Building Bedlam again – taking a leap forward to Monks Orchard

February 21, 2016February 3, 2022 / Harriet Richardson / 2 Comments

Bethlam_1896 — *Entrance gates to Bethlem Hospital, 1896 from* The Queen’s London : a Pictorial and Descriptive Record of the Streets, Buildings, Parks and Scenery of the Great Metropolis (*Public domain, from Wikimedia Commons)*

Bethlem Hospital remained in St George’s Fields, Southwark from 1815 to 1930. In that time numerous additions and alterations were made to the building, but the area around had also developed and changed almost beyond recognition. In the early nineteenth century it was airy and open, with few houses and market gardens in the immediate vicinity. It was on the other side of the river from the densely built-up urban centres of Westminster and the City, and on the outskirts of Southwark itself. But it did not remain a rural or even suburban idyll for long, as industrialisation and the population expansion of the capital brought waves of building activity.

*Greenwood’s map of c.1830 showing the area around Bethlem Hospital*

Greenwood’s map of London of 1830 captures the moment before this expansion, half a century later and Bethlem hospital had been engulfed. Population density increased as the century wore on, with the usual pattern of housing intended for single families increasingly occupied by two or three.

Screen Shot 2016-02-28 at 11.20.16 — *Booth’s Poverty Map. Printed Map Descriptive of London Poverty 1898-1899. Sheet 9. Inner Southern District. Reproduced courtesy of LSE Library*

Booth’s poverty map of London of the late 1890s showed that although those living in the immediate surroundings of the hospital were classed as fairly comfortable, on the other side of the Lambeth Road were pockets of the lowest class, the vicious and semi-criminal, amongst housing that was almost entirely occupied by the poor, or very poor.

*Broadmoor Asylum for Criminal Lunatics, from* The Illustrated London News, *1867*

Other changes had occurred during the century or so that Bethlem was at St George’s Fields. Legislation had been introduced to encourage the establishment of lunatic asylums for paupers early in the nineteenth century (the Lunacy Acts of 1808 and 1815), and this reduced the need for Bethlem to cater for the poorer class of patient. The County Asylums Act of 1845 made the establishment of pauper asylums compulsory, and this, coupled with a new regime headed by Dr W. Charles Hood, the first resident medical officer, saw a shift towards caring for a higher class of patient. This was consolidated after the opening in 1863 of Broadmoor for criminal lunatics, removing another class of patient formerly accommodated at Bethlem. Improvements to the accommodation were made, the comforts of home introduced and a convalescent home built at Witley (1866-9, designed by Sydney Smirke). [1]

V0013739 The Hospital of Bethlem [Bedlam], St. George's Fields, Lambe Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org The Hospital of Bethlem [Bedlam], St. George's Fields, Lambeth: the men's ward of the infirmary. Wood engraving by F. Vizetelly, 1860. 1860 By: Frederick VizetellyPublished: - Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/ — *The men’s ward of the infirmary at Bethlem Hospital, 1860 by Frederick Vizetelly, reproduced under Creative Commons Attribution only licence CC BY 4.0 from Wellcome Library, London*

So by the early twentieth century the type of patient at Bethlem had changed, and the locality had become more densely urban, but more importantly than either of these in prompting a move to a new site was the old-fashioned design of the building and the constant demands and cost of maintaining the ageing fabric of the asylum.

V0013741 The Hospital of Bethlem [Bedlam], St. George's Fields, Lambe Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org The Hospital of Bethlem [Bedlam], St. George's Fields, Lambeth: the female workroom. Wood engraving probably by F. Vizetelly after F. Palmer, 1860. 1860 By: F. Palmerafter: Frederick VizetellyPublished: - Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/ — *Female workroom, Bethlem Hospital. Wood engraving probably by F. Vizetelly after F. Palmer, 1860. Wellcome Library, London. Reproduced under Creative Commons Attribution only licence CC BY 4.0*

Asylum design had moved on since 1815, and a century later the ideal form for a mental hospital was considered to be the colony plan or villa system, comprising detached buildings set in landscaped grounds. Colony plan asylums were developed in Germany from the late 1870s but had their origins in the Gheel Colony in Belgium. Gheel had traditionally originated in medieval times as a place of pilgrimage to the shrine of St Dymphne which had gained a reputation for curing the insane. Pilgrims were boarded in the village and gradually it developed into a mental colony. In the nineteenth century the Belgian government placed its administration under the control of a Commissioner and Board of Governors. [2]

Screen Shot 2016-02-20 at 15.41.44 — *Plan of Altscherbitz Asylum, Germany, from Sibbald’s* Plans of Modern Asylums for the Insane Poor, *1897*

One of the most influential of the later colonies, was the Alt Scherbitz (now Altscherbitz) village asylum near Leipzig, established in 1876 for 960 patients. Its layout was published by John Sibbald, a Commissioner in Lunacy for Scotland, in 1897 in his Plans of Modern Asylums for the Insane Poor. At Altscherbitz, the site was naturally divided in two by the high road between Halle and Leipzig and this separation was used to divide the medical and non-medical sections. Gender informed the first level of classification, with the women’s houses to the west together with the kitchen and laundry, and the men to the east where a brick works provided manual labour.

Plan_of_Brislington_House-2 — The ground plan of Brislington House, near Bristol, a private asylum established by Dr Fox. The patients occupied detached houses arranged as a terrace. The plan dates from 1806. Reproduced from Wikimedia Commons.

This colony plan was welcomed as it seemed to offer a solution to new ideas about how the patients’ environment promoted recovery or cure. It aimed to provide recognizably domestic surroundings, emulating the home environment rather than reminding the patient that they were in an institution. There were earlier precedents for this, but in small private asylums such as Brislington House near Bristol, built in 1806.

1020962977_16c59e72d4_o — View over to Craighouse, the colony built in 1889-94 as part of the Royal Edinburgh Asylum. Craighouse in the middle distance, ‘Morningside and Craighouse’ by Pascal Blachier, taken in 2007, imaged licensed under CC BY 2.0

The first time the colony plan was attempted on a large scale and at a public institution was at Craighouse, built as an annexe to the Royal Edinburgh Asylum in 1889-94, although this was for paying patients. It was designed by Sydney Mitchell in close collaboration with Thomas Clouston, the asylum’s Medical Superintendent, to give architectural form to his ideas on the cure of mental illness. The buildings revived something of the palatial aspect that had largely disappeared from asylum architecture since Hooke’s Bethlem. Clouston wanted variety, in the colours of the building materials, in the architectural details, of size and of scale. Believing that patients associated phases of their illnesses with their surroundings, he particularly wanted to be able to move convalescent patients to a new environment.

canmore_image_SC00583578 — Rutherford House, designed by Sydney Mitchell in 1899 and completed in 1904 as a detached infirmary or admissions hospital for paupers. The year after it opened, Sydney Mitchell went to Germany to see asylums there. Photographed in 1993, © RCAHMS

Poorer patients got their taste of the colony system a little bit later at the Crichton Royal in Dumfries, where detached houses were added in the grounds during the early 1900s. Sydney Mitchell, was the architect, and he, along with a deputation from the asylum’s Board of Management, had set out in 1897 to visit Altscherbitz and similar asylums at Biesdorp and Lichtenberg near Berlin. Such missions became increasingly common. In 1899 a deputation of the Aberdeen District Lunacy Board made a tour of continental asylums before commissioning a design for their new district asylum on the Altscherbitz model.

hospitals051 — *The former Bangour Asylum, photographed in the late 1980s. The church was added later, though always intended as the focal point of the colony.*

Further colony plan asylums were built in Scotland at Bangour, which opened in 1906 serving Edinburgh, where a competition was held for the design which specified Altscerhbitz as the model, and Dykebar at Paisley which opened in 1909. Bangour is particularly significant for Bethlem: its architect, Hippolyte J. Blanc, had as one of his assistants working on the asylum plans, John Manuel, who later worked with Charles E. Elcock, architect of the new Bethlem Hospital. [3]

Rydinghurst House of 1908 at the former Epileptic Colony in Chalfont St Peter, Buckinghamshire, now the Epilepsy Society, photographed in 2011 © Copyright Nigel Cox and licensed for reuse under this Creative Commons Licence

In England colonies were built around the same time, but not as yet for general mental hospitals. Instead they were deemed appropriate in the first instance for epileptic colonies. In 1884 the National Society for the Employment of Epileptics established a home at Chalfont St Peter in Buckinghamshire. It began with just one villa, a temporary iron structure, to which further villas were gradually added.

a hospital474 — *Leybourne Grange Colony, Kent County Council, W. H. Robinson architect, built about 1935 for the so-called mentally deficient.*

But the colony plan was most widely adopted for a new breed of asylum ushered in by the Mental Deficiency Act of 1913. A Royal Commission had been appointed in 1904 to look into the care of the feeble-minded. This at least spoke out against the sterilization of those deemed mentally deficient that was being advocated by the Eugenics Education Society, and it was this Commission which resulted, eventually, in the 1913 Act. Amongst other things, the Act sought to define mental deficiency which was considered to be present from birth and incurable, as opposed to mental illness which was usually contracted later in life and deemed curable. The Act legislated for the provision of accommodation, care and protection of the former group whose removal from undesirable surroundings was thought necessary ‘in their own interests and that of society’. The Board of Control, which replaced the Commissioners in Lunacy in 1914, recommended the colony system for these new institutions, as it allowed ‘better classification and training’ and ensured that the inmates were happier and more contented than in institutions of the barracks type.

Bethlem aerial perspective — *Aerial perspective of Bethlem Royal Hospital showing proposed layout of the buildings, from commemorative booklet produced for the laying of the foundation stone*.

