Building Bedlam again – taking a leap forward to Monks Orchard

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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.

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Greenwood’s map of 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.

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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.

Asylum_for_Criminal_Lunatics,_BroadmoorBroadmoor 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]

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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.

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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.

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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.

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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.

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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]

geograph-2315257-by-Nigel-Cox-2Rydinghurst 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.

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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.

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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.

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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]

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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

  1. 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
  2. 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
  3. H. Richardson ‘Charles Ernest Elcock’ in Essays in Scots and English Architectural History, 2009, p.122
  4. Bethlem Royal Hospital Archives, Special Commitee Minutes, 1928 pp. 194, 196-7, 291
  5. Bethlem Royal Hospital Archives, Special Commitee Minutes, 1926-7, p.34
  6. Jonathan Andrews et al, History of Bethlem, p.566

The Ducker House, American prefab of the 1880s

While hunting for Doecker portable hospital buildings I came across its American counterpart, including an illustrated catalogue advertising their wares published in or after 1888. Ducker 23 Founded by William M. Ducker of Brooklyn, New York, U.S.A. who had patented his invention, the Ducker Portable House company had offices in New York and London. The catalogue showed a variety of uses for their buildings, ranging from the utilitarian hospital hut to more elaborate garden buildings. Ease of transportation was also emphasised. Ducker 22 Here one of their portable buildings is neatly packed onto a horse-drawn wagon. While below the image shows the mode of transporting a Ducker building in mountainous countries. Ducker 2 The buildings were ‘light, durable, well ventilated, warm in winter, cool in summer, healthful and cheap’. From reading the description of the buildings they seem to be almost indistinguishable from the Danish Doecker system, the components being wooden frames, hinged together, and covered with a special waterproof fibre. The same claims are made for both that they could be assembled without skilled labour. Ducker 4This example was said to be at Wellington Barracks in London. Another was erected in Blackpool; Henry Welsh, the local Medical Officer of Health, noted in August 1888 that the recently erected building ‘gives great satisfaction, and answers its purposes admirably’. The cost of this model was given as $600. The German War Department bought one, and they had been adopted by the United States Naval and Marine Hospital Service, and several Departments of Charities and Correction. In 1885 the Red Cross Society had organised an exhibition in Antwerp of portable hospitals at which the Ducker buildings (and Doecker prefabs) had been shown. Ducker’s was awarded a special medal by the Empress of Germany and, so it was claimed, garnered the ‘warmest encomiums from civil and military surgeons, engineers, architects and philanthropists from all parts of the civilised world’. Ducker 3 Wards are suitably Spartan, the interior here measured 18 x 34 ft. The Department of Public Charities and Correction, Randall’s Island Hospital erected a Ducker house. Of the many pest houses, generally for smallpox cases, erected in America, it seems likely that if they were not actually Ducker houses, they were of a similar design, as is suggested by an early photograph of a pest house put up at Storm Lake, Iowa, photographed in 1899 (see University of Iowa libraries)
Ducker 5 Temporary buildings were widely used at large construction sites to house migrant workers. Above is an administrative building, suitable for ‘Contractors and Construction Companies’ or for a private residence. It comprised a main building 16 x 30 ft and a separate kitchen and store-room connected by a covered passage. ducker 9 The workforce would be accommodated in huts such as this one. ducker 10 This is its interior, with simple iron bunk beads, it put me in mind of the description of the bunk house in Of Mice and Men. These huts were bigger than the hospital buildings, at 30 x 30 ft, and cost just over twice as much at $1,250. ducker 7 Versatility was key to healthy sales figures, so the catalogue demonstrates a variety of different uses for the Ducker portable building. Sports pavilions were an obvious use; above an athletic and bicycle hall, others illustrated were a racing stable, a boat house and a bowling alley. A photographer’s studio could be constructed for just $375, or a billiard room for $400 (billiard table not included). ‘The attention of hotel men is called to the fact that for annexes to hotels, to be used for sleeping apartments during the rush of midsummer, these building just exactly answer the purpose’. Ducker 14 For the domestic market there was a range of summer cottages (above), lawn pavilions (below) Ducker 13and camping houses. Ducker 12 The Norton Camp House could have been yours for $150 (and upward), measuring a cosy 9 x 12 feet and weighing 450 pounds. It could accommodate four people, and opened out on all sides. Camping was not necessarily a leisure pursuit, and this camp hut was also touted for cattle ranchmen, miners, prospectors, surveyors and contractors. If you were on vacation, however,  you might have considered a bathing house. Ducker 11‘The portability of these buildings make them simply invaluable… At the end of the season they can be taken down and stored until the opening of another season. They can be constructed in any form or style desired and can be made to comfortably accommodate more people than any other building known’. Ducker 15 The Lawn pavilions were the most decorative, being intended for ornament as well as usefulness, aimed at owners of large summer residences. ‘They are constructed in decidedly artistic style.’ Ducker 16 ‘and will be found useful and delightful for ladies’ sewing, reading and painting rooms, children’s play rooms, tea and lunch rooms, tennis purposes, and sleeping rooms as well if required’ Ducker 17 If you didn’t run to summer residence with large grounds in need of a lawn pavilion, then don’t worry, you could have an entire summer cottage or camping cottage. The latter pretty much the same as the hospital huts, but the former comprised the most ornate in the Ducker range. Ducker 18 This example seems to be giving a stylistic nod towards a Chinese pagoda or an Indian bungalow. As I am heading to Fife in Scotland later in the summer, I was particularly tickled to read the testimonial on the back cover of the catalogue which was furnished by one George C. Cheape, of Wellfield house, Strathmiglo in Fife, master of the Linlithgow and Stirlingshire hounds.  ‘No country house should be without one’  he wrote: ‘It was put up in one day by the village joiner and my gamekeeper.’ He continued to effuse about the merits of the building:  ‘In wet weather the children quite live in it, and play all day. I have gymnastic apparatus put up in it, swings, etc; the consequence is a quiet house, whilst the children are enjoying healthy exercise and games to their heart’s content, where they disturb no one, and their tea-parties in the Ducker House are enjoyed by all.’ Cheape was a Captain in the 11th Hussars, Justice of the Peace and Deputy Lieutenant of Fife. He was also widely travelled, had served in India, and had visited America on three occasions, having business interests in Texas, Colorado, Arizona and California. While in America he also travelled to Canada and Mexico, and worked to promote the interests of the International Company of Mexico, of which he was a shareholder. Sources: The catalogue for Ducker Portable House Co. can be found online from archive.org, information on George Cheape was from the census, marriage records, passenger lists etc and there is a brief biography in David Pinera Ramirez, American and English Influence on the Early Development of Ensenada, Baja California, Mexico, 1995 pp.99-100

