The earliest known lock hospitals in London date back to the twelfth and thirteenth centuries. Initially for the treatment of leprosy the term ‘lock’ is thought to derive equally from their purpose in removing infectious individuals from the community and the old French term ‘loques’, referring to the dressings applied to leprosy sores. As most of the traditional London hospitals refused to admit infectious patients, the ‘foul’ wards at St Thomas’s being one of the few exceptions, ten such ‘lock’ hospitals were established around the outskirts of the city. At the time of the Reformation London’s lock hospitals were assessed and the twelfth-century site at St Giles was closed. Henry VIII took over the hospital at St James which was then converted into a London residence for the King and six of the remaining lock hospitals were transferred over to the care of St Bartholomew’s in 1549.

By the eighteenth century two of these sites remained in use, but with the eradication of leprosy they increasingly became vital in the treatment of venereal disease. The site at Kingsland, founded c1280 and its contemporary at Southwark each held thirty beds, with the former reserved for female patients and the later male. Despite the evident overwhelming need for such hospitals there was much debate surrounding their funding, and the Kingsland and Southwark sites were eventually closed in 1760.

In 1746, concerned about London’s growing levels of syphilis and other forms of venereal disease, William Bromfield (surgeon to Frederick, Prince of Wales) embarked upon the founding of the city’s first purpose built Lock Hospital. Bromfield was the son of physician Thomas Bromfield and his wife Mary (neé Briggs). Born in New North Street, Holborn, William was baptised 30 July 1713. At a young age he entered the field of surgery, delivering a series of lectures on anatomy in 1741 and establishing himself at Governor and surgeon for St George’s Hospital.

Bromfield was an eminent surgeon of the day, publishing several treatises on the inoculation of smallpox. He moved within influential circles as surgeon to the royal family, first serving Frederick Prince of Wales then, upon the Prince’s death, as surgeon to Augusta, Dowager Princess of Wales, and the future Queen Charlotte.

It is partly due to Bromfield’s influence that the establishment of his lock hospital was such a success. In July 1746 he summoned a committee of notable individuals to discuss the need of just such a hospital and then proceeded to purchase a 95 year lease on a house in Grosvenor Place for the purpose. In January 1747 the Lock Hospital first opened its doors with capacity for thirty patients. Bromfield used his connections to creatively fund his establishment, even staging his rewrite of an earlier play (subsequently titled ‘The schemers’), which was produced by David Garrick at Drury Lane Theatre in 1775. Proceeds from the production were given over to the Hospital as were the takings for the first night of Handel’s ‘Judas Maccabeus’. Sadly, in later life Bromfield became disillusioned with his charity as a result of a disagreement with the Hospital’s Chaplain. He expressed his concern at the Chaplain’s failure to engage with the Hospital’s patients, but his complaints were dismissed. Following this, Bromfield resigned from his role at the Lock Hospital and urged his friends to cease paying subscriptions to the charity.

William Bromfield died at his house in Conduit Street in November 1792. His sons from his first marriage, William Heriot (d. 1762) and Charles (d. 1784), entered the medical profession, but both predeceased their father.

Bromfield’s Lock Hospital in Grosvenor Place was initially housed within a private residence to the south of Hyde Park Corner. The Hospital was to be funded by private subscriptions from prominent individuals and the Duke of Ancaster served and the Lock’s first President of the Board of Governors. In establishing the Hospital there was a recognised need for charity towards individuals for whom there was little support. A number of the traditional hospitals rejected cases of syphilis and other forms of infectious disease, yet in the eighteenth century the spread of venereal disease was of great concern. Priority was to be given to children with congenital syphilis and wives who had been infected by their husbands, but Cruickshank’s analysis of hospital admittances for the year 1771 tells a different story. Of the 5,500 women treated in that year, over 4,000 of them were unmarried. One of the principal purposes of the Hospital, therefore, was to address the issue of street prostitution.

The Hospital operated under a series of rules, for example all alcohol was prohibited and there was to be no association between patients of the opposite sex. Interestingly, one particular rule stated that any patient ‘having been once cured, or discharged for any other cause’ may not be admitted again.