It was a combination of these influences which lead to the adoption of a colony plan for the new Bethlem hospital at Monks Orchard. It was the first new mental hospital designed in England since the war. Elcock & Sutcliffe were appointed in February 1926 to work alongside the hospital surveyor, John Cheston. Charles Ernest Elcock was the key figure behind the design, which he hoped would ‘make a leap forward’. However, his plans still had to meet the approval of the Board of Control. While the Board was in favour of colonies, it disapproved of Modernism, thought flat roofs should be shunned, and was most comfortable with the blandest of Neo-Georgian styles.

*Administration Block, Bethlem Royal Hospital, photographed in 2008*

Unsurprisingly relations were often frosty between Elcock and the Board’s architect John Kirkland, and indeed Sir Frederick Willis, Chairman of the Board from 1921 to 1928. Willis criticized the ‘generous scale’ of the rooms, which he suggested were due to Elcock trying to balance the buildings, while Kirkland queried the necessity for Turkish Baths, and took a great deal of convincing over the flat roofs, which were only used on the peripheral buildings on the site. After much wrangling, the amended designs were approved and detailed drawings submitted in December 1928. [4]

Elcock Bethlem chapel from SW — *Bethlem Hospital chapel, photographed in about 2008 (© H. Richardson)*

It may have been the pressure of work involved in the Bethlem job that prompted Elcock to seek an assistant in 1928. He appointed Ralph Maynard Smith, a young man in his mid-twenties, who was as much an artist and a poet as an architect. Maynard Smith had studied at the Architectural Association, and spent a brief time working with the architect Michael Waterhouse immediately before joining Elcock & Sutcliffe. There undoubtedly were other assistants in Elcock’s office, making it difficult to know who did what in the design and planning process. A building at Bethlem where Smith’s influence may be felt is the chapel. It is a beguiling building, quite unlike the many hum-drum Gothic asylum chapels of earlier years. Its design was obviously considered a success as it was elaborated upon a few years later at Runwell Hospital in Essex, also by Elcock & Sutcliffe.

Bethlem chapel interior — Interior of Bethlem Hospital chapel, photographed around 2008 (© H. Richardson). It is all but identical to the interior of the chapel built for Runwell Hospital in Essex (below), although the exteriors were different, Runwell also had a tower – planned for the chapel at Bethlem but later omitted.

*Interior of Runwell hospital chapel, probably photographed soon after the building was completed, from a collection of negatives at the hospital leant to the author.*

Stylistically Bethlem presents something of a mix, from the conservative administration block, with its hipped roof and Neo-Georgian simplicity to the starkly modern boiler house and flat-roofed patients’ accommodation blocks and treatment unit. Elcock laid an emphasis on the setting to give attractiveness to the buildings with ‘pleasing roads, avenues, flower borders, etc’. [5]

Bethlem quiet unit perspective — Architectural perspective sketch of the quiet patients’ unit, unlike the Neo-Georgian administraton block, most of the patients’ villas had flat roofs, and if not strictly modernist, in this sketch, taken from a brochure produced by the hospital, there seems to be an echo of contemporary Dutch or German architecture

Elcock set new standards in the scale and type of accommodation he provided which included laboratories, hydrotherapy facilities, a lecture room for students, and a separate treatment and research block. The sexes were no longer strictly segregated either: male and female patients shared buildings, from the more severe ‘excited’ patients to convalescents. Elcock researched his subject thoroughly, touring the country to visit the best new buildings added to older hospitals, and consulting medical staff.

Bethlem treatment block perspective — *Architectural perspective of the Treatment and Research Unit, Bethlem Royal Hospital brochure.*

In the end the design was compromised both by the restrictions imposed by the Board of Control and the necessary cost-cutting in the face inflation in the years after the General Strike. But if it wasn’t quite the magnificent hospital originally proposed, it was certainly well-equipped and incorporated many innovative features. There were four main villas for patients, two for quiet cases, one for ‘excited’ patients, the fourth for convalescents. Nearly all the patients were accommodated in single rooms, in line with private general hospitals and in contrast to tendency towards dormitories in municipal mental hospitals. In addition to the patients villas there were the usual service buildings – kitchens, boiler house, stores etc, and the innovative Treatment and Research unit, which provided hydrotherapy, psychotherapy, dental and electrical treatment, pharmacy, and operating theatre. [6]

Today the core buildings are little altered, but many of the outlying buildings have had many alterations and newer buildings have been added to the site to meet the changing needs of mental health care. In recognition of the hospital’s historic importance there is a museum on the site, the Museum of the Mind, which opened in 2015.

References

Survey of London, vol.25 St George the Martyr, Southwark and St Mary Newton, Ida Darlington ed. 1955, p.78 (online version at British History Online): Jonathan Andrews, Asa Briggs, Roy Porter, Penny Tucker and Keir Waddington, The History of Bethlem, Routledge, London and New York, 1997, pp.503ff
H. Richardson ‘A Continental Solution to the Planning of Lunatic Asylums 1900-1940’ in J. Frew and D. Jones (eds) Scotland and Europe, Architecture and Design 1850-1940, 1991
H. Richardson ‘Charles Ernest Elcock’ in Essays in Scots and English Architectural History, 2009, p.122
Bethlem Royal Hospital Archives, Special Commitee Minutes, 1928 pp. 194, 196-7, 291
Bethlem Royal Hospital Archives, Special Commitee Minutes, 1926-7, p.34
Jonathan Andrews et al, History of Bethlem, p.566

Building Bedlam – Bethlem Royal Hospital’s early incarnations

February 13, 2016February 3, 2022 / Harriet Richardson / 4 Comments

From City fringe to St George’s Fields

*The dome of the Imperial War Museum, formerly Bethlem Hospital, photographed in January 2014*

Visitors to the Imperial War Museum south London may easily be unaware that they are walking through the remains of a former mental hospital, in fact the former mental hospital that gave us the word Bedlam. Only the central block remains of this, the third home of that exceptional, long-lived institution that is now Royal Bethlem Hospital in the London borough of Bromley. [1]

The origins of Bethlem hospital were monastic, evolving from the priory of St Mary of Bethlehem. The copperplate map of London of the 1550s shows its original site at Bishopsgate near the large open ground of Moorfields.

Copperplate_map_Moorfields — *The Moorfields section of the Copperplate map of London, 1559, Museum of London. Public Domain*

By the early 1400s it was already specializing in the care of the insane. In time it came to be owned and governed by the City, which also acquired Christ’s Hospital ‘erected for the vertuous bringing up of the myserable youth’, St Thomas’s hospital ‘for the relevynge of the neadye and deseased’, and Bridewell for ‘thenfocinge of the lewde and naughtie sorte to labor and worke’. Bridewell and Bethlem were managed by a joint court of governors. [2]

Plan_of_the_first_Bethlem_Hospital — *Plan of Bethlem hospital reproduced in Daniel Hack Tuke,* Chapters in the History of the Insane in the British Isles *(London, 1882)* – Project Gutenberg Ebook Edition

By the 1670s Bethlem had very much outgrown its site, the governors declaring their hospital to be ‘very old weake and ruinous’ and too small for the ‘great number of lunatics as are therein at present’. [3] The new building erected in 1674-6 just round the corner from the original hospital could not have contrasted more strongly with the old. It was designed by Robert Hooke with sufficient accommodation for 120 patients.

*The Hospital of Bethlem (Bedlam) at Moorfields, London: seen from the north, with people walking in the foreground. Engraving by H. Fletcher, c. 1750 Wellcome Library, London*

The engraving above shows the north elevation, viewed across the green expanse of Moorfields, and peeking above the roof ridge a regiment of City church towers and spires (and what appears to be Wren’s monument to the Fire on the left). Here is a hospital in the guise of a palace – its grandeur and French Renaissance style prompted the suggestion that it had been modelled on the Tuileries, and the apocryphal story that Louise XIV was so offended by the similarity that he ordered ‘a plan of St James’s Palace to be taken for offices of a very inferior nature’. [4]

V0013176 The Hospital of Bethlem [Bedlam] at Moorfields, London: seen — The Hospital of Bethlem (Bedlam) at Moorfields, London, showing the additional wings at either end of the building. Coloured engraving by T. Bowles after J. Maurer. Wellcome Library, London. CC BY 4.0

A grand architectural statement was the wish of the governors. It was a quite deliberate piece of self-advertisement, intended to to attract visitors and funds. The policy of opening their doors to visitors to view the inmates was already well established at the old site. At the time the intention was to raise awareness of the plight of the insane, to awaken the pity of the spectator, and prompt charitable and generous donations towards their care and treatment.

Hooke’s selection as architect was a logical one. He had been City Surveyor since 1666 and was at that time supervising the rebuilding Bridewell, Bethlem’s sister institution, after the fire. There were no other hospitals for the insane in Britain at the time, or indeed many hospitals of any kind. The very term ‘hospital’ had not yet become so exclusively the property of a medical establishment and was still being used with its broader meaning of a place of hospitality – and ‘infirmary’ might more usually be expected to be applied to a place for the sick. The plan for Bethlem called for a building that could house a large number of individuals, who might at times be disturbed or violent. This introduced the need for containment or confinement. To modern eyes the plan seems most closely allied to that of prisons, and in particular the model prisons of the nineteenth century.

