Bethlem Hospital (Imperial War Museum)

CHAPTER 9: BETHLEM HOSPITAL, NOW THE IMPERIAL WAR MUSEUM, IN LAMBETH ROAD

Bethlem Hospital, now the Imperial War Museum, though much truncated, is the largest remaining of the buildings originally erected in St. George's Fields. The institution for which it was built was the successor of the mediaeval hospital in the priory of St. Mary of Bethlehem in Bishopsgate Without (on the site of Liverpool Street Station), the "bedlam" of common parlance. The first reference to the hospital as such occurs in 1329, (fn. 21) though with no indication of the kind of patients for which it catered, but an inquisition of 1403 (fn. 210) leaves no doubt that by that date the patients treated there were suffering from mental disorders.

The Mayor and Commonalty of the City of London took the priory and hospital under their protection in 1346, (fn. 211) and in 1547, after the dissolution of religious houses, they purchased the hospital and its possessions from the King and by Royal Letters Patent re-established it as a hospital for lunatics. (fn. 212) Ten years later Bethlem was placed under the management of the governors of Bridewell, and the two foundations have since that time been closely associated though they have remained distinct. (fn. 172)

In 1676 Bethlem was moved to a new building on what was then an open site provided by the City in Moorfields. There it remained for over a century, but in 1792 the governors began to discuss the need for undertaking a thorough repair of the old premises or the erection of new ones. (fn. 213) Nothing more active was done until 1800, when James Lewis, the hospital surveyor, reported that the whole building was dangerous, not one floor being level, nor one wall upright. (fn. 214) There were reasons other than the unsatisfactory state of the building which swayed the Governors to adopt their surveyor's suggestion to remove to a new site. During the last quarter of the 18th century a gradual improvement had taken place in the public attitude towards the victims of mental disease, a change due in part to the work of John Howard and other reformers, and in part perhaps to the mental attacks of the King. (fn. n1) The inmates of Bethlem were no longer looked on as a "rareeshow" and the whip was discredited as an instrument of treatment, but fetters and straw were still in use, and the Governors, though resenting external criticism and control (they spent £600 in opposing the Madhouse Bill of 1815 in Parliament), were aware that the administration of the hospital left much to be desired. (fn. 217) The old building was too confined and its associations too strong to admit of any great improvements there, and the Governors decided to remove the hospital to larger premises where the patients could be separated into categories and given better conditions and where there was sufficient space to allow them outdoor exercise. From 1801 to 1807 various sites were discussed, and for a time it seemed probable that the remove might be to Islington, but in June, 1807, the President and Treasurer reported that they had viewed "certain land lying in St. George's Fields being the site lately occupied by the Dog & Duck and at present held by Mr. Hedger under the Bridge House Estates" and recommended it as being fit and proper for the purpose they had in mind. (fn. 218) The negotiations took another three years, but in 1810 an agreement was signed whereby, in exchange for the land in Moorfields, the City Corporation granted 11¾ acres of ground in St. George's Fields for the erection of a new hospital for a term of years equal to that still remaining on the Moorfields property (963 years) and at the token rent of a shilling a year. The ground, roughly triangular in shape, had some houses along the road frontages (see Plate 36), a few of which were demolished for the new building, but the remainder, together with any land not required by the institution, were included in the grant in order to provide a source of revenue for the hospital. (fn. 171)

In July, 1810, the newspapers carried an advertisement offering premiums of £200, £100, and £50 for the three best designs for a new Bethlem Hospital. James Lewis, the hospital surveyor, George Dance the younger, and S. P. Cockerell acted as adjudicators and they awarded first place to the design submitted by John Gandy (Plate 38). (fn. 218) Gandy's notes state that owing to the swampiness of the ground he did not think it possible to sink the building more than 3 feet from the surface. He proposed a basement storey for the domestic offices and 3 storeys above for the patients, each storey to contain 108 cells, eleven foot by seven foot six, with day rooms and keepers' rooms. The food was all to be carried up from the basement by back staircases. He suggested that a pediment supported by six Doric columns should form a central feature; otherwise the building was to be plain brick with a stucco cornice, since he deemed any fine or decorative architecture to be out of place. His proposed elevation, preserved among the archives at Bridewell, presents a dreary expanse of brickwork. (fn. n2) (fn. 219)

The plans and elevations prepared by James Lewis which were adopted for the building were drawn from the three winning designs with such modifications as were suggested by the surveyor's own experience of the needs of the hospital. They comprised a range of buildings of a basement and 3 storeys 580 feet long parallel to Lambeth Road, with a central entrance under a portico. Lewis planned to have rooms for uncleanly patients on the basement floor so that the straw on which they slept could be easily changed. All the patients' sleeping rooms were arched or groined to "Prevent accidents from fire and the noises of the turbulent affecting those above or below them." The infirmary, offices, and residential quarters for the staff were in the central block which served to separate the male and female patients.

