Trinity College Trinity College Digital Repository Masters Theses Student Scholarship 1993 Sanatorium Care for the Tubercular Poor in Hartford, 1900-1910 Sandra L. Wheeler Trinity College Follow this and additional works at: https://digitalrepository.trincoll.edu/grad Part of the Public Affairs, Public Policy and Public Administration Commons Recommended Citation Wheeler, Sandra L., "Sanatorium Care for the Tubercular Poor in Hartford, 1900-1910" (1993). Masters Theses. 2. https://digitalrepository.trincoll.edu/grad/2 This Thesis is brought to you for free and open access by the Student Scholarship at Trinity College Digital Repository. It has been accepted for inclusion in Masters Theses by an authorized administrator of Trinity College Digital Repository. TRINITY COLLEGE Thesis SANATORIUM CARE FOR THE TUBERCULAR POOR IN HARTFORD, 1900 - 1910 Submitted by Sandra L. Wheeler (B.S., Columbia University, 1963 M.A., University of Connecticut, 1980) In Partial Fulfillment of Requirements for the Degree of Master of Arts 1993 Unauthorized reproduction prohibited by copyright law. TABLE OF CONTENTS Preface .................................................. i - iv Introduction. • . 1 Chapter I: Tuberculosis and Sanatoria, 1900- 1915 ......... 15 Tuberculosis Treatment ••.........••••••••••...•...•.... 18 Sanatoria ............................•................. 23 The Sanatorium Experience •.•••••••••••••••••••••••••••. 37 Outcomes. • • • • • • • • . • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 44 Conclusion. • . 50 Chapter II: Hartford and Its Poor and Sick .........•...•... 53 The Poor: Public Support and Private Philanthropy ..... 56 The Poor: The Almshouse ..••••••••••••..••..........••• 61 The Sick Poor: Sources of Care. • . • . 62 The Sick Poor and the City Hospital .................... 66 The Sick Poor and Hartford Hospital .................... 72 Conclusion ...................•......................... 76 Chapter III: Tuberculosis in Hartford ...................... 78 Tuberculosis: The Bar bella Family. 82 Tuberculosis and Hartford Hospital. 84 Wildwood Sanatorium .................................... 86 Conclusion ............................................. 99 Chapter IV: Charity, Politics and Tuberculosis ............. 103 The Gunshanan Family ..................•.•.............. 106 John Gunshanan and the Workingmen's Club .•............. l11 John Gunshanan and the Tuberculosis Commission ......... 117 Conclusion ............................................. 120 conclusion .................................................. 124 Epilogue .................................................... 131 Bibliography: primary sources ............................... 132 secondary sources ............................. 141 ILLUSTRATIONS Fig. 1: Outcome Statistics as Presented in 1912 •.. facing page 48 Fig. 2: The City Hospital and Almshouse .......•... facing page 67 Fig. 3: Wildwood Sanatorium .....................•. facing page 89 i PREFACE People have always suffered from disease. It is, however, as much a social as a biological construct: What defines the state of being ill, and what is considered an appropriate response to it, differ both cross culturally and over time. As Charles Rosenberg says, perceptions of disease are both "context-specific" and 11 context-determining."1 To the social historian, investigating the expressions and effects of disease can be a fruitful way to study the contexts in which they occur -- social institutions, gender roles, religious beliefs, power relationships, political forces, class and racial divisions. If the study of illness can be a boon to the historian, however, it can also be a bane. Some responses are highly visible (hospitals, nurse and physician roles, health insurance) and not too difficult to interpret. Others, however, are emotionally charged, not visible at all and present serious research problems. Did a diarist not mention the illness from which a loved one died because it was unknown, or because it was too painful (or shameful) to think about? How can we know the "codes 11 by which socially unacceptable diseases were discussed, or recover the knowing look or lifted eyebrow by which people conveyed information about them? How can we tease out prescriptive behaviors for patients, families, 1 11 charles E. Rosenberg, Introduction, II in Framing Disease: Studies in Cultural History, eds. Rosenberg and Janet Golden (New Brunswick NJ: Rutgers University Press, 1992), p. xx. ii care-givers when they were often deeply embedded in the cultures in which they occurred? How can we convince guardians of medical records that historical research is a respectable undertaking in which it is possible to honor tenets of medical confidentiality? For the social historian of