Planning the Nation: the sanatorium movement in Germany

Abstract

With the nineteenth-century conviction that cities were true breeding grounds for disease, in particular tuberculosis, also came the theory that there were places of health outside of the city. The medical theory of the ‘immune place’, developed by Hermann Brehmer in the 1850s, would serve as the impetus for the development and justification of the tuberculosis sanatorium, which, as the ‘place of health’, was to be situated in natural surroundings, ideally in the dry air of an unspoilt mountain region.The first sanatorium dedicated to the treatment of tuberculosis was Görbersdorf in Silesia. It prompted a great number of successors and, by the end of the nineteenth century a veritable sanatorium or ‘Heilstätten-movement’ had taken place in Germany. However, the treatment did not prove as successful as initially hoped and, during the 1899 Conference on TB in Berlin, alternatives in the fight against the disease were considered, among them the ‘home sanatorium’, proposed by the military surgeon Dr von Unterberger. He attempted to bring the place of health back into the city, and therefore to ignore the demand for a particular site, the precondition of the original sanatorium cure.This paper will discuss the way in which the renunciation of site specificity, which led the sanatorium idea itself ad absurdum, provided new opportunities for the strategic governing of the young German Nation. The idea of a sanatorium network would now come to be associated with the idea of an evenly distributed grid determined by its distance from certain cities, their population density and other statistical or measurable indicators, which had become important in political decision-making processes. Less dependent on regional characteristics and on the necessity to acquire a particular location, centralised planning became feasible, which enabled the government in Berlin to project and advance a close-meshed institutional network and therefore stabilise its power.