hospital

The Hospitals Investigator 4

/ Harriet Richardson / 6 Comments

Issue 4 of Robert Taylor’s Hospitals Investigator was circulated in July 1992 and in his editorial he wrote that the theme for this issue would be lunacy, in particular, baths and fire precautions. It concluded with a report on the Cambridge team’s trip to Cornwall and what they found there.

Baths

‘One of the many criminal economies practised in public institutions in the 19th century was the sparing use of bath water. At the Suffolk Asylum at Melton the male attendants used a single filling of the bath for five men, but on the opposite side of the same institution  the female attendants managed to make a single filling serve ten women. This amazing achievement gives a new and unexpected meaning to sexual discrimination. At some asylums things were managed differently, and they put two lunatics at a time into the same tub, thereby ensuring that all and an equal chanced to enjoy hot water. Oxford, however, held the record and regularly managed to bath three at a time, thereby beating Cambridge by a factor of three. We have yet to see the size of the Oxford baths.

Considering that the water was frequently delivered at such a high temperature that patients were in real danger of scalding themselves and the taps could only be controlled by the attendant, one wonders at the temperature of the bath water at Melton when the first woman got in, and when the tenth got out.’

While looking for an illustration of bathrooms in asylums, I searched through the Wellcome Images collection which has this photograph taken around 1930 of Long Grove Asylum, Epsom in Surrey. Shared bath water was no longer acceptable, and a modicum of privacy was afforded by the  fixed screens.

L0015468 Male patients being washe by hospital orderlies. Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Male patients being washed by hospital orderlies, Long Grove Asylum, Epsom. In the Royal College of Psychiatrists. circa 1930? Published: - Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/
L0015468 Male patients being washed by hospital orderlies. Wellcome Library, London.

Fire Precautions in Asylums

‘Methods of preventing the start and avoiding the spread of fire in hospitals have developed in stages, usually one set of ideas at a time.’

‘The first fire precautions in the 18th and 19th centuries were purely structural, along the same lines as the various contemporary local regulations and the London Building Acts. The aim was to make buildings unlikely to catch fire or to burn, in other words, fireproof construction. Most of these techniques had become standard best building practice by the beginning of the 18th century, and included such things as not having timbers let into chimneys. This particular concern can be seen in an obvious form at the workhouse at Tattingstone in Suffolk, where ceiling beams are skewed in order to miss the fireplaces. The use of masonry for walls, and slates or tiles for roof covering were standard from the beginning; timber frame and thatch are not used for purpose-built hospitals.’

Tattingstone Hospital in 1990 © Copyright Clint Mann and licensed for reuse under this Creative Commons LicenceOriginally built as a House of Industry in 1766, and later extended as Samford Workhouse, it became St Mary’s Hospital in 1930, finally closing in 1991 and was converted into housing around 2001. see also  http://www.workhouses.org.uk/Samford/

‘At a later date non-burning floor structures were used, called ‘fireproof’ and depending at first on the use of iron beams and shallow brick vaults. This system had the disadvantage that it relied on exposed iron girders, which were liable to buckle in a fire. Later in the 19th century, devices such as hollow bricks forming flat arches, sometimes strengthened by steel rods cased in concrete, were used to avoid this problem and produce a lighter structure. Perhaps the most common fireproofing device is the use of stone for staircase treads, almost invariably combined with iron balusters.’

‘Despite all of these precautions, fires broke out and even spread. Limiting the damage done by a fire was an important consideration, and it is interesting to learn that in asylum building in the middle of the century it was considered desirable to restrict patients to two storeys, for greater ease of escape or rescue in case of fire, as well as to reduce the amount of building that might be damaged. [The Builder, 27 Nov 1852 p.754] This is a contrast with the earlier practice at workhouses, where three-storey main ranges to accommodate the inmates were common. The Commissioners in Lunacy seem to have been particularly concerned by the fire at the Cambridgeshire Asylum  in 1872. No lives were lost, and damage was limited, but the general opinion was that the fire very nearly destroyed the whole asylum.’

VLUU L210 / Samsung L210
Central block of Fulbourn Hospital, originally Cambridgeshire County Asylum, and now reconstructed NHS offices. (Photograph by Tom Ellis taken in 2009 and licensed under CC BY-NC-ND 2.0)

‘The boilers and pumps were in the basement of the central block, and as the call for steam and hot water had increased, the size of the boilers had been increased, well beyond the capacity of both the basement and the flues. It seems that this situation was very common, and it was this that led to a new wave of precautions in asylums during the 1870s, particularly after 1875. In that year the reports of the Commissioners on their annual visits to asylums pay great attention to fire prevention, and include descriptions of a number of devices.’

‘The major new concern of this decade was with the provision of a sufficient quantity of water at high enough pressure to extinguish any fire that should break out. Water mains with hydrants were installed both inside and outside the buildings and examined during visitations, when the Commissioners hoped to see an efficient fire drill and a jet of water that toped the highest roofs of the asylum. The pressure was usually produced by a steam engine. A sufficient quantity of water to extinguish a fire was essential and the problem was underlined when the Commissioners visited Ipswich Asylum on the day when each week the water company did not supply water. Under such circumstances a large reserve supply was essential. Tanks at a high level, thereby providing a head of water without recourse to a steam engine that would take time to get going, were favoured. There was a water tower on each side of the establishment at Herrison, Dorset, in 1863.’

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Old postcard with aerial photograph of Herrison Hospital, posted on flickr by Alwyn Ladell and licensed under CC BY-NC-ND 2.0 Originally the Dorset County Asylum, near Charminster, it has now been converted into housing, with much additional new building on the site, and re-named Charlton Down.

‘A new concern with the structural side of fire prevention is shown in 1874 by the visit to the Leicester and Rutland Asylum of Captain Shaw of the Metropolitan Fire Brigade. He suggested a system of intersecting walls with iron doors to prevent the spread of fire. From the way in which the Commissioners in Lunacy reported this visit, one senses that they wished that more asylums would follow the same course and obtain professional advice. The extent to which this was done is not clear.’