L0015088 Statues of "raving" and "melancholy" madness, each reclining Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Statues of "raving" and "melancholy" madness, each reclining on one half of a broken segmental pediment, formerly crowning the gates at Bethlem [Bedlam] Hospital. Engraving by C. Warren, 1808, after C. Cibber, 1680. Engraving 1808 By: Caius Gabriel Cibberafter: Charles Turner WarrenPublished: 10 December 1808 Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/ — These statues, thought to depict raving and melancholy madness crowned the entrance gates, they have been preserved and can be seen at the Museum of the Mind at the present Bethlem Royal Hospital. Engraving by C. Warren, 1808, after C. Cibber, 1680. Wellcome Library, London. Reproduced under Creative Commons Attribution only licence CC BY 4.0

Although Hooke presented two ground plots and a model of his intended asylum to the governors before building work began, no plan has ever come to light. However, there are sufficient descriptions of the interior for key elements to be deduced. The central pavilion, with the main entrance, contained a hall, ornamented by tablets bearing the names of the hospital’s benefactors linked together by carved cherubs’ heads. Off the hall were the steward’s office and a room for the chief physician and apothecary where new admissions were examined and from which patients were discharged. To the rear of the hall the principal staircase rose to the committee room, probably the grandest internal space decorated with an ornamental plaster ceiling. This central block also gave access to the patients’ accommodation which was contained within the wings on either side. These were of two storeys over a raised basement, with the inmates on the raised ground and first floors where the plan comprised a row of single cells, lit by small high windows on the south side of the building, off a long gallery, lit by larger windows. In the basement were the kitchen, laundry and stores.

The plan by Hooke is remarkable. It seems to be the first time that such an arrangement was devised, there being no obvious precedent in this country. This was also the first charitable building to be erected in London since the Reformation. In fact the first entirely new charitable foundation since the Savoy Hospital of 1505-17. It was one of the first public buildings completed after the Great Fire, pipped at the post by the rebuilt Royal Exchange designed by Edward Jarman and Wren’s Custom House, both of which were completed in 1671. [5]

*Anonymous etching of the Royal Exchange from the British Museum*

Although there may not have been any lunatic asylums in Britain to provide a model, there were other buildings where large numbers were housed under one roof. Schools, almshouses, prisons, and even royal palaces. Including palaces in this selection is not a mere frivolous reference to the Tuileries. The galleries at Bethlem may well have their origins in the long gallery and cloister walks of the great Tudor houses and palaces, where they were intended to serve the same function of a place for exercise, particularly in bad weather. Bridewell was built as a palace, to which a long gallery was added in the early sixteenth century. It was only turned into a workhouse some decades later.

512px-Haddon_Hall_Long_Gallery_(7167229240) — The long gallery at Haddon Hall, Derbyshire, photographed in 2011 by Michael Beckwith. Galleries in Tudor houses provided exercise in wet weather, and are a possible model for the galleries in asylums. Image licensed under Creative Commons CC-BY 2.0

The galleries at Bethlem also served as corridors of communication, and were open to visitors. Hogarth’s final scene of the Rake’s Progress is set in Bethlem and shows one of the new men’s wards added at the east end of the asylum in 1725. This gives a glimpse of the cell/gallery arrangement, here the gallery is occupied by several patients, apart form Hogarth’s hero Tom Rakewell, and just two female visitors clinging to each other and keeping close to the wall in the background. It should be noted, however, that this wing, which was intended for incurable patients, had cells on both sides of the gallery. One of the key features of Hooke’s layout was therefore lost, that of creating a ‘permeable’ structure, with the cell doors opposite the gallery windows allowing light and air to pierce the building.

Screen Shot 2016-02-12 at 14.36.19 — *William Hogarth’s* Rake’s Progress, Wellcome Library, London An insane man (Tom Rakewell) sits on the floor manically grasping at his head, his lover (Sarah Young) cries at the spectacle whilst two attendants attach chains to his legs; they are surrounded by other lunatics at Bethlem hospital, London. Engraving by W. Hogarth, 1763, after earlier engraving by himself, 1735. Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0

It may seem strange that the galleries were placed on the north rather than the sunnier and warmer south side of the building. This was no error, cool temperatures and even light were considered beneficial to a disturbed mind, having a ‘sedative power’. Some went so far as to argue that the insane were in fact insensible to cold, though at Bethlem, at least, there is evidence that measures were introduced to keep the patients warm.

L0011828 The Hospital of Bethlem [Bedlam] at Moorfields, London: seen — *The second of J. T. Smith’s 1814 views of Bethlem showing its humble back elevation. Wellcome Library, London. Reproduced under Creative Commons Attribution only licence CC BY 4.0*

Two views published in 1814 show the north side of the hospital. They demonstrate how severe this elevation was in comparison to the front, with these small, high windows that lit the cells, as well as its proximity to the boundary and the road.

L0015087 The Hospital of Bethlem [Bedlam] at Moorfields, London: seen Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org The Hospital of Bethlem [Bedlam] at Moorfields, London: seen from the south, with part of London Wall in the foreground, and a muck-raker scraping at the cobblestones. Etching by J. T. Smith, 1814, after himself, June 1812. 1812-1814 By: John Thomas Smithafter: Robert HookePublished: 15 September 1814 Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/

Christine Stevenson has pointed out the similarities between Hooke’s design for Bethlem with that of his nearby Aske’s Hospital an almshouse for the haberdashers’ Company designed in 1692. [6]

*Aske’s Hospital, Shoreditch, London: a bird’s-eye view of the facade. Engraving, 1720. Wellcome Library, London. Reproduced under Creative Commons Attribution only licence CC BY 4.0*

Like Bethlem the building is single pile, which, as Roger North noted later, was particularly suitable for a college or hospital, to be divided into cells, and chambers independent of each other. In asylum architecture this pattern of patient accommodation in single cells off a gallery remained set for almost two centuries, although it was some time before anything on a comparable scale was built in Britain. In fact, not until St Luke’s Hospital was built in 1750. And so, when Bethlem took the decision to move to a new location, the plan of the new hospital pretty much followed that of the old.

AN00754479_001_l — *The Moorfields building around 1811, depicted in a state of decay. Etching after a drawing by G. Arnald for the* Beauties of England and Wales. *From the British Museum*

A competition had been held to design the new building in 1810, judged by James Lewis, the hospital’s surveyor, George Dance the younger and S P Cockerell. Although Lewis’s pupil, William Lochner was awarded the first prize of £300, it was Lewis who was given the task of drawing up the final plans and elevations based on the three winning entries. (the second pirze was awarded to J. A. and G. S. Repton and the third to John Dotchen)

V0013727 The Hospital of Bethlem [Bedlam], St. George's Fields, Lambe — *The new Bethlem Hospital in Southwark, engraving from Ackerman’s Repository 1817. Wellcome Library, London. Reproduced under Creative Commons Attribution only licence CC BY 4.0*

The opening of the new asylum coincided with the publication of a Select Committee Report on Madhouses in England in which it was immediately censured. There was a long list of complaints from its excessive expense to the gloominess of some of the rooms, particularly those at the front overshadowed by the ‘immense portico’.

V0013728 The Hospital of Bethlem [Bedlam], St. George's Fields, Lambe Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org The Hospital of Bethlem [Bedlam], St. George's Fields, Lambeth: elevation and plan, with a scale and a key. Engraving by J. Le Keux, 1823, after P. Hardwick. 1823 By: Philip Hardwickafter: John Le Keux and James LewisPublished: 1 December 1823 Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/ — *Bethlem Hospital elevation and plan, 1823. Wellcome Library, London. Reproduced under Creative Commons Attribution only licence CC BY 4.0*

The classification of the patients was deemed inadequate due to an absence of separate staircases to each of the galleries. There were complaints about the lack of glass in the patients’ sleeping rooms (a complaint no doubt shared by the patients, whose misery was increased by the fact that the system of warming the asylum by steam was installed only in the basement). This absence of glazing was no oversight, but a deliberate omission to ensure the ventilation of the cells and, as the governors claimed, obviate ‘the disagreeable effluvias peculiar to all madhouses’. A year later, however, the windows were glazed. The Report also disapproved of the way in which the front windows were closed up, preventing the patients from looking out of them. [7]

Screen Shot 2016-02-13 at 09.30.15 — *Extract from the 25-inch OS map surveyed in 1872. Reproduced by permission of the National Library of Scotland*

The new Bethlem was neither so very different nor so very much worse than most other asylums built both before and after. It had a central administration block from which sprouted the patients’ wings, most of which followed the ‘cells on one side gallery on the other’ arrangement. Also repeating the earlier arrangement of having the galleries on the north side of the building. At either end of the building, again repeating the arrangement of the old building after the early eighteenth-century additions, there were cells on both sides of a central corridor. A chapel was provided under the shallow dome; sniffily referred to as a ‘species of pumpkin-shaped cupola’ by the Government in 1812 when it was proposed to put a semaphore on top, as an early warning system in the event of an attack from France. The dome was rebuilt in 1844-6 as part of general additions and alterations carried out to designs by Sydney Smirke.

