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Sufferers of comsumption or tuberculosis as it is now called for centuries were treated at home. Only after a German doctor isolated the tubercle bacillus did treatment begin in health facilities. Other German doctors proposed the closed institution on sanatorium approach. They proposed facilities that woukd expose patients to healthy diets along with fresh air and sunshine. TheGermans considered cold mountain air especially healthful. As a result, snatitoria were opened at Alpine sites in both southern Germny and neigboring Switzerland. Swiss sanitoria were especially popular because of the many beautiful mountain sites that were developed. Doctors in other countries followed the German/Swiss developments with inteest. Sanitorium were also opened in America, but rather than in the distant Western montains, the pristine area north of New York city with forests and lakes were developed. Similar sites were developed in Finland. Subsequently, desert sites in American Southwest with dry warm air became popular. We notice Canadian sanatorium in the western mountains, but most were built close to population centers. We do not notice many sanatoria in Britain. Rather suferers who could afford itcwentvto Switzerland. Sanatoria were opened in Russia and later the Soviet Union, but they did not have the focus on tuberculosis that the western sanatoria had.
American doctors followed developments in Europe. The Adirondack Cottage Sanitarium was at Saranac Lake, New York (1885). This was the first sanitorium in North America. Highh mountains like the Alps did not exist in the East. Thus the American sanitoria did not have the mountin locations and cold mountain air like the Swiss ones, but they did have fresh air and sunshine in forrested areas near pristine lakes north of New York City. This was the same cplace many summer camps were founded. Quite a nunmber if sanitoria were subsequently founded througout the United states. And with the settlement of the West, we see them in areas far from the northeastern cities where tuberculosis was a problem. We see them being founded in dry desert areas, about as far away from green and snowy Swiss mountains locations as one could imagine. These desert sanitoria, many located in Arizona, did offer clean air and plenty of sunshine. People often called 'lungers', but they attracted not only those sufferig from tuberculosis, but rheumatism, asthma and other dehibilitating diseases. Arizona became known for these sanitiri, and quite a range of facilities were opened Therec were exclusuve facilities for the wealthy as well as tent cities for the poor.
Colorado especially Colorado City, with its dry climate and mountains also became a popular site for sanitoria. Almost at the same time. At about the same time that sanitoria began to appear, Americans and Europeans began visiting seaside beaches. The advent of the railroads made it easy for holiday goers of even modest meanh to reach beach resorts. The sea air, sunshine, and beaches wre seen as healthful, At first in America this meant places like Coney Island or Atlantic City. And as Florida developed as a popular resort area, we see sanitoria being located there as well. Today the A.G. Holley Hospital in Lantana, Florida is the last remaining freestanding tuberculosis sanatorium in the United States.
At the time that German docyors founded the sanatria moven=ment, Austria was the center of the Austro-Hungarian Empire. And doctos throughout the Empire were ffected by developments in Germany. Thus quite a number of sanatoria adopting the German methods of fresh air and sunshine were opened throughout the Empire. Austria of course is an Alpine country and thus like Switzerland there were many ideal spots.
We do not have much infornmation on British sanatoria. Given the weather, Britain does not seen to be the best place for sanatoiria. Well to do people apparently went to sanatoria in Switzerland. The first British sanitorium we know of was thev Stannington Sanatorium opened in the North East of England to treat children who had contracted tuberculosis (1907). A local charity, the Poor Children's Holiday Association, collected money to fund the sanitorium. The Natioianl Children's Homes opened several sanatoria at about the saame time. It is now region's oldest children's charity--Children North East. With the advent of the National Health Service in Britain (1946), the Service funded a few patients for treatment in Switzerland. The politicians were keen, but the Hospitals who had to fund the patients were not! I read a Parliamentary debate where the local MP for Birmingham wanted to know why of 90 patients with the disease, only two were deemed suitable by the Hospital Doctors.
Sir William Gage helped found the National Sanatorium Association (NSA) to promote Canadian snitoria to treat tunberclosis. The first Canadian sanatorium was opened at Muskoka Lake, Ontario (1897). Ontario and neighbiring Quebec are the most populace Canadian provinces. The Muskoka facility was similar to the sanitoria being opened to the south in the United States rather than the mountain sites used in Switzerlad. The NSA opened two more sanatoriums in Ontario during the 1900s. The NSA did not suceed in founding many sanatoria in other province, but the work in Ontario brought the need forcsimilar facilities to the attention of authorities in other provinces. Eventually therecould be sanitoria located throughoutvthe country. Authorities open a small (eight bed) Highland View Sanatorium in Nova Scotia (1899) and replaced byy the 18 bed Kentville Sanatorium (1904). Sir William and the NSA opened the Toronto Free Hospital for Consumptive Poor (1904). Thec city donated used horse-drawn street-cars to the City for use as patient pavilions. Subsequent sanatora included: King Edward San in Tranquille, British Colombia (1907); Laurentian San in St. Agathe, Quebec (1908), Ninette San in Manitoba (1910); Jordan Memorial San at River Glade, New Brunswick (1913), Dalton San in Charlottetown (1915), Fort Qu�Appelle San in Saskatchewan (1917), St. Johns San in Newfoundland (1917), and Bowness San in Calgary (1920). Canada is a veryblarge country. There were mountains in the West that could emulate the Swiss sanatoria. Canadian authoritie, hweve, decided tht it was more imporant to have sanatoria near the population centers. And they could also benefit by being close to hospitals with medical supplies and doctors. Canada eventually built an extensive national network of sanitoria, many operated by provinicial/municipal authorities. As in other countries, the development of antibiotics meant that after World War II, these facilities began to close, but we see some operating into the 1970s.
