. Nevertheless, by 2012 the condition of the buildings had deteriorated and the chapel was placed on the Heritage at Risk register. In 2015 work began on the redevelopment of the site, turning it into a luxury estate, by the developers City and Country.

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A rather scratchy slide from June 1992 of the King Edward VII Hospital, as it then was.

As the name of the hospital implies, the origins of this sanatorium were closely linked with Edward VII. Having decided to fund the erection of a sanatorium in England for patients suffering from tuberculosis, in 1901, the year that he acceded to the throne, the king appointed an advisory committee comprising some of the leading medical men of the day to ensure that it should be of the most up-to-date design. There were six men on the committee: Sir William Broadbent Bt KCVO; Sir Richard Douglas Powell Bt KCVO; Sir Francis Laking KCVO; Sir Felix Semon; Sir Hermann Weber; and Dr C. Theodore Williams. In February 1902 the committee announced in the medical press of Europe and America that a competition was to be held for an essay and plans for the erection of the sanatorium. There was no restriction as to the nationality of the entrants, and they might be either from medical men or jointly from a medic and an architect (but not just from architects). The sanatorium was to provide for 100 patients, equally divided between the sexes, of which 88 beds were to be for the ‘necessitous classes’ the remaining 12 set aside for the well-to-do. All the accommodation was to be comfortable, with a single room for each patient, though with ‘superior arrangements’ being made for the wealthy patients. The building was to have the latest sanitary fittings and have facilities for scientific research. Entries were to be anonymous, but have a motto to distinguish them. The king was to provide £800 in prize money, awarding £500 for the best entry, then £200 and £100 for second and third place.

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Arthur Latham deposited this bound edition of his prize-winning entry in the library of the Royal College of Physicians. It has been digitised by the internet archive

There were 180 entries, and the winners were announced in August 1902. The top prize went to Dr Arthur Latham of London and William West, architect, also from London (motto – ‘Give him air, he’ll straight be well’). Second prize went to Dr F. J. Wethered with Messrs Law and Allen, architects, also all from London (motto – ‘If preventable, why not prevented?’), and third prize to Dr E. C. Morland with Mr G. Morland, architect, both of Croydon (motto – ‘Vis Medicatrix naturae’, roughly ‘the healing power of nature’, a motto associated with the nature cure movement).  On the architectural side, these were not well-known names. There were four honourable mentions, amongst whom were some better-known architects: Dr P. S. Hichens of Northampton submitted his essay in association with the architect Robert Weir Schultz, and Dr Jane Walker with Smith & Brewer. The only non-English entrant that featured in this list was the celebrated Dr Karl Turban of Davos whose architect was J. Gros. The final honourable mention went to Dr J. P. Wills of Bexhill, with Mr Wills, architect, London.

In the mean time the site had been chosen, at Midhurst in Sussex (now West Sussex). But the commission to design the new sanatorium did not go to Latham’s little-known architect William West, but to H. Percy Adams, presumably considered a safer pair of hands as he was already a well-experienced hospital architect. Since 1898 Charles Holden had been in Adams’ practice, and the final design for Midhurst Sanatorium bears the hallmarks of Holden’s characteristic style.

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Aerial perspective of the ‘King’s Sanatorium’ as designed by H. Percy Adams and Charles Holden in 1902, published in Academy Architecture, 1903

To assist them in drawing up the design Adams and Holden had the benefit of Latham and West’s essay and plans, but they also visited sanatoria in Germany and Switzerland – Edward VII had been particularly impressed by the sanatorium at Falkenstein in Germany. The aerial perspective above shows the arrangement of the building. The patients were to occupy the shallow-V-shaped range to the right, which faced south, behind which was a U-plan administration block. These two ranges were linked by a central corridor. The admin block contained suites of offices, the committee room and service rooms, as well as an operating theatre, X-ray and casualty rooms, laboratories, a medical library, and the patients’ dining hall.

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Plan from Latham and West’s essay. Their preferred scheme was to provide separate blocks for the wealthy and necessitous patients, this plan being the block for the more wealthy patients. 

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This was Latham & West’s alternative plan, which housed the wealthy and necessitous in one building. Both plans have elements in common with the designs drawn up by Adams & Holden.

Edward VII retained his interest in the progress of the sanatorium, laying the foundation stone on 3 November 1903. Delays in construction, in part over the water supply, caused the king some vexation, but it was finally opened on 13 June 1906.

