Arkansas Historic Preservation Program
Arkansas Tuberculosis Sanatorium Historic District
Arkansas Tuberculosis Sanatorium Historic District
c.1940 postcard of the Arkansas Tuberculosis Sanatorium Historic District
c.1940 postcard of the Arkansas Tuberculosis Sanatorium Historic District

ARKANSAS TUBERCULOSIS SANATORIUM HISTORIC DISTRICT, BOONEVILLE, LOGAN COUNTY

SUMMARY

Located approximately 2.5 miles south of Booneville on “The Hill,” an extension of Potts Ridge, the Arkansas Tuberculosis Sanatorium Historic District is comprised of 76 buildings, structures, and objects located on approximately 896.18 acres.  By the early 1940s the Arkansas Tuberculosis Sanatorium had a capacity of approximately 1,100 patients and was touted as the “largest and best institution of its kind as regards treatment facilities in the nation.”  The campus was essentially its own independent city with a complete farming operation, its own fire department, telephone system, post office, and water treatment plant.  For its associations with the nationwide fight against tuberculosis throughout much of the twentieth century, the Arkansas Tuberculosis Sanatorium Historic District is being nominated to the National Register of Historic Places with national significance under Criterion A.

The buildings on the campus were built beginning in 1909 with the creation of the Sanatorium and the majority of them were built by 1960.  However, many of the buildings were built in the late 1930s and early 1940s by the Public Works Administration (PWA) and represent an excellent collection of early twentieth century architectural styles, including the Art Deco, Craftsman, and Colonial Revival styles.  The Art Deco buildings on campus, which include the former Administration Building, Hamp Williams Building, and Leo Nyberg Building, comprise one of the best collections of the Art Deco style in Arkansas.  In addition, the number of buildings and acreage associated with the Arkansas Tuberculosis Sanatorium Historic District represent the largest known facility of its kind remaining in the country, and an extremely large and intact example of a twentieth-century tuberculosis sanatorium.  As a result, the Arkansas Tuberculosis Sanatorium Historic District is also being nominated to the National Register with national significance under Criterion C.

ELABORATION

Tuberculosis, which is a disease characterized by a cough that is worse in the morning (sometimes with hemoptysis, or blood in the sputum), chest pain, breathlessness, night sweats, and signs of pneumonia, has been around for thousands of years.  The mummified body of the Egyptian Priest of Ammon, dating to 1000 BC, showed evidence of bone lesions likely caused by tubercle bacilli, and the Greek physician Hippocrates (460-375 BC), known as the Father of Medicine, did a scientific study of the disease “consumption.”  However, it was not until the Frenchman Gaspard Laurent Bayle (1774-1816) studied the disease that the word “tuberculosis” was coined and the fundamentals of the modern knowledge of the disease were written.[1]

In the United States, the fight against tuberculosis essentially began in 1884 with Edward Livingston Trudeau, a New York doctor who contracted the disease.  After Dr. Alfred Loomis, another New York physician, recommended that a tubercular patient (along with Trudeau), spend some time in the Adirondack Mountains, they were elated to find that both individuals had noticeable improvement in their disease.  As a result of the positive results of the time spent in the Adirondacks, Trudeau decided to build a sanatorium outside of Saranac Lake, New York.  The first building at the sanatorium, a two-patient cottage called “Little Red,” was built in 1884 (NR-listed 06/11/92).[2]

In the early days of tuberculosis treatment prior to 1900, the majority of patients received treatment in private facilities, although there were no known private sanatoria in Arkansas.  Although some private sanatoriums survive, notably Waverly Hills in Louisville, Kentucky (NR-listed 07/12/83), the size of the private facilities did not approach the size of many state-run facilities, and definitely were not as large as the Booneville facility.

The disparity of sizes is likely a result of economics.  Private facilities would have likely charged their patients more than state-run facilities would have, limiting the patients who could afford the treatment.  As a result, the facilities would have remained smaller because of the limited number of people who could take advantage of them.

However, as the twentieth century dawned and progressed, there was a greater role of state-run facilities in tuberculosis treatment.  Although private sanatoria were important, especially in the early days of treatment in the late 1800s, when the Booneville facility was being developed in 1909 and beyond, there was a shift beginning.  More state-run facilities were being developed for tuberculosis patients which had not been the case previously.  (All tuberculosis treatment in Arkansas was done at the Sanatorium in Booneville or at the Sanatorium for Blacks in Alexander, which was established in the late 1920s.Other treatment included Burr Cottages erected at private homes, but it appears this was used after the 1930s and the establishment of the Works Progress Administration [WPA]).

It was not long before the threat of tuberculosis became an issue in other states around the country, including Arkansas.  An article in the October 1, 1908, edition of the Booneville Democrat was headlined “State Sanitation Society Proposed.”  The article stated that “the organization of an Arkansas Sanitation Society, to be composed of the members of Boards of Health throughout the state, property owners, doctors, lawyers, and business men and to have for its purpose the prevention of disease by sanitation, is now being talked by many physicians throughout the state.  Definite steps toward the organization of such a society will probably be taken soon.”[3]

In fact, some steps were already being taken to combat tuberculosis around the state.  In June 1908, Dr. A. T. Sweatland of Little Rock presented the following resolution in the journal of the Arkansas Medical Society:

"Whereas, Tuberculosis is exceedingly prevalent in our midst to the extent of causing the death of 3,000 human beings in the past year, and

"Whereas, Scientific research has shown it to be a preventable disease and

"Whereas, the Death rate in communities where cooperation of the citizens directed by the medical profession has been greatly reduced, therefore, be it

"Resolved that the President of the Arkansas Medical Society be instructed to appoint a committee of not less than five members whose duty it shall be to perfect the organization of the Arkansas association for the study and prevention of tuberculosis to work along the general line and in cooperation with the national association for the study and prevention of tuberculosis…"

The committee’s first meeting took place on September 22, 1908, in the Supreme Court rooms in Little Rock, and the state’s fight against tuberculosis was underway.[4]

At the first semi-annual meeting of the Arkansas Tuberculosis Association in Little Rock on January 26, 1909, the Association deliberated on a “Bill for an Act to provide for the location, erection, organization, management and maintenance of a State Sanatorium for the treatment of tuberculosis in the State of Arkansas…”  The bill had been prepared by Senator Kie Oldham at the urging of Judge Joseph M. Hill.  (Hill had been diagnosed with tuberculosis in 1905, and moved to Arizona as a result.  It was the move to Arizona that convinced him that Arkansas needed its own sanatorium.[5])  The bill, which was Act 378 of the Legislature, was approved by Governor George Donaghey on May 31, 1909, and appropriated $50,000 for the establishment of a tuberculosis sanatorium and $30,000 for two years of maintenance.  Unfortunately, due to a lack of funds in the treasury for the project, the Board of Trustees had to wait until the following fiscal year to begin work on the facility.[6]

Although there was a broader trend to build state-run tuberculosis hospitals, Arkansas appeared to be on the leading edge of the trend.  A few hospitals in other states were established between 1900 and 1910, but the majority of the state-run facilities known came later.  When the state established the sanatorium in Booneville in 1909, it represented a pioneering effort in providing a state-run facility for the care of tuberculosis patients.  Although private facilities specifically for the treatment of tuberculosis patients had existed since the early 1880s, very few states had state-run facilities prior to 1910.  In New Jersey, for example, a state-run isolation hospital was begun c.1907, but it was not popular.  From 1910 to 1935, counties with large numbers of tuberculosis patients built county-run isolation hospitals that proved much more popular.[7]  In Michigan, private care existed initially, but legislation was adopted in 1905 to establish a state-run tuberculosis sanatorium.  The Michigan State Sanatorium was established in Howell in 1907 and a second facility, the Northern Michigan Tuberculosis Sanatorium was established in the 1930s.[8]  The State of West Virginia also started taking care of tuberculosis patients in the early 1900s with the establishment of three hospitals – Hopemont (1912), Denmar (1919), and Pinecrest (1930).[9]

Even in states around Arkansas and in the south, the establishment of the sanatorium at Booneville was a pioneering effort for a state to provide specific tuberculosis care.  Missouri established its first state mental hospital in 1847 and in the late 1800s many tuberculosis patients were sent to the mental hospitals for treatment since it was believed by some that tuberculosis caused insanity.  However, the first facility specific for tuberculosis treatment was not established until 1907 at Mount Vernon, and the big push by the state to establish facilities occurred between c.1907 and 1940.[10]  In Virginia, prior to the 1910s there were many private facilities for tuberculosis patients.  However, with respect to state-run facilities, the state built three facilities for patients (200-500 patients each) in 1909, 1918, and 1920.  Two were for white patients and one was for African-Americans.[11]  In Florida, on the other hand, the establishment of tuberculosis sanatoria came much later.  The A.G. Holley State Hospital, opened in 1950 while the W.T. Edwards Hospital near Tampa opened in 1952.[12]

At least one state’s establishment of state-run tuberculosis facilities was directly influenced by Arkansas’s efforts.  Tennessee had two facilities for tuberculosis treatment, the Tennessee Veteran’s Hospital in Johnson City (built c.1902-1903) and the Pressman’s Home in eastern Tennessee, which began as a resort and was then converted to part of a complex used by the Pressman’s Union.[13]  According to the February 1942 issue of the Sanatorium Outlook, “Dr. W. W. Hubbard, director, and Dr. Harrison, of the Tuberculosis Hospitalization Service of the Department of Public Health of Tennessee, were guests of the Sanatorium, January 6-7.  The state of Tennessee has recently secured an appropriation for the establishment of a tuberculosis sanatorium, and Dr. Hubbard and Dr. Harrison came here for the purpose of observing Arkansas’ tuberculosis control program…”[14]

In the meantime, as plans were being finalized for the sanatorium’s establishment, a suitable location for the sanatorium had to be found, and when it was announced that approximately 1,000 acres was needed for the facility, the competition between Arkansas towns heated up.  When Booneville offered to donate 973 acres of land for the sanatorium, its offer was accepted.[15]

The site chosen for the Arkansas Tuberculosis Sanatorium echoed the locations chosen for sanatoria in the eastern U.S., especially around Saranac Lake, New York.  The site was in a mountainous area away from large cities where the air would be fresher, supposedly bringing better relief from the disease.  A pamphlet issued by the Arkansas Tuberculosis Sanatorium c.1925 touted the facility’s location by saying:

