Set Square and Stethoscope: The Architecture of London's Medical Profession

09 March 2016

Set Square and Stethoscope:
The Architecture of London’s Medical Profession

Professor Simon Thurley

This evening, I wanted to talk to you a little bit about the Royal College of Physicians. You might wonder why on earth I have chosen such an extraordinary, obscure subject. Augustus Welby Pugin once said that architecture is the history of the world and those of you who have been to my lectures before will know that I believe that you can indeed tell the story of the world through architecture because, of course, buildings reflect the personal preferences of the people who commission them. Public buildings reflect public values, and corporate buildings reflect the buildings of the corporations that build them. All you have to do is just look around you when you leave the Museum to see what I mean. So, this evening, what I want to talk about is how one institution used architecture to express its values and ambitions and how we, by looking back at these buildings, can learn something of how doctors and physicians saw themselves and their profession since the reign of Henry VIII.

Of course, there had been public buildings in London for an awfully long time before the Royal College of Physicians was founded in 1518. The most prominent of these were the halls of the livery companies. I show you here the Apothecaries Hall, which you can see in its eighteenth century guise, but it was one of the halls to survive the Great Fire of London. The halls of the livery companies looked, at first sight, just like a private house, but they were on closer inspection, the corporate headquarters of the trade guilds, and these were always grouped round a great hall, as indeed they are today. 

There were also, in terms of corporate buildings, the Inns of Chancery and the Inns of Court, and here you see Middle Temple Hall, a wonderful Elizabethan hall that is still there. This was essentially London’s third university, training young men to be lawyers. These were great houses of the merchants, centred on great halls where the students dined together every day.

The first buildings erected by the medics were of exactly this sort. From the 13th Century, various medical groups emerged, and soon clubbed together to form closed-shops. The Barber-Surgeons were established in 1308.  Now they gave you much more than just a close shave. They started off by letting blood and pulling teeth, before graduating to their own particularly gruesome form of surgery. Like the surgeons, who started as barbers, the apothecaries started as grocers, and they eventually isolated their medical specialism in an exclusive company, and both the apothecaries and the barber-surgeons had halls in the City of London.

The physicians started life slightly differently. Unlike the surgeons and the apothecaries, they did not graduate from being barbers or grocers, they went straight in as physicians, but not as a livery, they went in as a college. In 1518, Thomas Linacre, along with five other physicians, along with the support of Cardinal Wolsey, successfully petitioned Henry VIII to create a College of Physicians in London, which would be responsible for the inspection and control of all physicians within the City of London for seven miles around. The idea was for an educational and standard-setting institution. Linacre, who was a man of great learning, became its first self-appointed president. As, in its first years, it had barely a dozen members and no fancy hall was built. In fact, they met in Linacre’s own house in the City, which in due course he handed over to the College. We do not know what it looked like, but we do know that his own library formed the kernel of the College’s library and that a theatre was built for anatomy lectures and a garden was laid out which was stocked with medicinal plants.

Well, poverty meant that when they outgrew this, their first home, they leased another domestic building, this time in Paternoster Row. You can see here St Paul’s Cathedral, and here you see the site of the physicians’ location. Here, I think their architectural fortunes began to look up, and let me explain what happened.

From around 1600, institutional buildings began to become a little bit more specialised and move away from the ubiquitous model of the great house, and this certainly applied to colleges but it also applied now to the livery halls, and the barber-surgeons were amongst the first. They, like the physicians, had a special licence to dissect a small number of human cadavers every year, but this neither satisfied medical science nor did it satisfy the gruesome curiosity of the spectators who clamoured to come and watch, and so this was the context of the barber-surgeons’ anatomy theatre, which you see the original drawings for here, built in 1636 to the design of no one lesser than Inigo Jones. This remarkable structure, which you see here in elevation, you can see how you could enter it and go up these staircases and sit in the seats here, while, in the middle, here is the slab upon which the cadaver was laid for them to carve it up. This remarkable structure was lucky enough to survive the Great Fire of London, but was very sadly demolished in the 1780s.

