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Architecture as a cure for disease

Editor’s Note: Jonesborough’s homes and businesses have witnessed a great deal of challenges and success over the years. It seems appropriate in this year’s Progress Edition and during the current crisis, to see what they have to say courtesy of the Historic Zoning Commission’s “Watching Buildings.”

Throughout the late nineteenth and early twentieth centuries, tuberculosis was a feared infectious disease. Often referred to as “consumption,” the contagious lung ailment was frequently considered fatal. In Dec. 23, 1896 the Herald and Tribune bemoaned that, “consumption means death.” Earlier that year, the newspaper also warned readers about the symptoms of consumption, including, “cough, short breathing, tightness of the chest, quick pulse, chillness, slight fever, perspiration, pale face, languid, and loss of vitality.” It took decades for the power of the disease to lessen. In fact, by 1943, tuberculosis was still the third highest cause of death in Tennessee. 

Throughout much of the 1800s, consumptive patients were prescribed rest and a healthful climate in order to alter the course of the disease. Medical experts advocated for good hygiene, arguing that germ-free fresh air and proper sleep were essential for good health. After all, as one Tennessee newspaper reported in June 1906: “Consumption… is a disease which is produced by residence in houses. The germs which cause it thrive in the living quarters of man where sunlight and air are often excluded.” In order to combat tuberculosis, and the conditions that fostered it, patients turned to a new architectural innovation – the “cure porch.”     

This house located at 311 W. Main Street in Jonesborough is a house that exhibits a “cure porch.”

“Cure porches” hoped to remedy patients by exposing them to fresh air and were intended to protect other members of the household. “Cure porches” could be new additions, or built by enclosing previously existing porches. As The Nashville Banner described in June 12, 1906: “The porch can be boarded in at the bottom and fitted with window glass, which should be so arranged as to permit free entrance of air.” Anti-tubercular porches were often located on the front of the house, and had crank-out windows to control the airflow and manage temperature. “Cure porches” often used glass because it admitted light and sunshine, believed to alleviate the disease. 

Anti-tubercular porches were embodiments of the open-air movement, which celebrated the health benefits of outdoor exposure. In the Rules for Recovery From Pulmonary Tuberculosis, published in 1916, Dr. Lawrason Brown described the importance of these additions for patient recovery: “The Porch is the haven of rest for the patient, where, anchored in the ebb and flow of invigorating air, he escapes the jetsam and flotsam of the air of the house.” Identified as the most important part of the house, patients were encouraged to spend at least eight to ten hours every day outside. Some patients spent as much as twenty to twenty-four hours per day out-of-doors as part of their treatment, which was made possible by the construction of anti-tubercular porches. 

This house at 314 W. Main Street offers a porch that could have been handy during the days of the Spanish influenza.

Social and medical developments of the late nineteenth and early twentieth centuries greatly influenced residential architecture, with “cure porches” representing homeowners’ efforts to live a hygienic lifestyle. The absence of zoning laws or building codes permitted individuals and families to create rehabilitative spaces at home, where tuberculosis patients could recover from a vicious and often fatal disease. Today, there are several examples of anti-tubercular porches in historic Jonesborough at 130, 311, and 314 West Main Street.