Grantham Hospital

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Grantham & District Hospital, photographed in 2009, the redundant Victorian building. © Copyright Richard Croft and licensed for reuse under this Creative Commons Licence

The future of this fine old building is under threat. It has stood empty for many years and there are fears that it may be demolished, despite its important place in the local history of Grantham and in the wider history of hospital architecture in England.

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Postcard of the hospital c.1900 

A day of public celebration, parade and partying accompanied the ceremony of laying the foundation stone of Grantham Hospital on 29 October 1874. The band of the Royal South Lincoln Militia lead a procession, followed by the architect and builder, local dignitaries, and interested parties, that marched from Grantham Guildhall to the site of the new hospital on the Manthorpe Road to the north of the town centre.

Countess Brownlow, who was closely associated with the project from its inception, conducted the actual ceremony, once she had listened to an address by the chairman of the building committee, a short service by the Vicar, and been presented with a silver trowel. A public luncheon was given at the Guildhall presided over by Earl Brownlow. Tickets for this event could be purchased for 2s 6d. Earl Brownlow and his wife donated funds towards the hospital and took an interest in the plans, and the Earl of Dysart gave £1,000 to the building fund. [Grantham Journal, 24 Oct 1874, p.4]

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Extract from the 25-inch OS map, surveyed in 1885. Reproduced by permission of the National Library of Scotland.
Extract from the 25-inch OS map, revised in 1903. Reproduced by permission of the National Library of Scotland. This shows extensions to the rear of the hospital and an additional block.

Grantham Cottage Hospital was designed by the London architect Richard Adolphus Came (1848-1919), who went on to lay out the development of Woodhall Spa in Lincolnshire where he later settled, designing many of its buildings. He appears in the 1901 census as the proprietor of the Royal Hydro Hotel there. Came freely adapted a basic pavilion plan to create a picturesque elevation. Unusually, the wards were T-shaped, an arrangement which was commended by the great champion of hospital architecture in the late 19th century, Henry C. Burdett. He thought the wards were novel, pleasing and noteworthy, presenting a cheerful and airy appearance ‘which fills the visitor with pleasure’.[H. C. Burdett, Cottage Hospitals, 2nd edition 1880 p.412]

Baroness Brownlow also officiated at the official opening on 5 January 1876. ‘As it now stands approaching completion, the building with its neatly arranged grounds, and trim Gothic porch, forms a somewhat picturesque object’, reported the Grantham Journal. 

The hospital, which is Gothic in character, is constructed of local stone with Ancaster dressings, and consists of three distinct blocks of buildings. The main building, which faces the road … is composed of a central block of two stories, providing a waiting-room, entrance lobby, surgeons’ sitting-room and operating-room, kitchen, offices and store-rooms, &c. on the ground floor; convalescent and board rooms, and four bedrooms on the first floor; and two bedrooms and lumber room in attics. There are wings stretching right and left of this block, forming the wards for male and female patients, and containing seven beds each, together with nurses’ room, bathroom, and other offices. The Gothic timber porch, which certainly contributes much to the appearance of the building, has been erected at the expense of the Earl Brownlow. Some distance in the rear of the main building, the fever hospital has been erected, and will contain five beds, bathroom, nurses’ room, kitchen &c., the working of this department being kept entirely separate from the other part of the hospital. A convenient laundry is also provided, with the addition of washing and ironing rooms, drying closet, and other similar accommodation. [Grantham Journal, 8 Jan 1876, p.4]

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Grantham & Kesteven Hospital, photographed in 2010. Opened in 1874, the old buildings are now obsolete, superseded by new facilities and left decaying. © Copyright Richard Croft and licensed for reuse under this Creative Commons Licence

A major extension to Grantham Hospital was built in the mid-1930s to designs by the local architect F. J. Lenton, of Traylen & Lenton. The plans were approved by the British Hospitals Association, the Ministry of Health and the County Council. It was partly as a result of Kesteven County Council’s obligation to provide hospital accommodation that Grantham Hospital was extended, and the enlarged hospital was to take patients from the county as a whole. This raised the number of beds provided in the hospital from 33 to 76 initially. A new entrance was formed to the south of the original building. New ward blocks ‘of the latest verandah type’ were built for men, women and children. There was also separate provision for private patients, a new isolation block and operating theatre unit.