"The site of the Arkansas Tuberculosis Sanatorium near Booneville is a beautiful one, 900 feet above sea level, among the pines, high enough for refreshing breezes in summer and not high enough for the cold fogs of winter; with a bountiful supply of excellent water and perfect drainage.  The climate the year round is unexcelled by any in the South or West, free from the winter’s dampness of the Gulf coast and from the sand storms and enervating heat of the South arid regions, and the blizzards of those farther north."[16]

However, before construction could begin, two large obstacles had to be overcome – building a road to access the site and securing a supply of water.  A route for the road was selected on December 21, 1909, and a pond was built south of the sanatorium, which was pumped full of water from the Petit Jean River, to provide water.  Construction then began on the buildings that the plans called for, including an administration building, one ward building, two A cottages, two B cottages, five tent houses, four cabins and a superintendent’s cottage.[17]  Dr. John Shibley was chosen to serve as the first head of the State Sanatorium, and the first patient was admitted on August 2, 1910, with the formal opening held on September 1, 1910.[18]

The number of patients at the sanatorium quickly increased.  In August 1910, a total of 16 patients were admitted, 27 patients arrived in September, 22 in October, and 19 in November.  It was not long before patients had to be turned away because there was not any room to house and care for them.[19]

However, the problem of the growing number of tuberculosis cases across the state was not felt just at the sanatorium in Booneville.  In Little Rock, for example, tuberculosis was also a problem, according to a 1914 survey.  From 1909 to 1913, Little Rock alone lost an average of 101.6 people to tuberculosis each year (an average of 45.3 whites and 56 blacks).  The report stated that “the State Sanatorium for Incipient Cases at Booneville has a few beds available for cases from Pulaski County.  The County authorities are to be commended for using their full quota of beds at this institution.”[20]

Pulaski County was beginning to take active steps to fight the disease, including the establishment of the Pulaski County Anti-Tuberculosis Society, which was “composed of individuals organized for the purpose of fighting the white plague in Pulaski County.”  The Society was “supported by donations and the proceeds of the Red Cross Seal sale,” and its “activities to date (1914) have consisted of a limited campaign of education, the engaging of a visiting nurse, and plans and preparations for the operating of a free dispensary, which was opened in September 1914.”[21]

The Little Rock tuberculosis survey also helped educate people on how to combat the disease, specifically through the following five items:

1)An intensive and continuous county-wide campaign of education.

2)The operation of two or more free dispensaries in the county.

3)Perfecting and increasing the visiting nurse service.

4)Co-operation with the Board of Education in establishing open-air schools.

5)Campaign for adequate public hospital and sanatorium facilities.

Interestingly enough, the survey also stated that “an active campaign for the suppression of tuberculosis does not give undesirable publicity to a community, but, on the contrary, stamps it as progressive and up to date.  The preventing of preventable disease is to be commended in as strong terms as failure to so do must be condemned.”[22]

The increased awareness of tuberculosis and increased efforts to fight the disease was part of a larger movement in the late nineteenth and early twentieth centuries to eradicate some troublesome diseases around the country and especially in the South.  The South often fell victim to epidemics of several diseases that swept the river valleys of the region with great regularity.  The diseases that were most common included yellow fever, cholera, small pox, typhoid and meningitis.  In addition to the epidemics, some diseases seemed to never leave, which included malaria, hookworm, pellagra, and tuberculosis.  The diseases, at least in the South after the Civil War, slowed down the region’s recovery.  As a result, in the late nineteenth century, fighting these diseases became a crucial element in the region’s recovery and advancement.[23]

Pellagra, although rare now, was once a huge problem in the U.S., infecting three million people and killing 100,000 between 1906 and 1940.  It was prevalent in the South where the diet consisted of meat, molasses, and meal – the “three M’s.”  Malnutrition or a diet consisting primarily of niacin-deficient foods, are the primary causes.  The initial steps in fighting pellagra, as with hookworm, came later than the fight against tuberculosis.  The majority of the campaign against the disease was fought by the U.S. Public Health Service (PHS), which started its fight on a small scale shortly after the disease was diagnosed in the South.  Dr. Clarendon H. Lavinder, a PHS staff member, was sent to South Carolina in 1909 after cases started appearing at the South Carolina State Hospital for the Insane.  As with Dr. Goldberger’s later experiments, Dr. Lavinder tried to induce the disease in other beings, namely rabbits, rats, chickens, and guinea pigs, by injecting them with fluids from infected people.  Although few physicians were initially concerned with the disease, as the number of infected people mushroomed, state officials appealed to Congress for assistance.  Eventually, a program of field epidemiology and a Pellagra Hospital, in Spartanburg, South Carolina, were established.  In addition, the PHS assigned 41 men to study the disease in the field from every angle.[24]

Although Dr. Lavinder made progress with understanding pellagra, it was Dr. Joseph Goldberger who was instrumental in solving the problem of pellagra.  He was assigned in 1914 to the South’s problem of pellagra by the U.S. Public Health Service.  He determined, after inspecting Southern orphanages, mental hospitals, and prisons, that the malnourished inmates were more often suffering from pellagra while the better fed inmates did not.  As a result, he determined that pellagra was not caused by germs, as previously believed, but arose from nutritional deficiencies.  To back up his theories, he, his wife, and assistants, conducted experiments called “filth parties” where they injected themselves with blood or ingested scabs, feces, or body fluids of patients, and nobody developed pellagra.  However, experiments with nutrition and Mississippi prison inmates conclusively proved that the disease was indeed caused specifically by malnutrition.[25]

Hookworm, like pellagra and tuberculosis, was once widespread in the Southeastern U.S. in the early twentieth century and was caused by the species Necator americanus.  The infection was contracted by contact with soil that was contaminated with hookworm.  Children were usually most susceptible to the infection because they often played in dirt and went barefoot increasing their chances for infection.  Infection started out as itching and a rash at the site where the skin was penetrated, and it may have been followed by abdominal pain, diarrhea, loss of appetite and weight loss, and anemia.  (Chronic heavy infection could also damage the development and growth of children, and it could be fatal in infants.)[26]

As with tuberculosis, Arkansas was heavily involved and quite progressive in the fight against hookworm.  Arkansas’s recovery from the ruin of the Civil War was hampered by the diseases that plagued the area.  As a result, in the 1870s, physicians undertook an effort to organize a statewide medical society to deal with the constant epidemics.  Although the governor did sign a charter for the organizations, there were no state funds available for the effort.  As a result, it had to rely on private donations, which meant that the effort was doomed due to the state’s economic condition at the time.  Although some people organized county and municipal boards of health and operating them with volunteers, the outcome was the same – a loss against poverty and disease.[27]

However, Arkansas’s attitudes towards health would soon change.  When Abraham Flexner, an educator hired by the Carnegie Foundation for the Advancement of Teaching, conducted a survey and critique of U.S. and Canadian medical schools and published the Flexner Report in June 1910, it blasted Arkansas.  The Donaghey Administration then made reform of medical education a top priority.[28]

Flexner arrived in Little Rock on November 15, 1909.  The older of the two medical schools in Arkansas had been founded in 1878 and was a department of the Arkansas (Industrial) University although it received no public funding.  The state’s other school was the College of Physicians and Surgeons, incorporated in 1906.  Flexner reported that “Both the Arkansas Schools are local institutions in a state that has at this date three times as many doctors as it needs; neither has a single redeeming feature.”[29]

As a result of persuasion from the medical profession, in 1911 the state legislature assumed fiscal responsibility of medical education in Arkansas as a part of the (Industrial) University of Arkansas.  The Old State House became the home of the school when the school and the temporary Board of Health needed a home.  It was in response to the Rockefeller Foundation planning to form a Sanitary Commission for the eradication of endemic disease in the South – starting with hookworm.  The Foundation pledged $1 million for the effort, but for a state to qualify it had to have a board of health and a bureau of vital statistics, neither of which Arkansas had.[30]

As the state undertook an almost three year effort to start a permanent Board of Health, the Rockefeller Foundation’s efforts against hookworm in Arkansas and other southern states began.  (Interestingly, the support of public health reform came from Mothers’ Clubs and Federated Women’s Clubs.Since women could not wield political power, they used their social organizations for reform.  For example, the creation of the first Welfare Department grew out of a committee for the study of tuberculosis headed by Mrs. John Fletcher of Little Rock, president of the State Federation in 1909.)[31]

The fight against hookworm, as with tuberculosis, consisted of several steps.  First, was education, which was accomplished through county medical societies hosting “hookworm meetings” for the public.  Second, was the completion of a survey that showed that 57 of Arkansas’s 75 counties were infected with the disease.  Third, counties were assisted with inspection tours and in opening free dispensaries for treatment.[32]

The hookworm campaign ended in 1914, and the results were remarkable.  Arkansas had a Board of Health in place, and many city and county boards were working on water purification and sanitation.  Over 50,000 people had been examined for hookworm and over 10,000 people had received treatment.  Forty-three counties had free dispensaries and over 190,000 pieces of educational material had been distributed.  In addition, 287 public lectures had been held.  The work of the state brought the third annual conference of the Southern Association for the Eradication of Hookworm Disease to Little Rock in 1912, and many of the methods used in field work around Arkansas were used in many other parts of the South.[33]

With respect to hookworm, the concerted efforts to contain and eradicate the disease came later than the efforts with tuberculosis. According to Disease and Distinctiveness in the American South, “…the Medical Record’s Thomas L. Stedman maintained that any efforts to compel ‘the children of the southern small farmers’ to use sanitary privies and to wear shoes would surely fail.  Instead, he called on the South’s better classes to employ community pressure and concerted action.  He especially appealed to ‘the charitably disposed and the patriotic people of the South’ to establish ‘leagues for combating the hookworm’ modeled ‘after the plan of the antituberculosis leagues.’  Action of this type was imperative, he maintained, because ‘the regeneration…of the South depended absolutely upon the extermination’ of the disease ‘that is literally sucking its lifeblood.’”[34]

