Horse Ambulances

Horse Ambulance 1908. Horse-drawn ambulance in front of the Q.A.T.B. Hospital.

Written by Kevin Langley, with Cole Dutton

Among the most mutualistic human to animal relationship has been with the horse. Horses, unlike many other animals, are large, powerful, and were easily domesticated. Due to these features, horses were heavily used in wars and agriculture. Before the invention of the automobile, horses were a major form of transportation, in the country and in the city. In urban environments, “horses were depended upon [due to] their ability to pull heavy weights” (Atkins, ed., 2012). This led to horses being used by police and fire departments for carrying people and pulling material (Police ambulances).

Between the late 1800s and early 1900s, London and the areas surrounding it were starting to expand and become more urbanized, but there were still plenty of people living in the rural communities. Healthcare was a big deal as many sicknesses that can be easily cured now were quite contagious and deadly, especially without immediate treatment. This was a pressing issue for those living outside the center of the city. In the 1890s, London and many towns surrounding it started using horse-drawn ambulances.

However, these ambulances were not to be used for every emergency. Many boroughs put restrictions on when to use these ambulances. For example, the MOH from Whitechapel indicated in 1876 that, “if the ambulance be intended only for journeys of not more than a mile, it may be made so as to be carried between two people; or it may be on wheels to be drawn by a horse. If the distance be above a mile, the ambulance should be drawn by a horse” (Whitechapel 1876). Horses were also used to transport doctors to patients. Doctors “needed strong and fast horses that could travel long distances, but could also draw up to the patient’s door with style” (Velten, 2013).

The horse ambulance helped quickly improve healthcare delivery as patients with sicknesses were no longer waiting long periods of time before they could be brought into the hospital or before a physician could see them at their home.The London County Council reported in 1901 on the advantages of horse-drawn ambulances:

The following extracts from the Annual Report for 1899 of the St. John Ambulance Association as regards horse ambulance services are of interest.
At Birkenhead where the horse ambulance is worked by the fire brigade, the men are all certificated by the St. John Ambulance Association. The superintendent reports that the ambulance has received 433 calls in 1899, all of which have been responded to, being an increase of 43 calls” compared with the year 1898. The distance travelled was 1,304 miles, or an average of three miles per journey, and the work is still increasing owing to the public recognising the advantages of obtaining the service of the horse ambulance when accidents occur. At Halifax the horse ambulance has been out 198 times, and travelled 620 miles in 1899, and one of the leading surgeons informs me, ‘I don’t know what we should do without it at the infirmary.’ (London County Council 1901).

As previously mentioned, the horse ambulance was not used for all emergencies and was actually only applied to cases with very infectious disease. London had “horse-drawn ambulances after the 1880s, but they were attached to the London hospitals and were mainly used for transporting patients with infectious diseases” (Velten, 2013).  Police and fire departments looking to use the horse ambulances had to apply the same way as any other resident of the district as if it were for an infectious disease (Kensington 1906).

Some of the first ambulances brought in by a town was a horsed conveyance containing stretchers for two patients lying down and a seat for the attendants who accompanied them (London County Council 1949). These were definitely an upgrade to carrying on foot but it was not necessarily the most comfortable ride to the hospital. Nevertheless, it provided a much quicker option for those in dire need. The average distance per journey of an ambulance was, “three miles per journey, and the work is still increasing owing to the public recognizing the advantages of obtaining the service of the horse ambulance when accidents occur,” (London County Council 1901).

However, as cities grew more traffic, more people, and more animals like dogs, soon became a problem for the horses. As the streets became more congested with traffic, horses became more antsy and “the unpredictability of horses, and the noises and sights that they were subjected to in the streets, made them a danger to pedestrians” (Velten, 2013). This was a problem but it was not too much longer before one of the first steam ambulances were invented and used.

In 1902, a steam ambulance was first tried out carrying eight stretchers and attaining a speed of five miles an hour (London County Council 1949). This was a major step in what would be the future of the ambulance system. Five miles an hour is not fast at all, but it was a safer option in the fast modernization of the cities. From 1904, when a motor ambulance was introduced, horse ambulances were declining in use until they were completely abandoned by hospitals as the sole provider of transportation. (London County Council 1949). However, before their abandonment many hospitals had both a motor ambulance and a horse ambulance for infectious cases and non-infectious cases. Two horse ambulances were provided for the removal of cases of infectious disease, one for patients suffering from tuberculosis, and one for other cases of infectious disease. For non-infectious and accident cases a motor-ambulance was provided. It was primarily intended for use in cases of accidents (Barnes 1922). As the usage of automobiles increased, many hospitals started to use the motor ambulance more often even for infectious disease and used the horse ambulance as a backup incase there was a problem with the vehicle (Edmonton 1921).