There is a fascinating set of photographs of the asylum from the University of Leicester Archives and  the Record Office for Leicestershire, Leicester & Rutland which can been seen on the website expresseumpoetics.org.uk 

‘In the 1880s the major concern of the Commissioners in Lunacy was with the escape of patients from an asylum should it catch fire. Every ward had to have a second means of getting out, an alternative exit. As many rooms seem to have had only one entrance, this sometimes tested the ingenuity of those responsible. By 1885 the provision of external fire escape staircases was in full swing. The stairs had to be suitable for both infirm and deranged patients to use, and it is interesting to see how many still meet these requirements. It was necessary to have sufficient space a the top of the stair for patients to be prepared for the descent, and the stairs themselves had to be wide and easy. The time scale of this development is shown by the second Birmingham asylum at Rubery, opened in 1882 without fire escape staircases, which were provided in 1886.’

‘References to fire escapes should, however, be interpreted carefully, for not all were fixed to the building. In 1888 Cornwall Asylum bought a fire escape and built a house to put it in; the two similar contraptions at the Norfolk asylum in 1896 were of wood. At Norfolk the Commissioners were more concerned with their inadequate number than with their material. The introduction of fire escapes at asylums continued into the present century. It seems that in workhouse infirmaries the similar provision of fire escapes was about a decade later than in asylums, only getting under way in the 1890s’.

L0012311 Middlesex County Lunatic Asylum, Colney Hatch, Southgate, Mi
Perspective view and ground-floor plan of Middlesex County Asylum, Colney Hatch, later Friern Hospital. Now converted into housing. From the Wellcome Library, London

‘The fire at Colney Hatch on 27 January 1903, when 51 patients lost their lives in a fire in temporary buildings of 1895, brought a new realisation of the problems associated with fire. Rescue had been hampered by smoke, and a new urgency was now given to the containment of smoke in large asylums, particularly on staircases. In that same year, smoke doors were called for at the heads of certain staircases at Knowle in Hampshire, and at the Buckinghamshire asylum the doors with bars that opened onto the staircase had to be made solid. Smoke doors had already appeared in some institutions, as at Northampton in 1901, but are rarely mentioned.’

‘Immediately after the Colney Hatch fire, the Commissioners in Lunacy enquired after other temporary buildings, and tried hard to have them removed. They continued to accept timber framed buildings clad in corrugated iron, particularly it seems when the interiors were plastered rather than clad in boarding.’

A Letter from Cornwall

‘Five days of fieldwork were allotted by the Cambridge Office to investigate … the hospitals of Cornwall… The first that we visited, Truro workhouse, introduced us to the intractable nature of granite and the most informed attempt at Grecian style so far. The granite was so hard and difficult to work that the mason could do no more than produce a blocky outline of what was wanted but the result was still striking.’

‘Much of the county is swept by high, wet, winds, so that most of the early settlements hide in hollows or the lee of hills for shelter. The windward side of a building is often slate-hung to give extra protection. Although rendering houses is not as common as in some other exposed communities, the fashion for rendered walls in the 1920s was welcomed here. The textures are not always interesting, and when the paint is not renewed the effect is usually sombre.’

‘Despite the winds, workhouse were built on hills just as everywhere else in England, although the thick jungle around some of them shows that they are on the sheltered side. Palm trees were an unexpected impediment to photography at Truro and elsewhere. The usual Cornish workhouse consists of three parallel ranges. First comes an entrance range, often single storey; then comes the House, sometimes with short cross-wings but always a linear building with a single-storey kitchen behind. Finally comes either a row of workshops with the infirmary in the middle, or just the infirmary in large workhouses. There is almost no variation on this pattern. Bodmin had a rectangular infirmary, but several including Truro and Redruth had a small U-shaped block usually with a lean-to on the workhouse side There were always two doorways, but the internal arrangements could not be discovered.’

For images of Liskeard Union Workhouse, built 1937-9 to designs by Scott & Moffatt, including a postcard from around 1915 see workhouses.org.uk 

‘Many workhouses also had a small isolation hospital placed close to the main building. Few are dated, including Falmouth of 1871, and that at Bodmin could be 1842. They have a standard arrangement of two wards flanking a central duty room or set of central rooms, and all are uniformly plain. Some may by chance respect the 40-foot cordon sanitaire that was required by at least 1892, but they probably all date from before about 1880. It is interesting to compare them with Suffolk, where the only isolation hospitals associated with workhouses respected the quarter-mile cordon required for smallpox hospitals, and none was recognised closer to the workhouse except at Semer.’

‘Apart from these workhouse examples, surviving isolation hospitals were prominently absent from the cornish landscape, and one of the two that we did manage to find was occupied by such a desperate character that we did not approach too closely. …’

‘The Cornish cottage hospitals were frankly disappointing, for they had been savagely treated by enlargements. A curiously high proportion had a main range and cross-wings type of plan, or appearance, for the plans did not always accord with the outside. Our greatest joy was to discover that the Falmouth hospital, built in 1894 and replaced by a new building on a new site in 1930, survived intact and unaltered…’

Images of Falmouth Hospital, designed by H. C. Rogers and built with funds from J. Passmore Edwards can be seen on the web site passmoreedwards.org.uk  

‘Two hospitals, at Redruth and St Austell, and been established with the needs of accident-prone miners in mind, but the buildings told us nothing about these needs.’

‘Cornwall has a large number of ports, and had a corresponding number of Port Sanitary Authorities in the late 19th century. In general they provided makeshift hospitals of no size, and only a fragment of the Falmouth hospital, which also served the local urban population, was discovered. Fowey, constituted in 1886, had a corrugated iron building with a duty room and four beds by 1899; it got its water from a nearby spring, and although last used about 1920 it was still being maintained in 1943.  The Truro hospital was near the centre of the town and has not survived. Perhaps because the provision in the county was so small the Truro workhouse was converted into a 110-bed isolation hospital in 1940, mainly for the benefit of evacuees. We did not notice any evidence of pest-houses to either explain or supplement this poor provision of isolation hospitals.’

See also: old photograph of Truro workhouse on Truro Uncovered website 

Huntin’ Shootin’ and Fishin’ at an upper-crust, prefab sanatorium

/ Harriet Richardson / 1 Comment
alderney manor sanatorium

In the third edition of Rufenacht Walters’ Sanatoria for Consumptives published in 1905 is an account of Alderney Manor Sanatorium and the photograph above of the patients’ accommodation. This type of simple prefabricated timber and corrugated iron structure were commonly used for small schools, hospitals and chapels (tin tabernacles), often intended as a temporary measure to get an establishment up and running quickly.

Alderney Manor Sanatorium, situated at Parkstone between Poole and Bournemouth in Dorset, was for private, paying patients.  Surrounded by pine woods and heather-covered heath, it was set up around Alderney Manor, the house itself used for administrative offices. Despite the proximity to Bournemouth the climate was described as being ‘less relaxing’ in the summer time. Which to me sounds as though it was wetter, colder and/or windier.