The creation of the Arkansas Tuberculosis Sanatorium was a reflection of the progressive stance that Arkansas had taken against some of the most prevalent diseases of the period, a stance that was often ahead of many other states.  The earliest buildings built at the Arkansas Tuberculosis Sanatorium around the time of its founding consisted of two main types – frame buildings and “tent houses” according to the 1913 Sanborn map.  To the southeast of the driveway were located the Administration Building, Hospital Building, Goldman Pavilion (patient housing), the Superintendent’s Cottage, two Women’s Cottages, and a water tank, all of which were frame, except for the water tank.  Frame construction would have been ideal for the first buildings at the Sanatorium, since they would have been easily constructed and there was an abundance of timber on “The Hill.”[35]

To the northwest of the driveway, were three Men’s Cottages and nine tent houses.  Only one of these buildings, one of the Men’s Cottages labeled “Cottage Sebastian” on the 1913 Sanborn map, was apparently all frame construction.  The rest of the buildings, according to early photographs, had low frame walls with large flaps, hinged at the top, which opened out to provide airflow through the buildings.  The buildings were crowned with gable roofs.  The tent houses would have been easy to construct to allow the sanatorium to be operational in a short amount of time, and they would have also provided as much fresh air as possible to the patients, the latest treatment for tuberculosis.[36]

However, with the increasing number of tuberculosis patients around the state that needed to be served and the wider variety of cases being seen, it soon became apparent that more buildings needed to be built at the sanatorium.  To aid in this the 1913 legislature appropriated $15,000 for a hospital to be built to care for “the far advanced and hemorrhagic cases.”  The building had a capacity of twenty-four patients and was named Kie Oldham Hall after Senator Oldham who had worked tirelessly to get the sanatorium established.[37]  In addition to Kie Oldham Hall, $4,000 was appropriated for “a small but satisfactory” laundry so that the laundry would no longer need to be done by hand.[38]

The late 1910s and early 1920s brought additional new construction to the sanatorium, including Echols Hall, a twenty-four bed building costing $5,000, and the gift of Mrs. W. J. Echols of Fort Smith in memory of her husband, and a $21,000 water plant and a $12,000 dairy.  The dairy had an “excellent herd of twenty-one cows” that provided enough milk for the 114 patients living at the sanatorium.  However, the facility was still growing as an average of approximately 400 patients were being accepted each year for treatment.[39]

Because the sanatorium was also seeing an influx of children as patients, Judge Hill proposed to the Belle Point Lodge, Free and Accepted Masons in Fort Smith, on December 10, 1922, at the time of their 75th anniversary celebration, that the Masons build a building at the sanatorium for the care of children.  The Masons accepted the proposal and a twenty-four bed building, which cost approximately $57,000, was built and formally dedicated on September 21, 1924.  Furnishings for the building were also donated by Masonic lodges and Order of the Eastern Star chapters around the state.[40]

The changing treatments for tuberculosis were reflected in the construction of the Kelley Building built in 1927.  The building was originally known as the Occupational Therapy building, and was used for occupational therapy, a form of treatment that came about in full form in the early 1920s.  With occupational therapy, patients who were confined to their beds could also enjoy some activity.  Occupational therapy allowed patients to make things while in bed (i.e., leather-working, knitting, crocheting, or embroidery) to pass the time, releasing built-up tension, or even be able to support themselves.[41]  Even though the Kelley Building was a gift to the sanatorium, it was kept secret for almost ten years.An item in the September 1935 issue of the Sanatorium Outlook stated:

"After ten years’ secrecy, the identity of the donor of the Occupational Therapy building was made known recently in a talk by Judge Hill to the patient body.  He is Mr. Harry E. Kelley, of Fort Smith.Mr. Kelley gave $6,000 to the institution for the construction of a building to be used for occupational therapy for patients.  This experiment in tuberculosis therapy was abandoned some years ago, however, and the building has since housed the Sanatorium library.  Now that the building is to be converted into a patients’ building, it will be known as the Kelley Building."[42]

Patient life at the sanatorium was very regimented by the 1920s.  A c.1925 brochure published by the sanatorium gave the following typical daily schedule for a patient, although it was modified depending on a patient’s individual needs.

"7 to 7:30 – Awake; a glass of hot water and a cold sponge above the waist.

7:30 to 8:00 – Breakfast.

8:30 – Out of doors, sitting or reclining.

10:30 – Lunch, milk and eggs.

11:00 – Exercise if permissible.

11:30 – Rest until dinner.

12:00 – Dinner.

1:00 – Out of doors, sitting or reclining.

3:30 – Lunch, milk and eggs.

4:00 – Exercise if permissible.

5:00 – Rest out of doors, lying down.

6:00 – Supper.

7:00 – Out of doors, sitting or reclining.

9:00 – Lunch and bed."[43]

The use of milk and eggs for the diet was a treatment that many doctors used in order to combat the emaciation that often accompanied tuberculosis.  The treatment was an old one, having been used at least since the eleventh century at the medical school in Salerno, Italy.  The treatment was even featured in poetry:

"In Great Consumption learn’d Physicians thinke,

‘Tis good a Goat or Camels milke to drinke

Cowes’-milke and Sheepes’ doe well, but yet an Asses

Is best of all, and all the others passes."[44]

Surprisingly, even though the sanatorium was run by the State of Arkansas, treatment was not free.  The same c.1925 brochure gave the following information on costs.  “The treatment will be strictly up to date and the tables will be supplied with the best the markets of the state afford.  The terms are $10.00 per week.  This pays for lodging, board, medical treatment, nursing and plain laundry.  Bona fide residents of the state suffering from tuberculosis and unable to pay for maintenance may be admitted free on written order of the County Judge of their county, setting forth these facts, in which case a charge of $5.00 per week for one-half the maintenance will be made against the patient’s county.”[45]

Holidays were special occasions for the patients during the 1920s.  At Thanksgiving, for example, “the program for the day began with a Sunrise Service of song and prayer in which patients, staff, and employees joined in offering up thanks to the Creator for the blessings bestowed upon them during the past year.  …Once more the fine Thanksgiving dinner, served in the main dining hall left nothing to be desired.  The hospital and the ambulant buildings sent over all their patients that were able to attend, and plates were laid for 210 patients.  …Last on the day’s program came the picture show – “Ben Hur” – rebooked especially for the occasion by Dr. Stewart.”[46]

Christmas was also a special time at the sanatorium, as the patients eagerly awaited the arrival of Santa Claus and the hopes that their Christmas wishes would come true.  Each building wing published their Christmas wish lists in the December 1929 issue of the Sanatorium Outlook, and some of the wishes were reflective of most people from the period.  For example, “Chambers wants a little red wagon, painted blue,” “Anna wants a new boy patient – she’s tired of winking at the old ones,” and “Mabel and Evelyn say please stop and get their husbands and bring them along.  …If there isn’t room in the sleigh for [Evelyn’s] husband, let him ride one of the reindeers, he rides – mules – well.”  However, some of the wishes reflected the fact that tuberculosis was a serious disease with serious effects.  For example, “Esther wants ether, so she can sleep at night,” “Ruth wants a new leg, and not a wooden one,” “Florene wishes a new temp stick that will not register over 99,” and “Herring, a new throat so she can talk, and we’ll all know she is around.”[47]

Even though additional buildings to accommodate a larger number of patients were built throughout the 1920s, it was not long before overcrowding became an issue again.  The overcrowding at the Booneville facility also caused some counties to put in measures to do some of their own care of tuberculosis patients.  In Craighead County, for example, according to the August 1937 issue of the Sanatorium Outlook, “Craighead County will have 13 Burr Cottages built by the WPA.  Eight will be built on the county farm for patients who are waiting a chance to enter the Sanatorium.”[48]  Crawford County also used Burr Cottages, according to the Sanatorium Outlook.  In the April 1936 issue, an article appeared stating:

"Two Burr Cottages, constructed on the plans used for the one now in service in Crawford County, will be erected with funds obtained in the annual sale of Arkansas Tuberculosis Association Christmas seals, according to Judge R. S. Wilson of Van Buren, county chairman.  The cottages are portable and can be moved easily from one section of the county to another and are for use of tuberculosis patients.

"The cottage built last year has been in service for several months and has been of much benefit to the patient using it, Judge Wilson said."[49]

Although the counties’ efforts around the state did help to relieve some of the issues of overcrowding at Booneville, it was only a short-term solution, and something much more substantial needed to be done.  A solution came in late 1935 or early 1936 with the beginning of the Wildcat Mountain Sub-Hospital, located approximately five miles east of Fort Smith.  It had originally been built by the government as a part of its emergency relief work as a country camp for transients.

"It was a well constructed camp with the necessary administrative buildings and utility lines, and comfortably housed several hundreds of transients for some time.  The Government then decided to abandon it, and the land together with all improvements reverted to the city of Fort Smith.  Mr. Henry Armstrong, WPA Director of the Fourth District, knew of the Sanatorium’s need for more room to relieve the waiting list of tuberculosis patients in need of institutional treatment, and he conceived the idea of converting the camp into a sub-hospital to the Sanatorium.…

"About a year ago reconstruction of the buildings and grounds began.  Stone foundations were added to the buildings on the grounds; hardwood floors were laid throughout; hot and cold water systems were installed; complete refrigerating equipment and cold storage rooms were added, and basic equipment for cooking and serving hospital patients were added to the dining hall and kitchen.  Gas had already been installed, and this was supplemented by electric lighting and power systems; a sewage disposal plant was constructed; a ten-acre lake was built; and paving, bridges, drains, walks and landscaping further added to the value and beauty of the property.

"The hospital plan includes six patient buildings (sufficient to care for about 100 patients) an administrative and treatment unit, a central kitchen and serving room, two brick veneer apartment houses for employees, a physician’s home and a supervisor’ home."[50]

Work on the Wildcat Mountain facility was finished by early 1937, and it opened on March 21, 1937, with 43 patients.[51]

It is important to note that, although there were many more tuberculosis patients throughout the first part of the twentieth century, there was also a great amount of success in fighting the disease.  The Sanatorium Outlook for July 1934 reported that there was a “mortality drop for tuberculosis [of] more than 70 per cent in 22 years.”[52]  It further reported that the mortality rate “was 7.4 per cent last year [1933].”  Even though there was success in fighting the disease, there was still a lot of progress that needed to be made.

The WPA’s efforts at Wildcat Mountain greatly aided the fight against tuberculosis in Arkansas by allowing more patients to be adequately served and treated.  However, it was not just the WPA that aided in providing adequate facilities for the sanatorium.  Beginning in 1935, it was the PWA that began to drastically transform the Arkansas Tuberculosis Sanatorium campus into the massive facility that is present today.

