CDC History of Tuberculosis Control - Medical and Public Health ...

joining forces with a young rabbi, the two
raised enough money to buy some land and
erect a building, which was ready for patients
in 1893. Unfortunately, however, Denver was
hit with the Silver Crisis that year, and there
was not enough money to open and run the
hospital.
This setback convinced the organizers that
they should expand their fundraising efforts
beyond Colorado. The thinking in Denver
was that, since patients came there from all
over the nation, people all over the United
States should help support the hospital. They
turned to B’nai B’rith, a national Jewish
service organization, and contributions came
in from across the country. The building
finally opened in 1899 as the “National Jewish
Hospital for Consumptives.”
National Jewish was the first hospital in the
nation to focus exclusively on indigent TB
patients. As expressed in a singular motto, this
philosophy was “None may enter who can
pay, none can pay who enter.” From day one,
National Jewish was non-profit and nonsectarian.
The hospital opened with a capacity of 60
patients; the goal was to treat 150 patients per
year. This was made possible by putting a 6month
limit on patient stays. Furthermore,
National Jewish only accepted patients in the
early stages of TB. At least that was the plan.
In reality, however, several chronic sufferers
were admitted, and after a few months, the 6month
limit was lifted.
The treatment at National Jewish was in line
with the protocols at other turn-of-the-century
TB sanatoria: plenty of fresh air, lots of food,
moderate exercise, and close scrutiny of every
aspect of patients’ lives. The inhabitants of
National Jewish, thus, could expect to sleep
outside — or with their heads outside — every
night, and were all but stuffed with food. In
1911, for instance, the annual report records
that National Jewish spent $3,631 on eggs —
Notable Events in TB Control
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roughly equivalent to $62,000 today — for just
120 patients.
In 1914, National Jewish erected a building for
the study of TB; this was the first place in
which research on the disease was done outside
of a medical school setting. Other advances
included the nation’s first self-contained
facility for treating children with active
cases of TB and work on anti-TB drugs such as
isoniazid (INH) in the early 1950s. Later in
that same decade, doctors at National Jewish
came up with a new protocol for TB that
included abandonment of bed rest and a
substitution of physical activity; use of microbiological
assay measurements to determine
the proper dosage of INH; and combined drug
therapy using streptomycin, INH, and paraaminosalicylic
acid.
As TB gradually came under control in the
United States, National Jewish expanded its
mission to include asthma and other respiratory
diseases, but maintained a strong presence
in TB. Research continued on better drugs,
and the institution expanded its education
efforts. In 1963, the 1- to 2-week TB control
course was offered for specialists from all over
the world, a course that is still offered today.
Indeed, over the past 20 years, nearly 5,000
physicians and nurses have visited Denver for
the course.
Rifampin, the most widely used drug for TB
today, was tested at National Jewish in 1970.
Two years later, federal funds established a
state-of-the-art laboratory to study difficult TB
cases. This helped establish National Jewish as
a highly specialized center for drug-resistant
TB and atypical mycobacterial infections.
Today, National Jewish continues to be a
steady contributor in the fight against TB.
The hospital offers compassionate care to
victims of MDR TB, often providing treatment
for the poor at no charge. Leading
pharmaceutical companies collaborate with
National Jewish to test new drugs. Perhaps