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Being constructed by Andrew Roberts using materials provided by Peter Cracknell (Cambridge), Susan Piddock (Australia) and Sarah Rutherford (DeMontfort)
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Notes on asylum architecture

Using the work of several people researching the history of function and form in the buildings and grounds used for psychiatric purposes. The index to the right will be developed as a means of finding ones way around.

The European Hospitals Heritage (PAPHE) website has a typology and a glossary from which we might take concepts to span the time from medieval hospitals to the present day. PAPHE's primary language appears to be French. I think it helps to avoid confusion to start with its French words for the concepts.

asile d'aliénés ou hôpital psychiatrique: Lunatic asylum or psychiatric hospital. The glossary says that in most European countries these were mostly built in the 19th century, but adds "Previously, convents of certain religious orders fulfilled this function of taking in mentally ill persons". Hôpital conventuel: Monastic or Conventual Hospital. An establishment dependent on a religious order but used as a hospital. See dictionary Hôpital

hôpital type "halle" (hall type). Hospital churches. The word halle comes from a covered market. It is used, by extension, for a room divided into naves of an equal height. The hospitals classified as halle appear to be medieval (see examples, which are museums or such like): "Hospital churches add a generally rectangular-shaped room (sometimes several such rooms), laid out perpendicular to the religious buildings and characterized by grand architecture. The huge hall was sometimes endowed with an altar at one end or the other, so that patients could attend religious services from their beds". Examples: Hotel de Dieu, Beaune, Bourgoyne, France - Leeuenbergkerk, Utrecht, Nertherlands (originally a pest house) - St Giles Hospital, Norwich, England

maison hospitalière hospital house. In the same tradition as the halle, a place that recieves the disinherited. "Generally ... in the center of the cities, it occupies sometimes a whole small island and is organized, as a large urban residence, around a central court.". I have not yet found examples on the PAPHE database. The Bishopsgate Bedlam may be an example of what is meant.

hôpital général [See dictionary Hôpital] Initially intended for people living on the fringes of society considered in need of confinement and correction. Soon became a home for people unable to provide for themselves, such as orphans and abandoned children, needy old people, invalids and the insane. [English: Workhouse. French: Hôpital général d'enfermement]

hôpital classique ou en damier: checkerboard (chess or draughts board). Built in one or more squares. Examples: France: old Bicêtre and old Salpêtrière [See mental health timeline] - England: Haslar Royal Naval Hospital, Portsmouth [See Mental Health Timeline] - London: Guys [See asylum index] - Chelsea - St Bartholomews (also polybloc) - Charterhouse - University College Hospital
Spain: Hospital of Saint Joan, Reus (psychiatric sanatorium)

palais hospitalier: palace hospital. Often financed by rich patrons or philanthropists. Can take the shape of a small castle or a rich person's villa. Accompanied by gardens and small houses which supplement the composition, it is often built in periphery of the cities. Example: Paris: Rochefoucauld - London: Royal London -

aérisme: a late 18th century theory according to which infected air is the essential factor of morbidity. Air being the main carrier of miasmas (substances exhaled by sick bodies and organic matter in putrefaction). It had repercussions on architecture in general and town- planning in particular throughout the 19th century.

antisepsie: antisepsis. Procedures "aimed at destroying microbes responsible for infecting wounds and at preventing post-operative suppuration. The initial antiseptics, used since the end of the 1860s, were non-specific anti-microbial chemical substances such as phenol or phenol- acid. Specific substances of chemical (sulpha drugs) and biological (antibiotics) origin were developed subsequently."

hôpital en peigne like a comb or rack. Separate pavilions are joined together by a gallery. "This shape is the direct result of deliberations on hygiene, the desire for good ventilation and the separation of pathologies." Examples Thurgaton Workhouse, Southwell, Nottingham, 1824 [See under Nottingham Asylum and Radial Plan] - Colney Hatch 1848-1851 [See asylums index and Corridor Plan] - Royal Herbert, Woolwich 1861-1865 (military) [See Pavilion Plan] - St Thomas's (1868) - France: Auxerre, Burgoyne (pychiatric)

asepsie: asepsis. Procedures "for preventing infectious agents from penetrating surgical areas. The sterilisation of surgical instruments and dressing material is done through moist heat or dry heat. Historically, antisepsis preceded asepsis, which spread in the period between 1880-1890".

hôpital pavillonnaire (detached pavilions) "the direct offshoot of" the peigne hospital, "taking the quest for the separation of pathologies and the desire to prevent contagion effects to the extreme. The hospital complex, which is described as fragmented, consists of completely detached pavilions. Movement between pavilions is sometimes provided by underground galleries providing technical connections. The composition of the gardens is as important as that of the buildings and contributes to health care." Example: Paris: Broussais 1883 (constructed during cholera epidemic - Boucicaut (1887) - 1883 Bicêtre and new Salpêtrière (1911) - Rothschild

An example not in paphe is Am Steinhof, Vienna

Has similarities to Peter Cracknell's "colony plan". See also Sarah Rutherford on Brislington House (1806). Asylum dysentery was a problem when the colony plan was adopted in England (early 20th century), and may have influenced its adoption. The 1930 Bethlem Royal [See Mental Health History Timeline] is shown by PAPHE as peigne although the text clearly says that it was constructed on the villa system "in contrast to the large asylums that dominated the 19th century"

hôpital monobloc: single unit hospital. Examples Princess Margaret Hospital, Swindon, Wiltshire, 1957

hôpital tour sur socle: tower on a plinth.

hôpital polybloc: multiple-unit hospitals. Examples: St Mary's Newport, Isle of Wight [See asylums index] - Paris: 1982 Bicêtre

Functions of architecture in the therapeutic period of asylums

Based on Susan Piddock's thesis (2002) A Space of Their Own: Nineteenth Century Lunatic Asylums in Britain, South Australia and Tasmania

"The modern and nineteenth century literature on insanity and lunatic asylums revealed that the asylum was a central part of the new treatment regimes of moral therapy and non-restraint, and that a range of nineteenth century writers had written books and articles describing all facets of lunatic asylum design and management (for example Browne 1837, Jacobi 1841, Conolly 1847, Sankey 1856, Arlidge 1859, and Robertson 1863 and 1867)."

Susan takes a sample of twenty British asylums, which she divides into four early asylums (plus one a plan, never built) and sixteen from the "period of major asylum construction" (1845 on). This division is matched by Peter Cracknell's "early forms" and "corridor plan".

Susan's four early asylums are the St George's Field Bethlem - Wakefield - Hanwell and Devon. The plan was the London Asylum of 1815.

She examined the plans with respect to the following functions: Classification - Observation - Employment - Amusements/activities - Exercise

Observation: "The key to non-restraint had been the removal of restraints which was to be replaced by visual observation of the patients by the attendants and medical superintendent. The radial design had first been recommended for prisoners, as its design supported the constant observation of the prisoners, by the staff in the central hub, and noise could be carried up and down the enclosed wings. This same design made it ideal for an asylum, and observation was further supported by the placement of day rooms close together in the hubs of both the London and West Riding Asylums, allowing easier observation by a few attendants. In contrast, the large wards of Bethlem presented more extreme difficulties for observation as the overall length of the building was 580ft."

Conolly's Ideal Features Found in the British Lunatic Asylums

A   An appropriate site with some form of scenery

B   An arrangement of the buildings that allowed light in and cross ventilation, with no building overshadowing another or the airing courts

C   A linear form to the layout

D   It should accommodate no more than 360 to 400 inmates

Ea A building that offered a range of wards for classification

Eb Each ward should have its own attendant's rooms

Ec There should be open areas as opposed to day rooms for patients

F   Each ward should have access to a bathroom, lavatory and water closets

G   Each ward should have a wide gallery furnished as a day room with windows low enough to allow a view outside

Ha There should be a large recreation room

Hb School rooms

Hc Work rooms and workshops

Hd A chapel for the use of patients

Ia The offices should be centrally located

Ib There should be a means of accessing the various wards without passing through each

J   Attendant's should have their own dining hall

K   Accommodation should primarily be in the form of single rooms with a few dormitories

Cheshire 1827-1829 0 0 C 0 Ea Eb 0 F G 0 0 Hc 0 Ia 0 0 K
Derby 1844 A B C D Ea Eb Ec F G 0 0 Hc 0 Ia Ib J K
Abergavenny 1852 A B C D Ea Eb 0 F G 0 0 Hc Hd Ia Ib 0 K
Eglinton 1852 0 B C 0 Ea Eb 0 F G 0 0 Hc Hd Ia 0 J 0
Lincolnshire 1852 A B C D Ea Eb 0 F G Ha 0 Hc Hd Ia Ib J 0
Buckinghamshire 1853 A B C D Ea Eb 0 F G Ha Hb Hc Hd Ia Ib 0 K
Essex 1853 A B C 0 Ea Eb 0 F 0 Ha Hb Hc Hd Ia Ib 0 0
Cambridgeshire 1858 A B C D Ea Eb Ec F G 0 Hb Hc Hd Ia 0 0 0
Cumberland 1858 A B C D Ea Eb Ec F G Ha 0 Hc Hd Ia 0 J 0
Sussex 1859 A B C 0 Ea Eb Ec F G Ha 0 Hc Hd Ia Ib 0 K
Bedford 1860 A B C 0 Ea Eb 0 F 0 0 0 Hc Hd Ia Ib 0 0
Bristol 1861 A B C D Ea Eb 0 F 0 Ha 0 Hc Hd Ia 0 J 0
Carmarthen 1862 0 B C 0 Ea Eb 0 F 0 Ha 0 Hc 0 Ia 0 0 0
Surrey 1862 0 B C 0 Ea Eb 0 F 0 0 0 Hc 0 Ia 0 0 0
Hereford 1871 0 B C D Ea Eb 0 F 0 Ha 0 Hc 0 Ia Ib 0 0
Whittingham 1873 0 B 0 0 Ea Eb 0 F 0 0 0 Hc 0 Ia 0 J 0

Extracts from Jacobi, C.W.M. 1841 On the construction and management of Hospitals for the Insane

" What is the most desirable situation for an hospital for the insane?