V0013730 The Hospital of Bethlem [Bedlam], St. George's Fields, Lambe — *Bethlem Hospital with Smirke’s new dome. Wellcome Library, London. Reproduced under Creative Commons Attribution only licence CC BY 4.0*

When Bethlem moved for the fourth time to Monks Orchard the freehold of the old site was bought by Viscount Rothermere in 1930 and vested in the LCC for the formation of a public open space named in memory of his mother, Gerladine Mary Harmsworth. Much of the hospital was demolished but the remainder was leased to the Commissioners of Works to house the Imperial War Museum. It opened to the public in 1936, was closed during the Second World War during which time it received bomb damage in 1940, 1941 and 1944. An account of its history was published in volume 25 of the Survey of London, published in 1955 less than ten years after the museum had reopened. The volume was edited by Ida Darlington, and it is perhaps her words which end the account thus: ‘It is perhaps appropriate that a building occupied for so many years by men and women of unsound mind should now be used to house exhibits of that major insanity of our own time, war.’ [8]

*Imperial War Museum, photographed January 2014*

References

The main source used here is the definitive history by Jonathan Andrews, Asa Briggs, Roy Porter, Penny Tucker and Keir Waddington, The History of Bethlem, Routledge, London and New York, 1997
The History of Bethlem, p.76, quote from Christ’s Hospital minute books
ibid, p.248 quote from Bethlem Court of Governors Minutes
Thomas Bowen, An Historical Account of the Rise, Progress and Present State of Bethlem Hospital, London, 1783 p. 5n, see also Christine Stevenson’s article (below) p.256
Christine Stevenson ‘Robert Hooke’s Bethlem’ in Journal of the Society of Architectural Historians, vol.55, no.3 (1996), p.257
Christine Stevenson ‘Robert Hooke’s Bethlem’ in Journal of the Society of Architectural Historians, vol.55 no.3 (1996), pp.254-275
Survey of London, vol.25 St George the Martyr, Southwark and St Mary Newton, Ida Darlington ed. 1955, pp 78 (online version at British History Online)
ibid, p.80

King Edward VII Estate: Midhurst Sanatorium

January 24, 2016January 22, 2022 / Harriet Richardson / 80 Comments

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.

hospitals083 — *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.

Screen Shot 2016-01-24 at 14.20.21 — *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.

hospitals088 — *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.

Screen Shot 2016-01-24 at 14.52.33 — *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.*

Screen Shot 2016-01-24 at 14.53.50 — *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.

hospitals086 — *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.

Midhurst Screenshot — *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.

hospitals085 — *Detail of the central gabled bay, June 1992*

hospitals089 — *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.

Midhurst aerial scr — *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

A mysterious coded message from Midhurst Sanatorium

January 10, 2016January 22, 2022 / Harriet Richardson / 4 Comments

Recently I bought this post-card of the chapel at the King Edward VII Sanatorium, Midhurst, and was both surprised and puzzled to find what I assume to be a coded message on the back. The postmark is Aldershot, 7 August 1912, another puzzle as it suggests that the postcard was not sent from the hospital. If anyone has any idea how to translate the code I would be very grateful for any clues or explanations.

The puzzling message on a 1912 postcard to Miss Goddard of Ufton Green from ‘J’. A search in the census found a Georgina Goddard, born about 1887, who grew up on her Grandfather’s farm at Ufton in Berkshire and was living at the farm with her parents in 1911.

I had no idea about the message when I bought the card, it was the photograph of the chapel that I was interested in. The former Midhurst Sanatorium is one of the finest examples of this type of hospital. It was designed by H. Percy Adams and Charles Holden and was opened by Edward VII in 1906. The King had founded, and funded, the sanatorium which was for paying patients suffering from tuberculosis not wealthy enough to seek treatment abroad. Edward VII had been impressed with sanatoria on the Continent and their open air regimes.

hospitals092 — Not the best snap, but it gives an idea of the unusual V-shaped plan which created two naves stretching out from a central chancel under the squat tower. At the centre is an open-air pulpit – seen more clearly in the photograph below.

In 1901 the King formed an advisory committee comprising eminent physicians and authorities on the treatment of tuberculosis. It was decided to hold a competition, not for the design of a sanatoria, but for an essay on the subject, and was aimed at members of the medical profession as much as, or even rather than architects. The competition was won by Dr Arthur Latham and the architect William West of London, Robert Weir Schultz gained an honourable mention, but the commission went to H. Percy Adams. Adams was able to consult the winning entry before drawing up his plans and also visited several sanatoria in Germany and Switzerland.

hospitals081 — Open-air pulpit at the Midhurst Sanatorium chapel, from which the chaplain could address a garden congregation. The arcade in front of the arched windows lighting the nave provided shade or shelter, as the windows originally were unglazed.

hospitals091 — *Looking across from one arcade to the other. The main sanatorium building can just be glimpsed to the right of the photograph.*

hospitals082 — *Looking down one of the arcades*

hospitals093 — *The entrance to the west nave, off-set from the nave behind. It has a commanding and solid presence, faced in stone with a chequerboard band below the parapet.*

The idea of designing an open-air chapel did not come from Adams and Holden, it had been suggested by the Advisory Committee, but without any clear indication of what form it should take. The twin naves Adams and Holden designed allowed for the division of men from women, and the V-shaped or half-butterfly plan is common to sanatoria and some country houses as it produced a sun-trap.

hospitals079 — The tall arched openings leading out to the arcade were originally unglazed and open to the elements, so that even while attending a chapel service patients could continue their open-air regime. The glazing was added in 1957 designed by Brian Poulter, the hospital’s consulting architect.

In an open-air chapel, heating was important and here a system of under-floor heating was provided. It comprised steam pipes which warmed the stone floor, and was similar to that used at Eppendorf Hospital, Hamburg.

hospitals087 — *The chancel is octagonal and domed, the pulpit, lectern and altar have carved teak and inlaid ebony detailing.*

hospitals078 — *Another view of the chancel. The walls of Bath stone are finely jointed ashlar and the floor is of York stone.*

Sir John Brickwood, brewer of Portsmouth, provided the £25,000 to build the chapel, which opened at the same time as the hospital in 1906. His wife, Lady Jessie Brickwood, embroidered an intricate altar cloth that had a central figure of Christ flanked by the emblems of the four evangelists set against scrolling foliage. (There is a picture of the altar with its altar cloth on Brickwoods.co.uk, with much more information on the family)

hospitals090 — The rear of the chapel. Although the later extension to the right detracts a little from the impact of this elevation, the tower is still impressive with its graded stripes and patterns in the brickwork and the boldness of its *composition, suggestive of the talents of Charles Holden.*

Sources

RCHME Report on King Edward VII Hospital, NBR No. 101270, written by H. Richardson and C. Thom November 1992, for which the following sources were used: Academy Architecture, 1903, ii, 116-9: Allibone, F, typescript notes to collection of drawings by Adams, Holden & Pearson in RIBA Drawings Collection: The Builder, 23 May 1903, 531-2; 22 April 1905, 440; 23 June 1906, 707: Building News, 27 May 1904, 761: Kelly’s Directory of Sussex 1934, 1934, 243: Large, S E, 1986. King Edward VII Hospital Midhurst 1901-1986: Nairn, I & Pevsner, N, 1965. The Buildings of England: Sussex: Recent English Ecclesiastical Architecture, 2nd ed, 212-6

Twelfth Night at Hanwell Asylum

January 6, 2016January 5, 2023 / Harriet Richardson / 1 Comment

L0000640 The twelth night entertainment — *The Twelfth Night entertainment at the Hanwell Lunatic Asylum. Wellcome Library, London. Wellcome Images from the* Illustrated London News, *15 Jan 1848 reproduced under Creative Commons Attribution only licence CC BY 4.0*

Twelfth Night for many people is now just the date in the calendar when we take the Christmas decorations down. In our house this usually includes a certain amount of confusion as to whether twelfth night is on the 5th or the 6th of January. As I write this, it is January 5th 2023, the boxes are out ready for me to pack away the tree (a plastic one that we have re-used for at least the past 15 years) and the decorations.

Marking the end of the twelve days of Christmas and the coming of Epiphany, Twelfth Night was part of the festivities and often celebrated with a feast. The illustration above shows a dance and a feast that took place in celebration of Twelfth Night on January 6th 1848 at Hanwell Asylum (the county pauper lunatic asylum for Middlesex, at Hanwell, to the west of London). The entertainment was just for the male patients, the women had been given a similar festivity on New Year’s Eve.

*OS 6-inch map, surveyed in 1864, showing the ‘County Lunatic Asylum’ for Middlesex, now largely converted to private housing. CC-BY (NLS)*

The Twelfth Night party was held in the gallery of ward 9, and about 250 patients, staff and guests were assembled. The Gallery was decorated with evergreens, devices and mottoes, with coloured lamps hanging from the ceiling, while the gas-burners that usually lit the gallery were altered to ‘appear like ornamental fan-lights’. The entertainment began with coffee and cake at about 4.30pm, after which there was music making by some and games played by others – cards, draughts, dominoes and bagatelle. Supper was served at 8pm and comprised roast beef and vegetables, ‘with an allowance of beer and tobacco’. [1]

In the foreground of the illustration were the dancers, and the right hand figure was a portrait of William Rayner, a former actor best known for his role as Harlequin which he played at Covent Garden opposite his wife’s Columbine. After his wife died he ‘took to fretting’ and was committed to the asylum. By 1848 he had been a patient at Hanwell for about seventeen years. He was always ready to cut a caper for the amusement of his fellow patients: a ‘fine old jovial-looking man, dressed in a mixed costume, crowned with a motley cap, bedizened with various coloured ribands’. [2]

Photograph of part of the site in 2008 on **Geograph** *taken by J. Taylor*

The photograph above shows part of the site, now known as ‘Osterley Views’. I wonder how many of the folks who live there now are also taking down Christmas decorations just now, or might know about the celebrations that took place there 175 years ago.

William Rayner is easily confused with his better-known contemporary Lionel Benjamin Rayner, who played at Covent Garden at the same time.

[1] Illustrated London News, 15 Jan 1848, p.27
[2] London Evening Standard, 18 May 1843, p.2

Dry January? Head for a Hydro! A brief look at Victorian hydropathic establishments in Scotland

January 1, 2016January 2, 2023 / Harriet Richardson / Leave a comment

After the feasting and convivial drinking over Christmas and the New Year, a dry January has become increasingly common. The adverse effects of alcohol on our health are widely known and understood today, as are the benefits of keeping well hydrated, preferably by drinking plenty of water. These twin truths go a long way to explain why hydropathic establishments and spas have survived long after other institutions offering specialist treatments have either disappeared or remain rare. Sea-bathing, anti-vivisection, galvanic, and mesmeric hospitals all had their promoters and supporters from the eighteenth into the twentieth centuries, though widely condemned by the medical profession. But a water cure, particularly if it was balanced with exercise in country air and abstinence from alcohol, did few any harm and benefitted many.

