In the third edition of Rufenacht Walters’ Sanatoria for Consumptives published in 1905 is an account of Alderney Manor Sanatorium and the photograph above of the patients’ accommodation. This type of simple prefabricated timber and corrugated iron structure were commonly used for small schools, hospitals and chapels (tin tabernacles), often intended as a temporary measure to get an establishment up and running quickly.
Alderney Manor Sanatorium, situated at Parkstone between Poole and Bournemouth in Dorset, was for private, paying patients. Surrounded by pine woods and heather-covered heath, it was set up around Alderney Manor, the house itself used for administrative offices. Despite the proximity to Bournemouth the climate was described as being ‘less relaxing’ in the summer time. Which to me sounds as though it was wetter, colder and/or windier.
In the grounds a dining-hall, a bungalow and a number of sleeping huts or chalets were erected, all prefabricated, made of wood with corrugated iron roofs and outer walls, large windows on four sides and ventilation in the gable, heated by anthracite-burning stoves (Choubersky’s stoves). The sanatorium also boasted two ‘sun baths’ for ‘ladies and gentlemen respectively’, and ‘sun bathing machines for bed patients’.
For amusements patients were offered the type of gentle pursuits one might expect: croquet, and, given the location, sea-bathing (under medical supervision, naturally). There was also a bandstand for musical entertainments. More unusual activities offered included fishing on Lord Wimborne’s preserves, and rabbit shooting on the estate itself. In addition to all this: ‘a local land agent gives lessons by arrangement in the management of landed property’. Not something I have ever come across before.
I have no idea what a sun-bathing machine looks like, nor what shape the ‘sun baths’ took. However, I did find a picture on the web of a Choubersky stove, from, naturally enough, a ‘Stove Identification Gallery’ provided by Stovemica. Whether this is the same Choubersky that manufactured an early form of in-line skates I couldn’t say.
(Jean de Paleologu [Public domain], via Wikimedia Commons)
The sanatorium was right next to the local authority infectious diseases hospital, now Alderney Hospital, specialising in mental health problems and learning disabilities. Alderney manor, which in earlier maps appears merely as Alderney Cottage, was demolished some time in the 1920s or 30s, and the area where it stood was built over for housing after the Second World War.
The subject of pine trees formed a digression in the second issue of the Hospitals Investigator, and it put me in mind of earlier research that I had done in Scotland where Sanatoria were set amongst pines so that the patients might benefit from terabinthine vapours. Nordrach-on-Dee was one such, later Glen O’Dee Hospital, near Banchory.
The former Glen O’Dee Hospital
Forests, Woods and Trees in relation to Hygiene was published in 1919, by Augustine Henry. Here he discussed the latest research into the effects of pine trees in a chapter on ‘Forests as sites for Sanatoria’. Even Pliny, it seems, considered that ‘forests, particularly those which abound in pitch and balsam, are most beneficial to consumptives or to those who do not gather strength after a long illness; and are of more value than a voyage to Egypt’.
In New York patients with tuberculosis were sent to the Adirondack Forest, where they might benefit from the pure and invigorating air. In England the earliest experiments with fresh-air treatment for consumption were made in 1840 by Dr George Boddington, at Sutton Coldfield in Warwickshire and in Ireland by Dr Henry MacCormac of Belfast in 1856. Dr Walther systematised and popularised open-air treatment in the Black Forest with his Nordrach Colonie Sanatorium, which was hugely influential in Britain. Treatment in an alpine sanatorium in Switzerland was beyond the financial reach of most invalids, but pine woods could easily be planted, and already existed in abundance, allowing this form of treatment to be widely replicated.
I particularly like this dramatic architectural perspective of the West Wales Sanatorium, at Llanybydder, Carmarthenshire, with its fringe of pine trees on the hillside behind. It was designed by E. V. Collier and treated women and children. As built in about 1906, without the side wings, it didn’t look quite so romantic, and the regime within the hospital was equally grim. In 1923 complaints were made that sick girls were made to go out into the surrounding pine forest to saw trees while kneeling in the snow. [ref: Linda Bryder, Below the Magic Mountain quoted in the New Scientist 14 July 1988 p.63] The Pevsner Guide for Carmarthenshire and Ceredigion published in 2006 describes the building as ‘originally a cheerful Neo-Georgian with red-tiled roofs and green shutters, now very decayed’.
By the early twentieth century the value of the ‘exhalations of turpentine etc’ from Scots Fir trees was being questioned, and instead it was as shelter belts that pine trees continued to play an important role at hospitals. In the second issue of Robert Taylor’s Hospitals Investigator he drew attention to these surviving shelter belts of pines around many of the sites that the Cambridge team visited. It also brought back memories of his own experience of being interned in an isolation hospital as a small child. I remember him telling us that parents were not allowed on the wards, so they would remain outside and could only see their children through the window. At one former isolation hospital he found a shelf under a window, provided so that a parent could kneel on it and see inside.
