Bristol Royal Infirmary

‘A Perspective View and Plans of the Charitable Infirmary at Bristol as it now is with the addition of two intended wings’ 1742. Image reproduced under licence CC BY 4.0 from the Wellcome Collection

The old Royal Infirmary at Bristol was one of the first to be founded in England outside London. Subscriptions began to be made in November 1736 and the present site was acquired shortly afterwards. The first patients were admitted the following year. It was not until 1782 that the decision to provide a new, purpose-built infirmary was taken. Thomas Paty, a local architect, drew up the plans and building proceeded in three phases. The east wing was erected first between 1784 and 1786. The central block was put up in 1788-92 and the west wing added in 1806-10. It was a large and impressive building of three storeys and basement, to which an attic storey was added later.

Early photograph of the main front, probably early 20th century. From Paul Townsend flickr site. Reproduced under Creative Commons License CC BY-NC-SA 2.0

A chapel with a museum underneath was added in 1858, an unusual combination. In 1911-12 the King Edward VII wing was built to designs by H. Percy Adams and Charles Holden in a stylish, stripped classical style which looks forward to inter-war modernism. In 2017 the original part of the hospital was empty, boarded up and under threat of demolition.

The Royal Infirmary, Bristol, from the 2nd-edition OS 25-inch map revised in 1901. Reproduced by permission of the National Library of Scotland

In November 1736 a subscription was opened for erecting ‘an infirmary in the City of Bristol for the relief of such persons as should be judged proper objects of a Charity of that kind’. [1] A site in Maudlin Lane was acquired which contained various buildings, including tenements, a warehouse and some waste ground. The existing buildings were adapted and a ward built and furnished. Out-patients were admitted to the infirmary from June 1737 and the first in-patients were admitted at the formal opening in December of that year. Initially there were 34 patients, with an equal number of men and women. As one of the first hospitals to be founded in England outside London, the Bristol Infirmary has some claim to historic importance. It vies with Addenbrooke’s Hospital in Cambridge, founded in 1719 although not built until 1740, and Winchester Infirmary, established in 1736.

This view shows the south front of the infirmary as it appeared  in 1765. Public Domain image.

Within a year or so of the infirmary’s opening, plans were made to extend the building by two new wings extending from the south front. The first wing, to the south east, was completed in 1740, the south-west wing had been added by 1750. As well as being able to take in more patients, the infirmary had two cellars – one let to a tenant, the other used for preserving meat – a cold bath, rooms for the apothecary and his apprentices, and in the garrets, along with linen rooms and staff bedrooms, were wards for patients being ‘cut for the stone’. A colonnade was formed along the south front for convalescent patients.

View of the new front, from Munro Smith’s History of The Bristol Royal Infirmary published in 1917. From the Wellcome Collection, CC BY 4.0

A few additions were made over the next decades, but by the 1780s conditions were poor. The infirmary was always overcrowded, wards were ill-ventilated and infectious diseases frequently claimed the lives of patients and staff. In 1782 it was at last decided that a new building would have to be provided. Some attempt was made to establish the new building on a new site but this was eventually rejected by the Building Committee. Plans were drawn up by Thomas Paty, a local architect, for a U-shaped hospital with the main entrance on the north side facing Marlborough Street. Work was carried on in three stages, one wing at a time. The first to be built was the East Wing, in 1784-6, followed by the central block in 1788-92 and the West Wing, completing the original scheme, was added in 1806-10. Financial difficulties had prompted the managers of the infirmary to build piecemeal, but circumstances were so straitened in 1811 that it was not possible to admit any patients to the newly completed wing. When it finally opened some three years later the infirmary provided a total of 180 beds.

The north front of Bristol Royal Infirmary, photographed in 1993 © H. Richardson

In 1858 plans were drawn up for the addition of a chapel and museum to the infirmary. The museum was to house a collection of specimens which had been presented to the infirmary by Richard Smith. The two were neatly accommodated in one building on the east side of the infirmary, the museum was at ground floor level and the chapel built over it. Work was completed and the building opened in 1860.

The chapel with its tall lancet windows with the museum on the floor below,  photographed in 1993 © H. Richardson

The chapel abuts Whitson Street to the east. Constructed of rubble masonry with ashlar dressings, it is a simple five-bay rectangle without a break for chancel or transepts. The windows are  lancets with cusped heads and plate tracery for the east end. The eaves course is ornamented by a corbel table. The interior is quite plain, but has a good stained glass window depicting Joshua and one of Saint Elizabeth.