Shandon Hydro library of congress — Shandon Hydro, Helensburgh, image from National Library of Congress. West Shandon House, built in 1851, was altered and greatly extended by Peddie & Kinnear in the 1870s to turn it into a fairy tale castle of a hydropathic establishment.

Spas and Hydropathic establishments are generally set in attractive locations, occupying imposing buildings, and have not been neglected by historians. Health tourism has been studied both from an architectural and historical perspective in recent years. [1] Hydros had their heyday in Scotland in the later nineteenth century, the Shandon Hydro at Helensburgh and the Dunblane Hydro were both built to designs by Peddie & Kinnear in the 1870s. By that time they had become popular as health resorts and were often closely linked to the temperance movement. They attracted the healthy as well as the invalid, and water treatments began to subside in importance. Unsurprisingly, in terms of architectural planning later hydros were little different from hotels, only the treatment rooms set them apart.

*Dunblane Hydro, designed by Peddie & Kinnear 1875. Image from National Library of Congress*

The water cure had been introduced into Britain from the Continent in the mid-nineteenth century, as a separate medical strand from taking the waters at a Spa. For the water cure primarily concerned water as an external treatment, with baths, douches and other inventive ways of applying water to the body. Hydropathy was big business in England and Wales before it gained much ground in Scotland. The first hydropathic establishments north of the border were small, located at Rothesay, Dunoon and Aberdeen. [2]

L0010944 Graefenberg: Hydropathic Establishment of Vincent Priessnitz Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Graefenberg: Hydropathic Establishment of Vincent Priessnitz, circa 1839 Life of Vincent Priessnitz Metcalfe, R. Published: 1898 Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/ — *Graefenberg, Hydropathic Establishment of Vincent Priessnitz, from the Wellcome Library reproduced under under Creative Commons Attribution only licence CC BY 4.0*

At Rothesay the hydro was set up in 1843 by Dr William Paterson who had visited Vincent Priessnitz, the founder of the water cure movement, at Graefenberg. Paterson’s hydropathic establishment occupied Glenburn House, overlooking Rothesay Bay on the Isle of Bute. The house was converted to provide accommodation for just ‘a few invalids’. [2] Unlike Priessnitz, Paterson combined the ‘judicious use of medicine’ alongside cold water in his treatments. The hydro was successful and underwent a number of additions before it was rebuilt in the 1890s following a fire. [3]

Glenburn hydropathic Rothesay — *Glenburn Hydro, Rothesay from* Wilson’s Guide to Rothesay and the Isle of Bute, *1848*

The short-lived hydro at Dunoon was established in 1846 by another Scottish doctor who had been directly inspired by Priesstnitz, Dr Rowland East. It too was in a converted house, which was situated near the recently built Kirn Pier, on the banks of the Clyde. Here water treatment was combined with a regime of sea-water bathing. The third hydro, opened at Aberdeen in 1850, was perhaps the most influential, but it was begun not by a doctor but a churchman, the Reverend Alexander Munro. Munro belonged to the Evangelical Union, and his interest in hydropathy was very much a product of his faith, providing scope for ministering to both the physical and spiritual needs of his flock. [4]

Extract from the 1st edition OS map, surveyed in 1867, showing the Aberdeen hydro at Loch-head, (just west of the Royal Lunatic Asylum). Reproduced by permission of the National Library of Scotland. Alexander Munro moved the hydro here in 1853 from Angusfield, where he had begun his hydropathic establishment in 1850. [5]

Munro’s Aberdeen hydro proved sufficiently successful to warrant additions to the house at Loch-head. He built a new wing ‘of three storeys, two of these having fine oriel windows’. The new wing contained a dining room, drawing room and recreation room in addition to further bedrooms. Later he added a Turkish bath, in moorish style. In 1864 Munro left for the new Cluny Hills Hydro and his position at Loch-head was filled by Dr Meikle, for whom it proved a stepping stone to founding a new purpose-built hydro at Crieff.

*Bridge of Allan Hydro, National Library of Congress*

The Allan Water Hydropathic establishment was built in 1861-4 to designs by a lesser Glasgow architect James Hamilton, and was an early work in his career. Soon after he was commissioned to design the West of Scotland Seaside Home at Dunoon (later remodelled as the Dunoon Hydro), the Glasgow Hydropathic and Turkish Bath, and possibly designed extensions to the Glenburn Hydro, Rothesay. James, his son John and grandson Arthur were all closely associated with Rothesay and designed a number of villas thereabouts.

Strathearn Hydro, Crieff. **Library of Congress**

The Hydro at Crieff is possibly the best known Scottish hydro, and one of the few to survive as a hotel to this day. It was first opened as the Strathearn Hydro in 1868, built for the not inconsiderable sum of £30,000 and founded by Dr Thomas Henry Meikle, on the back of the success of the Loch-head hydro at Aberdeen. The original building was designed by Robert Ewan, an architect and engineer who was commissioned in 1866 while still working as an assistant architect to J. Russell Mackenzie in Aberdeen. The early success of the establishment is attested by the almost immediate need to extend the accommodation, first with attic bedrooms in 1872, then in 1875 the dining and drawing rooms were extended. Further substantial additions were made in 1888 and 1894, and a winter garden was added in 1903-5. Ewan and his architect sons, Robert and Charles, were retained for these additional works. They were not foremost amongst Scottish architects, and the hydro is not the finest piece of architectural design, but it has distinct charm and a lively roofline of turrets and gables.

hospitals119 — *The Winter Garden from Strathearn Hydro’s souvenir brochure produced in the 1950s.*

During the Second World War the Strathearn Hydro at Crieff was requisitioned by the army, it partially re-opened in 1949 and after refurbishment a souvenir brochure was produced to entice new visitors and encourage former guests to return. It advertised various sports: golf, tennis and croquet out of doors, billiards and a swimming-pool in doors. It also boasted 58 separate ‘lock-up’ compartments for motor cars. The medical side had not been entirely abandoned, there was a physiotherapy department, which it was hoped would prove increasingly helpful in the treatment of rheumatism ‘and in the restoration of function’. [6] It remained dry, though, until the 1970s, when the management finally applied for a table licence. [2]

References
[1] Phyllis Hembry, British Spas from 1815 to the Present… 1997: J.Bradley, M. Dupree, and A. Durie ‘Taking the Water-Cure: The Hydropathic Movement in Scotland, 1840-1940’ in Business and Economic History, vol.26 no.2, Winter 1997 pp.426-37: James Bradley ‘Medicine on the margins? Hydropathy and orthodoxy in Britain, 1840-60’ in Waltraud Ernst ed, Plural Medicine, Tradition and Modernity 1800-2000, Routledge, 2002: Allan Brodie, Travel and Tourism in Britain, 1700 – 1914, 2014: Eric Zeulow, A History of Modern Tourism, 2015.
[2] Alastair J. Durie, Water is Best The Hydros and Health Tourism in Scotland 1840-1940, 2006
[3] John Wilson, Wilson’s Guide to Rothesay and the Isle of Bute, 1848: Richard Metcalfe, The rise and progress of hydropathy in England and Scotland, 1906, p.157
[4] Alastair J. Durie ‘”The drugs, the blister and the lancet are all laid aside” Hydropathy and medical orthodoxy in Scotland, 1840-1900’ in Repositioning Victorian Sciences: Shifting Centres in 19th century… D. Clifford, E. Wadge, A. Warwick, M. Willis eds, 2006
[5] ‘Aberdeen in Byegone Days’, Aberdeen Journal, 30 Sept 1909, p.2
[6] Strathearn Hydropathic Crieff, souvenir brochure printed by David Philips, Crieff, n.d. but describes the hydro as being 90 years old.

The Asylum at Christmas

December 23, 2015February 3, 2022 / Harriet Richardson / 1 Comment

Celebrating Christmas with entertainments and a special dinner was introduced into the workhouse and even prisons before it was provided in pauper lunatic asylums. It only seems to have become widespread from about the 1850s.

