Guy's Hospital was founded in 1721 and opened in 1725 close to Saint Thomas' Hospital at the southern approach to Old London Bridge. Thomas Guy had specified that his hospital would admit the incurable and the insane, both categories of patient for which Saint Thomas' Hospital, of which Guy was a governor, did not provide. Accommodation for the insane was initially met by a temporary building erected in 1728. Later the governors engaged the architect James Bevans to design a permanent building. The Lunatic House opened in 1797.
The Guy's Lunatic House was the first hospital building in the British Isles, and possibly in the world, to follow the principle of the panopticon as proposed by the philosopher Jeremy Bentham in 1787. He suggested that buildings such as prisons, schools, factories and hospitals, where supervision of inmates and staff was desirable, be designed in such a way that senior staff could observe the work of their institution without themselves being seen, making supervision virtually continuous. Bentham believed that the good conduct of institutions would benefit the inmates.
The Guy's building consisted of a central block of two stories with wards for patients of each gender extending on each side at an angle to the centre. There were day rooms for patients each gender, a central mixed day room, provision for patients with physical illnesses, as well as rooms for catering, laundry and staff. The crucial feature of the design was the positioning of matron's day room between the angled wings. There were corner windows in her room which allowed uninterrupted views of the two wards. This simple design fulfilled the requirements of the model proposed by Bentham.
Subsequently, a number of mental hospitals were built on the panopticon principle, the earliest being in Glasgow, Bodmin and Wakefield. The structure of the buildings to allow observation allowed dirt, noise and infections to spread between the wards. Furthermore, many staff were required for the wards to work as envisaged. These factors led to the concept losing favour. The hospitals were soon too small to meet rising demand. Much larger hospitals were built on different models to provide accommodation for patients more cheaply but less humanely.
In 1859 the governors of Guy's successfully applied for an Act of Parliament to allow them to deviate from the founder's wishes and cease to provide for the insane. The Lunatic House was used for other purposes until its demolition in 1919.
The photograph is taken from the Jubilee number of the Guy's Hospital Gazette of 1936 and is used with permission of the Editor.