Even though hospitals remained low-rise structures well into the twentieth century, given the vulnerable condition of the bedridden patients a fire in a hospital could prove catastrophic. The innovative hospital design of the Mary Hitchcock Memorial Hospital of Dartmouth, NH, designed by Architects Rand & Taylor, was a product of its fireproof construction.
In order to create the large open space required by wards, the designers used a vaulted masonry structure–the ‘cohesive system’ of tile domes made famous by Carl Guastavino and used in many public structures. Brick, tiles, marble and non-absorptive materials made up the bulk of the building materials not only in the domed wards but throughout the building. The only wood used was for baseboards, door and window trim, and for pine floors (which were non-structural and laid on a masonry underfloor).The centralized space created by the fireproof dome dovetailed nicely with contemporary interest in centralized ward layouts as the most efficient for controlling ventilation flow within the ward. The vaulted structure also created smooth, impervious building surfaces that facilitated air flow and simplified cleaning.
The surgical amphitheater was also a vaulted structure, providing a large open space that focused attention on the field of operation for the students in the medical college.
Plan taken from Henry Burdett, Hospitals and Asylums, 1893, portfolio, p. 11; section from Hammond, Treatise on Hospitals and Asylums, 1891, p. 157. See also Edward Cowles, “The Mary Hitchcock Memorial Hospital,” American Architect and Building News, 10 Aug 1895.