Building up our Health: the architecture of ’s

Building up our Health historic

From the day we are born we all have reason to visit the many hospitals which distinguish our towns, cities and villages. They have evolved from the almshouse and the philanthropic initiative of local lairds, to the municipal benefaction of the Victorian Infirmary and the streamlined designs tailored for today, contributing significantly throughout to our national identity. Whether we prefer the homely scale of the cottage or the vast microcosm of a nineteenth century sanatorium, this richly illustrated book shows how hospital architecture has adapted over the centuries in response to medical advances, changing philosophies and the necessities of their day. The informative overview closes with a look at their continued evolution to a sustainable future.

ISBN: 978 1 84917 039 0

Historic Scotland FRONT COVER Elevation of Oldmill Poorhouse, , Brown & Watt, 1907. © Robert Gordon University. Licensor www.scran.ac.uk H1.605 The House 3/10 Produced from sustainable material Building up our Health: the architecture of Scotland’s historic hospitals

Building up our Health: the architecture of Scotland’s historic hospitals

Historic Scotland iv | Building up our Health Building up our Health

Acknowledgments The text for this book was prepared by Harriet Richardson, with contribution from Ranald MacInnes.

Harriet Richardson has since 1991 been a researcher and writer with the Survey of , a part of English Heritage. During her time there she worked on a National survey of hospitals, editing the resulting book, English Hospitals 1660-1948, published in 1998. Prior to this she had conducted a similar survey in Scotland and worked briefly with the listing team at Historic Scotland.

Ranald MacInnes is Principal Inspector of Historic Buildings at Historic Scotland.

Most of the research for this publication was carried out as part of a national survey of hospitals conducted in 1989-1990. The work was funded by the Scottish Research Council and Historic Scotland, and directed expertly by Professor David Walker and Anne Riches at Historic Scotland, with John Gerrard and the Scottish Civic Trust. Material assistance came from the University Archives and the Greater Glasgow Health Board Archives. Morag Williams, then archivist to and Galloway Health Board and Fiona Watson, the Northern Health Services archivist (covering Grampian and Highlands), contributed their encyclopaedic knowledge of the hospitals in their respective areas and are thanked for this and their unstinting kindness and help. We also thank Development Company Ltd.

Illustrations for the publication were researched by Joan Richardson with the assistance of Michelle Andersson. Original photography was taken by David Fleetwood, Laurence Parkerson and (on behalf of The House) Sam Sills. Copy and style editing was by Abigail Grater. Proof reading by Joan Richardson and Dawn McDowell.

Illustrations Illustrations unless otherwise stated are supplied by Historic Scotland (www.historicscotlandimages.gov.uk) and are covered by © Crown Copyright.

We have done our best to track down the original copyright owners. In instances where they are unknown or could not be traced, if you have any information, we would be grateful to receive it.

© Crown Copyright 2010 Building up our Health Building up our Health | v

Contents

Foreword vi Introduction 1

Chapter 1: General Hospitals 9 Chapter 2: Cottage Hospitals 27 Chapter 3: Mental Health 35 Chapter 4: Poorhouses 51 Chapter 5: Infectious Diseases Hospitals and Sanatoria 67 Chapter 6: Specialist Hospitals 83 Chapter 7: Architecture and Health in Post-war Scotland 97

Bibliography 112 Historic Scotland 116

Foreword

For many of us, a visit to a local hospital will happen at one stage or another, whether it be a maternity ward, a cottage hospital or a city infirmary. This perhaps explains in part the popularity of medical dramas on television, but also the regular discussion of our health service provision in the media. Our hospitals are prominently sited and designed with pride to cater for changing needs, many are an important part of the character of our towns and villages, even where the buildings have found new uses as part of wider changes to our health infrastucture.

n 1989 Historic Buildings and which may have been listed for ways, from offices (such as Historic Monuments (now Historic their special architectural or historic Scotland’s own HQ at Longmore IScotland), aware of new pressure interest. We believe this resource is House in ) to residential on the hospital estate resulting from worthy of broader publication and (as the Marcus Humphrey House, at the creation of hospital trusts, worked celebration. Quarrier’s Village, Bridge of Weir). with the Scottish Civic Trust to Building up our Health celebrates We hope you enjoy this book – a provide a nationwide overview of this rich legacy, explaining the fascinating story of the development hospital buildings. In this we were evolution of the different types of and evolution of one of Scotland’s key aided by funding from the Scottish hospitals and giving examples of building types. Research Council. This provided the best. Evolving to suit medical an instructive report on the history, advances and new philosophies of Malcolm Cooper diversity and extent of the building healthcare, hospital architecture is Chief Inspector type, which in turn has been a key developing all the time and many Historic Scotland’s Inspectorate resource for those working on the former hospitals now continue to future management of these hospitals benefit their communities in other VIII | Building up our Health Building up our Health

Introduction

This book aims to give a taste of the rich architectural heritage of Scotland’s hospitals. The hospital is a distinctive building type, and one with which we are all intimately familiar. When we think of a hospital, most of us would probably imagine one of the great Victorian general hospitals, such as the former Edinburgh Royal Infirmary, with its old-fashioned Nightingale wards. These long wards, where the patients’ beds were placed opposite each other, have lost their appeal to modern planners and designers, though are often remembered fondly by both patients and nurses. From the latter’s point of view they were easy to supervise, and from the former’s, one never felt forgotten or out of sight.

Elevation drawing of , , James Matthews, 1864. © Royal Commission on the Ancient and Historical Monuments of Scotland; D/73039/P. Licensor www.scran.ac.uk 2 | Building up our Health Introduction

Plan of Fyvie Cottage Hospital, Duncan and Munro, 1879. © RCAHMS (Duncan and Munro Collection). Licensor www.rcahms.gov.uk Introduction | 3

Corstorphine Convalescent Hospital, Edinburgh, 1867, photo 1912. © Lothian Health Services Archive. Licensor www.scran.ac.uk

ospitals come in many and they are considered in separate . Alongside famous Scottish different guises and sizes. chapters. medics such as Archibald Pitcairne, HSince the first ‘modern’ These pages are to present only James Syme, Sir James Young Simpson medical institutions appeared in the a brief overview of a broad spectrum and Sir Alexander Fleming, students 18th century there have been hospitals of these buildings, an outline of their came from far and wide to study here. with as few as three beds, to vast evolution, providing a good sense of These included Joseph Lister, who complexes housing many hundreds. their architectural merit. came to Edinburgh in the 1850s, later Apart from general hospitals there Scotland has a particularly rich to become Professor of Surgery there. were cottage hospitals, asylums for medical heritage with a long and But sometimes progress had a the mentally ill, poorhouses (most of distinguished history of academic darker side, and undoubtedly the which cared for the sick as well as the excellence. The Royal College of most infamous pair associated with poor), isolation hospitals for people Surgeons in Edinburgh has, indeed, Edinburgh’s medical past was Burke suffering from infectious diseases, and some claim to being the oldest and Hare. For a brief period they sold a raft of specialist hospitals which medical incorporation in the world, fresh corpses to Professor Robert catered for different illnesses, groups dating back to 1505, while in the Knox for dissection. Unlike the within the community or parts of 18th century Scottish universities ‘resurrectionists’ who traded in bodies the body. Each of these produced a established themselves as important stolen from burial grounds, before slightly different architectural response, centres for the study and practice of they were caught Burke and Hare 4 | Building up our Health Introduction

Glasgow Royal Infirmary in Cathedral murdered their hapless victims, whom built in which to treat the sick. The Square, Glasgow, photo circa 1910. they lured to their lodging house in first truly medical institutions appeared © Reproduced courtesy of Glasgow City Archives and Special Collections Tanner’s Close. almost three hundred years ago, in the Less well known perhaps, and early 18th century. Before that time long overdue for celebration, is the medical care was mostly conducted architectural heritage of Scottish within the home, and ‘hospitals’ were medicine, and in particular, the many more commonly understood to hundreds of hospitals that have been be places of refuge for the poor, or Building up our Health Introduction | 5

schools such as Donaldson’s Hospital. founded subsequently. In London London was in Edinburgh, where Before the Reformation, monasteries these included St Thomas’s and St the Royal Infirmary began humbly often included a small infirmary, Bartholomew’s, general teaching enough in a rented house in 1729. though this would usually have hospitals, and St Mary of Bethlehem It was not until 1736 that a general been reserved for members of the for the mentally ill – or Bedlam as it hospital opened in the provinces order. Treatment of the sick outside was known. Epidemics of infectious in England, at Winchester, also in a the monastic community is hard to diseases or plague, from the Black converted house. document, but certainly did occur and Death in 1348 to the Great Plague These marked the beginnings is associated with particular monastic in 1665–6, led to pest houses being of the voluntary hospital movement, orders – notably the Augustinians. provided. These were temporary meaning charitable institutions More common were leper places where the infectious could be that were funded by voluntary hospitals which began to appear from isolated from the healthy, and would subscription. Subscribers were granted about the 12th century, a mark of be abandoned once an epidemic privileges dependent upon the how readily identifiable the disease subsided. amount of their donation. The most was. They were usually separate By the early 18th century the generous would be entitled to a place communities, on the edge of a larger study of medical science was gaining on the governing board, but all would settlement. In Scotland 178 medieval momentum, but outside London there be able to recommend candidates hospitals have been identified, but were no hospitals in Britain where for admission. Most patients were the majority of these had no medical patients could be observed in great very poor – anyone with enough function, serving as poorhouses, numbers. This was also the dawning of money would have procured medical almshouses or hospices for pilgrims the Enlightenment, when humanism attendance within their own home. and travellers. engendered a desire to improve the Even operations were conducted on Few of these survived into the human lot. The time, therefore, was kitchen tables. late 16th century. In England, Henry ripe for establishing hospitals for Hospitals were founded by VIII’s dissolution of the monasteries the sick poor, especially in towns physicians but also by a variety of during the 1530s and 1540s wiped or cities where medicine was being philanthropic individuals, wealthy out nearly all the hospitals; only studied. It is significant that the first merchants and through the efforts a very few survived or were re- general hospital to be founded outside of guilds, institutions and public 6 | Building up our Health Introduction

bodies. Truly municipal hospitals needed – a boiler house to provide devised to bring together the Royal came later, in the wake of legislation heating and hot water, kitchen, Infirmary, maternity and children’s concerning public health, poverty laundry, operating theatres, X-ray hospitals and the University medical and mental illness. Public health acts room, outpatient departments, offices, school on one site. were instrumental in establishing a committee room, chapel, mortuary, During the Depression years of network of isolation hospitals, while and a nurses’ home. Asylums were the 1920s and 1930s many voluntary the new Poor Law set up ‘workhouses’ designed as self-sufficient communities hospitals were financially stretched, in England, Wales and Ireland and with their own farm for produce and with fund-raising a constant effort. ‘poorhouses’ in Scotland, where the occupation for the patients, recreation Yet the concept of a National Health destitute sick were given medical care. halls, garden grounds and staff houses Service (NHS) was not welcomed by A series of Lunacy Acts established – the medical superintendent’s house all. Primarily resisted by the medical county asylums for paupers suffering was often a substantial detached villa. profession, it was also viewed with from a range of conditions which In the 20th century hospitals alarm by many who had devoted were then certifiable as ‘lunacy’. became less the sole preserve of themselves to keeping their local In the second half of the 19th the very poor, encouraged by hospital going. Nevertheless, in 1948 century hospital design began developments that made operations the NHS was inaugurated and the to change, responding to new safer and more successful, such as opportunity was there to modernise understanding about the way in which antisepsis and anaesthetics. The state buildings and rationalise services. The spread and a belief in the began to intervene more formally, enormous advances in medical science beneficial effects of sunshine, fresh providing sanatoria for people in the 20th century have changed air and cleanliness. The architectural suffering from and hospital requirements in so many press promoted the new pavilion-plan introducing maternity and child respects. Transport too has played a hospital with its cross-ventilated wards, welfare schemes. There were also part, with public transport and then and separation of different patients, widespread calls for reform of the car ownership making the logistics of whether surgical from medical in Poor Law. Some areas developed hospital locations very different from a general hospital or from initiatives in municipal pre-war days. diphtheria in an isolation hospital. By which foreshadowed the National Although post-war architecture the end of the century an ever greater Health Service. In Aberdeen in the and design is only now gaining greater complexity of ancillary buildings was 1920s a joint hospitals scheme was popularity amongst the population at Building up our Health Introduction | 7

large, it will not be too long before of hospital construction was the and a listed building could be hospital buildings of the later 1960s, redundancy of older buildings. The altered without regard to its historic 1970s and into the 1980s will be more final chapter of this book considers value. Many hospitals with special widely appreciated, though many have their fate, and looks at some which architectural and historic importance been so greatly added to and altered have been successfully converted now have full protection through that the integrity of the original to new uses. Until 1990 health- listed building status, and many have design has been compromised. care buildings were given ‘Crown been saved that might otherwise have Part and parcel of this new wave immunity’ from planning regulations, been demolished.

Children at Hospital, Glasgow, circa 1922. © Reproduced courtesy of Glasgow City Archives and Special Collections 8 | Building up our Health

Interior of Ward 16, Royal Infirmary of Edinburgh. © Lothian Health Services Archive. Licensor www.scran.ac.uk Building up our Health

General Hospitals

Mr Malcolm Macnicol, a but less cheerily communal and and are barrack-like, with Consultant Orthopaedic Surgeon, harder for the nursing staff to no outside views. At the old has some personal thoughts supervise). Bangour General Hospital a cow about the change in hospital would occasionally chew the cud architecture. ‘For doctors the serried ranks of with its head inside a theatre patients in one large ward were window, while the original ‘The changes in hospital daunting but the open geography Royal Hospital for Sick Children architecture from 1962 include did encourage larger, more theatre opened directly on to the the move from sandstone Gothic communicative ward rounds, southern front hall and door, and or red brick to the geometric and sociable meals at one or two also offered great views to the and box-like, although the tables, with informal concerts north and east.’ earliest modern buildings to the whole ward at Christmas evoked interest in us, as medical when the turkey was carved by students – not least the Nuffield the senior surgeon. Now these Transplant Unit at Edinburgh’s full ward rounds are impossible and the and the small, often windowless, Group Practice Surgery at Kelso. offices mean that staff even eat With the new hospital buildings lunch and dinner in isolation. came segmentation of the old Gone also are the wood-panelled “Nightingale” wards into four- board rooms where coffee and and one-bedded units (better conversation were enjoyed. for privacy and control ‘Theatre suites too have changed 10 | Building up our Health General Hospitals

Chapter 1: General Hospitals

The modern general hospital has its origins in a handful of institutions founded in the early 18th century. In Scotland, the first amongst these was Edinburgh’s Royal Infirmary, which began in a small rented house in 1729, having been proposed a few years earlier by the Royal College of Physicians. Its success soon led to the construction of a handsome new building. This was a new type of public building, paid for by the wealthy to serve the poor, and so in its appearance a balance had to be struck between the dignity and philanthropy of the benefactors and the modest status of those whom it was to benefit.

Fig 1.1 Royal Infirmary of Edinburgh, William Adam (begun 1738), photograph circa 1870. © RCAHMS (Scottish Colorfoto Collection). Licensor www.rcahms. gov.uk Building up our Health General Hospitals | 11

Fig 1.2 Royal Infirmary of Edinburgh, plan by William Adam, taken from Adam’s Vitrivius Scoticus, 1812. © Courtesy of RCAHMS. Licensor www.rcahms.gov.uk

he architect commissioned to design Edinburgh Royal TInfirmary was William Adam (c.1689–1748). The foremost architect in Scotland at that time, Adam was instructed to design a solid and durable building, with little or no expense on functionless ornament. He achieved the balance perfectly by using simple elegant classical proportions, with rich embellishment reserved for the very centre of the building. The Infirmary was built in stages, beginning in 1738, and only completed ten years later [1.1 and 1.2]. In all, it was intended that it should conveniently accommodate 200 patients, and it was even stipulated that each patient should be allowed a bed. This is an uncomfortable reminder of conditions that the poor might 12 | Building up our Health General Hospitals

Fig 1.3 , Inverness, circa 1830-1860, John Smith of Banff. © NHS Archive have expected at that date, if single in the late 15th century, but to hospital, which was founded in 1739 occupancy of a bed had to be spelled gain clinical experience medical and for which William Christall out or advertised as a peculiar benefit practitioners completed their training produced the design, the foundation of the institution. Wards contained abroad. Once the Royal Infirmary stone being laid in January 1740. either twelve or 24 beds, the smaller was established, this was no longer In Dumfries, the Royal Infirmary ones in the wings, the larger in the a necessity. Surgery and anatomy began in a modest Georgian building central section. In terms of size, could now be demonstrated to two erected in 1778, while in Inverness external appearance and internal hundred students at a time in the large the Royal Northern Infirmary was layout, the infirmary was every operating theatre in the attic, top lit by founded at the very end of the 18th bit as well designed as its London the cupola that ornamented the roof. century, opening after some delay counterparts: St Thomas’s, Guy’s and A few further general hospitals in 1804. Designed by John Smith St Bartholomew’s hospitals. were founded over the course of the of Banff, the core of this building The Royal Infirmary of 18th century, but not on quite such survives, much added to at different Edinburgh was not merely of Scottish ambitious lines. In Glasgow the Town’s periods, but retaining a strong sense significance; it was the first teaching Hospital of 1732 was also purpose of its original appearance. It was not hospital to be established in Britain built and on a large scale, but was dissimilar to contemporary country outside London. By 1700 Scotland principally a workhouse or poorhouse houses, with the central block had already gained a reputation as with some medical attendance. graced by a pediment supported by an important centre for studying Nevertheless, this and the Royal Corinthian pilasters resting on the medicine. The first Chair of Medicine Infirmary in Edinburgh served as the rusticated ground storey. Originally in Britain was established at Aberdeen models for Aberdeen’s first general this far smaller central block was Building up our Health General Hospitals | 13

