Everything, in five sections
Sixteen entries. Every one is a single building or a single rule, and the theory of disease that produced it.
The Pavilion
01 · Long narrow wards, set apart.The pavilion plan
Wards as separate parallel blocks joined by corridors, so that air could cross each one and never pass from one to the next — an entire hospital shaped by a diagram of ventilation.
Lariboisière
The Paris hospital that made the pavilion argument concrete: Lariboisière turned a ventilation theory into stone and was studied by all.
Billings draws Baltimore
John Shaw Billings planned Johns Hopkins around ventilation before germ theory settled, and the building opened in 1889 already halfway between two worlds.
What a pavilion cost to run
Heating a building designed to leak air is expensive, and the accounts eventually decided the argument.
Bad Air
02 · The theory that built it.Miasma
For most of the nineteenth century, disease was believed to travel in foul air — and because the theory was wrong for the right reasons, the buildings it produced often worked.
The open window
Cross-ventilation as a medical instrument, with the window as the prescription.
Light as treatment
Sunlight was believed to be actively curative, which put wards on particular orientations.
The Turn
03 · Germ theory, and the reason evaporates.Germ theory arrives
Once infection had a mechanism, the reason for all that air disappeared, and the plan was free to become compact.
The sealed tower
Lifts, mechanical ventilation and deep plans made height practical, and the hospital stopped being a landscape of separate blocks.
What was lost
Daylight, view and orientation were traded for efficiency, and are now being argued back.
Paimio
04 · A building designed for the person lying down.Paimio Sanatorium
Alvar Aalto's 1933 building designed around a patient lying on their back: ceiling colours chosen for that view, heating placed to avoid draughts, and a basin shaped not to splash.
The sun balcony
Rest cure architecture put beds outdoors in cold air, and the balcony became the building's whole south face.
Furniture as prescription
Furniture as prescription: the Paimio chair was designed to open the sitter's chest, a medical claim made in bent plywood at Aalto's sanatorium.
Measures
05 · The rules written down.Notes on Hospitals
Florence Nightingale published the ward as a set of numbers in 1859 — beds per ward, distance between them, window area, cubic feet of air per patient — and hospitals were built to those figures for decades.
Cubic feet per bed
A ventilation standard expressed as volume, and what it did to ceiling heights.
The ward round as a plan
Sightlines from the nurse's position shaped the long open ward as much as air did.