chapter  8
Cities Within Cities
Early hospital foundations and urban space
ByPeregrine Horden
Pages 17

This prospect, or bird’s-eye-view print, of St Thomas’s Hospital, London, was engraved in the eighteenth century. 1 A medieval foundation, the hospital had survived the English Reformation and had escaped the Great Fire of London. Yet by the closing decade of the seventeenth century it had become dilapidated and was seen as unfit for purpose. Supported by voluntary subscription, its governors paid for it to be refurbished and enlarged, to consist of three quadrangles and a number of subordinate buildings. ‘Prospect’ prints of this sort were circulated in the eighteenth century to attract benefactions to public projects. 2 Some were notably successful. The greatest benefactor of St Thomas’s was Sir Robert Clayton. 3 The governors acknowledged and proclaimed his outstanding generosity by erecting a statue to him inside the hospital. In the version of the prospect illustrated, published in 1756 in Maitland’s Survey of London, the statue is visible in the quadrangle most distant from the viewer. The hospital, with its large connected courts, appears to drive a wedge through the capital’s topography towards the distant horizon. No building round about seems to rival it in spaciousness. Its elegant architecture contrasts with the cramped zigzags of roofs everywhere else in view. And, in the middle distance on the central axis, stands the statue of its great benefactor, virtually its second founder. Did he hope for a statue or some such memorial when he transferred the funds that helped make all this possible? As Bernard Mandeville wrote in The Fable of the Bees in 1714, not long after Clayton would have earned his memorial, ‘pride and vanity have built more hospitals than all the Virtues together’. 4 Clayton’s wealth had refashioned not only the hospital but the entire landscape of this part of London (Southwark). Consider the likely number of patients housed around those three quadrangles, the staff needed to attend them, and the ramifications of an establishment on this apparent scale for the local movement of goods and people. Especially if we see St Thomas’s through the eye of the engraver, who has magnified it, and heightened the contrast with its surrounding buildings, it is easy to envisage this hospital as a city within a city.