Housing the Victims of the Great White Plague: The Oregon State Tuberculosis Hospital

Oregon State Tuberculosis Hospital, 1st State-owned TB Sanatorium in the West.

Oregon led the Northwest in the fight against tuberculosis, what was then one of the ten major causes of death in the United States. There was evidence of tuberculosis in the Northwest Indians but the first reported case among the whites was Meredith Gairdner who came to Fort Vancouver in 1833 as a resident physician. The census of Oregon in 1860 reports a population of 52,465 with 300 deaths. TB or consumption, as it was known, was the cause of eleven percent of these. At this time, health care for the tubercular patient was home care. Patients who had the economic wherewithal were advised to seek drier climates. From 1904-1906, 774 deaths in Oregon were reported from tuberculosis. When the State Board of Health was formed in 1903, one of the first problems addressed was an open-air sanatorium for the treatment of tuberculosis.

The first sanatorium in the Pacific Northwest was opened on Milwaukie Heights in 1905. However, those who were not financially able remained neglected. A state facility was needed, and finally the abandoned Deaf-Mute School in Salem was purchased to accommodate the Oregon State Tuberculosis Hospital, the first state owned and operated tuberculosis sanatorium in the West.

In 1909 the Oregon State Legislature enacted laws designating that a tuberculosis sanatorium was to be operated to provide treatment for tuberculosis patients who were unable to secure proper care elsewhere, where patients were to be educated in the proper techniques of healthful living and how to avoid spreading the disease and also to segregate those in the advanced state of the disease to eliminate the danger of infection. This was the first such action taken by any of the Western states.

Prior to this, in 1894, construction was started on a building designated to be the Oregon State Deaf-Mute School, and was so occupied during the years of 1896 and 1897, but because of the inability to transport supplies over the nearly non-existent roads this building southeast of Salem was abandoned. After the Legislature enacted the laws for a sanatorium for treatment of the tubercular, one of the senators of that time saw this site, nestled in the foothills with available buildings, and action was taken to utilize this for the proposed Oregon State Tuberculosis Hospital.

On November 21, 1910 the first five patients were admitted to the fifty-bed Oregon State Tuberculosis Hospital. H. J. Clement, M.D., who was superintendent in 1910 and 1911, then administered hospital business and the medical program. During that time additional open-air facilities, Pavilion Pierce and an open air Summer House were completed. P. H. Fitzgerald, M.D., served as superintendent in 1912, and Grover C. Bellinger, M.D. became superintendent in 1913. He remained the only physician on the staff until the end of World War I, when Dr. P. L. Newmyer joined him.

Also in 1913, the Board of Control was created and became director of the Oregon State Tuberculosis Hospital.

Early construction was centered mostly on the pavilion type of treatment facility, with Pavilion Butler constructed in 1919, Pavilion C erected in 1923 and Pavilion D constructed in 1925. Physicians Cottage I was constructed in 1919 and before this, the engine room and dairy barn were built in 1912. For many years the hospital maintained a large herd of cows to supply the needs of both patients and employees living there. At this time, and for many years following, they also maintained a farming project which included raising of all garden supplies and feed for the dairy animals. The greenhouse was constructed in 1922. Physicians Cottage II was built in 1932.

Pavilion C was made into a children’s’ preventorium and treatment center, with schooling offered to both bed patients and patients with exercise. In 1941 this program was taken over by the State Program for Education of the Handicapped Children, and the department furnished teachers and school programs for all school age pupils so that they could maintain their study program while hospitalized.

A professional rehabilitation program was initiated with the assistance of the Oregon State Tuberculosis and Health Association; this was eventually taken over by the Oregon State Vocational Rehabilitation Department.

In 1910 the Oregon State Tuberculosis Hospital had only 50 beds available; in 1917 there were 75 beds in operation. In 1919 construction of Pavilion Butler brought the bed count up to 105, and construction of Pavilion C in 1923 made 150 beds available. In 1923 a modern paved highway extended from Salem to the hospital, and additional facilities in Pavilion D made 195 available beds for the treatment and care of the tubercular.

As the need for beds was so much greater than the facilities available a modern two-story hospital was completed in 1932; in 1933, 15 extra beds were placed in the Administration Building for a colony of patients who had reached a satisfactory stage of convalescence. Also, at that time a 270 bed hospital was constructed in Eastern Oregon at The Dalles, known as the Eastern Oregon Tuberculosis Hospital, to better care for more of the State of Oregon who were afflicted with this dreaded, contagious disease, to make facilities for the long “waiting list” of persons who needed treatment. These two hospitals were run in conjunction until 1934, when

J. M. O’Dell became Superintendent at Eastern Oregon Tuberculosis Hospital.

In 1934 a third floor was added to the hospital in Salem, and a Nurses Home was constructed that housed 40 of the nursing personnel. Good use was made of WPA labor and brick reclaimed after the fire of the Oregon State Capitol in this construction. Physicians Cottage III was made in 1938 and Physicians Cottage IV was built in 1949. In 1955 Physicians Cottage V was completed.

