Wisconsin Tuberculosis and Consumption Sanatorium
Selection of a Location
Source: Report of the Wisconsin State Tuberculosis Commission Prepared in compliance with Joint Resoluton No. 12 of the Legislature of 1903
Members of the Commission Gustav Schmitt, M.D. President Milwaukee Michael Ravn, M.D. Vice President Merrill H.L. Russell, Ph. D., Secretary Madison
In order to be guided more specifically in the proper selection of a site for the proposed sanatorium, the commission has put itself in communication with a number of other state commissions, and has also visited the more important eastern institutions, both under state and private control, in which this disease is treated.
As a result of these studies, the following conditions are submitted as important, and should be taken into consideration in selecting a proper site.
(1)General Accessibility Of first importance is the general accessibility of the selected site; it should be located on or near a trunk railroad line, readily accessible from the more thickly populated portions of the state, so as to cause the minimum inconvenience in transferring patients from their homes to the sanatorium. It is preferable not to have too far a distant from a railroad station, yet it should not be located in a town or village. The expense of administration is material increased if the location is too remote from settled regions.
(2)Climatic Consideration The value of climatic conditions in the treatment of this disease has been greatly overestimated in the past. Still for several reasons a relatively low degree of humidity and equability of temperature is, of course desirable if it can be secured, but a maximum amount of sunshine is more important than the mere matter of temperature or moisture. It is therefore advisable not to locate the proposed sanatorium in close proximity to the great lakes, as the climatic conditions which obtain here are somewhat less favorable from a general point of view than would obtain further inland, where the air is somewhat dryer and the percentage of winter sunshine is greater.
(3) Protection from the Winds. In selecting a proper location, protection from winds especially those of winter, is of more importance than almost any other factor, inasmuch as it is necessary for the patients to remain out of doors a large portion, if not all day, winter as well as summer. Care must be taken that ample protection be afforded by means of hills and forests not only to the sanatorium itself, but especially to the surrounding walks and grounds that are used by the patients in their exercise. This protection should be especially good from east winds (on account of their increased humidity), and the prevailing winter winds which are usually north or northwest in most portions of the state. This protection can best be secured by placing the building on the southern aspect of good sized hills, and the desired protection is greatly improved if such hills are well covered with vigorous forest growth.
(4)Influence of Forests It is a popular belief that some peculiar virtue is inherent to coniferous forests, but such a hypothesis has no substantial basis for support. The main advantage of forest areas is the relative freedom from dust and the condition is quite as well secured in a hardwood as in a coniferous forest. Locally their chief beneficial function is that of a windbreak.
(5) Altitude Formerly it was thought that the altitude of any locality was of material importance in the selection of a proper location, but the factor is now regarded as of less value. Moderate elevations (from 1,000 to 1,200 feet) are to be preferred to extremely higher altitudes. The only advantages which the higher altitude possesses are those which are incident to the elevation namely (lower temperature, less precipitation, and dryer air). Too marked an increase in altitude is not infrequently deleterious to the health of the consumptive.
(6) Local Elevation The sanatorium site and immediate surroundings should be place on rolling or hilly grounds, so that the patients are not exposed to the influence of local fogs.
In the fall of the year cold, damp air currents are apt to settle in the valleys, especially in the vicinity of lakes and streams. It is therefore desirable that the local elevation be sufficient to place the site above such currents.
Hilly surroundings are also desirable for the purpose of exercise. Walks and paths protected by windbreaks should be laid out for the exercise of patients, and it is desirable that gentle, graded ascents be used by the patients when possible. If possible a high elevation should be had for water reservoir, so as to have abundant fire pressure.
(7) Sightly Location A fine prospect is desirable for the mental effect which it exerts upon patients. Therefore the buildings should be place so as to have favorable views, vistas, etc. Woodland and water make the ideal combination, and if the same can be secured without losing other essential characteristics, it is very desirable that such a location be chosen. Immediate proximity to the water is not so important, but on the other hand, it is not undesirable, if the site is sufficiently high to escape the local dampness and fogs. Lakes are preferable to river views, as they are less liable to have strong wind currents. Large lakes afford an opportunity for more severe wind action, and are not so desirable as smaller irregular lakes that can be used for recreational purposes in a greater range of weather.
(8)Character of Soil The immediate surroundings of the sanatorium should be placed on light, well-drained soil. It is especially desirable that the walks and paths be constructed so as to dry quickly after rains. For this purpose a sandy or gravelly loam is best suited. Clay soils are to be avoided because of the amount of moisture which they retain. It is also desirable to have light soils for the proper and efficient disposal of sewage.
In close connection with the are devoted to building and grounds, there should be solid suitable for certain types of farming, especially grazing, so that stock can be kept for dairy purposes. For this purpose naturally a heavier soil could be utilized than for the immediate surroundings of buildings.
(9)Accessibility of Food Supplies One of the most important factors in the treatment of tuberculosis is to supply patients liberally with good, nourishing food. Eggs, milk and vegetables make up the main constituents of such a dietary, and they must be had in fresh condition and in abundance. It is therefore advisable that dairy products, poultry and garden vegetables be produced on the farm, or if this is not done, that the sanatorium be not too far distant from a regular and adequate source of supplies of this character. As it is advisable to have the dairy herd tested for tuberculosis, it should be under the immediate direction of the sanatorium authorities. Swine can be well utilized to consume a large part of the kitchen refuse.
(10) Size of Area Desired. In order to control the neighboring surroundings, considerably beyond the limits actually used by the patients in their regular exercise, and also because of the need for agricultural purposes, it is desirable that the tract secured be at least several hundred acres. The short-sighted experience of several eastern sanatoria in this manner furnishes several cogent examples of the necessity of controlling considerable tracts.
(11)Water Supply An adequate supply of pure drinking water, preferably from a spring or subterranean source, should be had. This must be protected securely from all danger of pollution. There should also be an abundant supply for fire protection, and possibly for irrigation of garden crops.
Examination of Different Sites After having determined the conditions desirable to take into consideration in the matter of the selection of a site for the proposed sanatorium, correspondence was taken up with persons in each county in which it was deemed advisable to make a further study. A considerable number of locations, and a systematic examination has made of those regarded as possibly eligible. The great majority of the sites investigated have been found lacking in several important and quite essential particulars. Several localities, however, have been found which fulfill more or less completely the requirements recorded as essential for institutions of this character. These have been placed in the eligible class for further consideration. For obvious reasons it is preferable not to publicly announce the final decision of the commission relative to eligible sites as such a course would without doubt result in a material enhancement of the values placed upon the selected properties. This eligible list is, however, submitted to you for further consideration. The most suitable locations are summarily described, and the relative merits of the leading localities compared.
For more information on Tuberculosis in Wisconsin see these links:
See also Muirdale Sanitorium, Wauwatosa, Milwaukee County See also the 1916 Wisconsin directory of sanatoriums
See also the 1919 Wisconsin directory of sanatoriums
See also History of Tuberculosis in Wisconsin
See also Criteria for Location Selection
Life in Wisconsin Sanatoriums-offsite link by John T. Wells