English Hospitals, 1660-1948: A Survey of Their Architecture and Design (review)

Harriet Richardson, ed. English Hospitals, 1660-1948: A Survey of Their Architecture and Design. Swindon: Royal Commission on the Historical Monuments of England, 1998. x + 222 pp. Ill. £35.00.

This study is the elegant façade of a much greater building. It is based on a survey of English hospitals carried out between 1991 and 1994 by staff of the Royal Commission on the Historical Monuments of England. Three teams of two investigators based in different parts of the country compiled an archive containing information on some two thousand hospital sites, many of them now only map references to long-demolished institutions. The survey covered the entire range of hospital types, including the buildings of the armed forces. Each site was entered in a database, and an associated file was created containing a brief report, Ordnance Survey maps, available documentation, and photographs both early (some very early) and modern (including aerial). The archive is publicly accessible at the National Monuments Record Centre, Swindon, Wiltshire. A county-by-county list of the sites appears as an appendix to this volume.

The book, then, besides its inherent scholarly value, draws attention to the work of the commission. It has, in other words, an entirely justified tone of satisfaction in a job well done, and is not afraid to adopt the large format, glossy pages, and copious illustrations of a coffee-table work. It can in fact be read in just that way: the first time I opened it I found myself rushing through the photographs and captions and skimming the text, anxious to see what the next section or page would offer. So much the better, for if it brings the commission's work to a wider audience it will do valuable service.

However, those seeking more serious fare will certainly find that here too. There are nine chapters: "Historical Context," "General Hospitals," "Cottage Hospitals," "Workhouse Infirmaries," "The Hospitals of the Armed Forces," "Specialist Hospitals," "Hospitals for Infectious Diseases," "Mental Hospitals," and "Convalescent Homes and Hospitals." Each chapter describes in detail a small number of institutions in these categories. The authors are not architectural highbrows, for the text and illustrations range from the spectacular original Bethlem built to Robert Hooke's design to the Nissen huts used by the Emergency Medical Service in the Second World War.

Personally, I could have done with rather more architecture and less medical history. To a great extent in this book the engine of hospital design and its continuity and change over time is medical views on ventilation, cleanliness, fever, and so forth. I wanted to read more about the similarity of hospitals, both internally and externally, to other sorts of buildings, such as those for managing the poor. I wanted more, too, about the architects, and how far their designs were transfers from other commissions. This appears occasionally, as in the fact that John Carr, architect of the notorious York asylum, had previously designed Harewood, the magnificent country house and estate near Leeds of the Lascelles family. These are minor points, and in any case it is likely that the majority of readers will want more rather than less history of medicine, if this impressive volume finds the wide audience it certainly deserves.

Christopher Lawrence
Wellcome Trust Centre for the History of Medicine
at University College London

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