Edinburgh

Astley Ainslie Hospital, Edinburgh

/ Harriet Richardson / 1 Comment
Astley Ainslie Hospital, gates by Thomas Hadden, photographed February 2024, © H. Blakeman

This post looks at the early history of the Astley Ainslie Hospital and the development of a more scientific approach to convalescence in the early twentieth century.

The balcony and veranda on the south side of the new ward wing added to Canaan Park House, from The Nursing Times, 9 Jan. 1926

The Astley Ainslie Hospital is the main rehabilitation hospital in the NHS Lothian region. There are buildings of various dates, from the early 19th century to the early 21st century on the large site in the Grange area of Edinburgh. The hospital was established for convalescent patients from the Royal Infirmary of Edinburgh by a generous bequest from David Ainslie. The site comprising four large villas and a golf course was acquired in 1921, and the architect John Jerdan commissioned to adapt one of the villas – Canaan Park – as the first phase of turning the new hospital. The house became the main administration department with a new wing added to the south for 34 female patients under the charge of Dr (Isabella) Mary Mears, the resident medical officer.

The first patients were admitted in 1923, and three years later the Nursing Times provided a description of the new institution along with a photograph of the recently built ward unit (see above). The article noted the beautiful grounds, with fine view to the Braid Hills, and that the new ward unit was ideally suited to its purpose of a ‘convalescent retreat’. Although the Astley Ainslie was intended for patients from the Royal Infirmary it was independently run, with its own body of governors, as intended by its benefactor, David Ainslie. It was on his instruction that the hospital was named after John Astley-Ainslie, David Ainslie’s nephew who had died at the young aged of 26. It was also intended that the institution should be for cases that required longer care than was provided at the Infirmary’s existing convalescent home at Corstorphine (see the Edinburgh page for more details).

Canaan Lodge, Millbank, Canaan House and Canaan Park, on the 25-inch OS map surveyed in 1893 reproduced courtesy of the National Library of Scotland, CC-BY (NLS)

The Nursing Times described the entrance hall of Canaan Park House as having a piano and that it was ‘bright with pots of growing chrysanthemums’. The colour scheme generally was white and green – colours chosen for their calming and restful qualities. No operations were to be conducted at the hospital, but post-operative treatment, such as changing dressings, was one of the potential nursing duties. Initially the patients were generally surgical, tuberculosis or adolescent heart cases. The wards were ‘big, bright, airy places built on the horseshoe plan’, the balcony and veranda were accessed from large French windows, and had five beds on each, with a further twelve within the ward. Some patients slept out on the balcony or veranda in winter and summer. As well as the two wards, the patients had the use of a dining-room that also served as a recreation room.

Canaan Park House, with the 1920s ward wing on far right. Photographed February 2024, © H. Blakeman

The ample grounds at the Astley Ainslie allowed out-door recreation including bowls, croquet and clock golf. Patients could also undertake gardening in the vegetable garden. Indoors there was a well-stocked library, while concerts, lectures and entertainments were organised regularly.

Canaan House in 2024, © H. Blakeman

Flowers, fruit and vegetables were supplied from the gardens, and the original gardeners to the large houses were retained with a view to preserving the ‘old-world appearance’ of the grounds. An ample supply of fresh produce was a vital part of providing patients with a nutritious diet, with a stress on milk, butter, eggs, green vegetables and fruit. A considerable part of the estate was laid out as a kitchen and fruit garden in order to maintain a constant supply. The best diet for convalescents was an ongoing subject of study. Early experiments at the Astley Ainslie in trying to encourage patients to consume plenty of green vegetables, especially when raw – such as lettuce and tomatoes – was too much of a novelty for some, being ‘often neither appreciated nor eaten without persuasion’.[J. Cunningham, Edinburgh Medical Journal, 1931 v.38 (9), p.146.]

OS map revised 1913, part of site acquired for the hospital CC-BY (NLS)

The beneficial effects of nature, of fresh air, sunlight and pleasant grounds, had long been recognised as an important part of the therapeutic treatment of convalescent patients and before the development of effective drugs to treat tuberculosis had been shown to slow the progress of that disease in some patients. Sanatoria were designed with sun-trapping angled plans – a butterfly, or half-butterfly plan – with verandas in front onto which beds could be wheeled. This was the form adopted for the new blocks built in the hospital grounds, but even in the first ward extension to Canaan Park House a sun-trap was created where ‘screen-enclosed, sun bathing takes place in summer’ and a wooden shelter was built where patients could sit out and enjoy ‘the wintry sunshine, each clad in a big coat and wrapped about with a warm fleecy blanket’.

East Pavilion, north elevation, photographed February 2024 © H. Blakeman

Two neighbouring villas were acquired in the 1920s to extend the site: Morelands and St Roque House. In the second half of this decade the first two new hospital blocks and a nurses’ home were constructed. For the design of the new buildings the governors turned to the architects Auldjo Jamieson and Arnott, who had taken over the practice of Sydney Mitchell and Wilson, architects of many hospital buildings including extensions to the Royal Infirmary. The grandly named and wealthy Ernest Arthur Oliphant Auldjo Jamieson (1880-1937) had worked in Mitchell and Wilson’s office early in his career before setting up on his own account around 1909-10, but soon after the two practices were merged and James Alexander Arnott (1871-1950) joined as a partner.

OS map revised 1932 showing the East and West Pavilions, Scientific block, Kitchen Block and Nurses’ Home CC-BY (NLS)

The 1920s hospital blocks (now the East and West Pavilions) were single-storey, butterfly-plan buildings built on the site of the ladies’ golf course (see maps above and below). The slope of the site gave uninterrupted views of Blackford Hill to the south.

