Tuberculosis Infirmaries of The Public Works Administration and Racial Equality

By Abigail Meester


In the early 20th century, Tuberculosis was the leading cause of death in the Unites States. Southern states were more susceptible to Tuberculosis due to a high percentage of poverty. In particular, Virginia had a ranking among the highest in the country. The state of Virginia tried to alleviate this problem by opening state run sanatoria. The Catawba Sanatorium was the first to open in Virginia in 1909. Located near Roanoke, it offered a mountainous landscape and healing waters. The first sanatorium for the treatment of blacks in the state of Virginia was opened in 1918 near Burkeville, VA. In 1919, The Virginia Department of Health opened The Blue Ridge Sanatorium near Charlottesville.

The Blue Ridge Sanatorium inhabited the Moore’s Brook Sanatorium, used for the treatment of mental and nervous disorders, that had closed it’s doors in 1914. This location was decided upon for several reasons. The State General Assembly created an act that not only allowed cities to decide whether or not to have a sanatorium located in its vicinity, but it also allowed for the city to make contributions. The City of Charlottesville was an ideal location due to the proximity of the University of Virginia Hospital, the generous donation of $15,000, and free water from the city. The sanatorium responded to a growing need to accommodate as many patients as possible.

The United States economy took a huge downturn in 1929 and sent the country into a depression. In 1933 Franklin Delano Roosevelt created the Industrial Recovery Act in order to prepare a Comprehensive Public Works Program to boost the economy. This program was renamed Public Works Administration, or PWA, in 1939 and placed under the Federal Works Agency. This agency spent $6 million on strengthening the nations infrastructure, such as public buildings, bridges, dams, roads, tunnels, and housing developments.


Black vs. White Tuberculosis

Prior to 1918 the only place that black people could be treated for Tuberculosis was at the Central State Hospital for Mental Diseases or in the Virginia State Penitentiary. This was a problem because black people were more often infected with Tuberculosis than whites and often if they did make it to the hospital it was when the disease was so far advanced that the treatment would rarely yield improvement. The Negro Organization Society organized the building of the first Black Virginia sanatorium, and quite possible the first in the United States. The Negro Organization Society purchased 310 acres of land near Burkeville, VA and built the Piedmont Sanatorium. Unfortunately, the number of beds at the Piedmont Sanatorium remained well below the total number of beds for white patients. In 1938 the total number of beds at the Blue Ridge Sanatorium (white) was 270, this number remained the same until 1939 when a new infirmary was built and then the sanatorium held 370 patients. The Catawba Sanatorium (white) held 340 patients before the addition of a new infirmary building that housed another 80 people in 1939. The Piedmont Sanatorium (black) held 150 people in 1938 and 269 in 1939 after a hospital addition.

The supply of infirmaries did not meet the demand leading to almost triple the deaths in the black patients versus the white patients. In the late 1930’s all three hospitals received new infirmaries that were partially funded by the PWA.
In the charts on the adjacent page show the number of deaths from Tuberculosis in Virginia based on Color. The population and rate of death per 100,000 are also given.

Population in the State of Virginia

Year 1938 1939 1940 1941
Whites 1,813,693 1,995,477 2,019,805 2,078,784
Colored 657,279 663,102 664,366 685,557
Total 2,470,972 2,658,579 2,684,171 2,764,341

Number of Deaths from Tuberculosis in the State of Virginia

Year 1938 1939 1940 1941
Whites 861 780 732 746
Colored 948 838 828 892
Total 1,809 1,618 1,560 1,638

Death Rate Per 100,000 from Tuberculosis in the State of Virginia

Year 1938 1939 1940 1941
Whites 43.6 39.1 36.2 35.9
Colored 143.6 126.7 125.0 130.1
Total 68.7 60.9 58.1 59.3


Public Works Administration Additions

In 1938, Catawba, Blue Ridge, and Piedmont sanatoria all requested funds from the Public Works Administration to construct an infirmary building to house the growing population infected with Tuberculosis. All three were granted money that totaled 45 percent of the total cost upon completion for each new project.

Piedmont Sanatorium

Piedmont Sanatorium was granted the sum of $77,060 to build necessary additions to the hospital, an eight room addition to the nurses’ home and an addition to the power plant. This amount was later amended to the amount of $83,181. Williams, Coilie, and Pipino Architects was the firm commissioned for the project. The new infirmary held 119 beds.

“...the United States of America hereby offers to aid in financing the construction of a power plant and pump house and of additions to a hospital, including necessary equipment, and the construction of an addition to the nurses home, at the Piedmont Sanatorium at Burkeville, VA…”

The project was completed in 1940. The Carter building, the old infirmary, was completely remodeled after patients were transferred to the new infirmary building. The construction of a dairy barn that housed 50 cows, a milk house, pasteurizing plant and grain room, all were completed in 1941. The barns were funded by $20,000 left over from the PWA grant and 33% ($22,000) from the state. In the 1942 annual report from Piedmont they expressed difficulty in finding labor to run the new dairy and also labor and materials to build two new cottages, an employee dwelling, and an addition to the nurses’ home.

Catawba Sanatorium

Catawba Sanatorium was granted the sum of $91,022 to build a new hospital and other additions. H.M Miller was the architect commissioned for the project.

”…The United States of America hereby offers to aid in financing the construction of a hospital building (including a connecting corridor to the main infirmary building), and the construction of alterations and additions to the main infirmary building and to the nurses’ home at Catawba Sanatorium, including necessary equipment…”

The building program started in the fall of 1938 was finished in January of 1940. It included a new 80 bed infirmary, an addition to the 126 bed infirmary; 8 isolation rooms, five porches were inclosed, new addition to the nurses’ home and porches enclosed, apartment building for the staff, and a six room cottage for “colored women employees”.

