"White Plague" in Black and White at Blue Ridge: Race, Children, and and the Ethics of Tuberculosis Prevention in Charlottesville, Virginia, 1920-1945

This paper uses the Blue Ridge Sanatorium as a case study through which to analyze the ethical implications of tuberculosis (TB) prevention in Virginian children between 1920 and 1945. The early twentieth century finding that many children harbored the TB bacillus galvanized activists to implement institutionally-based therapeutics for indigent children. When the Blue Ridge sanatorium opened in1920, children were admitted to adult wards, but by 1925 a separate children's build opened. Most youngsters admitted to Blue Ridge suffered from “childhood” TB, meaning they were infected with the tubercule bacillus, but not actively ill. Middle-class cultural ideals and extreme regimentation suffused the care provided to the children, who often remained hospitalized for a year or more. This research is significant for what it reveals about the confused logic underpinning the removal of poor white children from their homes. Reluctant parents were told that institutional treatment was essential to minimize TB's spread in “at-risk” families. But no black children went to Blue Ridge, even though the TB death rate in Virginia's black population was twice that of whites. Because the nearby black sanatorium, Piedmont, accepted only adults, there were no facilities during this era for black children who met the same criteria as their white counterparts. Primary sources included the archival documents from Blue Ridge Sanatorium, Virginia's State Board of Health and Tuberculosis Association, housed at the University of Virginia. Secondary sources included historiography relevant to the history of children's health care in the United States, nursing, medicine, public health, and tuberculosis.