Here are Robert’s remarks on pine trees:
“In the very first day of fieldwork in Suffolk it was noticed that there was an association between hospitals and pine trees. Tuberculosis sanatoria, cottage hospitals and isolation hospitals all appear with shelter belts; indeed the site of one isolation hospital was completely inaccessible because of the fallen conifers and evergreens. The Beccles War Memorial Hospital appears from amps to have had new planting, and the surviving trees confirm this. Even the isolation hospital where one of us spent a month in 1944 has a belt of pines. It was obviously considered that a shelter belt of conifers afforded a perceptible improvement in the quality of the air. The reasoning behind this seems to smack of black magic and the symbiotic theory of disease, physicians had relatively few methods of cure, and little reliable theory with which to evaluate those methods. A belief in the specific effect of climate was harmless and must have appeared plausible. The first practical application of the theory was at the Royal Sea Bathing Infirmary at Margate in 1791, where consumptives were treated. Nothing more seems to have been done until 1854 when Brehmer believed that he could cure tuberculosis by living in high mountains, and opened an institution in Silesia. The general theory was given a more specific interpretation in 1862 when Dr. L. C. Lane of San Francisco considered that the fragrant smell from the resin of the Sierra Nevada pines was salutary: ‘in chronic pulmonary affections the breathing of such an atmosphere must be productive of a highly salutary influence’. At the same time many people thought that some leaves, particular pine and balsam, are disinfectants, and this idea still lingers with the toilet cleaner industry. In America patients were encouraged to take holidays in areas of differing air; in England that air was brought to the patient by means of sanitary plantations around the hospital, the resinous smell of the trees contribution to the recovery of those within the building. In some cases the hospitals are on such poor soil that birch and conifers are the only sensible trees to plant, as at Ipswich Sanatorium.”
Issue number three of the Hospitals Investigator was produced by Robert Taylor in April 1992 and was largely devoted to the subject of isolation hospitals, and more particularly the model plans published by the Local Government Board from 1888 onwards. Just about all local authority isolation hospitals built after that adopted these plans.
This plan from the Wellcome Images collection of Bucknall Hospital is a typical example. Colin and I visited the hospital in May 1993, when it was still functioning under the NHS specialising in care for the elderly – a not uncommon re-use of former infectious diseases hospitals. It closed in 2012, and plans for housing on the site were in the pipe line in 2014, retaining just two of the hospital buildings.
Bucknhall Hospital was originally the Hanley, Stoke and Fenton Joint Infectious Diseases Hospital and the first five blocks were built in 1885-6. G. W. Bradford drew up the plans. One of the five blocks was a temporary ward block that was later demolished. Additions were made to the site from 1898, mostly carried out by Elijah Jones, architect to the Joint Hospitals Board. In the 1920s two cubicle isolation blocks were added. [see Historic England Archives file on the hospital ref NBR No.101124]
All the original blocks at Bucknall Hospital closely followed the model plans produced by the Local Government Board. Robert’s summary of the Board’s instructions and different types of plans issued follows:
The Local Government Board issued several memoranda to local authorities on the subject of arrangements for infectious diseases. The Board had the duty of persuading local authorities to make suitable provision, preferably by means o hospitals, but also gave or withheld sanction to raise loans for such purposes. This meant that plasm for proposed hospitals had to be approved by the Board if the building costs were to be raised by borrowing money The hospital plans contained in the Board’s memoranda were thereof important guides to local authorities wanting to building hospitals.
The first memorandum was issued in 1876 and was titled Memoranda for Local Arrangements relating to Infectious Disease; it related to hospitals and ambulances. It addresses itself to those authorities who have power to provide hospitals under section 131 of the Public Health Act of 1875, and begins by laying down several principles:
The sick should be separated from the healthy. this is especially important with the poor, living in crowded and ill-ventilated conditions
The accommodation must be ready beforehand
Patients with different infectious diseases cannot be kept in the same ward.
Villages should be able to accommodate about four patients in two separate rooms at small notice, and the memorandum, and all editions up to and including 1893 then describes the type of arrangement associated with ‘pest houses’. Tents or huts could be used to extend this basic accommodation if needed, but tents are not mentioned after 1888.
Towns need more accommodation more frequently, and there is greater likelihood that more than one disease will have to be treated. Consequently the minimum provision is two pairs of rooms, the size depending on the size of the town. Permanent building should ideally provide for more than the average requirements of the town, and should have space around for the erection of tents.
Several basic points regarding hospital planning are made:
The hospital should be reasonably accessible
Each patient to have 2,000 cubic feet of ward space and not less than 400 square feet of floor space
Thoroughly good ventilation
Security against foul air entering the ward
Means of warming the wards in winter and keeping them cool in summer
Safe disposal of excrement
In an epidemic it may be necessary to extend the hospital, by means of huts or, in summer, tents. The tents may be bell tents or Army Hospital Tents, with paved approaches and boarded floors. Regulation bell tents are said to be 14 feet in diameter, and regulation hospitals marquees 29 feet by 14 feet. Huts should be raised eighteen inches above ground level, and spaced not less than three times wall height apart. they should have ventilators along the length of the ridge.