Chapel interior, photographed in 1993 © H. Richardson

Various additions were made during the nineteenth century. An out-patients’ department was established which underwent many alterations over the century. In 1866 the west wing was extended and two new wards created. By the turn of the century a nurses’ home had been built on high ground to the west of the hospital on Terrell Street. The largest addition to the infirmary before the advent of the National Health Service was the King Edward VII Memorial Building, situated on the opposite side of Marlborough Street, erected in 1911-12. It was designed by H. Percy Adams and Charles Holden to provide new surgical wards and it was largely through the efforts of Sir George White, the president and Treasurer of the Infirmary since 1904, that it was carried out. White made his fortune working at the Stock Exchange before setting himself up in business. He developed the Bristol Tramways Company and established the Bristol Colonial Aeroplane Company in 1910. He worked hard to clear the infirmary from debt and raise sufficient funds to improve the accommodation.

Postcard showing the new wing, with the original hospital on the right  © H. Martin

A competition was held in 1908 for an extension scheme which comprised the remodelling of the old infirmary building, adding a new ward pavilion with 75 beds, a new casualty and out-patients’ department, and an isolation building with 24 beds for sceptic and infectious cases. [Allibone, J. Adams, Holden Pearson catalogue of plans in RIBA] The competition was assessed by Edwin T. Hall, and twelve firms of architects were invited to take part, amongst whom were the foremost hospital architects of the day. Apart from H. Percy Adams they were: Thomas W. Aldwinckle, W. A. Pite, J. W. Simpson, A. Saxon Snell, Alfred Hessell Tiltman, Young & Hall, all based in London; Arthur Marshall from Nottingham; Everard, Son & Pick from Leicester; Henman & Cooper, from Birmingham; T. Worthington & Son, of Manchester and E. Kirby & Sons of Liverpool. [Building News, 31 July 1908, p. 168]

South front of the King Edward VII Memorial Wing,  photographed in 1993 © H. Richardson

The site itself was awkward, being bisected by Marlborough Street which became Upper Maudlin Street at the corner with Lower Maudlin Street. The winning design by Adams and Holden comprised a large new out-patients’ block with a central waiting hall, situated nearly opposite the old infirmary building, and adjacent to it a ward pavilion, alongside which further extensions could be erected. Behind the ward pavilion was the isolation block. The plans submitted by A. H. Tiltman, which were also published at the time, are notable for comprising circular ward towers.

This detail of the postcard shows patients on the balconies at the ends of the ward wings.

Insufficient funds led to the plans being modified. It was also decided to delay the building of the new out-patients’ block until more money was available. The foundation stone was laid on 14 March 1911 and the new building formally opened by King George V and Queen Mary on 28 June 1912. The nurses’ home was extended at the same time, this pushed the total cost up to £137,000 and left the infirmary with a debt of over £12,000.

The opening of the King Edward VII Memorial Wing. Image from Paul Townsend’s Flickr site, reproduced under Creative Commons CC  BY-NC-SA 2.0

Following the outbreak of the First World War, just two years after the new wing opened,  the Memorial Building was handed over to the military authorities and, along with Southmead Hospital, it became known as the Second Southern General War Hospital (C. Bruce Perry, The Bristol Royal Infirmary 1904-1974, 1980, p.27).

Postcard showing the interior of  King George’s Ward, probably in the King Edward VII Memorial wing. Image from Paul Townsend’s Flickr site, reproduced under Creative Commons CC  BY-NC-SA 2.0

Lack of money continued to darken the administration of the infirmary. After the War costs continued to rise and income diminish. In 1921 over one hundred beds were closed at the infirmary through a shortage of funds and two years later a shortage of nurses caused beds to remain unusable. The managers laid the blame for this deficiency in nursing staff to the inadequate nurses’ home. They were able to go some way to rectifying this by using a generous gift from Henry Herbert Wills to extend the existing home. This opened in 1925, the work having been carried out by the architect Sir George Oatley.