Millbank Pavilion, south elevation, photographed February 2024, © H. Blakeman

A third butterfly-plan pavilion was built on the site of Millbank House which was acquired by the governors around 1930. At the same time a new main entrance to the site was created on Grange Loan with its fine wrought-iron gates made by Thomas Hadden in his characteristic Arts & Crafts style of flowing natural forms (see photographs at the top of the post and below). The gates were hung between square sentry pavilions with pyramidal roofs and over-sized circular window.

The ornamental wrought iron gates made by Thomas Hadden, photographed when newly installed, image from HES Archives

The nurses’ home was completed in 1930, a two-storey and attic, H-plan building, built on the site of South Bank House, just west of the former golf course. Plans of the home had been drawn up by 1925 when they were published in the Architects’ Journal. It followed the conventions of the time, with single bed-rooms for 45 nurses and shared bathrooms and toilets on the upper floors, and communal recreation rooms on the ground floor.

Nurses’ Home, north elevation, photographed February 2024 © H. Blakeman

Just north of the nurses’ home a central kitchen block was built, now the Blackford Pavilion and still functioning as a kitchen and canteen. It also houses NHS Lothian’s health promotion Resource Centre. A covered corridor connects the centre to the nurses’ home.

The Blackford Pavilion © H. Blakeman

A scientific block was amongst the early buildings at the Astley Ainslie, reflecting the governors’ decision that the institution should act as a centre for investigating the problems connected with convalescence and the greater prominence of rehabilitation in the years after the First World War. The large numbers of military personnel who became disabled in action led to developments in prosthetics and a range of treatments or therapies. The scientific block was designed in more formal style than the ward pavilions, its south front featuring an arcade of Grecian Doric columns within which the main entrance sits behind a pair of columns set in Antis. It housed a gymnasium for physiotherapy (at the time termed ‘massage’ and remedial exercises – a reminder of physiotherapy’s origins in ‘Swedish Gymnastics’). It also had an electric department with x-ray equipment, rooms for ultra-violet radiation and electric therapeutics, a dentist’s room, dispensary and research laboratory. Heliotherapy was an important part of convalescent treatment, but the unreliability of the weather soon led to the addition of an artificial sunlight lamp.

Scientific Block, photographed February 2024, © H. Blakeman.

In April 1929 Lieutenant-Colonel John Cunningham was appointed as the Medical Superintendent of the Institution. He delivered a number of papers about the new science of convalescence to the Edinburgh Medical Society that were subsequently published in the Society’s journal. In a paper of 1931 he noted that the organised study of convalescence and the methods of dealing with it were of recent growth, and that there were few publications on the subject. Historically the main ingredients of successful convalescence were ‘moderation in exercise, peace of mind, tranquil sleep, and proper hygiene’. [Cunningham, ‘The Convalescent State’, Edinburgh Medical Journal, 1931, vol.38 (9), p.137.] However, until at least the mid-19th century, convalescence had been available only to the rich – ‘the poor man had no time to be sick, and still less were facilities for recovery provided for him’. [Idem. p.138.]

View of the Scientific block from the west © H. Blakeman

The earliest convalescent hospital founded in Britain was probably the Metropolitan Convalescent Institution, founded in 1841 and later moving to purpose-built accommodation at Walton-on-Thames (later named Ellesmere Hospital, see the Surrey page for more details). The type of convalescent home that developed concentrated on cases that were already well on the way to recovery. Most were unable to take patients who required active medical attention.

Metropolitan Convalescent Institution, later Ellesmere Hospital, Surrey Wellcome Collection

The Health Insurance Acts improved access to basic convalescence to the working classes (see Convalescing in Colwyn Bay for more details). There had long been an economic advantage to giving the work force a proper opportunity to convalescence – both from an employers’ point of view and for hospitals. Apart from freeing beds in an acute hospital by transferring convalescents to a different setting, the relative cost per bed of a convalescent home was significantly less than for an acute hospital.

During the First World War convalescent establishments were provided as well as hospitals for the military. This spurred advances in the study and treatment of convalescence, as well as bolstering the arguments for separate convalescent institutions that were specially designed and equipped for the purpose. Classification of convalescent patients was developed to outline the different requirements of particular groups, such as cardiac, orthopaedic or psychiatric.

Occupational Therapy Unit, photographed February 2024 © H. Blakeman

By the 1920s America was forging ahead in refining the treatment of convalescents. The main sources of information were publication by John Bryant in the 1920s, and the example of the Burke Foundation near New York. The Burke Foundation had 300 beds and dealt with many cases previously excluded from convalescent homes, such as chronic illness and physical disabilities. Occupation and recreation as aids to recovery played an important role. There are cross-overs here with therapies in psychiatric hospitals of the time and particularly in institutions for those with learning disabilities, but the benefits of encouraging some form of occupation for convalescent patients had been recommended by many, including Florence Nightingale. Occupational therapy developed during the First World War, when it was shown to have positive effects on mental wellbeing (or in the language of the time, ‘mental tone and preventing moral deterioration).

One of the pioneering advocates of occupational therapy in Britain was Sir Robert Jones, who noted the lesson learnt during the First World War of the psychological and physical value of work. Workshops for wounded soldiers filled the hours when they weren’t undergoing treatment, usefully distracting their minds. The Canadian war hospitals were some of the first to place ‘Occupational therapy’ on an organised basis, while some of the earliest training schools for occupational therapists were established in Canada and the United States. The Astley Ainslie was one of the first to establish a school of Occupational Therapy in Scotland.

In a future post I will look at some of the later developments at the hospital.