We may presume, without further question, that the same circumstances, in regard to situation, which are found by a person who is free from any morbid tendency, to have a beneficial influence on his mental feelings, will generally, in some degree, contribute to the restoration of a mind diseased.

The establishment should be situated, then, under a mild sky, in an agreeable, fertile, and sufficiently dry part of the country, where the surrounding scenery, diversified with mountains, valleys, and plains, is calculated to enliven the spirits of the beholder, and invite him to wander and explore its beauties.

In the next place, there should be an unfailing spring of good drinking water, a running stream which will afford a constant supply for other purposes, and easy communication with some large market town, bestowing opportunities for procuring the necessaries of life, and for social and scientific intercourse.

So much of general attributes. As we descend into particulars, however, it admits of some doubt, whether, if the situation be left entirely to choice, it would be more advisable to erect the buildings of the establishment on a plain, or on an eminence; and whether they should be quite solitary, or contiguous to some town or village. And this certainly deserves some consideration.

A situation upon a moderate, easily accessible eminence, of from 150 to 250 feet at the highest, above the level of the nearest river, and commanding an extensive range of agreeable scenery, and an unconfined view of the heavens, is certainly productive in a mild and serene climate, of exhilarating and joyful emotions. Besides the advantage of a dry and salubrious atmosphere conferred by such a situation, it is not its least recommendation, that it enables the patients to extend their view far and wide, over the boundary walls or hedges of the estate, as these may be placed at the lowest purl, of the establishment. The patients are thus not so easily reminded every moment of their incarceration, and, through it, of their other miseries.

Whilst an establishment in a level situation is deprived of all these advantages, and must, therefore, generally cause a less kindly impression, both on diseased and healthy minds; still it enjoys other very important advantages, not possessed by the former.

The principal of these is the abundant supply of water, which a full stream affords for the baths, washing, and every kind of cleaning, as well as for the most appropriate construction of the privies.

Other advantages of a level situation, consist in the greater facility of enlarging the ground-floor of the buildings, to any required extent; in the greater protection from the influence of the winds and storms, thus materially affecting the consumption of fuel, and the ease of warming the day-rooms in winter; in the easier conveyance and delivery of all articles of consumption; and lastly in this, that the patients are more sheltered from the prying gaze of the inquisitive, to which they are too much exposed on a hill, which lies open to these glances from all sides.

All these advantages are met by exactly correspondent disadvantages which, in the situation of an establishment upon a hill can never be entirely overcome, and only even partially diminished, by a great outlay of money.

    {fotnote: I cannot doubt that a piece of ground on a level with a running stream, would be, in general, a highly inexpedient site for a lunatic asylum in England. The dampness of such a situation in our humid climate - especially in the time of heavy rains, when the stream may lie swollen into a flood, is an irremediable evil which has no counterpart in an elevated situation, unless we speak of such an extreme height, as no one would contemplate for such a purpose. Besidcs there is scarcely any thing more important, in regard to the site of an asylum, than that it should afford a most complete drainage; and this can hardly be obtained, except in a somewhat elevated situation: and this character is by no mean' incompatilible with the advantage of retirement and shelter. (Editor)}

In the same way, the advantages and disadvantages at tending the entirely isolated situation of an establishment, and one contiguous to a town or large village, appear very nearly equivalent to each other. The neighbourhood of a market town certainly affords many conveniences and comforts, both in an economical point of view, from the promptitude with which various wants may be supplied, by the resident mechanics and tradespeople, and in other respects from the intercourse which may be kept up with the inhabitants. On the other hand, the vicinity of a town containing a population not entirely agricultural, but which consists-of mixed classes, is so annoying and inconvenient, from the intrusive curiosity excited by the patients, and the incessant scrutiny to which they are exposed at every step they take abroad; the difficulty of completely releasing them from the usual noise and tumult of society, however desirable it may be that many of them should enjoy this liberation, is so much increased, and so much facility afforded to the servants, and in some degree to the patients also, for carrying on forbidden intercourse with the inhabitants, that these reasons would compel me to select a situation nearly solitary. I should prefer, however, most of all, one in which the establishment should lie about half an hour's walk from a town. All the advantages to be thence derived, would then be within reach, divested of the prejudicial accompaniments of immediate contiguity.

We have now reached that much discussed part of our subject, the consideration, of the most appropriate arrangement and form of the several departments required in a lunatic establishment.

In order to arrive at a clear decision on these points, we must, above all things, hold steadily in view, the chief objects which claim the first and most immediate consideration in fixing every plan of this kind.

These objects appear to me to be the following:

First: An effectual separation of the male and female patients.

Second: To remove the raving, screaming, dirty, and highly fatuous patients to as great a distance as possible from the rest; without, at the same time, thereby withdrawing them from the eye of superintendence; since it is precisely they and their attendants, who require the most vigilant oversight.

Third: The greatest possible security of the patients, as far as it can be effected by architectural arrangements.

Forth: To afford the greatest possible convenience and expedition, in every thing pertaining to the care and treatment of the patients; as well as the most absolute oversight of the servants.

Fifth: To aim at the greatest cheerfulness and commodiousness for the inmates of every part of the institution, without, at the same time, sacrificing any of the requirement above specified. To this head, also, belongs attention to the agreeableness of the prospect, and to facility of access to the courts and gardens, with other items of the same nature."

Forms of asylum

Jacobi discusses the following "forms at present chiefly recommended for the buildings:

Several distinct quadrangles having a certain connection and relation with each other.

Examples: "the one at Ivry, the house for females at Charenton, and the large establishment at Rouen"..."All these were builit according to the maxims of the excellent Esquirol

The one Jacobi describes was at Rouen:

"The institution is adapted for three hundred patients, and intended to receive the incurable, as well as the curable. In front of the more ancient buildings, which had been used a long time previously as a lunatic asylum, five handsome quadrangles have been erected, one story high, containing the dwellings of the patients..."

H form

Example: Wakefield. The junction building has the "house- keeping" and common rooms for the use of both sexes and the two long wings are used one by the women and the other by the men.

Lineal Form "in which all the buildings are ranged in a straight line... the domestic apartments are most properly placed in the centre... the divisions for the male and female patients...on their respective sides, in such a manner , that the convalescents and least deranged patients occupy the most distant wings."

Examples: Bethlem (1815) and Perth

Star or radiating

Example: Glasgow

Dr Falret's at Vanves


Pavilions - [Pavilion is later used for a large, Florence Nightingale style building - We might call this early colony plan] "...it has been strongly recommended, that a certain number of distinct pavilions one story high, should be erected in a large piece of ground laid out like a park, and appropriated to the different classes of insane patients.... such an idea could only be realised in the case of a small private establishment, for twenty-five or thirty patients at the outside, and ... it would require a much milder climate than we are favoured with in Germany... An institution for two hundred patients, arranged on such a plan, would be so lost and dispersed on its own ground, that any regular superintendence and medical treatment of the patients would be impossible, even in the finest weather..."

No Jacobi example. Compare Brislington House (1806) and the Colony Plan 1902 -1967

Jacobi's model falls in the period where there are few examples in Susan Piddock's sample. Few of the asylums after 1845 met Jacobi's requirement of having 200 patients. One of these was Buckinghamshire Asylum . Cambridgeshire and Lincolnshire came close at 252 and 250 patients respectively. All favoured a linear layout, but none of the asylums followed Jacobi's suggestion of arranging houses around courtyards. Most met the requirements of a country location with the exception of Essex Asylum which was placed in the urban setting of Brentwood. While there was a strict separation of the sexes, the linear design meant that the various classes were visible to each other to some degree. Certainly all the asylums offered classification of the patients and small spur wards which could be used to separate the noisy and infirmary patients if necessary. As these asylums were for paupers there was no emphasis in providing different rooms for the various social classes as Jacobi recommended.

Model of the original 1818 building made by Mr A.L. Ashworth, Hospital Secretary 1961-1973, using the original plans and drawings fo the asylum
mental health history

"The really old part of the hospital is shaped like an H where the cross piece has been extended on both sides so that it resembles two plus signs joined together. While the outside of the building preserves and eighteenth century dignity and balance, its plan is strictly functional, conforming to nineteenth century scientific theories of social control. This is in fact the 'double panopticon' which is to be found in so many prisons and places of correction - and mental hospitals - built at this period and for many years afterwards. Once having taken up position at one of the points of intersection, whoever is in charge can look anywhere, keeping an eye on things north, south east and west along the length of the four radiating corridors. Modern psychiatric nurses have never liked this arrangement. Apart from not being all that effective for 'ambulant' patients, it brings home the custodial role in a way that is nowadays felt to be unacceptable. This, however, is the architecture that they have inherited and must make the best of.