There are plans of two types of hut. The first is arranged on one or both sides of a covered walkway, and consists of a hut with bathroom and kitchen next to the walkway, and a lower sanitary annexe at the outer end. these are arranged on either side of an administrative building, and resemble Emergency Medical Scheme hutted hospitals. The second contains two wards and a central nurses’ room etc in one hut, and a sanitary annexe at each end, generally resembling later simple ward blocks. There is also a detached kitchen.
The second memorandum, the first of several to be titled On the Provision of Isolation Accommodation by Local Sanitary Authorities, was dated March 1888. Although it is only an edited version of the earlier document, it reflects the experience gained since the Public Health Act of 1875. The principal change is in the plans of hospitals Both of the original plates are abandoned in favour of three new plates with four plans – A to D.
Local Government Board model plan A, 1888
Plan A is a small building for four patients, with two-storeyed nurses’ accommodation flanked by two single-storey wards reached independently by a verandah. There is a detached laundry and mortuary. The same plan was also published in the 1892 memorandum, but not thereafter.
Local Government Board model plan B, 1888-1892
Local Government Board model plan D, 1888
Plans B and D are of a completely new type of ward block, characterised by having the verandahs in front of the male and female wards facing opposite directions, and having the duty room recessed between two flanking wards. Plan B is a single range with all wards in line, while D has the larger end wards set at right-angles as cross-wings. Water closets and sinks are in detached blocks against the outer face of the verandahs. Plan B was included in the 1892 memorandum, but otherwise these distinctive plans were not published in the later editions.
An example of ‘Plan C’: Plan, elevations and section of proposed Cholera Hospital for the Couty Borough of Cardiff, Flat Holm Island, drawn up by the Borough Engineer M. Harpur. It appears to be stamped 1905, or perhaps 1906. Posted by J W Smith (Flat Holm Project Archives) licensed under CC BY 3.0
Plan C is of a rectangular block with two wards separated by an entrance lobby and a projecting duty room. At the outer ends of the wards are small projections with water closet and sink. This basic plan was repeated in all subsequent memoranda. In 1900 it is described as the most advantageous and convenient plan, and it is suggested that one ward could be larger than the other so that children could be included with women.
Local Government Board model plan C 1900-21 (top) and 1902-21 (below)
Local Government Board model plan C 1888-9
In 1902 and 1921 the plan was repeated along with an alternative arrangement, having two projecting single-bed wards flanking the duty room. In all of these later publications, the original plan letters were retained.
To the requirements of 2,000 cubic feet of air space and 144 square feet of floor space are added 12 linear feet of wall space for each bed, and also the necessity for a space of 40 feet between wards and hospital boundary. In 1892 a height of 6 feet 6 inches is given as the minimum height of the boundary fence, which should be a wall or close fence. In a note added in 1902 a hedge between barbed wire fencing is regarded as acceptable in ‘unfrequented situations’.
The special recommendations regarding isolation of smallpox hospitals first appears in the 1895 re-issue of the 1892 memorandum. Smallpox hospitals are forbidden where the site:
is within quarter of a mile of a hospital of any kind, workhouse or population of 150 to 200 people (200 people after 1900)
is within half a mile of a population of 500 to 600 people (600 people after 1900)
Gloucester smallpox epidemic, 1896: a ward in the Hempsted Isolation Hospital. Wellcome Library, London. Wellcome Images
An enlarged edition of the memorandum was published in 1900 and reprinted with minor changes in 1902, 1908 and 1921. It is emphasised that the hospital should be in readiness beforehand, and that it is for the protection of the pubic at large rather than the benefit of individuals, so that restrictive charges should not be imposed. The combination of authorities in sparsely populated districts is encouraged, provided that patients do not have to travel long distances. A proportion of one bed to each thousand inhabitants is mentioned as a rough but unreliable guide to size of hospital.
Although a site plan had been published in 1892 showing the three principal buildings and the 40 foot cordon around them, they were not defined and described until 1900. They are ward block, administration block and out-offices. A new site plan is published, appearing as plan A from 1900 onwards. Wooden and iron buildings are poorly insulated and difficult to maintain, and so unsuitable; the Board does not sanction loans for them.
The administration block should contain no patients, but accommodate the matron, nurses and servants, and have a single-storey kitchen. It may be an existing house, and should control the entrance to the hospital. It should also be larger than at first required. Ward blocks should be single-storey unless unavoidable, in which case each storey should have a separate entrance from the open air. Two types are described as being suitable for small hospitals; large hospitals may need other types. Plan C has been discussed above; a note added in 1902 says that the space in the centre over the duty room is sometimes used as a day room for convalescent patients.