A recognition for the need for social change saw the establishment of the Hospital’s Asylum in April 1787. A house close by was taken up in a bid to help alleviate female patients from a life of prostitution. Once treated the women were supported by the Asylum and ‘kept from ever seeing or conversing with their former abandoned companions’, the idea being that they would be returned to responsible friends or taught a skill before returning to the community. Unfortunately, as Cruickshank highlights, this had mixed success. Analysis of the figures for the asylum from 1787 to 1796 showed that over 50% of the women were expelled for ill behaviour or for returning to their former life.

In 1753 it was decided that the site at Grosvenor Place would need to be rebuilt with the new premises containing six wards for a total of sixty patients. The building does not survive, but as Cruickshank notes an elevation of the Hospital can be observed in Nathaniel Dance’s portrait of Bromfield. This shows the Hospital as three storeys in height and nine bays wide, with a pedimented central window.

In an attempt to assert the moral tone of the charity, a key feature for the new building was to be its chapel. The Lock Hospital’s Chaplain during this period was the Reverend Martin Madan, who first took up his post in 1750. Madan (b. 1726-1790) made a great success of the Lock Chapel and his sermons attracted large crowds.

Inaugurated in March 1764, Cruickshank notes that by the year 1766-7, the Chapel’s pew rents made a total of £521.2s.0d per annum, approximately one third of the Hospital’s annual income. Madan was eventually forced to resign from his post after the publication of his ‘Thelyphthora or A Treatise on Female Ruin’ in which he promoted the benefits of polygamy as a solution to prostitution.

The Adam designs are undated, but significantly Bolton suggests they are probably of an early date, the use of the rotunda a possible reference to the Pantheon and Adam’s time in Rome. Interestingly Bolton assigns the commission to the notorious Reverend Dr Dodd, later executed for forgery. Dodd was an associate of Madan’s and Bolton appears to have confused the two men in relation to the Lock Hospital. The chapel is the dominant feature of the Adam scheme and the designs probably date to c1759 when the new addition for the Hospital was under consideration. It is interesting that the scheme includes curved wings for the Hospital and the designs may be slightly earlier in date as part of the plans to rebuild the Lock. Adam’s scheme, however, was unexecuted and it is probable that the designs were considered too elaborate for the charity. In 1776 Walter Harrison’s description of the executed chapel noted it as ‘elegant…in which is a very handsome organ’.

After Madan’s dismissal the chapel continued to prove popular for its sermons and included William Wilberforce amongst its congregation.

The Hospital, its chapel and asylum remained at the site until the early 1840s, when the original lease expired. The area around the Lock had developed into the fashionable Belgravia and as a result the decision to relocate the Hospital was taken, with a new four-acre site acquired in Paddington. Significantly the architect Louis Vulliamy, famed for his church designs, was employed and the chapel continued as a prominent feature of the new site. The foundation stone of the new hospital building was laid in May 1841 by the Duke of Cambridge and it continued in use until its eventual closure in October 1952.

The importance of Bromfield’s Lock Hospital can be ascertained from an analysis of the figures. By 1811, some 60 years after it was founded, the Lock had treated upwards of 30,000 patients.

Literature:
N. Moore, ‘William Bromfield 1713-1792’, Section of the History of Medicine, May 19 1915, pp.103-126; A.T. Bolton, The architecture of Robert and James Adam, 1922, Volume II, Index, p.39; J. Bettley, ‘Post Voluptatem Misericordia: The Rise and Fall of the London Lock Hospitals’, The London Journal, Vol. 10, Winter 1984, pp. 167-175; D. Cruickshank, The Secret History of Georgian London, 2010, pp. 300-310; F. Sands, Robert Adam's London, 2016, pp. 88-89; M. Bevan, ‘Bromfield, William (bap. 1713, d. 1792)’, 2004, www.oxforddnb.com; ‘William Bromfield (1712-1792), surgeon to Queen Charlotte; founder of the Lock Hospital’, www.collections.ed.ac.uk (accessed December 2020)

Anna McAlaney, 2020