In the grounds a dining-hall, a bungalow and a number of sleeping huts or chalets were erected, all prefabricated, made of wood with corrugated iron roofs and outer walls, large windows on four sides and ventilation in the gable, heated by anthracite-burning stoves (Choubersky’s stoves). The sanatorium also boasted two ‘sun baths’ for ‘ladies and gentlemen respectively’, and ‘sun bathing machines for bed patients’.

For amusements patients were offered the type of gentle pursuits one might expect: croquet, and, given the location, sea-bathing (under medical supervision, naturally). There was also a bandstand for musical entertainments. More unusual activities offered included fishing on Lord Wimborne’s preserves, and rabbit shooting on the estate itself. In addition to all this: ‘a local land agent gives lessons by arrangement in the management of landed property’. Not something I have ever come across before.

I have no idea what a sun-bathing machine looks like, nor what shape the ‘sun baths’ took. However, I did find a picture on the web of a Choubersky stove, from, naturally enough, a ‘Stove Identification Gallery’ provided by Stovemica. Whether this is the same Choubersky that manufactured an early form of in-line skates I couldn’t say.

Jean_de_Paleologu,_Patin-bicyclette_-_Richard-Choubersky
(Jean de Paleologu [Public domain], via Wikimedia Commons)

The sanatorium was right next to the local authority infectious diseases hospital, now Alderney Hospital, specialising in mental health problems and learning disabilities. Alderney manor, which in earlier maps appears merely as Alderney Cottage, was demolished some time in the 1920s or 30s, and the area where it stood was built over for housing after the Second World War.

Pine Trees

/ Harriet Richardson / 1 Comment

The subject of pine trees formed a digression in the second issue of the Hospitals Investigator, and it put me in mind of earlier research that I had done in Scotland where Sanatoria were set amongst pines so that the patients might benefit from terabinthine vapours. Nordrach-on-Dee was one such, later Glen-0-Dee Hospital, near Banchory.

The former Glen-o-Dee Hospital

Forests, Woods and Trees in relation to Hygiene was published in 1919, by Augustine Henry. Here he discussed the latest research into the effects of pine trees in a chapter on ‘Forests as sites for Sanatoria’. Even Pliny, it seems, considered that ‘forests, particularly those which abound in pitch and balsam, are most beneficial to consumptives or to those who do not gather strength after a long illness; and are of more value than a voyage to Egypt’.

In New York patients with tuberculosis were sent to the Adirondack Forest, where they might benefit from the pure and invigorating air. In England the earliest experiments with fresh-air treatment for consumption were made in 1840 by Dr George Boddington, at Sutton Coldfield in Warwickshire and in Ireland by Dr Henry MacCormac of Belfast in 1856. Dr Walther systematised and popularised open-air treatment in the Black Forest with his Nordrach Colonie Sanatorium, which was hugely influential in Britain. Treatment in an alpine sanatorium in Switzerland was beyond the financial reach of most invalids, but pine woods could easily be planted, and already existed in abundance, allowing this form of treatment to be widely replicated.

Screen Shot 2015-05-31 at 11.30.09

I particularly like this dramatic architectural perspective of the West Wales Sanatorium, at Llanybydder, Carmarthenshire, with its fringe of pine trees on the hillside behind. It was designed by E. V. Collier and treated women and children. As built in about 1906, without the side wings, it didn’t look quite so romantic, and the regime within the hospital was equally grim. In 1923 complaints were made that sick girls were made to go out into the surrounding pine forest to saw trees  while kneeling in the snow. [ref: Linda Bryder, Below the Magic Mountain quoted in the New Scientist 14 July 1988 p.63] The Pevsner Guide for Carmarthenshire and Ceredigion published in 2006 describes the building as ‘originally a cheerful Neo-Georgian with red-tiled roofs and green shutters, now very decayed’.

By the early twentieth century the value of the ‘exhalations of turpentine etc’ from Scots Fir trees was being questioned, and instead it was as shelter belts that pine trees continued to play an important role at hospitals. In the second issue of Robert Taylor’s Hospitals Investigator he drew attention to these surviving shelter belts of pines around many of the sites that the Cambridge team visited. It also brought back memories of his own experience of being interned in an isolation hospital as a small child. I remember him telling us that parents were not allowed on the wards, so they would remain outside and could only see their children through the window. At one former isolation hospital he found a shelf under a window, provided so that a parent could kneel on it and see inside.

Here are Robert’s remarks on pine trees:

“In the very first day of fieldwork in Suffolk it was noticed that there was an association between hospitals and pine trees. Tuberculosis sanatoria, cottage hospitals and isolation hospitals all appear with shelter belts; indeed the site of one isolation hospital was completely inaccessible because of the fallen conifers and evergreens. The Beccles War Memorial Hospital appears from amps to have had new planting, and the surviving trees confirm this. Even the isolation hospital where one of us spent a month in 1944 has a belt of pines. It was obviously considered that a shelter belt of conifers afforded a perceptible improvement in the quality of the air. The reasoning behind this seems to smack of black magic and the symbiotic theory of disease, physicians had relatively few methods of cure, and little reliable theory with which to evaluate those methods. A belief in the specific effect of climate was harmless and must have appeared plausible. The first practical application of the theory was at the Royal Sea Bathing Infirmary at Margate in 1791, where consumptives were treated. Nothing more seems to have been done until 1854 when Brehmer believed that he could cure tuberculosis by living in high mountains, and opened an institution in Silesia. The general theory was given a more specific interpretation in 1862 when Dr. L. C. Lane of San Francisco considered that the fragrant smell from the resin of the Sierra Nevada pines was salutary: ‘in chronic pulmonary affections the breathing of such an atmosphere must be productive of a highly salutary influence’. At the same time many people thought that some leaves, particular pine and balsam, are disinfectants, and this idea still lingers with the toilet cleaner industry. In America patients were encouraged to take holidays in areas of differing air; in England that air was brought to the patient by means of sanitary plantations around the hospital, the resinous smell of the trees contribution to the recovery of those within the building. In some cases the hospitals are on such poor soil that birch and conifers are the only sensible trees to plant, as at Ipswich Sanatorium.”