Marianbad

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I bought this postcard on ebay the other week, and ever since have been footling about on the internet trying to find out something of the buildings shown here. Marianbad, or Mariánské Lázně, is in the Czech Republic, and was a fashionable spa town in the late nineteenth century and early twentieth – frequented by Edward VII (who opened the town’s first golf course in 1905) and many of his relatives, as well as wealthy Americans.

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from The Washington Post, 18 August 1907, p.11

Amongst the exuberant Rococo hotels and buildings where the health-giving waters could be taken,  there were numerous churches catering for the many visitors of different faiths. Amongst these an Anglican church was designed by William Burges and built in 1879. It was there that after the death of Edward VII a memorial was to be placed, designed by William Lethaby.Marianske_Lazne_CZ_Anglican_church

Marianske Lazne CZ Anglican church, by Jim Linwood (Anglikansky Kostel), Marianske Lazne (Marienbad), Czech Republic. Licensed under CC BY 2.0 

It is rather small. But recognisably British, and Burges. I haven’t discovered whether or not the memorial was made and is there. The church was founded by Lady Anna Scott in memory of her husband who died at Marinaded in 1867. The church is now a concert hall.

After the Second World War most of the native German inhabitants were forced to leave, under the terms of the Potsdam agreement. After 1989 many of the buildings were restored and it has once again become a popular tourist destination.  In its heyday it was visited by Goethe, Chopin, Wagner, and Thomas Edison, as well as Prince Friedrich of Saxony, Czar Nicholas II and Emperor Franz Joseph I.

The postcard identifies the buildings as the Sanatorium Kavkaz, (or Maison Balneaire) and seems to date from the 1950s or 60s. More research is required to find out about the architects, and landscape designers (the landscaping was an important aspect of the town) who worked here. Any information would be most gratefully received.