Blue Ridge Sanatorium

In 1936, Blue Ridge Sanatorium received $1,500 to pay for 7.7 acres of land adding to the 150 acres tract already in use.
Blue Ridge Sanatorium was granted the sum of $167,726 to build necessary additions to the hospital, adding 100 beds to the capacity, and upgrading many amenities on the campus. The architects commissioned for the project were W.E. Stainback and Pruitt and Brown Architects.

“...the United States of America hereby offers to aid in financing the construction of an infirmary-culinary building and of alterations of a central heating plant and of an existing culinary building, including necessary equipment, the construction of walks and roadways and the moving of two frame buildings, including the construction of new foundations and the installation of service connections therefor...”

The General Assembly paid for the remaining 55% of building costs for the new infirmary building. The building project started in 1938 and was completed in 1940. The project spurred construction of a new heating plant and new dairy and horse barns, along with the alterations to the nurses’ home.


Blue Ridge Sanatorium Community Development

The Blue Ridge Sanatorium had several stages of development. In the area just south of the Davis Building (central I-shaped building) three major changes can be seen not only in the development of the hospital, but in the development of the cure as well. After the hospital purchased the land they built pavilions that offered open-air treatment. The wards were called the Thomas, Strode and Addison buildings shown on the 1929 Sanborne map. These pavilions were similar to the buildings that were used in the prototypical cure cottages in Saranac Lake. As the need for infirmary space increased the sanatorium made plans to build the new Infirmary-Culinary Building on the site near these three pavilions. The 1951 Sanborne map shows the Addison building moved to the south of the Thomas building to accommodate the construction of the new hospital. After the development of Streptomycin, an antibiotic that drastically changed the healing time of a Tuberculosis patient, the pavilion type buildings were obsolete in the cure process. The Blue Ridge Sanatorium tore down the abandoned Thomas, Addison and Strode buildings (Sanborne map from 1966).

Infirmary-Culinary Building, Blue Ridge Sanatorium

The Infirmary-Culinary Building was built in 1939 with grant money from the PWA. The building is art deco-streamline style and is built with concrete and a brick façade. The building’s design reoriented the sanatorium complex by turning it’s face from the center. The entrance was planned to bring visitors to the front of the new building instead of winding slowly through the grounds. The front of the building faces south allowing the sleeping porches direct sunlight, as prescribed to patients seeking the cure. This infirmary shows the new ideals in Tuberculosis hospital design.
The following pages contain the typical plan and elevations of the new infirmary building. The building is linear in form with a t-shaped appendage on the north facade, the culinary wing. The central entrance core is flanked by two wards. The plans show sleeping porches along the south façade. Before 1944 the major ideal in fighting Tuberculosis was sleeping porches, good diet and lots of rest. Cure cottages were the first built structures to house the patients of Tuberculosis. These were open air buildings allowing fresh air in and even snow in winter time. Later, larger buildings were built that had maintenance on the north side, hallway, than private rooms that opened into sleeping porches on the south side. The private rooms were mostly used for check ups and other private times, but not for sleeping. The new infirmary had a double loaded corridor, it was a hybrid of pavilion and infirmary, it still offered sleeping porches along the south face. The antibiotic, discovered in 1944, was derived from the Streptomyces Griseus mold and greatly reduced the time it took to recover from Tuberculosis. With the discovery of the antibiotic, fresh air and good nutrition were no longer top priorities in fighting Tuberculosis. In later years the sleeping porches were filled in with windows and the private rooms were inhabited.

Piedmont Sanatorium Community Development

The Piedmont Sanatorium was sited near Burkeville, VA on a 310 acre tract of land. The first buildings built were a brick administration building and a pavilion (the Agnes Randolph Building). In June 1918, a second pavilion, the Moton Building for men, was built with money from the State Anti-Tuberculosis Association. In the Sanborne map from 1921, the Administration Building is flanked by the two pavilions. In 1923, the sanatorium added an infirmary, the Carter Building, to the north of the Administration Building. The 2000 map shows that the sanatorium had many additions and demolitions. The 1940 infirmary building housed the patients from the wooden pavilions and they were demolished shortly after. After the discovery of the antibiotic, the sanatorium site was abandoned and later used as the Piedmont Geriatric Hospital.

Infirmary Building, Piedmont Sanatorium

The Piedmont Sanatorium infirmary was built in 1939 with grant money from the PWA. The building was designed by Williams, Coilie, Pipino Architects to house 119 patients. The central entrance divides the ward into two equal parts. The building has a double-loaded corridor and unlike the Blue Ridge building it does not have sleeping porches along the south façade. The building is constructed primarily of concrete, contrasting the brick façade of Blue Ridge. The infirmary replaced the 2 pavilion buildings previously used to treat patients.


The entrances of Blue Ridge and Piedmont Sanatoria are very similar in form. Both have a main central piece flanked by a stepped façade. The Blue Ridge entrance is streamline in style with rounded flanking balconies and art-deco style iron detail on the ground windows. The doors are placed on either side of the central piece. The steps to the doors are central then divided to both sides. Piedmont’s entrance is less grandeur in design and material, however the continuation of the window regulating lines around the façade are also streamline. Glass block above the door adds an art-deco feel to the entrance. The steps are central and straight flanked by two planters.

Windows and Side Elevations

Both buildings have strip windows emphasizing the horizontality. The Piedmont building has a stratified façade, with vertical corrugated concrete in-between the windows. The stratification turns the corner onto the side façade and around to the north façade. Blue Ridge’s sleeping porches offer large openings separated by small brick columns along the south façade (these openings were later filled in with windows.) The corners of the building are detailed with alternating protruding courses of brick that wrap the corner and stop just short of the windows.

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