It was probably based on models that Inigo Jones had seen abroad, including perhaps the theatre at Leiden, which you see here, and you see here, and populated with rather gruesome-looking skeletons as a comment on the sort of appetite of the public to watch these dissections. Of course, the principle here is the principle of an ancient Roman amphitheatre, which provided an excellent view for everyone of the dissections in the centre.

What had this theatre, built by the barber-surgeons, have to do with the physicians? Well, at their new house, they lacked such a facility, but would very much like to have had one, and it seems as if one was in fact designed for them, and the prime mover in this was almost certainly Dr William Harvey. Of course, he was the discoverer of the circulation of the blood and he was a member of the College. He had been appointed Physician Extraordinary to James I in 1618, a post that he continued to occupy under Charles I too. Harvey and the King became very close friends and he was entrusted with many tasks, travelling both with the King and with members of the King’s inner circle as personal physician. 

There is a very nice story about him in 1635 performing an autopsy on the boy of old Tom Parr, a famous character, reputed to have been born in 1483, and so he would have, if this were true, lived through the lives of 10 sovereigns. He was brought to London and he was incredibly famous! He was painted by Van Dyck. He was painted by Rubens. His age, 152 years, was considered to be rather remarkable, and he was brought to London to be introduced to the King. Unfortunately, he died almost immediately afterwards, and when Harvey dissected the body, in the presence of lots of courtiers, he declared that the cause of his death was the shock of coming to London rather than any disease or deformity. 

Anyway, this is a slight diversion from the fact, which was that it was because Harvey was part of the close circle of Charles I that he met Inigo Jones and that he asked Inigo Jones to draw him this, which was an anatomy theatre for the physicians, based on ancient Roman models, as published in the books of Palladio and Serlio, and again, you can see the way that the thing is arranged like an amphitheatre, but this one with this extraordinary dome on the top of it would have been the first dome in England, modelled of course on the dome of the Pantheon in Rome.

Well, sadly, this remarkable, majestic thing was never to be built. In fact, the drawing has written on the other side of it I think “not taken”, in other words “not chosen”. However, at the end of his life, Harvey, who had become extremely rich in royal service, decided to leave both his library and a very large sum of money to the College for the construction of a new building.

This is a very nice little survey which shows the existing College, with its hall, its great parlour, physicians’ reading room, old library, stable, garden, etc. and here, on the outside edge here, it says “Harvarian new library”. This is the site which his new building that he left money for was to be built on.

The architect for this new extension was not Inigo Jones, who, by 1651, was old, ill and broken by the Civil War, it was his pupil, his pupil who inherited not only half of his money but all of his drawings, and that pupil of course was John Webb. We do not know exactly what Webb was asked to build, but we do have his drawings for this remarkable new classical building. On the ground floor, he proposed an arcade, above which was to be a three-bay library and a four-bay “Museum of Medical Specimens and Curiosities” – you can imagine what that contained. Here, you see a cross-section of the drawing and, here, you see the library, with its sort of traditional benches, which you would rest the books on, and here is the Museum of Curiosities. However, these drawings I am showing you were actually proposals because we know from descriptions that this was not actually built. The arcade was abandoned because it was too wasteful of space on such a small site, and it was replaced on the ground floor by a consultation room and a waiting room next-door, the first instance that I know of of that most familiar of all features of a doctor’s surgery. These rooms, as far as we know, were built upstairs.

This building and its functions I think very much set the physicians apart from the barber-surgeons, whose anatomy theatre was little more than an extension of the entertainments of the City. This building and the physicians’ library was a research resource, a practical centre for consulting the sick. This was serious scholarly stuff.

The building was completed by 1652, but of course, within less than 20 years, it was completely destroyed by the Great Fire of London. Now, the Great Fire did have some advantages, and the principle advantages for the physicians were that it enabled them to commission a completely new College. 

