To Live Again: Tuberculosis and the rise of sanatoriums in America
The ancient Greeks called it consumption. Later it also became known as the wasting disease. For 3,000 years it had afflicted people around the world. Symptoms included a bloody cough and extreme fatigue. With no known cure, it was a death knell to those who were diagnosed with it. “Galloping consumption” would enter the bloodstream and the person would die quickly. For others, they experienced a long slow decline of ten, twenty, even thirty years.
In the early 1800s, it hit America.
At the time, physicians thought the disease was hereditary, either you were born to have it or not. There was hardly a family that was not somehow touched by the disease in one way or another. (That was true for my own family. My dad’s father lost his first wife to consumption, leaving him alone with two boys under the age of four.) Eventually doctors saw that some consumptives were helped when they left the confines of crowded cities and relocated to areas where they had fresh air and outdoor living. For some it changed the course of the disease. Starting in the 1840s, many headed west of the Mississippi, as far as California to live primitive lives in the wilderness.
When the railroads connected the far west with the rest of the country in the 1870s, towns in the west began to advertise for consumptives to travel there to regain their health. Soon, tens of thousands of health seekers traveled to Colorado and California. But problems arose. The consumptives were not strong enough to labor and contribute to the towns. They needed to be taken care of and ended up in hospitals or crammed together in cramped, makeshift living quarters, mirroring the lives they’d left behind.
Edward Trudeau, a young physician from New York City, had watched his brother die of consumption within three months of diagnosis while in his teens. In 1873, at age twenty-five, Trudeau too was diagnosed with consumption. Discouraged and assuming he would soon die he followed the conventional thinking of seeking a change of climate. He went to live in the Adirondacks, spending as much time as possible in the fresh mountain air. Instead of getting worse, his health improved. He returned to New York for a time but his symptoms increased and his condition deteriorated. In 1876, he moved to Saranac Lake in the Adirondacks for the winter and set up a small medical practice.
In 1882, a German physician and scientist named Robert Koch came up with the radical idea that germs cause diseases. He isolated mycobacterium tuberculosis, the bacteria that causes tuberculosis. He explained that tuberculosis was highly contagious and spread by coughs, sneezing, and spittle. His research was ignored by other physicians. Trudeau however believed him and he began testing diseased blood. He also began writing papers and submitting them to medical journals. (It wasn’t until the mid-1890s when the medical community was finally persuaded of the ideas of germs and contagion. The name consumption was dropped, replaced by tuberculosis. Within a decade, Koch won a Nobel prize for his work.)
Also in 1882, Trudeau read of a Prussian doctor named Brehmer and his success in treating consumption with a rest cure in cold, clear mountain air. He studied other sanatoriums in Europe and in 1885 founded the Adirondack Cottage Sanatorium. His work started a movement. Hundreds of other sanatoriums sprang up across the country.
One of these was the Agnes Memorial Sanatorium in Denver, Colorado.
In 1902, Lawrence C. Phipps determined to construct a sanatorium in memory of his mother Agnes McCall Phipps who died of pulmonary consumption in 1884. The sanatorium opened in 1904 and cared for patients until 1932. Lawrence Phipps desired that the sanatorium be top-notch so he enlisted the help of physicians he had selected for a Medical Board to give details and requirements to make it so. The institution was planned to give patients the best care – outdoor living, physical quiet, a nourishing diet, and quality medical oversight. The sanatorium was also educational, teaching patients how to take care of themselves when their condition improved enough that they could leave.
There were originally five buildings: an administration house, two pavilions to house up to eighty patients, a medical building, and a power and laundry plant. The patient pavilions were planned and constructed so as to give every room direct sunlight every day of the year. Each pavilion was surrounded by verandas which provided sunlight in the winter and shade in the summer. Patients spent most of their time in reclining chairs on the verandas. This was true of all sanatoriums. In fact, when patients first entered, they were on twenty-four hour bed rest. As their health improved they were allowed to be up and about for longer periods of time – but rest was vital for their treatment, rest in the open air. The verandas at Agnes Memorial provided free circulation of air and an abundance of natural light. They served as piazzas during the day and sleeping quarters at night. Canvas partitions were fastened to the wall between each two rooms, dividing the veranda into 12 x 9 foot porches, one for each room. This gave patients their privacy. Beds were rolled out to the porch at night and if for some reason the patient needed to stay in bed for a longer period of time, the partitions could remain.