In later years, the line of sight has been interrupted by the erection of glazed partitions, which subdivide each corridor into distinctly separate wards, so that you would have had to pass through several other wards on the way to the one you wanted. At Christmas this could be a delightful journey, as each ward would be decorated in its own fashion by the patients and staff. The long central corridor, barrel-vaulted like the rest of the hospital, seemed like a succession of Aladdin's caves, each more fascinating and exotic than the one you were in and the journey developed from staging post to staging post, each new length of corridor a fresh unveiling - not at all what the architect had in mind" (Roger Grainger, 1996, Asylum. Memories of a local Institution p.36)

Peter Cracknell's analysis of forms

Early - later adapted to corridor - Most early county asylums do not seem to have followed a typical plan. In most cases, however, a Corridor type layout was later adapted around them. I am assuming a date of 1810-1830 for these. Examples could be Nottinghamshire County Asylum (1810), Norfolk County Asylum (1814), Staffordshire County Asylum (1818), West Riding of Yorkshire County Asylum (Wakefield) (1818), [described as H form at the time],

Panopticon and radial Arthur Allen differentiates: "A number of your entries refer to the radial plan of some asylums as a "Panopticon" design per Jeremy Benthams concept. (eg the Glasgow Asylum by Stark). I disagree; the radial plan, although it has a central point of inspection, does not have a clear view from that point into every cell, as in Bentham's circular plan where the cells are at the circumference of the space, facing the central inspection point. In that design the inspector has a clear view into each cell." (Email 25.5.2006)


The all-seeing eye of Jeremy Bentham's Panopticon. It was the design W. Stark used for the Glasgow Asylum, opened in 1814, and for the proposed London Asylum in 1815. Stark used the H Form for his subsequent Dundee design.

Long wings radiating from a central (often semi circular) hub. Considered inhumane even in its own time and only really implemented in the south-west (other than prisons). The close nature of the wings at the point nearest the hub would allow little access for air and light to the buildings and airing courts between them. One source suggests this plan offered a deterrent to potential admissions as asylum care would have been preferable (and more expensive) to the workhouse. Eg. The main block at St. Lawrences (Cornwall, 1820), and Exe Vale/Exminster (Devon, 1845).

The Thurgarton Hundred Workhouse (1824) had a radial hub, designed to allow classification and (in particular) complete gender separation.

A radial plan with only two wings - radiating on the same diameter line, either side of the hub - is a corridor plan


The model for the linear or corridor form may have been the 1815 Bethlem (See Jacobi). It is the form favoured by John Conolly in The Construction and Government of Lunatic Asylums (1847). One of his reasons is that it allows the all-seeing eye of the superintendent from the centre, without the inconvenience of the radial form

Originally Corridor - A long running and variable group 1830-1890. They are typified by a (often projecting or recessed) central block including admin and former officers quarters, flanked by long wings either side, each with appropriate working areas and segregated by sex. Built to two or three storeys in height. Typically (as the name suggests) a corridor or 'passage of communication would run the length of the building to ease access. Widespread across England and Wales.

In the following lists, Susan Piddock's selection of asylums having "a linear form to the layout" are in bold: Lincolnshire, Hanwell (1831), Surrey County Asylum (1841), North and East Riding and York County Asylum (1847), Somerset County Asylum (1848), Abergavenny - North Wales (1848), Lancashire County at Rainhill (1851), Second Midddlesex County Asylum (1851), Derby County (1851 - ventilation), Buckinghamshire County Asylum (1853), Essex County Asylum (1853), Cambridgeshire County Asylum (1858), Durham County Asylum (1858), Sussex (1859?), Bedfordshire, Hertfordshire and Huntingdonshire (Arlesey) (1860), Cardigan, Carmarthen, Glamorgan and Pembroke (1860s?), Bristol Lunatic Asylum (1861), Cumberland and Westmoreland Asylum (1862), Hereford County and City Asylum (1871), Cheshire County at Macclesfield (1871), Portsmouth Borough (1879),

Eglinton, Ireland


Original meaning a tent; Pavilion became a term of hospital architecture in the mid nineteenth century. It means a detached or semi-detached block or building in a hospital complex. The PAPHE glossary defines a pavilion as "a building or a main building with a block plan". However, PAPHE uses the term "Pavilion Hospital" in an extended sense for "an edifice consisting of independent buildings (completely isolated or linked to each other through open galleries), irrespective of the layout".

The first Pavilion type hospital was the Royal Herbert, on Shooters Hill Eltham, a military hospital. [Opened 1.11.1865. See external link - archive].

The second was St. Thomas' in London [opened 1871]. These were designed on principles recommended by Florence Nightingale. The Architect of Royal Herbert being her nephew. Therefore all pavilion and corridor-pavilion types should post-date these

Corridor-Pavilion: About 1870 to 1890. An ill-defined group of buildings intermediate in character between the two types. Thanks to its vague definition, I cannot really seem to identify many to this layout. Possibly used at St. John's and St. Lukes (on a radial corridor) divisions at Whittingham (Lancs), De La Pole (Hull). The first and last show a courtyard type plan with wards facing into this area.

Brookwood? (1867 - Gas - Water - Sewage)

Pavilion - 1870 - 1907 (in asylums). A hugely widespread type, and essentially the first common hospital plan and greatly advocated by Florence Nightingale, but little used within asylum design. The principles of it seem to have been utilised in the echelon plan.

i, Standard Pavilion - Usually consisting of a long linear corridor with individual ward blocks to allow free passage of air and light. Central admin block. Hall and services could be central or remote. Eg. Hellesdon (Norwich), Darenth Park (MAB)(original block and first annexe)

ii, Dual Pavilion - Axial services and facilities flanked on either side by long corridors with individual blocks. The sheer size of these complexes blocks made them operationally difficult and they were initially intended as somewhere to segregate incurables and chronic cases away from other patients. Typified by the huge Caterham (deep well) and Leavesden Imbecile Asylums of 1870 for the Metropolitain Asylums Board of London (which used the pavilion plan in nearly all of its hospital buildings). Banstead 1877 (for Middlesex) and Possibly Winwick (1897) may have been the only non-imbecile examples. Calderstones Certified Institution 1905 (Lancashire Asylum Board) is a late example.

iii, Radial Pavilion - An oddity, and intermediate between the standard pavilion and the development towards the echeon plan. Individual ward blocks arranged around a semi circular corridor with axial office and service accomodation. Cane Hill (Surrey 1883 - water tower) is the only true example but could include Whittingham's St. Luke's Block (which had remote services) in some respects.

Long Grove Hospital, Epsom
Simon Cornwall Asylums Forum 18.3.2004: "Cane Hill is a radiating pavilion type asylum, which appeared to be the intermediate step between corridor and echelon asylums. As such, it suffered from lack of light between the wards as they came together to join the corridor (a notable problem with prison construction as well). Howell's solution was to stagger the wards and make them different sizes. Not all that efficient as some wards became separated by the central corridor; the day room on one side and the cells on the other. Hine's echelon plan for Claybury became the next pattern, although he improved it at Bexley by connecting the wards. That way a consulting doctor could do his rounds without having to return to the semi-circular corridor after each ward. Rauceby also shows some of Claybury's characteristics; but thereafter, Hine built his hospitals with the interconnecting corridors (Horton, Long Grove, Hellingly etc.) His design for Park Prewett is rather different and seems to share characteristics with that of the villa/colony West Park."

iv, Irregular Pavilion - eg. The Manor Certified Institution (at Epsom for London CC) was a large structure consisting of temporary pavilions arranged around an L- shaped corridor, with a pre-existing mansion as its hub and offices. Darenth Park 2nd Annexe consisted of two groups of five y-shaped pavilions linked by corridors.


Echelon - 1880 - 1932. Largely superseded the Pavilion plan of Asylums in all but the Metropolitan and Lancashire Asylums Boards. Its sudden rise in popularity being the arrangement of wards, offices and services within easy reach of each other by a network of interconnecting corridors. Typically forming a triangular, trapezium or semi-circular format.

i, Broad Arrow 1880-1890. The earlier form of echelon plan consisting of the typical layout with services and wards (segregated by sex) located on a wide spreading complex. Broad Arrow wards were essentially detached pavilion blocks linked by stubby corridors to the main corridor network. Coney Hill (Gloucester 2nd) by Giles and Gough would have been the first had it been completed to plan. High Royds (Menston, West Riding) 1888 by J. Vickers-Edwards was probably the best example.

ii, Compact Arrow 1890 - 1932. This plan revolutionised the construction of Asylums and Mental Hospitals and was probably the most practical type devised. The linking corridors of the Broad Arrow were retained, but instead the ward blocks 'hugged' the main corridors rather than being placed away from them. Ward blocks could be either interconnecting or distinct from each other. Typically these wards would give the appearance of a zig zag as they were stepped along the main corridor. As in previous designs, male and female workplaces would be located on their respective sides with shared services and offices occupying the centre.

Later examples had detached villas in the grounds for working, epileptic or chronic patients, and also Acute blocks to avoid incorporation of recent cases to the main building. Later developments towards the Colony layout included some asylums with open sided corridors and ward blocks becoming further detached.

Claybury Claybury (opened 1893 in Essex for London County) was the first compact arrow plan and was greatly praised in its time, becoming the model for asylum design and its architect GT Hine becoming the most accomplished and successful of asylum architects.

Bexley (in Kent for London County), Hellingly (West Sussex), Barnsley Hall (Worcestershire) and most other Hine Asylums are based upon Claybury. Other architects such as Giles, Gough and Trollope - ( Cheddleton County Asylum, Staffordshire) and Tone Vale (Somerset) - Vickers-Edwards (Storthes Hall - West Riding) and many others adopted this principal for their works. Park Prewett (1910-1921) (by Hine) is of the later type with open corridors and separate wards blocks.