Entertainment to the patients at the Middlesex County Lunatic Asylum, Colney Hatch. This was a New Year’s celebration, but the dancing and the decoration with flags were typical of the entertainments held for Christmas. Illustrated London News, 15 Jan 1853. Wellcome Library, London. Wellcome Images Image reproduced under Creative Commons Attribution only licence CC BY 4.0

According to the Chelmsford Chronicle reporting on the Christmas festivities at the Essex County Asylum in 1858, it was only in recent years that ‘the poor lunatic’ was thought capable of appreciating the ‘social enjoyments’ associated with the season: ‘it is one of the humane discoveries of modern medical science, that he is far more successfully worked upon by the music of the kind word than by the rattle of the iron chain.’ [1]

*The County Lunatic Asylum, Brentwood, Essex: bird’s eye view. Wood engraving by W.E. Hodgkin, 1857, after H.E. Kendall. Wellcome Library, London.* Essex County Asylum was designed by H. E. Kendall in 1849 and completed in 1853. Originally for between 400 and 500 patients it was extended many times. Two of the earliest additions were a dining-hall in 1863 and a recreation hall in 1879. The asylum was later renamed Warley Hospital. It closed in 2001. The Builder, *16 May 1857 Wellcome Images Image reproduced under Creative Commons Attribution only licence CC BY 4.0*

On Christmas day at the Essex Asylum one of the wards was fitted up as a dining hall, the ward itself measuring some seventy feet in length and seating 230 inmates. The walls were decorated with flags and evergreens in ‘tasteful devices’… ‘while forty ponderous plum puddings and 350 lbs of roast beef smoked upon the tables’. In addition to the dinner there was a musical evening held in the recreation hall, which was decorated for the occasion. A Mrs Campbell supplied 1,200 artificial flowers which the patients had interwoven into figures and festoons of laurel. Sketches from Uncle Tom’s Cabin, the Essex arms and portraits of the Indian heroes Havelock and Wilson also formed an unlikely combination of pictorial decoration in the hall, all painted or drawn by the patients. The orchestra, too, was composed of patients, who supplied the music for the country dances. Between dances patients amused the company with songs and recitations. [1]

From the late 1850s the number of newspaper reports of similar entertainments elsewhere in Britain began to grow, these were often occasions attended by the local gentry. At the Birmingham Borough Asylum the Christmas festivities comprised country dancing, singing and games on Christmas eve. During the evening ‘an immense circle was formed for ‘drop the glove’. Half an hour of exciting fun was the result’. There was also a ‘jingling match’ and a jumping match. A female patient with an ‘exceedingly melodious voice’ sang Where are you going to, my pretty maid? and amidst the music and activities, spiced ale and plum-cake were served for refreshment. The Christmas dinner featured roast beef, plum pudding and ‘various seasonable accessories’. Entertainments continued nightly throughout the week with amateurs from the town visiting the asylum to provide vocal and instrumental music. One evening there was an exhibition of ‘dissolving views’. [2]

In the 1880s similar entertainments were reported at the Guernsey asylum, where games included musical chairs and candle-buff. [3]

Sources

[1] Chelmsford Chronicle, 1 Jan 1858, p.3
[2] Birmingham Daily Post, 27 Dec 1859, p.3
[3] The Star, Guernsey, 1 Jan 1889, p.2

The Hospitals Investigator 9

December 6, 2015November 20, 2024 / Harriet Richardson / 11 Comments

In December 1992 Robert Taylor circulated the ninth edition of his newsletter amongst his colleagues working on the Royal Commission’s hospitals project. In this issue he provided more useful source material on isolation hospitals from Parliamentary Papers: a ‘Sanitary Survey’ undertaken in 1893-5 and the annual report of the Local Government Board of 1914-15, which highlighted the problems encountered in municipal hospital provision during the first year of the war.

The Sanitary Survey covered England and Wales and was prompted by ‘the ever recurring source of danger’ to Britain of cholera spreading from the continent. Publication of the inland survey was delayed following a ‘serious accident’ which befell Dr Frederick W. Barry, Senior Medical Inspector of the Local Government Board, who was supervising the work. A year later he died suddenly, it was presumed from the injury he sustained. The inland survey followed one on the ‘Port and Riparian Districts of England and Wales’ submitted in September 1895. When attention was turned inland, districts where the purity of the water supply was in doubt were investigated as a priority and then districts in which the administration was believed to be defective or ‘in which former experience had shown that filth diseases prevailed’.

Screen Shot 2015-12-05 at 17.22.50 — *The late Dr F. W. Barry, from* The Graphic, 23 Oct 1897, p.17. Barry had struck his head on a stone doorway causing severe injury to his skull the previous year. He died suddenly after he had retired to bed at the Grand Hotel, Birmingham, and was found the following morning by the chambermaid.

The actual work of inspection was conducted under Barry’s supervision by a team of doctors in the LGB Medical Department. The bulk of the sites were covered by Dr Bruce Low, Dr Fletcher, Dr Reece, Dr Wilson, and Dr Wheaton, a few were inspected by the late T. W. Thompson, Dr Sweeting, Dr Theodore Thomson, Dr Coleman, Dr Bulstrode, Dr Horne and Mr Evan Evans (surely one of the inspectors of Welsh hospitals). Each inspector was given a set of forms containing questions as to the general sanitary circumstances of the district, its sanitary administration and cholera precautions.

Under the first of these three headings the inspectors were to report on the condition of dwellings and their surroundings, the purity and sufficiency of the water supply, the efficiency of public sewage, domestic drainage and sewage disposal, methods of excrement and refuse disposal and removal, and the condition and nature of supervision over registered premises and trades. As regarded ‘sanitary administration’ the inspectors were to report on the general character and efficiency of the administration of the local sanitary authority, noting the bylaws, regulations and adoptive Acts in force. They were also to report on the work done by the local Medical Officer of Health and Inspector of Nuisances, and on the provisions made for dealing with infectious diseases and ‘infected articles’.

As to ‘Cholera Precautions’ the inspectors were instructed to ascertain what general arrangements existed in each district to deal with an outbreak of cholera and what special arrangements had been made for action in an emergency. Detailed reports were made and submitted to the local sanitary authorities together with recommendations for improvements. Only the detailed reports for Sunderland were reproduced in the Report, for the other districts abstracts were published.

The inspection of the County Borough of Sunderland was made on 19 April 1894, the district covered Sunderland, Bishopwearmouth, South Bishopwearmouth and Monkwearmouth with a population in 1891 of 131,015. The chief industries were shipbuilding, engineering, mining, seafaring and glass-blowing. The sewers are described in detail and house drainage. There were an estimated 4,000 water closets and 1,100 ‘tub closets’ (galvanised iron tubs) in the district, but the majority of houses used privy middens which were found to be mostly of a ‘very defective type’. The local Medical Officer of Health was John Caudell Wood, who was paid a salary of £500 p.a. with an additional £20 as Port Medical Officer of Health and £5 as Public Analyst. He was described as having a good knowledge of his district but ‘wanting in judgment’, and therefore ‘cannot be regarded as a very satisfactory officer’.

*Extracts from the 6-inch OS map of Sunderland published in 1898. Reproduced by permission of the National Library of Scotland*

Sunderland Isolation Hospital was found to be a good brick building for 42 patients, situated on an isolated site about two miles north-west of the Town Hall. (This is probably what became Havelock Hospital east site, formerly Sunderland Borough Infectious Diseases Hospital, the west site being formerly the infectious hospital for Sunderland Rural District, situated to the west of Bishopwearmouth cemetery on Hylton Road.) It had been built in 1890, and consisted of two fever pavilions each for 16 beds designed generally on the lines of Plan C of the LGB 1892 memorandum, and an isolation pavilion for 10 beds on the lines of Plan D in the 1888 memorandum. There was also an admin block, with accommodation for 11 nurses and 9 servants as well as a medical officer and matron, a mortuary, post-mortem room, laundry, and disinfecting house.

Emergency plans included arrangements for opening the ‘House of Recovery’ as a cholera hospitals, this had been the old borough fever hospital a the end of Dunning Street near the river and could take about twelve patients.The following is Robert Taylor’s list of the English isolation hospitals noted in the report. The page numbers are those given in the Blue Books, not the report’s pagination. There are some oddities: Bishop Auckland Urban District’s isolation hospital was in converted dog kennels, while at Lyme they set aside a room in a warehouse on the Cobb. At Dudley they had built a hospital comprising three blocks and a tent on a pit mound, which the inspector described as ‘very bad’. It supposedly only had space for six patients, although it had been used for 23 smallpox patients.

Sanitary Survey

The ‘Report on the Inland Sanitary Survey, 1893-95’, by the late F. W. Barry, undertaken for the Local Government Board was published in Parliamentary Papers 1896 XXXVII, pp 669ff. Just how Mr Barry met his death is not recorded, but we trust that it was not a direct result of the time spent investigating hospitals. He presented, albeit posthumously, a series of short descriptions of a sample of infectious diseases hospital visited between 1893 and 1895. A list and summary may be of some use, even if only to show what sort of buildings are missing from our own survey a century later. The abbreviations used are familiar – UD for Urban District, B for Borough, CB for County Borough.

