In 1902 the Wisconsin Legislature responded to pressure from Progressives and public health reformers and authorized the creation of a commission to study the problem of tuberculosis in Wisconsin. On August 3, 1903, Governor Robert M. La Follette instructed a three-person commission to investigate tuberculosis in the state, its treatment and prevention, and the practicality of a state sanatorium. Based on the commission's recommendations, the Wisconsin State Sanatorium, also know as "Statesan," was established by the legislature under Chapter 361, Laws of 1905, for the treatment of pulmonary tuberculosis.
The sanatorium was located on 200 acres of land near Wales in Waukesha County. Dr. Chester A. Paull of Massachusetts was selected as superintendent, and the sanatorium opened with 40 patients on November 9, 1907. From 1905 to 1909, Statesan was jointly managed by the State Board of Control and a five-member advisory board that included one member of the State Board of Health. The advisory board was responsible for the general supervision and government of the sanatorium, and the Board of Control was responsible for financial management. In 1909 the Board of Control assumed full responsibility for management. Moreover, the appointment of medical staff and other employees, supervision of sanatorium grounds, buildings, employees and patients, and rule proposed by the superintendent were also subject to the approval of the State Board of Control. The advisory board supervised medical policy, made inspections, and reported to the board.
During the supervision of the Board of Control, there were nine superintendents: Dr. J.W. Coon (1909-1915), Dr. Norman L. Hoffman (1915), Dr. Frank Brockway (1915-1917), Dr. Robert W. Williams (1917-1922), Dr. Louis Dudley (1922-1929), Dr. R.D. Thompson (1929-1932, 1933-1937), Dr. E.K. Steinkopf (1932-1933), and Dr. H.M. Coon (1937-1939). At various times the sanatorium also employed an assistant superintendent, a steward and assistant steward, and many physicians and nurses. In 1938, there were four physicians and thirty nurses on staff, as well as a visiting surgeon, dental consultant, and an ENT specialist.
In 1907 the grounds consisted of an administration building, a dining hall, two cottages, and a power house. Between 1907 and 1939 a number of buildings and additions were added: two cottages (1908); a laundry (1908); an infirmary and additional cottages (1910); a cottage for male patients (1912); a dormitory for male employees (1912); a superintendent's residence (1912); an assembly hall for recreation and religious services (1914); a rehabilitation workshop (1914); a children's cottage (1914); and a hospital (1929). As a result of this construction, patient capacity grew from 89 beds in 1909 to 240 beds in 1939.
Statesan only accepted patients in the early or moderately advanced stages of tuberculosis. Additionally, applicants had to be at least sixteen years old and to have lived in Wisconsin for at least one year. The superintendent then made a final determination based on the applicant's stage of infection and space availability. Patients were required to pay a weekly fee for room and board and medical care ($15.00 in 1929), however, with the approval of a county judge, those unable to pay were admitted as county charges. Indigent patients without a legal residence were admitted at state expense.
Between 1910 and 1939 Statesan was part of a network of tuberculosis institutions supervised by the State Board of Control. This network included county and private sanatoria and another state institution, Lake Tomahawk State Camp, which was established in 1913 in Oneida County to provide graded work and vocational rehabilitation for patients in the arrested stage of tuberculosis. Patients were transferred to the camp from the county sanatoria and Statesan with the approval of the camp's medical director (who was also the superintendent of Statesan) and the State Board of Control. Statesan superintendents also made routine visits to examine patients at Lake Tomahawk State Camp. Thus, the county and private sanatoria specialized in care of advanced cases, Statesan provided for incipient cases, and Lake Tomahawk State Camp rehabilitated patients in the arrested stage of the disease. The first option for most patients was a county or a private sanatorium, but Statesan often accepted applicants who were unable to find places in local institutions. Patients were frequently transferred between institutions as their conditions changed, and space became available.