Chile iuntoduced socialized medicine (1924). The government, however, did not have adequate revenue to adequately fund the system. About 10 sanatoria were eventually opened in the country. Some were apparently opened through Catholic charities. There were suitable siutes fir both mountain and seaside sanitoria. One was the Sanatorio Marítimo San Juan de Dios (Maritime Sanatorium St. John of God) which was founded in the seaside town of Viña del Mar by the Brothers Hospitallers of St. John of God (1929). The Catholic order was founded in Spain during 1572. Tuberculosis by the time of Woirld War II was Chile's moist serious health problem. The death rate was 400 per 100,000 patiens, compared to the American rate of 30 deaths.
France set up sanatoria as well as preventoria for treating children. The first sanatorium established in was along the coast at Beck to expose pstirmnts to sea air. It was not just for tuberculosis (1870). French doctors noted the work on tuberculosis in Germany and the success of sanatoiria in Switzerlanbd and America. A Medical Congregation in Paris determined that fresh air and sunshine could benefit ptients who had contracted tuberculosis (1893). As a result, sanatoria also began to open in France. One source estimates that an estimated 250 treament centers were opened in France (1893-1950). French schools had home keeping classes for schools. The girls were taught that children should be dressed to enjoy the maximum of fresh air and sunshine as long as they did not catch cold. Children were often sent to sanatoria and a unique medical facility established in France fior children--the preventoria. These were for children whoi had not yet contracted tuberculosis or other infectous diseases. Many parents also sent children to live with relatives in what was considered healthy country environments. Another facility created in France was the aerium center for children that were not sick, but would benefit from fresh air and sunshine. Many French city dwealers had grown up in the country and come to Paris and other cities for jobs. Thus may had parentys anf other relatives still living in rural areas. Sometimes these stays could be for extended periods. It seems that in many of the sanatoria, the concern was primarily clinical. The children involved now report tht there was little affection and separtion from thei parents was very painful. Sometimes if the family was well off, a parent might accompany a child placed in one of the sanatoria. This subject was treated in the classic French film, Le Souffle Au Coeur ("Mummer of the Heart").
Finland is a large norther country with a small population. Much of the country is an untouched environment. Quite a number of tuberculosis sanatoria were built throughout the country in forest areas and pristine lakes. The best known kjniwn was the Paimio Sanatorium opened in 1930 . It was designed by the renowned architect, Alvar Aalto. There were rooftop terraces where the patients would lie all day long on specially designed chairs, the famous Paimio Chair. .
It was a German doctor that finally identified the ccause of tuberculosis. Two other vGernman doctors initiated the closed institution/sanitoria concept of fresh air and sunshine to treat tiberculosis. Quite a number of sanitoria were founded, especially in montabeous areas of southern Germany and neighboring Switzerland. The sanitoria in Germany were operated by private individuals as well as charity groups. Most of the charity sanitoria were funded and operated by religious groups. After the NAZI take over (1933), Jewish sanitoria were seized by the state. And the NAZI welfare organization, the Nationalsozialistische Volkswohlfahrt (People's Welfare Organization--NSV) also gradually began taking control of facilities like sanitoria from the Christian religious groups. This was in part done by gaining control over charitable fund raising which had been dominted by religious groups. After this ws accomplished, only a small part of the donated funds were allocated to the religious groups. It was at NAZI-controlled sanatoria that much of the T-4 euthenasia killing of children was carried out, without informing the parents as to what ws being done. Surprisingly not many Jewish childrn were killed as part of the T-4 program. Most Jewish doctors by this time were no longer able to practice medicine nor were Jews allowed to use many healtcare services like sanitoria. During World War II, many German sanitoria were used for servicemnen recovering from war wounds.
Hungary until after World War I was a part of the Austro-Hungarian Empire and thus tied into the German speaking world and German academic system. As a result, sanatoria were opened in Hungary before the War. The country did not, however, have many of the ideal mountain sites that German-trained doctors wanted. Nor any warm seaside sites.
Doctors since Roman times have prescribed treating tuberculosis by moving to a warm temperate climate. As science developed, reaschers actually learned about the disease we begin to see sanatotia being opened (mid-19th century).
