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.


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