Local Government Board model plan B 1900
Plan B is a new plan that underwent several changes. It is called Isolation Block on the site plan, and is described as useful under a variety of circumstances, such as keeping complicated cases under observation, for paying patients, and for extra diseases. The plan of 1900 is of a rectangular block with a recessed duty room between two small wards; there is a continuous verandah across one side, with a single detached toilet block opposite the duty room. An internal lobby protects the door of each ward.
Local Government Board model plan B 1902-21
In 1902 this plan is modified significantly. The duty room is made to project slightly, and the internal lobbies removed from the wards. More important, the toilet block is divided into two separate blocks, with an enclosed lobby linking them to the ward doors, and also separating the two end sections of the verandah. The sink room is only accessible from in front of the duty room.
Local Government Board model plan D 1908-21
A third plan D, was added in 1908 and repeated in 1921. It is called an observation block, and is said to be for single cases of a disease, or for mixed or doubtful cases. The lower provision of 1,400 cubic feet of air is justified on the grounds of efficient ventilation and the separation of individual patients. It consists of a rectangular block with two single-bed wards on each side of a central duty room. A glazed partition separates the pairs of wards. All rooms are reached from a continuous verandah, on the outer side of which is a single block containing water closet, sink and portable bath.
The space for each bed is repeated, wight he additional restriction that in calculating the 2,000 cubic feet any space above 13 feet from the floor should be ignored. One square foot of window to every 70 cubic feet of ward is regarded as suitable.
The out-offices as defined as laundry, disinfecting chamber, mortuary, and ambulance shed; boiler house and engine house are only needed in large hospitals. A discharging block is said to be provided in some hospitals.
Bibliography:
Memoranda for Local Arrangements relating to Infectious Diseases (December 1876), published in the Annual Report of the Medical Officer of the Local Government Board, PP 1882 XXX pt2, 503-7
On the Provision of Isolation Hospital Accommodation by Local Sanitary Authorities. (March 1888) published in the Annual Report of the Medical Officer of the Local Government Board, PP 1888 XLIX, 875-83
On the Provision of Isolation hospital Accommodation by Local Authorities (September 1892)
Memorandum on the Provision of Isolation hospital Accommodation by Local Authorities. (January 1895) published in the Annual Report of the Medical Officer of the Local Government Board, PP 1895 LI, 627-35
On the provision of Isolation Hospital Accommodation by Local Authorities. (August 1900)
On the provision of Isolation Hospital Accommodation by Local Authorities. (1902) published in the Annual Report of the Medical Officer of the Local Government Board, PP, 1912-13 XXXVI, 136-40
On the provision of Isolation Hospital Accommodation by Local Authorities. (1921)
The rest of Robert Taylor’s newsletter from July 1991 considered the richly varied topics of ridge lanterns, sanatoria, sewage works, pine trees, lunacy, and the grisly discovery of a body in a former hospital. I’m going to save the pine trees for a separate post, as I’d like to expand on the subject, (always leave the customers wanting more). For the rest, read on.
Ridge Lanterns
“At several hospitals there are buildings with rectangular lanterns on the ridge of the roof, giving light to the room below. These ought to have some diagnostic significance, but so far the Suffolk examples have given only rather vague guidance. The following uses have been noticed.”
(1) Laundries. Large examples, on big structures, usually close to the boiler house. Part of their function will have been to release steam and heat, but for that a normal louvred lantern was often adequate.
(2) Post-mortem rooms. These are relatively small examples, on small structures, and usually next to a mortuary… The function is to give top lighting to the dissection table. Curiously we have not yet observed them over an operating theatre. [see below]
(3) Store rooms. These are generally square or nearly square rooms, the equivalent of two storeys high, with racking or shelving inside on both ground floor and on a gallery defining a central light well. This well is lit by the lantern, as side windows would reduce the amount of shelf-space available, and so are generally absent. The only examples of this type of room so far seen appear to be of the twentieth century.
(4) Butcher’s shop. This is an unexpected building at the Suffolk County Asylum, dating from about 1902. Perhaps the top lighting is for similar reasons to that over a dissecting table. This stray example points to the fact that such top lighting is absent from all of the observed workshops at Suffolk workhouses and asylums.
Operating theatres at most hospitals did not have roof-ridge lanterns, but,for most of the 19th and early 20th centuries, large north-facing windows, with an element of top-lighting as they usually continued a little way into the roof.
Teaching hospitals, where there was a large operating theatre in which demonstrations could be made before students, or anatomy theatres, were sometimes lit by a roof lantern, such as William Adam’s Royal Infirmary at Edinburgh. A surviving example that has become a museum served the original St Thomas’s Hospital (before it moved to its present site opposite the House of Commons to make way for the expanding railways at Southwark) http://www.thegarret.org.uk.