Conversely, the motor-ambulance was not free and charged by the distance and could be accessed by anyone living in the district of the hospital (Leyton 1923). Since many hospitals kept both motor and horse ambulances, proper care had to be ensured. “Horse and vehicle were an animal-machine collective that also required a human driver and all of the connections that kept the horse fed and the vehicle maintained” (Atkins, 2012). Horse ambulances were usually kept at the council’s disinfecting station were they were cleaned and made ready for the next journey (Finchley 1925).

Eventually, the number of motor ambulances used started beating out horse ambulances. In 1914 in the borough of Croydon when the first motor ambulance was introduced to the city, 738 journeys were still made by the horse ambulance compared to just 225 by that of the motor ambulance (Croydon 1914). By 1920 the number of journeys of motor ambulance had quadrupled the journeys of horse ambulances with motor ambulances at 355 journeys per year compared to horse ambulances at a mere 88 journeys per year (Edmonton 1920). As the usage of horses were completely coming to an end one last person’s journal noted that “it was a day that marked the end of the once familiar sight of urchins pursuing the slow-moving vehicles shouting ‘Fever!’” (Velten, 2013).

St. Arnaud’s Horse drawn ambulance

Although the motor ambulances began to quickly phase out the horse-drawn ambulances in the 1920s, because the reliability and cost effectiveness that horse ambulances provided, were still extremely beneficial to aid soldiers on the battlefront in WWI. Most of these horse ambulances were specialized for the battlefield. There were many different models of carriages ranging from mark one to mark six, which adapted to accommodate two to three stretchers and up to six walking-wounded passengers. This allowed field doctors to administer first aid to patients who would otherwise bleed out without immediate attention. Horse ambulances soon became a necessity for quick transport from the battlefield in WWI for higher-ranking officials that were injured in battle as well, (Medical History of WWI).

L0023337 Horse ambulance at Ypres, World War I
Horse ambulance at Ypres, World War I Credit: Wellcome Library,.

Because of the vast need for these ambulances during the war, horses were subject to harsh living conditions and on occasions become a part of the problem of spreading diseases amongst individuals; “These horses, often badly fed and overworked, and so offering little resistance to infection, are still liable to constitute a serious source of infection, both to other horses and to man,” (London County Council 1912). This differed from the horse ambulances used around urban cities at the turn of the century that were cared for and attended to regularly.

The city of London, England, established a set of rules to which each ambulance and its crew were to follow. The rules state to which type of care would be treated by the hospital as well as the order of operations that must be completed by the crew before the patient could be registered into the hospital. “The Drivers of the Board’s Ambulances are not allowed to loiter on their journeys or to stop for refreshments on pain of instant dismissal. It is particularly requested that any breach of this regulation, or any neglect or incivility on the part of the Drivers, Nurses or Attendants may be immediately reported to the undersigned,” (City of London 1894). This quote provides the evidence of how the city would tolerate ill-advised actions of the crew, as they were held to such a high standard. Other requirements specifically stated

As one can see, with the ever-increasing demand for medical ambulances, the motor ambulances soon took over horse-powered ambulances. Soon after Henry Ford’s invention of the assembly line in 1914, the cost and maintenance of motorized ambulances began to fall dramatically making horse use unnecessary for ambulances.


Report on the sanitary condition of the City of London for the year 1894

Report of the Medical Officer of Health for London County Council

London County Council 1912

London County Council 1921

City of London 1889

City of London 1894 (P. 27-29)

Evolution of the Ambulance

London County Council 1901

Edmonton 1921

London County Council 1949

Finchley 1925

Kensington 1906

Barnes 1922

Croydon 1914

Edmonton 1920

Leyton 1923

Whitechapel 1876

Police ambulances

Atkins, Peter, ed. Animal cities: Beastly urban histories. Routledge, 2016. 11-12, 183-186.

Sullivan, Dick. “The Long Drag.” The Victorian Web, April 21, 2006.

Velten, Hannah. Beastly London: A History of Animals in the City. Reaktion Books, 2013. 59-60, 43-45.