 

The Hospitals Investigator 3

/ Harriet Richardson / 5 Comments

Isolation Hospitals

Issue number three of the Hospitals Investigator was produced by Robert Taylor in April 1992 and was largely devoted to the subject of isolation hospitals, and more particularly the model plans published by the Local Government Board from 1888 onwards. Just about all local authority isolation hospitals built after that adopted these plans.

V0047600 Hanley, Stoke & Fenton Joint Infectious Diseases Hospital, S

This plan from the Wellcome Images collection of Bucknall Hospital  is a typical example. Colin and I visited the hospital in May 1993, when it was still functioning under the NHS specialising in care for the elderly – a not uncommon re-use of former infectious diseases hospitals. It closed in 2012, and plans for housing on the site were in the pipe line in 2014, retaining just two of the hospital buildings.

Bucknhall Hospital was originally the Hanley, Stoke and Fenton Joint Infectious Diseases Hospital and the first five blocks were built in 1885-6. G. W. Bradford drew up the plans. One of the five blocks was a temporary ward block that was later demolished. Additions were made to the site from 1898, mostly carried out by Elijah Jones, architect to the Joint Hospitals Board. In the 1920s two cubicle isolation blocks were added.  [see Historic England Archives file on the hospital ref NBR No.101124]

All the original blocks at Bucknall Hospital closely followed the model plans produced by the Local Government Board.  Robert’s summary of the Board’s instructions and different types of plans issued follows:

The Local Government Board issued several memoranda to local authorities on the subject of arrangements for infectious diseases. The Board had the duty of persuading local authorities to make suitable provision, preferably by means o  hospitals, but also gave or withheld sanction to raise loans for such purposes. This meant that plasm for proposed hospitals had to be approved by the Board if the building costs were to be raised by borrowing money The hospital plans contained in the Board’s memoranda were thereof important guides to local authorities wanting to building hospitals.

The first memorandum was issued in 1876 and was titled Memoranda for Local Arrangements relating to Infectious Disease; it related to hospitals and ambulances. It addresses itself to those authorities who have power to provide hospitals under section 131 of the Public Health Act of 1875, and begins by laying down several principles:

  1. The sick should be separated from the healthy. this is especially important with the poor, living in crowded and ill-ventilated conditions
  2. The accommodation must be ready beforehand
  3. Patients with different infectious diseases cannot be kept in the same ward.

Villages should be able to accommodate about four patients in two separate rooms at small notice, and the memorandum, and all editions up to and including 1893 then describes the type of arrangement associated with ‘pest houses’. Tents or huts could be used to extend this basic accommodation if needed, but tents are not mentioned after 1888.

Towns need more accommodation more frequently, and there is greater likelihood that more than one disease will have to be treated. Consequently the minimum provision is two pairs of rooms, the size depending on the size of the town. Permanent building should ideally provide for more than the average requirements of the town, and should have space around for the erection of tents.

Several basic points regarding hospital planning are made:

  1. The hospital should be reasonably accessible
  2. Each patient to have 2,000 cubic feet of ward space and not less than 400 square feet of floor space
  3. Thoroughly good ventilation
  4. Security against foul air entering the ward
  5. Means of warming the wards in winter and keeping them cool in summer
  6. Safe disposal of excrement

In an epidemic it may be necessary to extend the hospital, by means of huts or, in summer, tents. The tents may be bell tents or Army Hospital Tents, with paved approaches and boarded floors. Regulation bell tents are said to be 14 feet in diameter, and regulation hospitals marquees 29 feet by 14 feet. Huts should be raised eighteen inches above ground level, and spaced not less than three times wall height apart. they should have ventilators along the length of the ridge.

There are plans of two types of hut. The first is arranged on one or both sides of a covered walkway, and consists of a hut with bathroom and kitchen next to the walkway, and a lower sanitary annexe at the outer end. these are arranged on either side of an administrative building, and resemble Emergency Medical Scheme hutted hospitals. The second contains two wards and a central nurses’ room etc in one hut, and a sanitary annexe at each end, generally resembling later simple ward blocks. There is also a detached kitchen.

The second memorandum, the first of several to be titled On the Provision of Isolation Accommodation by Local Sanitary Authorities, was dated March 1888. Although it is only an edited version of the earlier document, it reflects the experience gained since the Public Health Act of 1875. The principal change is in the plans of hospitals Both of the original plates are abandoned in favour of three new plates with four plans – A to D.

LGB A 1888 to 92

Local Government Board model plan A, 1888

Plan A is a small building for four patients, with two-storeyed nurses’ accommodation flanked by two single-storey wards reached independently by a verandah. There is a detached laundry and mortuary. The same plan was also published in the 1892 memorandum, but not thereafter.

LGB B 1888 to 92
Local Government Board model plan B, 1888-1892

Local Government Board model plan D, 1888

Plans B and D are of a completely new type of ward block, characterised by having the verandahs in front of the male and female wards facing opposite directions, and having the duty room recessed between two flanking wards. Plan B is a single range with all wards in line, while D has the larger end wards set at right-angles as cross-wings. Water closets and sinks are in detached blocks against the outer face of the verandahs. Plan B was included in the 1892 memorandum, but otherwise these distinctive plans were not published in the later editions.

Flat_Holm_isolation_hospital_plan_April_1895
An example of  ‘Plan C’: Plan, elevations and section of proposed Cholera Hospital for the Couty Borough of Cardiff, Flat Holm Island, drawn up by the Borough Engineer M. Harpur. It appears to be stamped 1905, or perhaps 1906. Posted by J W Smith (Flat Holm Project Archives) licensed under CC BY 3.0 

Plan C is of a rectangular block with two wards separated by an entrance lobby and a projecting duty room. At the outer ends of the wards are small projections with water closet and sink. This basic plan was repeated in all subsequent memoranda. In 1900 it is described as the most advantageous and convenient plan, and it is suggested that one ward could be larger than the other so that children could be included with women.

LGB plan c 1888 to 9
Local Government Board model plan C 1900-21 (top) and 1902-21 (below)

Local Government Board model plan C 1888-9

In 1902 and 1921 the plan was repeated along with an alternative arrangement, having two projecting single-bed wards flanking the duty room. In all of these later publications, the original plan letters were retained.

LGB C 1900 to 21

To the requirements of 2,000 cubic feet of air space and 144 square feet of floor space are added 12 linear feet of wall space for each bed, and also the necessity for a space of 40 feet between wards and hospital boundary. In 1892 a height of 6 feet 6 inches is given as the minimum height of the boundary fence, which should be a wall or close fence. In a note added in 1902 a hedge between barbed wire fencing is regarded as acceptable in ‘unfrequented situations’.