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Architectural perspective of the extensions to Grantham Hospital by F. J. Lenton, architect

Verandah wards with folding windows, usually occupying the length of one side, originated in Denmark, and were introduced to England by Charles Ernest Elcock at the County Hospital, Hertford. Beds were placed parallel to the the side walls in groups of four, separated by glass partitions, instead of the old pattern in Nightingale-style wards where the beds were placed in rows at right-angles to the side walls. Each ward had five groups of four beds and two separate observation wards. The south-facing children’s ward had a paved terrace in front of the folding windows to allow cots to be wheeled out into the open air.

Verandah wards were hailed as revolutionizing hospital planning by providing improved access to fresh air and sunshine, and the psychological effect of smaller groups of beds (‘cosy communities’). It is interesting to note that the local paper praised the hospital for its functional design. ‘Rigid economy’ was observed in order to be able to provide the most up-to-date equipment: ‘In past days Hospitals were so often designed for external effect first and foremost’… ‘present-day designers always have in mind that their building should not be monumental, but sufficient for the present, and of a type that can be readily altered or adapted to the possible requirements of the future. [Grantham Journal, 27 Jan 1934, p.5]

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Partly obsolete buildings at Grantham and Kesteven Hospital, photographed in 2010. © Copyright Richard Croft and licensed for reuse under this Creative Commons Licence

In the new hospital, the private wards occupied a separate unit to the west of the complex which had its own enclosed garden. It had six private wards, with bedrooms for special nurses and separate ward kitchens. A subterranean boiler house was constructed at the edge of the site to provide heating and hot-water, operating on the panel-heating system by low pressure hot water, accelerated by electric pumps. All pipework was concealed in the ceilings. This was supplemented in the wards either with conventional open coal fires or gas fires. The building contractors for the extension were Bernard Pumphrey Ltd of Gainsborough. [Grantham Journal, 22 Sept 1934, p.5]

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Extract from the 6-inch OS map, revised in 1938. Reproduced by permission of the National Library of Scotland. This shows the extension to the south of the hospital.

The new buildings were completed early in March 1935, after which the old hospital was refurbished to provide accommodation for the nursing and domestic staffs. At the same time a maternity unit was created in the old south ward wing of and the old theatre converted into a special labour ward. These alterations brought the hospital’s capacity up to 100 beds. [Nottingham Evening Post, 24 March 1936.]

Further additions were made following transfer to the NHS, including a new maternity unit which opened in 1972. Grantham Hospital has retained huge local support, as witnessed by the demonstrations that took place earlier this year to protest against the drastic reduction of the opening hours of the A&E department.

 

Galashiels Cottage Hospital

The future of the former Galashiels Cottage Hospital seems to be uncertain once again. When the Borders District General Hospital opened at Melrose in 1988, it had been intended that the cottage hospitals at Galashiels and Selkirk should close permanently, but the local health board changed its mind and decided it could find a new use for the buildings. For Galashiels, that new use was a rehabilitation unit for people with long-term mental health problems, and it re-opened as such under the name Galavale House. But more recently there have been concerns that the standard of accommodation is not longer fit for purpose, and a scheme was under consideration in 2015 to relocate services to Crumhaugh House, Hawick.

In 2006 Galavale House and lodge were listed category C (s) for their architectural and local historic interest. The origins of the hospital date back to 1891 when subscriptions were first raised for a cottage hospital in the town. Originally it was intended to be for accident cases, but in the end it took in medical and surgical cases, though paupers were excluded. Sick paupers were cared for at the local poorhouse.

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Galashiels Cottage Hospital, engraved view from Building News, 1893

Built to designs by John Wallace of Edinburgh, the hospital was formally opened by the Earl of Dalkeith in November 1893. Wallace was originally from the Borders, and the few architectural commissions that he is known to have carried out were all in this area. In 1891, the year before he was commissioned to design the cottage hospital, he had designed Blynlee Tower in Galashiels.

The plan below was not as executed, only the front wards were built, so at first there were just two wards with six beds each, and two single wards for private patients. The local building firm of Robert Hall & Co. carried out the construction work.

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Detail showing the proposed plan of the hospital.

