A historical geography of tuberculosis sanatoria in Western North Carolina and Eastern Tennessee

Tuberculosis was a leading cause of death in the United States in the nineteenth and early twentieth centuries. Sanatoria were an effort to isolate the sick and provide treatment. Asheville, North Carolina was the center of tuberculosis treatment in the Southeast. It attracted many sufferers of the disease due to its climate. The pine-scented air of surrounding mountains was deemed beneficial to the cure of tuberculosis. In this study, I examine the distribution of tuberculosis sanatoria from the late 1800s to the demise of sanatorium treatment in the 1970s in western North Carolina and eastern Tennessee, encompassing the Blue Ridge and Ridge and Valley physiographic regions. Through the years, there was a shift from treatment in rural sanatoria to urban tuberculosis hospitals. Also, the number of private facilities declined with the opening of large public facilities, which were modem and less costly. Eventually, all tuberculosis hospitals were closed; treatment occurred on an outpatient basis at general hospitals. I classified the present uses of the former sanatoria sites. The sites remained medical in use or became institutional non-medical, residential, commercial, religious, vacant, or abandoned. This thesis shows the transformation of land use that occurred with the supposed conquering of the disease. With this knowledge of the past, it is possible to hypothesize what the geography of tuberculosis treatment will be in the near future since the disease is reemerging in the United States today