What is tuberculosis?
Tuberculosis, commonly referred to as TB, is as old as civilization. In 460 B.C. Hippocrates identified “phthisis” as the most prevalent disease of his time. Tuberculosis is contagious, spread primarily through the air via phlegm or sputum during a cough or sneeze. Its underlying cause is a rod-shaped bacillus, Mycobacterium tuberculosis.
Our bodies encapsulate the bacillus in a firm nodule called a tubercle so the germs cannot multiply elsewhere. If that process is completed, a person is considered to have arrested tuberculosis and is not contagious. If immunity is compromised by overwork, poor nutrition, or other illnesses, bacteria can breech the capsule walls, and the disease is once again active.
If tuberculosis is in the lungs, the most frequent location, it is known as pulmonary TB. Because the lungs have no sensory nerve fibers to cause pain, the disease can be far advanced before diagnosis. Pulmonary TB was commonly called consumption for its tendency to slowly consume its victims, who would lose weight, become pale, and waste away. Some forms acted more quickly and were described as “galloping consumption.” The sufferers’ pallor led to a popular description, “the white plague.”
The disease can affect any part of the body, however. It can be in the brain and any of the inner organs such as stomach and kidneys, as well as the spine, knee, hip, etc. About the only parts of the body that the tubercle bacillus can’t infect are hair and nails. Tuberculosis is not always fatal. Mortality records kept in the years before the advent of antibiotics and chemotherapy vary considerably in reliability, but they indicate that 50 to 60 percent of people affected by TB would survive.
Were sanatoriums effective?
The greatest benefit that sanatoriums offered in Minnesota was the removal of contagious individuals from the community. The peak year for deaths from all forms of tuberculosis in Minnesota was 1918, when 2,543 people died. That was a death rate of 109.4 per 100,000 population when the state's population was 2,324,842. By 1918, all fourteen county sanatoriums had opened, in addition to the state sanatorium and two private institutions. Ten years later, 1,462 people died from tuberculosis in Minnesota, a death rate of 57.8 per 100,000. That significant drop, even though the population increased by 200,000 people, accompanied a decreased infection rate.
In addition, several relatively new surgical techniques were implemented at the larger sanatoriums. Pneumotheraphy, the artificial collapse of a lung, forced the lung into a resting state. Thoracoplasties removed ribs on the affected side of the chest and collapsed both the lung and the chest wall. Heliotherapy, which involved intensive and regulated exposure to the sun, was a non-surgical treatment that was effective on forms of bone tuberculosis. Combined with isolation, these interventions saved lives within sanatoriums and in the communities even before the advent of streptomycin and other chemotherapy.
AUTHOR
This website was created by Mary Krugerud as part of a project funded by a Legacy Research Fellowship awarded to her in 2015 by the Minnesota Historical Society. Mary Krugerud is an independent researcher and historian. She is the author of Interrupted Lives: The History of Tuberculosis in Minnesota and Glen Lake Sanatorium (2017, North Star Press, St. Cloud MN) and The Girl in Building C: The True Story of a Teenage Tuberculosis Patient (2018, Minnesota Historical Society Press, St. Paul). Articles about tuberculosis and sanatoriums are published in her blog, eMKaywrites. She is also co-author of Lac qui Parle County: 150 Years of History, Volumes 1 & 2. (2020 and 2021, available from the Lac qui Parle County Historical Society, Minnesota).
Sanatorium or Sanitarium?
In the 1800s, most institutions concerned with mental or physical health were known as sanitariums, including Trudeau’s Cottage Sanitarium. By the turn of the century, the National (Canadian) and American (United States) anti-tuberculosis associations wanted to distinguish between health resorts and the new type of hospital for tuberculosis. Instead of using the word sanitarium, which is derived from the Latin noun “sanitas,” meaning health, they emphasized the role of treatment in their institutions. In 1904, the associations formally approved using the word sanatorium, from the Latin verb root “sano,” meaning to heal.
The Minnesota's Tuberculosis Sanatoriums website exists to:
- document Minnesota's unique system of county tuberculosis sanatoriums
- provide information about sanatoriums beyond the common story of fresh air and rest
- present the mostly unknown story of children in sanatoriums
- counteract the proliferating myths and inaccuracies about treatment