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Extract from the Galashiels & Selkirk Almanac and Directory of 1903

As built, the hospital comprised an appealing small scale building. The wide single‑storey centrepiece of the main block has generous roofs with dormers, and the eaves are supported on cast‑iron columns to create a verandah. The wards in the projecting outer bays are lit by broad bay windows. A small nurses’ home was built on the site with thirteen bedrooms in 1929-30 to designs by the local architects J. & J. Hall, John Hall was the nephew of Robert Hall, the builder of the original hospital. In 1938 extensions were built, in sympathetic style, to the south-west (Hume Ward) and north. In that year four beds were set aside for maternity cases.

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Extract from the 25-inch OS map revised in 1930. Reproduced by permission of the National Library of Scotland

Sources: 

The Builder, 18 June 1892, p.480; Building News, 24 Nov. 1893, p.703: Border Telegraph18 August 2015 accessed online 16 April 2016.

The Hospitals Investigator 6

October 1992 brought forth the sixth newsletter from the Cambridge team of the RCHME Hospitals Project. It included short pieces on mortuaries and asylum farms, and accounts of the Victoria Cottage Hospital, Wimborne, Dorset, with thoughts on holiday closures of hospitals. There is also a note on Sleaford’s isolation hospital, a portable hospital with what sounds like a camper van for the nurse. Extra curricular activities at hospitals were discovered too, with money making schemes in a Yorkshire madhouse and an unofficial B&B at Addenbrooke’s Hospital in Cambridge.

Victoria Cottage Hospital, Wimborne

This unremarkable little Dorset hospital has a history written in 1955 by someone hiding behind the initials G. H. W. From this booklet we can extract several amusing bits of hospital history.

 

First must come the sanitation. In 1887 when the hospital was built there was one earth closet for the patients. This came to light in 1907 when water was installed along with an extra closet. The operating theatre was another horror for it doubled as the bathroom from 1887 until 1904 when a new operating room was built. Even this new theatre did not have an electric light until 1934. Provision of a separate operating theatre did not end the dual use of the bathroom, however. Until 1927 it housed the telephone. In that year the telephone was moved to the matron’s office.

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Extract from the 1901 OS map. The cottage hospital is to the north-west of the town, almost on a level with the union workhouse, which is to the north-east. Reproduced by permission of the National Library of Scotland

Until 1924 the hospital closed completely for about a moth every year, for cleaning and repairs. During this time the staff took holidays, and the patients were dismissed. Some were sent to the small 18th-century workhouse in Wimborne, for in 1922 the Guardians sent the hospital a bill for care of patients. We have met this sort of annual closing and cleansing elsewhere, but it seems poorly documented. In 1946 the Passmore Edwards Hospital at Liskeard closed for a moth because that was the only way in which the staff could take a holiday; our source does not say whether this was a regular event. The Royal National Sanatorium at Bournemouth closed in winter, allegedly because the hospital was only intended to provide a summer break for consumptives (and thus for their carers as well). At Northampton the General Infirmary managed cleaning and repairs by simply closing one ward at a time, but as this was a large hospital part-closing was easier than in a small hospital like Wimborne.

Finally, on a frivolous note, when the townsmen were discussing whether to commemorate Victoria’s jubilee by building a hospital or by some other means, one suggestion was ‘erecting a statue of Queen Victoria with a clock on top’. Just how this was to be arranged is not explained.

Sleaford Hospital

The Sleaford Rural District Council bought an isolation hospital in 1901 for the sum of £127. It was ‘an ingenious contrivance’ of numbered wooden sections that could be put together in a few hours, measured 20 feet by 12 feet and could hold up to four patients. A van on wheels provided both accommodation for a nurse and the necessary cooking arrangements. There was also a portable steam disinfector that was reported to be too heavy to be portable. This magnificent hospital was stored at the Sleaford Workhouse, and was erected for the very first time for the benefit of an inquisitive Local Government Board inspector in 1905. It is not known whether it was ever used after that. [The inspector’s report is in Parliamentary Papers, 1907 XXVI, 200-201.]