The foundation stone of the hospital was laid by the President, Sir Richard Carr Glyn, on 18th April, 1812. By October, 1814, the main structure was complete. The royal coat of arms in the pediment was made of Coade's artificial stone, the cost, 130 guineas for making and fixing, comparing favourably with the estimate of £500 for Portland stone. Across the frieze of the entablature was placed the inscription—

"HEN · VIII · REGE · FVNDATVM · CIVIVM · LARGITAS · PERFECIT"

The Governors sought the advice of John Bacon, the sculptor, as to the disposition of Caius Cibber's statues of Raving Madness and Melancholy from the gates of the old hospital which Gandy had proposed to place above the pediment. Bacon advised that apart from renewing the toe of one of the figures and cleaning off the paint no attempt should be made to restore them. In his own words, no "intrusive chisel of any modern Sculpture [sic]" should be "suffered to invade the surface of these specimens of Original Art." (fn. 218) The statues were accordingly placed in the entrance hall where they remained until the 1850's. They are now in the Guildhall Museum (Plate 41).

In August, 1815, 122 patients were conveyed in hackney coaches from Moorfields to their new quarters. They must have suffered acute discomfort during their first winter; the system of warming by steam was installed only in the basement storey and the windows in the upper storeys were not glazed so that the sleeping cells were either exposed to the full blast of cold air or were completely darkened. The deputy surveyor replied to the complaints of the members of the Select Commission that the omission of glass was deliberate, since it allowed the cells to be ventilated to obviate "the disagreable effluvias peculiar to all madhouses." (fn. 220) The windows were, however, glazed during the summer of 1816.

While the plans for the building were in preparation, the Governors received a request from the government to provide accommodation for criminal lunatics who until then had been confined with ordinary prisoners in gaol. The request was the result of a Select Committee report of 1807 pointing out the disadvantages of mixing lunatics indiscriminately with other prisoners. The expense of the criminal blocks, completed in 1816, was defrayed by the government, who also paid for the maintenance of the inmates. Accommodation was provided for 15 women and 45 men. (fn. 172)

The eastern end of the hospital grounds, abutting on Ely Place (now Geraldine Street) and the gardens of the houses in West Square (see Plate 36), remained open until 1828, when the Governors leased it for 61 years to the Governors of the sister institution, Bridewell, for the erection of "a House of Occupations for the employment and relief of destitute of both sexes." (fn. 171) These premises, which were afterwards known as King Edward's Schools, remained in use until 1931, when the children were removed to Witley. The old schools were pulled down soon after.

The first big alteration to the hospital was made in 1835, when the male criminal block was enlarged to take another 30 men. By this time the ordinary wards of the hospital had become congested, and Sydney Smirke was engaged to plan an enlargement of the whole institution. Besides providing accommodation for nearly double the original number of patients, Smirke was asked to provide workshops for the male patients and laundries for the employment of the female patients, while retaining the symmetry of the front elevation. The plan on Plate 39 shows how he solved the problem by building wing blocks at either end of the frontage and two long galleried blocks across the garden at the rear. Workshops and storage sheds were erected in the front yards, but the administrative block in the centre of the building was left with an unimpeded view of the gardens in front of the hospital which had been enlarged by the diversion northwards of Lambeth Road (see Plate 39), and which Smirke laid out afresh. (fn. 221) Smirke also designed the single-storey lodge fronting Lambeth Road.

The original building had a low cupola as its central feature. In 1812, when the Admiralty was arranging communication by telegraph with Sheerness, it was suggested that the cupola might be used as one of the stations, but the Governors objected on the grounds that the instrument would be noisy and would affect light and ventilation and it was placed in West Square instead (fn. 218) (see Plate 44a). The cupola was replaced in 1844–46 by the existing copper-covered dome, designed by Smirke, and built mainly to enlarge the chapel beneath. (fn. 218)

As a result of the Acts of 1808 and 1815, a number of county asylums were built during the second quarter of the 19th century, and there was less need for Bethlem to cater for the poorer type of patient. The complaint of a female patient led to an inspection of the hospital by the Lunacy Commissioners in 1851, and as a result of their recommendations, the first resident medical officer, Dr. W. Charles Hood, was appointed. (fn. 222) During his term of office he gradually replaced the pauper patients by men and women of education and culture, a process which was hastened by the removal of the criminal patients to Broadmoor in 1864. Many of the new patients could afford to pay for their keep, and Dr. Hood improved the amenities of the building to give them, as far as possible, the comforts to which they had been accustomed in their own homes. (fn. 172)

Between 1866 and 1869 the Governors of Bethlem built a convalescent home at Witley, designed by Smirke, for patients on the way to recovery, but the main part of the institution remained in Southwark until after the 1914–18 war, when the Governors decided to build new premises in rural surroundings. The removal to Monks Orchard at Addington in Surrey was sanctioned by Act of Parliament in 1926. (fn. 223) The freehold of the old site was purchased by Viscount Rothermere in 1930 and vested in the London County Council for the formation of a public open space, to be known as the Geraldine Mary Harmsworth Park in memory of his mother. The side wings and some other parts of the building were demolished. The central portion of the front, with the dome looking disproportionately high above it, and the rear galleries were leased to the Commissioners of Works to house the Imperial War Museum. (fn. 177)

The building, which was opened to the public in 1936, was damaged considerably by bombs in 1940, 1941, and 1944, but by 1946 was sufficiently repaired for the museum to be re-opened. It is perhaps appropriate that a building occupied for so many years by men and women of unsound mind should now be used to house exhibits of that major insanity of our own time, war.