Historians estimate that perhaps as many as one-third of Colorado’s early settlers moved to the state for reasons directly or indirectly associated with health. Most came because they believed the arid mountain climate could cure them of one of the nineteenth-century’s deadliest diseases: tuberculosis. The prevalence of tuberculosis in the nineteenth century, as well as myths about its abatement in drier climates, fueled white settlement in Colorado and brought noteworthy individuals such as Helen Hunt Jackson and Gustaf Nordenskiöld to the state.

Although such logic may seem odd today, moving for health reasons made a great deal of sense to nineteenth-century Americans. Unaware that pathogens caused illness, medical practitioners espoused the belief that certain landscapes were healthy and others were unhealthy. Places with putrid water, stagnant air, and sudden changes of temperature were believed to breed disease, while places like Colorado, with clean water, fresh air, and sunshine, were thought to foster health. The surest way to good health, many doctors advised, was to find the climate that best suited one’s bodily predisposition. If such a place did not happen to be nearby, doctors often prescribed temporary or permanent relocation.

Colorado’s reputed ability to cure tuberculosis sufferers made it a particularly alluring destination. Perhaps the most feared disease of the period, tuberculosis caused between one-eighth and one-fifth of American deaths between 1800 and 1880. It killed its victim slowly, infecting first the lungs and then spreading throughout the body. Today, we know that tuberculosis is an infectious airborne disease that spreads when an infected person coughs, spits, or sneezes particles, known as droplet nuclei, that contain the tubercle bacillus. At the time, however, the cause of the disease was unknown, and most doctors did not believe it was communicable.

At first, Colorado officials and boosters welcomed health seekers, and tuberculosis sufferers were among the state’s early champions. In 1872, poet and novelist Helen Hunt Jackson traveled to Colorado Springs for the cure and published a number of poems, short stories, and travelogues that showcased the state’s natural beauty. In the 1890s, ailing Swedish scientist and aristocrat Gustaf Nordenskiöld explored the Cliff Dwellings at Mesa Verde and conducted the first archaeological excavation of the site. His book, The Cliff Dwellers of Mesa Verde, brought the ruins worldwide fame.

Countless other tuberculars buttressed Colorado’s growing economy. More than a dozen sanatoriums were built to accommodate these immigrants, and a burgeoning health industry formed in towns such as Colorado Springs. However, as germ theory gained prominence in the late 1890s and doctors began to suspect that tuberculosis was transferred from person to person, state officials began to worry that unchecked migration of tuberculars would endanger healthy residents. By the first decade of the twentieth century, state officials were discouraging people with advanced or incurable forms of tuberculosis from moving to the state, and tubercular patients found that the state’s once-welcoming innkeepers, shop owners, and residents wanted little to do with them. Sanatoriums either shut their doors or began to offer more generalized health treatments.

During the Great Depression, the Colorado legislature passed a measure that prohibited non-residents from receiving public assistance for tuberculosis treatment. Efforts to eradicate the disease in the state intensified after World War II. Policymakers noted counties with high rates of the disease to better identify infected individuals and isolate them from the rest of the population. Central to this campaign was the creation of mobile tuberculosis clinics – vans equipped with X-ray machines designed to travel to Colorado’s rural and remote locations in search of tuberculosis patients. These efforts proved successful, and the disease was largely eradicated by the 1950s.

Legacy in the State

The role tuberculosis played in Colorado’s early settlement is only part of the disease’s legacy in the state. Tuberculosis was also instrumental in establishing Colorado’s reputation as a healthy place. There are a number of reasons for this, but the most important seems to be the unusual and perplexing nature of tuberculosis itself.

Although scientists discovered Mycobacterium tuberculosis – tuberculosis’s disease-causing agent – in the 1880s, doctors struggled to explain why and how it spread. The tubercle bacillus did not fit into any existing germ theory model and seemed to possess a logic all its own. Unlike cholera, which can survive and reproduce in water, the tubercle bacillus survives in the air only for a short time (minutes or hours, depending on ventilation), and doctors could not figure out how it spread from one person to the next.

Tuberculosis’s elusive nature stemmed from its early interaction with humans. Like most living things, pathogens have adopted myriad strategies to survive – the AIDS virus mutates rapidly, intestinal parasites withstand the stomach’s acidic conditions, and Lyme disease infects multiple human and animal hosts. About 15,000 years ago, the tubercle bacillus developed the capacity to lie dormant in human and animal bodies. Humans or animals that become infected with Mycobacterium tuberculosis or a related species do not necessarily contract tuberculosis. The majority of those infected have immune systems capable of inhibiting the replication and spread of bacteria.

However, human and animal bodies cannot rid themselves of the bacillus, as they are able to do with other microbes, and once they become sick the microbe can replicate and colonize host tissue. Until that time, an infected individual will not exhibit symptoms of the disease and cannot infect others.

Germ theorists did not understand this process until the 1930s, and no reliable treatment for tuberculosis existed until the development of antibiotics in the 1940s. The scientific uncertainty surrounding tuberculosis created a knowledge vacuum – a space where anyone, regardless of educational background or status, could discuss the disease’s potential remedies, cures, and theories. Many of Colorado’s doctors and patients chose to fill this space with renewed theories about climate therapy.

Instead of citing the innate healthfulness of Colorado’s climate, as they had in the 1870s and 1880s, physicians argued that the state fostered a healthy lifestyle. Carroll E. Edson, an MD from Denver, wrote that Colorado’s air quality and plentiful sunshine encouraged outdoor activities such as walking and bicycling.

One became healthy, Coloradans argued, not by avoiding certain places or keeping microscopic particles out of the body but through the manner in which one lived. By engaging in outdoor activities, eating unprocessed foods, and lounging in the sun, tubercular men and women claimed to be healthy despite their failing bodies. Those who profited from health migration, such as Colorado Springs resort owners, quickly adopted this rhetoric and once again began to tout the state’s innate healthfulness.

Eventually, the link between these ideas and tuberculosis would be forgotten, but not before Colorado’s reputation as a place whose citizens enjoyed particularly good health was firmly cemented in the popular imagination.