Fig 1.4 , Robert Adam, perspective engraving, 1847 from Sketch of the History of Glasgow, by James Pagan. © Glasgow City Libraries. Licensor www.scran.ac.uk

building, elegantly neoclassical in style, with accommodation for 200 patients. It was remarkably tall, with four full storeys and attic over a basement, the central bays ornamented with a raised portico and surmounted by a dome. linked by single-storey ranges to two- (1728–1792) design for the Glasgow This could not be confused with storey pavilions at either end [1.3]. building was far more ambitious, and any private gentleman’s residence, The need for more accommodation its impressive principal elevation was but was far more obviously a public eventually led to the single-storey a dignified expression of civic pride. building more akin to a university. ranges being built over, and later still Adam was not the first choice and was It was indeed paid for by public and an operating theatre was built out only brought in, almost by chance, institutional subscriptions, and, like onto the front above a new covered following the death of the appointed its rival in Edinburgh, was a teaching entrance. architect and the refusal of his assistant hospital [1.4]. Its near contemporary, the to take over the commission. Adam A surviving Georgian hospital Glasgow Royal Infirmary, was both himself died in March 1792 shortly which shares something of the more sophisticated and more complex after completing his designs. His verve of Adam’s Glasgow Royal is in plan and elevation. Here, at last, brother James (1732–1794) took over Gray’s Hospital in Elgin. Its founder, was Glasgow’s answer to Edinburgh’s the job until he too died in 1794, the Alexander Gray, was a surgeon in the Royal Infirmary. In comparison with year that the infirmary opened. Navy and to the Bengal Establishment the other town infirmaries which Demolished to make way for of the East India Company. When were in existence by the end of James Miller’s (1860–1947) new he died on 26th July 1807 he left the 18th century, such as in the early 1900s, £20,000 to establish a hospital for the and Dumfries, Robert Adam’s the Adam infirmary was a palatial local sick and poor. His will contained 14 | Building up our Health General Hospitals

many oddities and was contested by on 1st January 1819, providing just elevations fronted unadventurous his relatives. In particular his wife 30 beds which were available to plans that had moved on little since rejected his accusation that she was any parishioner in the county of the earlier 18th century. Typically ‘the most abandoned and deliberately Moray on presentation of a note of they comprised wards, an operating infamous wife that ever distinguished recommendation from their local theatre ideally top lit or with even the annals of turpitude’. Between minister [1.5]. north light, a board room and other 1807 and 1814 the case was in the In the next decades further rooms for hospital officials, a kitchen Court of Chancery, but the family general hospitals were built, usually and laundry, a dispensary, and often were unsuccessful. founded by the local gentry a chapel and mortuary. There might (1776– and funded by voluntary public be accommodation for the matron 1855) was appointed as architect on subscription, and thus termed or for senior medical officers, but not the recommendation of the Earl of ‘voluntary hospitals’. The elegant yet for nurses. Heating was by open Moray, with whom he had worked classical proportions of their fires until well into the 19th century. in laying out his estate in Edinburgh’s New Town. The architect’s skill in town planning is evident in the positioning of the Elgin hospital, its main front aligned with the town church, later rebuilt on the same site by Archibald Simpson (1790–1847). In 1815, on 11th June, the foundation stone was laid. Reputedly the ceremony was interrupted by news of Wellington’s victory over Napoleon at Waterloo. The hospital opened

Fig 1.5 Dr Gray’s Hospital, Elgin, James Gillespie Graham, completed 1819. © Elgin Museum Building up our Health General Hospitals | 15

Generally these components were Revival style, and opened in 1838. Fig 1.6 Montrose Infirmary, James Collie, 1839. arranged off a central corridor, hence Montrose Infirmary was built to the term ‘corridor plan’ for this type designs by a Glasgow architect, James of hospital. Collie (c.1810–1881), and opened Fine examples of provincial in 1839. Also adopting a Greek infirmaries from the 1830s can be Revival style, it featured a portico found in Perth and Montrose. In Perth supported by fluted Doric columns. Its a dispensary was established in the foundation was linked with that of the early 1830s. Dispensaries were often Montrose Lunatic Asylum, established the precursors of a hospital, operating in 1781 as an asylum, infirmary in a similar way to the modern and dispensary. When the separate outpatients’ clinic. A generous gift of infirmary was erected, it accepted all £1,000 in 1836 allowed a purpose- but the mentally ill, including those built infirmary to be erected. It was suffering from infectious diseases. Later designed by William Macdonald separate fever wards were built to stop Mackenzie (1797–1856), the City the spread of infection [1.6]. Architect, in a fashionable Greek 16 | Building up our Health General Hospitals Building up our Health General Hospitals | 17

Fig 1.7 Chalmers Hospital, Banff, William Lambie , 1864. © Crown Copyright: RCAHMS. Licensor www.rcahms.gov.uk

By the middle of the 19th century, advances in medical knowledge, coupled with technological innovations, paved the way for new types of hospital design in which the very layout and methods of construction would have a positive effect on the patients’ treatment and chances of recovery. Chief among these was a type of plan which separated out the different functions of the hospital, with the wards placed in blocks or pavilions in varying degrees of detachment. Familiar today as Nightingale wards, this shift in the basic design of the ward seen in pavilion-plan hospitals also saw the introduction of interior finishes that could be cleaned easily, radically reducing the risks of infection setting in or disease spreading throughout the hospital. The catalyst for this change was the Crimean War, and the appalling casualties in the hospitals from disease rather than battle wounds. The widespread adoption of the pavilion plan from the 1860s quickly caused hospitals built only a decade 18 | Building up our Health General Hospitals

Fig 1.8 Edinburgh Royal Infirmary, , elevation from The Builder, V28, Dec 17, 1870. Reproduced by permission of the Trustees of the National Library of Scotland

or so earlier to be outdated. Yet the few general hospitals built in this period are richly varied. The grace of Archibald Simpson’s Aberdeen Royal Infirmary at Woolmanhill, built in 1840 of cool and glittering grey granite, contrasts strongly with the mullioned windows and shaped gables created just fifteen years later for the new Royal Infirmary by the English architectural practice Coe & Goodwin. Chalmers Hospital in Banff of 1864 is another fine example [1.7]. Designed by Edinburgh-based architect William Lambie Moffatt left by Alexander Chalmers, who instead arranging the wards on one (1807–1882) in his characteristic died in 1835. His wife died in 1848, side of a corridor running around the Jacobean style, the tall, two-storey after which nearly ten years of legal inside of an open court. This and the original block has a busy skyline with wrangling delayed any progress on the rather grandiose style of the building a proliferation of gables crowned at building. Moffatt drew up the plans were deliberate attempts to distance the centre by an ogee-capped cupola. in 1860, but deliberately turned his the hospital from the new poorhouse Funds to build the hospital were back on the new pavilion principles, and workhouse infirmaries which Building up our Health General Hospitals | 19

invariably adopted the new type of (1814–1901), designed 1867, built plan. 1871–4 and the rebuilt Royal During the 1870s two large Infirmary of Edinburgh by David general hospitals were the first of Bryce (1803–1876), built 1870–9. their kind in Scotland to adopt the The Western was hampered by a lack pavilion plan: the Western Infirmary of funds which delayed building work in Glasgow by John Burnet senior and reduced the scale of the hospital 20 | Building up our Health General Hospitals

Fig 1.9 Detail of 1876-7 map showing plan of Royal Infirmary of Edinburgh. Reproduced by permission of the Trustees of the National Library of Scotland Building up our Health General Hospitals | 21

in the first instance to 150 beds. It United Kingdom and probably the was a teaching hospital, established as best planned. Despite its vastness it part of the move to relocate Glasgow was not long before additions and University to Gilmorehill. The new alterations were necessary – a nurses’ Royal Infirmary of Edinburgh, home in 1890, laundry buildings in on the other hand, provided an 1896, the Diamond Jubilee Pavilion unprecedented 600 beds, arranged of 1897 and two new pavilions for in eight three-storey pavilions ear, nose and throat cases in 1900 with one large ward on each floor. were all designed by Sydney Mitchell Though now itself replaced by the & Wilson. These were followed in newest Royal Infirmary, Bryce’s beefy 1935 by the Simpson Memorial Baronial masterpiece remains an Maternity Pavilion, designed by important architectural landmark in Thomas W Turnbull. the city. At its heart is the entrance The increasing size and scope range with a picturesque clock tower of the infirmary marked the rising rising high above the site. Behind success of hospital care. Medical this range was part of William Adam’s knowledge was expanding, treatments George Watson’s Hospital of 1738–41 were improving and hospital buildings which was incorporated into the new were becoming better suited to their building. The large roughly square site, function. Towards the end of the 19th sloping southwards, created a logical century an unusual ward type evolved split into the surgical hospital section in response to tight and awkward facing Lauriston Place to the north, sites; this was the circular ward. and the medical section facing the Circular ward towers could be placed Meadows to the south [1.8 and 1.9]. in a north corner of a site and still At the time of its opening, the provide ample sunshine, light and air. Illustrated London News described the The first to be built in Britain were in new infirmary as the largest in the London in the late 1880s. Only two 22 | Building up our Health General Hospitals

Fig 1.10 Balconies at the Royal Alexandra Infirmary, Paisley, Thomas Abercrombie, 1897-9.

hospitals in Scotland went in for such novelty. The first was the Kirkcaldy Cottage Hospital, now demolished, where plans for a circular ward were drawn up in 1895. The second was at Paisley at the Royal Alexandra Infirmary, rebuilt on a site off Neilston Road by the local architect Thomas Graham Abercrombie (1862–1926) in 1897–1900, but since superseded by the new hospital at Corsebar Road. Abercrombie’s elegant complex placed the circular ward tower at the north- east corner of the site and rectangular ward pavilions to the south, but their balconied ends were curved, echoing the circular tower and harmonising the design [1.10]. General hospitals continued to evolve in the early decades of the 20th century. Many of the older ones, such as the Royal Alexandra and Edinburgh’s Royal Infirmary, were rebuilt – often on a different site to allow for expansion as towns grew in size and the population swelled. More people now were willing to be admitted to a hospital, not just the Building up our Health General Hospitals | 23

poorest in society for whom treatment at home was impossible. Glasgow Royal Infirmary, however, was rebuilt on its existing site and Robert Adam’s fine building demolished to make way for the present building designed by James Miller in 1900. Miller was also the architect of the new built in 1911–14, and for Stirling Royal Infirmary, rebuilt in 1926–8. Fig 1.11 Aberdeen Royal Infirmary, James Brown Nicol, 1936. A growing trend was the provision © Aberdeen City Council, Arts & Recreation Department, Library & Information Services. Licensor www.scran.ac.uk of more specialist departments – such as the ear, nose and throat department different voluntary hospitals services James Brown Nicol (1867–1953) in added to the Royal Infirmary in Aberdeen on one large site bore 1927 and occupied a central position of Edinburgh. Separate specialist fruit at . Here the new in this ambitious scheme. Impressively hospitals had become a phenomenon Royal Infirmary was built alongside severe and uncompromising in grey of the later 19th century, but the a maternity hospital and children’s granite, the infirmary consisted of teaching hospitals in particular were hospital, together with a nurses’ home three five-storey ward blocks for keen to draw specialist cases back and the medical school buildings of medical, surgical and special cases. into the general hospital. The idea Aberdeen University. They shared The ward blocks extended south of centralising services, key to the services including steam for heating, from the gently curved east–west , had an kitchens, and sterilising and laundry corridor, fanning out from the central important forerunner at Aberdeen facilities. The University undertook administration area. This arrangement where a joint hospitals scheme was pathological, bacteriological and was a welcome variation to the usual devised by Professor Matthew Hay, biochemical work for the hospitals. long, straight barrack-like corridors, the city Medical Officer of Health. The new Aberdeen Royal and allowed a freer access of air His bold aim to bring together the Infirmary building was designed by and sunshine into the wards. When 24 | Building up our Health General Hospitals

Fig 1.12 Law Hospital, Carluke, Luftwaffe vertical photograph, taken 1940. © RCAHMS (Luftwaffe Collection). Licensor www.rcahms.gov.uk

the infirmary opened in 1936 the corridor, earning the building the added, notably at Bangour (West Aberdeen Press and Journal was warm nickname of ‘Siberia’ among the staff). Lothian). They had been built to take in its praise, and along the way noted Little different from an army camp, expected casualties from England, and that it had 1,995 ‘ultra-modern’ doors the Luftwaffe mistook Law Hospital so they were placed close to main and 2,652 windows [1.11]. for a military barracks and it was railway lines, though well away from lucky to evade bombing [1.12]. towns and cities that could themselves The Emergency Medical Scheme These most basic types of ward be targets for bombing raids. As it As war with Germany became huts were first devised during the turned out the numbers of casualties more certain, plans to cope with Crimean War by Isambard Kingdom from the south were not as high as at the possible casualties were put in Brunel (1806–1859), as quick kit- first feared, and the hospitals took in motion. The result in Scotland was hospitals that could be shipped out patients from nearby military camps, seven large new hospitals, of the most and assembled close to the scene of evacuees from city hospitals and basic and simple design, that were battle. Similar huts had been built sometimes prisoners of war. swiftly erected after the outbreak of during subsequent conflicts, and Although they were created war in 1939. The blueprint for the a small industry grew up making as temporary hospitals, and not hospitals was drawn up by the Office temporary buildings from timber expected to last more than twenty of Works but local architectural firms and corrugated iron that could be years, Killearn was the first to be were engaged to carry them out. Law bought cheaply and put up quickly. closed in 1972. The Peel closed next Hospital in Lanarkshire was the first, Many of these were acquired by local in 1989, and at about the same time completed before the end of 1939. authorities to serve as municipal Raigmore’s brick huts were pulled It comprised 16 wooden ward huts infectious diseases hospitals. down but the site retained for a new each containing two forty-bed wards, Six more emergency hospitals general hospital. The others were grouped in fours around a central were built or acquired across Scotland: upgraded and retained during the administrative and service section. Raigmore (Inverness); Stracathro (near 1980s. Bridge of Earn closed in 1992, There were also separate staff blocks Brechin); Bridge of Earn (Perthshire); and Ballochmyle in 2000, the hospital and an isolation unit. Heating was Killearn (Stirlingshire); Ballochmyle buildings demolished to make way by coal stoves (the nurses’ home at (Ayrshire) and the Peel (Selkirkshire). for a housing development. Stracathro Ballochmyle in Ayrshire was equipped Existing hospitals were also drawn Hospital is still in use with a few of with only three such stoves in the into the scheme with hutted annexes the wartime buildings surviving. Building up our Health General Hospitals | 25 26 | Building up our Health Building up our Health

Cottage Hospitals

Gillian Hutton is the senior while she sometimes misses for a long time. The location Charge Nurse at Aberfeldy the hustle and bustle of a busy of this hospital means that Community Hospital where she high-tech ward, she finds this is people do not have to make has worked for 10 years. more than compensated for by the journey to Perth Royal being recognised and thanked in Infirmary. The vernacular ‘The hospital is a great the street in Aberfeldy by past details in the architecture community resource,’ says patients or their relatives. ‘There of the building underline its Gillian, who is in charge of is a real sense of belonging recognition and status at the its day-to-day management. to the community here and a heart of the community. The hospital provides a variety great deal of community spirit of services for the people of amongst the patients and staff Aberfeldy and the surrounding of the hospital.’ district and has 12 inpatient beds which cater for a variety of Gillian notes the value of a needs, a physiotherapy service, local hospital to communities, an occupational health service however small, in that people and a minor injuries clinic. like to be treated where they know the staff and other Gillian worked previously in a patients and sometimes they large city-centre hospital, and meet friends they have not seen 28 | Building up our Health Cottage Hospitals

Chapter 2: Cottage Hospitals

General hospitals were only really viable in towns and cities, but in the mid-19th century the journey from villages and small rural communities to even the nearest town might be fraught with difficulty. Accidents needed swift treatment, and not a long uncomfortable ride in a cart over rough roads; and most patients would be deprived of visits from friends and family if they were removed too far from home. The answer was the cottage hospital – a small rural hospital run by the local medical practitioners, offering its services to a broader spectrum of the local community and usually charging a small fee to those who were in a position to pay for their treatment.

lorence Nightingale was a in 1880 but it was not until 1903 that great champion of this new a purpose-built hospital was erected, Ftype of hospital, the first of its designed by a local architect, Charles F kind opening in a converted house Anderson. in Surrey in 1859. It was not long By the turn of the century, before Scotland had its own cottage Scotland was peppered with cottage hospitals, two opening in 1865 – one hospitals, many with great architectural at Crimond in Aberdeenshire and the charm. They proved popular not only other in St Andrews. Little is known of with medical practitioners and patients the former, though unusually it seems but also with the wealthier local to have been purpose built from the citizens, who sometimes gave generous outset. In St Andrews the more usual sums towards their foundation and route was taken, with the hospital first endowment. Due partly to their opening in a rented house with just small scale, but also to their ethos, six beds. A larger house was acquired these were usually given a domestic Building up our Health Cottage Hospitals | 29

Fig 2.1 Gables at , Dingwall, William Cumming Joass, 1873.

appearance. Plans were more varied, on to have a highly successful career separated. Henry Burdett (1847– though often took on board the key as an architect in London, known for 1920), the philanthropist and hospital principles of pavilion planning. One his stylish commercial buildings. The reformer, commended the design and early example is the Ross Memorial father’s charming little Gothic hospital reproduced the plan in his book on Hospital at Dingwall, which opened is a far cry from these. Originally cottage hospitals, first published in in 1873 as a memorial to Dr William with just eight beds disposed in 1877. A low, single-storey building, it Ross who had died in 1869. It was two-bedded wards, it was unusual in has an array of gables to its main front designed by local architect William accepting fever and infectious cases that enliven what might otherwise Cumming Joass (d.1919), whose son as well as surgical and accident cases. have been rather a dull façade [2.1]. John James Joass (1868–1955) went These two sections were carefully 30 | Building up our Health Cottage Hospitals

Fig 2.2 , Forres, John Rhind with Henry Saxon Snell, 1892. Building up our Health Cottage Hospitals | 31

Leanchoil Hospital at Forres, materials and keeping to a single administer his bequest. A competition by contrast, makes a much grander storey [2.2]. for the design was assessed by Ewan architectural statement with its Perhaps the grandest cottage Christian (1814–1895), the ageing and two-storey gabled entrance block hospital was that built in Langholm in then ailing architect to the Church fronting a sturdy tower. A public 1896–8: the Thomas Hope Hospital Commissioners in England. In 1894, meeting held in 1888 first mooted [2.3]. Over £100,000 were left by its Christian awarded the job to John the possibility of building a cottage eponymous founder for a building of Henry Townsend Woodd of London, hospital here, and in the following good architectural character. Hope, a former pupil. Woodd and his partner year John Rhind (1836–1889) was a native of Langholm, had made his Wilfred Ainslie drew up the plans, asked to provide plans. These were fortune in America. After his death and work began in 1896. The hospital sent to Henry Saxon Snell & Son, the a group of trustees was appointed to opened in May 1898. Built of the pre-eminent London-based hospital Fig 2.3 Thomas Hope Hospital, Langholm, John Henry Townsend Woodd, 1896-8, architects in England at that date, for postcard circa 1905. © Unknown their comments. However, before they could reply, Rhind had died and Saxon Snell (1830–1904) took over as architect to the project. The resulting hospital, which opened in 1892, blends Baronial and Jacobean details which, along with the overall design, are probably the work of Rhind, with Snell refining the plan, perhaps in details such as the sanitary annexes separated from the wards by cross-ventilated lobbies. Extensions have been added at both ends, while a 1930s maternity wing blends its modern style sympathetically with the old by using the same tone of 32 | Building up our Health Cottage Hospitals

Fig 2.4 Former Cromarty Hospital, Cromarty, opened 1894. © Cromarty Courthouse Museum. Licensor www.scran.ac.uk

local white freestone, mostly bull- or hospitals that proliferated in the late 1909, and opened the following year. rock-faced, it was principally of one 19th century were plain and simple It was erected under the auspices storey over a raised basement that was buildings, and many of these fell foul of Sir Donald Currie of Garth on partly arcaded. It was described at the of the National Health Service (NHS) a site granted free by the Marquis time as being in the ‘Border style’, policy of centralisation. of Breadalbane. The architects were presumably because of its bold central Cromarty’s cottage hospital, for Dunn & Watson, who produced a tower with its hints of a peel tower. example, opened in 1894 but was design that blends with the local One of the building’s distinguishing closed in 1953. Its domestic scale architecture, being single-storey and features is its octagonal mortuary. readily leant itself to conversion to a white-harled with crowstepped gables There are also elaborate ironwork private house [2.4]. Plain and simple, and green slate roof. This sensitivity gates supplied by Peard & Co of in the hands of a gifted architect, to Scottish vernacular architecture is London. could also possess considerable reminiscent of Sir Robert Lorimer’s The Thomas Hope Hospital architectural flair. This is evident at (1864–1929) romantic Scots-style is exceptional; most of the cottage Aberfeldy’s cottage hospital, dated buildings. Building up our Health Cottage Hospitals | 33

Cottage hospitals continued to broken segmental pediment above the Wing at the Victoria Infirmary in prove popular in the interwar period, entrance, and the simple Lorimeresque Glasgow (1930–31). often being founded either as a dormerheads [2.5]. The quality of the Another memorial hospital of memorial to an individual or as a war masonry and slate work is excellent. the 1920s is St Margaret’s Hospital memorial. At Girvan, the Davidson Tilberthwaite slates were used, at Auchterarder, built in 1926 Cottage Hospital was built in 1921 to which are a silvery grey in colour. In from funds gifted by A T Reid of designs by Watson, Salmond & Gray. It this modest building the architects Auchterarder House in memory of was founded and endowed by Thomas produced an intimate character, very his family. Designed by Stewart & Davidson as a memorial to his mother. different from two other general Paterson, it opened in 1929, a simple The usual central administration hospital projects designed by the firm: but excellently conceived design with block was flanked by wards, but it has Philipshill Hospital at East Kilbride very little ornament but distinguished much charm with details such as the (1925–31), and the Paying Patients’ by scale and composition [2.6].