the early twentieth century, studying tuberculosis offers all the rewards and frustrations alluded to above. It was in some ways a new disease because its communicability was demonstrated only in 1882, but it was also an old disease, and people knew its symptoms and how it progressed. Accessible as much information is, it is almost impossible now to recover what the experience of being sick and dying of tuberculosis was like. There is an amazing paucity of representation of the disease in any artistic medium; materials in letters, diaries, memoirs and autobiographies is scant in the extreme. The silence surrounding the disease suggests that people were both ashamed and terrified. Such feelings persist still. On a visit to a town in upstate New York near both Trudeau's famous sanatorium and a state tuberculosis facility, both closed for nearly forty years, I asked at the local historical society if any section of the town still contained a concentration of houses with sleeping porches (an indication that they had housed tuberculosis patients or ex- patients). The sixty-something lady at the desk informed me in outraged tones "people like that" had NEVER lived in HER town. Rosenberg's comment that perceptions of disease are context­ shaping was in my mind constantly as I wrote this paper. It has become apparent in the last five years that people with AIDS have iii developed antibiotic-resistant strains of tuberculosis. If antibiotic therapy has indeed lost much of its efficacy, tubercula- sis today could be as communicable and dangerous as it was one hundred years ago. 2 Like many consumptives at the turn of the century, today's tuberculosis patients are defined by middle class society as "other." In 1900 they were often the immigrant poor; today they are the HIV-positive. If we are to make thoughtful decisions about how to ensure that these new consumptives obtain effective, humane treatment, we should be informed about the results of reactions of physicians, policy makers and citizens at the turn of the century. A project such as this inevitably owes much to many. My interest in Hartford and appreciation for what a fascinating city it is was first stimulated by Susan Pennybacker; she and the members of the Hartford Studies Group have been continuing sources of encouragement. Barbara Sicherman's contribution antedates her helpful comments as reader; my research on tuberculosis began as an independent study paper I did for her which appears here in altered form as Chapter I. Her knowledge of related work in the social history of medicine and public health is truly encyclopedic and made identifying secondary sources much more complete than it would have been without her. Eugene Leach was a most tolerant 2The recent periodical literature covering this development is extensive. The best summary of the social and medical ramifica­ tions of the re-emergence of TB appeared in a series of articles by reporters Michael Specter, Elisabeth Rosenthal and Lawrence Altman in The New York Times (October 11 - 15, 1992). See also Ken Chowder, "How TB Survived Its Own Death to Confront Us Again," Smithsonian 23 (November 1992): 180 - 194. iv thesis advisor, since I had no idea when I began where the research would lead. The final product has benefitted greatly from his careful, thoughtful reading, comments and questions. Finally, the research would not have been possible at all without the assistance of Steve Lytle, archivist at Hartford Hospital. I was fortunate that the principal sources of information I would need were in a repository so well organized and so efficiently run. Steve also answered questions, located photographs, and even managed to listen patiently and with every appearance of interest when I insisted upon telling him about new bits of information I discovered in the old board minutes he found for me. To all these people, as well as to friends and members of my family who now know more about tuberculosis than they ever wanted to, I am grateful. Responsibil­ ity for facts and interpretations offered here, of course, is mine alone. 1 INTRODUCTION One of the cliches of historical discourse is that Progressive Era reform in the United States brought with it bureaucratic structures through which professional elites sought to contain and control burgeoning, often unruly, urban populations. As this study will show, however, concepts as abstract as "social control" are not adequate to explain real events. An investigation of forces which shaped the institutional treatment of the tubercular poor in Hartford, Connecticut in the first decade of the twentieth century must illuminate why, after promoting and funding a voluntary hos­ pital's small sanatorium, city authorities, physicians and a representative of working