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

Brehmeris in the 1850s, did not take hold in
the United States until after 1884. Edward
Livingston Trudeau, a physician who recovered
from TB disease, started a sanatorium in
Saranac Lake, New York, based on the European
model of strict supervision in providing
fresh air and sunshine, bed rest, and nutritious
foods.
“Little Red,” first cottage for tuberculous patients at
Trudeau Sanatorium.
As infection control measures took hold in
large urban centers of the country, TB patients
who could not be treated in local dispensaries
were removed from the general population
and placed into sanatoriums. Soon a great
movement was underway to build TB sanatoriums.
By 1938 there were more than 700
sanatoriums throughout the United States, yet
the number of patients outnumbered the beds
available.
For those households in which the adults
could not be placed in a sanatorium, children
were removed from infected parents and
placed in preventoriums that were created for
children.
A milestone in the history of TB control in
the United States occurred in the autumn of
1893, when the New York City Board of
Health called on Dr. Hermann Michael Biggs,
the Chief Inspector of the Division of Pathology,
Bacteriology, and Disinfection, for a
report on TB. In the report, Biggs stated that
TB, which was responsible for more than
6,000 deaths in New York City in 1892, was
Notable Events in TB Control
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both communicable and preventable. Some of
the recommendations made to the Board in his
report were the need to
1) educate the public of the dangers that the
disease posed to the person and his/her contacts,
2) properly dispose of and immediately destroy
sputum or the “discharges from the
lungs” of individuals with disease,
3) have all physicians of pulmonary cases
report such cases to the health department,
4) have health inspectors visit the families
where TB exists and deliver proper literature
and take specific measures to disinfect the
areas as may be required,
5) obtain and submit sputum specimens to the
laboratory for analysis, and
6) create a consumptive hospital to care for
indigent patients.
The Board adopted most of the recommendations
made by Biggs, including the creation of
“The Consumptive Hospital.” These recommendations
created a storm of controversy
among the medical community. Many private
doctors objected to the mandatory reporting,
believing that it violated physician-patient
confidentiality. Because of the resistance from
the medical community, reporting practices
were not fully implemented for several years.
In the end, Biggs’ recommendations to the
Board and their implementation in New York
City created the model for TB control pro-
With no drug therapies, past TB suffers like
these in 1953 were isolated in sanatoriums.