Sanatoria
“Amongst the Blue Books [Parliamentary Papers] is a Supplement in Continuation of the Report of the Medical Officer for 1905-6 on Sanatoria for Consumption and Certain other Aspects of the Tuberculosis Question(1907.XXVII). Part Two of this breathtakingly-titled work is a survey of public sanatoria, with some illustrations. The following list gives the page number, and also the date of foundation. Those marked with a * have a published plan.”
265 Jewish Sanatorium, Daneswood 1903 274 London Open Air, Pinewood 1901 275 Manchester Sanatorium, Bowden 1885 277 Heswall Sanatorium 1902 343 Delamere Forest 1901 348 Crossley Sanatorium * 1905 358 Blencathra Sanatorium 1904 373 Durham County Sanatorium 1901 394 Benenden Sanatorium 1907 404 East Cliff, Margate 1898 405 Royal Sea Bathing Hospital, Margate 1791 409 Victoria Home for Invalid Children, Margate 1892 409 Clayton Vale Smallpox Hospital, Manchester n.d. 410 Liverpool Hospital for Consumption 1863 412 Moor End, Sheffield n.d. 447 Barrasford Sanatorium * 1907 450 Nottingham Sanatorium 1901 465 Brompton Hospital Sanatorium, Heatherside * 1904 474 Eversfield Hospital, St Leonards 1884 475 Fairlight Hall Convalescent Home, Hastings n.d. 476 King Edward VII Sanatorium, Midhurst * 1906 484 Millfield 1904 490 Westmorland Sanatorium 1900 524 Knightwick, Worcs. 1902 530 Skipton * 1903 540 Leeds 1901 543 Armley House n.d. 544 Hull and East Riding 1902
This report of some 800-plus-pages not only has plans, but photographs, including interiors, and line drawings. As a group these sanatoria are some of the most attractive hospital buildings. One of the best known, the King Edward VII Sanatorium at Midhurst in West Sussex, designed by Adams, Holden and Pearson and with Gertrude Jekyll gardens, was fairly recently converted into luxury apartments. The chapel there is a cracker.
Another sanatorium with a great chapel and fine main building is at Northwood, Middlesex (in Hillingdon Borough, Greater London), part of Mount Vernon Hospital. The main building is on the Heritage at Risk Register. It was built as the country branch of the original hospital in Hampstead.
Sewage Works
“There is a strange association between isolation hospitals and sewage works. It is not common, but frequent enough to be noticeable. Both share the ‘not in my back yard’ approach to siting and so are usually near the edge of the parish or, better still in the next parish. A splendid example of this is Peterborough, with a cluster of two isolation hospitals and a sewage works just over the border in the next county. Some time before 1898 the Aldershot Urban District Council built a galvanised iron smallpox hospital at the sewage farm, and by the end of the century had put a sewage workman in the building. Clearly smallpox presented less of a threat to human life than the sewage. In 1906 at Sheerness there was an interchange of buildings between the two types of institution, with the implication that the hospital was of less importance.”
Thorn Hill isolation hospital was in an enviable location, near the military cemetery and the gasworks, also handy for the railway, and that’s the edge of Mandora Barracks on the left. The quadrangular range of buildings just above ‘Round Hill’ formed an Army supply depot. This, the cemetery, barracks and government gas works all pre-dated the hospital.
Lunacy
“In the Suffolk Record Office at Ipswich is preserved from 1889 a sheet of paper from the archives of the County Asylum described succinctly in the catalogue as ‘Chart of daily rainfall and epidemic cases to show connections between monthly rainfall and cases of lunacy’.[ID407/B18/1] The idea that rainfall has a determining effect on madness has serious implications for our project. Should Cumbria have more or fewer lunatic asylums than rain-starved Cambridgeshire? Have the geographers missed something of crucial importance about the climate of Middlesex and the Home Counties? Perhaps our project will be able to make a valuable contribution to knowledge.”
Despite the well-known depressing effect of a grey and rainy day, and conversely the uplifting effect of sunshine, we never ‘did the math’ to see if there were higher numbers of certified insane per population in Cumbria than Cambridgeshire. The mere sight of some of the grimmer asylum buildings in the rain or otherwise would be enough to sink the spirits of even the most stout hearted, especially some of the earlier more prison-like institutions, such as Hanwell.
Hanwell was designed by William Alderson in 1828 as the Middlesex County Asylum, with accommodation for 300 patients. The hospital later became the St Bernard’s Wing of Ealing Hospital. It can be seen from the canal and from the railway line heading out from Paddington. That towering gateway seems particularly oppressive, it was added in 1839.
“The Cambridge Evening News has at last caught up with the nefarious activities of Harriet and Colin. Under the above heading the newspaper reported on 18 July: ‘Police have launched a murder enquiry after finding the body of a man hidden beneath the floor of a disused London hospital, Scotland Yard said today… It was hidden under an aluminium air conditioning duct in a tiled cavity below a trap door in the Belgrave Hospital, Clapham Road, Kennington. A man and a woman each made anonymous calls alerting the police to the body. Det Supt John Bassett, leading the inquiry, issued an appeal for them to come forward.’