Royal Hospital for Sick Children, Edinburgh

/ Harriet Richardson / 2 Comments

In 2016 the Royal Hospital for Sick Children was put up for sale, well in advance of its scheduled move to its new home alongside the Royal Infirmary at Little France. When the Sciennes Road buildings are finally vacated it will mark the end of more than 120 years on that site. But the foundation is even older, having started out in 1860 in a house in Lauriston Lane with just eight beds. A Royal charter was granted in 1863 when the hospital moved to nearby Meadowside House. This provided more beds (around 40, although accounts vary) and a separate fever ward for infectious cases. The conversion of the house into a hospital was undertaken by the architect David Macgibbon. A new wing was built in 1870 providing a further 30 beds.

Meadowside House, from History of Scottish Medicine by John D. Comrie.. Credit: Wellcome Collection. Attribution 4.0 International (CC BY 4.0)
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Meadowside House, shown here on the OS large-scale Town Plan of 1876, between the new Royal Infirmary (to the right) and Watson’s College. Reproduced by permission of the National Library of Scotland.

The map above shows the block behind the hospital that housed the hospital laundry and ‘dead house’. In November 1884 there were calls from the Ladies’ Committee to provide a separate mortuary so that the ‘dead house’ need no longer serve as both mortuary and post-mortem room: ‘…not only are the feelings of Mothers and relations shocked by seeing the necessary surroundings when taken to see the bodies of their little ones, but the combination of the two purposes in one room has a hardening effect on the nurses…'[1]

It was found that a coal house might be converted without any great expense. At first the mortuary was intended to be quite plain, but in February 1885 the hospital secretary wrote to the newly established Edinburgh Social Union with a request for it to be decorated. The Social Union was already active in providing decoration for the Fountainbridge Dispensary and the Children’s Shelter in the city. In April Phoebe Traquair was entrusted with the decoration of the mortuary chapel.[2]  The tiny space, just 12 feet by 8 feet, was adorned by murals, painted directly on to the plaster. A study for the original scheme is in the National Gallery in Edinburgh.

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Three Studies for the decoration of the Mortuary Chapel, 1885, photograph © National Galleries of Scotland reproduced courtesy of the National Galleries of Scotland

Just five years later the future of this jewel-box of a  mortuary chapel was under threat, when an outbreak of typhoid in 1890 prompted a temporary relocation to Plewlands House at Morningside. The managers then decided that Meadowside House was no longer suitable and a new building was required. They purchased Rill Bank House, then occupied by the Trades Maiden Hospital, and on the site erected the present building in 1892-5 to designs by by George Washington Browne, a leading architect in Edinburgh. Washington Browne also designed other public buildings including the Edinburgh City Library.  The old site, being right next to the Royal Infirmary, was readily disposed of to the Infirmary managers who wished to acquire additional land for their planned extensions. Neither the Royal Infirmary nor the Sick Children’s Hospital had any wish to preserve the murals in the mortuary chapel. The fact that they had been painted directly on to the wall surface made their preservation problematic at the very least.

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Rill Bank House was purchased as the site for the new Sick Children’s Hospital. Town Plan, OS Map of 1851, Reproduced by permission of the National Library of Scotland

At first it was simply planned to demolish the mortuary chapel along with the rest of Meadowside House. Phoebe Traquair wrote to her nephew in August 1891, angry and distressed at the proposed destruction. She blamed the directors of the hospital ‘the horrid Edinburgh little handful of bigots’, and could not see why the whole structure could not be ‘raised bodily from its foundations’ and moved to a new position.[3]  There was enough support for the preservation of the chapel to grant it an initial stay of execution, but it was only once the new hospital was nearing completion, three years later, that Washington Browne managed to negotiate an agreement between the hospital directors and the Social Union to move the murals to the new building. This agreement put the responsibility squarely upon the Social Union to manage and pay for the removal.[4]

‘Royal Hospital for Sick Children (Mr G. Washington Browne).Illustration from The Builder, Jan 1st 1898

The new Sick Children’s Hospital was officially opened by Princess Beatrice on 31 October 1895. It was built of bright red sandstone, with a tall three‑storey and attic central block rising to twin, shaped gables, and an ornate triumphal-arch doorpiece. The style was ‘based upon the English Renaissance’, according to The Scotsman, where the new building was described in detail. [5]

Sick Kids Hospital, Edinburgh by Stephencdickson – Own work. Licensed under CC BY-SA 4.0 photographed in 2014

The hospital was designed on a U‑shaped plan with central administration section. The main entrance at the centre gave onto a broad corridor running the length of the building, and which gave access to the ward pavilions at either end. These were of three stories, terminating in balconies between turrets housing the sanitary facilities – sinks, baths and WCs. Each ward had 24 beds, arranged in pairs between the windows, and was a lofty 15ft high, with its own kitchen and services. In addition there was a spare ward on the upper floor of the east wing with 16 beds and a smaller four-bed observation ward, plus two single-bed isolation rooms, on the upper floor of the west wing.

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OS Map, Edinburgh Town Plan of 1893. Reproduced by permission of the National Library of Scotland

The administration section contained two lecture theatres, one on the ground floor one on the first, fitted with galleries for students and demonstrating platform tables, lit by large north-facing oriel windows. Rooms were provided for resident doctors, honorary visiting physicians and the matron. There was also a board room, a small museum, dispensary, ophthalmic room, staff dining-room, nurses’ sitting-room, and, on the upper floors bedrooms for the nursing staff. Domestic staff had accommodation in the attics.

