The Bulfinch Building, opened in 1821, was the original Massachusetts General Hospital structure. The building, located on a bank of the Charles River, was accessible by land and sea. This photograph, taken in the late 1850s, already shows evidence of hospital expansion. To the right is the old Harvard Medical School; to the left, the Bulfinch Building; and to the far left, “The Brick,” or “Foul” Ward, constructed to serve as the hospital’s isolation ward.