Fig 2.5 Davidson Cottage Hospital, Girvan, Watson, Salmond & Gray, Fig 2.6 St Margaret’s Hospital, Auchterarder, Stewart & Paterson, 1926. 1921. © Crown Copyright: RCAHMS. Licensor wwwrcahms.gov.uk © St Andrews University Library. Licensor www.scran.ac.uk 34 | Building up our Health Building up our Health

Mental Health

Morag Williams was the superintendents over the years archivist for Dumfries & that it has an excellent archive Galloway Health Board for with a detailed record of every over 20 years. She was based patient in the hospital since in a variety of buildings at the 1839. These notes bring life to Crichton Royal Hospital in those who lived at the hospital. Dumfries. The Crichton consists Their ailments are often of buildings from different described in poetic language periods of local sandstone and in one instance the brain is which make up an important referred to as ‘the palace of the architectural site. These soul’. include the earliest, Crichton Hall, designed by William In her role as archivist, Mrs Burn, which opened in 1839; Williams has been involved a fine Gothic Revival church with a wide range of people, of 1897 by the Edinburgh from rose experts in India to architect, Sydney Mitchell; and those interested in Scottish a handsome farm quadrangle pipe music. She admits that of the 1890s. All are listed as being the archivist for such a category A. prestigious hospital has tended to take over her life, although It is testament to the she is grateful to have had the importance of the Crichton opportunity to make friends and its many dedicated from all over the world. 36 | Building up our Health Mental Health

Chapter 3: Mental Health

Our understanding and treatment of those suffering from mental illness is every bit as complex in its history and evolution as that of general medicine. As with general medicine, specific types of buildings were devised in which to take care of such patients when families or friends were unable or unwilling to do so. For these patients, asylums were built. Encouraged by a number of significant pieces of legislation, ‘lunatic’ asylums gradually proliferated in the course of the 19th and early 20th centuries.

y the mid-19th century than in separate wards. In addition seven chartered asylums there were some 23 licensed houses Bhad been founded: the royal or private establishments, and two asylums at Montrose (opened 1782); schools for ‘idiot’ children – that is Aberdeen (1800); Edinburgh (1813); children with some form of mental Glasgow (1814); Dundee (1820); Perth handicap. The very terms used until (1827) and Dumfries (1839). There relatively recently for the mentally was also just one unincorporated ill are indicative of changing public public asylum – Bilbohall, in Elgin perceptions. Expressions such as (1835). A dozen poorhouses had ‘lunatics’, ‘the mad’, ‘idiots’, ‘imbeciles’, separate wards for the mentally ill, and ‘the mentally defective’ or ‘deficient’ there was a ‘lunatic department’ at the often had quite specific definitions, general prison in Perth. A further 14 and were not necessarily meant to be poorhouses took in ‘paupers’ suffering pejorative. from various mental illnesses, usually It was during the 18th century of a harmless nature, housing them that a more humanitarian attitude to with the rest of the inmates rather the conditions of the insane emerged. Building up our Health Mental Health | 37

The very first lunatic asylum in Infirmary there, which had provided today. Montrose Asylum moved to Scotland was founded in Montrose. limited accommodation for lunatics. a new site in 1866 and the original Here in 1779 Susan Carnegie of In Edinburgh efforts to raise buildings have since been demolished. Benholm Castle enlisted the help funds to build an asylum were met In Aberdeen, the original modest of the Provost, Alexander Christie, with apathy. A public appeal launched single-storey asylum built in 1800 to raise subscriptions to establish an in January 1792 had raised little was replaced by a more commodious asylum. At that time ‘lunatics’ were more than £200 after 14 years. Even building in 1819 designed by kept imprisoned in the Tolbooth in the last of the Royal Asylums, the Archibald Simpson, which in turn the middle of the High Street. She Crichton Royal at Dumfries which was added to, subsumed and recently hoped that by providing a quiet opened in 1839, was dubbed by the pulled down. At the Royal Edinburgh and convenient asylum where such local press the ‘Crichton Foolery’ and Asylum the original buildings persons might receive good treatment bitterly attacked as a misguided and designed by Robert Reid (1774– and medical aid, some of them might undesirable avenue for philanthropy. 1856) in 1809 have also gone. be able to return to society. Her aim Early attempts to improve Perhaps the most regrettable loss, was to raise £500 with which to build conditions for lunatics through from an architectural viewpoint, is a lunatic hospital. Eventually almost legislation were unsuccessful. In the Glasgow Royal Asylum designed £700 was raised and the asylum was 1817 a Lunacy Bill was rejected by by William Stark (1770–1813) in completed in the summer of 1781. parliament, but the reports prepared 1810, probably the most influential Montrose’s Royal Lunatic Asylum, at the time reveal much about the purpose-built asylum of the early Infirmary and Dispensary began standards of accommodation offered 19th century. It was the first hospital as a combined general and mental to lunatics. Edinburgh was particularly built with a radial plan derived hospital, though these two functions bad, with overcrowding and neglect from Jeremy Bentham’s panopticon. later separated. In Aberdeen the Royal the principal causes for concern. Bentham (1748–1832), the great Asylum first opened in 1800 and was Of the first purpose-built philosopher and reformer, published founded by the managers of the Royal asylums in Scotland, few survive his writings on this unusual circular 38 | Building up our Health

Fig 3.1 Detail from 1st Edition Ordnance Survey Map, showing Glasgow Royal Asylum (City Poorhouse), 1857-8. Reproduced by permission of the Trustees of the National Library of Scotland

building design in 1791. Originally to keep watch over all the inmates. devised by his brother Samuel for a Stark commended this aspect of the workshop where the skilled craftsmen plan, noting that not only could the could occupy a central observation ‘keepers’ constantly watch over the post from which they could supervise patients but the superintendent could the work of unskilled men, Jeremy keep his eye on both patients and staff. saw the potential of the design for Stark’s variation on the panopticon – prisons, hospitals or even schools, which comprised four wings radiating where a small staff would be able from an octagonal tower with a spiral Building up our Health Mental Health | 39

stair at the centre – also allowed central two-storey-and-attic range was the main asylum were built, offering strict segregation of different types flanked by long single-storey wings. large rooms with fireplaces for the of patient, as well as the separation of This allowed for a greater variety of patients. the sexes, with separate passages and accommodation to suit the different Stark’s radial plan was developed stairs between day rooms, galleries and classes of patients. In the centre by Watson and Pritchett for the West grounds. The need for supervision of block, as well as areas for staff and a Riding Pauper Lunatic asylum built not only patients but also staff reflects committee room, there were good- at Wakefield, Yorkshire in 1816–18. the difficulty of attracting good staff sized rooms, often with fireplaces, for Their plans were published in 1819 to work in asylums, at a time when ‘higher-class’ patients. The wings were and clearly influenced the pay was poor and there was no similar to those at Glasgow, with a row (1789–1870), who designed additions training [3.1]. of single cells on one side and a long and alterations to the Dundee asylum As Stark had observed, the design corridor or gallery on the other. in the 1820s, the Murray Royal also had potential for expansion, and Contemporary with the Asylum at Perth in 1821, the Crichton it was not long before additions were Dundee Royal Asylum was Robert Royal at Dumfries in 1834 and being made at the outer ends of the Reid’ s Royal Edinburgh Asylum Edinburgh asylum’s West House for wings. Eventually, however, it was at Morningside, built in 1809–13. paupers in 1840. In particular Burn realised that a new building on a new Although originally founded with adopted the central octagonal tower site was necessary, and a new asylum a view to serving the very poor, from which wings for the patients was built at Gartnavel to which the financial constraints meant that Reid’s extended. As in Stark’s radial plan, at patients were transferred in 1843. The building was designed for paying the centre of the tower there was a original building continued in use as a patients. Reid devised a collegiate, spiral stair, and from the rooms around poorhouse and was finally demolished quadrangular plan comprising four this central core the patients could be in 1908. three-storey pavilions linked to square observed. Stark went on to design Dundee two-storey pavilions at the angles. In Burn’s plans for the Crichton Royal Asylum, begun in 1812 though the grounds there were to be detached Royal were on the most ambitious not opened until 1820 and also now houses for ‘higher-class’ patients where scale, comprising a double Greek demolished. Here Stark produced a they might keep servants, carriages cross with wings radiating from somewhat less obviously institutional and ‘other small comforts’, as Reid two octagonal stair towers, though design on an H-shaped plan where a himself explained. Only two ranges of only one half was built [3.2]. 40 | Building up our Health Mental Health

Fig 3.2 William Burn’s drawing of Crichton The importance of the Crichton had studied medicine at Edinburgh Royal Hospital, Dumfries, 1834. © Dumfries and Galloway Libraries, is not merely in its architectural University, after which he had Information and Archives history. As the building was continued his studies on the continent, approaching completion, its first notably in France, where he visited superintendent was appointed. On the asylums of Paris and studied under the recommendation of Elizabeth the leading psychiatric doctors of the Crichton, the asylum’s foundress, age, Philippe Pinel and Jean-Étienne the position went to Dr W A F Dominique Esquirol. In 1837 he Browne (1805–1885), who had been had published an influential series of Medical Superintendent of Montrose lectures on ‘What Asylums Were, Are Royal Asylum since 1834. Browne and Ought to Be’. Under Browne’s Building up our Health Mental Health | 41

management, the asylum acquired position. Charles Wilson (1810–1863) Wilson’s palatial building was Tudor the high reputation sustained by drew up the plans for this asylum Gothic, its appearance reminding subsequent medical superintendents. of two halves, comprising separate one spectator of Windsor Castle. The buildings were also added to, ranges for paupers and paying patients Each range was U-shaped with the and included many structures of great with a chapel at the heart of the site central section containing the main significance in asylum design. linking the two. Though the chapel entrance, reception rooms and staff In the same year that the was not built until 1904, the asylum accommodation while the patients Crichton Royal first opened, a new itself was built in 1842–3, initially for occupied the flanking wings. Almost site was acquired for the Glasgow 420 patients. Up to now asylums had all the private patients occupied single Royal Asylum at Gartnavel, outside been architecturally plain, generally rooms, but the paupers mostly slept the city, with an elevated, airy sparingly classical in style. By contrast in dormitories of varying sizes with 42 | Building up our Health

up to 22 beds. As well as the inmates form of lunatic wards attached to the from Stark’s old asylum, the new poorhouse, but sometimes entirely building took in large numbers of separate parochial asylums were built. pauper patients from Glasgow’s Town’s The first district pauper asylum to Hospital and other poorhouses, soon be built was for Argyll. Designed by leading to overcrowding and a need the Edinburgh City Architect, David for extension [3.3]. Cousin (1809–1878), it opened in By the mid-19th century the 1863 at Lochgilphead. Cousin’s plan royal asylums were stretched to was for an asylum for 200 patients, their limits, and there seemed to be comprising single rooms and ground- ever-increasing pressure to provide floor day rooms with dormitories more accommodation in particular and further single rooms above. Its for pauper lunatics. In 1855 a Royal first medical superintendent was Commission was appointed to Dr (later Sir) John Sibbald (1833– examine the problem, which resulted 1905), subsequently appointed as a in the first major piece of legislation Commissioner in Lunacy. to provide for the mentally ill: the Two further district asylums Lunacy (Scotland) Act of 1857. This were completed the following year established a central ‘Board of Lunacy’ in Perth (later Murthly Hospital, to oversee the provision of district opened April 1864), and Inverness asylums and inspect any establishment (Craig Dunain Hospital, May 1864). proposed new buildings or alterations where the mentally ill were lodged. Later district asylums opened in Banff to old ones. Funded from the rates, An amendment to the Act of 1862 (Ladysbridge, 1865), Fife (Stratheden, district asylums were typically fairly allowed parochial boards, which had 1866), Haddington (Herdmanflat, plain, but their architects often formerly only had responsibility for 1866), Ayrshire (, 1869), produced impressive buildings, with as the sane poor, to care for pauper and Stirlingshire (Bellsdyke, 1869). much variety as gables and bays could lunatics if they could offer suitable The Commissioners in Lunacy had provide. The Northern Counties accommodation. This usually took the the power to pass or reject plans for District Asylum in Inverness is a good Building up our Health Mental Health | 43

example. In 1859 the District Lunacy Kinnear of Edinburgh (who went on Fig 3.3 North and East elevations of Glasgow Royal Asylum at Gartnavel, Charles Wilson, Board purchased the site, 180 acres to design the Fife District Asylum), 1842-3. (73 hectares) on the hillside above and a York architect, George Fowler © Courtesy of RCAHMS. Inverness, and a restricted competition Jones (1817/18–1905). Matthews Licensor www.rcahms.gov.uk was held for the architect. Designs was an unsurprising choice given his were invited from James Matthews experience in poorhouse planning and (1819–1898) of Aberdeen, who design. His asylum bears more than secured the commission, Peddie & a passing resemblance to the model 44 | Building up our Health Building up our Health

Fig 3.4 South front of Craig Dunain Hospital, Inverness, James Matthews, 1864. © Royal Commission on the Ancient and Historical Monuments of Scotland; E/2968/cn Licensor www.scran.ac.uk

in 1872), and for and (later , 1874). In addition new parochial asylums were built, often as part of a large new complex that included a new poorhouse. There were already six such asylums by the mid-1860s, mostly in the populous areas in and around Glasgow. One of the few to be built on a separate site was the large and imposing Barony asylum () in Lanarkshire, of 1871–5. A need for more diverse classification of the patients and better management of different poorhouse plan he designed in 1847 to the rear. It was one of the first types of mental illness led to with his partner Thomas Mackenzie to remove its airing courts in 1874. experiments in planning. For the (1814–1854). This progressive act was somewhat City of Glasgow District Asylum Occupying a magnificent raised belittled by the constant complaints of at Gartloch inspiration came from site, the long, three-storey building the Commissioners in Lunacy, when abroad, in particular taking into followed the accepted plan, with they inspected the hospital, of the account developments in Germany a high proportion of single cells. lack of warmth in the buildings and and America. A competition held Modest innovations included the the poor diet of the patients [3.4 and for the design in 1889 was won by patients’ dining hall, brought to an introduction]. Thomson & Sandilands, with building unusually prominent position at the During the 1870s two more work under way in 1892. Completed heart of the patients’ accommodation, district asylums were built, at Melrose in 1896, this complex institution and the staff and service area placed (later , opened for 570 inmates was divided into Building up our Health Building up our Health | 45

Fig 3.5 Drawing of the administrative block at City of Glasgow District Asylum at Gartloch, Thomas & Sandilands, 1896. © Royal Commission on the Ancient and Historical Monuments of Scotland; B/41922. Licensor www.scran.ac.uk

two halves, with separate sections for medical and non-medical cases. A larger asylum section cared for chronic cases requiring little or no nursing, while a smaller hospital section cared for acute patients requiring special nursing. Situated on rising ground, this impressive group of red sandstone buildings was designed in a French Renaissance manner with richly carved details. The decorated, spiky dormerheads add particular verve, culminating in the massive twin pinnacled towers of the asylum section’s administration block. In this section the patients were classified and allocated to three-storey pavilions or villas, linked to the administration block by single-storey corridors. It was symmetrically laid out with the usual division of males to one side and females to the other. Gabled, single- storey ranges contained workshops on the male side and the laundry and wash house on the female side, reflecting the division of labour given to the patients [3.5 and 7.4]. 46 | Building up our Health

Fig 3.6 Interior of great hall, Craig House, Edinburgh, A G Sydney Mitchell, 1889-94. © Royal Commission on the Ancient and Historical Monuments of Scotland; B/64331 Licensor www.scran.ac.uk