Amble UD. A small cottage is rented for an isolation hospital, an unsatisfactory arrangement. [p.682]
Ashby de la Zouch UD. An old barn converted into a four-room cottage, very unsatisfactory. [p.684]
Ashton in Makerfield. A small eight-bed hospital, with no accommodation for two diseases in both sexes. [p.685]
Bacup B. A converted mill is used in common with Todmorden, Mytholmroyd and Hebden Bridge UDs. no means of separating two diseases. [p.687]
Banbury B. A well-built hospital of 1890. [p.688]
Bedlingtonshire UD An old granary converted to isolation hospital, with eight beds; unsatisfactory. [p.694]
Berwick on Tweed B. There are two wooden hospitals, one with four beds for the town, one with eight beds for port cases. [p.698]
Beverley B. Two hospital tents purchased in 1892. [p.700]
Bideford B. A six-bed hospital built in 1885; cannot separate two diseases. [p.701]
Bingley UD. Temporary hospitals shared with Keighley UD and RD, for smallpox cases only. [p.703]
Bishop Auckland U. Dog kennels converted, with five beds; unsatisfactory. [p.704]
Boston B. A converted farmhouse with 12 beds, used jointly with the Rural and Port authorities. [p.706]
Brandon and Byshottles UD. A temporary hospital built in 1891 with 16 beds; cannot isolate two diseases in both sexes. [p.707]
Bridport B. Temporary wooden hospital provided for cholera in 1866. [p.710]
Burton on Trent B. Three temporary hospitals; a permanent 30-bed hospitals being built in August 1893. [p.714]
Calne B. With Calne RD has a well-arranged hospital of 10 beds built in 1889. [p.716]
Carlisle B. Sixteen beds are provided permanently at Crozier Lodge Hospital, and further 16 are reserved. [p.719]
Chesterfield B. An unsatisfactory 10-bed hospital. [p.723]
Clay Cross. A four-ward building for smallpox on an old pit heap, used as two cottages in May 1894. [p.724]
Darlaston U. A house was purchased in 1885 and a tent was recently bought. Very unsatisfactory.[p.737]
Doncaster B. An old dilapidated house for smallpox, very unsuitable. In 1892 temporary wooden buildings were erected for cholera, but it is only used for the families of smallpox victims. [p.741]
Dronfield U. Four four-room cottages have recently been bought, but were unfurnished in May 1894. [p.744]
Dudley CB. The Infectious Diseases Hospital consists of three blocks and a tent on a pit mound, and is very bad. There is only space for six patients, but it was used for 23 smallpox patients. [p.745]
Durham B. An iron hospital being built in June 1894, very unsatisfactory. [p.746] {Is this by any chance the hospital supplied by Humphreys of Knightsbridge some time before 1914?}
East Retford. A farmhouse, only suitable for one disease at a time. [p.747]
Exeter CB. There are two ward blocks, one of wood and cement with four wards, one of brick and stone with two wards. Unsatisfactory and crowded.[p.753]
Faversham B. A brick hospital, with an administration building, a ward block with two wards each 10 by 13 feet and 13 feet high, and outbuildings. [p.756]
Gainsborough UD. Hospital consists of an administration building, two ward pavilions of brick, and a temporary wooden ward block. Apparently only used for smallpox. [p.759]
Great Yarmouth. Hospital being erected November 1893. [p.767]
Harwich B. Hospital at Dovercourt, built in 1882 with eight beds. [p.770]
Hastings CB. A building was purchased in 1874 and has 35 beds. Later a 30-bed iron hospital was bought for smallpox. The site is inadequate. [p.771]
Havant UD. Hospital shared with Havant RD, consists of two ward blocks, with 16 beds. [p.772]
Heanor UD. An eight-room cottage, used for smallpox; unsatisfactory. [p.775]
Heath Town UD. A temporary 10-bed smallpox building was recently erected with Wednesfield UDC. [p.777]
Hereford B. A 16-bed corrugated iron hospital built in 1893; unsatisfactory. [p.779] {Another Humphreys hospital?}
Herne Bay UD. Two cottages bought in 1891; unsatisfactory. [p.780]
Huntingdon B. An old brick house called the ‘Pest House’ with five beds, very unsatisfactory. [p.790] {Built in 1760 for £95 15s and now demolished}
Ilfracombe UD. A farmhouse at Mullacott for four patients, and a private house at Ilfracombe for six patients; very unsatisfactory. [p.793]
Ilkeston B. An 18-bed temporary wooden building provided in 1888 during a smallpox epidemic. [p.795]
Ipswich CB. Satisfactory 36-bed hospital. [p.796]
Keighley B. Keighley and B. J. H. B. have a temporary smallpox hospital. [p.797]
Lincoln CB. Temporary wooden building for smallpox cases. [p.805]
Longton B. An old cottage used for smallpox cases. [p.810]
Loughborough B. A cottage is rented as a hospital; unsatisfactory. [p.811]
Lyme B. A room in a warehouse on the Cobb. [p.817]
Margate B. Temporary 44-bed hospital at Northwood, shared with Ramsgate and Broadstairs. [p.819]
Maryport UD. A 4-bed hospital built on the model plan. [p.821]
Millom UD. A temporary hospital near the pier is used for cholera. [p.824]
Newark on Trent B. A 6-bed wooden hospital. [p.831]
Newbold and Dunston UD. A 12-bed temporary hospital used for smallpox cases only. [p.832]
Newcastle under Lyme B. An 18-bed hospitals built in 1872, now dilapidated. [p.834]
New Romney B. A temporary 12-bed iron hospital built in 1893, unsatisfactory. [p.837]
Northam UD. A temporary iron and wood hospital near Appledore, with no fittings, water supply, etc. [p.838]
Norwich. An excellent hospital completed in 1893. [p.840]
Oldbury UD. Smallpox hospital is a block of cottages leased by the Authority; unsatisfactory. [p.842]
Ormskirk UD. Hospital of four wards and six beds in one acre, built shortly before March 1894. [p.843]
Pemberton UD. One pavilion containing four wards and eight beds, built in 1886. [p.845]
Penrith UD. Hospital has two pavilions with 12 beds. In 1894 a new hospital building of two pavilions with eight beds, set in 2.5 acres. [p.848]
Poole B. Permanent hospital of 6 beds built in 1875. A temporary smallpox hospital built in 1886, with poor fencing. [p.850]
Runcorn UD. Two wards with 12 beds, built in 1881. Temporary building with 20 beds for smallpox cases erected on same site. [p.858]
Salford CB. Hospital at Ladywell built in 1884 with 5 pavilions set in 13 acres. Also a modern smallpox hospitals with 50 beds. [p.864]
Shipley UD. A ten-bed hospital at Stoney Ridge built according to the Board’s model plan. [p.872]
Shrewsbury B. An emergency hospital built in 1893 with two wards each with 3 beds, of iron lined with wood. Very unsatisfactory. [p.873]
Sidmouth UD. Wooden 10-bed hospital built in 1884, with no furniture, and which has never been used. [p.874]
Sittingbourne UD. A satisfactory 24-bed hospitals built in 1884. [p.876]
Stalybridge B. A building bought in 1888 and partly fitted up but never used. [p.887]
Stockport CB. Hospital with 28 beds in two pavilions, each with three wards, opened in 1881. A separate smallpox hospital at Whitehall. [p.891]
Truro B. St Mary’s Parish Workhouse fitted up, suitable for one disease only. [p.906]
Warrington B. A satisfactory 40-bed hospitals built in 1877. [p.916]
Widnes B. A satisfactory 24-bed hospital built in 1887. [p.920]
Wigan CB. A satisfactory 60-bed hospital built in 1889. [p.921]
Workington B. The old workhouse used, unsatisfactory. [p.927]

Isolation Hospitals

The Annual Report of the Local Government Board for 1914-15 (P.P. 1914-15 XXV, 29-30) gives some interesting information about hospitals. It is also interesting for referring to the conflict as the Great War as early as 1915.

In the early months of the First World War, it was discovered that the existing isolation hospital accommodation was often insufficient for the extra military population of the area. This was particularly the case in Eastern Command. In some districts, huts of an army pattern were built in the grounds of existing isolation hospitals by agreement between the local military and the hospital authorities. It was intended that after the war the local authority would buy the building from the military at a percentage of the original cost. These huts did not provide floor space to the requirements of the Local Government Board, and after a meeting with the Board, Eastern Command adopted a design by their architect which was a modification of the Board’s Model D of the Memorandum of May 1902. The pavilion had two ten-bed wards and two one-bed wards, was 24 feet wide, and provided 144 square feet of floor space for each bed.

The War Office built these pavilions at the following hospitals: Biggleswade (1 pavilion); Bedford (1 pavilion); East Grinstead (1 pavilion); Guildford (1 pavilion); Tring (2 pavilions); Chelmsford (1 pavilion); Bletchingley (1 pavilion); Dunstable (1 pavilion); Rochester (1 pavilion); Folkestone (2 pavilions).

Screen Shot 2015-12-05 at 16.42.28 — Folkestone Isolation Hospital. The two blocks added during the First World War are the pair to the south. Extract from the 2nd edition OS map revised 1937-8, reproduced by permission of the National Library of Scotland

Before this plan was completed, several authorities who objected to the original army hut prepared plans of their own, which were submitted to the LGB in the usual way. These authorities were: Northampton (2 pavilions); Colchester (2 pavilions); Ipswich (2 pavilions); Orsett Joint Hospital Board (1 pavilion).

Of those which came within the area covered by the Cambridge office (where Robert Taylor was based), the two wards built at Ipswich had been demolished, although OS maps showed their distinctive outline (which was the same as the single pavilion built in 1914-15 as the Ipswich Smallpox Hospital). At Northampton there was a pair of pavilions with sanitary annexes with stalks at each end, and the readily identifiable double projections of single wards flanking the duty room. The potentially more interesting military blocks at Bedford, Biggleswade and Dunstable did not survive. The block at Biggleswade appears from maps to have been a plain rectangular structure without any projections for sanitary annexes or duty rooms. The most likely pavilion shown on maps of Biggleswade was another plain rectangular building, with a central rear sanitary annexe with narrow stalk. no building can be identified on maps of Bedford.

The Hospitals Investigator 8

November 29, 2015February 3, 2022 / Harriet Richardson / Leave a comment

The eighth newsletter that Robert Taylor produced from the RCHME Cambridge office was written almost exactly 23 years ago, in November 1992. I was delighted to hear from Robert recently, and to receive his blessing for reproducing his work here. It was good to hear that he would seem to be just as productive in his retirement, and has not lost his interest in hospital buildings in general or the machinations of the Local Government Board in particular.

L0024801 The Cruciform Building, University College Hospital, London: Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org The Cruciform Building, University College Hospital, London: perspective from the south-east. Colour lithograph. Coloured Lithograph Published: [19--] Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/ — University College Hospital, designed by Alfred Waterhouse and built between 1897 and 1906. It is now UCL’s Cruciform Building. Image from the Wellcome Library reproduced under Creative Commons Attribution only licence CC BY 4.0

This issue largely consisted of lists: hospital designs by Alfred Waterhouse, culled from the list of works in Colin Cunningham’s monograph; locations where Humphreys’ patent iron hospitals were erected as given in an advertisement published in 1915; and plans of hospitals published in the aptly named R. Ward’s 1949 book the Design and Equipment of Hospitals. The list of Humphrey’s hospitals has already featured in a separate post which can be found here, the two others are transcribed below.

