State Tuberculosis Sanatoria

In the early 20th-century the double-barred cross, in honor of the Duke of Lorraine, became the international symbol of tuberculosis. This cross is (and was) present on the outside entrances of all of Kentucky’s state tuberculosis sanatoria.

(From the Journal of The House of Representatives of The Commonwealth of Kentucky, Vol. 1)

Map showing Kentucky’s six tuberculosis districts.


The first tuberculosis hospitals in the Commonwealth of Kentucky were county-operated facilities that served the local populations of each county. The first tuberculosis sanatorium in Kentucky was Hazelwood Sanatorium and accepted its first patients in 1907. Over the course of the next five years, two more tuberculosis sanatoria opened their doors, Waverly Hills and Jackson Hill. Additionally, the Branch Penitentiary and the Western Kentucky Asylum for the Insane had tubercular wards. In the same year, Kentucky passed the Acts of 1912 which included establishing tubercular districts throughout the state; in total, there were six districts. It was then that the anti-tuberculosis campaign took off. Continuing in the same year, the Kentucky Tuberculosis Commission began undertaking research efforts to ward off tuberculosis. In 1917 in Lexington, Fayette county opened the Blue Grass Sanatorium which would eventually become known as the Julius Marks Sanatorium. The Sanitorium contained a segregated “colored” patients building to house and treat African American patients.

Over time, tuberculosis became a continued issue and resulted in Hazelwood being stretched beyond its limits. The Kentucky Tuberculosis Sanatoria Commission sent an architect to travel throughout Kentucky in hopes of finding locations to build five state tuberculosis hospitals in the local communities. It was decided, then, that District One would be located in Madisonville, District Two would be located in Louisville, District Three would be located in Paris, District Four would be located in Ashland, District Five would be located in London, and District Six would be located in Glasgow. New hospitals would be built for each of the districts with the exception of District Two in Louisville where Hazelwood was already located.

In 1950-1951, the average daily cost of each tuberculosis patient in Kentucky was $9.16.

(From the Courier-Journal, Louisville, Kentucky, 22 July 1951)

Construction of the new tuberculosis hospitals began in 1946 and completed in 1950. Interestingly, all five of the new hospitals had nearly identical designs and layouts. The layouts were a standard five-building layout including the main hospital, residence of the director, residence for staff, a nurses’ residence, and a boiler and laundry house. The buildings were designed by architects John T. Gillig and Fred J. Harsten of Lexington and J. T. Wilson of Louisville was the construction engineering firm. Each hospital was to accommodate at least 100 patients with Hazelwood housing 250 patients and 750 additional beds in city and county tuberculosis sanatoria throughout Kentucky. Over time, however, drug therapy began making its mark on the fight against tuberculosis and by the mid-1970s, the few remaining tuberculosis hospitals were primarily treating chronic respiratory diseases. The remaining buildings were retrofitted for various uses ranging from long-term care to state governmental offices.

Primary tuberculosis in a 26-year-old black male from Kentucky. Posteroanterior and lateral radiographs reveal a cavitary infiltrate in the anterior segment of the left upper lobe along with paraaortic lymphadenopathy. (From the Journal of the Kentucky Medical Association)

Students at Paducah Tilghman High School Getting Mantoux Tuberculin Skin Tests. (From the Paducah Sun, Paducah, Kentucky, 17 November 1967)

Directory of Kentucky’s State Tuberculosis Hospitals

District One

Madisonville State Tuberculosis Hospital

District Two

Hazelwood State Tuberculosis Sanitarium

District Three

Paris State Tuberculosis Hospital

District Four

Ashland State Tuberculosis Hospital

District Five

London State Tuberculosis Hospital

District Six

Glasgow State Tuberculosis Hospital

Contributed by Phil Tkacz, Shawn Logan, Jay Gravatte, & Hope Bryant |

⁘ Works Cited ⁘

  1. The Lexington Leader, 9 December 1949
  2. The Lexington Leader, 12 December 1952
  1. United States Department of the Interior, National Park Service, and Jenna Stout. “National Register of Historic Places Multiple Property Documentation Form .” National Register of Historic Places Multiple Property Documentation Form , Kentucky, 2016, pp. 1–18.

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