The special recommendations regarding isolation of smallpox hospitals first appears in the 1895 re-issue of the 1892 memorandum. Smallpox hospitals are forbidden where the site:

  1. is within quarter of a mile of a hospital of any kind, workhouse or population of 150 to 200 people (200 people after 1900)
  2. is within half a mile of a population of 500 to 600 people (600 people after 1900)
V0031473 Gloucester smallpox epidemic, 1896: a ward in the Hempsted Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Gloucester smallpox epidemic, 1896: a ward in the Hempsted isolation hospital. Photograph by H.C.F., 1896. 1896 By: nameNegatives of the Gloucester smallpox epidemic, Published: 1896. Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/
Gloucester smallpox epidemic, 1896: a ward in the Hempsted Isolation Hospital.  Wellcome Library, London. Wellcome Images

An enlarged edition of the memorandum was published in 1900 and reprinted with minor changes in 1902, 1908 and 1921. It is emphasised that the hospital should be in readiness beforehand, and that it is for the protection of the pubic at large rather than the benefit of individuals, so that restrictive charges should not be imposed. The combination of authorities in sparsely populated districts is encouraged, provided that patients do not have to travel long distances. A proportion of one bed to each thousand inhabitants is mentioned as a rough but unreliable guide to size of hospital.

Although a site plan had been published in 1892 showing the three principal buildings and the 40 foot cordon around them, they were not defined and described until 1900. They are ward block, administration block and out-offices. A new site plan is published, appearing as plan A from 1900 onwards. Wooden and iron buildings are poorly insulated and difficult to maintain, and so unsuitable; the Board does not sanction loans for them.

LGB B 1900

The administration block should contain no patients, but accommodate the matron, nurses and servants, and have a single-storey kitchen. It may be an existing house, and should control the entrance to the hospital. It should also be larger than at first required. Ward blocks should be single-storey unless unavoidable, in which case each storey should have a separate entrance from the open air. Two types are described as being suitable for small hospitals; large hospitals may need other types. Plan C has been discussed above; a note added in 1902 says that the space in the centre over the duty room is sometimes used as a day room for convalescent patients.

Local Government Board model plan B 1900

Plan B is a new plan that underwent several changes. It is called Isolation Block on the site plan, and is described as useful under a variety of circumstances, such as keeping complicated cases under observation, for paying patients, and for extra diseases. The plan of 1900 is of a rectangular block with a recessed duty room between two small wards; there is a continuous verandah across one side, with a single detached toilet block opposite the duty room. An internal lobby protects the door of each ward.

LGB B 1902 to 21
Local Government Board model plan B 1902-21

In 1902 this plan is modified significantly. The duty room is made to project slightly, and the internal lobbies removed from the wards. More important, the toilet block is divided into two separate blocks, with an enclosed lobby linking them to the ward doors, and also separating the two end sections of the verandah. The sink room is only accessible from in front of the duty room.

LGB D 1908 to 21
Local Government Board model plan D 1908-21

A third plan D, was added in 1908 and repeated in 1921. It is called an observation block, and is said to be for single cases of a disease, or for mixed or doubtful cases. The lower provision of 1,400 cubic feet of air is justified on the grounds of efficient ventilation and the separation of individual patients. It consists of a rectangular block with two single-bed wards on each side of a central duty room. A glazed partition separates the pairs of wards. All rooms are reached from a continuous verandah, on the outer side of which is a single block containing water closet, sink and portable bath.

The space for each bed is repeated, wight he additional restriction that in calculating the 2,000 cubic feet any space above 13 feet from the floor should be ignored. One square foot of window to every 70 cubic feet of ward is regarded as suitable.

The out-offices as defined as laundry, disinfecting chamber, mortuary, and ambulance shed; boiler house and engine house are only needed in large hospitals. A discharging block is said to be provided in some hospitals.

Bibliography: 

  1. Memoranda for Local Arrangements relating to Infectious Diseases (December 1876), published in the Annual Report of the Medical Officer of the Local Government Board, PP 1882 XXX pt2, 503-7
  2. On the Provision of Isolation Hospital Accommodation by Local Sanitary Authorities. (March 1888) published in the Annual Report of the Medical Officer of the Local Government Board, PP 1888 XLIX, 875-83
  3. On the Provision of Isolation hospital Accommodation by Local Authorities (September 1892)
  4. Memorandum on the Provision of Isolation hospital Accommodation by Local Authorities. (January 1895) published in the Annual Report of the Medical Officer of the Local Government Board, PP 1895 LI, 627-35
  5. On the provision of Isolation Hospital Accommodation by Local Authorities. (August 1900)
  6. On the provision of Isolation Hospital Accommodation by Local Authorities. (1902) published in the Annual Report of the Medical Officer of the Local Government Board, PP, 1912-13 XXXVI, 136-40
  7. On the provision of Isolation Hospital Accommodation by Local Authorities. (1921)

The Hospitals Investigator 2, part 1

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In July 1991 Robert Taylor produced the second edition of The Hospitals Investigator, the newsletter he wrote and circulated to his five colleagues working on the RCHME survey of historic hospital buildings. Here he pondered Pest Houses, discussed deposited plans, and thought about (operating) theatres. In part 2b I will relay his discussion of ridge lanterns, sanatoria, and sewage works – we really knew how to enjoy ourselves.

Pest Houses

“Pest houses have been emerging from the Suffolk countryside at an alarming rate. The name indicates a house, usually an ordinary farm house, which was used by the local authority as an isolation hospital in the event of an outbreak of infectious disease, usually smallpox but in some early cases the plague as well. Details of the arrangements must have varied, but it seems that the tenant had an obligation to either nurse the victims or to move elsewhere for the duration of the sickness. The latter was perhaps the more common practice in the seventeenth century. The possibility of such an arrangement was taken for granted in the 1875 Public Health Act, although the Local Government Board did not like ad hoc hospitals very much and put pressure on local authorities to provide specialised buildings. A very few pest houses remained in use in the first years of this century.”

“So far the Cambridge office has seen only three surviving pest houses, at Halesworth, Framlingham and Bury St Edmunds. The first was a standard three-cell two-storey farmhouse of the late seventeenth century, and remained the centre of a working farm until the land was sold away recently. That at Framlinhgam was an early seventeenth century two-cell house with central stack, and similarly showed no sign of specialised planning. Although reputedly built in 1665, the Bury pesthouse displayed nothing earlier than the eighteenth century, and was  a three-cell, single-storey house with internal stack. Other pest houses remain to be located at Eye, Nayland and Huntingdon, as well as a few less certain cases.”