Extract from the 25-inch OS map, revised in 1913. Reproduced by permission of the National Library of Scotland

Further additions were carried out between the Wars. The isolation block was built in 1924, an x-ray department and dental department were added in 1925, and a massage department established in 1926. Henry Hill had been appointed as the infirmary’s clerk of works in 1906 and he drew up plans for two staff accommodation blocks which were completed in 1930 and 1931. During the Second World War the infirmary was lucky to escape serious damage from bombing. Only the mortuary was destroyed. After the war, greatly in debt, the infirmary was transferred to the National Health Service.

References

  1. Minutes of Bristol Royal Infirmary, quoted in C. Saunders, The United Bristol Hospitals, 1965, p. 11

 

 

Brislington House, now Long Fox Manor, Georgian Bristol’s exclusive private madhouse

V0012192 The asylum and front grounds, Bath. Steel engraving after S.

Brislington House, engraving after S. C. Jones, c.1865.  Wellcome Library, London. Reproduced under Creative Commons Attribution only licence CC BY 4.0 

Brislington House, together with its founder Dr Edward Long Fox, was one of the most influential asylums in the first half of the nineteenth century. It has much in common with the York Retreat. Fox was a Quaker, like the Tukes, and he held a similar belief in the restorative power of nature and the familiar comforts of a domestic environment. Brislington House originally comprised a row of separate houses, rather than the large rambling pile that survives today. It was designed to make the patients feel at home, rather than in an institution or a prison. This was, in a large part, possible by catering primarily for paying patients, and the well-to-do at that. In this manner it operated in a similar way to Ticehurst, Sussex and Laverstock House, Wiltshire, both lucrative private asylums.

a hospital606

Brislington House, now Long Fox Manor, private flats, photographed in October 1992

Edward Long Fox is an intriguing individual, he had an extensive private practice as a physician in Bristol, rose to be a senior physician at Bristol Royal Infirmary, and was an astute businessman, amassing a considerable fortune. Before embarking on the Brislington House venture he had operated a private asylum at Cleve Hill. But he was also involved in radical politics, and had an active interest in some less mainstream aspects of medicine. He seems to have been widely admired, but not universally so, accused at times of quackery and worse. [1]

Fox bought the Brislington estate in 1799, and spent several years over the planning and construction of the asylum and the laying out of the grounds around it. Building work seems to have begun in 1804, and the first patients were admitted in 1806. Fox described the arrangements:

The patients of each sex are arranged under three classes. Each class inhabits a distinct house, detached from the other by an interval of eighteen feet, with a separate court for the exercise of the patients, wherever they please; the ground of which is elevated, so that they can view the surrounding country, while a border sloping towards the wall secures them from escape. [2]

Although Brislington House is well documented, and plans survive for the buildings, no architect seems to be mentioned anywhere, or even a builder.

Plan_of_Brislington_House-2

Ground plan of Brislington House Asylum, probably published around 1809. (public domain image)

In addition to this idyllic accommodation were less glamorous cells for the refractory patients. These can be seen on the plan above, at the foot of the walled gardens to the south of each house. It was in one of these that John Perceval (son of the former prime minister, Spencer Percival, assassinated in 1812) recorded spending a miserable period. Perceval noted that the cells were lit from above, and heated by flues in the wall rather than with open fires.

L0012305 Engraving: Brislington house

Garden front, from  Francis Charles Fox, History and present state of Brislington house, 1836 Wellcome Library, London. Reproduced under Creative Commons Attribution only licence CC BY 4.0 

At either end of the row of houses were two small detached infirmaries. The use of separate houses to aid the classification of the patients may have been inspired by contemporary French asylums, notably La Salpêtrière in Paris where the different categories of patients were assigned to separate loges or detached blocks. However, the loges at La Salpêtrière, designed by François Viel c.1786, were all of one storey and the same design. At Brislington the houses were of two or three storeys and not identical.

The buildings were also interesting for their early use of fire-proof construction; a matter which was close to Fox’s heart. When the first county asylum was built at Nottingham in 1810, Fox was in correspondence with the Committee of Governors and warmly recommended the use of iron in construction which he considered ‘did not only serve to alleviate the dangers from fire, but also from lice and vermin’. [3]

Screen Shot 2016-03-18 at 14.45.39

Extract from the 6-inch OS map, revised in 1901-2. Reproduced by permission of the National Library of Scotland