Of all the buildings I think that were constructed after the Great Fire of London, I think the most important, in many, many ways, was the Bethlem Hospital for the Insane, built in 1674-76 and designed by Robert Hooke. Now, Hooke was appointed Curator of Experiments at the newly-founded Royal Society in 1662 and, like his very close friend and collaborator, Sir Christopher Wren, he turned to architecture. He was a very interesting choice for this very important public building, and I think his commission to build this hospital represented the triumph of a more scientific approach to healthcare than in previous medieval hospitals, where a good death and salvation were the best you could hope for. The Bethlem Hospital, as you see, was a palatial composition, 600 feet long but only one range deep – it is only one building deep, so that through-ventilation could be easily achieved. At each end were these wonderful pavilions, here, and in the centre, in this block, was the room for the governors and for the public, and the public could come in here and, through metal grills, could look down the long corridors on these two floors at the poor insane inmates ranting and raving, and the idea was that, having seen them, they would make a donation to the work of the hospital.

Before Hooke really started building this hugely influential commission, he was at work on another medical building, the College of Physicians, and this was in fact his first independent private commission, and he won it through his lectureship here at Gresham College. His lectureship had been sponsored by the millionaire financier Sir John Cutler. Cutler was fascinated by science and medicine and he settled the Gresham lectureship on the brilliant Hooke for life. Now, do not worry, there is no danger of any of us Gresham professors being treated the same, at least I do not think so, but Cutler was extremely generous. He had already paid for the rebuilding of the Grocers’ Hall after the Fire, and then he made an offer to the Royal College to build them an anatomy theatre, and they were to have one condition and that condition was to use Hooke as an architect.

Like so many City sights after the Great Fire, the footprint of the new building was a nightmare, a narrow street, a frontage onto the narrow street that was incredibly slim, and then a very, very deep plot that widened out at the rear. The model for Hooke’s first public building was still the traditional great house, but he created I think one of the most brilliant and interesting buildings created in the whole of the seventeenth century and I am just going to take you on a tour of it.

Here is a plan of Hooke’s building. This is the street, here. This is the gatehouse which you walked through and, like all buildings at the date, it was still very much planned on a great house, so here you have a great hall and the buildings elsewhere. But let us go out into the street; here is the street, the entranceway into the College. We are now going to walk through that archway, and you can see here that the gates and the carving, pediments, swags, and this is what you would have seen as you walked under the archway. Here is the College on the far side, with the steps leading up to it, more of these lovely swags, a niche here with Charles II in it, and here is the courtyard. Once you are in it, you can see this is where you would have come through, and the brilliance of the design was that the anatomy theatre was this structure here, sitting on top of the gatehouse. The other rooms for the College were in this building here, but you actually walked under the anatomy theatre when you came up to the College itself, and this building here contained the library, the consulting rooms, and other rooms that I will tell you about in just a moment. 

But looking back from the main rooms, this is the gatehouse, with the anatomy theatre sitting on top of it, lit by windows here, and here is a cross-section showing how the seats, incredibly steeply inside it, enabled you to watch the dissections in the middle, and how Hooke was very, very careful to make sure that the ventilation worked properly. Air was sucked in here and then came out through these louvres at the top. So, if you look at the top of his dome, you can see here this is all open work to create this magic circulation of air to keep the bad odours, the ill-humours, out.

So, it was quite a remarkable building. It was stylistically extremely original, it was functionally unique, and it was scientifically incredibly important in the way it tried to use the circulation of air to keep the rooms healthy. This dome was a great curiosity. There had not been a dome built anywhere in England before, and architects came literally from all over the country to look at this extraordinary piece of architecture. One of those architects was a man called Henry Bell who lived in King’s Lynn, and he came down specially from Norfolk to London to meet Hooke and to look at this, and went back to King’s Lynn and built his Market Cross there, with a dome based on Hooke’s scheme, and amazingly created the second dome of England in the wastes of north Norfolk.

