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For six decades, the Catawba Sanatorium treated patients ravaged by tuberculosis.
Courtesy of Collection of the Historical Society of Western Virginia
Patients slept on open verandas, regardless of temperature, due to the perceived benefit of inhaling fresh air.
It would often begin as fatigue occasionally accompanied by night sweats and persistent coughing. Once blood appeared in the mouth from a cough, the diagnosis was certain — tuberculosis. Originally called consumption, tuberculosis was the leading cause of death in the US in the 19th and early 20th century, with an estimated death rate of 450 Americans per day.
With no known cure, patients literally wasted away. The skin went pale due to the impact of the disease on the blood and organs, causing tuberculosis to be known as the “white death.” Even if one survived the disease, debilitating symptoms would reoccur throughout one’s lifetime. Physicians initially tried bleedings and purgings with no success and eventually settled on a treatment regimen of bed rest, a healthy diet and fresh air. The latter was deemed critically important as tuberculosis commonly affected the lungs.
Courtesy of Collection of the Historical Society of Western Virginia
Patients are being weighed in this 1930s image. Weight gain was believed to be a sign of recovery.
By the 1880s, researchers discovered that tuberculosis was not only contagious, as opposed to hereditary, but spread by coughing and sneezing. Urban centers, factories and the homes were Petri dishes, and the message to tuberculosis sufferers was clear — stay away! — giving rise to tuberculosis sanatoriums.
Virginia established its first tuberculosis sanatorium in 1908 at Catawba in Roanoke County by converting the Roanoke Red Sulphur Springs resort, purchasing the 30-room hotel, ten cottages and 600-acre campus for $19,000. Most of the cottages and farm buildings were in total disrepair.
Patients were initially housed in wooden pavilions with long verandas where they could be subjected to mountain air, regardless of temperature, and diets of farm fresh fruits, vegetables and meats to stave off weight loss. While rest was encouraged, patients also walked the grounds usually with the assistance of canes to enjoy the rural environment. The “healing waters” of the former resort were deemed an asset to treatment. Doctors and nurses lodged on site in separate quarters and over time the sanatorium gained a post office, amusement hall, crafts center and even a chapel.
The sanatorium had its limitations, however. At first it only admitted patients whose cases were deemed curable and remained limited to whites usually from middle class backgrounds. In 1917, the state opened the Piedmont Sanatorium for Blacks. Catawba grew to a 163-bed capacity, yet there were thousands of tuberculosis cases. Patients and supplies had to be hauled from Salem, 12 miles away, over the poorly maintained roads that crossed Catawba Mountain.
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The story above is a preview from our July/August 2025 issue. For more stories like it, Subscribe Today. Thank you!