I couldn’t find any photographs of these particular pest houses, though there will be photos taken by Robert and Kathryn in the relevant files in Historic England Archives. Here is a much smaller version in Hampshire at Odiham, where presumably, a small population did not require anything bigger.

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This 17th Century Pest (or Plague) House in Odiham, Hampshire is one of only five remaining in the country. Photograph by Anguskirk and licensed under CC BY-NC-ND 2.0

The Patrick Stead Hospital continues to function as a community hospital, and was designed as a cottage hospital by Henry Hall. It opened in 1882.

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Above is a postcard showing the hospital, and below an elevation and plans produced in The Builder in 1880. Originally it provided a dispensary, outpatients’ clinic and accident ward, all on the ground floor, with further wards above. Patrick Stead set up a maltings business in Halesworth, and bequeathed a generous £26,000 to establish the hospital.
 Deposited Plans

“Recently one of us was reading a letter written by an official of the Ministry of Health in 1926 when it suddenly became clear that the writer of the letter had in front of him a set of plans for an isolation hospital that had been sent to the Local Government Board in 1888 in connection with an application for sanction to raise a loan. Plans of isolation hospitals were deposited when an authority applied for permission to borrow money for hospital building, and also when the more responsible authorities voluntarily sought approval of their proposed hospital. The Local Government Board was replaced by the Ministry of Health, whose archive should contain these immeasurable riches, along with similar material for workhouses. Unfortunately most of the material dating from after about 1902 was lost in the blitz, and what survived that seems to have been mostly destroyed in a fire in Brighton. All that survives is at [the National Archives, at] Kew, hidden behind the catalogue code MH. The three main groups seem to be MH.12, MH.14 and MH.34.”

“MH.12 consists of Poor Law Union Papers, of which 16,741 bound volumes, arranged under Unions, survive from between 1834 and 1900… MH.14 is called Poor Law Union Plans, and there are 38 boxes of them dating from between 1861 and 1900. They have reference numbers linking them to MH.12… MH.34 is a register in 11 volumes of authorisations on workhouse expenditure between 1834 and 1902.”

Reading this today, it is a reminder of how much researchers now gain from online digitised archive catalogues, and perhaps a lesson not to grumble about them (as I frequently do) when we can’t find what we’re looking for, they crash, they change, or they assault ones aesthetic sensibilities.

Theatres

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The Hopgood operating theatre at the Royal Free Hospital, 1895, Royal Free Archive Centre on Flickr. Imaged licensed under CC BY-NC 2.0

“One of the problems met in small hospitals is the identification of the jumble of buildings behind the main block. As in a mediaeval house the identification of the hall acts as a key to understanding, or at least knowing the rough layout of, the entire house, so one might expect that the operating theatre might stand out and give some help in finding a way through the maze. Unfortunately this does not always happen. Plenty of light was necessary, so a roof light is an important indicator. A large North-facing window is another but less reliable sign, and far too often the windows appear to be ordinary ones, the lower parts filled with obscured glass, as at Southwold. At Felixstowe the theatre has a semi-octagonal North end, like a sitting room, with ordinary-sized windows that are now blocked. The Beccles Hospital of 1924 has a magnificent but sadly un-photographable theatre with a North wall and roof of glass. Sometimes it is possible, if we are very tall or can manage to balance on tip-toe or on a convenient upturned bucket, to glimpse through the windows the white-tiled walls, or even the upper parts of lighting equipment.”

Students from the London School of Medicine for Women watching an operation at the Royal Free Hospital.  Students observing an operation c.1900 Royal Free Archive Centre on Flickr. Imaged licensed under CC BY-NC 2.0

Stratheden Hospital

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Stratheden Hospital from the south, photographed in October 2014 by MacKlly (image reproduced under CC0 1.0 Universal)

Stratheden Hospital is administered by NHS Fife as a community hospital caring for patients with mental health issues. Most of the patients’ accommodation lies within the grounds of the Victorian hospital complex (pictured above), which was originally built as the Fife and Kinross District Asylum for Pauper Lunatics. The old buildings, deemed no longer fit for purpose, have been lying empty for the last three years or more, and are not designated as listed buildings.

Photograph taken in May 2001 © RCAHMS Aerial Photography

The aerial photograph from 2001 shows the site as it was then, with the historic core on the top right. New buildings added to the site in recent years have been built in the open space to the east – just below the original buildings on the photograph. The newest addition to the site is an 8-bed Intensive Psychiatric Care Unit (IPCU). On 6 July 2015 work was officially commenced on its construction, with Nicola Sturgeon joining the NHS Fife chief executive Paul Hawkins in a sod-cutting ceremony.

25-inch OS map of 1893, reproduced by permission of the National Library of Scotland

The oldest buildings on the site were designed in 1860 by Peddie and Kinnear, as the district pauper asylum for Fife and Kinross. The site had been acquired from a Mr R. Wilson of Cupar, comprising a large estate around a house named Retreat – rather apt. But the house seems to have been demolished to make way for the farm steading. The architects were awarded the commission following a limited competition in which Brown and Wardrop were the only other architects invited to submit plans. Peddie and Kinnear had themselves unsuccessfully competed for the design of the Inverness District Asylum the year before, and in 1860 produced plans for Haddington District Asylum. Earlier they had designed a number of poorhouses, and so were well versed in the complex requirements of such large institutions.

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 elevations and sections

Building work suffered various delays and only began in 1863, with the foundation stone being laid in August 1864. The delays were largely due to Lord Kinnoul whose amendment to the Lunacy (Scotland) Act allowed pauper lunatics to be accommodated in poorhouses. He was energetic in lobbying the Lunacy Board in an attempt to dissuade them from proceeding with the Fife asylum until the Bill was passed in 1863. However, the accommodation for lunatics generally provided in poorhouses was unsuitable and insufficient. As soon as Stratheden was completed the Commissioners in Lunacy withdrew the licence to keep lunatics in Dunfermline Poorhouse.

Extract from the 6-inch OS map, revised in 1938, reproduced by permission of the National Library of Scotland. The map shows the original block on the north side of the complex which by this date had been considerably extended.

