Pulmonary tuberculosis, a lung disease commonly referred to as TB, was the leading cause of death in the United States during the latter half of the 19th century and the turn of the 20th. For decades, doctors believed it was a hereditary condition, a sort of predisposition to poor health. Treatment relied on the “heroic cure,” which meant sending sick people to toughen up in the fresh air, to work on ranches and live in tents. It was thought that high, dry, sunny climates were best for this, with New Mexico being the ideal, though the manual labor inherent to the heroic cure was later found to be quite deadly, especially for those in the later stages of the disease. Climate was the chief selling point for New Mexico, as local politicians, business leaders, and other officials engaged in a long, frustrating bid for statehood. Scientists discovered in 1882 that tuberculosis was caused by communicable infectious bacteria, but since there was still no cure, doctors continued to recommend time in a salubrious climate as the best chance for survival. Treatment moved from hard labor to rest, along with recommendations of a diet rich in fats and proteins, and abundant fresh air and sunshine. TB sufferers — often called “lungers” — flocked here by the thousands, until a streptomycin was made available in 1949 that finally controlled the spread of the disease. Many patients remained in New Mexico after they recovered. They raised their families here and made lasting impacts on the state’s culture, economy, and history.
Nancy Owen Lewis, scholar-in-residence and former director of scholar programs at the School for Advanced Research, has written the first book-length, scholarly account of tuberculosis treatment and the sanatorium industry in New Mexico, Chasing the Cure in New Mexico: Tuberculosis and the Quest for Health, published by Museum of New Mexico Press. She reads from and signs copies of the book at Collected Works Bookstore on Tuesday, May 10.
Lewis became interested in tuberculosis treatment in New Mexico while researching information for A Strange Alchemy, the centennial history of SAR. She realized that SAR’s first director, Edgar Lee Hewett, landed in New Mexico because his wife, Cora, had TB, and they regularly traveled from Colorado to spend time in Santa Fe. Hewett was the founding director of New Mexico Normal School in Las Vegas, which is now New Mexico Highlands University. After his wife’s death, he became the founding director of SAR, then called the School of American Archaeology.
“He starts hiring staff in 1909,” Lewis told Pasatiempo. “He hires the artist Carlos Vierra, who came out here as a health-seeker in 1904. Then he hires Kenneth Chapman, another health-seeker who had already been working for Hewitt at New Mexico Normal University. John Gaw Meem, who was chair of our board, came out here because he had TB.” Meem was the architect partially responsible for refining and popularizing Pueblo Revival architecture in Santa Fe, a building style originally established as another way to sell the city as a destination for health seekers and tourists by trying to attract them with the city’s distinctive history and charm.
The list of prominent figures in the history of SAR and Santa Fe who originally came here to recover from TB goes on and on. Her interest piqued, Lewis looked for a book to read, but all she found were a few chapters and journal articles. “There really wasn’t a big picture on this topic. So I applied for a grant from the Office of the New Mexico State Historian to do 80 hours of research in the state archives.” She went looking for diaries and journals. Instead she found official records about the formation and actions of the New Mexico Bureau of Immigration, formed in 1880 to promote New Mexico statehood. Much of this effort was tied to bolstering the economy and population by getting lungers to relocate here. The first sanatoriums were created by the federal government at abandoned military forts to treat sick soldiers and veterans. Other sanatoriums were run by religious orders — including St. Vincent Sanatorium in Santa Fe, now the home of the Drury Plaza Inn on Palace Avenue — and by private investors and doctors. It was this third category in which officials put their hopes.
“What I gathered from reading this literature is that the Bureau of Immigration didn’t really care if these people had TB, as long as they were Anglo. They needed them to come out here and change the demographic,” Lewis said. Though it was never put expressly that way in the literature, she considers the implication that New Mexico had trouble achieving statehood because the territory lacked a sufficient population of white people to be pretty clear.
In addition to claims about the curative climate, the bureau’s marketing material made the astonishing assertion that New Mexico was such a healthful place to be that Native Americans and Hispanic New Mexicans could not contract tuberculosis. Even after the TB bacillus was discovered, many doctors and scientists believed that it could not survive at more than 5,000 feet above sea level. Lewis immediately started looking for evidence of immunity to TB among the local populace and found nothing of the sort. As patients arrived and lived in rooming houses, tent cities, sanatoriums, and on the streets, hoping the mountain air would cure them, locals became infected. Eventually there was such a high incidence of TB among Native American children, due to infection at boarding schools, that the federal government established four sanatorium schools, wherein children could be isolated and treated while they continued their education.
Two classes of TB sufferers emerged: those who could pay for private treatment and those who could not. New Mexico seemed to be able to treat patients from elsewhere but lacked the infrastructure to care for its own — a direct result of not having been granted statehood, which would have come with certain advantages, including federal funding for a public sanatorium. (Statehood was finally granted in 1912; the first public sanatorium didn’t open in New Mexico until the 1930s, a full generation later.) The question persisted for Lewis about why TB patients, especially artists and physicians, who came to New Mexico to heal, ultimately decided to stay. At the time, it was thought that the climate in which you regained your health was the one that would keep you well, but the lasting explanation might be as simple as it’s always been. Some people come to Santa Fe and can’t handle the altitude and the dry brown land. Others see it as beautiful and captivating, and can’t imagine ever leaving.
Unfortunately, as time went on — and more out-of-state health seekers arrived and the local population got sicker — the expense of care affected not only patients but sanatoriums. There simply weren’t enough beds available, and there was no money to update dilapidated facilities. Things got dire during the Great Depression, and suddenly transient lungers were encouraged to stay away. Even wealthy TB patients were no longer welcome at places purporting to be health spas and hotels. Rhetoric around the innate good health of the locals changed. No longer were Native Americans and Hispanics immune to TB; now the high rate of illness among these populations was attributed by doctors to living conditions and cultural misunderstandings of disease transmission.
“It became put on them [Native Americans and Hispanics],” Lewis said. Back East, she noted, immigrants were filling up the cities and TB was a problem in tenements. Organizations were formed to deal with the problem by sending the sick immigrants out west. “People with no hope came here. We were only too glad to get the lungers, especially if they were wealthy, but they made others sick. Yet, the indigent health-seekers were desperate. They were told coming to New Mexico would cure them of this deadly disease.” ◀
Much of this effort was tied to bolstering the economy and population by getting lungers to relocate here. The first sanatoriums were created by the federal government at abandoned military forts to treat sick soldiers and veterans. Other sanatoriums were run by religious orders — including St. Vincent Sanatorium in Santa Fe, now the home of the Drury Plaza Inn on Palace Avenue — and by private investors and doctors.