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General view of the entrance, photographed around 1900 by Bedford Lemere © RCAHMS

Reinstallation of the mortuary chapel murals proved almost impossible, and in the end only fragments were able to be saved. Some that were moved turned out to be too thick to be incorporated in the new chapel, as they included the sawn-through bricks that had been plastered and then painted. Others were more successfully moved, where the painted plaster rested on laths, but were badly cracked and damaged during the move. Phoebe Traquair carried out their restoration, but it became by and large a complete repainting following the underlying design. The new mortuary chapel was also larger, and so the artist painted new decoration to fill the gaps between the relocated panels. [6]

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Detail of mural in mortuary chapel, photographed in 1982  © RCAHMS

Hopefully, when the hospital moves again, modern technology will enable the murals to be transferred to the new site without losing any of them, and without them sustaining any damage. Hopefully, too, the present managers of the hospital are more keen to preserve them than their forebears were.

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Another detail of the mural in mortuary chapel, photographed in 1982 ©RCAHMS

After the hospital opened in Sciennes Road in 1892, various additions were made and the hospital slowly expanded into the surrounding houses. In 1903 Washington Browne added an out‑patients’ department in Sylvan Place, and in 1906-9 Muirfield House at Gullane was built as a convalescent home (see separate entry in Lothian).

25-inch OS map surveyed in 1947. Reproduced by permission of the National Library of Scotland

The hospital was extended from 1959 with a new lecture hall and operating theatre designed by Cullen, Lochhead & Brown of Hamilton, a well established firm in hospital design.

For the new hospital, due to open in 2018, the designs were drawn up by HLM Architects. It is of five storeys over a basement with its main entrance opening into an atrium. Beyond are the main hospital, with around 154 beds, and a new department of clinical neurosciences, with a further 67 beds, as well as a small mental health service unit for children and adolescents. There is also to be a family hotel – a free place to stay for families of patients. [7]

References

  1. LHSA, RHSC Minutes, meeting of committee of Management, 6 Nov 1884, quoted in Elizabeth S Cumming, PhD Thesis ‘Phoebe Anna Traquair, HRSA )1852-1936) and her Contribution to Arts and Crafts in Edinburgh’, University of Edinburgh, 1986
  2. Mins of Edinburgh Social Union 17 Feb 1835 – Edinburgh Public Library YHV 250 E235, quoted in E. Cumming Thesis
  3. NLS MS 8122 fols 10,11, quoted in E. Cumming Thesis
  4. LHSA,  mins HH 69/1/2, quoted in E. Cumming Thesis
    5. The Scotsman, 18 Oct 1892 p.5
  5. E. Cumming, Thesis
    7. Edinburgh Evening News, 21 April 2014

Further reading and other sources: Caledonian Mercury, 18 May 1863, p.2: The Builder, 1 Jan. 1898: LHSA  Story of the ‘Sick Kids’ Hospital: Guthrie, D Royal Edinburgh Hospital for Sick Children, 1860 – 1960, 1960:see nhslothian.scot.nhs.uk 

Records of the hospital are held by Lothian Health Services Archive in Edinburgh

Hospitals for Incurables: the former Longmore Hospital, Edinburgh

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Historic Scotland Offices in the former Longmore Hospital which closed in 1991 ©Copyright kim traynor and licensed for reuse under this Creative Commons Licence

Separate hospitals for incurables began to be established in Britain in the mid-nineteenth century and were welcomed by some, condemned by others. Andrew Reed, who founded the hospital for incurables in Putney in 1854 (which eventually became the Royal Hospital for Neuro-disability) firmly believed in the need to offer relief to such unfortunates, and had a few years earlier founded Royal Earlswood Asylum, for those with incurable mental disorders. While the Poor Law provided care for those who had been rendered destitute by their chronic illness, there was little provision for those above the poverty line, whose physical or mental condition was often made worse by their living conditions. Cancer, tuberculosis, rheumatism, paralysis, deformity and spinal disease or injury, were chief amongst the illnesses that were unwelcome in general hospitals because of the length of time a patient suffering from chronic disease occupied a place on the ward. The Middlesex Hospital in London was rare in having a cancer ward, established in 1792.

The first specialist cancer hospital in Britain was in London, opening in 1852 in a converted house in Fulham Road. Its founder was William Marsden, and his Free Cancer Hospital became known as the Royal Marsden in 1954. Other early cancer hospitals were established in Leeds (around 1858), Liverpool (1862) and Manchester (1871), although these did not just treat cancer. The first specialist cancer hospital in Scotland opened in 1890 in Glasgow (later the Beatson Memorial Hospital). The discovery of X-rays, radioactivity and radium in the late nineteenth century introduced new treatments and radical surgery.

By the late nineteenth century hospitals for incurables had become an established type.  Henry Burdett, the great chronicler of hospital planning and design in this period,  provided advice on what form such hospitals should take, reproducing plans of the Jaffray Hospital in Birmingham by way of an exemplar. This was a distinct hospital plan type, more analogous to a convalescent home where patients similarly might not be confined to bed all day. Day-rooms, sitting-rooms, libraries and smoking-rooms, with easy access to the open air, whether a balcony, verandah or garden, were considered desirable in hospitals for incurables. Wide corridors to accommodate wheelchairs, and a lift to access upper floors helped patients get about, and, Burdett urged, there should be  ‘an absence of everything which will tend to promote waste of energy of every kind’

In Scotland the first hospital for incurables was founded in Aberdeen in 1857, opening in a private house in Morningfield the following year. In 1874 the Scottish National Institution for the Relief of Incurables was established and this lead to a number of hospitals being founded. That in Edinburgh first opened in 1875 with accommodation for 22 patients, the Edinburgh Association for Incurables having purchased a house for the purpose at 3 Salisbury Place which was enlarged and altered at a cost of £3,265 14s 2d, plus another £300 or so for furniture and fittings. Within a year of its opening, the management committee was already hoping to add separate wards for cancer cases.

