Fever wards
Acute wards not fever
Superior class wards
Noisy wards
Head nurses’ rooms
Under nurses rooms
Bath and Examination rooms
Patients’  clothes  Mattress  store 
Medical officer’s Room
Dispensary
Office

The New London Fever Hospital

Builder [August 12,1848]

The erection of the New London Fever Hospital (illustrated by the accompanying engravings) has been occasioned by the Direct Northern Railway Company taking the site of the present structure, together with the Smallpox Hospital, for the purpose of forming their intended terminus near King's Cross. The site of the New Fever Hospital is in the Liverpool Road, Islington, at a higher level, and much more spacious and suitable than the present one.

The building is also upon as enlarged scale, calculated for the reception of 900 patients, the present hospital being for 120 patients only; and the accommodation is proposed to embrace the various improvements resulting from science and experience in sanitary matters. All the wards for fever patients are on the ground-floor, with upper wards for the convalescents; so that the greater part of the hospital is only of one storey. Particular provision is made for simultaneous supervision by the head nurses, as well as for a ready inspection of the whole establishment. The means of warming and ventilating are also provided for in the construction. The building is to be of a plain but substantial character; the rusticated work and architectural dressings in front to be of Caen stone, on a granite plinth; the remainder of the facing to be of red brick.

The first stone was laid by the president, the Earl of Devon; on the 29^th of June, assisted by the Earl of Eldon and several other trustees and members of the committee and friends of the institution. The building is advancing rapidly and is to he completed by the 31 st of March. 1849. Messrs. T. and W. Piper have undertaken the contract at the sum of £12,312, which is inclusive of lodges, boundary walls, and several other contingent works, required to render the plan complete.

The architect is Mr. Charles Fowler, and the design was selected in a competition, concerning which a correspondence appeared is our pages some time since.

The means of warming and ventilating are also provided for in the construction. The building is to be of a plain but substantial character; the rusticated work and architectural dressings in front to be of Caen stone, on a grantee plinth; the remainder of the facing to be of red brick.

The first stone was laid by the president, the Earl of Devon; on the 29^th of June, assisted by the Earl of Eldon and several other trustees and members of the committee and friends of the institution. The building is advancing rapidly and is to he completed by the 31 st of March. 1849. Messrs. T. and W. Piper have undertaken the contract at the sum of £12,3121., which is inclusive of lodges, boundary walls, and several other contingent works, required to render the plan complete.

The architect is Mr. Charles Fowler, and the design was selected in a competition, concerning which a correspondence appeared is our pages some time since.

A Fever Den

The Mercury Independent, 28 June, 1881

"Now if you are to see as bad a den as exists in this part of London, I'll take you there; its close by."

We assent with alacrity and follow our guide back into Upper Lisson Grove. At the lower end, just before reaching the Marylebone Road, our communicative guide stops. I should advise you to hold your handkerchiefs in your hands," he says, "You may require them. We are going into one of the foulest dens in the district."

Having favoured us with this attractive introduction, he leads the way up a passage some three feet wide. The narrow gangway is bounded by walls some eight feet high, and the lane thus formed is so long as to give one the idea of our being led into a trap. We know our guide has no such intention however and follow him with confidence.

As we reach the end, we are met by a most nauseous odour, which strikes one as being the veritable fever smell. This is what must be meant by the allusion to our handkerchiefs. Careful not to inhale the poisonous air, we pass under the archway and find ourselves in a square some fifty feet across. The place is surrounded by one-storey tenements, each being fronted by a so called garden bordered by broken railings. In the centre stands a dilapidated pump, and the place has the most ruinous and woebegone aspect. The smell is dreadful, especially at the corner where we enter, caused, we are informed, by the bursting of a drain.

There are twenty four houses round the square in all, twenty two of which are inhabited. They are all in a ramshackle condition, yet each of the twenty two houses harbours two families, one in each room, consisting in one case of eleven persons who sleep and eat, drink, when they have anything to eat or drink, in one room eleven feet square. Several of the upper floors let the water in through the roofs, while the staircases are in a dilapidated condition. As we enter the square the officer accosts a woman who is hanging some clothes to dry on a clothes line.

"Well Mrs. - how are you getting on?"

“Nicely thank you kindly sir."

“You have some work to do 1 see."

"Well sir, I manage to pay my way. I got a little sewing this week and now I've got some more coming in this afternoon. 1 can't do as much as I would like to though because of the smell. It's very bad sometimes."

"It's bad enough now," we remark, joining in the conversation. "But are not the authorities looking into the matter? Surely this state of things has not been going on long."