Wales: "The plan of the Mid Wales Hospital/Talgarth Asylum seems typical of the ... Compact Arrow or Echelon layout. This type was widespread in England and Wales and provided convenient access to most areas in what was a massive structure, which could still be extended without operational problems. Other echelon asylums in Wales would be St. Cadoc's at Newport, and Whitchurch in Cardiff." (Peter Cracknell - posting 25.8.2008)

Swansea Cefn Coed 1932 (Swansea Borough) seems to have been the last example of a compact arrow asylum to be completed.

This map is copied from the hospital website

Detached blocks Three "distinct houses with as much as possible the plain arrangment of a country home" were opened at the Essex County Asylum in 1863. The plan below shows the main buildings with subsequent blocks (later villas) fitted in around it.
Warley and villas

a trend ... towards lightness and even gaiety?
"By the 1890s asylums with 2,000 beds were normal around London and in Lancashire, and there was a corresponding growth elsewhere. In spite of this, many improvements are to be recorded during the period from 1888 onwards, when the asylums became the responsibility of the new County and County Borough Councils. Architecturally, they followed the prevailing trend in domestic building towards lightness and even gaiety. An open, spread-out plan, with wards stepped back to allow a south aspect everywhere, became almost standard. Besides the admissions units, other detached villas were built in the cottage garden-suburb style of Edwardian days. Finally, in the 1920s and 30s, main buildings were dispensed with altogether, and the lay-out consisted of separate units designed on a functional basis, as at Shenley and Runwell." (Alexander Walk 1962
iii, Colony [1900?] 1902 -1967 Villa - Dispersed Units

The disperasal of units is evident in plans that Peter Cracknell classifies separately: Irregular Pavilion and Compact Arrow Later Type

Peter Cracknell says "gradually the practical virtues of the echelon plan gave way to the perceived therapeutic benefits of a dispersed layout". Other factors may be infection and economy. The dispersed plan coincides with growing awareness of mico-organisms as the cause of diseases and the plan may have been thought to reduce this. The isolation hospitals built under the 1893 Isolation Hospital Act also tended to have dispersed units. Economy is manifest in the dispersed plan for The Manor 1896-1899 Epsom

The cottage system in Maryland, USA was investigated by a London County Council working group that reported favourably on it in 1902. London County Council who adopted a dispersed plan for Ewell Epileptic Colony (1903) Epsom, and incorporated disperesed units into the plan for Longrove (1903-1907) Epsom. Belfast adopted a dispersed plan for its new asylum in 1900. Peter suggests that the dispersed plan was mainly adopted in Poor Law Imbecile colonies such as those at Monyhull Hall 1908 (Birmingham) and Prudhoe 1913 (for Newcastle). Usually the early dispersed plans occupied a pre- existing estate often including the mansion for Staff accommodation of administrative purposes.

After the first world war this was perpetuated in the new County Deficiency Colonies such as Ockendon 1932 (Essex) - Stallington 1928 (Staffordshire) - Little Plumstead (Norfolk) - Barrow (Bristol).

Although Peter says that very few mental illness hospitals used the Colony plan to any great extent, it is also tru that very few mental illness hospitals were built after the first world war. West Park 1912-1924 Epsom uses colony priciples on an echelon plan. 1934-1937 (Southend and East Ham) has Villas linked by corridors. Only 1934-1937 (Middlesex) appears to be a true example of its type with acres of villa buildings still on an axial division of sexes, and surrounding the mansion house (it was the last 'asylum' type mental hospital to be built).

Following World War II and NHS takeover the deficiency colonies/mental handicap hospitals continued to use the plan- the final examples being Ida Darwin Hosp. (Cambridge) and Bryn-y-neuadd 1967 (Wales). This marked an end of large scale mental hospitals with the move towards mental health units and Care in the Community.


Sarah's Rutherford's study (9.2003), The Landscapes of Public Lunatic Asylums in England, includes nine case studies of asylum history, architecture and landscape: - Moorfields Bethlem (1676) - The Retreat - Brislington House - Nottingham - Norwich - Wakefield - Hanwell - Derby - Middlesbrough - Ewell Epileptic Colony

The main thesis analyses the English public asylum landscape during its development from 1808 to 1845, and subsequent consolidation and variation into other related types during the main period of public asylum building (from 1845 to 1914). It analyses the asylum as a distinct landscape type, its principal influences and context, also the main design influences, particularly the landscape of the country house estate. It also examines issues connected with the conservation of this type of landscape, in the face of current grave threats to the fabric. The work looks at the use of the asylum landscape, concluding that its principal function was therapeutic. For this it needed an extensive, ornamented landscape so that patients could undertake recreational and work activities. A number of individuals were found to have contributed to the design of various asylums, including professional landscape designers commissioned to design asylum sites. These included a previously unknown designer, Robert Lloyd of the Brookwood asylum, Surrey, who was particularly prolific in this field, and was associated with at least seven asylum sites.

The sites of the Bishopsgate Bethlem and the Moorfields Bethlem are shown on the sketch map

Until the 1530s the Bishopsgate Bethlem had been quite open around the main building, having gradually acquired a series of gardens and courts. Following the Reformation its open site was gradually reduced in size, with the sale of plots within it. [See 1559 map]

in the early 17th century, the space in front (and behind?) the main building contained a single airing court. A second court was added in an expansion of 1643-1644.

By the later 17th century Ogilby and Morgan's map of London shows that there was virtually nothing of the formerly spacious precinct left that had not been built upon, apart from the limited space in front of and behind the main buildings.

But by then it was set in a noisy, crowded location which did not suit the aspirations of the City of London or medical requirements for fresh air to combat infectious miasmata.

Moorfields Bethlem - The landscape - 1676-1815

Until the mid-eighteenth century, the Moorfields Bedlam, designed by Robert Hooke, was the only significant example of a purpose-built lunatic hospital in Britain. Major features of Hooke's Bethlem, in terms of the setting, accommodation and treatment, provided the model used for other charitable lunatic hospitals founded in the eighteenth century and even the publicly funded county asylums in the nineteenth century. As such its estate was very influential in asylum construction, including the principal elements of the estate: the building, airing courts and forecourt.

Robert Hooke's architecture (Moorfield's Bedlam)
Robert Hooke was a close colleague of Christopher Wren and designed several other institutional buildings in London including the Bridewell Hospital (1671-78), also for the City of London; the Haberdashers Aske's Hospital, an almshouse at Hoxton (c.1690-93); with John Oliver, Christ's Hospital Writing School (1675-6); as well as several town and country houses. Hooke's Hoxton building was of similar design to Bethlem: a long, single-pile building with an elaborate central block connected by flanking wings to two pavilions. A large, grassed forecourt appears to have been used by the inmates for recreation and exercise, and was divided from the road beyond by a wall and central gateway, the whole layout in similar formal style to that at Bethlem. It is illustrated in Strype's edition of John Stowe's Survey of the Cities of London and Westminster (1720). Hooke only used the single-pile design for these two hospitals, not for his houses.

The new site selected, close by Bishopsgate, at the head of Moorfields, was chosen for its "health and aire", the benefit of an ample, unsullied fresh air supply and its effective circulation being regarded by the Governors as the key to healthy surroundings.

The poem Bethlehem's Beauty (1676) emphasised the perceived virtues of the new site's healing air:

Th' Approaching Air, in every gentle Breeze,
Is Fan'd and Winnow'd through the neighbouring Trees,
And comes so Pure, the Spirits to Refine,
As if th' wise Governours had a Designe
That should alone, without Physick Restore
Those whom Gross Vapours discompos'd before

The Governors employed the prominent architect Robert Hooke (1635-1703), who was actively involved in the rebuilding of London after the Great Fire, to design the building. Largely constructed by 1676, it was probably only the third purpose-built asylum, after one in Valencia (1409, destroyed 1512) and the Dolhuys in Amsterdam (1562).

Andrews states, in connection with the intentions of the Governors, that they were

"much more concerned with the 'Grace and Ornament of the _ Building' than with the patients' exercise or any other therapeutic purpose - New Bethlem was constructed pre-eminently as fund-raising rhetoric, to attract the patronage and admiration of the elite, rather than for its present and future inmates, whose interests took a poor second place'"

The Moorfields Bethlem was in Lower Moorfields, to the west of Bishopsgate. . Like Bishpsgate, it was outside the north boundary of the City, although only just so. The site for the building ran parallel to the ancient London Wall, and only nine feet (3m) to the north of it, occupying open ground on the site of the old City ditch which had been filled in. The site formed the south boundary of, and overlooked, Moorfields, a series of substantial formal public open spaces laid out from 1605, which, although largely surrounded by development, formed a finger of open space which led directly out to the open fields to the north.

Moorfields Bethlem was palatial in scale, even in terms of new constructions put up as part of the building campaign after the Great Fire, being intended to accommodate 120 patients. The about 540 feet (166m) long entrance facade on the north front was depicted by Robert White in an engraving of 1677 (external link to picture), shortly after construction, together with parts of the grounds.

The single-pile building was of two storeys over a basement, and showed Dutch and French influences in its elaborate external decoration. The patients were segregated indoors, at first with males on the ground floor and females on the first floor. The cells, for individual patients, led off galleries which served for communication and for exercise in inclement weather.