To the south was the hospital section, comprising a two-storey, U-plan administration block, and a single-storey, H-plan ward block with central kitchen and dining facilities. South-facing verandas allowed open-air treatment. Here there were observation wards, with sections for the sick and for those suffering from infectious diseases. The Medical These developments towards were usually only available for the Superintendent was provided with a separating the patients into smaller wealthiest paying patients. Before large detached house on the site, and a groups depending on their illness, the widespread provision of asylums, nurses’ home was added to the south- particularly as seen in the linked villas pauper lunatics had been boarded west in 1900, closely resembling the in the asylum section at Gartloch, out, with a concentration of boarders asylum villas in style but with slightly were taken a stage further in the in Kennoway in Fife. There had also less decorative detail. Further additions early years of the 20th century with been suggestions of establishing a included a fifty-bed sanatorium in the colony or village-plan asylum. colony in the Orkneys at one time. 1902 (now demolished), and in 1904 The benefits of accommodating Many existing asylums began to build a farm workers’ block was completed patients in smaller groups in a villas on their estates. The Crichton (also now demolished), with a fine more home-like environment had Royal Asylum, for example, already farm steading. been evident for some time, but owned a number of domestic houses Building up our Health Mental Health | 47

in which it accommodated the On the continent the colony into a mental colony until, during wealthier patients together with their system had developed from the the 19th century, it was placed under servants. This was taken further at the Belgian colony at Gheel which, the control of a Commissioner and a Royal Edinburgh with the creation of legend has it, was founded in Board of Governors. the Craig House complex in 1889–94 medieval times after the Irish The success of the Gheel comprising two hospital buildings, Princess Dymphne was converted system led to village asylums being three detached villas and New Craig to Christianity and fled to Gheel. introduced elsewhere. They were House for central amenities such as Her father pursued her there and particularly favoured in Germany, recreation halls and dining rooms beheaded her, leading to her being and one of the earliest to be widely [3.6]. It was the brainchild of Dr canonised as a martyr. Her shrine publicised in Britain was Alt-Scherbitz Thomas Clouston (1840–1915), gained the reputation of curing the near Leipzig, founded in the 1870s. the Physician Superintendent at insane, whereupon Gheel became a The influential Commissioner Edinburgh, and his architect A G place of pilgrimage for the mentally in Lunacy for Scotland, Dr John Sydney Mitchell (1856–1930). They ill. Pilgrims were boarded in the Sibbald, was impressed by the system, worked closely together to produce village which gradually developed publishing a paper in 1897 on ‘The buildings which embodied Clouston’s approach to treating mental illness. Variety was the keynote; and so the buildings are eclectic in style with a plethora of different details, broken rooflines and differently coloured materials. Although first enjoyed by private patients, separate villas were slowly introduced for pauper and rate-aided patients as well. Murthly Hospital, Perth’s District Asylum, was one of the first to do so, with two Fig 3.7 Pinel Lodge, Murthly Hospital, Perth, built in grounds of hospital, 1894. © Royal Commission on the Ancient and Historical Monuments of Scotand; E/8581/cn villas being erected in 1894 [3.7]. Licensor www.scran.ac.uk 48 | Building up our Health

Fig 3.8 Church at Bangour Hospital, , H O Tarbolton, 1924-30. © Crown Copyright: RCAHMS. Licensor www.rcahms.gov.uk

The dormitories were located on the upper floors. Another important aspect of the colony system was the replacement of the large common dining halls with smaller dining rooms within the villas. This was also a feature of Kingseat and Dykebar. Bangour’s large recreation hall contained an area measuring 28 Plans of Modern Asylums for the finest of the three. A competition held metres by 16 metres, with a stage at Insane Poor’ in which he gave a full in 1898 for the asylum specified the the north end. By incorporating a description and plan of Alt-Scherbitz colony plan, and Blanc devised a self- lattice steel girder support for the and recommended it as a model for contained village with its own water roof, the entire space could be opened future asylums in Scotland. supply and reservoir, drainage system up without the need of supporting Three new district asylums were and firefighting equipment, that could pillars. There was even an orchestra pit built around the turn of the century be self-sufficient by the industry of in front of the footlights which was on this plan: for Aberdeen (Kingseat able patients. specially constructed to allow it to be Hospital), designed by Alexander As at Gartloch, the site was covered at floor level when the hall Marshall Mackenzie (1848–1933) and divided into two sections for the was used for dances. built in 1901–4; Edinburgh (Bangour), medical and non-medical patients, A church was added to the site by Hippolyte J Blanc (1844–1917), with power station, workshops, bakery, in 1924–30, designed by Harold 1898–1906; and Renfrew (Dykebar), stores, kitchen and laundry in the Ogle Tarbolton (1869–1947). Set in by Thomas Graham Abercrombie, middle. The patients’ villas housed a central position on the site and in a opened in 1909. The colony plan from 25 to 40 patients each and severe Romanesque style, it is one of lent itself particularly well to a gently varied from two to three storeys. On the most impressive hospital churches undulating site such as at Dykebar, the ground floor were day rooms, in Scotland. The dark brown stone of where the villas nestled in the dining rooms and a kitchen, with the church contrasts strongly with the landscape. Bangour was perhaps the separate dining rooms for the nurses. cream-painted villas near to it [3.8]. In Building up our Health Mental Health | 49

Fig 3.9 One of the buildings added to the Baldovan Institute around 1900. © Tayside Health Board. Licensor www.scran.gov.uk

1931 the nurses’ home, with its two ogee-roofed octagonal central turrets, was extended by Ebenezer J MacRae (1881–1951) with a large new wing, blending sympathetically with the original block. designs by J T Maclaren (1863–1948) central service and administrative Provision for those suffering [3.9]. section. from chronic or incurable forms of More ambitious in scale was the It was not until 1913 that the mental illness or disability took longer Royal Scottish National Institution Mental Deficiency and Lunacy to develop. Amongst paupers, those built in 1861–2 at Larbert. This (Scotland) Act introduced public viewed as quiet and harmless were evolved from a small training school funding for the care of mentally often housed within the workhouse for ‘idiot children’ run by a Dr Brodie disabled adults. After the First World alongside all the other inmates. Efforts from a house in Gayfield Square, War several institutions or colonies to improve the lot of children came Edinburgh, in 1855. From this the were founded, notably at Birkwood, first from individuals. At Baldovan Society for the Education of Imbecile Lanarkshire in 1923 and Lennox Institution, to the north of Dundee, Youth in Scotland was formed in Castle, Stirlingshire in 1936. Both the first serious attempt was made 1859 with a view to providing were centred on mansion houses with to provide education and homes for more suitable accommodation. Dr extensive grounds where purpose- ‘imbecile children’ and orphans in Brodie became the first Medical built accommodation was provided. 1852. Founded by Sir John and Lady Superintendent of the new Gogarburn, near Edinburgh, which Jane Ogilvie, in 1853 they provided a Institution, initially with just nine opened in 1931, and Hartwoodhill, new building, designed by the English children transferred from Edinburgh. by Shotts, a development of the later architects Coe & Goodwin who had Now largely demolished, the new 1930s, were built on the colony recently won the competition to Institution was designed by Frederick system, but the vast institution of design Dundee Royal Infirmary. The Thomas Pilkington (1832–1898) in Lennox Castle returned to a degree of asylum was a great success. The 1850s his characteristic rogue Gothic style. centralisation with its two vast dining building was replaced by a handsome It comprised five distinct sections for halls capable of seating 600 patients new hospital range erected in 1900 to different classes of inmates with one each. 50 | Building up our Health

Southern General Hospital, originally built as Govan Combination Poorhouse, 1872. © Reproduced courtesy of Glasgow City Archives and Special Collections Building up our Health

Poorhouses

Richard Frazer (right) and are in many ways the same as Josiah Lockhart (left) are both those for which the grandiose involved with the Grassmarket poorhouses of the 19th century Community Project in were designed, although the Edinburgh. This project provides philosophy is very different. a way of helping the poor in Unlike the poorhouses, which the 21st century, and offers food were intended to keep the poor and friendship, together with isolated from public view, here work and training in weaving, people are free to come and go gardening and woodwork. As as they wish. Richard notes, ‘The poorhouses may have gone but the poor are The project is currently using still with us.’ a rented building which they have adapted as best they can Poorhouses were usually the for their needs, but they are responsibility of parishes, and planning for a new, architect- this project echoes this pattern designed, purpose-built building in that it is associated with the in the near future which they parish church, . hope will challenge the current poverty of expectation which The problems that Richard associates helping the poor with and Josiah are dealing with mean buildings. 52 | Building up our Health Poorhouses

Chapter 4: Poorhouses

In the 19th century around seventy poorhouses were built in Scotland. Many of these not only housed the very poorest in society, but also offered varying degrees of medical attendance for the sick and provided some level of care for ‘paupers’ suffering from mental illness. The largest, set up in populous towns and cities, developed separate infirmaries and asylums that operated in tandem with other state provision. In their planning and design they evolved into a distinct building type, which, despite the often restricted funding, resulted in some handsome architectural responses.

he 1845 Poor Law (Scotland) the poor. In rural areas money was Act marked the starting given directly to them. Only the Tpoint of this new breed of large burghs and towns provided poorhouse. Before that the poor were ‘in-door’ relief, in either a workhouse, given assistance via the Kirk Session, a poorhouse or a hospital (the but with the establishment of the designation of ‘hospital’ was rarely Free Church after the Disruption of connected with medical institutions, 1843 the old system was in tatters. which were more usually called Locally raised rates or assessments infirmaries). The Town’s Hospital on the parish had been sporadically in Glasgow was one such, partly introduced in the 18th century and a municipal venture, but with the these became the principal way in involvement of both the Kirk and which money was raised to relieve the city merchants. In January 1732 Building up our Health Poorhouses | 53

a committee was appointed to look By the beginning of the 19th century Fig 4.1 Glasgow Town Hospital, 1733. for a site and to commission plans it also housed sick and ‘fatuous’ 19th century watercolour. © Glasgow University Library. for a suitable building. In May, plans (chronically mentally disabled) Licensor www.scran.ac.uk presented by John Craig (d.c.1745) persons. Limited medical care was and Allan Dreghorn (1706–1764) provided by the Glasgow College were selected – deemed to be ‘the of Surgeons and Physicians, who fittest and the cheepest’. The building alternated in attending the hospital. In was plain and simple, of three storeys 1840 it moved into the old Glasgow and attic with projecting wings at each Royal Asylum building, where it end. It contained a large hall in which remained until the early years of the the inmates assembled for worship, a 20th century. committee room and offices, as well In Aberdeen a poorhouse was as the inmates’ accommodation [4.1]. established in 1739, the same year 54 | Building up our Health Poorhouses

Fig 4.2 King James VI Hospital, Perth, 1748. © Crown Copyright: RCAHMS. Licensor www.rcahms.gov.uk

as there is evidence to suggest that the cupola and bell were gifted by the Duke of Atholl in 1764, having been removed from the Mansion of Nairn, to the north of Perth, which was being demolished at that time. The King James VI Hospital remained in its original use until 1812 when Perth adopted a system of ‘out- door’ relief only for its poor, and the hospital’s medical function was taken over by the new Perth Infirmary which opened in 1838. Subsequently the building was used for various as the Royal Infirmary. Edinburgh’s destroyed by Oliver Cromwell around charitable purposes, including a charity workhouse had been 1652, and the charity seems to have school. It survives today, having been established by 1742, and a poorhouse lapsed until the mid-18th century. A converted into flats in the 1970s [4.2]. was built at in 1756. new building was begun in 1748, the During the first decades of the In Perth a charitable hospital foundation stone laid by James Cree 19th century a series of parliamentary had been founded in 1569 by Royal who may have provided the design. select committees and an enquiry Charter, managed by the Minister Of four storeys, and on an H-shaped by the General Assembly of the and Kirk Session of St John’s Kirk. plan, it has minimal classical ornament Church of Scotland considered The King James VI Hospital was to imposed on a Scottish vernacular the management of the poor. The provide, ‘by all honest ways and means idiom. Contrasting with this well- workhouse system was ushered in to an Hospital for the poor, maimed, ordered simplicity is the oversized England and Wales following the Poor distressed, persons, orphans and belfry, capped by an ogee cupola and Law Act of 1834 and Scotland had a fatherless bairns within our burgh weathervane that crowns the building. good ten years in which to consider of Perth’. The first building was This may have been a later addition, its effectiveness before introducing Building up our Health Poorhouses | 55

Fig 4.3 Contrasted Residences for the Poor, published in A W Pugin, Contrasts, 1841. Reproduced by permission of the Trustees of the National Library of Scotland

its own legislation to reform poor relief here. Both north and south of the border, model plans were issued which, from an architectural viewpoint, graphically demonstrate the differences in hopes and aims of the two Acts. Even though the model Scottish plan was for a poorhouse considerably larger than most actually built in Scotland, it was significantly prettier than the model plans by Sampson Kempthorne (1809–1873) widely copied in England. Indeed, Kempthorne’s ‘hexagon plan’ was particularly grim, and was pilloried by A W N Pugin (1812–1852) in the 1841 edition of his book Contrasts. Here, pairs of illustrations contrasted Pugin’s idealised vision of medieval Britain with contemporary views. Thus the contemporary residence for the poor is in effect a prison in which the inmates endure a harsh regime, whereas the ancient poorhouse resembles a monastery, centred on a chapel, where the lives of the inmates are dominated by the Church [4.3]. 56 | Building up our Health

Stylistically, Pugin’s prison-like long before 1845. Between 1849 and Poorhouse contained sanctioned poorhouse was an austere near- 1859, 19 poorhouses were built, and accommodation for 130 paupers [4.4]. featureless building, with a mean between 1860 and 1870 a further 30 Most of the similarly sized rural classical-style entrance, while the were constructed. Only half-a-dozen poorhouses constructed the length ‘antient poor house’ was Gothic, with or so more were built after 1870. and breadth of the country in the lancet windows, gables, turrets and A typical example and one of the 1850s and 1860s differ little in crenellations. Pugin’s Contrasts reflects earlier generation of poorhouses is the outward appearance from that built a shift in the moral consciousness of Kirkcaldy Combination Poorhouse, for Kirkcaldy. Examples can be found the 1840s. The second generation situated between Kirkcaldy and in the Highlands, where William of workhouses erected in England Kinghorn. Its long, low two-storey Lawrie (d.1887) of Inverness was the eschewed classicism in favour main range punctuated by projecting architect of the Inverness Poorhouse, of Gothic detailing, if only in a gabled bays overlooks the Firth of built in 1859–61 (later Hilton gabled elevation. In 1846 plans for Forth. Plans for the building were Hospital); the Nairn Combination Canterbury Union Workhouse were provided in 1849 by William Lambie Poorhouse, 1860–62 (largely published in the Illustrated London Moffatt, a specialist in the field of demolished); and the Black Isle News, and although never built, it was hospital, asylum and poorhouse Combination Poorhouse at Fortrose, highly commended at the time, and architecture. He had been a pupil of 1856–9. Lawrie was the Inverness half appears to have formed the basis of William Burn and worked in England of the Aberdeen firm run by James Mackenzie & Matthews’ model plan with William Hurst (1787–1844) until Matthews, and became a partner of 1847. Hurst’s death when he returned to in 1864. Combination As in England the bulk of the Edinburgh. The poorhouse follows Poorhouse in Bonar Bridge, built in poorhouses were built in a relatively closely the model plan, with the 1863–5 (later ) [4.5], short space of time, not long after principal block providing the paupers’ is almost identical to the Inverness the introduction of the new Act and accommodation, a dining hall and Poorhouse but the architect here was the majority took the model plans kitchen centrally placed to the rear, Andrew Maitland (1802–1894) who as their starting point. In 1848 there and a single-storey range for stores. A had earlier produced plans for Easter were 14 poorhouses in Scotland, separate infirmary was added later. By Ross Poorhouse, Tain (1849). some of which had been in existence the turn of the century the Kirkcaldy The former Upper Strathearn Building up our Health Poorhouses | 57

Fig 4.4 Plan of Kirkcaldy Parochial Union Poorhouse, William Lambie Moffat, 1849.SCOTLANDSIMAGES. COM/The National Archives of Scotland RHP 30864/2 58 | Building up our Health

Fig 4.5 Sutherland Combination Poorhouse (Migdale Hospital). Fig 4.6 Upper Strathearn Poorhouse, Auchterarder, © NHS Highland Archive James Campbell Walker, 1862-3.

Poorhouse at Auchterarder in While these rural poorhouses the charity workhouse which was Perthshire is another good example, might typically accommodate around condemned in 1863 by the City’s with a number of its ancillary a hundred paupers, and sometimes Medical Officer of Health. Peddie & buildings surviving. Built in 1862–3, considerably fewer, in the densely Kinnear produced the plans for the though somewhat smaller than populated urban centres the numbers new, much-enlarged poorhouse in some of the Highland group, it is in need of relief were far greater. 1866; surprisingly for a poorhouse recognisably from the same stable In Edinburgh two new poorhouses it was Italianate in style, with a fine [4.6]. The architect here was James were erected in the 1860s to serve campanile gracing the entrance block. Campbell Walker (1821–1888) of the densely inhabited districts of It opened in 1868 as the Craigleith Edinburgh, who also furnished plans the City and St Cuthbert’s. These Hospital and Poorhouse. In 1930 it for poorhouses for Galashiels (1859), were large institutions, designed on was taken over by Edinburgh Town Dysart (1860), Athole (latterly Atholl) a modified pavilion plan, where the Council and became a municipal and Breadalbane (1861), Dumbarton different classifications of inmates general hospital – the Western (1862), and Islay (1865). Like William were separated – not merely male and General. Lambie Moffatt, Walker served his female, elderly, infirm and children, By contrast, on the other side apprenticeship with William Burn, but the ‘deserving’ poor, or those of of Edinburgh, the City Poorhouse who was equally proficient designing good character were housed separately at Craiglockhart adopted a distinct complex institutional buildings as the from the dissolute, ‘doubtful’, Scottish vocabulary in the Baronial great country houses for which he is improvident and vicious. details, string courses, and crowstepped chiefly remembered today. St Cuthbert’s evolved from gables. Accommodating a thousand Building up our Health Poorhouses | 59

paupers, it was built in 1867–9 and design had won, his plans bearing the it replaced an earlier institution, the was designed by the firm of George telling motto ‘Comfort for the Poor Edinburgh Charity Poorhouse built Beattie & Sons of Edinburgh. and Care for the Ratepayer’. In the in 1739–43. By the mid-19th century Their principal architect at that main, architectural embellishment it occupied a number of buildings on date was William Hamilton Beattie was kept to a minimum, but Beattie an overcrowded site at Forest Hill. The (1842–1898), who went on to design produced a decorative flourish on the new complex was designed to have department store in 1895. A central entrance bay which rises to an three main sections: the poorhouse competition had been held for the octagonal tower with facetted, steep- itself at the centre, and on either side poorhouse commission, and Beattie’s pitched roof [4.7]. Like St Cuthbert’s, an infirmary for sick paupers and an