In August 1935 officials at the sanatorium filed an application with the Arkansas PWA through E. Chester Nelson, an architect in Fort Smith, for $24,300 in grant funds for improvements at the facility.  It was estimated that the total amount needed for the proposed projects would be $54,000, although the sanatorium already had some funding on hand to complete the projects.  According to the Sanatorium Outlook, “Five items are proposed in the application…  The application proposes the construction of an addition to the present office building; a new ice and refrigeration plant and bakery to be attached to the present administration building and the purchase and installation of equipment; construction of a new laundry building; altering of McGehee Hall, and the reconstruction of the Occupational Therapy building, now called the Kelley building, to make it a building to accommodate 18 patients and the necessary equipment.”[53]  By the end of 1935, the grant had been received and “bids were opened for construction, and the contract has been given to Cooper Construction Company, of Booneville.”[54]

At the same time that the initial application materials for PWA improvements were being processed, other new construction was being planned, specifically the Rock Apartments.  At the same time that the first PWA grant was being processed, it was reported that “a 17-room apartment house for the accommodation of Sanatorium employees will be built at the Sanatorium within the near future.  Plans for the building, which will be erected directly behind the nurse’s home, have been approved and bids for construction will be taken Dec. 12.”[55]  By January 1936, the contract for the building was tentatively awarded to Gomer Krause of Clarksville, with an anticipated completion date of June 15, 1936.[56]

By the end of 1936, much of the work planned under the initial PWA grant was completed, including the Kelley Building, which was finished by October.According to the Sanatorium Outlook, “the building has two large wards that accommodate nine patients each, separated by serving room, individual lockers, and chart room.”[57]  Considering the work began on January 30, 1936, it was completed in a very timely manner.

By early 1938, in order to keep up with the new buildings that had been built, along with new buildings that were being planned, it was determined that improvements needed to be made to the facility’s water supply.  “Work on the project for enlarging the Sanatorium water supply lake began December 9 [1937].  The clearing and cleaning of ground preparatory for the moving of dirt is well under way and the steam shovels for the work are already (Dec. 28) on the grounds.”[58]  It did not take long for the improvements to be carried out and by July “finishing touches are being added to the Sanatorium dam, and by the time this appears in print the project will probably be completed.  …According to the present design it will impound approximately 100,000,000 gallons of water, as compared with its previous capacity of about 39,000,000 gallons, when the water reaches spillway level.  …The raising of the dam was done by WPA labor.”[59]  The WPA did further infrastructure improvements later in 1938 when “Presidential approval of a …project for hard surfacing three miles of highway inside the Sanatorium grounds has been received.  The road will be laid out according to plans prepared by the State Planning Board in connection with the building and improvement plan.”[60]

During the special session of the 1938 Legislature, Senators Lee Nichols of Booneville and Leo E. Nyberg of Helena, who was himself suffering from tuberculosis, fought for the passage of the Nichols-Nyberg Act, which appropriated $1,200,000 to fund an extensive building program at the sanatorium.  To supplement the appropriation, the PWA awarded the sanatorium a grant of $948,071, which allowed “the sanatorium to complete an extensive building program [that] will give the state the most adequate state tuberculosis institution with regard to facilities and capacities in the United States.”[61]

The importance of the PWA grant and the state appropriation in allowing necessary upgrades and new construction at the sanatorium was further expanded upon in the Sanatorium Outlook.  The magazine touted that:

"When the building program is completed, the patient bed capacity at the sanatorium will have been increased from its present 640 to a total of 1,200 beds.…

"With the state appropriation alone it would have been possible to do little more than construct the $700,000 main building and a boiler plant.

"Now the state can build additional nurses’ and employees’ quarters, remodel the main dining hall and kitchen, construct a new dairy barn, provide additional physicians’ cottages, build a modern sewage disposal plant and replace the old septic tanks, repair and remodel existing frame buildings and add to the children’s buildings."[62]

The architectural firms of Haralson & Mott of Fort Smith and Erhart & Eichenbaum of Little Rock were selected to complete the designs of the buildings (they had actually already been selected for the main hospital building, later named the Leo E. Nyberg Building), and the rendering of the Nyberg Building was proudly displayed in the May 1938 issue of the Sanatorium Outlook.  It was said that the building would have “…523 beds; 115 single rooms and 204 double rooms.  The building will have six stories including ground floor in the central wing and five stories including ground floor in each of the side wings.  The building is to be of modern hospital design and the construction is to consist of reinforced concrete beams, columns and slabs.”[63]

The sanatorium did not waste any time in getting the hospital building project underway.  Construction contracts were let on October 5, 1938, to J. H. Leveck & Sons, Little Rock, for the building, and to Wallace Plumbing Company, Dallas, for the plumbing and ventilation.  Ground was broken for construction on October 17.[64]

However, once the hospital building was underway, the sanatorium and its construction crews did not sit back and relax.  Rather, they jumped right into additional projects.  Bids for the construction of the central heating plant were opened at 10 a.m. on December 8 in the house chamber of the state capitol in Little Rock, and “bids for excavation work on several new buildings to be constructed under the building and expansion program at the Sanatorium were let December 23 to J. H. Leveck & Sons of Little Rock, for the low bid of $5,922.50.  Actual work on the projects was started December 27.  Buildings which are to be built under this program are two employees’ dormitories, one nurses’ home, twelve employees’ cottages, 2 dairy barns, employees’ barracks, incinerator, guinea pig piggery, cannery, children’s building addition, patient’s building and commons building.”[65]

The feverish pace of progress on the new construction continued throughout 1939.  Bids for the construction of the cannery building and the twelve doctors’ cottages were received on May 11, and although the three bids received for the construction of the cottages were rejected, J. H. Leveck of Little Rock was awarded the cannery contract with a bid of $27,900.[66]  Construction bids for the nurses’ home and two employees’ dormitories were received June 8, and the cottages were soon back on track with construction being “well under way” by August.[67]  In fact, at the June 8, 1939, meeting of the sanatorium board of trustees, contracts totaling $316,267.56 were awarded.[68]

Also by August 1939, “preliminary plans for a new administration building and commons building and a 120-bed building for ambulant patients were approved subject to revision.”[69]  The contract for the construction of the administration building was awarded August 17 to the Manhattan Construction Company of Muskogee, Oklahoma, which had the low bid of $35,795, and the contracts for the commons building and the patient’s building (Hamp Williams Building) were awarded on September 22.  The Manhattan Construction Company, with a bid of $157,990, received the contract for the commons building, while the patient’s building was awarded to the Harmon Construction Company of Oklahoma City for $124,831.[70]

By the end of 1939, projects were starting to be completed, an amazing accomplishment considering that construction had begun a little over a year before.  The new power plant was to be ready on October 1, and on December 15, “the board accepted as complete the cannery, power plant, employees’ barracks, guinea pig piggery, and twelve employees’ cottages.”[71]

Also, by late 1939, the hospital building was almost complete, and the progress was poetically described in the November 1939 Sanatorium Outlook along with an extensive description of the building’s features.

"Day by day for a little more than a year now, we have watched what at the beginning of that time was little more than a figment of the imagination, the gossamer from which dreams are made, unfold and develop into the beautiful reality which is the new hospital building now nearing completion at the Sanatorium.  It is little less than a revelation to see this magnificent structure proudly overlooking the countryside from a site that only a few months ago was waste land.  Bits of steel and brick and mortar and glass have been woven by skilled hands into an intricate pattern to form the most compete and modern hospital to be desired.  The transition has been slow as that of the butterfly emerging from its dark and unattractive chrysalis but our delight in its completeness is ample reward for patience.

"Miles before you reach Booneville from any direction, the new building may be seen, its light façade reflecting the light and acting as a beacon to tell of the interest of the people of our state and of our nation in the tuberculosis sick."[72]

With a façade that was 528 feet long, a depth of 50 feet, and a floor area of more than 140,000 square feet, it was definitely a sight to behold.

The feverish pace of construction continued at the sanatorium into 1940.  The February 1940 Sanatorium Outlook reported that:

"…The administration building has been completed and is now occupied; the dairy building is substantially complete and is already in use, and the 504-bed hospital building, main unit of the building and expansion program is almost finished.  …

"Employees’ dormitory No. 1 is finished but is as yet (January 24) unoccupied, except for one wing…  The new nurses’ home and employees’ dormitory No. 2 are rapidly nearing completion.  It is estimated that the commons building is 55 per cent complete, and the new three-story building for ambulant patients is about two-fifths finished."[73]

On February 23, “the main hospital building and equipment, dairy barn and silos, administration building, nurses’ home, and dormitory No. 1 were accepted as complete.”[74]  The last units to be completed were the commons building and the Hamp Williams Building, both of which were finished in April.

Finally, “a meeting of the Sanatorium Board of Trustees was held in Little Rock, May 16, at which time all new buildings at the Sanatorium were accepted as complete as of May 15th.”[75]  Amazingly, the completion of the all of the buildings took less than two years, and it is even more remarkable to note that the construction was completed ahead of schedule.  Significantly, “this building and expansion program, involving 38 contracts and 32 building units, is the largest Public Works Administration project in Arkansas, both in value and in number of buildings.”[76]

The dedication ceremonies for the new sanatorium buildings were scheduled for July 4, 1940, with the keynote addresses to be given by Dr. W. A. Doppler, Field Director of Health Education Service of the National Tuberculosis Association and Governor Carl E. Bailey.Dr. J. D. Riley, superintendent of the sanatorium, served as master of ceremonies while the North Little Rock high school band provided musical entertainment.  It was estimated that over 3,000 people attended the ceremonies.[77]

Although Arkansas now had the largest tuberculosis facility in the country, the disease was still a serious force to be reckoned with.  During Dr. Doppler’s address, he indicated that “during the First World War 70,000 Americans were killed and during the same time 100,000 died from tuberculosis.”  In fact, Senator Nyberg, who conceived the idea of the building campaign while a patient at the sanatorium, and for whom the main hospital building was named for, died of the disease before the construction was finished.  Nyberg’s legacy in fighting tuberculosis was eloquently stated by Representative Ernest Maner in a January 15, 1941, address delivered to the House of Representatives.  He said:

"Although Nyberg of Phillips contributed much to Arkansas progress in many ways, we know that his greatest contribution to Arkansas is the best State Tuberculosis Sanatorium in the United States.  This he accomplished with the cooperation of the General Assembly after he himself became a victim of tuberculosis.