The East Stow Rural District Council in Suffolk had a ‘small portable hospital’ for smallpox cases in 1913, and presumably this was also a sectional wooden building. [PP 1914 XXXVII, 746] In 1913 Bournemouth Corporation had lent the neighbouring Rural District Council a Doecker Hut for use as an extra hospital ward during an outbreak of enteric fever at Ringwood, another portable structure. [PP 1894 XL, 565 and see Doecker Portable Hospitals]

At least these buildings were of wood. Shortly before 1890 the Gainsborough Rural Council bought a hospital marquee for patients and a bell tent for the nurses. They were aired from time to time, but appear not to have been used. [PP 1894 XL, 565] Perhaps even these tents were better than the converted dog-kennels at Bishop Auckland in 1895. [PP 1896 XXXVII, 704]

Mortuaries

In the course of research for the project a file copy turned up of a Government questionnaire headed ‘Isolation Hospital Accommodation’, and filled in for the Southampton Smallpox Hospital. The printer’s rubric shows that it dates from 1926 and that some 10,000 copies were printed. The answers, together with a crude plan from another source, make a description of this vanished hospital possible, but there is little of interest until the question ‘is there a mortuary at the hospital?’ The answer is simply ‘Cubicles in Observation Hut used for this purpose’. The observation hut was a small building with two single-bed wards and a duty room If one cubicle was occupied by a patient, the psychological effect of comings and goings in the other cubicle can hardly have been good. Perhaps the real significance of this arrangement is that the observation wards of isolation hospitals were probably rarely used, and that there never was a living patient to be disturbed by the arrival and departure of a dead one. It also helps to suggest ways in which hospitals without mortuaries might have functioned.

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Extract from the 1934 OS map. Reproduced by permission of the National Library of Scotland

The smallpox hospital was at Millbrook Marsh, an inhospitable looking place even as late as the 1930s, surrounded by mud and marsh. It is interesting to see that development of the estuary was just beginning at this time, to the east is the King George V graving dock under construction. By the 1950s the hospital site had become a boat yard, re-using the existing buildings. A couple remained in the late 1960s, when the area to the north had become a sewage works, which eventually swallowed the remaining former hospital buildings.The huge Prince Charles Container Port was built over the mud flats and saltings.

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Extract from the 1897 OS map. Reproduced by permission of the National Library of Scotland

Southampton, in common with other ports, provided a number of isolation hospitals. As well as the smallpox hospital there was another isolation hospital at West Quay.

It is in the usual location, close to the water so that anyone arriving by ship suspected of having contracted an infectious disease could be taken directly to the hospital by boat. The site was later an Out-bathing and Disinfection Station for Infectious Diseases and later still used for a clinic and a mortuary. That was in the post-war era, and by then land reclamation had seen the site removed from the water’s edge. As far as I can make out, the Grand Harbour Hotel seems to occupy the site now.

Asylum Farms

Slowly it is becoming clear that asylum farms were unlike those in the world outside, at least in the South of England. Large barns for storing crops are absent from those seen so far, but piggeries are ubiquitous and any fragments of yards and single storey buildings appear to have been for cattle. Sometimes there are stables and cart sheds, but it is not certain that these were specifically for farm use. Indeed the buildings suggest that attention was concentrated on stock, especially pigs and cattle, and perhaps market gardening, where there was greater scope for farming as occupational therapy. At Digbys, Exeter, there is a tall building which had large opposed loading doors, one opening on to the yard, the other on to a lane outside the hospital grounds. The building is not large enough to hold much, and certainly is not suitable for storing a grain crop. It seems to have been intended for receiving bought-in material, presumably feedstuff for the pigs and cattle.

EPW024131Digby Hospital, formerly the Exeter Lunatic Asylum. The small farm complex is on the east near to the London & South Western Railway line. The buildings have been converted to housing as part of the re-development of the hospital and its site for housing.

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Extract from the 1st Edition OS Map published in 1889. Reproduced by permission of the National Library of Scotland

The advantages of concentration on livestock is that it would provide the asylum with pork, bacon, milk and beef, while a market garden would provide soft fruit and vegetables. All of these are labour-intensive occupations, providing maximum work throughout the year for the relatively large number of patients.

Secondary Employment

John Beal was the proprietor of a private madhouse at Nunkeeling in the Yorkshire Wolds. The financial success of this venture seems out of proportion to the small number of patients and the remoteness of its position. The truth emerged in 1823 when the excise men found 24 casks of tobacco, 25 of tea, and 264 of assorted spirits, mainly gin, concealed about the premises. Perhaps we should pay greater attention to such institutions, in the hope that more than just buildings survive.

