CRA completed state level recordation and an interpretive signage plan for the Paris Kentucky Tuberculosis Sanatorium in response to the Bourbon County Fiscal Court proposal to utilize funds from the U.S. Department of Housing and Urban Development to demolish five structures associated with the Sanatorium, which has been determined eligible for listing in the National Register of Historic Places. Since this undertaking, utilizing HUD-funding, constituted an adverse effect to the property, the Bourbon County Fiscal Court entered a Memorandum of Agreement with the Kentucky Heritage Council to mitigate the adverse effect. State level recordation of the facility and development of interpretation signage served as partial fulfillment of the stipulations of the Memorandum of Agreement.
History of Tuberculosis in the US
Tuberculosis is an airborne disease caused by the bacterium Mycobacterium tuberculosis, which primarily affects the lungs but can cause extra-pulmonary complications throughout the body. Historically, the disease was known as “consumption” or the “white plague” to denote the rapid weight loss and pallor associated with the disease. The disease did not carry the moniker “tuberculosis” until 1839. Tuberculosis historically killed indiscriminately, although in modern times, outbreaks tend to cluster within specific demographic or geographic groups (Meade and Emch 2010).
In the United States, deaths from tuberculosis peaked in the mid-nineteenth century. Death rates associated with tuberculosis had been declining since the mid-nineteenth century, although a more pronounced reduction in deaths from the disease began in the early twentieth century. Numerous reasons could account for the decline in deaths from tuberculosis in the United States during the first half of the twentieth century, including the isolating of those suffering from the illness, better diets and housing for the overall population, public health initiatives, and some of the radical medical treatments offered against the disease. Improvements in nutrition and housing, and public health in general, led to a decreasing incidence through the early twentieth century in the United States, although isolation of the infected in sanatoria undoubtedly contributed to the curtailment of the disease (Caldwell 1988; Dubos 1996). By 1979, the Kentucky Department of Human Resources could no longer maintain what was then known as the Paris Respiratory Disease Hospital and the facility was permanently closed.
Treating Tuberculosis in Kentucky
In an effort to combat tuberculosis in Kentucky, a site selection commission reviewed applications for locations of the proposed network of six sanatoria throughout 1944. Ultimately, Paris, Kentucky, was chosen as the site for one of the sanatoriums. The Paris location was one of five new sanatoria to open in Kentucky in 1950. The Paris Tuberculosis Sanatorium serviced the region for about 15 years before the threat of the disease finally diminished (Caldwell 1988). The Paris Tuberculosis Sanatorium complex consisted of six total buildings, including the main hospital building, the laundry/boiler facility, the director’s residence, the nurses’ residence, a staff residence, and a modern maintenance building added to the site after its initial construction. The hospital complex has been determined eligible for listing in the National Register of Historic Places.
The Paris Tuberculosis Sanatorium is significant for its association with efforts to address public health in Kentucky within the established context “Treatment of Tuberculosis in Kentucky, 1912 – 1977 (Graham 2007). A previous cultural historic survey found that the hospital “is an outstanding example of a mid-twentieth century Tuberculosis medical complex … eligible under Criterion A as it is significant for its association with significant major efforts to address public health in Kentucky (Ball and Daugherty 2009:7.1). ”
State Recordation and Interpretive Signage
CRA conducted intensive documentation of the facility, including extensive archival research and context development; digital photographic documentation to National Park Service standards; measured floor plans; and a written narrative of the entire property. The document, in its entirety, was crafted to serve as a comprehensive history and description of this significant National Register-eligible facility. In addition, utilizing information and photographs discovered during the archival research and employing an appealing aesthetic, CRA designed a series of interpretive signage panels meeting National Park Service best practices to be installed on the property, which was to become a park, to present the history of the site and evolving treatments for tuberculosis in the United States.
Ball, D.W and D.R. Daugherty. 2009 Cultural Historic Survey of Paris Tuberculosis Hospital, Bourbon County, Kentucky. Wilbur Smith Associates, Inc. Lexington Kentucky.
Caldwell, M. 1988 The Last Crusade: The War on Consumption 1862–1954. Athenaeum, New York.
Dubos, R. and J. 1996 The White Plague: Tuberculosis, Manand Society. Rutgers, the State University, New Jersey.
Graham, J. 2007 Ashland Tuberculosis Hospital. National Register of Historic Places Registration Form. Kentucky Heritage Council, Frankfort, Kentucky.
Meade M. S. and M. Emch. 2010 Medical Geography. Guilford Press, London.