If you’re a Baby Boomer (or older) you might have grown up knowing someone who had tuberculosis. The deadly lung disease took lives for centuries until streptomycin was discovered in the 1940s and doctors realized that it could kill the bacteria that caused TB.
Until that time however, the only treatment for tuberculosis was a long stint in a sanatorium, taking something called the rest cure. Sufferers spent months or even years in bed at these places, barely moving, eating lots of high calorie food to put weight back on, and enduring ghastly medical treatments. Sanatoriums were built to allow fresh air to flow into the wards all year long, even in the depths of winter. All of this helped the body heal itself until patients were no longer contagious and they could go back to their lives.
Tuberculosis sanatoriums were built all over the United States a century ago, many of them in California. The Golden State had plenty of open land for building and fine weather for “lungers,” as they were called. Around 1919, for example, the Ahwahnee Sanatorium was opened on property that had belonged to Yosemite hotelier William Sell. Three counties – Madera, Merced, and Stanislaus – collaborated to provide TB treatment to all of their residents, and Ahwahnee stayed open for 50 years.
The Bay Area didn’t have many sanatoriums in the early 1900s, and those that did exist were often just attachments to large hospitals, such as San Francisco General. These places treated both men and women (in separate wards) but it was especially hard for women to take time away from their families to receive treatment.
All of this changed on April 18, 1906. The earthquake on that day, and fires which followed, leveled a huge portion of San Francisco. As the city got back on its feet and began to rebuild, one doctor noticed something alarming.
He was Philip King Brown, M.D. His mother, Dr. Charlotte Brown, had been one of San Francisco’s first female surgeons, and Philip’s sister Adelaide was also a doctor. They were raised to value women’s health and to always be concerned for the less fortunate, despite their own wealth. Philip Brown and his family lost their home to the fire, and after volunteering his services to help the injured, Brown slowly built up his practice again.
He noticed that more women than men were coming into his examining room with tuberculosis, especially working women. He soon figured out why. The men were outdoors, rebuilding the city, where they could breathe the open air. Women were indoors, in department stores, schoolrooms, and factories, where the dust and grit of the construction seeped in and settled in corners and in their lungs. They were the most vulnerable, and Dr. Brown worried about them. Working women had no place to go to get inexpensive treatment, so he decided to open his own sanatorium, just for them.
He had powerful and wealthy friends, and a Marin County philanthropist named Henry Bothin gave him a plot of land near Fairfax, in the western part of the county. The wives of San Francisco’s leading men donated money and time, and on Sept. 9, 1911, the Arequipa Sanatorium was dedicated. The name meant Place of Rest or Here, Rest in the Peruvian Quechan language, a word Dr. Brown knew from a friend who was a former South American sea captain.
Arequipa was a rarity: there were only four other sanatoriums in the United States devoted to treating women alone, with only one in the entire West. The cost was $1 a day, and for the first 10 years the women who were no longer contagious and on the road to recovery were allowed to do pottery as occupational therapy.
Later on, they could learn typing and laboratory technology if they wanted, and many left Arequipa with new careers. The patients published their own newsletters in the 1920s and 1930s, writing goofy articles about each other, how their cures were progressing, and send-ups of the staff. Some patients also wrote poetry, which had titles like “Life in a Lung Resort.” But most of all, the women learned how to live to prevent a relapse of TB once they went home.
The TB cure sometimes included treatments like pneumothorax: injecting air or nitrogen into the space around the lung using a fearfully large needle. This temporarily collapsed the lung so it could rest and build up scar tissue around the bacteria. Some women had a rib removed to permanently collapse a lung, though this was only in the most dire of cases. Patients got regular x-rays and examinations with a fluoroscope, which showed the lungs at work (think old time cartoons where characters stood in front of a machine and watched their skeletons dance).
In 1927, a terrified young mother from Sonoma County walked through the sanatorium’s doors. She had tuberculosis, her doctor gave her three months to live, and said her only hope was the rest cure at Arequipa. She spent 14 months there, and went back to her family determined to never get TB again. She was my grandmother, Lois Downey.
I heard her stories about life at Arequipa throughout my childhood: the many pneumothorax treatments she endured, the time she doctored an unpopular patient’s candy with pepper, and how making friends with the other women made the experience bearable. She stayed healthy for the rest of her life, gave Arequipa’s doctors and nurses the credit, and lived to be 102 years old.
By the 1950s and 1960s sanatoriums were closing all over the U.S. Drug treatments meant that people didn’t have to lie in bed for years to beat tuberculosis. Many of these buildings were then sold and turned into different kinds of institutions. The Ahwahnee Sanatorium, for example, was closed in 1969, and then became the Ahwahnee Hills School for Boys.
Arequipa closed in 1957, and in 1960 the Girl Scouts acquired the property. A reporter for the Independent-Journal newspaper, Corena Green, said this about the former women’s sanatorium and its legacy for future generations: “So 50 years later the profile of Arequipa changes but not the heart nor the intent. The early pioneers and patients returning now surely would see only progress in the program about to be launched at the site — a program designed to produce happy, healthy young women, ready to take their place in the American scene.”
Lynn Downey is a western historian and writer. She was the Levi Strauss & Co. company historian for 25 years and published the book “Levi Strauss: The Man Who Gave Blue Jeans to the World” in 2016. She gave a talk about her book for the Southern Tuolumne Historical Society in Groveland in 2018. Her latest book is Arequipa Sanatorium: Life in California’s Lung Resort for Women, published by the University of Oklahoma Press.