Income

Those hospital administrators busy trying to generate income have all failed to exploit one obvious opportunity that was seen as long ago as 1770 by the Matron of Addenbrooke’s Hospital, Cambridge. The town has long had a shortage of short-term accommodation. The matron saw this and let beds to overnight visitors, presumably giving them breakfast as well. On discovering this the Governors dismissed her, partly because she was pocketing the income.

The Hospitals Investigator 4

Issue 4 of Robert Taylor’s Hospitals Investigator was circulated in July 1992 and in his editorial he wrote that the theme for this issue would be lunacy, in particular, baths and fire precautions. It concluded with a report on the Cambridge team’s trip to Cornwall and what they found there.

Baths

‘One of the many criminal economies practised in public institutions in the 19th century was the sparing use of bath water. At the Suffolk Asylum at Melton the male attendants used a single filling of the bath for five men, but on the opposite side of the same institution  the female attendants managed to make a single filling serve ten women. This amazing achievement gives a new and unexpected meaning to sexual discrimination. At some asylums things were managed differently, and they put two lunatics at a time into the same tub, thereby ensuring that all and an equal chanced to enjoy hot water. Oxford, however, held the record and regularly managed to bath three at a time, thereby beating Cambridge by a factor of three. We have yet to see the size of the Oxford baths.

Considering that the water was frequently delivered at such a high temperature that patients were in real danger of scalding themselves and the taps could only be controlled by the attendant, one wonders at the temperature of the bath water at Melton when the first woman got in, and when the tenth got out.’

While looking for an illustration of bathrooms in asylums, I searched through the Wellcome Images collection which has this photograph taken around 1930 of Long Grove Asylum, Epsom in Surrey. Shared bath water was no longer acceptable, and a modicum of privacy was afforded by the  fixed screens.

L0015468 Male patients being washe by hospital orderlies. Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Male patients being washed by hospital orderlies, Long Grove Asylum, Epsom. In the Royal College of Psychiatrists. circa 1930? Published: - Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/

L0015468 Male patients being washed by hospital orderlies. Wellcome Library, London.

Fire Precautions in Asylums

‘Methods of preventing the start and avoiding the spread of fire in hospitals have developed in stages, usually one set of ideas at a time.’

‘The first fire precautions in the 18th and 19th centuries were purely structural, along the same lines as the various contemporary local regulations and the London Building Acts. The aim was to make buildings unlikely to catch fire or to burn, in other words, fireproof construction. Most of these techniques had become standard best building practice by the beginning of the 18th century, and included such things as not having timbers let into chimneys. This particular concern can be seen in an obvious form at the workhouse at Tattingstone in Suffolk, where ceiling beams are skewed in order to miss the fireplaces. The use of masonry for walls, and slates or tiles for roof covering were standard from the beginning; timber frame and thatch are not used for purpose-built hospitals.’

 

geograph-4142138-by-Clint-MannTattingstone Hospital in 1990 © Copyright Clint Mann and licensed for reuse under this Creative Commons Licence Originally built as a House of Industry in 1766, and later extended as Samford Workhouse, it became St Mary’s Hospital in 1930, finally closing in 1991 and was converted into housing around 2001. see also  http://www.workhouses.org.uk/Samford/

‘At a later date non-burning floor structures were used, called ‘fireproof’ and depending at first on the use of iron beams and shallow brick vaults. This system had the disadvantage that it relied on exposed iron girders, which were liable to buckle in a fire. Later in the 19th century, devices such as hollow bricks forming flat arches, sometimes strengthened by steel rods cased in concrete, were used to avoid this problem and produce a lighter structure. Perhaps the most common fireproofing device is the use of stone for staircase treads, almost invariably combined with iron balusters.’

‘Despite all of these precautions, fires broke out and even spread. Limiting the damage done by a fire was an important consideration, and it is interesting to learn that in asylum building in the middle of the century it was considered desirable to restrict patients to two storeys, for greater ease of escape or rescue in case of fire, as well as to reduce the amount of building that might be damaged. [The Builder, 27 Nov 1852 p.754] This is a contrast with the earlier practice at workhouses, where three-storey main ranges to accommodate the inmates were common. The Commissioners in Lunacy seem to have been particularly concerned by the fire at the Cambridgeshire Asylum  in 1872. No lives were lost, and damage was limited, but the general opinion was that the fire very nearly destroyed the whole asylum.’

