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.

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.

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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

Building Bedlam – Bethlem Royal Hospital’s early incarnations

From City fringe to St George’s Fields

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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.

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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]

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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.

V0013179 The Hospital of Bethlem [Bedlam] at Moorfields, London: seenThe 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]

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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.

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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.

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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: seenBethlem Hospital from the south, showing the small high windows that lit the inmates’ cells. This view also shows 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. Wellcome Library, London. Reproduced under Creative Commons Attribution only licence CC 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]

V0013682 Aske's Hospital, Shoreditch, London: a bird's-eye view of thAske’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.

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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]

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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]

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Imperial War Museum, photographed January 2014

References

  1. 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
  2. The History of Bethlem, p.76, quote from Christ’s Hospital minute books
  3. ibid, p.248 quote from Bethlem Court of Governors Minutes
  4. Thomas Bowen, An Historical Account of the Rise, Progress and Present State of Behtlem Hospital, London, 1783 p. 5n, see also Christine Stevenson’s article (below) p.256
  5. Christine Stevenson ‘Robert Hooke’s Bethlem’ in Journal of the Society of Architectural Historians, vol.55, no.3 (1996), p.257
  6. Christine Stevenson ‘Robert Hooke’s Bethlem’ in Journal of the Society of Architectural Historians, vol.55 no.3 (1996), pp.254-275
  7. 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)
  8. ibid, p.80