Fox’s success was immediate and sustained. A mark of this is the erection on the estate of Lanesborough Cottage in 1816 for Lord Lanesborough, and of Swiss Cottage in 1819 for Lord Carysfoot. The Beeches was added in the 1820s and Heath House, the large villa to the north-west of the main asylum, was built around 1829 and was occupied by Edward Fox when he retired from the management of the asylum in that year. But the asylum remained a family business, his sons Francis and Charles, both also physicians, taking over its management. After their father’s death in 1835 they issued a brochure or booklet relating the history of the asylum and its present state. In 1850-1 they undertook a major remodelling of the buildings, joining them together as they are now, and building additions, including the chapel. Previously the laundry was converted into a chapel on a Sunday, and services regularly performed there. [4]

a hospital607

The chapel, Brislington House, photographed in 1992

The main building was oriented on a north-east to south-west axis, with the entrance front facing north-west, so the garden front had the sunnier south-east aspect. Both long elevations still have a rather disjointed appearance, presumably reflecting their former separation. The building is rendered with stone dressings in an Italianate palazzo style.

a hospital603

Main building north-west elevation, photographed in October 1992

The garden front is more informal, the central seven bays are flanked by full-height bows, rather resembling angle turrets, with three windows at first and second floor levels.

a hospital604

South-east elevation of the main range, 1992

Brislington House south front

South-east elevation, photographed in October 1992

Across the north end the chapel and recreation hall were built. The chapel has a Greek cross plan and follows the classical style of the rest of the asylum. Inside the box pews were still in situ in 1992 and a fine wood-carved reredos with gothic (or possibly gothick) details, some good light fittings and a painted timber compartmental ceiling. There was also a small gallery over the entrance.

a hospital617

Brislington House chapel, October 1992

Brislington_House_chapel_brighter

The chapel in 2013. Photograph by Rodw, from wikimedia commons, licence CC BY-SA 3.0

Brislington House chapel window

Detail of chapel window, the rendering was quite decayed in places in 1992, it has since been repaired and painted.

Brislington House chaple window

Memorial window in the chapel, from St Luke’s Church, Brislington. 

Brislington house chapel ceiling

Detail of the chapel ceiling. Slightly squiffy. October 1992.

The recreation hall, which was added in 1866, has a deceptively austere exterior – doubly so in the early 1990s when it was faced in rather grimy render. The interior was contrastingly lavish with a small platform at the west end, the walls panelled with bolection moulding and ornamented by anthemions and lyres, and broad pilasters with paterae decorating the frieze. The coved ceiling has bands of greek key pattern and, in the corners of the central flat section, decorative plasterwork scrolls. Similar neo-Classical inspired plaster ornamentation appears over the doors at the west end. The iron pendant lamps are equally ornate.

a hospital609

Recreation Hall, photographed in October 1992

Brislington House remained in the ownership of the fox family until 1947 when it was purchased by the Governors of the United Bristol Hospitals and was used as a nurses’ home.

5175075854_46249b82d2_z

Brislington House, undated photograph, perhaps from the time of the sale by the Health Authority in 1984. Image from flickr reproduced under creative commons license CC BY 2.0

In 1948 it passed to the National Health Service and was put on the market by the South Western Regional health Authority in September 1984. It was then run as a private nursing home for some years before it was sold again and turned into private flats in 2001 and renamed Long Fox Manor.

The landscaped grounds and their importance as a part of the therapy for patients at Brislington House have been researched and written about by Sarah Rutherford (see studymore) and Clare Hickman, see her article on ‘The Picturesque at Brislington House, Bristol…’ in Garden History, vol.33, No.1 Summer, 2005, pp. 47-60.

References

  1. Leonard Smith ‘A gentleman’s mad-doctor in Georgian England: Edward Long Fox and Brislington House’ in History of Psychiatry 2008, 19 (2), pp 163-184
  2. The reference that I had for this was from Fox’s evidence to the Parliamentary Select Committee on the state of Criminal and Pauper Lunatics in England and Wales of 1807. I cannot now find any such evidence from Fox to this Committee. Sarah Rutherford gives a reference to Fox giving evidence to the 1815 committee, but I can’t find that either. The quote is not from his evidence given in the late 1820s, nor does it match the report on the asylum in the 1815 committee, where the evidence was given by Edward Wakefield for Brislington House. Happy to be enlightened.
  3. Nottinghamshire Record Office, SO/40 1/50/4/1
  4. PP Report of the Committee on Madhouses in England, 11 July 1815, evidence of Edward Wakefield p.21