For decades in the 19th and early 20th centuries, Colorado’s identity was tied with one of the nation’s deadliest diseases. A century later, parts of the state are still marked by the years it was known as “the world’s sanitarium.”
Read more Watch live: Hegseth is facing questions from senators over funding for the Iran war
Tuberculosis, also known as “consumption” or the “white plague,” was one of the nation’s leading causes of death in the 19th and early 20th centuries, and Colorado was particularly affected by the disease.
It’s believed that in the early 1900s “in Colorado,about one-third of people were here related to TB,” according to Rachael Storm, an official with History Colorado. That included patients and their families, Storm said, adding: “We had an inordinately high number of doctors because of TB.”
Many patients flocked to the West in an effort to treat their tuberculosis, as the fresh and dry air was thought to be a cure for the disease. Though Wyoming and New Mexico both saw a fair share of tubercular migrants, Colorado saw such a large number of patients seeking to relieve their symptoms that it was known as “the world’s sanitarium” for years, Storm said.
(“Sanitarium” is a word for an establishment offering usually long-term treatment or a place to rest.)
“We’ve got (about) 300 days a year of sunshine, and prior to more modern things, the idea of sunshine being curative was really important,” said Storm, History Colorado’s head of curatorial services and curator of business and industry. “And Colorado was also already a tourist destination, so it already had the infrastructure to support building hospitals.”
At the time of Colorado’s tuberculosis era, better treatments for the disease weren’t available — but these historical remedies weren’t entirely fictional.
“The vast majority of tuberculosis is transmitted from person to person by what are called droplet nuclei, and those are little infectious particles of tuberculosis that are released from someone who has infectious tuberculosis by coughing or speaking or sneezing,” said Dr. Greg Downey, the executive vice president of academic affairs and provost of the National Jewish Hospital in Denver. “And those little particles that remain in the air can be breathed in by individuals in close proximity.”
“If you think about what ‘fresh air’ means, part of it is less-crowded living conditions,” Downey said, adding that in packed and higher-humidity conditions, “these droplet nuclei tend to remain in the air and facilitate transmission of the tuberculosis from person to person.”
Colorado’s famously sunny skies also could’ve had real, positive effects on a patient’s symptoms.
“Vitamin D is activated in part by exposure to sunshine, which converts an inactive form of vitamin D to active vitamin D, and we know that people who have vitamin D deficiency or relative vitamin D deficiency are more susceptible to infectious diseases,” Downey said. “And if they get an infectious disease, they have a more difficult time of ridding themselves of that disease.”
The symptoms of TB normally begin with lung-related issues, Downey said.
“The little infectious particles get inhaled into the lung, and they get deposited in the lung, and when they’re in the lung, they are ingested by cells of the immune system,” Downey said, adding that as the disease takes root in the lungs, it can cause granulomas, a kind of nodule, that can cause destruction of the lungs.
“In people with advanced tuberculosis, large parts of the lung can be completely replaced by cavities, and those cavities can have blood vessels in them that burst and bleed,” Downey said. “That is one common way that people with advanced TB can die — actually bleeding into the lung.”
The degeneration of tissue caused by tuberculosis, combined with the way it would cause patients to rapidly lose weight, is how it got the nickname “consumption” — people who contracted the disease would slowly waste away, as if they were being consumed.
“The thing about tuberculosis, which at the time was called consumption, or the white plague, was that it was a wasting disease, so it didn’t just kill people right away,” Storm said. “It tended to kill people over time, so about 60% of Americans who had tuberculosis would die within 10 years of getting the disease.”[q comment=”cq stat approx tracks with a quick search, exact numbers would probs only match for this specific time period but seems reasonable” ]
Tuberculosis killed hundreds of thousands of Americans between the Civil War and World War II. For all the people looking to come out west and take the cure, not all of them settled in Denver.
Hygiene is a small, unincorporated town outside of Longmont, and its name comes from the Hygiene Home, according to Erik Mason, director of the Longmont Museum. That was a sanitarium built on what is now the quaint community west of McIntosh Lake.