John Evelyn was one of the many admirers of new Bethlem, describing it as "magnificently built, & most sweetely placed in Morefields". There must surely have been a service entrance on the south side of the building, between it and the City Wall, although the space between the two was only nine feet (3m).

White's engraving clearly shows the grounds and part of the provision made for patient exercise.

The outline in plan form of the building and its open spaces in relation to their setting is also shown on contemporary maps of London such as Morgan's map of 1682 (external link to map)

Robert White's 1677 engraving and Morgan's 1682 map are the two main illustrative sources available for Hooke's Bethlem as it was when first built.

The grounds were divided into a large rectangular forecourt in front of the building, flanked by two smaller exercise yards. The whole was approached via the formally laid out and enclosed lawns of Moorfields, a fashionable recreational space for the local inhabitants which had been one of the first such formally designated public open spaces.

Security at Bethlem was of great concern, as patients were perceived to be continually likely to abscond as the opportunity arose. As reliable staff to supervise patients were difficult to find, the Governors had to rely on making the environment itself provide the means for ensuring confinement. The first three reports on the construction of the building by the hospital's Committee of Governors were largely taken up with matters concerning the boundary wall that was to surround the hospital and its grounds, and to confine the patients.

The above reports provide a narrative of the layout of part of the grounds and, together with White's engraving, provide the basis for the following analysis of their construction. The committee reports of 13th, 16th and 20th October 1674 were read into the Bridewell and Bethlem Court of Governors Minutes for 23.10.1674 (Bethlem Royal Hospital Archives)

The existing London Wall was used to form part of the secure 680 feet (c.207m) long south boundary wall. On the other sides a wall was to be constructed at 14 feet (4.2m) high along the sections which bounded the airing courts, with a coping expressly intended to stop the lunatics escaping. The exception was the front, north, wall of the forecourt which ran parallel to the whole length of the building and divided it from the adjacent Moorfields. This c.420 feet (c.128m) long central section of the whole north wall would be only eight feet (2.5m) high, so

"that the Grace and Ornament of the said intended Building may better appeare towards Morefeilds"

The lowering of the forecourt wall did not affect security, for the patients were forbidden to exercise in the forecourt. (Bethlem Royal Hospital Archives, Bridewell and Bethlem Court of Governors Minutes, 23.10.1674)

The wall was broken by six evenly spaced panels of iron railings, each forming a ten-foot (c.3m) wide clairvoie intended to enhance the views of the building from the adjacent and impressively laid out Moorfields open recreational space. The views were clearly intended to impress the users of Moorfields, both nearby residents and visitors alike, and the visitors to Bethlem itself upon their approach.

Clairvoie (clear view): a gate, fence or grille placed in an otherwise solid barrier to provide a clear view of outside scenery or, in this case, the building inside.

The north side of the building and the forecourt are shown in detail on White's engraving , with a passer-by admiring the ensemble. The clairvoie panels were flanked by piers surmounted by stone pineapples.

At the centre of the forecourt wall an elaborate triple gateway gave access from the formally fenced and tree-lined lawns of Moorfields to the north, between which the visitor approached. The portentous gateway was elevated above a flight of steps and surmounted by the life-sized statues of two figures depicting raving and melancholy madness, attributed to Caius Cibber.

From here the visitor crossed the expensively paved and gravelled forecourt to gain access to the main entrance at the centre of the building. There were numerous large windows in the north walls of the ward wings, flanking the central administrative block, allowing for the ample ingress of light and air. Those in the raised ground floor and first floor, in particular, gave the patients an elevated view of the forecourt, and beyond this of the designed open spaces of Moorfields.

Bethlem exercise courts after the 1730s

The boundary wall also enclosed the two exercise yards, which flanked the forecourt at the corners of the building. The forecourt was several times larger than either of the exercise yards, which were limited in their extent by, apart from the forecourt which divided them, the proximity of Moorfields to the north, the London Wall to the south, and development to the west and east. Two yards were provided "reserved for the use and benefitt" of the inmates, one each for the separate sexes to exercise in. Those patients "well enough" were "permitted to walke the Yards there in the day tyme", so that they could "take the aire in order to [aid] their recovery". (Bethlem Royal Hospital Archives, Bridewell and Bethlem Court of Governors Minutes, 23.101674 and 5.5.1676, and Bethlem Committee report, 16.10.1674.

Each yard was surrounded by the 14 feet (4.2m) high wall, topped with a "Coping _ intended to p'vent the Escape of Lunatickes". Both were laid out with grass and gravel plots of 120 feet (36.5m), with, set into the rear wall, a small pavilion with windows at first-floor level. (Bethlem Royal Hospital Archives, Bridewell and Bethlem Court of Governors Minutes, 23.10.1674 and White's engraving 1677

The upper level of the pavilions may have provided shelter for attendants supervising patients whilst allowing them an elevated view of their charges in the yard, with the lower level providing shelter for the patients.

Bethlem airing courts after the 1730s before the 1730s

By 1786, Bethlem was noted for its "fine gardens" where the patients "enjoy fresh air and recreate themselves amongst trees, flowers and plants".

Although there was no formal classification by symptoms, there was obviously a category of patients who were allowed to exercise outdoors. Those whose behaviour was deemed to be too wayward or who were physically too unwell remained indoors.

By 1740 the wings had been extended to west and east in L-shaped form, covering much of the site of the early airing courts. Provision for patient exercise was made by reducing the width of the forecourt, such that it only extended half way along each of the original wings. It had also lost the clairvoies formerly sited in the north boundary wall. The open ground formerly flanking the forecourt was given over to airing courts, surrounded by higher walls. The old gateway had been re-sited to the south, much closer to the front door and a curved carriage sweep open to Moorfields now provided more direct access to theentrance to the building, while dividing the forecourt into two compartments. This removed the need for visitors to cross the forecourt on foot to gain admittance. The opening up of the approach physically linked the main entrance to the building with the main axial walk of Lower Moorfields pleasure grounds.

The Moorfields site was abandoned in 1815, when a new site was opened in St George's Fields, Southwark. The old building had for long been unsound, having been constructed very quickly of poor materials over the unstable infilled ground of the City ditch below the City wall. The building was demolished and Finsbury Circus was developed on its site.

The Retreat - The landscape

Elements drawn from Bethlem were used at the core of both The Retreat and Brislington House: These being principally the airing courts.

The use of moral treatment was manifested in the construction of further, new elements in the wider landscape.

Samuel Tuke described the grounds and the building, which had been designed by a London architect and builder, the Quaker John Bevans. Bevans had designed a number of other buildings for the Society of Friends including several meeting houses. The brick building, which by 1813 held 50 or so patients, was said by Tuke to be designed chiefly for economy and convenience. However, the layout of the building was also intended to facilitate the classification of patients in various ways: by gender, social class and by clinical state. The so-called quiet patients, those exhibiting non-disruptive symptoms and those being convalescent, were separated from the disturbing and disruptive behaviour of more refractory patients. The division by gender and by clinical state was manifested in the layout of the building and in the associated airing courts. Two ward wings, for the more tractable category of male and female patients, extended in opposite directions from the central block and benefited from airing courts adjacent on the south side, and the associated views out over the walls to the surrounding countryside. The two courts were divided by a central path giving access to baths at the back of them. A semicircular wall, which marked the outer boundary of the two inner courts for the more tractable patients, was about eight feet (2.4m) high "but, as the ground declines from the house, their apparent height is not so great; and the view from them of the country is consequently not so much obstructed, as it would be if the ground was level"

The two main wings led in turn to two smaller wings, almost entirely detached from the main building, with associated walled airing courts. Here were housed the more refractory class, who could be noisy, unclean in their personal habits, and violent. Because of such antisocial behaviour, physical isolation was practised in order to reduce their negative effect on the other patients and localise the amount of extra work which they created for the staff. Each of the four airing courts covered between four and five hundred square yards (334 to 418m sq.). For those patients too physically ill or difficult to control to be allowed beyond the confines of the courts, the courts were supplied with domestic animals as pets including rabbits, sea-gulls, hawks and poultry.

"These creatures are generally very familiar with the patients: and it is believed they are not only the means of innocent pleasure; but that the intercourse with them, sometimes tends to awaken the social and benevolent feelings."

Samuel Tuke censured the courts as being too small and confined, this, he believed, being deleterious to the patient's state of mind when the boundary of confinement was always so obvious. However, the sense of confinement, he said, was alleviated by taking such patients as were deemed suitable into the garden, and by frequent excursions into the city or the surrounding country, and into the fields of the Institution, one of these being surrounded by a walk, interspersed with trees and shrubs [in the manner of a ferme orn‚e]. The criteria for being regarded as "suitable" for these activities related to physical robustness and whether or not the patient's behaviour was considered to be too antisocial or whether they could conduct themselves with a reasonable measure of self-control.

The French doctor Charles-Gaspard de la Rive published a useful early account of The Retreat in the Bibliothèque Britannique following his visit in 1798. It suggests that he had an agreeable surprise at the pleasant conditions of the asylum, although Foucault believed that the main purpose of the institution was to serve as a repressive instrument of segregation. According to de la Rive it lay,

"in the midst of a fertile and smiling countryside; it is not at all the idea of a prison that it suggests, but rather that of a large farm; it is surrounded by a great, walled garden. No bars, no grilles on the windows".

It had 11 acres (4.5 ha.) of land and was largely given over to growing potatoes, and grazing cows which provided milk and butter for the establishment. A one-acre (0.4 ha.) kitchen garden lay to the north of the building and provided abundant fruit and vegetables which fed the establishment.