The dome was not all, for the College was full of other innovations. This was one of the first buildings in England with sash windows. Before the 1660s, all windows were casements, and you can actually see that this range here has casements, little metal panes that opened like this, but of course, opening panes like that restricted the amount of light and air available and so Hooke introduced into his building some of the first sash windows in England. The very first ones were introduced into Charles II’s house at Newmarket, and you can see, here, they weren’t quite like our current ones but there were individual sliding panes. The whole bottom part did not slide, but you could open one side, and it was these that Hooke put into his new building.

He also was very keen to make sure that the basement that was under here was properly ventilated and there were special ventilation outlets around the building to enable the basement to be used for medical work, with this flow of air.

But this building itself was a practical medical machine. This is the Great Hall. You would have crossed the courtyard and you would have come into the Great Hall. This, effectively, was the waiting room. This was the consulting room, next-door, where you would have your bunions looked at or whatever your ailment might be, and on the other side of the Hall, there was a dining-room and a library for the physicians. Then there was this very grand staircase which led upstairs to the courtroom.

The courtroom, or Censor’s Room as it was known, had rather an amazing history. It was very much the thing of its age, as you can see, panelled with oak, lovely plasters, and it was designed by Hooke and installed in 1675. It was paid for by one of the physicians who made it a donation. The room’s most important function was the examining of applicants to be physicians by a senior physician, who was known as the censor. In fact, the man, Baldwin Hamey, who paid for this room, was in fact the censor at the time of the new College, and it was his job to interview the candidates with an oral viva to test them, and then, if they passed, give them a licence to practise. As you will see as we go on this evening, this room, remarkably, survives today, but you will have to wait for just a few minutes to find out how and why.

What we have to remember is that, although both this building and its functions may sound rather forward-looking, the College was, until the nineteenth century, essentially a craft guild. Its jurisdiction was confined to seven miles around the City and its activities were, in many respects, indistinguishable from the restrictive apprenticeship practices of the other livery companies, but by 1800, the livery companies were virtually an irrelevance, and the City was no longer a residential district. Since 1660, the most fashionable new residences had been built in Westminster, and the culmination of this process was the development of Regent’s Park and the construction of a route from Regent’s Park, down Regent Street, to Charing Cross, to link the new districts up here with the old residential districts founded after the Restoration down here. This work was undertaken, under the supervision of John Nash, in a series of stages from 1811 onwards, and the final stage, after George IV had abandoned his palace at Carlton House, which is a palace – here is Buckingham Palace – a palace he wanted to put down here, in what is now St James’ Park, was the laying out of Trafalgar Square. This is the area that became Trafalgar Square. Here are the routes that were planned. Here is St Martin-in-the-Fields. This was the Royal Mews, on the site of where the National Gallery was later to be. 

This square that became known as Trafalgar Square was, from the start, designed to be the home to a number of public buildings, and what I show you here is Nash’s first design, with a new building for the Royal Academy in the middle and two major public buildings in the Greek revival style either side of it. This one, on the left, was eventually to become the Royal College of Physicians.

However, the College was to share its building with the Union Club, and here you see the building that was eventually built. This is the part of the building that was occupied by the College, and this is the end that was occupied by the Union Club. Bizarrely, the College was built in stone, and the Union Club was built in stucco, so it is quite a strange-looking building. The Club, clearly, was the junior partner. 

So, the question I want to ask this evening is: how on earth did this professional body manoeuvre itself into one of the finest locations in the capital?

Well, the key to it all was the appointment of Harry Halford as President of the College in 1820, a post he retained until 1844. Halford was an energetic and determined character, and he was physician to four successive monarchs, George III, George IV, William IV and Queen Victoria, and he became a very close personal friend of George IV, who actually made him a baronet in 1809, and it was his connections and his smooth manners that lubricated the rusty cogs of the Crown Estate who granted the physicians the coveted ground which was to become Trafalgar Square. 

