Sanitary Interior Design: Glazed Tiles & Modernism in Kentucky’s State TB Hospitals

Over the past six months, I’ve been busy researching and documenting Kentucky’s tubercular past. The five state hospitals created from 1946 to 1950 adhered to a standard institutional design. The brick exteriors, south-facing solaria (solariums), and imposing stone portico facades with double-barred crosses easily identify the remaining main hospitals as former sanatoria. In the original hospital design, yellow glazed tiles adorned the walls while dark brown/red tiles made of asphalt, ceramic, and quarry materials covered the floors. Since the extant buildings have been adaptively repurposed, it’s understandable that interior modifications occurred to facilitate this process. One distinctive interior element that is a holdout from the sanatorium days is the yellow glazed wall tiles.


Glazed Yellow Tiled Walls at Madisonville TB Hospital (January 2016)


Described as “cheerful” in newspaper accounts, glazed yellow tiles decorated the interior walls of the main hospital building, parts of the nurses’ dormitory, and the boiler house/laundry. Glazed tiles proved to be a popular decorative touch for tuberculosis hospitals as far back as the early 1900s. According to René Fan’s 2001 “Terra-Cotta Tile Mosaics at Sea View Hospital: Endangered Glazed Ceramics on State Island,” tiles were used to ‘furnish plain wall surfaces…and to eliminate the oppressive and dismal appearance of the building and its approaches.’ Praised for its impermeability and nonporous quality, glazed tile’s smooth surface repelled dust and germs. Tile, considered a sanitary building material that could easily be cleaned, found its way into the hygienic design of 20th-century sanatoria and hospitals.

In the early 20th century, it was believed that the tubercle bacilli could survive in household dust and that sunlight offered a way to destroy the bacteria lingering in the built environment. Light and air ultimately became intrinsically linked to the Anti-Tuberculosis Movement. Margaret Campbell, in “What Tuberculosis did for Modernism: The Influence of a Curative Environment on Modernist Design and Architecture,” contends that “light and air, and specifically sunlight, were influential in the interpretation of modernist hygienic ideas for the design of flat roofs, balconies, terraces and recliner chairs.” Modernism was articulated in Kentucky’s state sanatoria through the use of flat roofs, tiled interior spaces, and large glass windows. The modernism reflected in these buildings combined hygienic and environmental knowledge. When the state hospitals were constructed in Kentucky, the medical community and public still directly connected architectural design and environment with the treatment of tuberculosis. That association proved short-lived as the introduction of the triple therapy treatment diminished the need for sanatoria by the 1950s. Despite this poor timing in construction, the Commonwealth’s decision to fund state sanatoria, rather than remain in local hands, demonstrated a pervasive view in the power of medical and scientific progress. Thanks to the state sanatoria and new medical knowledge, tuberculosis deaths fell almost seventy percent from 1073 in 1950 to only 335 in 1960.



Adams, Annmarie. Medicine by Design: The Architect and the Modern Hospital, 1893 – 1943. Minneapolis: University of Minnesota Press, 2008.

Campbell, M. “What Tuberculosis did for Modernism: The Influence of a Curative Environment on Modernist Design and Architecture.” Medical History 49, no.4 (2005): 463 – 488.

Fan, René. “Terra-Cotta Tile Mosaics at Sea View Hospital: Endangered Glazed Ceramics on State Island.” ATP Bulletin 32, no. 4 (2001): 37 – 42.

Grimmer, Anne E. and Kimberly A. Konrad. “Preserving Historic Ceramic Tile Floors.” Preservation Briefs 40.

“Tuberculosis Hospital Dedication Section.” The Glasgow Times. Thursday, August 24, 1950.

Tuberculosis Sanatoria Commission Annual Reports. 1950 – 1970. Kentucky Department of Libraries and Archives. Frankfort, KY.


From Paris to Glasgow: The Razed TB State Hospitals of Kentucky

Kentucky’s State Tuberculosis Hospitals once dotted the landscape of the Commonwealth. Five hospitals, erected from 1946 to 1950, were situated in district locations selected by the Tuberculosis Sanatoria Commission of Kentucky. The decommissioning of the hospitals saw the transition of the London and Madisonville sites into state office buildings. The Ashland Tuberculosis Hospital buildings found new life as offices and shelter housing for Safe Harbor, Inc. The two remaining sanatoria sites, Glasgow and Paris, fell into disrepair and ultimately were razed.