"Mr. Speaker, on October 4, 1936, when Dr. Riley was examining Leo, our Sanatorium was only make-shift.  The buildings were fire traps; the equipment was out of date; the medical personnel was far from adequate; and still worse, hundreds – yes, thousands of persons with tuberculosis, some with light cases, some at the point of death – were forced to wait to enter that institution – many until it was too late for help.  Gentlemen, Leo Nyberg saw this condition and promised his God that, if he were permitted to live, the remaining number of his days would be devoted to aiding the sick of Arkansas.

"You know how well that promise was kept.

"There are some 25 new modern buildings besides other improvements on those beautiful hills near Booneville.  The main building, with a capacity of 511 patients, is properly named “The Leo E. Nyberg Building.”  This building of brick and stone rises six floors, and in it, as in the other buildings, can be found the finest and most modern equipment for the treatment of tuberculosis known to medical science.  Because of increased facilities, the waiting list is now controllable and persons with serious cases of tuberculosis need no longer die while awaiting their chance to enter that health-giving institution."[78]

Even though the buildings were completed and dedicated in 1940, ground improvements, including landscaping and paving, continued into 1941 and were completed by the WPA.[79]

The completed Arkansas Tuberculosis Sanatorium had a capacity of 1,155 patients and was described as the “largest and best institution of its kind as regards treatment facilities in the nation.”[80]  In fact, the increased capacity of the sanatorium meant that by the end of the 1940s, 5,393 patients were cared for at the facility during the 1948-1950 biennium.[81]  (In comparison, only 1,144 patients were cared for in the biennium ending in 1940.[82])  The sanatorium was also included as a site of interest in the WPA Guide to 1930s Arkansas:

"Left from Booneville on asphalt-paved State 116 is the ARKANSAS TUBERCULOSIS SANATORIUM, 3.6 m., high on a hill overlooking the round-topped Ouachitas.  The five-story brick and concrete main hospital, completed in 1940, is surrounded by long, low two-story structures, some stuccoed and some frame.  Total capacity is about 1,100 patients.  The sanatorium has its own post office, school, power plant, and cannery.  In the valley below are gardens, vineyards, orchards, and cattle barns."[83]

The scale of the Arkansas Tuberculosis Sanatorium was significant for being the largest tuberculosis sanatorium in the United States by the time the PWA buildings were finished in the early 1940s, and it remains the largest extant tuberculosis sanatorium today.  By 1938, the sanatorium had a movie theatre along with its own water supply, and it eventually got its own wastewater treatment plant and heating plant.  A post office (State Sanatorium) was established in 1927 and remained in operation until 1968.  The Commons Building also had a store for the sanatorium’s residents.  A dairy was established by 1926, according to the Sanborn maps, and other farming operations were also in place.  An ice plant was also located in the same building as the kitchen and dining rooms and the administrative area.  The sanatorium also had its own laundry.[84]

Housing was provided for the workers and families, especially after the PWA expansion in 1938-1940, through cottages, apartments, dormitories, and barracks.  The theory was to keep everybody isolated at the sanatorium as much as possible in order to help prevent the spread of the disease beyond the facility’s boundaries.  Frank Ryan notes in his book The Forgotten Plague that “the single most important achievement of such institutions [sanatoria] – a very real and dramatically effective one – was the isolation of the infected from other potential victims.”  The scale of the facility at Booneville, which allowed it to offer so many more services than other sanatoria, allowed it to take very seriously the concept of “isolation of the infected from other potential victims.”[85]

The number of buildings on the campus is much larger than other identified tuberculosis sanatoria around the country, and illustrates the wide variety of buildings needed to provide the proper treatments, goods, and services, to the sanatorium’s staff and patients.  The size of the facility is a reflection of the progressiveness of Arkansas in battling the disease and the fact that some of the individuals who were influential in getting the sanatorium established had personal experiences with the disease.  From the very beginning of trying to establish a tuberculosis sanatorium in Arkansas, the state looked for approximately 1,000 acres for the facility.  The fact that the bill for the establishment of the sanatorium was being pushed by Judge Joseph M. Hill (who had been diagnosed and treated in Arizona for tuberculosis) meant that the people seeking to establish the sanatorium had first-hand knowledge of what was needed in a sanatorium.  Tuberculosis was a serious disease in Arkansas and there was always a waiting list for treatments.  It wasn’t until the completion of the PWA expansions in 1938-1940 that “the waiting list [was] now controllable and persons with serious cases of tuberculosis need no longer die.”[86]

There were several factors that influenced the need for a tuberculosis sanatorium of such vast proportions.  First were the patients.  In the early years of the sanatorium, there were always more patients needing treatment than there was space.  By the late 1910s and early 1920s, approximately 400 patients were being admitted each year for treatment.  By the 1930s, overcrowding became so bad that the Wildcat Mountain facility was opened near Fort Smith, and the WPA built Burr Cottages to help treat patients at their homes.  (The large number of patients always needing treatment is likely linked to the fact that the poor were more susceptible to the disease.[87]  Since Arkansas historically had been a relatively poor state, there was a relatively higher risk of the state’s residents contracting the disease.)

The variety of patients at the sanatorium also helped contribute to the number of buildings and the size of the facility.  Oldham Hall, for example, was built to care for “the far advanced and hemorrhagic cases” while the Masonic Hall was built specifically for children.  Even from the earliest days of the facility, according to the 1918 Sanborn map, there were separate cottages for men and women.

The second factor that influenced the need for such a large facility was the fact that the sanatorium always tried to provide the widest variety of treatments for patients, and it led to the construction of more buildings.  The sanatorium always tried to be on top of the latest research on the disease and offer the latest and greatest treatments to the facility’s patients.  The Kelley Building, for example, which was built in the 1920s, was specifically built to allow for occupational therapy treatment, which came about in full form in the 1920s.  Postcards of the facility published in the early 1940s also show the Surgery Room in the Stewart Building and the X-Ray Room in the Nyberg Building, illustrating the pride that existed in having the modern and up-to-date facilities to provide the patients the best treatments possible.

The third factor that influenced the need for such a large facility was the need for support facilities.  From the sanatorium’s earliest days, there were buildings that were built to provide support services to the patients and staff, whether it was staff housing, a movie theatre, fire station, dairy barns, or water facilities.  As early as 1918, according to the Sanborn maps, there were water tanks or well houses along with staff housing, specifically a superintendent’s cottage.  The number of these facilities grew dramatically by the 1930s and especially after the completion of the PWA expansion.  The reason for the support facilities was to try and keep the sanatorium as self-sufficient as possible.  This minimized the contact the between the sanatorium’s patients and employees and the members of the surrounding community, therefore hopefully minimizing the potential spread of the disease.

The final factor that influenced the development of such a large complex was funding.  The state supported construction at the facility financially from the very beginning with the establishment of the sanatorium.  From the initial construction to the improvements at the facility up through the 1960s, the state provided financial support.  However, funding came from other sources.  The Masons funded the construction of the Masonic Building in 1922 and its addition in 1948-1949.  Mrs. W. J. Echols of Fort Smith built Echols Hall in memory of her husband and the Kelley Building was donated by Harry Kelley, also of Fort Smith.  Additional funding, at least during the 1920s was brought in through patient fees.

The funding and labor given by the PWA and WPA also greatly affected the growth and size of the built environment at the facility.  The Nichols-Nyberg Act of 1938, which was partially sponsored by Leo E. Nyberg, a tuberculosis sufferer, appropriated $1.2 million to fund an extensive building program at the sanatorium.

Once the PWA construction was finished in 1940, it represented the last new construction until after World War II.  However, by the late 1940s, it was decided to construct a new school and recreational wing onto the Masonic Building.  The addition was constructed in honor of the 100th anniversary of the Belle Point Lodge, which had funded the construction of the original building.  The addition, which cost approximately $125,000, was dedicated on September 9, 1949.[88]

All of the new facilities at the sanatorium allowed it to take full advantage of the new medical advancements that had been developed by the 1950s.  By 1950, the death rate from tuberculosis in Arkansas had dropped to 31.3 per 100,000 people, and treatment options had increased to include chemotherapy, antibiotics, and surgery.[89]  The development of the X-ray also aided in fighting tuberculosis by allowing large numbers of people to be screened, often with the aid of mobile X-ray units.  This allowed people to be screened and diagnosed early enough to enable better and more effective treatment.[90]

The surgery department at the sanatorium was considered second to none, and in October 1954 the first pulmonary resection, which was a procedure that removed the diseased portion of the lung to prevent the spread of the disease, was performed.  The sanatorium also had a modern laboratory, X-ray department and chemotherapy department.  All of the medical advances allowed a patient’s average stay at the sanatorium to be two to three months by the late 1950s rather than two to three years, which it was in 1934.[91]

Although advancements in the treatment of tuberculosis were made in the 1940s and 1950s, there were some aspects of a patient’s life at the facility that had not changed since the 1920s.  In the case of Richard Myers, who was admitted to the sanatorium in 1946 and stayed for approximately six to seven years, he described things in his daily regimen that were similar to the routine of the 1920s.  He was initially admitted to the Nyberg Building, but was transferred to the Masonic Building, which had babies up through children in the 8th grade.  All activities, at least with the children, were segregated boys and girls, and the children were divided into groups with the 1st through 4th grades going to school in the morning and the 5th through 8th grades going to school in the afternoon.  Myers remembered that school really did not focus much on academics but was more of a babysitting service.[92]

The daily routine at the sanatorium c.1950 for the children was that they lived on the verandas when they could.  Each wing had three or four nurses that got the patients up in the morning.  They would change clothes three times a week and they would get their clothing from a large clothing room.  The children would line up in the hall by height for breakfast.  Patients ate in a large dining room and everyone stood by their chair until all of the patients were there.  They then had a prayer and ate and then cleaned up their area after breakfast.  The younger children went to school in the morning, which included Myers, before having lunch.  From 1 p.m. until 3 p.m. there was a rest period that involved lying down quietly.  After 3 p.m., they played outside where they had a swingset and playground, but no toys.  The patients then ate supper and then stayed inside until 9 p.m. when it was bedtime.[93]

Friday nights and weekends did bring some variety to the schedule.  Friday nights often involved seeing a movie in the commons building, and the children, at least, also got ice cream.  On the weekends, the children could play or read more, essentially entertaining themselves as best they could.  Excursions off the sanatorium grounds were rare, although Myers does remember one such trip to Fort Smith in the early 1950s to see a rodeo.[94]

Even though people understood the seriousness of tuberculosis, and understood the extensive treatment that could be had at the sanatorium by the 1940s, there were infected people who refused to seek treatment.  Act 161 of the 1955 legislature provided for compulsory isolation of patients, and the sanatorium converted English Cottage No. 1 into a secure facility to house those patients.  Rehabilitation programs also grew at the sanatorium during the 1950s.  A vocational rehabilitation program was developed in 1955, and a renovation and expansion of the Kelley Building was completed at a cost of $86,532 and dedicated on March 21, 1958, to house the program.[95]  In addition, to house the increasing number of employees needed at the facility, a new 72-person dormitory, Dormitory No. 3, was built in 1953 at a cost of more than $150,000, and five new apartment buildings, A-Complex through E-Complex, were started in 1957 and finished the following year.[96]  A new fire station followed in 1959 and a new superintendent’s house was built in 1960.