Apart from the lists we were informed of the novel re-use of the Oxford Smallpox Hospital, a corrugated-iron building with all the characteristics of one of Mr Humphreys’ constructions (1900 catalogue, no.3), which, no longer needed for patients, was the centre of a flourishing enterprise called Spend-a-Penny Event Hire, from which people holding large parties and public entertainments can borrow certain necessary portable buildings. (I can find no reference to this company today, so perhaps the Oxford Smallpox Hospital has finally gone out of use.)

In other news, the Cambridge team had lately visited their first army hospital dating from before the reforms influenced by the Crimean War, and were fascinated by the planning. (Kathryn Morrison, Robert’s partner in crime in the Cambridge team, went on to write the chapter on military hospitals in English Hospitals, 1660-1948: A Survey of Their Architecture and Design.) Here is Robert’s description of the Peninsula Barracks Hospital at Winchester:

‘On each of three storeys were three wards on either side of a central stair. Only the end wards had cross-ventilation. The hospitals remained in use until December 1985, and the fittings on the walls allowed us to see that there had been eleven beds in each of the larger wards, and ten in the smaller ones. The larger wards were paced at 34ft by 19ft and the smaller wards 29ft by 19ft, which gives floor areas for the wards of 646 and 551 sq ft respectively. The height of the wards was not measured (we do not yet have a successful technique for walking up walls), but allowing for a 13ft height gives cubic volumes of 7,163 and 8,398 cubic ft respectively. Miss Nightingale would have been horrified to work out that this means that the beds in the larger wards had 763 cubic feet each, and those in the smaller wards (which were not cross-ventilated properly) a mere 716 cubic feet. Moreover, as the hospital was apparently built for 130 beds this suggests that the beds were more congested in 1985 than in 1855.’

Screen Shot 2015-11-29 at 11.51.14 — Extract from the 2nd edition OS map revised 1894-5, showing the barracks hospital fronting St James’s Street (now Romsey Road). Reproduced by permission of the National Library of Scotland. The hospital building has been converted to private flats, but some of the other former barracks buildings now form part of Winchester’s Military Museums.

‘The original sanitation was contained in a small room opening off the half-landings of the staircase, but some time early in the present century a larger room was added to this. In addition, a four-foot square sanitary tower was added between each end ward and its neighbour, with a triangular lobby contrived in the wall between the wards to give unventilated access.’

‘This account hardly inspires faith in the care that the army lavished on its cannon fodder, although we should perhaps bear in mind that this was presumably not for usual hospital cases but complaints such as influenza and sore feet that needed to be taken out of the barrack block near by.’

Waterhouse

Works listed in Colin Cunningham and Prudence Waterhouse’s, Alfred Waterhouse, 1830-1905: Biography of a Practice, Clarendon Press, 1992. Although the word hospital is not in the otherwise good index, there is a list of some 647 commissions and works, including nine hospitals. An abstract follows, using the numbers in Cunningham’s list. (Curiously Robert omitted what to me is Waterhouse’s best-known hospital building, the extraordinary cruciform University College Hospital built 1897-1906, replaced by the new UCH on Euston Road, now used by University College London, and shorn of some ugly later additions.)

[111] Manchester Royal Infirmary, Piccadilly, 1861. Renovation and valuation, re-ventilation and design of memorial tablet to J. C. Harter (Office correspondence in private collection).
[146] Cheadle, Royal Lunatic Asylum, 1863. Additional villas, cost £2,620. (Drawings and correspondence at RIBA).
[210] Macclesfield Infirmary competition, 1865. Withdrew, with compensation.
[218] Manchester Royal Infirmary, Piccadilly, 1865. New stables etc. (demolished) cost £340 (Office correspondence etc. in private collection and RIBA).
[293] Cheadle, Royal Lunatic Asylum, 1868-9, chapel. (Office archives in private collection).
[447] London, University College Hospital, Gower Street, 1877. Sketch plan for rebuilding, not executed. (Office archives in private collection).
[488] Liverpool, alterations to old asylum building to form Liverpool University, 1881-3, cost £4,450. (it is not clear from the text what sort of asylum this was).
[532] Liverpool Royal Infirmary, hospital, nurses’ home and medical school, 1886-92. Cost £123,500. (Drawings at RIBA and Infirmary)

OLYMPUS DIGITAL CAMERA — *Part of Royal Liverpool Infirmary, photographed in 2009 © John Bradley CC-BY-SA-3.0*

[571] Manchester, St Mary’s Hospital (demolished), maternity hospital, cost £65,140. Designed 1891, built 1899ff. (Drawings at RIBA).
[599] Liverpool University Medical School, extension, 1895-7, cost £1,795.
[628] Nottingham General Hospital, Jubilee Wing, 1898. Circular ward block with sanitary tower; laundry; out patients’ department; staircases and lift. (Cited by S. A. Smith in Courtauld theses of 1970 but not corroborated by Cunningham).
[630] Rhyl, Royal Alexandra Hospital, 1898. Cost £30,430.
[643] Newbury, Children’s Hospital, 1900. (Cited by S. A. Smith as above, not corroborated by Cunningham). This hospital is also unknown to the Cambridge office, although we may be able to suggest confusion with an earlier scheme by a different architect in a nearby village.

Ward on Hospitals

In 1949 Ronald Ward published his book The Design and Equipment of Hospitals. It is illustrated by both typical designs and by plans drawn from a very small number of real buildings. Here is a list of the plans of real hospitals, and the page number.

Addenbrooke’s Hospital, X-ray department p.199
Birmingham Hospital Centre layout p.27; operating theatre p.216
Brentwood District Hospital p.193
Central Middlesex County Hospital, children’s wards p.253
Coventry Infectious Hospital, general plan p.283; general ward p.285
German Hospital, wards p.164; children’s wards p.255
Guy’s Hospital, psychiatric clinic p.268
Hammersmith Hospital, reception department p.125; ante-natal department p.138
Harefield Hospital, stores p.65; laundry p.111; observation wards p.278; children’s block p.279; men’s or women’s block p.280
Harefield Sanatorium, general plan p.276
Hospital for Sick Children, nurses’ home p.93
Leeds general infirmary, outpatients’ department p.129-30; private wards p.232; kitchen for private wards p.233
Leeds, Institute of Pathology p.149
Maccelsfield Infirmary, nurses’ home p.97
Monkwearmouth Hospital, outpatients’ department p.134
Monkwearmouth and Southwick Hospital, electric department p.202
North Eastern Isolation Hospital, receiving block p.286; general wards p.290, p.292
North Western Hospital, laboratory p.147
Queen Charlotte’s Hospital, operating theatre p.222
Royal Masonic Hospital, power house p.59; nurses’ home pp 95-6; wards p.165; electric department p.210; operating theatre p.217

V0014883 Royal Masonic Hospital, London: three-quarter view of the ad — *Royal Masonic Hospital, Burnet, Tait and Lorne architects, 1933 from the Wellcome Library licensed for reuse CC BY 4.0*

St Bartholomew’s Hospital, wards p.177; operating theatre p.220
Scarborough Hospital, layout p.30; nurses’ home p.98; laundry p.110; outpatients’ department p.135; wards p.181; X-ray department p.201; operating theatre p.220; maternity ward p.239; children’s wards p.254
Surbiton Hospital, Kitchen p.79; nurses’ home p.99; mortuary p.116; wards p.178; X-ray department p.200; operating theatre p.222; maternity ward p.243
Tolworth Isolation Hospital, pavilion ward p.287; cubicle ward p.291
Welwyn Cottage Hospital, pp 32-3
West London Hospital, operating theatre p. 219
Westminster Hospital, kitchen p.77; nurses’ home p.92; casualty department p.123; outpatients’ department p.133; wards p.172; operating theatre p.218
Wolverhampton Eye Infirmary, outpatients’ department p.141

Hospitals for Incurables: the former Longmore Hospital, Edinburgh

October 7, 2015May 2, 2023 / Harriet Richardson / 1 Comment

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 14s 2d, 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.

canmore_image_DP00167147 — *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.

canmore_image_DP00167155 — *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.

canmore_image_DP00167149 — *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.

canmore_image_DP00167148 — 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

canmore_image_DP00167151 — *And its counterpart for male cancer patients. From RCAHMS*

canmore_image_DP00167150 — *Interior of a ward for male TB patients, from RCAHMS*

canmore_image_DP00167154 — *A private ward, from RCAHMS*

canmore_image_DP00167153 — *It is particularly poignant to see children in hospital, but even more so in a hospital for incurables. From RCAHMS*

canmore_image_DP00167156 — *Not all patients were confined to bed, here is a ‘recreation room’ for male patients. From RCAHMS*

canmore_image_DP00167157 — *Probationer Nurses’ drawing room. From RCAHMS*

canmore_image_DP00167158 — *The main hospital kitchen, rebuilt in 1899. From RCAHMS*

canmore_image_DP00167159 — *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

Historic Hospitals

An Architectural Gazetteer

English Hospitals

Building Bedlam again – taking a leap forward to Monks Orchard

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Building Bedlam – Bethlem Royal Hospital’s early incarnations

From City fringe to St George’s Fields

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King Edward VII Estate: Midhurst Sanatorium

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A mysterious coded message from Midhurst Sanatorium

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Twelfth Night at Hanwell Asylum

William Rayner is easily confused with his better-known contemporary Lionel Benjamin Rayner, who played at Covent Garden at the same time.

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Dry January? Head for a Hydro! A brief look at Victorian hydropathic establishments in Scotland

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The Asylum at Christmas

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