The Retreat also provided a place for recreation and employment for many of the patients,

"being divided by gravel-walks, interspersed with shrubs and flowers, and sheltered from the intrusive eye of the passenger, by a narrow plantation and shrubbery".

The clothing of the grounds was apparently a major feature; fourteen pounds and ten shillings-worth of native and exotic woody plants were bought in 1794 from the notable York nurseries of John and George Telford, and Thomas Rigg, at a time when the erection of the building was hardly advanced. For this amount 768 plants were purchased. The asylum building was therefore surrounded by the equivalent of a small country estate, with ornamental pleasure grounds, and productive kitchen garden and farmland. It fused the elements which were purely asylum-related with the type of carefully constructed country house-type landscape that was being promoted by landscape improvers and designers such as Humphry Repton (1752- 1818)

Brislington House - The Landscape

Brislington House was the first purpose-built private asylum (1804-1806) Its proprietor, Dr Edward Long Fox (1762-1835), was a Quaker, and the structure and regime were almost certainly influenced by The Retreat. Brislington House reflected the layout of the site at The Retreat, while extending, developing and increasing the individual elements. Its patients were mostly wealthy, members of the gentry and nobility, but it took some paupers.

The influence of Fox and Brislington House extended widely in England and Scotland and was influential on the erection of the county asylums. [See history]

By the late 1820s Dr Fox accommodated "all Classes of Society" at Brislington House, but there were very few pauper lunatics. Classification was as important as in the early days of the institution, "Not only are the Classes of Society kept distinct, but three Classes of each Society are kept distinct according to the State of the Disease". There was also division by sex. To effect this classification, the establishment was divided into six "houses", with two attendants for each one. One other house was provided, for paupers, detached from the main group. In terms of cures effected, in 1826 Fox received 42 patients, 22 of whom were cured and nine were under gradual improvement; one was discharged to another asylum, five died, and the remainder continued at Brislington. There were on average 90 patients in the asylum.

The building stood at the heart of the site, with an open and informal forecourt to the front and a block of rectangular airing courts to the rear, and views from the rear towards the distant Bath Hills. Its six separate ward pavilions, referred to by Fox as "houses", comprised three for males and three for females flanking a central block.

Initially the patients were classified by social rank, then by severity of symptoms, rather than by type of illness. Those of the highest social rank were referred to as "ladies" and "gentlemen", and were allocated themost prestigious accommodation within the upper floors of the main central block (divided into two for the separate sexes). The lower ranks comprised males and females of the second and third classes who inhabited the two larger pavilions of the three on either side of the main block. The various social classes and sexes were never to meet. The accommodation was graded such that the central block, where Dr Fox himself lived, was for the higher class, the central two of the flanking pavilions were for the second-class patients, whilst those furthest from the main block were for the third, lowest class. The smallest of the three pavilions on either side of the main block was for use as an infirmary or isolation block. An unusual management and treatment feature was the manner in which a line of cells was sited at the far end of each of the airing courts at the back of the building. These isolation cells, for the more recalcitrant patients, were placed well away from the ward pavilions so that those patients who were quieter and less disruptive were less disturbed by noisy patients. However, they were still within call of staff and services from the main buildings. The main building, cells and courts were enclosed by a wall and the only entrance and exit, apart from the doorway to the walled garden behind, was via the main central door opening onto the forecourt.

On the front, entrance side of the building lay an informal forecourt with a grand turning circle. This was divided from the main house and its individual ward blocks by two outdoor sunken service passages to allow communication between the blocks, which also flanked and linked with the central block. To prevent escapes these passages were divided from the forecourt and wider estate by a stone wall 11 feet (3.5m) high.

Behind the ward pavilions lay the line of six walled airing courts, to which Fox said, patients had access "whenever they please". Each of the three social class divisions within each sex was specifically allocated one of the courts. Those two for the second class were a few feet broader than those for the other classes, and the "gentlemen's" court had direct access to the walled garden behind. Each court contained lawns, paths and a central viewing mount to allow the patients views over the countryside to distant hills. The provision of these mounts was a novel feature designed by Fox. A border sloping towards the outer wall of each court in the form of a ha-ha prevented them from escaping, while allowing a good view of the surrounding country.28 In general the courts resembled domestic town gardens, where the emphasis in each enclosed space was on combining rural views, if available, with ornamental and convenient amenities for recreation. The therapeutic use of airing courts had not been classified to such a degree before. Neither, it seems, had their layout been so elaborate or provided with features allowing the patients to take advantage of "therapeutic" views. Brislington House, along with The Retreat, was one of the earliest asylums to promote the enjoyment of the surrounding setting of the asylum for therapeutic purposes. It is clear that Dr Fox, as part of as his aim of curing via moral therapy, constructed these core elements, building, airing courts and walled garden, to ensure that those patients whom he considered required confinement were not allowed the opportunity to escape.

Beyond the airing courts a bowling green and fives-court were provided, and other "innocent amusements for exercise" were allowed, probably largely for the higher social classes of patients.30 In order to provide ample recreation and employment facilities, and because Fox did not want patients to be disturbed, or incommoded by neighbours complaining of disturbance, the asylum was sited in 80 acres (32 ha.) outside Bristol on an isolated tract of former common heathland. The main buildings stood at the centre of what amounted to an extensive and purpose-built country house estate with modifications for use in the treatment of lunatics (Plate 27, annotated plan of estate, 1902). The traditional country estate elements, parkland, pleasure ground, lodges, approach drives, and kitchen garden, all enclosed by a stone wall, were supplemented with secure, walled airing courts adjacent to the main buildings. Additionally, a number of cottages were erected in picturesque style around the grounds, in a manner reminiscent of Blaise Hamlet (c.1810), built nearby on the west side of Bristol to designs by John Nash. The patients' cottages, scattered in the park in their own small grounds, were for the most wealthy patients who could not be accommodated in the main block in the style to which they were accustomed (for example, see Plate 24, the Swiss Cottage, built in 1819). In this way they could live, with their own retinue if desired, splendidly isolated from all possible social and medical taint associated with the main asylum buildings, while benefiting from the proximity of the expert Dr Fox and his establishment.31 Several passages written by John Perceval concerning his enforced stay as a patient at Brislington House in 1831 address the uses to which this early therapeutic landscape was put. Although Fox was initially reluctant to give gentlemen activities below their perceived status, Perceval's narrative indicates that gentlemen were allowed to work in the gardens and grounds of the House. Perceval complained that upon his admission in January 1831 there was little for him to do indoors, apart from looking out of the window and reading the newspaper. His mother asked Dr F.C. Fox to let Perceval work in Fox's garden "this was indeed beneficial, as it gave me occupation and more privacy". Later on in the year he was employed with two other gentlemen and an attendant to do further work, cutting out a small path in the shrubbery, having been entrusted with a mattock and spade, although he rejected these when his voices teased him with contrary instructions, reverting instead to wheeling the barrow, picking up sticks and using a bill-hook.

Perceval refers to the use of the airing courts, or yards, for exercise and a change of scenery, as a common activity for patients, used together with walks further afield within and outside the grounds. Seats were provided, and patients might be left on their own, "When left alone in the yard, [a patient] amused himself with picking up stones, climbing up into a small tree and sitting there looking over the country, and one day he picked nearly all the leaves off this tree".33 Later on in the 1870s, the Reverend Francis Kilvert recounted in his diary visiting his aunt Emma who was to be found sitting in the gardens, doing some work with a cat or two on her lap, where they walked whilst talking.34 Perceval describes a precipitous pleasure ground known as The Battery, situated on a terrace above the River Avon, to which the patients were often taken, and its drawbacks for those experiencing hallucinatory voices. "At one elevated spot that commanded a view down the valley, a natural or artificial precipice yawned in the red soil, crowned with a small parapet, in rear of which was a small terrace and summer house [the Battery]". The view was, apparently, enchanting. A photograph shows the picturesque summerhouse at the turn of the century.35 Here Perceval sat on the parapet, overlooking the precipice, "My voices commanded me to throw myself over, that I should be immediately in heavenly places" and having managed to resist this injunction, on subsequent visits he refused to go up to the parapet, but instead sat in the summerhouse "to avoid the temptation". Other patients sat on the Battery, but Perceval disapproved of them being taken there at all for safety reasons.

The asylum continued to be owned and run by the family until c.1950, when the asylum building was sold to the NHS as a nurses' home. Following a period as a nursing home in the 1990s it has been converted into private apartments, and a school built in part of the park.

Asylums - patients - acres of land (1840s)
Nottingham - 200 patients - 8 acres of land
Bedford - 180 patients - 9 acres of land
Norwich - 220 patients - 4 acres of land
Wakefield - 420 patients - 40 acres of land
Hanwell - 1,000 patients - 77 acres of land

Nottingham - The landscape

Nottingham, Bedford 1810-1812 and Norwich 1811-1814), the first three asylums constructed under the 1808 County Asylums Act, had buildings and estates largely arranged in a similar fashion.

The early county asylums were out before patients were widely considered to benefit from a regime of exercise, recreation and employment.

In 1808 just under five acres (2 ha.) of land were purchased at Sneinton on the south-east edge of Nottingham. The asylum was set at the edge of a rapidly expanding urban area and took patients from both rural and industrial areas. It was constructed initially as a relatively large establishment for 60 patients.

Elements of the grounds beyond the airing courts were used for patient recreation, and (from about 1818) for employment for those patients who were considered to be in an appropriate condition to use them.