However, a new force in the fight of tuberculosis – antibiotics, specifically streptomycin and para-aminosalicylic acid, or PAS – began showing great promise in the 1940s in the treatment of tuberculosis, especially if the two drugs were combined.[97]  As a result, by the 1950s, tuberculosis began to decline and the use of sanatoria was not of as much importance.  The nationwide decline of patients was also reflected in Arkansas where, by the 1956-1958 biennium, only 3,958 patients were admitted for observation and treatment at the sanatorium.[98]

The dramatic reductions of tuberculosis cases and deaths as a result of the use of antibiotics continued into the 1960s as well.  According to the book, The Last Crusade, “by 1967 tuberculosis was causing only fourteen new cases and 4.1 deaths per 100,000 per year.  From the time reliable record keeping began to be possible, around 1900, both new cases of tuberculosis and deaths from it had been declining at a rate of from 4 to 6 percent a year; and with the introduction of antibiotics, the falloff rate doubled.”[99]  Again the reduction in cases was reflected in Arkansas.  By 1966, Pulaski County had the largest number of cases reported that year at 44, while the other counties only had one or two new cases to report.[100]

The 1960s also started to bring about the end of the Arkansas Tuberculosis Sanatorium.  The last major construction project at the facility took place with the construction of the Judge Joseph M. Hill Building in 1963-1964.  It was built as a surgery/intensive care unit at a cost of approximately $700,000, and was funded through monies saved by the sanatorium out of its operational funds.[101]  The building was built on the site previously occupied by Meriweather Hall, which had been built in the 1920s, while two residences that stood on the site were moved to Nature Lane, where they remain today.[102]

By the mid-1960s, the patient population at the sanatorium had decreased dramatically.  In 1965, the sanatorium was rated by the Public Health Service as having 847 beds.  However, only an average of 374 beds were occupied in 1965, and $1,783,098 was expended on operation of the sanatorium during the 1965-1966 fiscal year.[103]  As a result, many aspects of the institution were gradually phased out.  The bakery, post office, and various other buildings were closed as operations were scaled back.  In 1968, the dairy was closed and all of the cattle and equipment were transferred to the Arkansas Department of Corrections.[104]

The last patient was discharged from the Arkansas Tuberculosis Sanatorium on February 26, 1973, and Act 320 of the 1973 legislature was passed to “Transfer Title to the Arkansas Tuberculosis Sanatorium to the State of Arkansas; to Transfer Jurisdiction and Control Over the Sanatorium From the Department of Health to Mental Retardation-Developmental Disability Services, a Division of the Department of Social and Rehabilitative Services; to Abolish the Board of Trustees of the Arkansas Tuberculosis Sanatorium; and for Other Purposes.”  The sanatorium officially closed on June 30, 1973, and when it closed it was estimated that 70,000 patients had passed through its doors.[105]

It is possible that the Arkansas Tuberculosis Sanatorium was one of the last tuberculosis sanatoria operating in the country.  According to The Last Crusade, “…for all practical purposes, by 1960 the American sanatorium had vanished from the landscape.”  In fact, in New York where the first sanatorium opened in 1884, the last state sanatorium, Homer Folks in Oneonta, closed in 1973.[106]

Although the Arkansas Tuberculosis Sanatorium closed on June 30, 1973, it was not long before the campus was put to use again, opening as the Booneville Human Development Center (BHDC) in July 1973.  The facility is one of six human development centers around the state that provide residential services to people with developmental disabilities.  The BHDC currently serves a maximum of 159 people with developmental disabilities, age 19 or older.  The facility is able to provide people who are ambulatory with no severe medical needs a variety of training programs, including on-campus and off-campus trainee positions, and a variety of living arrangements from a dormitory setting to semi-independent cottage and apartment living.  The BHDC still provides these services today, and utilizes the vast majority of the buildings on campus.[107]

In comparison to other tuberculosis sanatoria around the country listed on the National Register, the Arkansas Tuberculosis Sanatorium Historic District appears to be much larger and more intact with a wider variety of structures.  The Tuberculosis Hospital of Pittsburgh, Pennsylvania, (NR-listed on 02/25/93), for example, is a small-scale complex that contains only eight buildings on 4.9 acres while the Waverly Hills Tuberculosis Sanitarium Historic Buildings in Louisville, Kentucky, (NR-listed on 07/12/83) contains three buildings on approximately 16 acres.[108]  The Statesan Historic District near Wales, Wisconsin (NR-listed on 04/21/88), which is a portion of the Wisconsin State Sanatorium, contains eight buildings on four acres in the middle of the modern buildings of the Ethan Allen School for Boys.[109]  Finally, the A. G. Holley State Hospital (NR listing in process) in Lantana, Florida, contains 30 buildings on approximately 144 acres.[110]

Although many of the sanatoria listed on the National Register are small-scale complexes, other large-scale facilities do exist.  The Minnesota State Sanatorium for Consumptives near Walker, Minnesota (NR-listed on 07/25/01) consists of 31 buildings and structures on 176.2 acres, and does include some support structures in addition to the hospital and staff buildings.  However, the buildings on the campus do not include the variety (i.e., a dairy, water treatment plant, wastewater treatment plant, fire station, guinea pig piggery, or commons building with theater, among others) that are present at the Arkansas Tuberculosis Sanatorium.[111]

Another large-scale complex that still exists is the Choctaw Nation Indian Hospital Complex (Talihina) in Oklahoma, which consists of 26 buildings.  Although the complex did include a variety of structures at its peak, including a commissary and a working farm that had a dairy barn, hog shed, cow shed, poultry house, hay storage, and feed storage, the farm complex no longer exists.  It also does not appear that the Talihina facility includes the vast amount of acreage that the Arkansas facility contains.[112]

The South Carolina Tuberculosis Sanatorium was another large-scale complex, but still does not approach the size of the Arkansas Tuberculosis Sanatorium.  Sited on 200 acres, the facility included both white and black patients, and had a total of 550 patients by 1941.  (Arkansas had a separate black tuberculosis sanatorium located outside of Alexander, Saline County, portions which remain today as the Alexander Human Development Center.)  The parts of the complex that still stand include original patient wards, administrative buildings, nurse and doctor cottages, and maintenance structures.[113]

Today, the Arkansas Tuberculosis Sanatorium Historic District remains an impressive complex on its hilltop location south of Booneville.  The 76 buildings and structures on just under 900 acres remain the largest extant tuberculosis facility in the nation, and illustrate the wide variety of buildings needed to operate a self-sufficient facility – from hospitals and patient buildings to doctors and nurses cottages, and from dairy buildings to water and wastewater treatment plants.  The excellent examples of the Art Deco, Colonial Revival, and Craftsman styles of architecture, among others, also represent an impressive collection of early twentieth-century architectural styles.

Although the physical fabric of the district is impressive and important, the district also remains a notable illustration of the fight against tuberculosis in the United States throughout much of the twentieth century.  The Arkansas Tuberculosis Sanatorium Historic District reflects the evolution in treatment of tuberculosis from exposure to fresh air, to surgery, to the use of antibiotics in the last half of the century.  The vast amount of new construction that took place at the facility in the late 1930s and early 1940s and the slowdown in construction in the 1950s and 1960s illustrates the growth and decline in the need for facilities to care for tuberculosis patients as medical science was able to gain the upper hand on the disease.

The practices used at the Arkansas Tuberculosis Sanatorium were examined by health professionals and influenced practices at similar facilities both nationally and internationally.  In Tennessee, for example, “Dr. W. W. Hubbard, director, and Dr. Harrison, of the Tuberculosis Hospitalization Service of the Department of Public Health of Tennessee, were guests of the Sanatorium, January 6-7.  The state of Tennessee has recently secured an appropriation for the establishment of a tuberculosis sanatorium, and Dr. Hubbard and Dr. Harrison came here for the purpose of observing Arkansas’ tuberculosis control program…”[114]  Other notable national visitors were noted by the Sanatorium Outlook.  In the April 1943 issue it mentioned that, “an interested and interesting visitor at the Sanatorium March 10 was Dr. C. M. Sharp, consultant in the Division of Tuberculosis Control of the United States Public Health Service.  Dr. Sharp, before his entrance into the service, was the superintendent of the Georgia State Sanatorium.”[115]  However, interest was not limited to the United States.  The September 1928 issue of the Sanatorium Outlook indicated that a questionnaire had been received from Professor Enrico Ronzani, Director of the Instituti Ospotalieri di Milano in Italy.  The questionnaire asked about several aspects of the sanatorium including the number of patients, average stay, how much they paid for treatment, the facility’s staff, their salaries, and duties.

