Male Tuberculosis Patients Taking the Fresh Air Cure in Howell, Michigan

The Sanatorium in Howell

Michigan Public Act 254 of 1905 called for a state tuberculosis sanatorium to be built at a “suitable location.” Physicians supported this endeavor because they wanted a healing place for those afflicted with TB.

By popular subscription, citizens of Howell, Michigan raised the money to purchase 192 acres, located about a quarter mile southwest of their town. This land was then conveyed to the State, free of charge. The State bought additional land for a total of 270 acres. The Howell Sanatorium was soon born.

The Fresh Air Cure

The Howell site offered pure air, pure natural spring water and rolling hills about 1100 feet above sea level. It offered light, sandy, well-drained soil needed for growing fruits and vegetables, fresh food being essential for the treatment of the disease.

The Howell Sanatorium was patterned after the Adirondack Cottage Sanatorium at Saranac Lake in New York. Founded by Dr. Edward Livingston Trudeau, this New York facility consisted of shacks or cottages clustered around an administration building. Dr. Trudeau, himself a consumptive, espoused the “fresh air cure.” Cottages with open porches were built so that patients could have sun, fresh air, plenty of rest and gentle exercise—all important components of “the cure.”

Shacks were built at Howell, and the first male patients were admitted there in 1907. Female patients were admitted in 1908. Howell Sanatorium patients paid $1.00 per day for six months, the standard amount of time allowed to take the cure. Michigan counties paid for indigent patients; this provision was part of the enabling legislation.

Learning to Live with Tuberculosis

Most of the patients at Howell were classified “incipient,” that is, the symptoms were light and the patient was not bedridden. The sanatorium staff taught them good health habits: keep a clean, ventilated house; eat plain, nourishing food; get plenty of sleep; cover your mouth with a cloth when coughing. They were taught to boil and disinfect that cloth with carbolic acid. People learned to live with tuberculosis. The chief goal was to make the patient well enough to return home and not be a danger to his family or community. It is important to understand that early treatment of tuberculosis was general medical care. Thoracic surgery, supported by physicians from the University of Michigan, became a more aggressive medical option circa 1928. Effective drugs for fighting the disease, like streptomycin, became available for therapeutic use by circa 1945.

Howell Sanatorium, 1960

Changes, 1913-1982

In 1913, the State of Michigan appropriated money to establish a second sanatorium for the care of moderately advanced and far advanced TB cases. The State selected Midland, Michigan as the site. However, that city’s water supply was poor, so no sanatorium was built there. By 1919, the appropriation was transferred to the Howell facility, and the hospital expanded its admission policy to include advanced TB cases. By 1923, TB experts considered the open shacks too crude and inefficient for housing tuberculosis patients, especially during the Michigan winters. The state built a permanent, brick hospital at Howell that served TB patients until 1961.

With the introduction of drug therapy, many tuberculosis patients could be treated as outpatients. In 1954, the State enacted legislation that allowed the Sanatorium to broaden its admission policy to accept patients who were not suffering from TB. In May of 1961, the State legislature officially closed the TB Sanatorium with the passage of Public Act 111. Staff, buildings and funding were transferred to the newly established Howell State Hospital for the care and treatment of mentally ill patients. In 1971, the state hospital became the Hillcrest Center and, later, the Hillcrest Center for the Developmentally Disabled (1978). In 1982, the State closed Hillcrest, and the hospital at Howell was razed circa 1985.