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The main front of the sanatorium, photographed in June 1992

The patients’ wing to the south was symmetrically arranged with a taller central block of three storeys. The ground floor breaks forward, its flat roof providing a terrace for the rooms on the first floor. Within were two spacious recreation rooms on the ground floor, one either side of the central corridor which marked the division of the sexes (males on the west, females on the east side). There were also hydro-therapy rooms flanking the garden entrance. Each patient had a separate room, as the original competition rules had required.

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Photograph of the sanatorium taken c.1950. (Image kindly supplied by W. Parker.)

The rooms faced south and opened on to a terrace or balcony. Bathrooms and WCs were provided in sanitary towers to the north of the patients’ corridor that ran along the back of their rooms and at the far ends of the building. The wealthier or higher class patients had slightly larger rooms with private balconies situated in the central range, while the lower-class patients occupied the wings.

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Detail of the central gabled bay, June 1992

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One of the stone alcoves on the south front, which provided a secluded shelter

The furnishings and fittings combined hygienic and aesthetic requirements. Washable wallpaper was used in the patients’ bedrooms, an early use of this new product in England, and the floors were of wood blocks. Moulmein teak was used for the staircases which was less susceptible to fire than other, coarser grained wood. The dining-hall and kitchen walls were lined with Doulton’s Carrara tiles.

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Postcard with aerial view of the sanatorium. (Image kindly supplied by W. Parker.)

A formal garden was designed for the area to the south of the main building by the horticulturalist Gertrude Jekyll. Her layout, of gardens built on terraces on several levels, with buttressed stone walls separating one level from another, follows closely the scheme indicated by Adams in his perspective drawing. Lawns and flower beds were laid out on the terraces, and various shrubs, flowers and aromatic herbs were planted, many supplied personally by Jekyll. She also designed small gardens to fill the spaces between the administration block and the patients’ wings, again following closely Adams’ original designs. The work was carried out under Jekyll’s direction by two gardeners aided by some of the patients.

Sources
A. Latham The Prize Essay on the erection of a sanatorium for tuberculosis… 1903
Academy Architecture, 1903, ii, pp.116-9
F. Allibone, typescript notes to collection of drawings by Adams, Holden & Pearson in RIBA Drawings Collection
The Builder, 23 May 1903, pp.531-2; 22 April 1905, pp.440; 23 June 1906, p.707
Building News, 27 May 1904, p.761
Kelly’s Directory of Sussex 1934, 1934, p.243
S. E. Large, King Edward VII Hospital Midhurst 1901-1986, 1986
I. Nairn & N. Pevsner, The Buildings of England: Sussex, 1965

see also urbexer’s exploration of the site from 2012 on 28dayslater

Doecker portable hospitals

In the Hospitals Investigator number 5 the following list of suppliers of temporary hospital buildings was given: Humphrey’s of Knightsbridge;  Boulton and Paul of Norwich; Portable Building Company of Manchester; Hygienic Constructions and Portable Buildings Ltd; Wire Wove Roofing Company of London; G. W. Beattie of Putney; and Kenman and Sons of Dublin. To this list should be added Spiers and Co. of Glasgow, prolific providers of isolation hospitals pretty much throughout Scotland.

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A Doecker hospital hut at Netley Hospital during the Boer War, from Wellcome Library, London. Wellcome Images http://wellcomeimages.org V0015643

The Hygienic Constructions and Portable Buildings Ltd were the agents for temporary buildings constructed on the Doecker system  invented by Captain Döcker (usually rendered Doecker in English) of the Royal Danish Army. Johann Gerhard Clemens Döcker (1828-1904) first patented his portable building system in 1880. (He filed patents in France and Germany in October 1880,  in Denmark and Austria-Hungary in 1881, in Norway, England, Spain, Belgium, and Italy in 1882;  in Russia, Sweden and Victoria in 1883; and in New Zealand and the United States in 1884.) The full text of the patent he submitted in the United States can be read online here http://www.google.com/patents/US308833.

Three sheets of drawings provided details of his system:

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Sheet 1 from Doecker’s USA patent 1884. [Source: United States Patent and Trademark Office, www.uspto.gov]

‘My improved portable and impermeable structure is composed of a series of light frames which may be made of wood or metal, and for general purposes such frames are polygonal in shape. Each frame a is covered with a sheet of impermeable material,  permanently connected therewith in any suitable manner, as by nailing, riveting, or gluing. Two such frames are permanently hinged together by means of any suitable form of hinge, and a pair of such frames constitute a panel.