Fig 4.7 City Poorhouse, Edinburgh, George Beattie & Sons of Edinburgh, 1867-9. 60 | Building up our Health

asylum for the mentally infirm, only and hospital sections. The three- estimate, and considerably more than the first two being completed in 1869. storey poorhouse was dominated by a the poorhouses of a decade earlier, The poorhouse section comprised five distinctive French Renaissance-style provoking a public outcry. Built of blocks linked by corridors. Centrally clock tower, and has a varied roofline Wemyss Bay red sandstone and with placed to the rear were the dining with pavilion roofs capped with Cumberland slate roofs, it comprised hall, kitchen and ancillary service decorative ironwork. To the south, the usual three sections – poorhouse, buildings. There were separate blocks the asylum section was of two storeys hospital and asylum. Starforth, an for the different classes of inmates, with twin square towers capped by Edinburgh-based architect, had trained including departments for children pavilion roofs. To the north, the two- with Burn & Bryce, and there is more that incorporated school rooms. storey hospital block was designed than a hint of Bryce in the Baronial Comparable large-scale on the pavilion plan. It was renamed detailing of the Greenock poorhouse. poorhouses were built in the west of the Southern General Hospital in Bartizans and crowstepped gables Scotland. Glasgow’s Southern General 1923, by which time most of the beds lend movement and interest to the Hospital at Govan began as the new were occupied by chronic or infirm building, particularly on the long Govan Poorhouse, designed in 1867 cases. The last of the poorhouse beds principal elevation that faced north by James Thomson (1835–1905) to disappeared in June 1936 and the and stretched on for 102 metres. replace the old premises in disused hospital was handed over to the Public In 1894 central control of the cavalry barracks in Eglinton Street. Health Department. Poor Law and its buildings was taken The barracks had been converted into A new poorhouse and parochial over by the Local Government Board poorhouse accommodation in 1852 asylum for Greenock was built in (LGB), which was also responsible by Black & Salmon, and comprised 1876–9 (later Ravenscraig Hospital) for the control of infectious diseases. a series of day rooms on the ground [4.8]. It replaced a succession Unsurprisingly, then, the Board was floor with a double row of wards of buildings which the parish keen to improve medical facilities above. Ill-ventilated, with just one had employed since 1821. Plans within poorhouses. Larger urban window, the wards mostly held 12 were drawn up by poorhouses commonly had separate beds. Like Craiglockhart, the new (1822–1898) for an institution to blocks for infectious cases, and even building was designed with a central house 750 paupers. At £122,904 the smallest would have provided poorhouse block flanked by asylum it cost far more than the original some separation. A more sophisticated Building up our Health Poorhouses | 61

Fig 4.8 Detail of Ravenscraig Hospital, Greenock, John Starforth, 1876-9.

separation of the medical and non- medical functions of the poorhouse was introduced at Oldmill Poorhouse in Aberdeen (now ). Designed by the local firm of Brown & Watt, it opened on 15th May 1907 and was one of the last poorhouses to be built in Scotland. It comprised two sections: the poorhouse and the hospital. The hospital section was further divided into two, with one part for infectious cases and the other for the non-infectious. The Aberdeen Daily Journal report on the plans for the Oldmill Poorhouse in 1901 noted that: As the general view of the poorhouse to most people will be from the Skene Road, a few hundred yards away, it is not intended that any expense should be put upon fine masonry details, and the effect of a satisfactory composition will, therefore, be obtained by means of the grouping of the various buildings and arranging them in such a fashion as to give a suitable yet dignified appearance to the whole. Surprisingly, the main poorhouse was still closely based on the 1847 model plan. It is perhaps not 62 | Building up our Health

Fig 4.9 Elevation of Oldmill Poorhouse, insignificant that both Alexander in sparkling grey granite form an Aberdeen, Brown & Watt, 1907. Brown (1853–1925) and George Watt impressive group, retaining many of © Robert Gordon University. Licensor www.scran.ac.uk (1865–1931) had connections with their contemporary features. In the Mackenzie & Matthews, the architects hospital block the diamond-shaped of the model plan. Brown had worked glazing patterns of the upper sashes as an architectural surveyor for the add a dash to an otherwise severe firm early in his career at the same building [4.9]. time that Watt was serving his articles Oldmill was one of the first poor there. The chief variation from the law institutions to have a separate model plans is the addition of a tall nurses’ home from the outset. This was clock tower. This elaborately decorated a mark of the progress in poor law structure topped by a cupola housed medical provision – in the early years the large water tanks. Despite its nursing was done by the paupers. dated form, the original buildings By 1900 there was a general Building up our Health Poorhouses | 63

realisation that the Poor Law was Hospital) and Duke Street (Eastern transomed bay windows surmounted unsatisfactory. In 1905 a Royal District Hospital). by carved panels. Much plainer were Commission was appointed which, was the largest of the three, with the red-brick ward pavilions. for the first time, looked into how the 1,200 beds. A competition was held The Medical Superintendent’s poor laws operated throughout the for the design which specified that house to the west of the United Kingdom. The Commissioners the hospital should comprise four administration block has quite a examined the state of destitution sections: a hospital of 800 beds with different character. It was designed and distress amongst the poor but accommodation for mentally ill and as a charming Arts & Crafts-style were split in their recommendations, epileptic cases, a children’s section domestic villa, with half-timbered producing majority and minority for 100 healthy children under five gables and overhanging eaves capping reports, published in 1909. Although in ‘separate or ordinary wards or the asymmetrical house. they could not agree on what course detached cottages’, a section for Although the Royal Commission should be taken, they agreed on the the ordinary infirm of 240 beds, of 1905 had not resulted in any failure of the poorhouse system, and a section for 30 aged married amendment to the poor laws, new particularly to provide classified couples. The competition was finally legislation was introduced at the accommodation. The result had awarded to Thomson & Sandilands beginning of the 20th century which been an increasing number of mixed and the foundation stone was laid in began to improve the conditions of poorhouses, where non-medical and September 1901. the poor, directly or indirectly. The medical cases occupied the same The site is dominated by a giant Old Age Pensions Act of 1908, which standard of accommodation. Only water tower, built mainly in brick came into effect on 1st January 1909, the large urban poorhouses had crowned with stone angle turrets and introduced pensions for those over 70. fully embraced separate provision a bold domed cupola. Brick pilaster Initially paupers were excluded – that for medical cases but, as the Report strips clasp the angles, and each face is those who had been in receipt of pointed out, only in Glasgow had this is finished with brick panels and a poor relief within the past year – but been truly successful. prominent clock. The two-storey this was dropped in 1911. That year In 1904 three new hospitals for administration block, with its richly also saw the National Insurance Act the poor opened in Glasgow – at carved stone above the entrance, has which introduced limited health and Stobhill, Oakbank (Western District gabled end bays with mullioned-and- unemployment cover for those insured 64 | Building up our Health

under the scheme. These measures In 1936 William Barrie, architect without exposure to the weather, but the helped to reduce the numbers of poor to the Glasgow Public Assistance inmates should be allowed to make their seeking relief. Department, prepared plans for a other meals in their own rooms if they so During the 1920s there was a major development on this site to desire. discernible move towards broader provide accommodation for the Crookston Cottage Homes municipal provision for health care. elderly, including married couples, were officially opened on 8th Under the Local Government Act which was an innovation long resisted September 1938. They comprised of 1929, an attempt was made to by the Local Government Board. The a symmetrical layout of two-storey remove the stigma of the poorhouse Department of Health acknowledged blocks arranged around a horseshoe- by changing the name to Public the progressive step the Corporation shaped garden. There were 12 blocks Assistance Institution and placing was proposing and added a brief each containing small flats with a them under the management of newly outline of what such a home should living room, bedroom, kitchenette created Public Assistance Departments. offer: and bathroom. With the exception For the smaller rural poorhouses this An old people’s home should usually of dinner, residents had the facilities made little real difference. be small, and the needs of populous areas to make their own meals and were A major step forward in housing should be met by multiplying the number given rations to do so if they wished. the poor, and in particular the elderly of homes rather than by increasing the size The main building of the former poor, came in the 1930s with the of the institution. Such a home should poorhouse was altered to provide Crookston Cottage Homes on the be, if possible, near the old haunts of the modern dining rooms and day rooms outskirts of Glasgow [4.10]. Boundary people who are to occupy it, so that they where the elderly could congregate changes in Glasgow resulting from may not feel exiled or be too far from their to read newspapers or listen to the the Local Government Act meant that friends. Most of the accommodation should wireless. This was the first attempt to Glasgow Corporation found itself consist of rooms for private occupation by design accommodation tailored to the responsible for a much larger area. single people, with possibly one or more needs of elderly residents rather than This included the former Renfrew dormitories containing not more than four for easy administration, and it became Combination Poorhouse, built in 1902 or five beds for inmates who prefer them or a model for subsequent developments to designs by the Glasgow architects for whom they are adjudged more suitable. throughout Britain. Ninian Macwhannell (1860–1939) One good hot meal a day should be and John Rogerson (c.1862–1930). provided in a central dining room accessible Building up our Health

Fig 4.10 Crookston Cottage Homes, near Glasgow, 1938. © Newsquest (Herald and Times) Licensor www.scran.ac.uk 66 | Building up our Health

Opening ceremony, City Hospital, Edinburgh. © Lothian Health Services Archive. Licensor www.scran.ac.uk Building up our Health

Infectious Diseases Hospitals and Sanatoria

Both Dr Leslie and Dr Nancie City Hospital grounds was wards were positioned far apart Stokoe trained in Edinburgh not complete which is why to minimise cross-infection. and worked their houseman these cottages were used. I was ‘I cycled from ward to ward years from 1944 to 1947. gowned and masked and taken along the walkways in order to into one of the buildings. The save time when going to see They both vividly remember experience is something I will patients.’ the outbreak of smallpox never forget. It is a horrendous in 1942. A mass vaccination disease.’ By 1979 smallpox had programme was instigated. been eradicated worldwide. The whole City Hospital was cordoned off to all except She returned to the City as essential services. Dr Nancie houseman in 1945. The hospital Stokoe recalls: ‘It was strictly was made up of a number against this rule that a senior of separate wards linked by doctor who was a family friend covered walkways, each ward took me, a 4th-year student, catering for a different ailment. particularly interested in These illnesses were ones which public health, to see smallpox are now much less common patients housed in two small – diphtheria, scarlet fever and stone observation cottages whooping cough, to name within the hospital grounds. a few. Children and adults Rapid renovation of the official with the same condition were smallpox hospital outwith the treated in the same ward. The 68 | Building up our Health

Chapter 5: Infectious Diseases Hospitals and Sanatoria

Even before the identification of different infectious diseases or causes had been established, it was well understood that such cases could erupt quickly and multiply. Patients suffering from ‘fever’ – the usual catch-all for any illness considered infectious – were isolated from the healthy as far as possible. Isolation was practised at home where there was a spare room, but for the poor the early general hospitals mostly had fever wards. During epidemics temporary fever hospitals were sometimes set up in whatever accommodation could be acquired, but once the epidemic subsided, these hospitals closed. Similarly, local Boards of Health, set up following the 1831 cholera epidemic, were disbanded as the cholera abated. Ports were most vulnerable, with their influx of sailors who could bring new diseases from distant shores, and a number of temporary fever or small cholera hospitals were established to isolate sailors suspected of carrying diseases. Building up our Health

Fig 5.1 Belvidere Hospital, Glasgow, photo, circa 1922. © Reproduced Courtesy of Glasgow City Archives and Special Collections

his reliance on the municipal fever hospital was to be appointed and for money to established voluntary established in 1865 in Kennedy Street. be raised through the rates for health Tgeneral hospitals, and later This important first step was followed purposes. poorhouses, to provide fever wards by a new Public Health (Scotland) Most of the isolation hospitals became increasingly inadequate Act in 1867 which paved the way built subsequently served the larger as industrialisation got underway, for similar hospitals to be established centres of population. Glasgow Town seeing rising populations and greater throughout the country and to tackle Council established a second fever densities of the urban poor, conditions the sources of infection – water hospital in 1870 in the grounds of in which infection could be rife. supplies, sewers, overcrowding, filth Belvidere House, two years later There was a need for more organised and rubbish in the streets – and thus building a separate smallpox hospital state intervention and a network attempt to prevent disease breaking there [5.1]. Smallpox was one of the of municipal hospitals. Glasgow led out in the first place. The Act also most readily identifiable, and most the way when the first permanent allowed Medical Officers of Health dreaded, infectious diseases. Although 70 | Building up our Health

Fig 5.2 King’s Cross Hospital, Dundee, a vaccine was discovered in the late completely disinfected. It comprised William Mackinson and James Thomson, 18th century, it was a long time before four single-storey ward pavilions 1887-9. © – Archive Services. Licensor its use became widespread. with accommodation for 72 patients, www.scran.ac.uk It was an outbreak of smallpox together with a reception block, in the early 1870s in Aberdeen administration building, laundry and that prompted the Corporation to disinfecting station. The hospital was turn a disused match factory into a doubled in size in 1891–5 under the temporary hospital, while a permanent City Architect, John Rust (1844– hospital was begun in 1874 designed 1919). by William Smith (1817–1891). In Dundee, the Town Council Unusually it was constructed of provided a temporary hospital for concrete, with no wooden floors smallpox in 1867, later extended to or walls, on the principle that the provide accommodation for typhus wards could be hosed down and fever. In 1877 a further temporary Building up our Health Infectious Diseases Hospitals and Sanatoria | 71

hospital was built to the south of Clepington Road. After abandoning the idea of establishing a floating hospital, plans were drawn up for permanent buildings on the existing site. The Burgh Engineer, William Mackinson (1833–1906), with his assistant James Thomson (1851–1927), designed the handsome new King’s Cross Hospital, which was built in 1887–9. At first it consisted of just a Fig 5.3 Former Meadowside Hospital Kincraig, Alexander Cattanach, 1906. rather grand, central administration © NHS Highland Archive block with two ward pavilions. The site was bounded by fine iron gates for which isolation was necessary hospitals serving rural districts. and railings of cast iron [5.2]. were scarlet fever, measles, diphtheria Alexander Cattanach (c.1857–1928), By the last decade of the 19th and enteric fever (typhoid). Smaller architect and contractor of Kingussie, century, progress in building new hospitals usually made provision produced the plans and the hospital isolation hospitals was disappointing, for the treatment of three different opened in 1906 with accommodation but a Public Health (Scotland) Act of diseases, while smallpox cases tended for just 12 patients. These were 1897 transferred responsibility to the to be dealt with separate even from plain and simple buildings solidly Local Government Board (LGB) and the main fever hospital. The number constructed of stone. The central two- made providing hospitals an absolute of notifiable diseases gradually storey administration block contained requirement of local authorities. Two increased (there were 37 by the mid- offices and matron’s and doctor’s years later the Board issued guidelines 1920s), and special small isolation rooms, together with five bedrooms, on sites and plans for hospitals. In wards for observation and diagnosis kitchen and services. Link corridors the years following the Act many had to be included. provided access to the single-storey new hospitals were built, and existing The former Meadowside Hospital ward blocks on either side [5.3]. hospitals often extended or rebuilt. By at Kincraig (near Kingussie) is a good By contrast the near this date the most common diseases example of the smaller isolation contemporary Ruchill Hospital in 72 | Building up our Health

Fig 5.4 Ruchill Hospital, Glasgow, A B McDonald, 1900. © Reproduced Courtesy of Glasgow City Archives and Special Collections

Glasgow and City Fever Hospital preserve the amenity, was chosen to Hospital was built in 1897–1903 to in Edinburgh were on a vast scale ensure plenty of fresh air and sunshine designs by the City Architect, Robert and designed with architectural flair. to the patients, in an otherwise Morham (1839–1912). Of deep red For Ruchill the City Surveyor, A B industrial area. It opened in 1900 with sandstone, the buildings were arranged McDonald (1847–1915), drew up over four hundred beds in 16 brick- symmetrically, with two rows of two- plans in 1892, Glasgow Corporation built ward pavilions with pleasingly storey ward pavilions, terminated by having purchased the lands of Ruchill shaped gables. In addition to the wards pairs of conical-roofed towers with for the joint purpose of laying out a there were various ancillary buildings; sun balconies stretched between them. public park and building a hospital an administration block which also The hospital was originally designed for infectious diseases. The site was contained the nurses’ home was the to provide no less than 600 beds, and selected for its accessibility from only building of stone on the site about half of these, on the west side of numerous districts occupied by an [5.4]. The hospital was dominated by a the central administration and service expanding working class. Its position lavishly ornamented water tower. buildings, were allocated to scarlet on a hill, with the park adjacent to In Edinburgh the City Fever fever cases. Usually the towers at the Building up our Health Infectious Diseases Hospitals and Sanatoria | 73

Fig 5.5 Opening ceremony, Hawkhead Hospital, Paisley, Thomas Tait, 1936. © Newsquest (Herald & Times). Licensor www.scran.ac.uk

ends of ward pavilions contained the century, a major development took nurse to oversee the wards. Such ward patients’ WCs and wash-hand basins, place in ward design that solved the blocks often formed part of larger but here in the pavilions on the south problem of housing under one roof isolation hospitals built between the side, the towers contained an escape the large number of different diseases wars, when improved transportation stair and surgeon’s rooms. This made requiring treatment, some of which encouraged greater centralisation of rather better use of the sunny aspect, were difficult to diagnose. This was hospitals. New infectious diseases the WCs being more sensibly placed the cubicle isolation ward. In 1908 hospitals of this period were often in a tower on one side of the pavilion the Local Government Board in built to replace a number of the small about halfway along the length of the England published a simple plan for rural hospitals. ward. The pavilions were linked at such a ward block with just four beds, Hawkhead Hospital in Paisley set ground-floor level by a covered way, in single rooms separated by a partly a new standard in hospital architecture and set sufficiently far apart so as not glazed partition, two on either side when it opened in 1936 [5.5]. The to overshadow each other. of a nurse’s room. Small observation architect was Thomas Smith Tait In the early years of the 20th windows from this room allowed the (1882–1954), who was appointed as 74 | Building up our Health