Statesan's primary function was to isolate, treat, and rehabilitate persons affected with pulmonary tuberculosis in the incipient or slightly advanced stages of the disease. In the early years of Statesan's operation, the primary treatment was fresh air, rest, and nourishing food. Since it was believed that cold air was therapeutic, patients slept on open porches or in unheated cottages. By the early 1920s, this rest cure was supplemented by pneumothorax, a procedure in which “sterile” air was injected between layers of the pleura in the patient's lungs. With the construction of the hospital in 1929, Statesan began offering surgical treatments under the direction of Dr. J.W. Gale of the University of Wisconsin Medical School. At the time, the most common surgical treatment for pulmonary tuberculosis was thoracoplasty, by which all or part of the lung cage was removed. In the 1930s, pneumonolysis (cutting the adhesions between the layers of pleura in the lungs) was added as a surgical treatment. Statesan also had a laboratory and equipment for diagnosis and monitoring. The chief diagnostic tools at the time were X-ray and urine and sputum analysis.
From the beginning, rehabilitation of patients at Statesan included some sort of graded work or occupational therapy. By 1910, patients were gardening and working in a poultry plant. In 1912, a workshop was constructed, and patients were allowed to gradually prepare themselves for work after their discharge. Other forms of vocational training included typing, shorthand, and secretarial work. Patients also edited and contributed to various publications: The Badger Outlook, and The Beacon (1931-1957). By the late 1930s, Statesan had established a program of occupational therapy administered by a registered therapist.
Statesan also provided medical training in the treatment of tuberculosis. The official recognition of Statesan by the American Medical Association enabled physicians to serve two-year residencies at the sanatorium. Moreover, beginning in 1937 and continuing through the 1950s, senior medical students at the University of Wisconsin Medical School were required to spend two weeks at the sanatorium.
In February 1938, Statesan was transferred to the State Board of Health. This executive order was rescinded on January 15, 1939, however, and the Board of Control resumed administration of the institution. Later that year Statesan was again transferred to the Board of Health. Finally, in July 1941, the Board of Health organized a Division of Tuberculosis to oversee the county sanatoria, Lake Tomahawk State Camp, and Statesan and to plan and supervise a broad program of tuberculosis control.
In 1940, Dr. R.H. Schmidt Jr., became the ninth superintendent of Statesan. He held the post until 1950, when the management of the sanatorium was divided between a lay administrator and a medical director. Occupational therapy remained an area of expansion at Statesan, and in 1945 Superintendent Schmidt recommended the appointment of an in-patient rehabilitation coordinator. During the next three years, full-time vocational instructors were employed and in 1948 a rehabilitation counselor was appointed. Based on patient surveys, programs in home economics, commercial subjects, and handicrafts were implemented or expanded. Patients were also offered instruction in academic subjects.
During this time there was a general decrease in the patient population and staff size. In 1945 the third floor and part of the second floor of the hospital was closed, and in 1954 the cottages for ambulatory patients were closed. Much of the decline in patient population came as a result of new treatments. By the early 1940s the sanatorium had added pneumoperitoneum, an injection of sterile air into the outer layer of pleura, to its treatment regimen. In 1947, the sanatorium was still employing pneumothorax and collapse procedures, but it had also begun to use the antibiotic streptomycin. By 1952 the sanatorium had largely abandoned collapse procedures in favor of surgical removal of the diseased areas of the lung. This new procedure, combined with anti-bacterial drugs greatly reduced the death rate from tuberculosis. As a result of these effective new treatments, Statesan began to accept patients in all stages of the disease. By 1954, the average daily patient population had dropped to 77, compared with 200 patients in 1942. The number of doctors on the staff was cut from four to two, and cuts were made in other staff as well. In 1956 the sanatorium's annual report stated that even chronic patients who had lived at the sanatorium for years were being cured and sent home. Citing increased costs due to the number of vacancies at Statesan and Lake Tomahawk State Camp, the legislature voted to close both institutions on November 1, 1957, and the buildings at Statesan were transferred to the Department of Public Welfare for the housing of juvenile offenders, known as the Wisconsin School for Boys, then later called the Ethan Allen School for Boys.