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Extract from the OS Large Scale Town Plans, 1877. Reproduced by permission of the National Library of Scotland. The Longmore Hospital is the building on the north side of Salisbury Place set furthest back from the road, with two rear wings. 

The inadequacy of the original house lead to the acquisition of adjoining properties and rebuilding on the site. The patients were evacuated to a house in Fisher Row until the new hospital was completed at the end of 1880. Most of the cost was met by the trustees of J. A. Longmore, and the name of the hospital changed to honour this generosity.

Efforts to expand continued, Nos 6 and 7 Salisbury Place were purchased and fitted up for patients in 1886.

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A visit from the Lord High Commissioner from RCAHMS

The Lord High Commissioner made more than one visit to the hospital, so it is hard to date the photograph. In May 1890 he paid a long visit with Lady Tweeddale, and in June 1894 The Lancet reported that the Lord High Commissioner and the Marchioness of Breadalbane had paid their ‘usual visits to the various hospitals in Edinburgh’ on which occasion the Marchioness opened a bazaar at the Longmore.

In 1891 plans for enlarging the hospital were approved which involved pulling down the old east wing of the building. This was to make way for a ‘more suitable wing’ which was intended to provide accommodation for 34 additional patients, with two 14-bed wards, nurses’ rooms, lavatories, kitchens, but no mention of where the other six patients were to be fitted in.

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Women’s ward from the ‘old East wing, now demolished’, from RCAHMS

The OS map below from 1893 shows how much the hospital had evolved in the relatively short time since it first opened.

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Extract from the OS Large Scale Town Plans, 1893. Reproduced by permission of the National Library of Scotland.

Princess May and the Duke of York opened the new East Wing in 1891.

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Princess May Ward. From RCAHMS

The west wing was added in 1899, along with a new laundry, kitchen, chapel and mortuary, and electric lighting was installed. The new wing, of two storeys over a basement, was attached to the main building by a ‘wide corridor of iron and glass’. The ground floor was set apart for phthisical (TB) patients, the upper floor for cancer.

The map below from 1905 shows this later phase of the development.

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Extract from the 2nd edition OS map, revised 1905. Reproduced by permission of the National Library of Scotland. 

A series of photographs of the interior of the hospital has been preserved in the National Monuments Record of Scotland, and provide a glimpse of what life was like there for patients and staff. The photographs seem to have been taken in the 1890s as a record of the new additions to the hospital, though as we have seen, they include at least one photograph of older parts of the hospital prior to demolition.

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Interior of a ward for female cancer patients. The cancer wards along with the TB wards were probably in the 1899 addition which comprised a two-storey and basement wing connected to the main building by a broad glazed corridor. From RCAHMS
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And its counterpart for male cancer patients. From RCAHMS
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Interior of a ward for male TB patients, from RCAHMS
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A private ward, from RCAHMS
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It is particularly poignant to see children in hospital, but even more so in a hospital for incurables. From RCAHMS
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Not all patients were confined to bed, here is a ‘recreation room’ for male patients. From RCAHMS
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Probationer Nurses’ drawing room. From RCAHMS
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The main hospital kitchen, rebuilt in 1899. From RCAHMS
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A ward kitchen. From RCAHMS

References: H. C. Burdett, Hospitals and Asylums of the World, vol.3, 1893, pp.303-5: The Lancet, 4 July 1891, p.47; 6 Feb 1892, p.336, 9 June 1894, p.1476; 14 Jan 1899, pp.125-6: Edinburgh Evening News, 4 Feb 1876; 11 Nov 1880; 15 June 1886, p.2

see also: Lothian Health Services Archive blogspot and Building up our Health pp. 92-3

Craighouse, Edinburgh: former private asylum, future housing development

/ Harriet Richardson / 9 Comments
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These blue remembered hills… Craighouse in the middle distance, ‘Morningside and Craighouse’ by Pascal Blachier, taken in 2007, imaged licensed under CC BY 2.0

A year ago planning permission was granted for the redevelopment of Craighouse, Edinburgh, latterly the campus of Edinburgh Napier University. The impressive group of Victorian buildings erected in the grounds of Old Craig House were originally a private psychiatric hospital, created as an annex to the Royal Edinburgh Asylum, and possibly the most luxurious private mental hospital ever built in Britain.

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Craighouse, photographed in 2015  © Copyright Richard Webb and licensed for reuse under this Creative Commons Licence

The hospital closed in the early 1990s and was subsequently bought by Napier University. With a hefty Historic Buildings Grant, the University refurbished the buildings on the site as a new campus. But in 2011 the University took the decision to close the campus. Plans were submitted to redevelop the site for housing. Despite vigorous opposition from heritage bodies and local community groups permission was granted in September 2014. Oberlanders Architects drew up plans for the development for The Craighouse Partnership, which comprise the conversion of New Craig House into 64 homes. New blocks on the site include Kings Craig, a four-storey terrace of town houses, directly to the south of New Craighouse; a similar block, West Craig, in front of Queen’s Craig villa; another on the east of the site, Burton Villa, and a lower block north of New Craighouse, name North Craig. The new buildings, in a style reminiscent to my eye of 1960s university campuses, mimic the colours of the nineteenth century buildings, in the way that always seems to pass muster these days where there is a desire to be sympathetic to the character of existing  buildings. Very often a pointless exercise, as it seldom seems successful.

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Craighouse, photographed in 2015 © Copyright Richard Webb and licensed for reuse under this Creative Commons Licence

A year on, the campaign to modify the plans and lessen the impact of the housing scheme continues and work had not yet commenced. The Craighouse scheme makes an interesting comparison with Holloway Sanatorium, Egham – Craighouses’ nearest rival in terms of a private asylum that was highly decorative and lavishly appointed – which was converted into luxury homes in the 1990s.