I must clarify, that it was not the London team that discovered the body at the Belgrave Hospital. Because of its condition at the time, we didn’t get access to the building at all, which was a great shame. I think it is one of the finest hospitals, architecturally, of the late-nineteenth and early twentieth centuries. It was designed by Charles Holden and begun in 1899.
In July 1991 Robert Taylor produced the second edition of The Hospitals Investigator, the newsletter he wrote and circulated to his five colleagues working on the RCHME survey of historic hospital buildings. Here he pondered Pest Houses, discussed deposited plans, and thought about (operating) theatres. In part 2b I will relay his discussion of ridge lanterns, sanatoria, and sewage works – we really knew how to enjoy ourselves.
Pest Houses
“Pest houses have been emerging from the Suffolk countryside at an alarming rate. The name indicates a house, usually an ordinary farm house, which was used by the local authority as an isolation hospital in the event of an outbreak of infectious disease, usually smallpox but in some early cases the plague as well. Details of the arrangements must have varied, but it seems that the tenant had an obligation to either nurse the victims or to move elsewhere for the duration of the sickness. The latter was perhaps the more common practice in the seventeenth century. The possibility of such an arrangement was taken for granted in the 1875 Public Health Act, although the Local Government Board did not like ad hoc hospitals very much and put pressure on local authorities to provide specialised buildings. A very few pest houses remained in use in the first years of this century.”
“So far the Cambridge office has seen only three surviving pest houses, at Halesworth, Framlingham and Bury St Edmunds. The first was a standard three-cell two-storey farmhouse of the late seventeenth century, and remained the centre of a working farm until the land was sold away recently. That at Framlinhgam was an early seventeenth century two-cell house with central stack, and similarly showed no sign of specialised planning. Although reputedly built in 1665, the Bury pesthouse displayed nothing earlier than the eighteenth century, and was a three-cell, single-storey house with internal stack. Other pest houses remain to be located at Eye, Nayland and Huntingdon, as well as a few less certain cases.”
I couldn’t find any photographs of these particular pest houses, though there will be photos taken by Robert and Kathryn in the relevant files in Historic England Archives. Here is a much smaller version in Hampshire at Odiham, where presumably, a small population did not require anything bigger.
The Patrick Stead Hospital continues to function as a community hospital, and was designed as a cottage hospital by Henry Hall. It opened in 1882.
Above is a postcard showing the hospital, and below an elevation and plans produced in The Builder in 1880. Originally it provided a dispensary, outpatients’ clinic and accident ward, all on the ground floor, with further wards above. Patrick Stead set up a maltings business in Halesworth, and bequeathed a generous £26,000 to establish the hospital. Deposited Plans
“Recently one of us was reading a letter written by an official of the Ministry of Health in 1926 when it suddenly became clear that the writer of the letter had in front of him a set of plans for an isolation hospital that had been sent to the Local Government Board in 1888 in connection with an application for sanction to raise a loan. Plans of isolation hospitals were deposited when an authority applied for permission to borrow money for hospital building, and also when the more responsible authorities voluntarily sought approval of their proposed hospital. The Local Government Board was replaced by the Ministry of Health, whose archive should contain these immeasurable riches, along with similar material for workhouses. Unfortunately most of the material dating from after about 1902 was lost in the blitz, and what survived that seems to have been mostly destroyed in a fire in Brighton. All that survives is at [the National Archives, at] Kew, hidden behind the catalogue code MH. The three main groups seem to be MH.12, MH.14 and MH.34.”
“MH.12 consists of Poor Law Union Papers, of which 16,741 bound volumes, arranged under Unions, survive from between 1834 and 1900… MH.14 is called Poor Law Union Plans, and there are 38 boxes of them dating from between 1861 and 1900. They have reference numbers linking them to MH.12… MH.34 is a register in 11 volumes of authorisations on workhouse expenditure between 1834 and 1902.”
Reading this today, it is a reminder of how much researchers now gain from online digitised archive catalogues, and perhaps a lesson not to grumble about them (as I frequently do) when we can’t find what we’re looking for, they crash, they change, or they assault ones aesthetic sensibilities.
“One of the problems met in small hospitals is the identification of the jumble of buildings behind the main block. As in a mediaeval house the identification of the hall acts as a key to understanding, or at least knowing the rough layout of, the entire house, so one might expect that the operating theatre might stand out and give some help in finding a way through the maze. Unfortunately this does not always happen. Plenty of light was necessary, so a roof light is an important indicator. A large North-facing window is another but less reliable sign, and far too often the windows appear to be ordinary ones, the lower parts filled with obscured glass, as at Southwold. At Felixstowe the theatre has a semi-octagonal North end, like a sitting room, with ordinary-sized windows that are now blocked. The Beccles Hospital of 1924 has a magnificent but sadly un-photographable theatre with a North wall and roof of glass. Sometimes it is possible, if we are very tall or can manage to balance on tip-toe or on a convenient upturned bucket, to glimpse through the windows the white-tiled walls, or even the upper parts of lighting equipment.”