The asylum was described in the Commissioners’ annual reports as being of ‘plain and economical construction’ with a separate house for the Medical Superintendent and a porter’s lodge. In 1865 it was noted that: ‘the whole of the main building is roofed in excepting the centre block, containing the dining‑hall, amusement room, etc, the roof of which has been delayed in consequence of the iron beams required for its support having been lost at sea.’

Stratheden Hospital was opened without ceremony on 4 July 1866 for 200 hundred pauper lunatics; the Fife Herald noted that the first patient to be admitted was a woman ‘who stared considerably at the sight of the palatial display and who had ultimately to be forcibly introduced to a home in everything but name’. Just before the asylum opened it was inspected by two of the Commissioners in Lunacy, an event that was reported in the Fife Herald with considerable local pride. The warm sunshine and strong breeze of wind on that late June day meant that the means of ventilation were well exercised, ‘imparting to the asylum a fresh and delightful odour, such as is only to be found in green fields and rural scenes’. [Fife Herald, 21 June 1866]

Upper-floor plan by Peddie & Kinnear, one of a set of plans by the architects in the NMRS collection

Fife and Kinross asylum was up-to-date in its provision of a mix of single rooms and larger dormitories and day rooms for the patients. It boasted no architectural display, efficiency with economy being the requirements of the Lunacy Board. With a frontage of 410 feet, the main building was symmetrical, males occupying the east, the females the west side. The end wings were for infirmary and refractory patients on the ground floor with quiet and convalescent patients above. At the centre was the dining-hall and a recreation hall that was also to serve as a chapel, the usual arrangement at this date. On the north side, the two-storey range at the centre contained the main entrance, reception rooms, a laboratory and staff offices.

Amongst later additions, a hospital block was added by Kinnear and Peddie in 1891 and a large new nurses’ home, designed by Andrew Haxton was built in 1929. [Sources: Commissioners in Lunacy, Annual Report, 1865: RCAHMS drawings collection]

former Murthly Hospital, Perthshire

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MURTHLY HOSPITAL   Built as the Perth District Asylum, it was designed by Edward & Robertson, of Dundee and opened in 1864. It was the second district asylum to open in Scotland. Five architects submitted plans from which the Dundee architects were chosen. David Smart designed the Italianate administration block at the centre. In 1885 a cottage hospital was added on the site which later became the nurses’ home. In 1894 two villas were built which were an early attempt at providing accommodation for pauper patients on the colony system. They were named after the pioneers in psychiatry Pinel and Tuke. The hospital closed in 1984.

aerial photograph taken in 2001  © RCAHMS

Now largely demolished and the site developed as a housing estate called Druids Park (inspired by the stone circle on the eastern side of the site).

south front photographed in 2001 © RCAHMS ref SC 785510

A few of the old hospital buildings have been retained. The administrative block on the north side of the asylum , though considerably altered, which is the only part to be listed (at grade C). Although I previously stated that this was designed by David Smart, and elsewhere it has been dated to 1871, I have been unable to find – or re-find – any evidence of such an addition at that time, and the wing seems to appear on the first edition OS Map, so I am inclined to conclude that it is a part of the original building. (A possible caveat is an advertisement for tenders for the erection of additional offices at the asylum but this is not until 1893) Also surviving are the two villas, Pinel and Tuke, built in 1894 and of similar design by David Smart.

These are historically of great significance, being particularly early examples of detached villas for patients added to asylums. The medical superintendent’s house, to the east of the site, appears to have survived, if so this is also one of the earliest buildings on the site, being part of the first phase of building. Lastly the nurses’ home, added in 1885 by David Smart, which has been incorporated into Stewart Lodge, on the south-west side of the site.

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Staff houses photographed in 2001 by RCAHMS

Perthshire Advertiser gave a list of the contractors for the original building, and noted that the stone for the rubble work was from Arbroath, while the hewn stone, used for dressings and quoins, was from Bannockburn. 

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Lennox Castle

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Lennox Castle in 2014, photographed by Robert Adam at RCAHMS One of a series of aerial photographs of the site

Lennox Castle has been on the Buildings at Risk register for Scotland since 1992, the website provides a good summary of the history of the building and the site. Rather wonderfully, the Book of Lennox Castle produced for the opening ceremony of the hospital in 1936 has been scanned and put online by S J McLaughlin, who has charted the history of the hospital and includes numerous photographs. Records from the hospital are deposited with NHS Greater Glasgow and Clyde Archives.

An extraordinary aerial photo  posted early in 2014 shows part of the site after the patients’ blocks had been demolished. In 2006 planning permission was granted for this area to be developed as the Celtic FC training centre. Below is an aerofilms photograph, taken from the north in 1953, showing Lennox Castle on the right, and the former female division to the left. But this was only a part of the hospital site overall. The OS map from 1958 shows the other sections of the hospital. At this date the blocks to the north-east formed a separate maternity hospital.

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Aerial photograph 1953 in the collection of RCAHMS

The aerial photograph of that section of the hospital (below) was taken in 1953. It was turned into a maternity unit in 1941, as part of the Emergency Medical Scheme during the Second World War and continued as such until 1964. All the buildings were demolished to make way for a housing development, for which planning permission was granted in 2006.

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Aerial photograph 1953 in the collection of RCAHMS. This shows the former male division which became an emergency hospital during the Second World War and partly used as a Maternity Hospital.

Below is a revised version of the piece I wrote on the hospital around 1990. I remember the hospital quite well, it was one that was particularly impressive, architecturally and for its setting. It was quite a shock to see what has happened since.

LENNOX CASTLE HOSPITAL, LENNOXTOWN   Lennox Castle, situated at the western edge of the hospital complex, was built between 1837 and 1841 to designs by David Hamilton.

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Lennox Castle, before it became a roofless ruin, photographed by RCAHMS

It was designed in a picturesque neo‑Norman style with castellated and battered walls, and an imposing porte‑cochere. In the 1980s there were some fine interiors on the principal floor but the building had suffered badly from subsidence. The external stonework was also in very poor condition near the ground and had been roughly patched up with concrete rendering.

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View of the dining-room ceiling at Lennox Castle, photograph from RCAHMS, nd.