The bedrooms actually served more as a comfortable dressing room, since patients did not generally sleep in them. The bedroom furniture was simple: an enamel rolling bed, an enamel washstand, a dresser, a small table, and a chair. Floors were bare except for a small rug at the bedside.
Apart from extremely severe winter weather, patients slept out on the veranda year-round. During the day there were also sitting rooms available – again with plenty of circulating air and natural light.
Agnes Memorial Sanatorium is the one I chose for Mama to be admitted to in my historical fiction novel Love, Mary Elisabeth.
Mary Elisabeth and her parents lived in Seattle but after Mama’s diagnosis and journey to Denver, Mary Elisabeth travels to Northeast Washington, north of Spokane, to live on her uncle’s farm.Though there were sanatoriums in both Seattle and Spokane which were no doubt fine institutions, for the sake of my story line I chose Denver. I wrote that Mama’s doctor felt Agnes Memorial was the best place for her treatment and the family was willing to endure difficult sacrifices in order to make her stay there happen.
In Edward Trudeau’s journals, he stated that only about one third of his patients regained their health. I could find no records showing the percentages of recovery for patients at Agnes Memorial Sanatorium. When Trudeau died in 1915 after having had tuberculosis for forty years, a miracle cure still did not exist.
It wasn’t until the 1940s that scientists discovered a compound to treat tuberculosis. They called it streptomycin. Tested on patients, doctors saw miraculous results. Across the nation people were being cured of tuberculosis. There was a setback though. Many patients relapsed after several months. Doctors realized that not all of the bacteria had been killed and those that survived became drug resistant. Scientists set to work again and came up with a cocktail of three strands of streptomycin to treat the initial tuberculosis bacteria and any that had become drug resistant. This new drug exhibited a much higher rate of recovery. By 1950, most tuberculosis patients were getting well and leading normal lives. As cures mounted, sanatoriums began to close.
In the 1980s, there was a spike in tuberculosis as a result of the AIDS epidemic and more drug-resistant bacteria, requiring months of treatment. There are still many, many cases worldwide – particularly in third world countries. But, thankfully, tuberculosis in the United States is uncommon.
Years after my dad’s father remarried and had more children, he had a bout with TB. He spent a couple of months in a sanatorium and when he returned home the family built a screened-in sleeping porch for him. In his 80’s he was devastated to learn he had tested positive to TB again. However it was unclear if it was active or perhaps, because he’d had it before, dormant bacteria remained in his system. He lived to be 96 years old, though!
(Photograph by Anja)
The age of sanatoriums is long past, living on in the memories of patients and their families and in old black and white or sepia photographs.
The stories of that bygone era, bringing help and hope in the midst of a disease that once brought such devastation and heartbreak, endure in the pages of history.
Photos of Agnes Memorial Sanatorium from the Western History and Genealogical Departments, Denver Public Library. Used by permission.
Much of the information on tuberculosis and sanatoriums is from a heartbreaking but fascinating DVD by PBS called The Forgotten Plague – Tuberculosis in America.
Love, Mary Elisabeth
Eleven-year-old Mary Elisabeth’s life will never be the same. It’s 1924 and her mother has contracted tuberculosis – a deadly, terrifying disease.
Far away in Colorado, a sanatorium holds the only hope of saving her. Papa takes a grueling job at the shipyards in Bremerton to pay for her treatment. Mary Elisabeth must travel 350 miles from home to begin a new life on her uncle’s farm in northeast Washington.
Her only connection to her parents is by letter. Will that be enough to give her courage to brave the challenges that await?
More info →