Fig 5.6 Ayrshire Central Hospital, Irvine, a result of a limited competition in hospitals, marking developments in the William Reid, 1935. 1932. Tait’s Modernist design could treatment of some infectious diseases not have contrasted more strongly such as the pneumothorax operation with the likes of Edinburgh’s City for tuberculosis widely practised in the Hospital in its sharp lines and cool interwar period. white finish. There were six detached Each of the main ward blocks was single-storey ward pavilions as well as designed specifically for a different a two-storey cubicle isolation block type of disease: pneumonia, diphtheria, for doubtful cases, altogether providing measles, scarlet fever, whooping cough 181 beds. On the north side of the and, at the eastern edge of the site, cubicle block was an operating theatre, tuberculosis. Verandas, solariums and a relatively new requirement for such floor-length windows maximised the Building up our Health Infectious Diseases Hospitals and Sanatoria | 75

beneficial effects of sunlight and fresh disparate functions, with the isolation improved methods of treatment and air. At the entrance to the hospital section opening first in 1941 followed the discovery of new drugs led to was a dramatic curved gateway, by the maternity section in 1944. a decline in mortality rates and the looking more like the entrance to a A nurses’ home occupied a central reduction of the length of time a Hollywood film set than a municipal position between the two sections, patient needed to remain in hospital. isolation hospital. Beyond this was and is a particularly notable example Notably the mass production of a porter’s lodge, the administration of its kind, with some good detailing penicillin after the Second World War block, nurses’ home, cottages for male such as the arcaded ground floor. dramatically reduced the need for staff, laundry block, boiler house, and Hospital replaced an these hospitals. mortuary. Originally the buildings earlier isolation hospital built in were rendered and painted white, with 1897. The architect R Leslie Rollo Hospitals for the treatment of minimal strips of tile decoration in (1888–1948) drew up the plans in consumption or tuberculosis black, pale blue, yellow or green. 1936 with advice from the Medical Before Robert Koch discovered in Officer of Health. Provision was made the tubercle bacillus in 1882, the Aberdeenshire, which opened in 1940, for 60 beds, 20 in a cubicle block of cause and manner of spreading and Ayrshire Central Hospital of 1941, two storeys and 40 in two single- tuberculosis were unknown. Known took their inspiration from Hawkhead. storey pavilions. These ward blocks as consumption or phthisis, it was Clean lines, smooth curves and flat were arranged about a square, with a classless disease, striking rich and roofs were particularly suited to the the nurses’ home on the fourth side poor alike. There was no cure, though clinical ethos of a hospital. Ayrshire opposite the cubicle block. There was wealthy sufferers often derived Central, in Irvine, is the larger of the also an administration block with benefit from mountain air, while two, designed in 1935 by William kitchen, stores and dining rooms and the few hospitals that tried to treat Reid, the County Architect, to replace the usual service buildings. Space was consumptives merely offered small the old, small isolation hospitals reserved for additional pavilions if wards or single rooms that were scattered over the county, and to meet required. often kept warm and airless. Once the local authority’s new responsibility Apart from the general it had been realised that this was in for maternity cases [5.6]. The site was improvement in sanitary conditions fact an infectious disease, sanatoria split into two halves to cater for the and the housing of the poorer classes, were established which looked 76 | Building up our Health Infectious Diseases Hospitals and Sanatoria

Fig 5.7 Revolving shelter at Royal Victoria to the continent for methods of patients, were attractive buildings Hospital, Edinburgh. treatment. The discovery of X-rays often designed with a hint of their © The Scotsman Publications Ltd. Licensor www.scran.ac.uk in 1895 slowly improved diagnosis Alpine counterparts. Planning evolved and attempts were made to treat the into a quite specific form, and with disease by surgery. Legislative changes the early reliance on fresh air for from 1907 shifted responsibility for treatment, balconies and verandas were treating cases to local authorities. conspicuous features. TB wards were added to isolation In 1887 the first dispensary for hospitals, asylums and poorhouses tuberculosis was opened in Edinburgh and in some areas publicly funded under the impetus of Dr (later Sir) county sanatoria were built. Many Robert Philip (1857–1939). This of the first generation of sanatoria, developed into the Royal Victoria particularly those catering for private Hospital for Consumption which Building up our Health Infectious Diseases Hospitals and Sanatoria | 77

opened in 1894. The hospital was the William Quarrier in Glasgow used as a private sanatorium since principal element of a broader scheme established the first hospital for 1895, but once it had been taken for the control of tuberculosis which tuberculosis in the west of Scotland, over by the National Association also included the dispensary, home at Bridge of Weir. With his architect, simple ward pavilions of wood-and- treatment, education through the Robert Alexander Bryden (1841– iron construction were put up in the distribution of leaflets, and an asylum 1906), Quarrier visited the Hospital grounds. for advanced cases. It was the first co- for Consumptives at Ventnor on the Open-air treatment had been ordinated attempt in Britain not only Isle of Wight, which comprised a developed on the continent, especially to treat but also to prevent the spread series of grand hotel-style villas for the in Switzerland and Germany amid of TB, and was widely imitated. patients. Something of this is evident the pure air of the Alps and the Black At first the hospital occupied at the Bridge of Weir Sanatorium, Forest. Out of many influential figures, the converted Craigleith House, but though on a more modest scale, with the work of one man in particular from 1903 eight detached, single- its detached ‘houses’ for the patients. attracted attention in Britain: Dr Otto storey ward pavilions were built in the Work began in 1894 and continued Walther (1853–1919). He established grounds. Designed by A G Sydney slowly until 1907, by which time their the Nordrach System in the late Mitchell on a Y-shaped plan, they design was already outmoded. 1880s at a sanatorium in Nordrach- provided sunny and sheltered wards After the foundation in 1898 in-Baden. This produced a rash of for the patients. Simple timber shelters of the National Association for similar sanatoria in Britain, such as in the grounds were used for open- the Prevention of Consumption, Nordrach-upon-Mendip, and in air treatment; either rest or graduated the Glasgow and District Branch Scotland Nordrach-on-Dee [5.8]. exercise in the open air were the established Bellefield Sanatorium at The latter was the first sanatorium principal methods of treating TB [5.7]. Lanark in 1904. Glasgow Corporation in Scotland designed to operate on In 1906 an administration block had donated £500 to the Society the open-air system of treatment. It was built, designed in a pleasing Scots in 1901, the first municipal aid for opened in 1900 on a site high above vernacular idiom by Sydney Mitchell work against tuberculosis in Scotland. the Dee in the middle of a pine forest, & Wilson, with to the rear, services, Later the Corporation granted specifically chosen because of the kitchens and a striking Italianate £5,500 towards the Sanatorium. favourable climate and the supposed dining hall, complete with campanile. Bellefield House had already been beneficial effects of the scent of pine. 78 | Building up our Health Infectious Diseases Hospitals and Sanatoria

Fig 5.8 Nordrach-on-Dee Hospital, Deeside, It was founded as a private sanatorium drawn up by George Coutts (c.1851– George Coutts, 1900. © Crown Copyright: by Dr David Lawson (c.1868–1952) 1924) of Aberdeen, for a building RCAHMS. Licensor www.rcahms.gov.uk of Banchory, who had a distinguished mainly of Black Forest timber with a career, pioneering work in the central tower of Hill of Fare granite. treatment of pulmonary tuberculosis. Balconies and verandas were provided It was one of the first sanatoria to use for all the rooms, facing south across X-rays for diagnosis. the Dee. Initially there were 40 Plans for the sanatorium were bedrooms, though later additions were Building up our Health Infectious Diseases Hospitals and Sanatoria | 79

made. Each room was designed so as was situated at the eastern end. A to admit a maximum of pure sunlight recreation pavilion was added later and fresh air. Windows occupied near by. over two thirds of the outside wall In 1928 the sanatorium closed, space and were so arranged that they later re-opening as a hotel under could be kept open in all weathers. the name Glen o’ Dee in 1934. Corridors and stairs were placed During the Second World War the on the north side, and a dining hall hotel was requisitioned by the army 80 | Building up our Health

and subsequently purchased by the Cross, without change of carriage, in in Dundee, attached to the Royal Scottish Red Cross Society, which less than 13 hours. In the 1930s it was Infirmary there. Two years later the refitted it as a sanatorium for ex- taken over by the Sisters of Charity infirmary took over the Dundee service men and women suffering of St Vincent de Paul, and changed Sanatorium, rescuing it from closure. from tuberculosis. It was opened as its name to the St Vincent’s Home For the counties of Ross and such by Queen Mary in 1949. Hospital. Cromarty, a rich endowment from Further private sanatoria were For the Dundee Sanatorium at Colonel Stewart Mackenzie of established at Kingussie in 1901, and , the architect William Seaforth and his wife helped to Milnathort and Auchterhouse in Alexander (1841–1904) substituted provide a delightful and picturesque 1902. As with Nordrach-on-Dee, the wards for the more-usual single rooms sanatorium on the edge of Grampian Sanatorium at Kingussie – but arranged on the same principle Maryburgh. Designed by Alexander was founded by a medical practitioner, of occupying the south front of the Ross & Macbeth of Inverness, Dr de Watteville. It was a substantial building with access to a balcony or it opened in 1908. The patients’ two-storey stone building designed veranda. This more economical plan accommodation was in the two by the local architect and engineer reflected the original intention that it single-storey wings, angled southwards Alexander Mackenzie, set amongst should be for the poor from Dundee, to maximise the amount of sunshine pine trees. Its main gabled front but despite generous bequests of the in the wards which also had tall and unusually featured arched windows, site and funds for building, it ran into broad windows through which beds mostly in pairs, those on the lower financial difficulties and accepted fee- could be pushed on to the veranda. floor reaching down to the ground. paying patients. On the central two-storey block It was visited by a doctor from Leeds Aberchalder Sanatorium were elaborate armorials of the not long after it opened, and he was (Inverness-shire) was one of the Stewart Mackenzies carved on the impressed by its superior sanitary earliest county sanatoria to be built, dormerheads. arrangements as well as its position, opening in 1907. It was a simple One of the last sanatoria to be comparing it favourably to some of corrugated-iron and wooden structure built in Scotland was Mearnskirk the best Bavarian sanatoria. He was providing 26 beds. In the same year Hospital. Established by the also delighted to discover that it could the first municipal dispensary for Corporation of Glasgow’s Public be reached from Euston or King’s tuberculosis in Scotland opened Health Department, the site had been Building up our Health Infectious Diseases Hospitals and Sanatoria | 81

bought in 1913 and plans drawn up neo-Georgian style that was more Fig 5.9 Children at Mearnskirk Hospital, the following year for a sanatorium commonly favoured for hospitals Newton Mearns, J A T Houston, opened 1930. © Reproduced Courtesy of Glasgow City Archives and for 500 children. This was to be part during the interwar period than Special Collections of a wider scheme for the prevention Modernism. A very pleasing ensemble and treatment of tuberculosis, but was created, the buildings themselves the outbreak of the First World had generous white-painted or stone War called a halt to building work dressings and the setting was carefully and it was not resumed until 1921. landscaped [5.9 and 7.2]. The large complex of detached red-brick buildings was designed by J A T Houston (1878–1927) in a 82 | Building up our Health

The Royal Aberdeen Hospital for Sick Children, opened 1929. © NHS Grampian Archives Building up our Health

Specialist Hospitals

The Royal Aberdeen Pat is an advocate of cared for, many of whom Children’s Hospital, where specialist children’s still recognise her in the Pat Moir worked as the hospitals. ‘Children are street. The environment Sister in charge of the not little adults,’ she says; she worked in changed Accident & Emergency ‘they benefit from having over the course of her Department, was built specialist staff who can career, as play became in 1929. This hospital at provide the treatments an important part of the Foresterhill replaced an and drugs they require.’ care given to children, and older, more cramped She also feels that caring the once pristine walls building and comprised for children in their own gave way to ones brightly four wards, all single hospital protects them in decorated with colourful storey and each with some way from the wider murals. a veranda to allow the world of adult wards, children to be wheeled which can be busy and outside in their beds in distressing places. fine weather. The hospital also had an operating Pat has dealt with a great theatre, an outpatient variety of accidents and department and an emergencies over the isolation unit. years and remembers with affection the children she 84 | Building up our Health Specialist Hospitals

Chapter 6: Specialist Hospitals

Although general hospitals treated and cared for a wide variety of patients, they commonly excluded certain cases, such as maternity, incurables and those with venereal diseases. There was also much debate as to whether children should be admitted. It was not long before separate hospitals were set up to cater for such patients.

or some medical practitioners the 20th century the movement a specialist hospital could towards founding specialist hospitals Foffer the chance to study was reversed, as general hospitals, more effectively a particular type of particularly the large teaching disease or parts of the body – such hospitals, set up their own specialist as eyes, or ear, nose and throat. As departments. such, establishing a specialist hospital In terms of the architecture and might pave the way to fame and design of specialist hospitals, they fortune. Other types of specialist differed only in small ways from hospital catered for distinct groups general hospitals. Often they began of people: women, the armed forces, in converted premises, with limited French, German, Italian and Jewish accommodation for inpatients. They communities. There were also were almost exclusively established specialist hospitals that provided in the largest cities, with the most alternative forms of treatment, in Glasgow and Edinburgh. After such as sea bathing, mineral water maternity and lock hospitals (for or homeopathy. In the course of venereal diseases), eye hospitals were Building up our Health Specialist Hospitals | 85

Fig 6.1 Simpson Memorial Maternity Pavilion, Edinburgh, Thomas W Turnbull, 1935. © Lothian Health Services Archive. Licensor www.scran.ac.uk

the earliest, responding to the rise in century. The latter, the former Royal a hospital for skin diseases founded eye infections brought back by soldiers Victoria Eye Infirmary, has whimsical in Glasgow in 1861, dental hospitals, in the Napoleonic wars, and also to ‘spectacle’ glazing bars. and the Glasgow Cancer and Skin accidents sustained by granite hewers. Specialist hospitals for the Institution founded in 1886 which Heavy industry may also lie behind connected diseases of ear, nose and developed into the Royal Beatson the foundation of eye infirmaries at throat began to appear in the second Memorial Hospital. There was also Greenock and Paisley in the late 19th half of the 19th century, along with the homeopathic hospital in Glasgow 86 | Building up our Health

which began as a dispensary in 1909. establishments maintained links with for the resident medical officer and A few groups of specialist the cities’ general infirmaries, and one for the matron), and a delivery hospitals occurred in larger had been prompted at least in part by ward with three beds. In the wing numbers and are worthy of separate inadequate facilities there. Purpose- running along the west side of the consideration. Maternity hospitals built accommodation for the renamed hospital there was a large ward of have already been mentioned as Edinburgh Royal Maternity and ten beds, with a small ward divided one of the earliest types of specialist Simpson Memorial Hospital, designed off at the south end containing two hospital to be established. Hospitals for by MacGibbon & Ross, opened in beds for patients and one for a nurse. children and women obviously link 1879 at No.79 Lauriston Place. Sir A similar arrangement was followed closely with these. There were also James Young Simpson (1811–1870) on the first floor. The Lauriston Place significant numbers of hospitals for had been appointed Professor of building was eventually replaced by ‘incurables’ and convalescent homes, Midwifery at Edinburgh University in the Simpson Memorial Maternity often architecturally quite distinct 1840 and pioneered the use of ether as Pavilion built next to the Royal from a standard medical building. an anaesthetic in childbirth and later Infirmary in 1935. The architect of of chloroform, the effects of which this streamlined Moderne building Maternity hospitals he discovered by experimenting on was Thomas W Turnbull, with James Perhaps the most widely himself and his assistants. He also held Miller acting as consultant [6.1]. It established specialist hospital type, strong views on hospital reform and too has been superseded by the new and the most enduring, was for design. Unsurprisingly the maternity Royal Infirmary completed in 2003. maternity cases. The Glasgow hospital in Edinburgh was designed Glasgow’s early lying-in hospital Lying-in Hospital was the first in ‘in accordance with the expressed proved short-lived, but was re- Scotland, opening around 1790, and views of Sir James Simpson as to founded in the 1830s. Later in the set up by James Towers (d.1820), what such an hospital should be’. century it moved to a new building in later Professor of Midwifery at the Largely three-storey over a basement, the Rottenrow, opened in 1881 and . This was and with an L-shaped plan, the main designed by Robert Baldie (c.1824– soon followed by one in Edinburgh entrance was in Lauriston Place and 1890). A maternity hospital was founded by Dr Alexander Hamilton led into a suite of four rooms: the founded in Aberdeen around 1893. It (c.1739–1802) in 1793. Both of these dispensary, two sitting rooms (one occupied adapted domestic buildings Building up our Health Specialist Hospitals | 87

until the 1930s when it moved into purpose-built accommodation designed as part of the Aberdeen’s Joint Hospitals Scheme at Foresterhill. By this time maternity homes and hospitals were on the increase throughout the country, reflecting changing legislation that placed responsibility for maternity cases and child welfare with the local authorities. Most were not purpose Younger in 1902 to designs by Paul Fig 6.2 Craigtoun House, St Andrews, Paul built, but were in simply adapted Waterhouse (1861–1924) [6.2]. Waterhouse, 1902. © Royal Commission on the Ancient and Historical houses. Airdrie House Maternity In addition to domestic Monuments of Scotland; B/64515. Hospital, in Airdrie, was set up in 1919 conversions, maternity units were Licensor www.scran.ac.uk in the Tudor-style house that had added to existing general and cottage belonged to John Wilson, the MP for hospitals such as at the John Martin Falkirk. Barshaw House in Paisley was Hospital at Uig on Skye. The cottage acquired by the Town Council and hospital had opened in 1905, designed converted into a maternity and child by local architect from Portree, James welfare home in 1921, a maternity A H Mackenzie, and a maternity ward added to it in the 1930s. Perhaps annexe was added in 1936. Shortly one of the most lavish was Craigtoun afterwards it became solely a maternity House on the edge of St Andrews, hospital, continuing as such until 1964. converted into a maternity home Later it was taken over by the Youth by Fife County Architect, Robert Hostel Association. The house behind Sorley Lawrie (d.1980), in 1949. The the present hostel was the original large Jacobean-style Edwardian house hospital. had been built for the brewer James 88 | Building up our Health Specialist Hospitals

There were also a number of Jamieson Hospital, built in 1937–9); Women’s Hospitals movement during separate purpose-built hospitals. and Dunfermline (built in 1934–6 to the First World War setting up units Motherwell Maternity Hospital was designs by Muirhead & Rutherford). in France, Serbia, Russia, Corsica the first large purpose-built maternity On a much bigger scale was the and Greece before her early death. and child welfare centre in Scotland, Elsie Inglis Memorial Hospital in The maternity hospital built in her opening in 1923. Designed by William Edinburgh. It was built in 1923–5 as memory was designed by Harold Ogle Mair Bishop (1881–1941), it has a memorial to Dr Elsie Inglis (1864– Tarbolton on a prime site overlooking an unassuming but attractive gable- 1917), a pioneer in championing Salisbury Crags. His plan made the fronted elevation to the main road. Its the cause of women doctors and in most of this with its south-facing importance lay in providing care not providing care for the poorer women rooms and wards, some opening only for women during childbirth, but of Edinburgh during pregnancy. directly out onto a terrace [6.3]. also during pregnancy and for mother She also worked with the Scottish

and baby after delivery, and continuing Fig 6.3 Elsie Inglis Memorial Hospital, Edinburgh, H O Tarbolton, 1923-5. to offer treatment to children up to © Lothian Health Services Archive. Licensor www.scran.ac.uk the age of five. There were also dental and skin clinics, plus lecture and demonstration rooms. John Wilson (1877–1959), the architect to the Scottish Board of Health, published plans of the centre as a model in an article on hospital planning in Scotland. Other small purpose-built maternity hospitals were erected in Torphins (Kincardine O’Neil Hospital, built as a war memorial and opened in 1925); Helmsdale (General Pope Hospital, 1935); Forfar (Fyfe Building up our Health Specialist Hospitals | 89

