type^226 , and as such was less dependent on established models.^227 On a more gener-
alised level, Finnish hospital design developed to the international level in the 1930s.
Besides Paimio Sanatorium, the Women’s Hospital designed by Jussi Paatela^228 was
held up as a model of hospital design, both in Finland and internationally.^229
Paimio Sanatorium, like other modern 1930s hospitals, made use of medical
technology such as the x-ray equipment used for mass screening of patients, oper-
ating theatres with instruments and the equipment needed for phototherapy. This
study does not, however, deal with the development of medical science, technology
or treatment methods.^230 In the 1930s in Finland, despite equipment, the treatment
of tuberculosis was mainly based on improvement of the patient’s general physical
condition and on making the patients lie in large open-air wards for several hours
a day.^231 In Finnish legislation, hospital buildings were considered to be medical
instruments, as the Act on State Aid which came into force in 1930 laid down many
of the physical features applying to sanatorium buildings.^232 Adrian Forty has argued
that the change in the hospital type^233 cannot be explained by scientific development
alone, and that changes in the typology of hospital buildings reflect the ambition of
physicians to exercise power.^234 The research of Stephen Verderber and David J. Fine
Healthcare Architecture in an Era of Radical Transformation deals with huge hospital
complexes of the late 20th century as social, technological and architectural entities.
They divided the historical development of hospitals into six waves. Juxtaposed to
their classification Paimio Sanatorium resembles the “Minimalist Megahospital”,
which became common only in the decades following World War II. The researchers
characterised this type of Modernist hospitals as perfect architectural expressions
of high-tech medicine, which were reduced to their structural essence and became
sheer containers of volumetric machines to be healed. The hospital became more
specialised and there were zones for different functions. The hospital grew in size
226 The sanatorium as a building type existed for about half a century until the 1960s in Sweden and the 1970s in
Finland. Åman 1976, p. 269; Pesonen 1980, passim, especially p. 479.
227 In the 1920s, architecturally new types of institutions had been developed in Europe, such as the Zonnestraal
Sanatorium, with its freely orientated wings but still part of an entirely symmetrical composition, designed by
B. Bivojet and J. Duicker and the Weiblingen Sanatorium, a terraced building, designed by R. Döcker, which
had become known to the architects participating in the open architectural competition for Paimio Sanatorium
through publications, exhibitions and visits, and from which they had drawn influences. Heinonen 1986, p. 237
and pp. 239–240.
228 Architect Jussi Paatela worked as a specialist with the Hospital Department of the State Medical Board during the
planning of Paimio Sanatorium. Henttonen 2009, pp. 141–148.
229 Henttonen 2009, p. 320.
230 Medical treatment methods included pneumothorax treatment, thoracoplasty (plastic surgery of the thorax) sev-
ering of the phrenic nerve and oleothorax treatment. Forsius 2000a.
231 Forsius 2000a.
232 In addition to the plan for establishing a sanatorium, a description of the location, site and intended buildings of
the institution and a site plan showing the organisation of the buildings in relation to one another, the drawings
of the hospital buildings proper, showing floor plans and height of rooms, the number of beds to be placed in the
various wards, the structure of windows, lighting, heating and ventilation equipment and cost calculations, were
to be appended to the application for state aid for the costs of establishment. Asetus valtionavusta 270/1929,
pykälä 3. (Decree on State Aid 270 /1929, Section 3).
233 The hospital type changed in the 18th century from a manor-like castle to a pavilion-type hospital and then to a
block-type hospital building in the 20th century. Forty 1984, p. 61.
234 Forty 1984, pp. 61–93.