September 2022

By Ray Jerrems, Sydney

Here is a picturesque photo of a rainbow at Wentworth Falls. The relevance of Wentworth Falls will become apparent later in this article.

This article describes the role of hospitals known as “sanatoriums” in the early 20th Century in the treatment of tuberculosis (also known as TB), a disease affecting the lungs. Known as “consumption” it was quite common and a number of Jerrems family members died from it in the USA in the 1850s and 1860s.

The most tragic case was Sarah Jerrems (Sandra’s great great grandmother), who died in 1865 in Utica, New York, leaving two young daughters, Anna and Sarah Cornelia.

The disease was common in the 1800s and up to the mid 1900s when antibiotics were found to be a cure for it.

My first specific knowledge of TB dates back to the late 1950s when I had an X Ray in a van conveniently parked near the main pedestrian crossing at Artarmon Railway Station. Passengers alighting from the train were encouraged to call in at the van as part of a huge nation-wide screening programme which was instrumental in eradicating the disease in Australia.

It was not until much later that I learned how serious a disease it had been, and the comparatively low rate of survival from it. It was a debilitating disease comparable with lung cancer. It was also not until later that I realised the role which had been played by sanatoriums.

This is a photo of the North Turramurra Sphinx, which is about four metres high.

In the early 1950s when I was a Boy Scout we visited what is now known as Ku-ring-gai National Park for a bushwalk. At the start of the bushwalk was a scaled down version of the Sphinx, meticulously hewn out of the native sandstone. This initially involved the removal of tons of sandstone from around the structure so that it projected out of the original rock shelf, and then the shaping of the projection so that it looked exactly like the Sphinx.

This mammoth task had been undertaken by a soldier (Private William Shirley) who had returned from the First World War after being gassed. He created the work as a memorial to his comrades who fell in the war.

He worked on the project from 1924 to 1926 when he was a patient in Lady Davidson Hospital, a rehabilitation hospital at North Turramurra for returned soldiers suffering from tuberculosis and from lung complaints arising from “gassing”.

A stone mason by trade, he was a long-term patient and became bored with the routine.

When walking in the nearby bush one day he saw a rock formation which he felt he could carve into a miniature of the great sphinx in Egypt. The medical staff encouraged him in his project as a way of occupying his time and using his skills. He worked a few hours each day although he was ill. Sadly he succumbed to his wartime injuries in 1929.

Other sanatoriums

A small number of sanatoriums had been established in New South Wales prior to Lady Davidson Hospital. These were at Wentworth Falls in the Blue Mountains (established in 1903), at Wahroonga (not far from North Turramurra) at the Sanatarium Hospital established in the same year, at Waterfall (south of Sydney) established in 1909, and in the same year a second sanatorium was built at Wentworth Falls (Bodington Sanatorium).

Florence Small

Florence Hilda Small was a granddaughter of Big Bill’s daughter Elizabeth. She was born in Sydney and the family later moved to Melbourne, where her father Jabez William Small died in 1891.

Florence died in April, 1907 at the age of 29. Her place of death gives us a valuable clue. She died at Wentworth Falls.

The 1903 Census shows Florence living in Canterbury in Melbourne, employed as a clerk. When she presumably contracted tuberculosis the family must have decided to send her to Wentworth Falls (three full days train travel from Melbourne) in the hope that she would recover there. She would probably have been accompanied on this long trip by a family member. One can sense her feeling of desperation in undertaking this trip. However, sadly she did not recover from the illness and passed away.

Queen Victoria Sanatorium

This is a modern photo showing the Sanatorium, which had been developed significantly in later years.

It seems likely that Florence went to the Queen Victoria Sanatorium at Wentworth Falls.

It is interesting to find a contemporary account of a visit by a newspaper correspondent to the Sanatorium shortly after it opened in 1903.

Readers should bear in mind that Wentworth Falls is almost at the top of the Blue Mountains, west of Sydney, and it snows there periodically. At least the sanatorium was in a comparatively sheltered small valley protected from the direct blast of the bitter southerly and westerly winter winds.