Children’s hospitals The first children’s hospital in Scotland was in Edinburgh, opening in 1860 in Lauriston Lane. At that time opinion was divided on the need for such hospitals. Florence Nightingale for one was a strong voice against. Certainly the speed and severity with which infections could spread amongst children were discouraging. Nevertheless, children’s hospitals ward pavilion on either side of the Fig 6.4 Pheobe Traquair painted mural in were also established at Aberdeen in large centre block on a U-shaped chapel at Royal Hospital for Sick Children, Edinburgh, 1885-6. 1877 and Glasgow in 1883, while the layout. Many hospitals had chapels, © Crown Copyright: RCAHMS. Dundee Infant Hospital began within used by staff and by patients who were Licensor www.rcahms.gov.uk the Royal Infirmary in 1883, moving able to do so, as well as by friends and to a house in Broughty Ferry after the relatives. Particularly poignant is the First World War. chapel here with its murals by Phoebe After a humble start, Edinburgh’s Traquair (1852–1936). They had Hospital for Sick Children was been painted for the hospital’s earlier granted a royal charter in 1863 home at Meadowside House and were and moved twice more before its transferred to the new building [6.4]. new premises in Sciennes Road A country branch for chronic and were completed in 1895. George convalescent cases was built at Gullane Washington Browne (1853–1939), in 1906–9. Simply designed by Robert one of Edinburgh’s leading architects, Lorimer, it had just two wards with 12 produced the design of this handsome, beds in each. Jacobean building. Browne adopted In the interwar period, the accepted pavilion plan, placing a legislation encouraged concerted 90 | Building up our Health

Fig 6.5 Children basking in the sun at the Princess Margaret Rose Hospital, Edinburgh. © The Scotsman Publications Ltd. Licensor www.scran.ac.uk

efforts to improve the health of found to be beneficial. Surgical Women’s hospitals young children, a movement that intervention was first popularised on The late 19th century saw the went hand in hand with improved the continent in the 19th century but debate about women’s education and maternity and antenatal care. One was only really widely accepted here training as doctors reach new heights, area that required more specialist once X-rays and antiseptic surgery and a handful of women’s hospitals institutions was the treatment of had become more current after 1900. founded from around that time crippled children, whose disability The earliest and best-known hospital offered either treatment of conditions was most commonly caused by the in Scotland, originally set up to treat commonly suffered by women, or non-pulmonary form of tuberculosis crippled children, was the Princess treatment by an all-female staff. These which attacked the joints. There was Margaret Rose Orthopaedic Hospital perhaps have greater interest for their no known cure, treatment usually at Fairmilehead in Edinburgh. It was place in medical history than in the following that for pulmonary TB built in 1929–32, designed by Reginald development of hospital architecture and comprising prolonged exposure Fairlie (1883–1952), with wards that and design. to fresh air [6.5]. Sunlight, too, was were completely open at the south end. Of the latter type, Bruntsfield Building up our Health Specialist Hospitals | 91

Fig 6.6 Royal Samaritan Hospital for Women, Glasgow, Macwhannell & Rogerson, 1895. © Reproduced Courtesy of Glasgow City Archives and Special Collections

Hospital in Edinburgh is inextricably Hospital in West Cumberland (now (c.1878–1938) and opened in 1915. linked to two of the most influential Ashley) Street in a converted house, Set on rising ground near Victoria women doctors Sophia Jex-Blake and moved first to Lynedoch Place Park, the main front faced south with (1840–1912), the first female general and then to Redlands House in 1924. views towards the Tay and featured practitioner in Scotland, and Elsie The earliest purpose-built a sheltered veranda with balcony Inglis. Jex-Blake opened a Provident women’s hospital was also in Glasgow: above. This pleasing red-brick and Dispensary for Women and Children the Royal Samaritan Hospital for harled two-storey hospital replaced in 1878 which expanded to take Women. This specialised in obstetrics a converted house in Seafield Road, inpatients in 1885. When she retired and gynaecology, and began in a which itself had replaced a dispensary in 1899 the hospital moved into her converted house in 1886. The new set up around 1891. The aim of the former home, Bruntsfield Lodge. In hospital designed by Macwhannell & hospital was to treat diseases ‘peculiar the same year Elsie Inglis and the Rogerson in 1895 was deliberately to women’ and to offer treatment by Medical Women’s Club opened a domestic in character, recognising women doctors. small hospital later known as the the beneficial effects of familiar Hospice, and this amalgamated with surroundings on the patients [6.6]. Incurables the Bruntsfield in 1910. Similarly domestic in style was The earliest attempts to provide Redlands Hospital in Glasgow the new building for the Dundee hospitals for those suffering from also operated as a hospital for women Women’s Hospital, designed by the incurable diseases came in the second run by women doctors. It started in architect James Findlay (1866–1943) half of the 19th century, with the first 1902 as the Glasgow Women’s Private and his chief assistant David Smith of such a kind founded in Aberdeen 92 | Building up our Health Specialist Hopitals

in 1857. Others followed in the hospital, where the priority was to 1870s with the establishment of the keep the patients comfortable and Edinburgh Association for Incurables free from pain. For those able to get and the Scottish National Institution about there might be pleasant garden for the Relief of Incurables, both grounds, sitting rooms, and even in 1874. For the latter, Broomhill smoking rooms. House at Kirkintilloch was purchased This can also be seen in the few and opened in 1876 for adults and purpose-built hospitals for incurables, children. It was substantially added to a fine example of which is the former in the following decades. A cottage Longmore Hospital, the first part home for incurable consumptives built of which was built in 1880. The in 1904 and named the Lanfine Home Hospital had been founded by the amalgamated with Broomhill as late Edinburgh Association for Incurables as 1960 under the National Health and first opened in 1875. Generous Service. funds left by J A Longmore allowed Hillside Hospital in Perth the new hospital to be built on the was founded in 1876, gradually existing site in Salisbury Place. Plans expanding into larger premises, and were drawn up by John More Dick also including a sanatorium; while in Peddie (1853–1921), who designed an Dundee a home for incurables was imposing, classical-style building with first established in 1878. At the turn of a long, elegant frontage. As money the century Balgay House – then on permitted, additions were made. the outskirts of Dundee – was turned Within the hospital there was a mix of into the Royal Victoria Hospital relatively small ten-bedded wards for for Incurables, to which a cancer the poorer patients in the side wings wing was added a few years later. and more commodious rooms for Comfortable domestic surroundings paying patients in the central block were key features of this type of [6.7]. It closed circa 1990 and since Building up our Health Specialist Hopitals | 93

Fig 6.7 First-floor plan for Longmore Hospital, Edinburgh, Kinnear and Peddie, 1878. Shown as originally built. © RCAHMS (Dick Peddie and McKay Collection). Licensor www.rchams.gov.uk 94 | Building up our Health Specialist Hopitals

Fig 6.8 Schaw Convalescent Home, Bearsden, James Thomson, 1891. © Newsquest (Herald & Times). Licensor www.scran.ac.uk

the home followed a similar plan to the infirmary with Nightingale-style wards. This was common for the earlier generation of convalescent homes. Later, smaller wards were preferred, together with day rooms and other more home-like spaces that could benefit patients not confined to bed. Early on, alterations and additions 1994 has been given a new life as the As might be expected, these were to the Hospital included headquarters of Historic Scotland. less institutional buildings, not unlike an arcade (now obliterated by later those for incurables, though here the alterations) which provided shelter on Auxiliary hospitals and patients were on the road to recovery. the ground floor and a terrace above. convalescent homes Some were in converted houses, or This allowed the patients to enjoy the As the pressure on beds steadily began that way – such as the Glasgow fine views southwards, making the rose in the later 19th century, with Royal Infirmary’s, which originally most of the splendid elevated situation ever-increasing numbers of patients opened in a rented house in 1866 – of the building. seeking or requiring admission to but most were purpose built. Lenzie A similar story can be seen in hospital, one way to free beds more Hospital was built in 1871 to replace Glasgow, where the Royal Infirmary’s rapidly was to move patients not the rented houses for Glasgow’s first convalescent home was a very quite ready to go back to their own Royal Infirmary, while Corstorphine plain affair, and contrasts vividly with homes out to a place where they Hospital was built as a convalescent its second home built twenty years could convalesce. Most of the larger home for the Edinburgh Royal later. Marjory Shanks Schaw gave voluntary general hospitals went down Infirmary, opening in 1867. The latter an impressive £40,000 to build the this route, setting up convalescent was the more splendid architecturally, new home in memory of her brother. homes, often on the edge of or a fine Italianate building designed James Thomson (1835–1905) had outside the town so that the patients by the stalwart hospital architects been the architect of the Lenzie home, could benefit from fresh, clean air. Peddie & Kinnear. As originally built, and he also designed this building. Building up our Health Specialist Hopitals | 95

The Schaw Convalescent Home is their dangerous working conditions. Functioning alongside riotously Gothic with a soaring tower Blair Castle, at Culross, was bought by convalescent homes, and often with at the centre, and contained a mix of the Fife Coal Company during the a convalescent element, were a few small wards or dormitories and some First World War to acquire mineral auxiliary hospitals set up by some of single rooms, with sufficient space rights but was later given to the local the larger general hospitals. Philipshill for about fifty patients. There was a welfare committee as a convalescent Hospital at East Kilbride was a good central dining hall, recreation or day home, opening around 1927. At about example, built in the 1920s to serve rooms, a smoking room for men and a the same date on the other side of the Victoria Infirmary in Glasgow. large workroom for women as well as the country in Ayrshire, another key plentiful accommodation for the staff mining area, a home was established at [6.8]. Kirkmichael House. More than two dozen Fig 6.9 Abbotsview Convalescent Home, Galashiels, 1935. convalescent homes had been © St Andrews University Libraries. Licensor www.scran.ac.uk established by the end of the 1930s. In addition to those built by hospitals were a few that were set up by charities or societies including the Co-op (Abbotsview Convalescent Home at Galashiels) [6.9] and the Scottish Rural Workers’ Friendly Society (Alderston Convalescent Home at Haddington). There was also a railway workers’ home at Blair Lodge on the Isle of Bute, which opened in about 1924–5. The miners, too, were particularly well organised in terms of welfare and health-care provision – a reflection of 96 | Building up our Health Building up our Health

Architecture and Health in Post-war Scotland

The streamlined Canniesburn between, working to establish to retain its original form. Hospital in Glasgow was pleasant pedestrian areas whilst Now residential, Canniesburn designed by James Miller in managing the vehicle traffic.’ continues to make a positive the late 1930s and was built statement in Bearsden, as an auxilliary hospital for The overall design strategy anchoring the rich history of Glasgow Royal Infirmary. The of the project was to create the area. hospital closed in 2003 and was courtyard spaces at each of converted into housing in 2006 the three original hospital by the Glasgow architectural blocks. To achieve this, new firm, Holmes Partnership. flats were designed to face the original buildings and enclose Architect Douglas Jack landscaped areas for recreation. worked on the project. Whilst there were the usual tensions For Douglas, the visual between economics, planning integrity of the buildings was requirements and maintaining an important aspect of his the historical character of the vision for the project. Most of building, it was, for him, an the original buildings have the enjoyable experience. clean lines of the Modernist style and this presented some ‘You are creating a community challenges: the original Crittall with a large hospital site like windows, for example, had to be this. You have a number of replaced in a way which would buildings to work on and you respect the striking horizontal also have to create the spaces in emphasis, and the roofline had 98 | Building up our Health Architecture and Health in Post-war Scotland

Chapter 7: Architecture and Health in Post-war Scotland

Hospitals and infirmaries are very often prominent – in every sense – within a community and beyond. They have an important place in the public consciousness. This presents particular challenges in relation to both the design of new facilities, and the question of what should be done with hospital buildings that are no longer considered suitable for their original use, due to scientific developments or changing attitudes to health care.

rom the 18th century, hospitals from places of last spiritual resort for have been thought of as ‘state the sick and dying to centres of hope Fof the art’, purpose-built for physical cure and recovery and, laboratories of well-being, their form eventually, for bringing new life into and layout responding quickly to the world. But what was perceived advances in technology, discoveries as the best form of treatment or about infection and its control, and patient accommodation in the 19th more theoretical ideas relating, for century is not necessarily viewed in example, to grouping of conditions the same way today. New research and their treatment. Broadly, by the and developing social attitudes have beginning of the 19th century, their informed the design of many pieces function had shifted dramatically of exceptional hospital architecture Building up our Health Architecture and Health in Post-war Scotland | 99

Fig 7.1 Remnant arch of Rottenrow Maternity Hospital, Glasgow, demolished 2001.

Strathclyde University to a garden/stepped public square with the surviving portico of the famous hospital preserved as an architectural feature. The whole project generated huge public interest and the resulting space reminds us very strongly of in the post-war period. They have elevated, airy site high above the the power of place, architecture, and given us something of a dilemma: centre. The simple word ‘Rottenrow’ memory. It could hardly be thought must hospitals simply be condemned – the street on which it was located of as a conversion and yet, although to demolition when their original from the 1860s onwards, which was almost completely demolished, the use has expired, wiping out not only soon adopted as a nickname for the huge complex of 19th-century the architecture but also the personal hospital – still means a great deal to buildings seem somehow almost narratives associated with them; or can thousands of people whose parents, present on the site [7.1]. new uses be found so that they can be brothers, sisters or they themselves The ambivalent yet powerful preserved for future generations? were born there. In 2001, when the attitude to hospitals has played an hospital moved on, the buildings were important part in thinking about their Converting to conversion demolished (with commemorative future leading up to and following Glasgow Royal Maternity and pieces of rubble selling at £10 ‘decommissioning’. Demolition at Women’s Hospital was one of the apiece) and GROSS.MAX landscape Rottenrow was a very public act, most celebrated in the city, on an architects converted the site for a kind of celebration of what the 100 | Building up our Health Architecture and Health in Post-war Scotland

Fig 7.2 New and old buildings at the former hospital had been and would continue also pass these irreplaceable assets on Mearnskirk Hospital, Glasgow, converted to be in its new location at Glasgow to future generations. 1999. Royal Infirmary. The alternative to When the trend for conversion demolition, of course, is reuse and of redundant listed buildings began renewal, and this section of the book in earnest during the late 1970s demonstrates through examples and early 1980s, hospitals were that conversion can and does work. among the last building type to be By retaining and reusing important considered in Scotland. There had historic buildings we honour the work been some fairly large-scale hospital of the architects, the clients, and the conversions in England, but these culture that produced them and we were mainly in rural locations and Building up our Health Architecture and Health in Post-war Scotland | 101

therefore perhaps less challenging conversion of hospitals persisted. not been fully tested. for the property market, since they However, even within the scope Around the same time, J A T were often set in country house-style of the hospital building type some Houston’s neat and compact complex designed landscapes or in protected presented fewer ‘image’ problems at Mearnskirk Hospital, Newton suburban locations. Larger-scale, than others. Big urban hospitals Mearns, East Renfrewshire, was more multi-apartment historic building appeared to be the biggest challenge. promisingly located on the edge of conversions in Scotland have tended The Royal Alexandra Hospital in an existing suburban community. to be part of wider urban regeneration Paisley, designed in 1900 by Thomas In this case, there was a collection projects, and the building types most Graham Abercrombie, is an instantly of very attractive ‘Wrenaissance’- commonly converted in this way have identifiable ‘infirmary’ type with style (evoking the work of Sir been warehouses or other industrial central core and radiating, balconied Chistopher Wren (1632–1723)) structures. The idea of converting wings [1.10]. It was something of a buildings originally designed as a listed buildings was fully accepted showpiece near the centre of town: children’s tuberculosis hospital by within a fairly short time. The scale stone built and elaborately detailed. Glasgow Corporation in the 1930s. of conversion of industrial buildings During the early 1990s, some of In the 1990s, the site was sold to – such as the former jute mills in the main buildings were converted developers, who built 261 houses and Dundee or the bonded warehouses of to flats while the remainder of the 107 flats. Six of the listed buildings Speirs Wharf in Glasgow – was quite complex became a nursing home. were converted for residential and remarkable and created vibrant new Some new ‘enabling development’ two for community use. The hospital communities. The question now was: (new buildings erected within the administrative unit was redeveloped could this approach be extended to grounds to fund the conversion) was as Hazeldene Nursery School, and hospitals? also put up between the hospital and another building was redeveloped as From the early 1980s, more or less the main street. In this way, the future a long-term continuing care hospital all surviving listed buildings going out of one of Paisley’s superb collection of called Mearnskirk House. John Dickie of their original use were considered late-19th/early-20th-century public Homes won a Civic Trust Award for conversion. Some very successful buildings was assured. It was a bold in 1999 for the development of the schemes emerged, but a certain step, taken at a time when the market former nurses’ home, now named nervousness around the residential for residential hospital conversions had Southwood Place [7.2]. 102 | Building up our Health Architecture and Health in Post-war Scotland

Fig 7.3 The Rutherford/McCowan Building at the University of Glasgow Dumfries Campus; part of the former Crichton Royal Hospital. Building up our Health Architecture and Health in Post-war Scotland | 103

One of the most successful and wide-ranging hospital complex conversions has been at the Crichton in Dumfries. In this case the uses were business and educational, with some associated hotel provision. Set in a designed landscape on the edge of the town, the Crichton was developed from 1834 through the bequest of Elizabeth Crichton as a ‘lunatic asylum’, although, appropriately enough, the initial intention had been to create a university. The first asylum building – still in use as a hospital – was designed by William Burn, opened in 1839 and much extended. Over time, the site was added to with buildings of various dates and functions, including the Crichton Memorial Church by Sydney Mitchell & Wilson (1890–97) and many villa- planned patient blocks. The award- winning conversion of part of the site for Glasgow University’s Dumfries Campus has creatively mixed the old and the new, adding value to both [7.3]. 104 | Building up our Health Architecture and Health in Post-war Scotland

