Tuberculosis at Fort Spokane

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In the early 1900s, tuberculosis was known as the “great white plague,” and at the turn of the century it killed around 450 Americans every day. An infectious disease of the lungs, tuberculosis spreads through the air, usually via coughing fits. Until the discovery of antibiotics in the mid-20th century, the principal treatment was to isolate the patient in a special hospital or sanatorium for tuberculosis patients.

After the Indian boarding school at Fort Spokane was replaced by day schools on the reservations, the fort entered its third phase in 1916, as a tuberculosis sanatorium for members of the Spokane, Colville, and other local tribes. The goals of the hospital were twofold: to slow the spread of TB by isolating the contagious victims, and to try to cure them of the disease with the crude methods of the time. The disease was unfortunately prevalent among Native Americans. A survey of Indian boarding schools in Washington state showed that 85 of the 589 total students showed symptoms. Overall, the disease struck thirteen percent of all Indians in Washington. Sanatoriums for the Indians’ ‘trachoma problem’ (another phrase for TB) began operating around 1910 on or near reservations at Fort Lapwai in north central Idaho, as well as in Phoenix, Arizona and Laguna, New Mexico. By 1912, there were 53 hospitals and sanatoriums in the Indian service.

A common treatment for TB was to place patients outdoors in fresh, cool mountain air, and many former Indian schools were remodeled to allow for outdoor sleeping quarters. Other treatments were not so delicate. One method was to punch a hole in the chest and collapse a patient’s lung in order to let it rest and facilitate healing. Another treatment was to surgically remove the affected portion of the lung. Neither was particularly effective.

While few records remain about cases of TB at Fort Spokane, similar hospitals throughout the country provide a snapshot at daily life for patients with the disease. In 1920, patients of Catawba Sanatorium followed this daily schedule:
7:15 - Rising Bell
8:00 to 8:30 - Breakfast
8:30 to 11:00 - Rest or Exercise as Ordered
11:00 to 12:45 - Rest on Bed
1:00 to 1:30 - Dinner
1:45 to 4:00 - Rest on Bed, Reading but no talking allowed. Quiet hour.
4:00 to 5:45 - Rest or Exercise as Ordered
6:00 - Supper
8:00 - Nourishment if ordered
9:00 - All patients in pavilions
9:30 - All lights out

The hospital at Fort Spokane treated 64 patients in its first year. But the fort’s isolated location made it difficult to get supplies, and the sanatorium was abandoned in 1929. Tuberculosis remained a problem among all races in the United States until after the Second World War, when the development of modern antibiotics provided the first effective cure for the disease. However, the story of TB in the United States may not be over, as new, drug-resistant strains of the disease continue to challenge medical authorities.