The Arkansas Tuberculosis Sanatorium Historic District is nationally significant for its role in the national (and international) fight against tuberculosis beginning in the early twentieth century, and for its influence on the fight against tuberculosis in other parts of the country.  The facility reflects the state of Arkansas’s progressive stance against tuberculosis and the pioneering establishment of a state-run sanatorium to actively and aggressively fight a disease that was severely debilitating to the state.  At the same time, it also reflects Arkansas’s concerted efforts to deal with a variety of public health issues throughout the early twentieth century.  The complex also reflects the wide variety of buildings and support facilities that were needed to stay on top of the latest treatments and offer the widest variety of treatments for tuberculosis patients.  In addition, the size of the complex reflects the vast amount of resources needed to take seriously the concept of “isolation of the infected from other potential victims,” which was “the single most important achievement of such institutions [sanatoria].”[116]

Overall, the Arkansas Tuberculosis Sanatorium Historic District remains a nationally important example of a twentieth-century tuberculosis sanatorium that illustrates the trends in tuberculosis treatment and retains the physical fabric to reflect its heyday as the “largest and best institution of its kind as regards treatment facilities in the nation.”



[1] Rene Dubos and Jean Dubos.  The White Plague:  Tuberculosis, Man and Society.  Boston:Little, Brown and Company, 1952, and the Sanatorium Outlook, July 1935, p. 24.

[2] Mark Caldwell.  The Last Crusade:  The War on Consumption, 1862-1954.  New York:Atheneum, 1988, p. 43.

[3] “State Sanitation Society Proposed.”  Booneville Democrat, 1 October 1908, p. 2, column 5.

[4] “50 Year Fighting Tuberculosis in Arkansas.”  Arkansas Tuberculosis Association, 1967, p. 3.

[5] Logan County Arkansas:  Its History and Its Peoples.  Taylor Publishing Company, 1987, p. 46.

[6] Ibid.

[7] Craig, Bob.  Registration Coordinator, New Jersey Historic Preservation Office.  E-mail to the author.  27 July 2006.

[8] Christensen, Bob.  Michigan State Historic Preservation Office.  E-mail to the author.  27 July 2006.

[9] Rowe, Alan.  National Register Coordinator, West Virginia State Historic Preservation Office.  E-mail to the author.  26 July 2006.

[10] Patterson, Tiffany.  National Register Coordinator.  Missouri State Historic Preservation Office.  E-mail to the author. 26 July 2006.

[11] Wagner, Marc.  State and National Registers Manager, Virginia Department of Historic Resources.  E-mail to the author.  26 July 2006.

[12] Forbes, Jessica.  Florida Department of State, Bureau of Historic Preservation.  E-mail to the author.  28 July 2006.

[13] Stager, Claudette.  Tennessee Historical Commission.  E-mail to the author.  26 July 2006.

[14] Sanatorium Outlook, February 1942, p. 8.

[15] Ibid.

[16] Arkansas Tuberculosis Sanatorium.  Tuberculosis or Consumption:  Its Prevention and Treatment.”  Booneville, AR:  Progress Printing Co., c.1925, p. 15.

[17] Ibid.

[18] “50 Year Fighting Tuberculosis in Arkansas.”  Arkansas Tuberculosis Association, 1967, p. 5.

[19] Logan County Arkansas:  Its History and Its Peoples.  Taylor Publishing Company, 1987, p. 46.

[20] “Tuberculosis Survey of Little Rock.”June 1914, p. 6.  In the files of the Butler Center for Arkansas Studies, Little Rock, AR.

[21] Ibid, p. 8.

[22] Ibid, pp. 2, 9.

[23] Pitcock, Cynthia DeHaven.  The Old State House and the Crossett Experiment.  Little Rock:  Arkansas Historic Preservation Program, 1997, p. 1.

[24] Etheridge, Elizabeth W.  “Pellagra:An Unappreciated Reminder.”  Disease and Distinctiveness in the American South.  Eds.  Todd L. Savitt and James Harvey Young.  Knoxville:  The University of Tennessee Press, 1988, pp. 104-105.

[27] Pitcock, pp. 1-2.

[28] Pitcock, p. 3.

[29] Pitcock, pp. 3-4.

[30] Pitcock, p. 5.

[31] Pitcock, pp. 5-6.

[32] Pitcock, p. 6.

[33] Pitcock, p. 7.

[34] Marcus, Alan I.  “The South’s Native Foreigners:  Hookworm as a Factor in Southern Distinctiveness.”  Disease and Distinctiveness in the American South.  Eds.  Todd L. Savitt and James Harvey Young.  Knoxville:  The University of Tennessee Press, 1988, p. 93.

[35] Sanborn Fire Insurance map for Booneville, Arkansas:  October 1913.

[36] Ibid.

[37] Charlotte A. Power.  “A History of the Arkansas State Tuberculosis Sanatorium.”  Unpublished research paper in the files of the Booneville Human Development Center and the Arkansas Historic Preservation Program, 25 April 1989, p. 10.

[38] Ethel Hale Cox.  “Reflection of Five Decades of Service, 1909-1959:  A History of the Arkansas Tuberculosis Sanatorium.”  State Sanatorium, AR:  Board of Trustees of the Arkansas Tuberculosis Sanatorium, 1959, p. 23.

[39] Charlotte A. Power.  “A History of the Arkansas State Tuberculosis Sanatorium.”  Unpublished research paper in the files of the Booneville Human Development Center and the Arkansas Historic Preservation Program, 25 April 1989, p. 11, and Ethel Hale Cox.  “Reflection of Five Decades of Service, 1909-1959:  A History of the Arkansas Tuberculosis Sanatorium.”  State Sanatorium, AR:  Board of Trustees of the Arkansas Tuberculosis Sanatorium, 1959, p. 23.

[40] Ethel Hale Cox.  “Reflection of Five Decades of Service, 1909-1959:  A History of the Arkansas Tuberculosis Sanatorium.”  State Sanatorium, AR:  Board of Trustees of the Arkansas Tuberculosis Sanatorium, 1959, p. 24.

[41] Mark Caldwell.  The Last Crusade:  The War on Consumption, 1862-1954.  New York:Atheneum, 1988, p. 121.

[42] Sanatorium Outlook, September 1935, p. 5.

[43] Arkansas Tuberculosis Sanatorium.  Tuberculosis or Consumption:  Its Prevention and Treatment.”  Booneville, AR:  Progress Printing Co., c.1925, p. 4.

[44] Rene Dubos and Jean Dubos.  The White Plague:  Tuberculosis, Man and Society.  Boston:  Little, Brown and Company, 1952, pp. 137 and 256.

[45] Ibid, p.p. 15-16.

[46] Sanatorium Outlook, December 1929, p. 10.

[47] Ibid, pp. 15 and 23.

[48] Sanatorium Outlook, August 1937, p. 13.

[49] Sanatorium Outlook, April 1936, p. 6.  Although it is not known where the name Burr Cottage originated, according to the A Review of Work Relief Activities in Arkansas, April 1st, 1934, to July 1st, 1935 (p. 42), it says that “This cabin is erected in ‘knock down’ form at Works Progress work shops and when completed constitutes a small load for a one-ton truck.  Moved to the site of erection it requires the services of two men for a period of four hours to assemble it complete and ready for occupancy.  Through the use of this cabin, it is possible to segregate the tuberculars from other members of the family while permitting them to remain at home.  This cabin is being used rather extensively in several of the counties and its plan has been provided to all the counties in the state, nearly all of which are using it to some extent.  The total man hour expenditure on these cabins is indeterminate but the construction of the cabin itself requires forty man hours of labor.”

[50] Sanatorium Outlook, February 1937, p. 8.

[51] Sanatorium Outlook, April 1937, p. 6.

[52] Sanatorium Outlook, July 1934, p.7.

[53] Sanatorium Outlook, September 1935, p. 5.

[54] Sanatorium Outlook, December 1935, p. 10.

[55] Ibid.

[56] Sanatorium Outlook, January 1936, p. 8, and Sanatorium Outlook, February 1936, p. 2.

[57] Sanatorium Outlook, October 1936, p. 7.

[58] Sanatorium Outlook, January 1938, p. 8.

[59] Sanatorium Outlook, July 1938, p. 8.

[60] Sanatorium Outlook, September 1938, p. 8.

[61] Ibid, p. 5.

[62] Ibid.

[63] Sanatorium Outlook, May 1938, p. 5.

[64] Sanatorium Outlook, November 1938, p. 7.

[65] Sanatorium Outlook, December 1938, p. 10, and Sanatorium Outlook, January 1939, p. 8.

[66] Sanatorium Outlook, May 1939, p. 8, and Sanatorium Outlook, June 1939, p. 8.

[67] Sanatorium Outlook, June 1939, p. 8, and Sanatorium Outlook, August 1939, p. 8.

[68] Sanatorium Outlook, July 1939, p. 8.

[69] Sanatorium Outlook, August 1939, p. 8.

[70] Sanatorium Outlook, September 1939, p. 8, and Sanatorium Outlook, October 1939, p. 4.

[71] Sanatorium Outlook, September 1939, p. 14, and Sanatorium Outlook, January 1940, p. 8.

[72] Sanatorium Outlook, November 1939, p. 4.

[73] Sanatorium Outlook, February 1940, p. 8.

[74] Sanatorium Outlook, March 1940, p. 8.

[75] Sanatorium Outlook, May 1940, p. 8.

[76] Sanatorium Outlook, March 1940, p. 4.

[77] Sanatorium Outlook, July 1940, p. 3, and Sanatorium Outlook, August 1940, p. 5.

[78] Maner, Representative Ernest.  “On the Life of Leo E. Nyberg.”  Address given in the Arkansas House of Representatives on January 15, 1941.  In the files of the Arkansas History Commission.

[79] Sanatorium Outlook, July 1941, p. 10.

[80] Ethel Hale Cox.  “Reflection of Five Decades of Service, 1909-1959:  A History of the Arkansas Tuberculosis Sanatorium.”  State Sanatorium, AR:  Board of Trustees of the Arkansas Tuberculosis Sanatorium, 1959, p. 34.

[81] Ibid.

[82] Ibid, p. 31.

[83] Elliot West, ed.  The WPA Guide to 1930s Arkansas.  Lawrence, KS:  University Press of Kansas, 1987 reprint of 1941 publication, p. 365.

[84] Baker, Russell Pierce.  From Memdag to Norsk:  A Historical Directory of Arkansas Post Offices, 1832-1971.  Hot Springs, AR: Arkansas Genealogical Society, 1988, p. 209, and Sanborn Fire Insurance maps for Booneville, Arkansas:  October 1913, December 1918, April 1926, and 1938, in the files of the Arkansas Historic Preservation Program.