But Halford’s principal objective in moving the College was to make it fashionable, to attract gentlemen, and to raise the social and political status of the medical profession. This he saw as the future of medicine, and he opposed such new-fangled notions such as the physical examination of patients and he disliked innovations in the profession. The medical journal, the Lancet, said of him: “He is all tact and nothing else. He is ignorant of the modern discoveries in pathology and never employs the modern instruments of diagnosis. He has never written a line that is worthy of perusal on any scientific subject.” Pretty damning stuff, I would say!

So, the new College was essentially – and here it is, on the other side of Trafalgar Square – a gentlemen’s club. The juxtaposition of the Club and the College was thus not bizarre – it was in fact the whole point of the move. The new building had no laboratories. It had no anatomy theatre. The rooms, in fact, looked rather like St James’ Club. Here was the fine entrance hall, with a Greek Doric column screen on its staircase, and then, upstairs, there was a reception room, a library, a lecture room, all of which had this rather restrained Greek decoration. The rooms were open to lectures, and after the lectures, tea was served and the professions mingled with fashionable society. The architect, Sir Robert Smirke, had one or two little jokes, and this is one of the capitals, a composite capital for the library, which has the torch of life and a serpent in it, representing the god of medical art, but that was about as far as they went in terms of making the building specifically suitable for doctors.

However, I think the architectural choices made at this point were much more self-conscious than the choices that had been made after the Great Fire of London. Hooke was completely unknown as an architect, but, in 1822, the Physicians chose, as I have already said, Sir Robert Smirke. He was one of the most successful architects of his age. He was also one who had built a vast practice on political patronage. Essentially, he worked for the Tories and cleaned up on all the great public commissions for buildings in Central London - the Covent Garden Theatre, the Royal Mint, King’s College, the General Post Office, the British Museum, together with four St James’ Clubs. Smirke was the establishment architect, and it was this architectural establishment that the College was very keen to buy into, and Smirke more or less made the revival of Greek architecture the dominant style of building in London in the 1820s. It was an extremely chaste and structurally functionalist style, but of course it was a style that came right on the eve of the Gothic revival, a style that was very quickly reviled and despised by the likes of Ruskin and others.

I will just read you a section from “The Stones of Venice”, where Ruskin described the Greek revival style, and he was really referring to buildings like the Royal College of Surgeons, and I quote: “Utterly devoid of life, virtue, honourableness or power of doing good. It is base, unnatural, unfruitful, unenjoyable and impious, pagan in its origin, proud and unholy in its revival, paralysed in its old age, an architecture invented to make plagiarists of its architects, slaves of its workmen, and syberites of its inhabitants, an architecture in which intellect is idle, invention impossible, but in which all luxury is gratified and all insolence fortified.” Great!

I think there is something in that. I think it is difficult to engage in this building. But what it lacks I think in emotional engagement, it makes up in its urban presence, and here you see an aerial view. It is of course been altered by the time this view was taken place, but you can see it was a very, very imposing building and very much achieved what the Physicians wanted to achieve of establishing the profession in the centre of the City.

Well, the College opened its doors for business in 1825, but it was not until 1858 that its powers and duties were finally extended beyond London and finally covered the country as a whole. The College was not now just issuing licences to practise. Instead, its membership signified that you had qualifications that you have satisfactorily gained. 

If you remember, there was the room in the Hooke’s College in which the vivas took place before a licence was issued. This room, the Censor’s Room, was actually dismantled when the College left the City, and it was re-assembled by Smirke in the new building in Trafalgar Square, and here you see it. The room was slightly smaller, but it had this huge historical resonance as the place where generation upon generation of physicians had been licensed. When it was first installed in Trafalgar Square, the vivas still took place in here, but very soon, it was much more than a single viva that gave you license to practise. It was in fact an exam, and it was not just a few London doctors taking it. It was now a national qualification. So, the College was forced to agree, with the Royal College of Surgeons, a joint examining board for doctors in England, and it was decided that they would build a new premises for the examinations to take place in. 