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Sheet 2 from Doecker’s USA patent of 1884. [Source: United States Patent and Trademark Office, www.uspto.gov]

‘The frames are hinged together so as to fold inwardly toward each other, so that their covering will not come in contact when folded. I prefer to cover the frames with strips of felt, which may be rendered water-proof either before or after being attached to the frames, and I prefer the latter method, especially when the felt is attached by means of nails or rivets, for the reason that the points of attachment will then be covered by the waterproofing substance applied, and produce water-proof joints, which would not be the case when the felt is applied after being rendered impermeable. This impermeability may be imparted to the felt by any one of the many waterproofing compositions or water and fire proofing compositions, or by means of oil-paints. I prefer to use felt, owing to its density and non-conductive properties, it being better adapted than any other material to shield the occupants of the structure both from heat and cold.’

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Sheet 3 of Doecker’s USA patent of 1884. [Source: United States Patent and Trademark Office, www.uspto.gov]

The term Doecker hospital was sometimes used generally for portable hospital buildings, whether or not they were in fact of Doecker construction. Doecker buildings were largely used on the continent, and in Britain were also used for elementary and open-air schools.  There were two types: strong or light. The strong type were intended asa a substitute for permanent brick or stone buildings, while the light were for temporary and/or portable buildings, which could be put up quickly and cheaply.

For both types the buildings were made in sections roughly 3ft x 3ft (a little less than a metre squared). These sections could be fastened together with iron hooks and studs, allowing for de-construction and re-erection on another site. The strong type comprised timber frames weather-boarded on the outer side and covered on the inside with a composition called ‘Doecker material’ – a non-inflammable, water- and acid-proof. These two layers provided a cavity that was filled with insulating material, though the walls were only 4 1/2 inches thick (about 11 cm). The roof was covered with a flexible and water-proof material (‘ruberoyd’).

The light construction had a lighter frame covered on both sides by Doecker material. The whole building was made in sections, and the packing formed the floor ‘thus saving weight, space, and freight in transit’. No foundations were required, the building sat on adjustable wooden feet. Constructed these light buildings measured 50ft x 16ft (15.24m x 4.8m) and could be erected in one day by unskilled labour. Their insulation properties were commended: ‘Portable hospitals of this construction were used by the German Red Cross Society during the cold of a Manchurian winter in the Russo-Japanese war, and they have also been used in the tropical heat of South-West Africa’.

V0015642 Boer War: the Doecker Hospital Huts at Netley with patients

An image from 1900 of Doecker hospital huts, Wellcome Library, London. Wellcome Images http://wellcomeimages.org V0015642

Doecker system hospital buildings, along with other prefabricated buildings, featured in H. Franklin Parson’s book Isolation Hospitals, originally published in 1914 and revised in 1922 by R. Bruce Low.

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This hospital pavilion, with is sun-catching angled wards, was a type provided by the Hygienic Constructions and Portable Buildings Ltd, Stockholm Road, South Bermondsey.

The 1922 second edition formed part of a series of books on public health and hygiene (the Cambridge Public Health series) designed to advise those working for the government and the medical profession. It addressed the way in which infectious diseases were contained and treated, and defended the government’s decision to spend a significant amount of money on isolation hospitals. Parsons and Low discussed the most advantageous designs and locations for these institutions, the containment of diseases such as small pox and tuberculosis, and the issues that arose around both the staffing of isolation hospitals and the changing provisions made for those patients affected by severe poverty.

 

 

 

The Hospitals Investigator 2, part 1

In July 1991 Robert Taylor produced the second edition of The Hospitals Investigator, the newsletter he wrote and circulated to his five colleagues working on the RCHME survey of historic hospital buildings. Here he pondered Pest Houses, discussed deposited plans, and thought about (operating) theatres. In part 2b I will relay his discussion of ridge lanterns, sanatoria, and sewage works – we really knew how to enjoy ourselves.

Pest Houses

“Pest houses have been emerging from the Suffolk countryside at an alarming rate. The name indicates a house, usually an ordinary farm house, which was used by the local authority as an isolation hospital in the event of an outbreak of infectious disease, usually smallpox but in some early cases the plague as well. Details of the arrangements must have varied, but it seems that the tenant had an obligation to either nurse the victims or to move elsewhere for the duration of the sickness. The latter was perhaps the more common practice in the seventeenth century. The possibility of such an arrangement was taken for granted in the 1875 Public Health Act, although the Local Government Board did not like ad hoc hospitals very much and put pressure on local authorities to provide specialised buildings. A very few pest houses remained in use in the first years of this century.”