"Well sir, it's always been bad since I came here two months ago. The two houses at the end are empty now; they can't get anyone to take them. The stench is so bad. They rose the rents all round six weeks ago except those two. When I first came here I paid six shillings but I have to pay seven now. They used to be five I am told. It's very unhealthy here. We've got two down at the fever hospital now, but what are we to do?

"Surely people would be better off in the workhouse than living in such a place as this?"

"Well yes sir, I suppose they would, but people have such a horror of the House. They won't go into it now if they can keep out of it. 1 think they are wrong. Thank God 1 have always been able to keep out myself, but if I could not get enough work to get my little comforts somehow, I would ask for an order at once.'

We thank our intelligent informant and make a tour of the 'square', talking to some of the residents. It is acknowledged to be foul and unhealthy, the rents are high, but there was nowhere else to go.

A representative of this journal has since visited the locality indicated. It is certainly not the foulest den fever den in the district as in the very next court there is a much graver danger to the inhabitants who are fully aware of the necessity for a change, and have frequently appealed to the landlord as the person most directly responsible for the nuisance. Should the remedy not be forthcoming, the sanitary authorities ought at once to take action. With the prospect of a hot summer before us and the warning of the mortality caused by cholera in Spain before our eyes, no one can say that matters like these may not prove of life and death importance to many besides those immediately affected.'

Dr. Southwood Smith (1788 - 1861)

Dr. Southwood Smith was a great Victorian health reformer who became Minister for Health, He was born in Mortock, in Somersetshire, began training to become a minister but could not accept all the church teachings and his grant was withdrawn. His family, which was narrowly religious, cast him off at once and for good. He married but his wife died young, leaving him at the age of 24 with two young children. In 1813 he decided to leave the children in the loving care of his wife's relations and study medicine at Edinburgh University.

Passing his examinations in 1816, he married again, this time to a girl from Hackney, and came to London. He was appointed to The London Fever Hospital, then on the site of future King's Cross Station. At this period, years before Pasteur, fever was a mysterious subject. Doctors could not distinguish one fever from the other. They still thought that disease was spread by smell (miasma) as the Greeks had done. It was before the realization that there were many forms of fever, with different causes. Bacterial infection was not understood. Everything was obscure. It would be generations before the different fevers were understood, and in the meantime, Southwood Smith's thoughts were concentrated on how fevers in general might be prevented.

The Fever Hospital patients seemed to show a pattern. Patients (mainly women) came in with ‘a low fever', were cured by rest and nursing, returned to their miserable homes, only to develop fever again. There seemed to be a connection between poor living conditions and ill-health. There was also some connection between being in the same house all day and going out to work somewhere else all day, as men did.

He published reports on this. In 1833 he worked on the Factory Commission and in 1834 he published ‘The Philosophy of Health' which was widely read. Three years later there was a serious fever epidemic in London and Southwood Smith was appointed to report on East London. From this came ‘The Report on the Physical Causes of Sickness and Mortality to which the Poor are particularly exposed and which are capable of prevention by Sanitary Measures‘.

Later, Southwood Smith and his friends had carried out a deliberately planned experiment to try to prove that good housing would help to produce good health. In 1842 a few individuals formed themselves into an Association to prove that health could be improved by building houses on well-drained sites; admitting light and fresh air into every inhabited room; abolishing cess pits (earth closets) and introducing water closets; supplying abundant clean water and removing rubbish regularly.

The Association thought some houses could be built on these principles, but money had to be raised from shareholders. This was before the Limited Liability Act, so a special Act of Parliament had to be passed so that shareholders were liable only for the value of their share and not everything they owned (as Lloyd's shareholders still are today).

The Association took the name ‘The Metropolitan Association for Improving the Dwellings of the Industrious Classes' and its first venture was ‘The Metropolitan Buildings' in Old Pancras Road, King's Cross. They consisted of 110 sets of rooms, 20 two-room and 90 three-room flats, in five-storey blocks.

Southwood Smith published a book on the results of the experiment, and holding it in ones hand, in red cloth covers and tiny six-point type, is a vivid experience. In the three years 1850-52, child deaths in the Buildings were only one third those of the Metropolis as a whole. The contrast to The Potteries, in Ladboroke Grove) was even greater.

(The average age of death was twelve years. Sanitary Report for 1856.)