Back in 1991 a National Survey was commenced by the Royal Commission on the Historic Monuments of England to record English hospital buildings. It was undertaken by six men and women in three offices (in London, Cambridge and York). Robert Taylor, in the Cambridge office, produced a regular newsletter over the next three years, which thankfully, I have kept. The first instalment, produced in May 1991, explained that its purpose was to allow for the exchange of ideas and information that would normally take place over coffee. ‘Some form of communication seems needed which allows these ideas and observations to be collected and disseminated without taking up time, and the new technology of the word processor seems to give one answer’, he wrote. I wonder if he might have written a blog had we been starting the project now? It is frightening to think how much technology has changed the way we work in such a short time.
Here is the content of issue 1, with a few additional notes on the sites mentioned.
Expedition
A joint expedition of the York and Cambridge offices had been made to the Stour Valley visiting seven sites. At the time they thought that they had only managed six, but the following day discovered that Sudbury Workhouse, which they visited, was on the site of an 18th Century Pest House, which counted as a separate isolation hospital. It was demolished in 1836, so they would not have found any trace of it even if they had looked.
(Sudbury Union Workhouse later became Walnut Tree Hospital. A report, written in the early 1990s by either Robert or Kathryn Morrison, the other member of the Cambridge team, together with photographs, maps and research notes, were deposited in the National Monuments Record, now Historic England Archives, at Swindon, ref NBR 1000073. There is more information on the Sudbury Workhouse here http://www.workhouses.org.uk/Sudbury/ This aerial photograph taken in 1929 shows the workhouse with St Gregory’s Church behind.)
The Matron’s Dog
On 8 June 1926 the Board of the Newmarket and Moulton Joint Hospital “considered a complaint received from Mr G. S. Fuller of 9 Powells Row, Burwell, to the effect that his son who had been an inmate of the Hospital was bitten by the Matron’s dog in the hospital on the 21st march last.” The matron declared that neither she nor her staff knew of any such incident, and the Board duly asked the secretary to tell Mr. Fuller that he was mistaken. [Bury St Edmunds Record Office, ID 504/2, 369]
The amazing thing is not that a patient was or was not bitten, but that nobody questioned the possibility that a dog was loose in the wards. The staff response implied that if Master Fuller had indeed been bitten (which they doubted), then it was not by the Matron’s dog but by another unknown animal for which they accepted no responsibility. Perhaps the people of Exning, the parish in which the hospital was built, brought their dogs with them when they exercised the right to unrestricted visiting that they claimed, to the exasperation of the hospital’s staff. The Matron lived in a cottage in a corner of the hospitals enclosure, and does not appear to have had a separate garden.
(Newmarket Isolation Hospital was built in the late 1880s, and had an additional ward block added, probably for TB patients, in about the 1920s. This later ward block, along with the lodge and nurses home survive at the site, which was redeveloped as Beech House Hospital, a low secure unit for men with mental health disorders. The site report from the early 1990s, photographs and research notes, can be found at Historic England Archives, Swindon ref NBR 1000055)
Construction Delayed
The announcement of a proposal to build a ward or hospitals should always be regarded with extreme caution, as indicative of nothing more than an idea. An opening ceremony is the only reliable evidence that a building was actually started, for even the award of a contract can prove to be insecure evidence.
Both World Wars led to building works being abandoned either before or after commencement. Several cases of contracts being awarded before 1915 according to The Builder, and then being re-advertised some time after 1918 in exactly the same wording suggest that only the later contract should be regarded as indicating building work. A major war was not the only cause of delay, however. Municipal indecision, or criminal unwillingness to spend money, was another cause. Norwich Corporation was ready to build a Lunatic Asylum in 1866, with plans prepared and a site bought. Some researchers appear to have assumed that they went ahead immediately, but in fact they did not move until 1874, after the Secretary of State had taken mandamus proceedings against the corporation in order to force them into activity.
(The Norwich City Asylum changed its name to Hellesdon Hospital. It was designed by R. M. Phipson. An handsome admission hospital was added in 1934-6, designed by W. H. Town, single-storeyed with abundant verandas – though this block may have demolished. Research file and photographs at Historic England Archives, ref NBR 100570)
Addresses
Considerable difficulties were experienced when trying to locate the Sudbury Isolation Hospital. Kelly gave a clear address in Friar Street, but when we looked at a map of the town it proved to be a corner house on one of the main streets. This was quite implausible as a site for an isolation hospital, especially as there was not even room in the garden for another building. Further research showed that this was the private house of the Medical Officer of the Corporation. Following another clue, the hospital was eventually located in a chalk pit on the outskirts of the town, a far more logical position. This sort of problem almost certainly accounts for the similarly ridiculous and otherwise unknown hospital on Newmarket Hight Street, which seems to be in reality the office address of the Secretary to the Joint Hospital Board.