When Craighouse was newly opened, the architectural photographer Bedford Lemere was commissioned to record the buildings. This photographic record – eerily devoid of people -preserved at the National Monuments Record of Scotland, provides a glimpse of the surroundings that were thought beneficial in curing those suffering from mental illness at the end of the nineteenth century. The photographs reproduced below are of the communal spaces within the hospital – the grandest of these being the Great Hall.

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Great Hall, Craig House photographed by RCAHMS

In 1894, the Journal of Decorative Art quoted: ‘It is one of Dr Clouston’s leading principles that in the treatment of the insane, their surroundings should be made as bright and as pleasant as possible’.

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Great Hall, Craig House, photographed in 1895 by Bedford Lemere, from RCAHMS
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High-level view of the Great Hall (from RCAHMS)
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Another view of the Great Hall (from RCAHMS)
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Detail of fireplace and doorway in the Great Hall, Craig House, photographed in 1895 by Bedford Lemere, from RCAHMS

The hall was designed as an ‘uplifting’ environment for patients. It was used for social functions including musical evenings, theatrical productions and orchestral recitals.

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General view of Craig House (from RCAHMS)
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North elevation of New Craig House, Sydney Mitchell & Wilson, 1889 – the Great Hall is just to the left of the tower – recognisable from the tall venetian window (from RCAHMS)

Other interiors photographed by Bedford Lemere included the dining-room and sitting-room in one of the detached villas beside New Craig House. South Craig Villa, one of three detached villas designed in 1889 by Sydney Mitchell, accommodated 15 female private paying patients, many of whom were accompanied by their personal staff of servants and attendants. The ladies were classified as first- or second-class patients, depending on how much they could afford to pay, and were allocated a dining room accordingly.

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Dining-Room in South Craig Villa, photographed in 1895 by Bedford Lemere from RCAHMS
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A sitting-room in South Craig Villa (from RCAHMS)
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This plan is labelled as South East Villa, New Craig House – but seems to equate to South Craig Villa (from RCAHMS)

There were less formal rooms within New Craig House, the billiard room photographed here could just as easily be from a country house, there is nothing institutional about the room.

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Billiard Room, Craig House, photographed by Bedford Lemere in 1895, from RCAHMS
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A sitting-room in Craig House, photographed by Bedford Lemere in 1895, from RCAHMS
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A sitting-room in Craig House, photographed by Bedford Lemere in 1895, from RCAHMS
The same room, looking the other way, or a similar one? This one also described as a sitting-room in Craig House (from RCAHMS).

The room pictured below may have been belonged to a patients. It is labelled as ‘McGregor’s room’ but I do not know whether McGregor was male or female, a patient or a member of staff.

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identified only as ‘McGregor’s room’, one of the set of photographs of Craig House Clinic taken by Bedford Lemere in 1895, from RCAHMS

Victorian asylums were notorious for their miles of long corridors, in the earlier nineteenth century these were often broad and doubled as day rooms for the patients. The subject of asylum corridors was often hotly debated amongst architects and physicians, perhaps this is why so many of the corridors at Craighouse seem to have been recorded.

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A corridor in Craig House,  photographed by Bedford Lemere in 1895, from RCAHMS
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Another, grander, corridor, described as parlour, East Wing corridor, Craig House (from RCAHMS)
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perhaps looking the other way? This is also described as a corridor in East Wing, Craig House (from RCAHMS)
and another corridor in Craig House (from RCAHMS)

Below is a short history of the site extracted from the Edinburgh page of this site.

ROYAL EDINBURGH HOSPITAL, THOMAS CLOUSTON CLINIC, CRAIGHOUSE, CRAIGHOUSE ROAD Old Craighouse dates from 1565, the date appearing over the original entrance doorway. Macgibbon and Ross noted that the house appeared to have been built by the Symsones. A new wing was added in 1746. In 1877 Craighouse estate was purchased by the Royal Edinburgh Asylum and adapted for the accommodation of higher class patients.

Extract from the 2nd edition OS Map revised 1905-6. Reproduced by permission of the National Library of Scotland.

From 1889 to 1894 work on the new buildings was carried out to designs by Sydney Mitchell, these comprised the New Craighouse, East and West Hospital blocks, Queen’s Craig, South Craig and Bevan House. Dr Thomas Clouston was the key figure in the development of Craighouse. He had been appointed as Physician Superintendent to the Royal Edinburgh Asylum in 1873 and in his first Annual Report commented on the state of the buildings:

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Aerial photograph taken by RCAHMS in 2015 of Old Craighouse (top right) and New Craighouse.

As regards our structural arrangements we are undoubtedly behindhand somewhat. We need more accommodation for those who wish the benefits of the institution and can pay high boards… we should be prepared to extend our benefits to the wealthiest …our poorhouses are palatial buildings and in the new asylums for paupers through the country no expense has been spared to make them cheerful and comfortable.

Once Clouston had established patients at Old Craighouse in 1878 he began planning the development of the site in a new and bold way:

Craighouse site affords ample room for many villas of various kinds, surrounding a central block for recent acute cases, kitchens, dining and public rooms. In the construction of these a principle might be adopted which has never yet been fully carried out in asylums, viz of adaptation of each house or part of house to the varied needs and mental conditions of its inhabitants … an asylum so constructed should contain all the medical appliances that would be likely to do good, it should have a billiard room, gymnasium, swimming‑bath and work rooms.