So, on 24th March 1886, Queen Victoria, whom you see here, laid the foundation stone of a new building which was to be the examination hall of the Royal College of Surgeons and the Royal College of Physicians on Victoria Embankment. The building is still there today. It is known as Savoy Place and it is the home to the Institution of Electrical Engineers, but what you see is the building that was altered to make it look a bit more like a building that the engineers would occupy rather than doctors. So, what Charles Holden did in 1958 is strip off all the twiddly bits that the doctors had put on and created this very sort of chaste, austere, engineering-looking building which you see today. But that was the building that originally was built for the examination of all doctors in England before they were allowed to practise.

But even before this building was constructed, it was felt by the doctors that their building in Trafalgar Square was really too small, but it was not only size that bothered them because, after the War, they felt that the nature of medicine was changing, and more particularly, the relationship between doctors and the public was changing too.  The key moment came I think in 1962. This was the year that the College published its report called “Smoking and Health”, and it launched it at the College’s first ever press conference. For the first time ever, doctors had taken on the responsibility to speak directly to the public, and directly to the Government, on matters of personal health. The College originally published 5,000 copies of this report, but after it had been featured in a special edition of BBC’s Panorama, they had to reprint, and within a year, 33,000 Britons owned a copy of this document. So, for the first time, the profession was looking outwards, starting to try and fashion the environment in which they worked rather than simply reacting to it. The 1962 report was the first step toward the commonplace presentation of medical science to the public through the media.

It was Robert Platt, who was the President of the Royal College, who had promoted the idea of public medicine. In fact, here, you see him at the press conference for “Smoking and Health”. He saw that not only were the premises of the College in Trafalgar Square too small but they were wrong in every single way for an institution that the College wanted to become. His vision was not for an old boys’ club but for an outward-looking professional body that engaged and communicated with the public and the Government. The College looked for a new site, and it settled upon a bomb-damaged house in Regent’s Park, which they bought from the Crown Estate under the condition that anything they built there would harmonise with its surroundings.

Now, Platt knew the historian Sir John Summerson, who was then Curator of the Sir John Soane Museum – you see him there, sitting in the Museum – and he had written a book in 1946 on Georgian London. He asked Summerson to recommend some architects for this very, very sensitive site, set amongst the Nash terraces. Platt, no doubt encouraged by Summerson, wanted a modern building, and when the 44 year old Denys Lasdun sat in the old Censor’s Room in Trafalgar Square and he was asked whether he would like to design a building like the classical pile on the other side of the Square, Lasdun said no. He got the job.

Now, as you probably know, Lasdun is best known for building the National Theatre, famously once described by the heir to the throne as “an academy for the secret police”, but Lasdun, in my view, was in fact one of the best architects of the second half of the twentieth century. His aesthetic tastes were developed with some of the biggest names in modernist architecture in England, including Berthold Lubetkin, Wells Coates, and Maxwell Fry, but I think that Lasdun was much more original and powerful in many ways than the modernists he grew up with. He was fascinated with ancient architecture. He was deeply influenced by landscape and geology. He was an enthusiast for cities and a lover of rich texture. It was the new College of Physicians that made his career. It was his favourite building and, in my view, it was his best.

Platt’s vision and Lasdun’s brief was pretty terrifying because at its heart was a massive contradiction. Venerable colleges, with a hinterland of tradition, ceremonial archives and collections, are conservative and static bodies, and to marry such an institution with a radically new type of architecture was always going to be challenging, but Lasdun was the right man. His starting place was what the College did and what the College wanted to do, how it worked, what its daily, weekly, and annual requirements were.