The Hygiene Home was founded by the Rev. Jacob Flory, according to Mason. Flory moved to the area, called Pella at the time, from Virginia. He established the St. Vrain Church of the Brethren, which still stands in Hygiene today.
Hygiene Home had “two main floors, and then the third floor was a little cupola room that had blue glass in it,” Mason said. A cupola is a small structure on a building’s roof, with large windows or openings to let in light or air.
Read more Denver youth sports grapple with extreme heat, poor air quality
“Blue light was considered healing, so they put that in the cupola, and patients would be able to go up there and bathe in the blue light,” Mason said.
Some places in Colorado even had well-known people come to try to treat TB.
“Doc Holliday came to Glenwood Springs in May of 1887, and the main reason was because of his tuberculosis,” said Peggy Vidakovich, archivist for the Frontier Museum in Glenwood Springs.
Holliday was known in the west as a famous gunfighter and is now a staple of modern Wild West movies. Glenwood Springs had many TB patients, not just for the Colorado climate but for the hot springs in the area that many people believed could heal their ailments, Vidakovich said.
“He was only here a short time, he died Nov. 8, 1887,” Vidakovich said. “He lived in the Hotel Glenwood, in the area where they allowed TB patients to live, and that’s where he died.”
While the tuberculosis history of places such as Hygiene and Glenwood Springs can feel distant, several tuberculosis sanitariums in the state have transformed into modern hospitals that are operating today.
National Jewish Health east of downtown Denver is one of multiple medical facilities in the state with its history tied directly to a tuberculosis treatment center.
“The hospital opened up as a National Jewish Hospital for Consumptives in 1899,” Downey said. “In the late 1800s there was a lot of poverty, conflict, famines in Europe — many individuals who immigrated became patients at a variety of hospitals around the country, but National Jewish Health was one of the more prominent ones.”
The number of tuberculosis sanitariums was growing in Colorado around that time, but National Jewish sought to solve a problem other facilities weren’t addressing: The poorest of the patients sent out West to cure their TB often had nothing but a one-way train ticket and couldn’t afford treatment when they arrived.
“Many poor victims of the disease lived and died on the city’s streets,” the hospital’s website says. “In December 1899, the first patients checked into the new National Jewish Hospital for Consumptives under its official motto: ‘None may enter who can pay–none can pay who enter.’ ”
Despite more than a century of change since the hospital opened, National Jewish still focuses some of its modern research on tuberculosis, Downey said.
That research includes working toward more rapid and easily accessible testing, as well as research into treatment for drug resistance in tuberculosis, one of the most difficult aspects of curing the disease, Downey said.
“If you treat the TB with only one antibiotic, (the infection) rapidly becomes resistant to that antibiotic,” Downey said.
Tuberculosis must be treated with “combined chemotherapy,” or multiple antibiotics at once. National Jewish helped pioneer combined chemotherapy treatment for tuberculosis in the 1950s and ‘60s, according to Downey.
Despite the effort of research institutions, hospitals and local health officials, tuberculosis remains the world’s leading cause of death from a single infectious agent, according to the World Health Organization.
“Approximately 1.7 billion people around the world (as of 2014), that’s about a quarter of the world’s population, are thought to be infected with mycobacterium tuberculosis,” Downey said, citing data from the World Health Organization. “There were 10.7 million new cases of tuberculosis (in 2024), and about a quarter of those were undiagnosed.”
Poor nutrition and crowded living conditions contribute to TB spread, Downey noted. Tuberculosis is common in sub-Saharan Africa, India, Micronesia and Southeast Asia, Downey said.
Although the disease had a profound impact on the history of Colorado and the West, and many Americans associate TB with a bygone era, tuberculosis has not disappeared, Downey said.
“In the U.S., we’ve forgotten about TB, but we shouldn’t forget about how deadly it is,” he said.
Get more Colorado news by signing up for our daily Your Morning Dozen email newsletter.
Read more US civil rights agency moves to end demographic data collection after 60 years
