In the history of medicine, hospitals are usually seen as passive reflections of advances in medical knowledge and technology. In Medicine by Design, Annmarie Adams challenges these assumptions, examining how hospital design influenced the development of twentieth-century medicine and demonstrating the importance of these specialized buildings in the history of architecture.

At the center of this work is Montreal’s landmark Royal Victoria Hospital, built in 1893. Drawing on a wide range of visual and textual sources, Adams uses the “Royal Vic”—along with other hospitals built or modified over the next fifty years—to explore critical issues in architecture and medicine: the role of gender and class in both fields, the transformation of patients into consumers, the introduction of new medical concepts and technologies, and the use of domestic architecture and regionally inspired imagery to soften the jarring impact of high-tech medicine.

Identifying the roles played by architects in medical history and those played by patients, doctors, nurses, and other medical professionals in the design of hospitals, Adams also links architectural spaces to everyday hospital activities, from meal preparation to the ways in which patients entered the hospital and awaited treatment.

Methodologically and conceptually innovative, Medicine by Design makes a significant contribution to the histories of both architectural and medical practices in the twentieth century.