This article was downloaded by: [University College London] On: 11 March 2015, At: 05:23 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK The Journal of Architecture Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/rjar20 Planning the Nation: the sanatorium movement in Germany Eva Eylersa a The Bartlett School of Architecture, University College London, United Kingdom Published online: 23 Oct 2014. Click for updates To cite this article: Eva Eylers (2014) Planning the Nation: the sanatorium movement in Germany, The Journal of Architecture, 19:5, 667-692, DOI: 10.1080/13602365.2014.966587 To link to this article: http://dx.doi.org/10.1080/13602365.2014.966587 PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. 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The medical theory of the ‘immune place’, developed by Hermann Brehmer in the 1850s, would serve as the impetus for the development and justification of the tuberculosis sana- torium, which, as the ‘place of health’, was to be situated in natural surroundings, ideally in the dry air of an unspoilt mountain region. The first sanatorium dedicated to the treatment of tuberculosis was Görbersdorf in Silesia. It prompted a great number of successors and, by the end of the nineteenth century a veri- table sanatorium or ‘Heilstätten-movement’ had taken place in Germany. However, the treatment did not prove as successful as initially hoped and, during the 1899 Conference on TB in Berlin, alternatives in the fight against the disease were considered, among them the ‘home sanatorium’, proposed by the military surgeon Dr von Unterberger. He attempted to bring the place of health back into the city, and therefore to ignore the demand for a par- ticular site, the precondition of the original sanatorium cure. This paper will discuss the way in which the renunciation of site specificity, which led the sanatorium idea itself ad absurdum, provided new opportunities for the strategic governing of the young German Nation. The idea of a sanatorium network would now come to be associated with the idea of an evenly distributed grid determined by its distance from certain cities, their population density and other statistical or measurable indicators, which Downloaded by [University College London] at 05:23 11 March 2015 had become important in political decision-making processes. Less dependent on regional characteristics and on the necessity to acquire a particular location, centralised planning became feasible, which enabled the government in Berlin to project and advance a close- meshed institutional network and therefore stabilise its power. Introduction TB, and especially the tuberculosis sanatorium, Developments in medical thinking, changing ideas have recently experienced increasing attention in and ideals of health and disease, have a long the field of architectural history and theory: Paul history of familiar exchanges with architecture and Overy has discussed the role of the sanatorium the thinking of the city.1 This is particularly true for within the Modern movement2 and Margaret tuberculosis, which spread rapidly in wide parts of Campbell has looked at the therapeutic roots Europe during the nineteenth century. of characteristic architectural features of the # 2014 The Author(s). Published by Taylor & Francis. This is an Open Access article. Non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly attributed, cited, and is not altered, transformed, or built upon in any way, is permitted. The moral rights of the named author(s) have been asserted. 1360-2365 http://dx.doi.org/10.1080/13602365.2014.966587 668 Planning the Nation: the sanatorium movement in Germany Eva Eylers sanatorium and their influence on modern architec- tion’.10 The overcrowded living conditions caused ture and furniture design.3 In a similar way to Beatriz by industrialisation and subsequent population Colomina’s discussion of ‘The medical Body’,4 both growth in many European cities constituted there- Overy and Campbell explore the influence TB and fore favourable conditions for the spread of the the tuberculosis sanatorium had on the domestic lung disease. realm and the body. This was particularly true for Berlin. Compared to This paper, however, concentrates on the relation- other European countries such as England or ship between the sanatorium and the city, and the Belgium, Germany had been industrialised later but spatial implications related to the planning of the with even more ferocity. While the German popu- disease within a specific national context. ‘Planning lation altogether doubled between 1871 and the Nation’ focuses on the role architecture plays 1910, the capital’s population grew by a dramatic in realising medical or (bio-) political aims and strat- 300% within only thirty years (between 1856 and egies, and thus helps to bridge a gap between the 1886).11 It is estimated that during this period perspective provided by social historians such as more than 120,000 Berlin citizens had to live in Flurin Condrau5 or Jorge Molero-Mesa6 and the per- cellars. Refuges for the homeless were constantly spective commonly provided by architectural histor- overcrowded. By the end of the nineteenth century ians and theorists in regards to the medical it had become common practice to occupy the institution. newly built tenement blocks for the first months Corresponding to recent publications drawing on with so called ‘Trockenmietern’, tenants who Michel Foucault’s work, such as those by Dana would stay in the flats until they had dried or dehu- Arnold7 and Sven-Olov Wallenstein,8 this article midified. This had drastic consequences for the examines how the medical institution relates to tenants’ health, since the humid conditions wea- Downloaded by [University College London] at 05:23 11 March 2015 society as a whole and to the wider urban environ- kened the respiratory organs especially. ment through the spatial analysis of the German With tuberculosis, and the growing conviction in sanatorium movement. the nineteenth century that cities were true breeding Tuberculosis became associated with the industri- grounds for disease in particular, also came the alised city, long before Robert Koch in 1882 discov- theory that there were places of health outside the ered a bacterium to be the actual cause.9 After city. Dr Hermann Brehmer (1826–1889) opened receiving the Nobel Prize in 1905, Koch explained the first sanatorium, the first ‘place of healing’, for in his address to the ceremony’s audience what by tuberculosis patients in the mountains of Silesia in the turn of the century had become widely accepted: 1854. His theory of the ‘immune place’ served as TB was an airborne disease. Therefore, ‘even the the impetus for the justification of the sanatorium, smallest drops of mucus expelled into the air by which was to be situated far from the damaging the patient when he coughs, clears his throat, and city environment in natural surroundings, ideally in even speaks, contain bacilli and can cause infec- the dry air of an unspoilt mountain region. The 669 The Journal of Architecture Volume 19 Number 5 main argument for the implementation of sanatoria the disease were considered. This article will discuss had been the prospect of a cure for the individual one such alternative approach, the ‘home sanator- patient and in the last decades of the nineteenth ium’ proposed by the military surgeon Dr von Unter- century a veritable sanatorium or ‘Heilstätten move- berger. The home sanatorium was an attempt to ment’ occurred in Germany. bring the place of health back into the city, Although tuberculosis was not exclusively a thereby ignoring the demand for a particular site disease of the poor, the working class seemed the and its climate, the precondition of the original sana- more likely victim.12 The balancing of social differ- torium cure. ences, a charitable or humanitarian act, was there- The 800-page protocol of the 1899 meeting in fore an important aspect of this movement.