VLUU L210 / Samsung L210

VLUU L210 / Samsung L210

Central block of Fulbourn Hospital, originally Cambridgeshire County Asylum, and now reconstructed NHS offices. (Photograph by Tom Ellis taken in 2009 and licensed under CC BY-NC-ND 2.0)

‘The boilers and pumps were in the basement of the central block, and as the call for steam and hot water had increased, the size of the boilers had been increased, well beyond the capacity of both the basement and the flues. It seems that this situation was very common, and it was this that led to a new wave of precautions in asylums during the 1870s, particularly after 1875. In that year the reports of the Commissioners on their annual visits to asylums pay great attention to fire prevention, and include descriptions of a number of devices.’

‘The major new concern of this decade was with the provision of a sufficient quantity of water at high enough pressure to extinguish any fire that should break out. Water mains with hydrants were installed both inside and outside the buildings and examined during visitations, when the Commissioners hoped to see an efficient fire drill and a jet of water that toped the highest roofs of the asylum. The pressure was usually produced by a steam engine. A sufficient quantity of water to extinguish a fire was essential and the problem was underlined when the Commissioners visited Ipswich Asylum on the day when each week the water company did not supply water. Under such circumstances a large reserve supply was essential. Tanks at a high level, thereby providing a head of water without recourse to a steam engine that would take time to get going, were favoured. There was a water tower on each side of the establishment at Herrison, Dorset, in 1863.’

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Old postcard with aerial photograph of Herrison Hospital, posted on flickr by Alwyn Ladell and licensed under CC BY-NC-ND 2.0 Originally the Dorset County Asylum, near Charminster, it has now been converted into housing, with much additional new building on the site, and re-named Charlton Down.

‘A new concern with the structural side of fire prevention is shown in 1874 by the visit to the Leicester and Rutland Asylum of Captain Shaw of the Metropolitan Fire Brigade. He suggested a system of intersecting walls with iron doors to prevent the spread of fire. From the way in which the Commissioners in Lunacy reported this visit, one senses that they wished that more asylums would follow the same course and obtain professional advice. The extent to which this was done is not clear.’

 

There is a fascinating set of photographs of the asylum from the University of Leicester Archives and  the Record Office for Leicestershire, Leicester & Rutland which can been seen on the website expresseumpoetics.org.uk 

‘In the 1880s the major concern of the Commissioners in Lunacy was with the escape of patients from an asylum should it catch fire. Every ward had to have a second means of getting out, an alternative exit. As many rooms seem to have had only one entrance, this sometimes tested the ingenuity of those responsible. By 1885 the provision of external fire escape staircases was in full swing. The stairs had to be suitable for both infirm and deranged patients to use, and it is interesting to see how many still meet these requirements. It was necessary to have sufficient space a the top of the stair for patients to be prepared for the descent, and the stairs themselves had to be wide and easy. The time scale of this development is shown by the second Birmingham asylum at Rubery, opened in 1882 without fire escape staircases, which were provided in 1886.’

‘References to fire escapes should, however, be interpreted carefully, for not all were fixed to the building. In 1888 Cornwall Asylum bought a fire escape and built a house to put it in; the two similar contraptions at the Norfolk asylum in 1896 were of wood. At Norfolk the Commissioners were more concerned with their inadequate number than with their material. The introduction of fire escapes at asylums continued into the present century. It seems that in workhouse infirmaries the similar provision of fire escapes was about a decade later than in asylums, only getting under way in the 1890s’.

L0012311 Middlesex County Lunatic Asylum, Colney Hatch, Southgate, Mi

Perspective view and ground-floor plan of Middlesex County Asylum, Colney Hatch, later Friern Hospital. Now converted into housing. From the Wellcome Library, London

‘The fire at Colney Hatch on 27 January 1903, when 51 patients lost their lives in a fire in temporary buildings of 1895, brought a new realisation of the problems associated with fire. Rescue had been hampered by smoke, and a new urgency was now given to the containment of smoke in large asylums, particularly on staircases. In that same year, smoke doors were called for at the heads of certain staircases at Knowle in Hampshire, and at the Buckinghamshire asylum the doors with bars that opened onto the staircase had to be made solid. Smoke doors had already appeared in some institutions, as at Northampton in 1901, but are rarely mentioned.’

