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The White Plague in the City of Angels

Caroline Luce, Author

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Public Health Response - Treating the Body, ca. 1900

The second, overlapping public health campaign that followed Koch’s discovery of tubercle bacilli focused on preventing the spread of the infection within individual bodies. Medical professionals in the late 19th century accepted Koch’s premise that if one interrupted the bacilli’s infection before the bacteria could establish a stronghold in the body, those afflicted could delay the negative impact of the disease or even cure the infection. After Koch discovered the disease was contagious, both doctors and hucksters alike offered prescriptions for the disease they promised would slow or stop the infection, creating large institutions where health-seekers could pursue treatment that they called sanatoriums.

Public health and medical authorities who believed that “consumption” was caused by environmental factors first advanced the notion that the illness could be effectively treated and cured by creating therapeutic conditions in the late 19th century. Their therapeutic strategies focused on three factors. The first was exercise; although most practitioners recognized that excessive physical activity would make the infection worse, various health “experts” recommended outdoor activities such as skiing, horseback riding, hiking and walking as sure-fire means of reducing the impact of the disease. Maintaining a proper diet also was regarded as an absolute necessity, but the recommended nutritional regiments varied from starving oneself until symptoms declined to increasing one’s consumption of rich, creamy foods, including milk and cod-liver oil. And finally, certain climates were believed to be most conducive to treating consumption. Precisely what climate was the most effective was a source of debate. Some argued that the moist sea breezes of coastline could alleviate the effects of the disease, others thought the humidity of the Caribbean was most curative, and some insisted the cold, dry air and elevation of the mountains ensured swifter recovery. All of the strategies were premised on the same belief: that by creating the conditions most conducive to healthy living, one could treat and cure tuberculosis.

The Sanatorium movement grew out of these various individual approaches to treating the disease. The purpose of the sanatoriums was to remove the afflicted from the conditions in which they had contracted the disease and into a more therapeutic atmosphere where they could be treated as patients instead of invalids. At the institutions, doctors could control all contributing environmental factors and dispense closely guarded regimes of diet and exercise. In turn, the institutions could become research facilities where practitioners would test treatments and work towards finding a cure for the disease. The Sanatorium movement emerged in Europe in the latter half of the 19th century. Among the first facilities was one founded by physician Peter Dettweiler near Frankfurt where patients were required to spend their days outside reclining in “cure chairs.” The sanatorium operated by Dr. Friedrich Jessen high in the Alps in Davos, Switzerland, became the most famous in Europe as the subject of Thomas Mann's novel, Der Zauberberg (the Magic Mountain).
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