Dedicated on June 14, 1950, the Paris Tuberculosis Hospital (District Three State Sanatorium) received its first patients on July 24, 1950 and gained the distinction of being the first of the new sanatoria to open. The 100-bed sanatorium was designed following the same Gillig-Hartstern & Wilson architectural blueprint used for the new sanatoria sites in Kentucky. Land conveyed from the Bourbon County Fiscal Court to the Commonwealth of Kentucky provided the acreage for the five-building sanatorium complex in Paris.

Although the Commonwealth described the five new $1.5 million hospitals as a progressive step in public health, its timing was poor to say the least. The arrival of state tuberculosis sanatoria in Kentucky coincided with the development of streptomycin and the triple therapy drug treatment. These new medicine regimens basically eradicated the need for sanatoria and outdated the new tuberculosis hospitals before they were even a decade old. The topic of what to do with the sanatorium complexes came up for discussion in the late 1950s and early 1960s. Kentucky’s Tuberculosis Sanatoria Commission attempted to open the hospitals up to a wider range of pulmonary diseases; despite these efforts, the hospitals were decommissioned in the 1970s. Given the broader trend in tuberculosis treatment, it was surprising that the hospitals lasted even this long as sanatoria had largely become medical relics at the time of their inception.

In preparation for its decommissioning, the Paris Tuberculosis Hospital, known at the time as the Paris Respiratory Disease Hospital, underwent some substantial modifications in 1975 before its closure in 1979. The original 42.92 sanatorium property was eventually subdivided to make way for the Bourbon County Park and the construction of a softball diamond. Lack of use and routine maintenance left the sanatorium buildings in poor condition. With the Paris Tuberculosis Hospital slated for demolition, a 2011 survey by William M. Hunter of Cultural Resource Analysts, Inc. (CRA) documented the extant site buildings before the scheduled razing. In addition to photographing and researching the National Register-eligible Paris Tuberculosis Hospital, CRA created a series of interpretive panels to be installed at the county park.

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Glasgow TB Hospital Postcard

In late August of 1950, Glasgow Tuberculosis Hospital (District Six State Tuberculosis Sanatorium) became the second of the state sanatoria to open. According to Barren County records, land purchased from J.C. Hutcherson in 1947 formed the basis for the sanatorium site. Following decommissioning, the Glasgow Tuberculosis Hospital reopened in 1977 as the Glasgow State Nursing Facility, a long-term facility for intellectually disabled or mentally ill patients. A 2004 masonry project and subsequent structural analysis in 2006 led to the decision to replace the main hospital building. The General Assembly allocated a total of $20 million to construct a new facility on the premises that opened in 2013. In late June 2014, the old main hospital building was demolished.


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Remarking on the end of the sanatorium, Dr. Phillip Bale, the Glasgow State Nursing Facility’s former medical director noted:

That facility, of course, was built to be a tuberculosis hospital, and when you think of the things that went on there many years ago, how little we knew back then about so many things and where medicine has come…that building represented healthcare in the 1930s and the 1940s and the new building is magnificent and capable of so many things.

– Excerpt from “Glasgow State Nursing Facility Had Long History”



Cultural Resource Analysts, Inc. Paris Tuberculosis Sanatorium State Recordation and Interpretive Signage. 2011.

Hunter, William M. Paris Tuberculosis Sanatorium. Kentucky Individual Buildings Survey Form. 2011.

Kinslow, Gina. “Glasgow State Nursing Facility Had Long History.” Glasgow Daily Times (June 24, 2014).

Kinslow, Gina. “Nursing Facility Nearing Completion.” Glasgow Daily Times (December 10, 2011).

“New Glasgow State Nursing Facility Officially Opens.” The Lane Report (July 23, 2013).

“Paris TB Hospital.” Asylum Projects.

“TB Hospital Demolition.” O’Rourke: Demolition Specialists Since 1962.

“TB History – Historical Photographs.” Kentucky Cabinet for Health and Family Services.

Westerfield, Savannah. “Paris Tuberculosis Sanatorium State Recordation and Interpretive Signage.” November 4, 2013. Cultural Resource Analysts, Inc.