In 1861, Hollingshead described The Potteries as, ‘ a marshy district lying between the villas of Bayswater and Notting Hill.- - - (It had) highways not yet adopted by the public and consequently dedicated to nothing but rivers of mud. The inhabitants are pig-trainers and brick makers, ‘fanciers' of spurred gamecocks, and red-jawed bull terriers. The huts have grown a little the worse for wear. Refuse matter is still collected by the pig-trainers and boiled down in coppers, that the fat may be separated for sale. '

Southwood Smith wrote:-

‘In The Potteries, Kensington, an un-drained area in Notting Hill with no supply of clean water or method of removing filth, the child mortality was 51 in about 384. So the Potteries, with 80 fewer children, had 41 more deaths than the Metropolitan Buildings. '

Liverpool Road  N1 ( East Side )
Royal Free Hospital

TQ  3183 NW 58/1194

Formerly London Fever Hospital.

The Conversion of the site into housing in 1990

One of the largest housing association projects undertaken in London, this £11 million development will provide 182 new dwellings in a joint scheme by two housing associations and is due for completion in May 1990.

The scheme consists of a mixture of new build, conversion, and restoration of the original listed hospital buildings.

Extracts from the Architectural Survey made by architectural historian
who was asked to decide which of the buildings were of historical importance.

The Front Range

‘The front range, with or without the colonnades partly or completely opened up, is an interesting and important structure which is nevertheless possibly capable of interior conversion. Exterior alterations are not likely to be easily accommodated, with the exception of opening up certain bays of the colonnades.

The Side Wings

‘The side wings are, as my previous letter suggested, almost certainly contemporary with the front range. They are, by comparison, much plainer and less interesting. Internal alterations are not likely to prove objectionable, even quite radical re-organisation; exterior alterations on the outer and inner (courtyard) elevations could be accommodated within the context of a historically detailed scheme of adaptation. Alternatively, the side wings could be incorporated into a more extensive and architecturally ambitious scheme involving new building in the courtyard areas and substantial re-organisation of the existing buildings.

The returns of the side wings and the rear of the central element

‘Such a scheme could also extend to the rear returns of the side wings and the rear of the central element. Considered on their own, these latter two sections are not worthy of preservation. Indeed, there could be a case for suggesting that they actually detract from the special interest of the rest of the complex. Whether or not their demolition would release a viable site for redevelopment I cannot of course assess, but no resistance to this approach is likely to be offered.

The Lodges

The lodges are contemporary with the main hospital building, and are therefore of considerable intrinsic interest. They are possibly difficult to adapt or integrate into a scheme for housing use of the whole site. Extensions to the existing lodges or the erection of ‘lodge' sized pavilions or free standing pavilion sites towards the northern and southern boundaries of the forecourt could be contemplated provided the design was carefully evolved to reflect the original buildings.

The Forecourt

‘I consider that the front range, forecourt, fountain, railings and lodges form a unified architectural composition which it would be difficult to integrate with any substantial new building (with the exception of the ‘lodge' extensions above) whether for housing or other purposes.

The Staircase Additions

The staircase additions are of no particular interest.

The Railings

‘In such a scheme, openings in the railings (in addition to the central gates) could be incorporated allowing I access to ‘Lodges', perimeter access, or a circular route.

The walls are in London Stock bricks with an air cavity behind and a wall of thermal concrete. This arrangement preserves heat within the building and conforms to the new Building Regulation. The pavings are in blue engineering bricks which resist water and are very hard wearing. A band of glazed blue and yellow bricks has been laid as stretchers (long-ways) all around this end of the Square to tie the buildings together. A simple and subtle idea.

These railings are in rolled sections of Mild Steel, welded to shape. Early railings were made of Wrought Iron and fashioned by a blacksmith. In later times they were made of Cast Iron, poured into sand moulds. The railings round St Paul 's were made like this, much to Wren's annoyance. These are modern designs and are designed with different ideas. They do not aim to keep out burglars. There are no spikes on the top where adventurous children might be hurt. Instead the railings say politely that this particular piece of forecourt is the property of the people who live here so please give them some privacy

The New Southwood Smith Street Village Beyond the Square
by Levitt & Bernstein

These houses are typical of the ‘new build ‘houses and flats in appearance, but it is difficult to use the word typical when they are of so many different designs inside. The tall flats to the left are the diagonally split pairs of flats, shown in the drawings above. It is most unusual layout but they appear to be perfectly normal from the outside.

The old Water Tower appears as it ever did but it has been converted into flats.

The Water Tower, which supplied fresh water to the hospital, was a vital part of the whole concept of the original Fever Hospital. For decades much of London 's water was contaminated and Southwood Smith was a great advocate of plenty of clean water as a preventative of fever. It is very fitting that Southwood Smith should have a street named after him immediately below his water tower.