The scheme was long in the forming, in the Annual Report for 1885 Clouston comments that he has been devoting his attention to the principles of construction of hospitals for the better classes of the insane in the last years. He had visited asylums in America and other parts of Britain. In particular the Royal Asylums at Montrose, Dundee, Perth, Glasgow and Dumfries and in England the asylums at Northampton, Cheadle, Gloucester and St Ann’s Health Registered Hospital, the Bethlem Royal Hospital and two private asylums in London. By 1887 Sydney Mitchell had been appointed as architect. Work began in 1889 and the foundation stone of New Craighouse was laid on 16 July 1890 by the Earl of Stair.

There were five principal buildings. The main building or New Craighouse was situated to the west of Old Craighouse and further west again was the west hospital block, Queen’s Craig. To the south of these were the East Hospital, Bevan House and South Craig. New Craighouse was formally opened on 26 October 1894 by the Duke of Buccleuch and Queensberry. South Craig Villa, Bevan House and the Ladies Hospital had already been occupied for some time. The achievement was phenomenal, and on such a vast scale that it remains unrivalled in hospital architecture in Scotland. Variety was the key to the design, variety of style, colour and texture achieved through the finishes, the materials, the varied roof line and every conceivable means. Inside it was sumptuously furnished and fitted up. After 1972 the buildings became the Thomas Clouston Clinic, named after the individual whose personal ideals were embodied in the site. [Sources: Lothian Health Board Archives, Annual Reports of Royal Edinburgh Hospital: RCAHMS, National Monuments Record of Scotland, drawings collection: The Builder, 7 Jan. 1888, p.16; 15 June 1889, p.442; 10 March, 1894, p.203.]

former Royal Infirmary of Edinburgh, now Quartermile

/ Harriet Richardson / 16 Comments

The present Royal Infirmary of Edinburgh was built in 1996-2002 as a PFI project, to designs by Keppie Design of Glasgow on a large green-field site south-east of the city, close to the A7 at Little France, by Craigmillar Castle, in a large area of open countryside. If you follow the A7 northwards, and cross over the A701, you reach its predecessor on the north side of the Meadows, fronting Lauriston Place.

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Main entrance from Lauriston Place, taken in 1999 © Diane King, from the Public Monuments and Sculpture Association collection, RCAHMS
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Architectural perspective showing the north elevation of the infirmary fronting Lauriston Place, from RCAHMS

At the end of May 2004 The Scotsman reported that demolition work had begun on the old Edinburgh Royal Infirmary complex in Lauriston Place to make way for the £400m development. Contractors moved on to the site earlier that week to begin knocking down the Florence Nightingale nurse home, the boiler house and the dermatology ward (known as The Skins). The original developer was Southside Capital, which bought the site from Lothian University Hospitals Trust in 2001, and comprised a consortium with the Bank of Scotland, Taylor Woodrow and the Kilmartin Property Group. Planning permission was granted in December 2003, ‘after a battle with heritage watchdogs’, which included formal objections by Historic Scotland.  By 2009 the development was being undertaken by a joint venture of Gladedale Capital and the Bank of Scotland.

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This aerial photograph was taken in 2007 and shows the empty space where the Simpson Memorial Maternity pavilion and the nurses home formerly stood on the right, from RCAHMS

Quartermile is a mixed development, combining residential and commercial premises over the 19-acre site. The design team was headed by Foster + Partners as the masterplanners and Architects working with Richard Murphy Architects; Hurd Rolland Architects; CDA – Architects and EDAW – Landscape Architects.

Edinburgh Royal Infirmary in the snow, from the Meadows in the late 1980s. (photograph © Harriet Richardson)

After years of adapting itself to the needs of modern medicine, and having enjoyed decades of Crown immunity which enabled additions to be made to the buildings without deference to the usual planning procedures, the Infirmary was a bit of a mess. All these accretions have been cleared away and the ranks of ward pavilions are as imposing and uncluttered as the day they were first completed. But much more than just the clutter of late twentieth century lift towers and sundry infill buildings have been removed, other casualties include the listed Simpson’s Memorial Maternity Pavilion, the Queen Mary Nursing Home and the George Watson’s wing of the Surgical Hospital.

The same view, pretty much, taken in April 2015. (Photograph © Harriet Richardson)

Walking round the site in April this year (2015), there are positive aspects to the works that have been done. Clearing away the accretions around the ward pavilions allows them to be appreciated, with open balconies once more, where residents can sit out and take the air, and communal gardens laid out between the pavilions. The unity of style of the new glass curtain-walled buildings acts as a foil or counter-balance to the stone-built Victorian hospital blocks, retaining the Simpson Pavilion might have interrupted Foster’s flow, but as it was on the edge of the site it could have provided an impressive termination, and provided a gentler transition between the new development and the tenements beyond.

Perhaps the most surprising loss is the eighteenth-century William Adam school building, George Watson’s Hospital, that had been retained by Bryce and about which he had designed his large infirmary complex.

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Plans and elevation of George Watson’s Hospital, William Adam, from RCAHMS

It was not demolished without comment or protest. Even after the protests had failed to keep the building on the site, James Simpson made a plea for the building to be taken down stone by stone so that it might be rebuilt at some distant time.

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The heart of the site today, a cavernous view between grey-glass curtain walls to the back end of the old infirmary admin block, with the clock tower rising beyond. (photograph © Harriet Richardson)

The OS map of 1882 shows what was then the recently completed Royal Infirmary on that site designed by David Bryce and built between 1870 and 1879.

