History:
During the 18th century, there was some speculation as to whether the hospital environment could contribute to cure and several doctors proposed reforms for the design and management of hospitals. Amongst the most influential were John Aitken whose 'Thoughts on hospitals' was published in 1771 and in France, Tenon whose 'Memoires sur les hopitaux de Paris' was published in 1788. Sir John Pringle had written about the effects of different environments on patients from observations of soldiers being nursed in field hospitals and conventional buildings. All three proposed that ventilation helped with recovery by minimising the accumulation of foul air and this led them to propose that wards should be designed with cross ventilation and smaller wards to be able to segregate patients with different illnesses.
Plymouth was visited by Jacques Tenon and Charles Augustin Coulomb in 1787. They were representing the French Royal Commission set up to look at foreign hospitals, who reported that ' in not one of the hospitals of France and England, we would say in the whole of Europe, except Plymouth hospital are the individual buildings destined to receive patients as well ventilated and as completely isolated.' Ref Richardson H (ed) 1998 p 81.
Whist there is some uncertainty about whether the design was organised according to these principles, the hospital design does interpret the theory in its physical form. The wards blocks are separately organised around the courtyard allowing free circulation of air although the wards themselves lacked cross ventilation and were not therefore not a model for the pavilion plan.

Architecture:
The hospital was built in 1758-62 to plans by Alexander Rovehead comprising a courtyard surrounded by detached blocks. Ten rectangular ward blocks each of which were three storeys high, house twenty beds on each floor separated by a spine wall. These include wcs and nurses rooms. There were four single storey blocks for kitchens and support rooms.
Access to the hospital was by boat and the whole complex was enclosed by railings to deter patients from absconding.
The main entrance was through the administration block defined by a clock tower and lantern. This contained offices and a surgery, laboratory and dispensary, chapel and committee room, recovery wards and some nurses accommodation.