In April 1925 Glasgow Parish Council resolved to build a new Mental Deficiency Institution under the provisions of the 1913 Act. In 1927 Lennox Castle and its vast estate were purchased, and plans prepared for what was to be the largest and best equipped hospital of this type in Britain. It was to provide 1,200 beds at a cost of 1.25 million. Work began in 1929 to designs by Wylie, Shanks & Wylie. The hospital was finally completed in 1936. The site was divided into five sections; a male division, a female division, a hospital section, married staff houses and the engine house. The male and female sections each consisted of ten dormitory blocks for 60 patients. These were split into two main wards with 28 beds and two side rooms with two beds, together with a day‑room and sanitary annexe. Meals were to be provided in two central dining‑halls capable of seating 600 patients each. Above the dining‑hall, accommodation was provided for unmarried male attendants.

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The Assembly Hall, Lennox Castle Hospital, photographed around 1990 © Harriet Richardson

Lennox Castle itself was adapted into a nurses’ home. There was also a central Assembly Hall for all the patients, it contained a large hall with a stage and equipment for cinema shows as well as some administrative offices. All the new blocks were built of brick and incorporated many innovative features, in particular the heating system which operated on a system of underground tunnels.

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The dining-hall block, Lennox Castle Hospital, photographed about 1990 © Harriet Richardson

There was a considerable variety of plan and composition which added interest to the site. The Assembly Hall and dining‑halls featured arched windows on the ground floor and each had a central bold entrance bay. On the Assembly hall this comprised a grand arch rising the full‑height of the building and framing the porch, and on the dining‑hall blocks the door was set into an arch, which in turn was in a tall gabled centrepiece. The varied roof-line also added interest. A charming octagonal tea‑room in two tiers with plenty of windows, echoed the tea pavilion at Glen‑o‑Dee Hospital.

Lennox Castle Maternity Hospital and Institution, from the OS map published in 1958. Reproduced with permission of the National Library of Scotland.

During the Second World War the male division (on the map below) was taken over by the government for use as an Emergency Hospital and the male patients were moved to six of the villas in the female division and hutted ward blocks that were constructed near the Castle. Although intended for air raid casualties, the emergency hospital was not needed and so the beds were made available to relieve pressure on hospital accommodation in Glasgow. A post-confinement maternity unit was established at the site in 1941, initially in one villa consisting of three wards, plus another villa that was reserved for gynaecology cases.

The Maternity Hospital from the OS map revised in 1966, after it had ceased to take maternity patients. Reproduced with permission of the National Library of Scotland.

Although Lennox Castle was twenty miles from Glasgow, the maternity provision here, with its beautiful rural surroundings, proved very popular. Initial space for 30 patients was soon increased to 60 by using another villa. A certain number of women each week were transferred after confinement from one or other of Glasgow Corporation’s maternity units. The increasing demand for maternity beds in Glasgow was becoming harder to meet. In 1942 the total number of maternity beds available in voluntary and municipal institutions was 461, including ante-natal beds. In addition there were about 150 in nursing homes, and 44 beds for unmarried girls in four private homes. An extension of 32 beds was made at the Eastern District Hospital, and under the government evacuation scheme beds for expectant mothers were available at Haddo House, Peebles, Kilmacolm and Airthrey Castle.

Further beds were made over for maternity cases at Lennox Castle during and after the war. In 1960 work began on a new maternity hospital at Yorkhill, and additional beds were  provided at Redlands, and Robroyston Hospitals, and pavilions at Belvedere Fever were converted to maternity use, but there were still not enough beds to meet demand. Lennox Castle continued to provide maternity beds until 1964 when the Queen Mother’s Hospital at Yorkhill was completed. [Sources: Glasgow Corporation, The Book of Lennox Castle, Glasgow, c.1936. Glasgow Herald, 15 May 1936, p.12; 29 Sept. 1936, (ill.): RCAHMS, Inventory, Stirling, Vol.2, p.358.]

Airthrey Castle Maternity Hospital

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‘Airthrey Castle against the Blue’  by Amy Palko photographed in 2007, and licensed under  CC BY-NC-SA 2.0
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Below is the brief gazetteer entry of 1990, with additional notes in italics below. Airthrey Castle survives at the heart of University of Stirling

AIRTHREY CASTLE MATERNITY HOSPITAL, BRIDGE OF ALLAN   The hospital opened c.1941 in the mansion house, a daring design by Robert Adam in his castle style. However, it had closed by 1969 when the new maternity unit opened at Stirling Royal Infirmary. The estates of Airthrey Castle were built on to form Stirling University.

Revisions

Adam drew up designs for Airthrey Castle in 1791, but was not involved with its construction. Building work was supervised by Thomas Russell of Seton. The entrance front was rebuilt in 1891 to designs by David Thomson for Donald Graham, the chief partner in the firm of William Graham & Company, East India Merchants, of Glasgow. The interiors were fitted out with rich carved panelling, still in situ. He had purchased the estate in 1889, but died in January 1901 of erysipelas. After his death the house remained in his wife’s ownership,  but in 1924 the shipowner Charles Donaldson took a five-year lease of the estate. He died at the castle in December 1938.

At the outbreak of the Second World War the Estate was acquired by the Ministry of Health as an Emergency Maternity Hospital administered by Stirling County Council, taking patients from Stirling and Clyde. It remained in the ownership of the Graham family until after the war, having been put up for sale in November 1944. With the foundation of the National Health Service the hospital passed to the Western Regional Health Board. A nurses’ home was built in 1953 to the south-east of the house. This L-shaped, two-storey, flat-roofed building appears to have survived and was in use as a surgery/health centre for the University in the 1980s. 

In 1965 arrangements were made for the transfer to the new University of Stirling of the Airthrey Castle Estate, although it remained in use as a maternity hospital until 1968-9. It was replaced by new maternity units in Paisley and Stirling. The castle was listed in 1973 category B.

sources: Edinburgh Evening News, 23 Jan 1901: Dundee Courier, 1 Jan 1924: Western Daily Press, 8 Dec 1938: Dundee Courier, 15 Jan 1940: Dundee Evening Telegraph, 21 Feb 1944: PP ‘Report of the Department of Health for Scotland…’ 1953 c.9107: PP ‘Scottish Home and Health Department Review of the Hospital Plan for Scotland’ 1966 c.2877: OS maps.

Further Reading: N. Reid,  ‘Airthrey Castle Maternity Hospital 1939-1948’, and E. Rose ‘Airthrey Castle Maternity Hospital 1948-1969’ in Report of Proceedings of the Society of the Scottish History of Medicine, 1988-9, pp.14-17

I have just come across a conservation plan for Stirling University by Simpson and Brown  which includes a history of the Castle and the landscaping, it can be accessed here.