Canniesburn Hospital was soon rendered Hawkhead’s plan accommodation with some remaining designed in the 1930s by James Miller obsolete and it was adapted for other in health use, has also seen enabling as an auxiliary hospital for Glasgow medical purposes. Over time, the development of housing in its former Royal Infirmary and built in stages. hospital gradually became surplus grounds. The former City of Glasgow The design is sweeping, streamlined to requirements and finally fell into District Asylum at Gartloch, a superb and ocean liner-inspired, like many a state of disrepair. Sold to housing setpiece complex of architecturally buildings of the period. The complex developers, the entire complex will be exuberant buildings to the north-east sat in a similar position to Mearnskirk, converted by the Burrell Company of Glasgow (Thomson & Sandilands, on the edge of the city of Glasgow, with architects Elder & Cannon to from 1889) has, since 2003, been in Bearsden, Dunbartonshire, but was 131 flats and houses, with new build undergoing full conversion to gradually surrounded by suburban on the north of the site adjacent to residential use within a planned new development. The conversion to flats, existing development. However, the community [7.4]. The complex sits in along with ‘enabling development’ has individual single-storey hospital wards rolling countryside, clustered around been very successful, preserving and were found too difficult to convert, the Bishop’s Loch, a Site of Special conserving the hospital buildings and and consent was given for their Scientific Interest. giving them a bright new future as a demolition and replacement with Most of these out-of-town sites thriving residential community. high-quality new build that respected were built in a closely organised Hawkhead Hospital was a the formal layout of the original cluster, dominated by a central hall contemporary of Canniesburn’s, hospital. In this case the presence or, containing administration offices, designed by Thomas Smith Tait in the again, ‘memory’ of the listed buildings board rooms and a large assembly hall 1930s for his native town of Paisley. has informed an inspiring new design. and/or chapel. They were generally The infectious diseases hospital There have been several other given a grandiose architectural complex with its separate nurses’ conversions (or planned conversions) treatment, typically with a tower home, isolation unit, boilerhouse of hospital complexes on the outskirts or twin towers to broadcast their and wards was built on a grandiose of Scottish cities. existence and function widely beyond Beaux-Arts plan similar to Tait’s 1938 (originally Govan District Asylum) in their immediate setting. Not all of Empire Exhibition in Bellahouston Renfrewshire, whose buildings have these complexes have survived in Park, Glasgow. Medical discoveries partly been converted to residential a condition which would permit Building up our Health Architecture and Health in Post-war Scotland | 105

Fig 7.4 Former City of Glasgow District Asylum, Gartloch, converted from 2003. 106 | Building up our Health Architecture and Health in Post-war Scotland

continental village hospital system by Alexander Marshall Mackenzie and opened in 1904. As a self-contained community set on its own, there are similarities with contemporary institutions such as Gartloch or Woodilee, but these harked back to the older idea of a grandiose central building complete with board room and central hall set in a landscape Fig 7.5 Former City Hospital, Aberdeen, converted 2004. with lesser wards and ancillary conversion. Woodilee at Lenzie, if conditions are favourable, we can structures. Kingseat has more of designed in phases as a mental hospital creatively conserve and reuse the huge a ‘village’ atmosphere, similar to by the Salmon dynasty of architects cultural resource that is our surviving Bangour Hospital near Edinburgh, but and well known to commuters on health estate. using ‘villas’ on a segregated system the Glasgow–Edinburgh railway line, In 2004 the City Hospital, according to age, sex and disorder. has lost its central hall and chapel. Aberdeen – which had been built The hospital closed in 1994, but Rather forlornly, two wings of the near Aberdeen Beach in 1874–7 this beautifully built and maintained missing block remain and are to by William Smith as an Infectious surviving complex was recognised as be incorporated as managed relics Diseases Hospital and extended a major heritage and community asset within a housing development at the and enlarged by John Rust in the and a mixed, sustainable development site, another example of a fragment early 1890s – was partly converted is being created, with converted listed standing as a monument to a lost to flats. The slightly out-of-town, buildings and new build providing institution. There are other historic seaside location made it an attractive community facilities and a district hospital complexes which, clearly, proposition for buyers [7.5]. heating system. will not survive decommissioning. Similarly, a peaceful rural location Many of these conversion However, there are many examples, as near Aberdeen, Kingseat Hospital schemes have natural advantages such we have seen, that demonstrate how, at Newmachar was designed on a as a suburban location near an existing Building up our Health Architecture and Health in Post-war Scotland | 107

Fig 7.6 Quartermile development, former Royal Infirmary of Edinburgh, conversion started 2001. settlement, flexible buildings or an Nurses’ Homes (1890–2) and the same towers. The success of the project has open layout which lends itself to the firm’s Ear Nose and Throat Hospital demonstrated the significant cultural much-desired ideal of community. (1900). The Quartermile development, and economic value of these historic However, the principle of converting begun in 2001, seeks to retain and assets whose form and function has and reusing big, city hospital buildings restore most of the surviving buildings played such an important part in was greeted sceptically at first by some. (nine listed buildings) on this large the life of the city. A familiar scene The Royal Infirmary of Edinburgh brownfield site while introducing new has fundamentally changed, but is a complex site centred around development in the form of offices, the creation of the new quarter has David Bryce’s superb main block and shops, flats and leisure outlets. Bryce’s provided a new destination and a new pavilions, designed in the 1870s. To romantically detailed pavilions seen community in the heart of the city this initial group were added several from the Meadows above the tree line [7.6]. significant buildings, including Sydney are now dynamically contrasted with Quartermile is one of the Mitchell & Wilson’s Queen Anne-style Foster & Partners’ shimmering glazed most ambitious privately funded 108 | Building up our Health Architecture and Health in Post-war Scotland

Fig 7.7 Former Edinburgh Hospital for Incurables, Longmore House, Edinburgh, converted 1993-4.

throughout the country including Glasgow’s Duke Street Hospital (Alfred H Tiltman (1854–1910) of London, 1904) which was converted to offices and housing by Cooper Cromar in 2000. Conversion of 19th- and earlier- 20th-century hospitals is one thing. Mostly historicist in style, the function of these hospitals was to a large extent masked by their stylistic dress. In designing Donaldson’s Hospital in 1841 (confusingly a school, and not a medical hospital, in the manner of George Heriot’s or George Watson’s), the architect William Henry Playfair developments ever attempted. At (1790–1857) wrote that he wanted the other end of scale – individual to create a place ‘where Henry hospital buildings set within a city VIII might have met Anne Boleyn’. – there have been some interesting Conversion of such a block to conversions, often hardly noticed. residential use has its challenges, but Historic Scotland’s conversion of J the historical romantic architecture M Dick Peddie’s 1882 Edinburgh of the block is strongly in its favour. Royal Hospital for Incurables After the Second World War, there (Longmore House) in 1993–4 as a were no such historical references to headquarters building was intended the architecture of the past. Everything as a demonstration project [7.7], and was to be bright, modern and, above there have been several other examples all, scientific. Building up our Health Architecture and Health in Post-war Scotland | 109

Post-war hospitals and Canniesburn, but to some extent experimental prototype at Falkirk With the creation of the the older concerns with hierarchy, Royal Hospital (designed by Keppie National Health Service in 1948 symmetry and composition were Henderson & Partners in association came a massive expansion in hospital still evident. After the Second World with a team from the Scottish Home building. This was a key part of War, when so much hope rested on and Health Department, 1963–6), the what Jack Coia (1898–1981), one of new facilities and infrastructure, new multi-storey hospital block was rolled Scotland’s leading post-war architects hospitals began to appear which out across the country at Gartnavel and founder of Gillespie Kidd & seemed at the same time scientific, General Hospital (Keppie Henderson Coia, had called the ‘crusade’ of glamorous and functional. The first of & Partners, 1968–73), Aberdeen Royal new Scotland. Health was an area, the new general hospitals in Scotland Infirmary at Foresterhill (Charles perhaps more than any other, where was at Vale of Leven, Alexandria, C Wright, from 1964), and the Modernism in architecture would designed by Keppie Henderson hilltop ‘citadel’ block of Inverclyde equate directly with improvement. It & Gleave (1952–6). As with new Royal Hospital (Boswell, Mitchell was no coincidence that in the 1930s university planning, the new hospitals & Johnston, 1977–9). Similar blocks the influential Modernist émigré focused on open-ended planning, were built at Glasgow’s Western Berthold Lubetkin (1901–1990) had allowing for expansion on a ‘campus’ Infirmary (Keppie Henderson & chosen a ‘health centre’ (Finsbury basis. Partners, 1965–74) and at Glasgow Health Centre, London, 1938) – itself The general shift in hospital Royal Infirmary (Spence, Glover & a new concept – to demonstrate design after the Second World Ferguson, 1971–82). visually what he felt was the absurdity War was away from ‘pavilions’ for in Dundee of dressing up modern facilities with controlling infection and towards (Robert Matthew, Johnson-Marshall pompous, historicist architecture. Here compact blocks, often multi-storey, & Partners (latterly RMJM), begun was an opportunity for form to follow on a large urban scale with centralised 1961, completed 1974) represented a function in a science-based way. services on a ‘racetrack’ plan. The continuation of the campus principle. Scotland had already experimented first of these was Bellshill Maternity With no big central unit, the blocks widely with a rationalist approach Hospital, designed by Gillespie Kidd were designed to achieve separated to hospital architecture in schemes & Coia (1959–62) [7.8]. The type functions along a central service core. such as Hawkhead, Ayrshire Central proved successful and, following an The huge Crosshouse Hospital near 110 | Building up our Health Architecture and Health in Post-war Scotland

Kilmarnock, Ayrshire (built as North 2005); Glasgow, Western Infirmary building for the town. The greatest Ayrshire District General Hospital (Page & Park, 2002); Dundee, challenge and opportunity of all, to designs by Boissevain & Osmond, Ninewells Hospital (Frank Gehry, however, will come with the New from 1968) followed a similar pattern. 2003); and Fife, Victoria Hospital, South Glasgow Hospital, a massive Sitting on a wide plain with sparse Kirkcaldy (Zaha Hadid, 2006). Clearly, complex on the site of the Southern development nearby, Crosshouse the exuberant architectural form and General Hospital costing £600million presents an imposing image. layout of these important centres has and accommodating 30,000 people In terms of noteworthy been closely linked to their success as on a daily basis. NHS Scotland’s individual health-care buildings, Peter uplifting places. recent publication, enabled by Wormersley’s (1923–1993) Nuffield After recent years of cost- Architecture and Design Scotland, A Transplant Unit at the Western driven commodification of hospital Vision of Health (2009), puts design General Hospital, Edinburgh (1963–5) design – which has been criticised at the heart of new architecture, the stands out as an early concrete in some quarters – inspiring aspiration for which is ‘a level of care ‘sculptural’ block, international in design is once again on the agenda, and thought which conveys respect’. flavour. However, the same architect’s achieved through a restructuring of The new approach hopes to avoid Group Practice Surgery at Edenside, the procurement process. Reiach both imposing grandiose design Kelso (1967), with its clustered layout & Hall’s New Stobhill Hospital solutions and construction-orientated of harled buildings, focused much (begun 2006) makes a strong but not buildings where architecture in the more on the locality, pointing to an overpowering architectural statement traditional sense has been given a awakening interest in the vernacular. with a central atrium/‘street’ flooded low priority. Keppie’s new Maternity More recently, the five Scottish with light and offering clear access Unit at Crosshouse Hospital, with Maggie’s Centres for people affected to services. Archial’s Plean Street its figure-of-8 layout, builds on that by cancer were commissioned from Centre for Health and Care (2008) is firm’s long association with hospital some of Scotland’s and the world’s a compact version of this approach. planning. Less imposing now than the most acclaimed architects: Edinburgh, In contrast, Austin-Smith:Lord’s new confident slab blocks of the 1960s and Western General Hospital (Richard Community Hospital at Girvan, with 1970s, the new building responds to Murphy, 1996); Highlands, Raigmore its brightly clad, jutting frontage, its local context, mediating between Hospital, Inverness (Page & Park, will be something of a landmark the existing large hospital, to which it Building up our Health Architecture and Health in Post-war Scotland | 111

Fig 7.8 Bellshill Maternity Hospital, Gillespie Kidd and Coia, 1959-62. © Newsquest (Herald and Times). Licensor www.scran.ac.uk

acts as a bookend, and nearby housing results so far have demonstrated his son Robert’s Glasgow Royal where its scale drops. that the long tradition in Scotland Infirmary (both demolished) – has NHS health boards have of prestige hospital architecture – been reinvigorated for the benefit committed themselves to producing stretching back to William Adam’s of all. ‘high-quality design solutions’. The Royal Infirmary of Edinburgh or 112 | Building up our Health Building up our Health

Select Bibliography and a Note on Sources

The following is a guide to the key sources which informed this publication. Further online sources are now available, outstanding amongst which is Peter Higginbotham’s on workhouses (see below) a truly remarkable fund of information on all things relating to the poor laws.

Primary Sources Many of the archives in Scotland have records relating to hospitals, from the National Archives of Scotland to local history libraries. City and University Archives as well as Health Service Archives were also widely used. For photographs and plans of buildings the National Monuments Record of Scotland, the National Archives of Scotland and Health Services Archives were the principal sources. Some material remained with the hospitals themselves. Parliamentary Papers were also widely used, notably annual reports of the Poor Law Commissioners; Commissioners in Lunacy for Scotland, Local Government Board and Board of Control. Building up our Health Building up our Health | 113

Select Bibliography Browne, W A F, What Asylums Were, Are and Ought to Be, Edinburgh, 1837. British Medical Association, Aberdeen 1914, Handbook and Guide, Aberdeen, 1914. British Medical Association, The Book of Aberdeen, Aberdeen, 1939. Buildings of Scotland series. London, 1978-2007. Burdett, H C, Cottage Hospitals, London, 1880. Burdett, H C, Hospitals and Asylums of the World, London, 1891-3, 4 vols and portfolio of plans. Burdett, H C (Ed), Hospitals and Charities Year Book, 1925. Calder, J T, History of , 2nd ed, Wick, 1887. Comrie, J D, History of Scottish Medicine, London, 1932. Department of Health for Scotland, Annual Reports. Dow, D, Paisley Hospitals, Glasgow, 1988. Dow, D, The Rottenrow, Carnforth, 1984. Dow, D, The Royal Samaritan Hospital for Women, Glasgow, 1986. Dow, D and Slater S D (Eds), The Victoria Infirmary of Glasgow 1890‑1990, Glasgow, 1990. Easterbrook, C C, The Chronicle of Crichton Royal (1833‑1936), Dumfries, 1940. Gammie, Alexander, A Romance of Faith, London, 1945. Glasgow Corporation, The Book of Lennox Castle, Glasgow, circa 1936. Hall, Derek, Scottish Monastic Landscapes, Stroud, 2006. Haythornthwaite, J A, Scotland in the Nineteenth Century, Aldershot, 1993. Irving, Gordon, Dumfries & Galloway Royal Infirmary – the first two hundred years, Dumfries, 1875. Jenkinson, J, Moss, M and Russell, I, The Royal. The History of the Glasgow Royal Infirmary, 1794-1994, Glasgow, 1994. Kelynack T N (Ed), Tuberculosis Year Book and Sanatoria Annual, London, 1913‑14. Knox, James, Airdrie, a Historical Sketch, Airdrie, 1921. Mackay, G A, Management & Construction of Poorhouses & Almshouses, Edinburgh, 1908. Mackay, N D, Aberfeldy Past and Present, Aberfeldy, 1954. 114 | Building up our Health Building up our Health

MacKenzie, Alistair and Hodgson, Julian, ‘The History of Law Hospital’, in Glasgow Medicine, Vol 3, No 5, September‑October 1986. MacKenzie, T C, The Story of a Scottish Voluntary Hospital, Inverness, 1946. Mitchell, David, History of Montrose, Montrose, 1866. Poole, Richard, Memoranda Regarding the Royal Lunatic Asylum, Infirmary and Dispensary of Montrose, London, 1841. Presly, A S, A Sunnyside Chronicle, Tayside Health Board, Dundee, 1981. Robertson, Edna, The Yorkhill Story, Glasgow, 1972. Scottish Home and Health Department, The Falkirk Ward, Edinburgh, 1966. Sibbald, J, On the Plans of Modern Asylums for the Insane Poor, Edinburgh, 1897. Third Statistical Account of Scotland, Edinburgh, 1951-1992. Thomson, M Wright, The Glasgow Eye Infirmary, 1824‑1962, Glasgow, 1963. Turner, A Logan, The Royal Infirmary of Edinburgh, Edinburgh, 1929. Turner, A Logan, Story of a Great Hospital, Edinburgh, 1979. Turner, G B, The Chronicle of Crichton Royal 1937 – 1971, Cumbria, 1980. Watt, O M, Stobhill Hospital, first 70 years, Glasgow, 1971. Williams, Morag, History of Thomas Hope Hospital, 1989. Young, Robert, Annals of the Parish and Burgh of Elgin, Elgin, 1879. Building up our Health Building up our Health | 115

Journals The following is a list of the principal newspapers and journals used: Aberdeen Journal, Aberdeen Daily Journal, Architect & Buildings News, Architects Journal, British Medical Journal, The Builder, Building News, Glasgow Herald, Glasgow Medical Journal, The Hospital, Journal of the Royal Institute of British Architects, Journal of Mental Science, Lancet, Medical Directory.

Websites Dictionary of Scottish Architects www.scottisharchitects.org.uk

Glasgow Digital Library http://gdl.cdlr.strath.ac.uk/

Higginbotham, Peter “The Workhouse” http://www.workhouses.org.uk/

Lothian Health Services Archives http://www.lhsa.lib.ed.ac.uk/

The Mitchell Library, Glasgow http://www.mitchelllibrary.org/virtualmitchell/

Royal Commission on the Ancient and Historical Monuments of Scotland http://www.rcahms.gov.uk/search.html

The Royal College of Surgeons of Edinburgh, history of the college http://www.rcsed.ac.uk/site/345/default.aspx.

Scottish Archive Network website http://scan.org.uk/

Scottish Cultural Resources Access Network http://www.scran.ac.uk/

Unlocking the Medicine Chest http://134.36.1.31/dserve/dserve2/search/search.html 116 | Building up our Health Building up our Health

Historic Scotland

Historic Scotland is an executive agency of the Scottish Government. It is charged with safeguarding the nation’s historic environment and promoting its understanding and enjoyment. Many of the hospitals featured in this book are listed buildings (although inclusion in this book does not imply open access). Listing recognises a structure’s special architectural and historic interest and secures its protection under law through the planning system. Listing is intended to inform the management of the historic environment to reinforce sustainable development and, from this greater understanding, serves to protect Scotland’s defining character and its sense of place.

Historic Scotland’s Inspectorate can be contacted at: [email protected]

Historic Scotland Inspectorate Longmore House Salisbury Place Edinburgh EH9 1SH

Tel: 0131 668 8600 FRONT COVER Elevation of Oldmill Poorhouse, Aberdeen, Brown & Watt, 1907. © Robert Gordon University. Licensor www.scran.ac.uk H1.605 The House 3/10 Produced from sustainable material Building up our Health: the architecture of Scotland’s

Building up our Health historic hospitals

From the day we are born we all have reason to visit the many hospitals which distinguish our towns, cities and villages. They have evolved from the almshouse and the philanthropic initiative of local lairds, to the municipal benefaction of the Victorian Infirmary and the streamlined designs tailored for today, contributing significantly throughout to our national identity. Whether we prefer the homely scale of the cottage hospital or the vast microcosm of a nineteenth century sanatorium, this richly illustrated book shows how hospital architecture has adapted over the centuries in response to medical advances, changing philosophies and the necessities of their day. The informative overview closes with a look at their continued evolution to a sustainable future.

ISBN: 978 1 84917 039 0

Historic Scotland