In 1809, Nottingham Magistrates sought advice from Dr Fox of Brislington House about the the asylum and the layout of the asylum grounds. They were principally interested in his novel building layout of divisions into separate blocks (which they did not ultimately act upon), presumably because they were interested in systems of classification. Fox also advised on other matters including the grounds immediately surrounding the asylum building. (One of the magistrates who contacted Fox was the Rev John Becher of Southwell). (Nottinghamshire RO, SO/HO/1/1, Nottingham asylum, Committee minutes, entries for March and April 1809)

It was stated in the 1814 Annual Report that from the outset a "liberal spirit" suffused the intentions of the asylum governors, such that by their Fourth Annual Report of 1818 they could state that,

"they have seen that the system adopted in your Asylum is invariably that of tenderness and gentleness, united with a firm and powerful resistance against maniacal paroxysms, yet restraining and coercing the unhappy patient no longer than the occasion may require".
The liberal spirit was obviously tempered with a perceived need for practical restraint at times.

The 1818 Annual Report also related the purchase in the previous year, and at the considerable expense of £700, of a parcel of land behind (that is, to the east of) the asylum. There were three reasons given for this acquisition, which was considered to be of considerable importance to the welfare of the asylum. The steep slope of the land down from the east allowed passers-by to overlook the asylum and its airing courts, causing

"very great annoyance, which was too frequently found to harass and disturb the minds of the Patients placed in those Courts for air and exercise, and to retard their recovery".

The new parcel of land created a visual barrier to the inquisitive who had no business looking into the asylum grounds. The second reason given for the acquisition of this land was that,

"it is obvious, that more extensive means of employment will thus be furnished for such of the male patients, to whom bodily labour may be deemed serviceable".

This is a very early example of the managers of an asylum declaring the therapeutic benefits of employment.

It appears that the employment of patients had already been contemplated and possibly carried out, and the original extent of land not found to be great enough to allow all those to work who wished to or were able.

The final reason for acquiring the land was that

"in the cultivation of this ground, considerable benefit will be derived to the Asylum".

This probably referred to its economic use to provide fruit and vegetables for the institution.

Richard Ingleman designed a building which followed the general plan form of the Moorfields Bethlem, with men and women's wings flanking the central administration and service block. The asylum was built as one long, three-storey block, with galleries overlooking the airing courts to the rear. The asylum was set 300 feet (92 m) back from the road.

The building and airing courts were set within a tightly drawn walled enclosure (248 feet x 348 feet; 76 x 107m), behind an area of informal lawn which was obscured from the road by a screen of trees. A lodge, costing £390, was erected at the same time as the tree screen was planted in 1809, even before the committee could afford to put up the hospital building. From the lodge a serpentine drive was cut through the hillside, crossing the lawn to the turning circle in front of the asylum building. Dr Fox in 1809 advised that the approach to the asylum should prevent patients from seeing the asylum, from seeing visitors to the asylum, and from being able to guess its purpose.

The asylum did not have a farm attached, but the lawn at the front, encircled by woody planting in the manner of an informal pleasure ground, may have been used for supervised patient recreation.

Fox advised that instead of the three airing courts per side, which his establishment had, probably only two airing courts each for the male and female sides were required, one designated for the "filthy and refractory", and the other for the "temperate cleanly and convalescent patients".

The building and courts he recommended should face somewhere between the east and south-west, the whole being arranged so as to prevent communication between the sexes by speech or otherwise. Three airing courts per side were subsequently built, with a gap between the two central ones to provide access from the central administration block to the kitchen gardens beyond.

The airing courts on male and female sides each seem to have been assigned to a different medical class of patient.

In 1828 Halliday referred to the asylum. He expressed his dissatisfaction with the amount and use of space for patients to be employed within. He believed that there was 4.5 acres (c.1.8 ha.) of land attached to the building, which could take 80 patients.

"The land is laid out as a garden, the cultivation of which is the only employment the patients have. Their treatment however, seems to be well conducted, and the strictest economy preserved, as the expense of each person does not exceed 7s./week".

Some time after 1844 the building was extended, and the airing courts, of which there were now seven, were remodelled and thrown into two large main courts, with a third alongside to the south. The courts were terraced to accommodate the steep slope up to the east and laid out with lawns and paths. The land beyond the courts was laid out as an elaborate terraced garden with wooded zig-zag paths connecting the main terraces at the top and bottom. Seating areas were provided at the back of the upper terrace, overlooking the asylum grounds below, and a fountain at the centre of the lower terrace. The setting became more built up, with networks of streets with small houses to the west and south, although open ground remained to the north, and to the east lay large areas of detached town garden plots and other open ground.

Southwell workhouses
1808-1836: Southwell Parish Workhouse
1824 to present: Thurgarton Hundred Workhouse, which became Southwell Union Workhouse in 1836 (Now a museum)
Southwell workhouse open to the public
See Peter Higginbotham's site
PAPHE website

One of the magistrates who contacted Fox was the Revd. John Becher of Southwell). Becher was active in other schemes of social provision and classification, for in 1808 a workhouse had been erected in Southwell to his design, for 84 pauper residents of the parish, which was, as he maintained, "constructed and governed upon a principle of Inspection, Classification, and Seclusion".92 Becher piloted and also helped to design its even larger and more influential successor at nearby Thurgarton in 1824 (discussed in more detail in Chapter 4 of Sarah's thesis).

Norwich - The landscape

Norwich asylum was built three miles or so (5km) east of the city at Thorpe.

The individual airing courts were laid out with gravel paths and grass plats, and were enclosed by thirteen foot (4m) high brick walls which had to be raised once the first patient had escaped over them in 1814.

As with Nottingham, the two central courts were divided by a narrow passage, this time flanked by an arcade leading to the hospital buildings for men and women respectively, each with its own small airing court. The asylum was approached via a walled forecourt with railings flanking gates leading straight off the Yarmouth turnpike road which lay close by. The remainder of the grounds were given over to a cemetery, kitchen garden and drying ground.

The cemetery was laid out in 1815 at the south-east corner of the airing courts, enclosed by a four and a half-foot (1.5 m) high wall and consecrated by the Bishop of Norwich on 4.8.1815.

In the early years of the asylum little written reference has been located to the patients using spaces outdoors anywhere other than the airing courts.

A lengthy description of the asylum in 1825 presents a very positive account of the establishment and its management. The writer described the situation as being "on a fine, open healthy spot, near the Yarmouth Road", approached via four iron gates set into cast-iron palisades on low brick walls which gave access to the "fine, open yard" in front of the building. He writes approvingly about the arrangements for the patients within the building. The airing grounds were reached directly by the patients via their day rooms and galleries on the ground floor, each wing (one for each sex) having three areas, which the writer classified as an airing ground, a probation yard, and a convalescent yard. The description does not mention how the patients were classified within the accommodation in the building itself, although the men occupied the west wing and the women the east.

Each yard was enclosed by walls high enough to "insure the safety of the patients during the hours of recreation", and laid out with grass panels intersected by gravel walks which gave them a "neat and pleasant appearance".

The male and female yards were separated by a semicircular courtyard (as was shown on Stone's 1816 plan) from which a passage led south to the other offices. The court contained an arcade which continued along the passage, leading on the west side to the men's hospital, the nurses' room, a drying room and a stoving room. A yard was appropriated for the use of the hospital patients. On the east side of the passage was a similar arrangement for women, with the yard being used by convalescents. The author also mentioned the remaining part of the site being appropriated for a "burying ground", spacious kitchen garden, coach house, stables and other offices.

Halliday's brief description of 1828, as part of his countrywide survey of asylums, referred critically to the asylum in terms of the amount of space for patients to be employed within. "It has not the advantages to be derived from a farm or great extent of garden, but upon the whole, is a well-arranged and ably conducted establishment".

The original five-acre (2 ha.) site was not greatly extended until the 1840s, after the Metropolitan Commissioners in Lunacy had complained in 1843 about the seats and benches in the airing courts being furnished with chains and leg locks, and the inadequate extent of land which they viewed as so essential to the occupation of the patients. By January 1846 the Commissioners reported that a considerable number of men were employed in the yards and outhouses and the grounds and gardens. Two and a half acres (1 ha.) of land was bought in 1847, providing a total of seven and three quarter acres (3 ha.) for the use of the patients, the new land being laid out partly as a garden and partly as a pleasure ground intended for the women patients to enjoy air and exercise

The building was extended by the county surveyor, John Brown about 1849 and the male and female sides were reversed to east and west respectively. The original arrangement of six airing courts was remodelled to form two large airing courts, one on each side of the south front, with two new courts to the west and east of the building. At that time a large, square kitchen garden lay immediately to the west of the main building, with a further area of kitchen garden to the east, and to the north of this an area labelled "garden" containing what appears to be an orangery or similar structure. The cemetery, the narrow Governors' Garden, the Drying Ground and Bowling Green formed a narrow band of open land which separated the hospital from land running down to the river to the south. At the same time or shortly after, the turnpike road was moved further away to the north to allow more room for expansion and create more privacy from the public road. Because of this the main entrance and lodge were demolished and new lodges were built. Following the re-routing of the road in a cutting, in 1856 a new and substantial bridge, also by Brown, was erected across the road, allowing male patients unhindered access from their accommodation on the east side of the site to the farmland to the north of the road.86

By 1854 there were 298 patients, and a further 30 acres (12 ha.) of land had recently been bought, in response to further criticism by the Commissioners in Lunacy and their recommendation that this constituted the minimum amount required for an asylum containing up to 300 patients. It was hoped that the general increase in the space available to patients would lead to a lessening in the number of chronic patients and the lessening of the mortality of the other patients. The exact use of the land had yet to be decided, whether the more general activities of farming would be carried out in addition to "spade husbandry". It was believed that,

"The more varied and extensive the occupation of the patients, the more fully will be developed their individual capabilities".