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Extract from 2nd Edition OS Map reproduced by permission of National Library of Scotland

It was one of the first in Scotland to adopt the pavilion plan, widely adopted for new hospital buildings from the 1860s. Though it was pipped to the post by the Western Infirmary in Glasgow by John Burnet senior, designed in 1867 and built in 1871-4, Edinburgh’s infirmary was far bigger. The Western Infirmary in Glasgow was hampered by a lack of funds, which both delayed building work and reduced the scale of the project, so that it could only provide 150 beds at first. The new Royal Infirmary in Edinburgh had 600 beds, placed in eight 3-storey ward pavilions, with one large ward per floor.

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This aerial perspective of the infirmary, from RCAHMS,  makes an interesting comparison with the map of 1882 as it makes the hospital look as if it is almost in the middle of the countryside. It is apparently surrounded on all sides by green space, which of course was not actually the case.
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This early photograph from across the Meadows, with its artfully posed sheep, similarly evokes the image of the hospital set in a rural idyl, from RCAHMS

At the heart of the new hospital, Bryce incorporated a part of William Adam’s school building, George Watson’s Hospital, built in 1738 the same year that the previous royal infirmary building was begun to Adam’s designs. It is easily identified on the ground plan below at the centre, being the range that is slightly askew in relation to the alignment of the rest of the buildings. It was adapted to house some of the administrative offices and the hospital chapel. To its north and south the ward pavilions were disported, linked by single-storey corridors, with surgical wards to the north facing Lauriston Place, and the medical section on the south side. What the pavilion plan enabled were the primary requirements of separation and classification. Each ward was a self-contained unit, its occupants having no connection with any other ward, and thus hopefully preventing the spread of infection.

L0011802 Plan of Royal Infirmary, Edinburgh, 1893.
Plan of Royal Infirmary, Edinburgh, Wellcome Library, London (L0011802). Engraving from H. C. Burdett, Hospitals and asylums of the world, 1893

The ward itself featured windows placed opposite each other to promote the all important cross-ventilation, there were single rooms at the corridor end, which could be fitted up for a patient, the supervising nurse, a ward kitchen and sluice room.

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This photograph shows the interior of one of the top-floor wards, taken during the First World War, c.1917, from RCAHMS

The turrets at the opposite end were to contain water-closets and a bath. These sanitary towers evolved over the second half of the nineteenth century to become ever more separate from the ward itself, with the introduction of a small lobby, again, cross-ventilated, between ward and water-closet. Often a balcony was strung between the towers, offering a small space to sit out for ambulant patients.

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One of the southern, medical ward pavilions photographed in 2015 after conversion to private flats. (photograph © Harriet Richardson)

Each pavilion could serve a different classification of patient. As mentioned, here Bryce located the surgical cases to the northern pavilions and the medical cases to the south, further classification allowed men and women to be separated, but the possibilities were endless. It was this adaptability of the plan which made it ubiquitous for almost all types of hospital for decades: in hospitals for infectious diseases the separation was made more complete between the pavilions by omitting the connecting corridors.

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Elevation drawing of 1872 showing the southern medical ward pavilions connected by an arcaded link corridor, from RCAHMS

Despite the apparent vastness of the new Infirmary it was not long before additions and alterations were necessary. Sydney Mitchell & Wilson added a nurses’ home in 1890, the laundry in 1896, and the Diamond Jubilee Pavilion in 1897. In 1900 they designed two new pavilions for ear, nose and throat and ophthalmic patients.

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Drawing of 1896 for additions to the infirmary, this was the Jubilee pavilion and has been retained. It sits alongside the southern ward pavilions on the west side, from RCAHMS
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Photograph from RCAHMS.

 The photograph above is of Sydney Mitchell’s Nurses Home of 1890, fondly known as the Red Home. A courtyard plan, offered an internal garden where the nursing staff could escape for some peace and quiet. It was originally intended to retain this handsome building, but the developers were given permission to demolish. It was argued that the building did not make a positive contribution to the local townscape, as its design, scale and form were out of keeping with neighbouring buildings, including the retained listed buildings. It was also considered to be ‘not a particularly good example of a building by Sydney Mitchell’, the neighbouring Ear, Nose and Throat pavilion being thought ‘a much better example’. More credibly it was claimed that it was not commercially viable to convert it. Demolition was permitted on the grounds that what would replace it would be of high quality and create a local public space at the heart of the site. 

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This is what replaced the Red Home, photographed in February 2015. ( ‘Lines’ by Byronv2 is licensed under CC-BY-NC 2.0)

The major addition of the twentieth century was the Simpson Memorial Maternity Pavilion constructed in 1935 to designs by Thomas W. Turnbull, with James Miller acting as consultant. An imposing steel framed building faced with concrete, as was the Florence Nightingale Nurses’ Home which was built at the same time. The Pavilion was officially opened on 1 March 1939.

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The Simpson Memorial Maternity pavilion, photographed around 1940, viewed from the Meadows. Classically elegant, and a sad loss, from RCAHMS
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The monumental nurses’ home built to the rear of the maternity wing, photographed around the time that building work was completed in 1939, from RCAHMS

The Simpson Memorial had its origins in the Edinburgh Lying‑in Hospital which opened in Park Place in November 1793. This was financed by Professor Hamilton and then by his son, James, until his death in 1839. It moved in 1843 and occupied five further sites before becoming the Edinburgh Royal Maternity and Simpson Memorial Hospital, in commemoration of the achievements in obstetrics of Sir James Young Simpson who died in 1870. The resultant building, designed by D. Macgibbon & T. Ross, opened in May 1879 and later became the School of Radiology, at No.79 Lauriston Place. The first ante‑natal clinic in Britain was opened there in 1915 as a result of the work of James Haig Ferguson. After the First World War buildings in Lauriston Park and Graham Street were acquired to try to combat overcrowding but this was not satisfactorily overcome until the new Pavilion was provided in the 1930s.