“So far the Cambridge office has seen only three surviving pest houses, at Halesworth, Framlingham and Bury St Edmunds. The first was a standard three-cell two-storey farmhouse of the late seventeenth century, and remained the centre of a working farm until the land was sold away recently. That at Framlinhgam was an early seventeenth century two-cell house with central stack, and similarly showed no sign of specialised planning. Although reputedly built in 1665, the Bury pesthouse displayed nothing earlier than the eighteenth century, and was  a three-cell, single-storey house with internal stack. Other pest houses remain to be located at Eye, Nayland and Huntingdon, as well as a few less certain cases.”

I couldn’t find any photographs of these particular pest houses, though there will be photos taken by Robert and Kathryn in the relevant files in Historic England Archives. Here is a much smaller version in Hampshire at Odiham, where presumably, a small population did not require anything bigger.

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This 17th Century Pest (or Plague) House in Odiham, Hampshire is one of only five remaining in the country. Photograph by Anguskirk and licensed under CC BY-NC-ND 2.0

The Patrick Stead Hospital continues to function as a community hospital, and was designed as a cottage hospital by Henry Hall. It opened in 1882.

Screen Shot 2015-05-29 at 17.28.19Above is a postcard showing the hospital, and below an elevation and plans produced in The Builder in 1880. Originally it provided a dispensary, outpatients’ clinic and accident ward, all on the ground floor, with further wards above. Patrick Stead set up a maltings business in Halesworth, and bequeathed a generous £26,000 to establish the hospital.
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“Recently one of us was reading a letter written by an official of the Ministry of Health in 1926 when it suddenly became clear that the writer of the letter had in front of him a set of plans for an isolation hospital that had been sent to the Local Government Board in 1888 in connection with an application for sanction to raise a loan. Plans of isolation hospitals were deposited when an authority applied for permission to borrow money for hospital building, and also when the more responsible authorities voluntarily sought approval of their proposed hospital. The Local Government Board was replaced by the Ministry of Health, whose archive should contain these immeasurable riches, along with similar material for workhouses. Unfortunately most of the material dating from after about 1902 was lost in the blitz, and what survived that seems to have been mostly destroyed in a fire in Brighton. All that survives is at [the National Archives, at] Kew, hidden behind the catalogue code MH. The three main groups seem to be MH.12, MH.14 and MH.34.”

“MH.12 consists of Poor Law Union Papers, of which 16,741 bound volumes, arranged under Unions, survive from between 1834 and 1900… MH.14 is called Poor Law Union Plans, and there are 38 boxes of them dating from between 1861 and 1900. They have reference numbers linking them to MH.12… MH.34 is a register in 11 volumes of authorisations on workhouse expenditure between 1834 and 1902.”

Reading this today, it is a reminder of how much researchers now gain from online digitised archive catalogues, and perhaps a lesson not to grumble about them (as I frequently do) when we can’t find what we’re looking for, they crash, they change, or they assault ones aesthetic sensibilities.

Theatres

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The Hopgood operating theatre at the Royal Free Hospital, 1895, Royal Free Archive Centre on Flickr. Imaged licensed under CC BY-NC 2.0

“One of the problems met in small hospitals is the identification of the jumble of buildings behind the main block. As in a mediaeval house the identification of the hall acts as a key to understanding, or at least knowing the rough layout of, the entire house, so one might expect that the operating theatre might stand out and give some help in finding a way through the maze. Unfortunately this does not always happen. Plenty of light was necessary, so a roof light is an important indicator. A large North-facing window is another but less reliable sign, and far too often the windows appear to be ordinary ones, the lower parts filled with obscured glass, as at Southwold. At Felixstowe the theatre has a semi-octagonal North end, like a sitting room, with ordinary-sized windows that are now blocked. The Beccles Hospital of 1924 has a magnificent but sadly un-photographable theatre with a North wall and roof of glass. Sometimes it is possible, if we are very tall or can manage to balance on tip-toe or on a convenient upturned bucket, to glimpse through the windows the white-tiled walls, or even the upper parts of lighting equipment.”

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Students from the London School of Medicine for Women watching an operation at the Royal Free Hospital.  Students observing an operation c.1900 Royal Free Archive Centre on Flickr. Imaged licensed under CC BY-NC 2.0