Due to deterioration and fire hazard, Pavilion Pierce was razed in 1947; the Summer House was closed in 1948 and razed in 1956. However, a great need for beds still remained, with a long list of patients waiting for beds and in 1954 and 1955 two new floors were added to the hospital, with the first admission there on May 31, 1955. This construction also included the new, completely up to date surgery, pharmacy and laboratory. After that date it was not necessary for residents of Oregon with tuberculosis to wait for an admission to a tuberculosis hospital. During this period new construction included a paint shop, machinists shop and truck storage, and a new dormitory to house men and women employees, constructed in 1953.

University Tuberculosis Hospital, Portland, Oregon "under construction"

In June 1954, Dr. G. C. Bellinger retired as Superintendent of the Oregon State Tuberculosis Hospital, and Dr. Robert E. Joseph received appointment by the Board of Control to step up from Assistant Superintendent to Superintendent.

Prior to this date, the Oregon State Legislature adopted a measure to provide protection for the citizenry of the state by placing those recalcitrant who would not accept hospitalization and treatment under isolation and quarantine. Quarters were specifically prepared for the isolation and treatment of these patients.

With the advent of new drugs over the last few years, and surgical treatment, the need for hospital beds had lessened somewhat, as the period of treatment was shortened; subsequently the three remaining pavilions were closed but maintained in readiness. In 1957 Pavilion D was razed, leaving only two pavilions standing. Those 71 beds however, could be opened at any time to care for an influx of patients, or to care for patients in a time of national emergency.

In May 1959, because of the reduced population at both the Oregon State Tuberculosis Hospital and the Eastern Oregon Tuberculosis Hospital, the remaining 19 patients at the latter were moved to the hospital in Salem and the Eastern Oregon Tuberculosis Hospital was converted to a geriatric service with the title of Oregon State Mid-Columbia Home.

It was necessary to replace the reservoir constructed in 1894 by a new one-half million-gallon tank to store water for the institution, and for two neighboring state institutions.

The methods of treating tuberculosis years ago had long been replaced by new methods. The only available treatment in early years was that of complete rest and adequate diet. After that the patients were treated with pneumothorax and pneumoperitoneum, phrenic surgery, thoracoplasty, with very little medication to help the patient. Gold was first administered in the mid 1930's as a treatment for tuberculosis. Later streptomycin, then Isoniazid and Para-aminosalicylate acid were added to the list of anti-tuberculosis chemotherapy and gold was no longer used.

The patients with anti-tuberculosis medications and surgery available could anticipate an average stay of just over six months, instead of the hospitalization period of several years. Although the period of hospitalization was much shorter, many more patients were admitted yearly; for example during 1959, 324 patients were admitted to the Oregon State Tuberculosis Hospital.

Landscaped grounds surrounded the hospital, located on a hillside overlooking a wide expanse of the Willamette Valley. The original beauty of natural shrubbery was enhanced with rock walls, terraces, trees, shrubs, flowers, and winding paths. Inside the buildings you could find modern equipment for the use of the doctors and nurses in the care of the patients: x-ray, lamp therapy, a laboratory, surgery facilities and other departments. The dietary department maintained a high caliber of service with excellent food to help the patients to regain their health.

Film interpretation service was provided by the Oregon State Tuberculosis Hospital and was available without cost to all doctors and health departments in the state. During the year of 1959 the staff studied and reported on 12,126 x-rays, representing 6,714 different patients. Through this service 83 patients were admitted to the hospital for treatment. Also, through this service other patients were led to accept hospitalization and treatment either through their private physicians or through treatment centers such as the Veterans Administration Hospital.

During the year of 1959 the staff performed 1,399 examinations on outpatients – those patients who had been discharged from the hospital and those who had been referred by their physician or health department. The Oregon State Tuberculosis Hospital received a full accreditation by the Joint Commission on Accreditation of Hospitals of America and Canada on October 27, 1955, and was able to maintain this accreditation through tri-yearly inspections; they maintained membership in the Association of Western Hospitals.

Through the social service department the patients maintained contact with the Division of Vocational Rehabilitation, the Department of Public Welfare, the Veterans Administration and the State Department of Service for the Blind. The Occupational Therapy Department was fully equipped with wood working machinery, ceramic supplies and kiln, and supplies for leather tooling, knitting and other handicrafts, to help the patient keep busy during his period of treatment.

During this fifty-year period 8,050 new patients were admitted to the Oregon State Tuberculosis Hospital; also 25%, or at least 2,000 of these persons, were re-admitted for further hospitalization and treatment. Through the hospitalization of these many persons, the hospital had an active part in assisting over 8,000 residents of the State of Oregon regain their health, and helped them return to their homes and communities as active citizens. There were an estimated 3,600 employees of the Oregon State Tuberculosis Hospital to serve 8,050 patients.

An ex-patient, twenty-four years after his discharge, returned to tour the hospital, to view the place where he spent eight years of his life. On admission, at age 18, he was expected to live only one or two months. On discharge, at age 26, he had to borrow money to leave the hospital. He developed a business that grossed a million dollars yearly. Not all of the patients were this successful, but a great majority of the people returned to a useful, satisfying life.

The Oregon State Tuberculosis Hospital maintained an affiliation with the Practical Nurse Training Program of the Salem Adult Education Program. Through this, trainees were taught the specialties of tuberculosis care. They were justly proud of their association with the health departments of Oregon. To further this understanding between the hospital and health departments they held a Public Health Nurse orientation meeting of two days, where nurses from all over the state became acquainted with patient treatment and the recommended requirements of the patients at the time of their discharge.