Mortuaries
Mortuaries were found to come in various shapes and sizes, and were not immediately obvious. ‘That at Lothingland Workhouse was an ordinary single-storey outbuilding’. In 1991 it was in use as the Caterer’s Store. For the most part mortuaries were detached buildings, although some model plans suggested combining them with the laundry. ‘Some have a wide entrance with double doors, but again some do not. Some are oriented, even given a chapel-like appearance with gothicky details, but again many are just storerooms. One had visible drains in excess of what might otherwise be expected, but that hardly seemed diagnostic.’
Stuffing
In 1879 the new Lunatic Asylum at Portsmouth was opened, and in the following year the Commissioners in Lunacy made their first annual inspection. They were pleased with what they saw and appear to have liked the beer that was brewed at the Asylum. They made a few suggestions for improvement, one of which was that there should be an upholsterers’ shop on the premises, worked by the inmates. The reason was not that this was currently fashionable occupational therapy, but that it was the cheapest way of maintaining the condition of the Asylum’s mattresses. [PP 1881 XLVIII, 365]
(The Portsmouth asylum became St James’s Hospital, which closed in the 1990s. The early 1990s report, photographs etc written by the Cambridge team, is in the Historic England Archives, reference NBR 100167. There is also a history with photographs here http://www.thinkingahead.org.uk/history/building.htm )
Early Retirement
‘Of all the assorted almshouses that have emerged so far during the project, perhaps the most inviting so far is the Friendly Female Almshouse at Chumleigh.’
(These are those almshouses, though in fact at Chumleigh Street, in Camberwell. They were founded in 1819. Some of the buildings on the site were destroyed during the Second World War, the remainder now form Chumleigh Gardens, which house a café and meeting room.)
Via twitter, an article caught my eye that appeared in The Telegraph on the former Plymouth Borough Asylum, latterly Moorhaven Hospital and now a housing estate called Moorhaven Village.
The hospital closed in 1992, ninety-nine years after it had first opened to receive patients. It was sold in 1994 and some four years 120 homes had been created from the old buildings. The project was praised by SAVE Britain’s Heritage as a model of property enterprise and preservation. Jonathan Mathys and Andrea Peacock carried out the development, having already converted a convent and an abbey. They were guided by different principles from most commercial building developers, aiming to save and restore the historic fabric and create desirable homes. The central range of the hospital was turned into terraced housing, and the water tower has become a detached house, with one room per floor, the bedrooms occupying the lower floors and the reception rooms the upper floors, making the most of the views.
The conversion stands out amongst many former asylum site redevelopments where the original buildings have been less respectfully dealt with, if not entirely demolished. Somerset County Asylum, later Tone Vale Hospital, in Taunton, for example, was largely demolished to make way for the housing development there in 1995, while St Lawrence’s in Bodmin was pulled down in 2014.
A competition was held for the design in 1886, and it was the local firm of J. Hine and Odgers, placed third in the competition, that was given the commission (their design was the least costly). James Hine was the cousin of George Hine, one of the most prolific asylum designers in England.
Above is the plan of the asylum published in 1890
Plymouth Borough Asylum was built in 1888-91, initially for 200 patients, later expanded to twice that number. It is a good example of a small echelon-plan asylum, where the patients’ accommodation was arranged in an arrow or echelon formation, here in a flattened form. The random rubble walls make it rather more attractive than some of the plain brick versions built around this time.
In 1901 Hine and Odgers were recalled to design extensions including a new wing on the male side, commenced in 1903, a second storey on each side, an isolation hospital and an extension to the administrative section. The British Architect reported in June 1906 that recent additions and improvements had quite altered the appearance of the institution. This may have been because the additions were of brick rather than stone – constructed with hollow walls, Pinhoe bricks were used for the facings. Two wards were added to either side of the main block providing additional accommodation for 110 females and 90 males. Each ward contained associated dormitories, day rooms, single rooms, attendants rooms, store rooms ward scullery and larder with bathrooms, lavatory and sanitary arrangements separated from the main buildings by cross-ventilated lobbies.
Later alterations on the site included, in 1912, additions to the farm buildings, TB shelters in the early 1920s, a nurses home, designed by J. Wibberley in 1929, and an admission hospital c.1932, also by Wibberley. In 1936 two detached villas for convalescent patients were built and a house for the medical superintendent.
Sources and further reading: Historic England Archives, file NBR No. 100330: Bridget Franklyn ‘Monument to madness the rehabilitation of the Victorian Lunatic Asylum’ in the Journal of architectural Conservation Nov 2002, pp.24-39: http://www.moorhaven.org.uk/History/history.htm