[85] Ryan, Frank, M.D.  The Forgotten Plague:  How the Battle Against Tuberculosis was Won – and Lost.  Little, Brown & Company, 1992, p. 28.

[86] Maner, Representative Ernest.  “On the Life of Leo E. Nyberg.”  Address given in the Arkansas House of Representatives on January 15, 1941.  In the files of the Arkansas History Commission.

[87] Landau, Elaine.  Tuberculosis.  New York:Franklin Watts, 1995, p. 46.

[88] Ethel Hale Cox.  “Reflection of Five Decades of Service, 1909-1959:  A History of the Arkansas Tuberculosis Sanatorium.”  State Sanatorium, AR:  Board of Trustees of the Arkansas Tuberculosis Sanatorium, 1959, p. 25.

[89] Although the death rate had dropped in Arkansas, it was still the seventh highest in the country, because of the state’s large black population.  Blacks, Hispanics, and Native Americans were much more susceptible to the disease, which was reflected in the fact that the top ten highest death rates were found in states in the South or Southwest.  Found in:  Rene Dubos and Jean Dubos.  The White Plague:  Tuberculosis, Man and Society.  Boston:  Little, Brown and Company, 1952, p. 267.

[90] Charlotte A. Power.  “A History of the Arkansas State Tuberculosis Sanatorium.”  Unpublished research paper in the files of the Booneville Human Development Center and the Arkansas Historic Preservation Program, 25 April 1989, p. 17.

[91] Charlotte A. Power.  “A History of the Arkansas State Tuberculosis Sanatorium.”  Unpublished research paper in the files of the Booneville Human Development Center and the Arkansas Historic Preservation Program, 25 April 1989, pp. 17-18.

[92] Richard Myers (former patient at the Arkansas Tuberculosis Sanatorium).  Interview with the author.  20 September 2005.

[93] Ibid.

[94] Ibid.

[95] Charlotte A. Power.  “A History of the Arkansas State Tuberculosis Sanatorium.”  Unpublished research paper in the files of the Booneville Human Development Center and the Arkansas Historic Preservation Program, 25 April 1989, pp. 19-20.

[96] Ethel Hale Cox.  “Reflection of Five Decades of Service, 1909-1959:  A History of the Arkansas Tuberculosis Sanatorium.”  State Sanatorium, AR:  Board of Trustees of the Arkansas Tuberculosis Sanatorium, 1959, pp. 35 and 37.

[97] Mark Caldwell.  The Last Crusade:  The War on Consumption, 1862-1954.  New York:Atheneum, 1988, p. 264-265.

[98] Ethel Hale Cox.  “Reflection of Five Decades of Service, 1909-1959:  A History of the Arkansas Tuberculosis Sanatorium.”  State Sanatorium, AR:  Board of Trustees of the Arkansas Tuberculosis Sanatorium, 1959, p. 39.

[99] Mark Caldwell.  The Last Crusade:  The War on Consumption, 1862-1954.  New York:  Atheneum, 1988, p. 247.

[100] Charlotte A. Power.  “A History of the Arkansas State Tuberculosis Sanatorium.”  Unpublished research paper in the files of the Booneville Human Development Center and the Arkansas Historic Preservation Program, 25 April 1989, p. 21.

[101] Ibid.

[102] Richard Myers (former patient at the Arkansas Tuberculosis Sanatorium).  Interview with the author.  20 September 2005.

[103] Karl H. Pfeutze, M.D.  Tuberculosis Control in Arkansas.  Arkansas Tuberculosis Association, 1967, p. 28.

[104] Charlotte A. Power.  “A History of the Arkansas State Tuberculosis Sanatorium.”  Unpublished research paper in the files of the Booneville Human Development Center and the Arkansas Historic Preservation Program, 25 April 1989, pp. 21-22.

[105] Information on the Arkansas Tuberculosis Sanatorium found at:  http://www.booneville.com/C-TB.htm, and Charlotte A. Power.  “A History of the Arkansas State Tuberculosis Sanatorium.”  Unpublished research paper in the files of the Booneville Human Development Center and the Arkansas Historic Preservation Program, 25 April 1989, pp. 21-22.

[106] Mark Caldwell.  The Last Crusade:  The War on Consumption, 1862-1954.  New York:Atheneum, 1988, p. 270.

[107] Information on the Booneville Human Development Center found at:  http://www.arkansas.gov/dfa/budget/pdfs/0710_developmental_disabilities_manual-8_summary-8.pdf.

[108] Kevin G. Scott.  “Tuberculosis Hospital of Pittsburgh, Pittsburgh, Allegheny County, Pennsylvania.”  National Register of Historic Places Registration Form.  From the files of the Pennsylvania Historical and Museum Commission, 1992, and Information on the Waverly Hills Tuberculosis Sanitarium Historic Buildings.  From the files of the Kentucky Heritage Council, 1979.

[109] James Draeger.  “Statesan Historic District, Wales, Waukesha County, Wisconsin.”  National Register of Historic Places Registration Form.  From the files of the Wisconsin Historical Society, 1988.

[110] Bonnie Dearborn from the Southeast Florida Regional Preservation Office.  Telephone conversation with the author.  10 November 2005.

[111] Rolf T. Anderson.  “Minnesota State Sanatorium for Consumptives, Shingobee Township (Ah-Gwah-Ching), Walker, Cass County, Minnesota.”  National Register of Historic Places Registration Form.  From the files of the Minnesota Historical Society, 2001.

[112] Van Citters Historic Preservation, LLC.  “Oklahoma City Area Indian Health (OCAIHS) Historic Building Survey.”  Final Report in the files of the Oklahoma Historical Society, 12 July 2005, pp. 11-12 and 22-38.

[113] Information on the South Carolina Tuberculosis Sanatorium courtesy of the South Carolina Archives & History Center.

[114] Sanatorium Outlook, February 1942, p. 8.

[115] Sanatorium Outlook, April 1943, p. 8.

[116] Ryan, Frank, M.D.  The Forgotten Plague:  How the Battle Against Tuberculosis was Won – and Lost.  Little, Brown & Company, 1992, p. 28.

SIGNIFICANCE

Located approximately 2.5 miles south of Booneville on “The Hill,” an extension of Potts Ridge, the Arkansas Tuberculosis Sanatorium Historic District is comprised of 76 buildings, structures, and objects located on approximately 896.18 acres.  By the early 1940s the Arkansas Tuberculosis Sanatorium had a capacity of approximately 1,100 patients and was touted as the “largest and best institution of its kind as regards treatment facilities in the nation.”  The campus was essentially its own independent city with a complete farming operation, its own fire department, telephone system, post office, and water treatment plant.  For its associations with the nationwide fight against tuberculosis throughout much of the twentieth century, the Arkansas Tuberculosis Sanatorium Historic District is being nominated to the National Register of Historic Places with national significance under Criterion A.

The buildings on the campus were built beginning in 1909 with the creation of the Sanatorium and the majority of them were built by 1960.  However, many of the buildings were built in the late 1930s and early 1940s by the Public Works Administration (PWA) and represent an excellent collection of early twentieth century architectural styles, including the Art Deco, Craftsman, and Colonial Revival styles.  The Art Deco buildings on campus, which include the former Administration Building, Hamp Williams Building, and Leo Nyberg Building, comprise one of the best collections of the Art Deco style in Arkansas.  In addition, the number of buildings and acreage associated with the Arkansas Tuberculosis Sanatorium Historic District represent the largest known facility of its kind remaining in the country, and an extremely large and intact example of a twentieth-century tuberculosis sanatorium.  As a result, the Arkansas Tuberculosis Sanatorium Historic District is also being nominated to the National Register with national significance under Criterion C.

BIBLIOGRAPHY

“50 Year Fighting Tuberculosis in Arkansas.”  Arkansas Tuberculosis Association, 1967.

Anderson, Rolf T.  “Minnesota State Sanatorium for Consumptives, Shingobee Township (Ah-Gwah-Ching), Walker, Cass County, Minnesota.”  National Register of Historic Places Registration Form.  From the files of the Minnesota Historical Society, 2001.

Arkansas Tuberculosis Sanatorium.  "Tuberculosis or Consumption:  Its Prevention and Treatment.”  Booneville, AR:  Progress Printing Co., c.1925.

Baker, Russell Pierce.  From Memdag to Norsk:  A Historical Directory of Arkansas Post Offices, 1832-1971.  Hot Springs, AR:  Arkansas Genealogical Society, 1988.

Caldwell, Mark.  The Last Crusade:  The War on Consumption, 1862-1954.  New York:  Atheneum, 1988.

Christensen, Bob.  Michigan State Historic Preservation Office.  E-mail to the author.  27 July 2006.

Cox, Ethel Hale.  “Reflection of Five Decades of Service, 1909-1959:  A History of the Arkansas Tuberculosis Sanatorium.”  State Sanatorium, AR:  Board of Trustees of the Arkansas Tuberculosis Sanatorium, 1959.  In the files of the Booneville Human Development Center and the Arkansas Historic Preservation Program.

Craig, Bob.  Registration Coordinator, New Jersey Historic Preservation Office.  E-mail to the author.  27 July 2006.

Dearborn, Bonnie, from the Southeast Florida Regional Preservation Office.  Telephone conversation with the author.  10 November 2005.

Dormandy, Thomas.  The White Death:  A History of Tuberculosis.  New York:  New York University Press, 2000.

Draeger, James.  “Statesan Historic District, Wales, Waukesha County, Wisconsin.”  National Register of Historic Places Registration Form.  From the files of the Wisconsin Historical Society, 1988.

Dubos, Rene and Jean Dubos.  The White Plague:  Tuberculosis, Man and Society.  Boston:  Little, Brown and Company, 1952.

Etheridge, Elizabeth W.  “Pellagra:  An Unappreciated Reminder.”  Disease and Distinctiveness in the American South.  Eds.  Todd L. Savitt and James Harvey Young.  Knoxville:  The University of Tennessee Press, 1988.

Forbes, Jessica.  Florida Department of State, Bureau of Historic Preservation.  E-mail to the author.  28 July 2006.

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Information on the Booneville Human Development Center found at:  http://www.arkansas.gov/dfa/budget/pdfs/0710_developmental_disabilities_manual-8_summary-8.pdf.

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Myers, Richard (former patient at the Arkansas Tuberculosis Sanatorium).  Interview with the author.  20 September 2005.

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