In a lecture he gave very soon after finishing the building, he made the following incredibly revealing remarks, and I quote: “This is by no means a perfect building. That would be boring. In fact, it seems to me, looking at it, that it ceases to be a building with a capital “B”. It was more a piece of organisation, sensitised to its external context, and capable of growth and change. It is therefore an organism, in which the architect is primarily concerned with [routes], focal points, and enclosing fabric.”

Well, certainly, it is true that the building works beautifully. If you have not been there, I hope you will be inspired to go and have a look at it after this evening. It is organised around this central processional staircase, off which the various public and private functions are arranged, and off which also its incredible collections of portraits, artefacts, and manuscripts and books are also shown, and this still works extremely well today and is much loved by the College, but of course, it’s not loved by everyone because, although Lasdun believed that his building fitted in, or to use the planning condition’s words, “harmonised” with Regent’s Park terraces, many people feel that it is rather discordant. But Lasdun rightly saw Regent’s Park – and here you see the College juxtaposed with some of the buildings around it – as a piece of picturesque composition. John Nash’s terraces are not great architecture. They are actually quite badly built. John Nash’s genius was not the individual buildings themselves, it was the composition, and I think it can be said that if these are the grounds upon which you judge the College, it does indeed harmonise with its surroundings, and this is enormously helped by the fact that it is not built out of concrete. It is actually covered with these beautiful white tiles, which, unlike many buildings covered in white tiles, including the one that we are in now, has been beautifully maintained, and so, unlike the Museum of London, gleams in the sun and actually sort of glows and feels rather wonderful. 

Unfortunately, it has got this hideous rear elevation, a really brutal elevation, squeezed into these Georgian terraces on Albany Street, which was criticised at the time. But entering from the Park, it is a completely different experience. It has to be said, it is quite an odd-looking building. It has got this sort of spindly, three-legged portico at the front that seems to support the overhanging upper floors but sort of in the wrong place, but this is somehow…I think it is charm, it is wit even – I think it is quite a witty building, and if the pillars had been at the corners, I think the building would have been much diminished. They tell you where to get into the building, and from that moment, the building, completely unlike its regency predecessor, is all about facilitating access to the public. Close to the front door, when you come in, there was a lecture theatre, designed and located for access by the general public, and further in were these wonderful spaces which, as I say, you could display the College’s historic collections, and then upstairs was the Censor’s Room. Lasdun called the College’s traditions, collections, and this room, “the clobber of ancestral memories”, but it is in fact his understanding of the importance of “the clobber of ancestral memories” that makes this building so successful, and the re-erection of the Censor’s Room from the seventeenth century College – and here you see it in the room in Regent’s Park as it is today – was to become part of the theatre of the building, with the newly licensed physicians walking out and up the great staircase, passing the portraits of the great doctors and entering the library.

So, what is it that 500 years of the Royal College of Physicians can tell us in terms of architecture? The College has had an extraordinary, distinguished roll-call of architects working for it: Inigo Jones, John Webb, Hooke, Smirke, Lasdun. All these people were not only successful but they were innovative and creative architects. But what we see at each turn is architecture in the driving seat of reform, of re-casting the image of a profession, of establishing it on a different footing. Hooke’s building had begun in the scientific hothouse of the 1670s and 1680s, propelling medicine into a more scientific phase; Smirke’s building represented its transformation into a profession; and Lasdun’s into the modern, democratic world of the National Health Service. What I think is particularly interesting about these transformations is the self-conscious care with which the doctors thought about architecture as image as well as architecture as function. It would be so reassuring if doctors were now allowed to take a greater hand in the buildings of the NHS, which are, I am afraid to say, in general, of the most dismal and banal sort. Of course, money needs to be spent first on making people better, but people will get better faster if care is given to their environment. I’m not talking about hospitals tonight, but I hope what I have said shows that many in the architectural profession understand the relationship between mind, body, spirit and architecture, and that has been demonstrated, I think, with great skill, in three of the most interesting buildings to be built ever in London.

© Professor Simon Thurley, 2016