The earliest Italian efforts occurred at the turn of the 20th century. Italian and many other doctors were convinced that patients who had contracted pulmonary tuberculosis would benefit from a warm seaside climate and few countries had more potential sites than Italy with its extensive peinsukar seaside. One Itlaian academic, Biagio Castaldi. recommended the beneficial effects of mountain air and sunshine. He compiled dat showing a lower incidence of tuberculosis among people living in mountenous areas. Tis also gave some credence to the idea of a hereditary predisposition to TB. Several local committees (in Siena, Pisa, and Padua) were founded to deal with tuberculosis (1898). This lead to the founding of the Lega Italiana (Italian League) under the patronage of the King. This was the beginning of Italian state involvement in sanatoria. A pioneer in dedicated facilities to treatment tuberculosis was Edoardo Maragliano in Genoa (1896). This was followed by the first specialised hospital, with a capacity of 100 beds, in a non-mountainous area at Burdido (1900). Many doctors at the time subscribed to the idea of treating patients in the climatic environment to which they were accustomed. Facilities were opened throughout Italy (Bologna, Livorno, Rome, Turin and Venice). Mussolini's Fascist Government which seized power (1920s) took an interest in public health. They opened a large sanatorium for the treatment of working-class patients in Valtellina. Eugenio Morelli identified pine woods in Sortenna di Sondalo to be ideal for treating TB. World War I posed new challenges with men in the open in all clatic conditioms. the Italian Red Cross inaugurated the first military sanatorium at the'�Luigi Merello' maritime hospice in Bergeggi (SV) to treat soldiers affected by curable tuberculosis (December 1916). After the War, a new law ordered a 10-fold increase in funding for the construction of dispensaries and sanatoria (1919). The Provincial Anti-tuberculosis Committees were transformed into Consortiums of municipal and provincial authorities and anti-TB associations as part of an en effort to coordinate a national effort (1920s). Gradually the major effort to massist World War I veterans shifted to the civilian population. The Fascist Government ordered an Anti-tuberculosis Consortium be established in every province (1927).
Not all sanatoria were above ground. Some were underground in old salt mine workings. These were vast caves in which there were statues made out of salt. It was the salt which was supposed to have healing propertirs. This woulkd presumably be similkar to sanatiria located along the seacoast to epose ptients to sea air. We only know of one facility in Poland.
The Heliantia Sanatorium ws opened in Valadares (1930s). It specialize in the treatment of bone tuberculosis through the 1960s.
We are not sure to what extent sanatoria were founded in Russia during the Tsarist era. WEnote the American Red Cross establishing a sanatorum in Kiev (1920) which was briefly occupied by the Polish Army during the Soviet Polish War (1919-21). This focused on tuburculosis, but nutrition was also ma serious pronlem because of the faamine devloping in the Soviet Union. It can not be called a t Soivient san, but it did occur in the Ukraine which ultimately was part of the Soviet Union. As a result some Anerucan food got into the Soviet Union, but it was not until the dfolowingh yearb (1921) that the Soviet Government perrmit klarge-scale American food relief. During the Soviet era, 'sanatorium' was used to describe a spa-like resort during the pre-War era in western Europe. It was a kind of resort/recreational facility with a with a health image. They might provide medical care for short-term rest and care. Soviet sanatoria did not have the strong association with tuberculosis.
Some authors have described Switzerland as a health paradise because of all the sanatoria that were built there. Many sanatoria after the pioneering work by German doctors were opened in Switzerland. There was from the beginning strong connections with Germany and the Germam medical establishment. Switzerland bordered Germay and easily accessible by German patients. German doctors believed that clean, cold mountain air was the best treatment for tuberculosis and other lung diseases. We notice French-speaking Swiss dictors also opening sanatoria. Sanatoria were opened by both government agencies anbd private individuals. Authors describe a golden age during the first hlf of the 20th century. No country had the sane reputation for health that Switzerlad developed. Actually it did nit even begin with sanatoria movement, but the 18th century Enlightenment. Jean-Jacques Rousseau and Albrecht von Haller both championed the Alps as a healthy place of well-being. The small Swiss population was not large enough to support all these sanitoria. Germany was, however, a very populace country and many Germans sought treatment in the Swiss sanitoria. A HBC contributor tells us about growing up in a small Swiss village where his father ran a sanatorium. Swiss sanatoria developed a very strong health reputations. Not only Germans, but people from mauy other countries came to Switzerland for treatment. At any given time there were thousands of foreign patients in Swiss sanatoria. Some of the santoria were luxurious and frequented by wealkthy patients, but there were moderately priced sanatoria as well. Thecregome at the various sanatoria varied. All emphasized fresh air, sunshine, and a healthy diet. The actual diet varied, but often emphasized dresh fruit and vegetables--often served raw.
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