The 1854 report admitted that the limited amount of asylum estate land had until then made it difficult to find work for those patients used to agricultural work. Idleness was regarded as a major limiting factor to the recovery of the patients. In the summer a piece of land had been rented and 50 men were engaged daily in "cricketing" and after that a large number were employed on the land; however, nearly all the patients had some kind of physical ailment, restricting the amount of work they could be expected to undertake.

Marching drill occurred in the grounds, as

"Great control is gained over the patients, and the task of taking a vast number to a distance from the Asylum for air and exercise, becomes comparatively easy".

A self-contained annexe for 280 "quiet" cases of each sex was built about 1878-1880 at some distance to the north of the original complex, on 24 acres (10 ha.) of land bought for the purpose. This New Asylum stood remotely in a large expanse of agricultural land and was provided with airing courts which were enclosed by sunken fences. The old and new complexes were connected by a sunken drive across farmland which left the turnpike road opposite the lodges. The old path which had connected the two sides of the site since the 1850s, carried by the bridge across the turnpike road, had been planted up as an avenue. At the south end of the path, in 1891-1892, the superintendent's house was built, set in its own spacious grounds to the east of the path. In 1899 all the male patients were moved to the New Asylum and all the female patients to the Old Asylum. In 1900 13 acres (5.25 ha.) were bought, and the New Asylum extended for a further 150 patients. The southern, earliest part of the asylum closed in the late twentieth century, and the building was converted into apartments.

Wakefield - The landscape

The Wakefield asylum was the earliest public asylum to introduce the use of work in the building and grounds at a significant level as a form of therapy, reflecting the increasing interest in moral therapy in public asylums. As such it was influential on other public asylums. Its first medical superintendent, William (later Sir William) Ellis implemented this programme, the asylum having been constructed on an expansive site with advice from Samuel Tuke of The Retreat, York, where work was already a major element of treatment. Tuke expressed his opinions on the laying out of the asylum structure in print, and the plans for the asylum were also published.

Hanwell - The landscape

Derby - The landscape

When the plans for the erection of this asylum were published this was the estate which most closely followed John Conolly's ideal (the ground plan was reproduced in his Construction and Government of Lunatic Asylums ...). Although it was not erected exactly as depicted in the early plans, it was a typical county asylum which was in the course of design and erection as the 1845 Lunatics Act was passed. It displayed typical asylum landscape features and design from this period, which continued in use during the rest of the century and were commented upon favourably some decades later by authors such as Sibbald in 1897 and Hine in 1901.

When planning their asylum the Derbyshire magistrates visited Conolly at Hanwell together with existing asylums at Wakefield, Nottingham and Gloucester. The importance of buying a larger farm than was initially required was urged, as an asylum farm was regarded as beneficial in treating insanity. The value of separate airing grounds for the several classes of insanity was noted, and the magistrates recommended that no less than 50 acres (20 ha.) of land be attached. Henry Duesbury won the architectural competition in 1844, but the proceedings were delayed, so that the asylum was only completed in 1853 to modified designs. Meanwhile Conolly had somewhat misleadingly published Duesbury's earlier design in 1847 as that which was executed. The plan as built appeared with an engraved view and a description by Duesbury in the 1853 Annual Report.

A 79 acre (32 ha.) estate was laid out at Mickleover, three and a half miles (5.5 km) south-west of Derby, in an isolated rural area, the building being designed for 360 patients. The site lay between two major arterial routes, to the north the Derby to Uttoxeter road, and to the south-east the Derby to Lichfield/Birmingham road, but was separated from both by a buffer of fields. A lane constructed specifically to give access to the asylum from the Uttoxeter road entered at the north-east corner of the site.

The Tudor-style building stood towards the summit of rising ground with wide panoramic views to the south. The entrance lay at the north-east corner of the estate, at which stood entrance gates with a Tudor-style lodge on one side. From here one arm of the circuit drive around the c.30 acre (c.12 ha.) core of the site led south-westwards along the north front of the asylum building to the farm and cemetery at the south-west corner of the site, the other leading around to the south, entrance front at the centre of the building. The male half of the asylum was to the east and the female to the west of the central administration block. The patients were classified by degree of illness, i.e. severity of their symptoms, rather than by type of illness.

Henry Duesbury's Architect's Report (December 1852) provides a useful description of the earliest layout.

"The Asylum is situated about three quarters of a mile S.W. of the village of Mickleover, on an estate consisting of 79 acres of land, _ and stands, with a southern aspect, on rising ground overlooking the rich valley of the Trent, and commanding a panoramic view of the wide spread country beyond, bounded in the extreme distance to the South, by the Charnwood Hills, having Needwood to the West, and the flats of Nottinghamshire to the East - perhaps one of the most beautiful and varied views in the County. The Property is approached from Uttoxeter Rd by a pleasant lane, which forms its Northern boundary, and in which at the N.E. angle of the estate, are the entrance gates with a lodge attached; a carriage drive, with turfed slopes, leads from these gates past the Eastern front, and along the south terrace, which stretches across the property from East to West, to the CHIEF ENTRANCE in the centre of the Southern or principal front, the drive being continued forward to the Farm Building at the N.W. boundary. The Farm is also approached by a back road from the entrance lodge, which, skirting the plantation (about 4 acres in extent to the North), also affords access to the offices and back premises of the Establishment. A kitchen garden (containing about 5 acres) surrounds the building on the North, East and West sides, and occupies the remaining space enclosed by the roads before mentioned."

The site of the building and exercise gardens [airing courts] covers a space of 5.5 acres.

The main entrance at the centre of the south front gave access to the Superintendent's and officers' residences in the central block. It opened onto a paved terrace approached by a broad flight of steps from the drive running along the outer sides of the two southern airing courts. The drive itself at this point was carried on a broad terrace, separated from the parkland beyond by a ha-ha.

Duesbury's report continued:

" The Airing Grounds, being considered essential to the advantageous treatment of the Patients, are here placed in front to enjoy as much as possible the cheerfulness & warmth of the southern aspect. Each Airing Ground (or Exercise Garden) is surrounded by a sunkwall having a ha-ha on each side _ .

The EXERCISE GARDENS or Airing Courts attached to the Ward _ are all laid down with turf and have well drained gravel walks, the tops of the inclosing walls not being more than 3' above the surface - a novelty in the manner in which the slopes of the front Exercise Gardens are managed may be noticed, it is a double slope _, the small slope answering the two-fold purpose of forming a seat in fine weather, and of preventing a 'running jump' being taken from the top of the large slope to the wall."

The farm contained the steward's house, and adjoining bailiff's house. Beyond the latter was the farmyard, with a large covered manure shed in the centre, and a tank for liquid manure. The yard was enclosed by buildings including a visitors' stable, cart house, barn, cart-horse stable with harness room, slaughterhouse with copper to cook pig food, and hen house. The pigsties were arranged on Lord Torrington's principle. There were also carpenter's and blacksmith's shops, a fold yard, and cart sheds, calf house, cow house, magistrates' and officers' stable, harness room, and a double coach house. The surfaces of the farm and fold yards were both asphalted. The foul drainage from the asylum and farm drained into a large tank in the grounds, from which it was pumped for agricultural purposes. A stack yard lay at the back of the farm buildings, and beyond, in the extreme north-west angle, lay the burial ground surrounded by a dwarf wall. A small chapel in the cemetery also included a mortuary.

The 1879 25" OS plan shows a paddock immediately to the south beyond the triangular core of the site planted with a belt of trees and clumps of trees, the surrounding estate farmland being laid out as agricultural fields. The paddock is separated from the field beyond by a ha-ha. The whole estate was laid out to accomplish a complex series of tasks, as well as housing several hundred patients and staff.

Middlesbrough - The landscape

Ewell Epileptic Colony - The landscape

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Index: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z



asylums index

original airing courts
1730s airing courts
St Georges
Jacobi form - functions -

Brislington House:
early colony plan?

Broad Arrow



Compact Arrow - Later Type

Conolly 1847:
one of models -
ideal features -
table -

Corridor: - Corridor- Pavilion -

Peter Cracknell Forms

county asylums

criminal lunatics

functions - Landscapes

Double Panopticon

Dual Pavilion -


Early Colony

Echelon: - Broad Arrow - CompactArrow - Later Type

Ewell: Landscapes


France (Ivry, Charenton, Rouen, Vanves)


H form


Jacobi form
- Corridor plan - functions - Landscapes

Robert Hooke

hopital general

Hine (G.T.) asylums are nearly all classified as compact arrow echelon plan


Irregular Pavilion

Jacobi 1841 asylum situations - arrangement of departments -
forms -
model used?

Kendall asylums: ( Essex - Sussex - Dorset) are all classified as corridor plan.


licensed houses

mad houses



Middlesbrough: Landscapes

Norfolk: early - developed into corridor plan - Landscapes

Nottingham: early - developed into corridor plan - Landscapes





Pavilion: Corridor - Standard - Dual - Radial - Irregular - Echelon



Susan Piddock



Radial Pavilion

Retreat: Landscapes

Sarah Rutherford

Standard Pavilion


Jacobi form
- developed into corridor plan - functions - Landscapes


White 1677

workhouse asylums