‘Immediately after the Colney Hatch fire, the Commissioners in Lunacy enquired after other temporary buildings, and tried hard to have them removed. They continued to accept timber framed buildings clad in corrugated iron, particularly it seems when the interiors were plastered rather than clad in boarding.’

A Letter from Cornwall

‘Five days of fieldwork were allotted by the Cambridge Office to investigate … the hospitals of Cornwall… The first that we visited, Truro workhouse, introduced us to the intractable nature of granite and the most informed attempt at Grecian style so far. The granite was so hard and difficult to work that the mason could do no more than produce a blocky outline of what was wanted but the result was still striking.’

‘Much of the county is swept by high, wet, winds, so that most of the early settlements hide in hollows or the lee of hills for shelter. The windward side of a building is often slate-hung to give extra protection. Although rendering houses is not as common as in some other exposed communities, the fashion for rendered walls in the 1920s was welcomed here. The textures are not always interesting, and when the paint is not renewed the effect is usually sombre.’

‘Despite the winds, workhouse were built on hills just as everywhere else in England, although the thick jungle around some of them shows that they are on the sheltered side. Palm trees were an unexpected impediment to photography at Truro and elsewhere. The usual Cornish workhouse consists of three parallel ranges. First comes an entrance range, often single storey; then comes the House, sometimes with short cross-wings but always a linear building with a single-storey kitchen behind. Finally comes either a row of workshops with the infirmary in the middle, or just the infirmary in large workhouses. There is almost no variation on this pattern. Bodmin had a rectangular infirmary, but several including Truro and Redruth had a small U-shaped block usually with a lean-to on the workhouse side There were always two doorways, but the internal arrangements could not be discovered.’

For images of Liskeard Union Workhouse, built 1937-9 to designs by Scott & Moffatt, including a postcard from around 1915 see workhouses.org.uk 

‘Many workhouses also had a small isolation hospital placed close to the main building. Few are dated, including Falmouth of 1871, and that at Bodmin could be 1842. They have a standard arrangement of two wards flanking a central duty room or set of central rooms, and all are uniformly plain. Some may by chance respect the 40-foot cordon sanitaire that was required by at least 1892, but they probably all date from before about 1880. It is interesting to compare them with Suffolk, where the only isolation hospitals associated with workhouses respected the quarter-mile cordon required for smallpox hospitals, and none was recognised closer to the workhouse except at Semer.’

‘Apart from these workhouse examples, surviving isolation hospitals were prominently absent from the cornish landscape, and one of the two that we did manage to find was occupied by such a desperate character that we did not approach too closely. …’

‘The Cornish cottage hospitals were frankly disappointing, for they had been savagely treated by enlargements. A curiously high proportion had a main range and cross-wings type of plan, or appearance, for the plans did not always accord with the outside. Our greatest joy was to discover that the Falmouth hospital, built in 1894 and replaced by a new building on a new site in 1930, survived intact and unaltered…’

 

Images of Falmouth Hospital, designed by H. C. Rogers and built with funds from J. Passmore Edwards can be seen on the web site passmoreedwards.org.uk  

‘Two hospitals, at Redruth and St Austell, and been established with the needs of accident-prone miners in mind, but the buildings told us nothing about these needs.’

‘Cornwall has a large number of ports, and had a corresponding number of Port Sanitary Authorities in the late 19th century. In general they provided makeshift hospitals of no size, and only a fragment of the Falmouth hospital, which also served the local urban population, was discovered. Fowey, constituted in 1886, had a corrugated iron building with a duty room and four beds by 1899; it got its water from a nearby spring, and although last used about 1920 it was still being maintained in 1943.  The Truro hospital was near the centre of the town and has not survived. Perhaps because the provision in the county was so small the Truro workhouse was converted into a 110-bed isolation hospital in 1940, mainly for the benefit of evacuees. We did not notice any evidence of pest-houses to either explain or supplement this poor provision of isolation hospitals.’

See also: old photograph of Truro workhouse on Truro Uncovered website 

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.
Screen Shot 2015-05-29 at 17.29.04 Deposited Plans

“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