When you read the following account, published in the Sydney Morning Herald, you could be excused from concluding that the treatment regime was based on the principle of “kill or cure”.

The newspaper report

Here is the 1903 newspaper report, in italics, about the sanatorium. I have added headings.

THE WENTWORTH FALLS SANATORIUM

An interesting outcome of the Queen Victoria Memorial Fund was the opening, about seven months ago, of a home for consumptives at Wentworth Falls (Blue Mountains), the first hospital in this country worked upon the much-talked-about open-air system.

Though this system has from time to time been brought under our notice by interesting accounts of its workings in other countries, a visit to our own established “home” brings the science of the new method before one in a most vivid and convincing manner.

While spending a few days in the district, I took the opportunity of visiting this sanatorium. The physician in charge (Dr. Sinclair) was absent, but I was received by the matron (Miss Mulholland), who while taking me through the building most kindly explained the whole system of treatment to me, answering my numerous questions in the most pleasant and good-natured manner.

Location of the sanatorium

The sanatorium is situated about midway between Wentworth Falls and Lawson-a pleasant walk or drive from either station and commands one of the most healthy and wlnd-swept positions upon the mountains, though, of course, somewhat sheltered, being within a slight depression upon that broad expanse of open country known as “King’s Tableland.” The site is that which formerly formed part of the estate of Mr. Kelso King, his mountain residence, in fact, being converted into the nurses’ home.

The sanatorium is so constructed as to permit, or rather oblige, the patient to live to all intents and purposes “out-of-doors;” the wards, far from being kept at an even temperature, are subjected to every change of weather that favours the outside world. Upon entering the ward, this strikes one as being not only a most unfriendly attitude towards the consumptive microbe, but slightly so towards its human victim, whose home treatment hitherto would doubtless prove a striking contrast. Built between a wide verandah and an open corridor, each ward stands detached from the other, like a separate dwelling, and by means of large windows, fanlights, and doors, on all sides, catches the breeze, night and day, from every possible quarter:

The sanatorium’s wards

The walls of the ward are of composite wood, painted, the floor covering linoleum, the furniture the patient’s bed (with spring and horsehair mattress), no bed curtains, no hangings or drapes of any kind, nothing whatever to harbour germs; the patient’s day clothes even are removed at night, and placed in a small cloakroom by the nurse in attendance. The windows are entirely without blinds or shades, thus affording the patient, as well as abundant fresh air, the full benefit of the direct rays of the sun (the greatest of all germ destroyers).

In the large wards (there are three of them, six beds in each) I counted no less than 26 openings, and these, in winter as well as in summer, remain open day and night, excepting for a short time morning and evening, while patients dress and undress. Thus, coming from the open air no change in temperature is noticed when you enter a ward.

Wet weather

“But in wet weather,” I inquired, “how do you manage with your open doors?’ “Just the same,” said the matron, “though, of course, if the rain is too heavy in one quarter-that is, if the bedding is in danger of getting really wet-we close up the ward on the weather side.”

I was surprised to learn that a damp room is of so little consequence to these “hardy invalids” as long as they themselves remained dry; but Miss Mulholland convinced me of this by telling me that at times the ward has became so swamped that the nurses are obliged to attend in their galoshes though the patients are in no way affected. Remembering the bitter winds and frosty mornings upon the mountains, I inquired as to fires. Miss Mulholland informed me that they a very seldom lighted in the wards (there are no fireplaces in the two single wards), and even then the patients are not permitted to sit by them. They are lighted more to dry their clothes than for any other purpose, for the mountain mists are very heavy at times, and penetrate everywhere.

Then, of course, warm clothing (mostly woollen) is provided.

Precautions against spreading of disease

In answer to my questions regarding; the fear of infection and necessary precautions against spreading the disease, the matron said that the communication of the consumptive microbe is practically impossible when the rules of the hospital are carried out (and. I may remark that there was every evidence that these rules are carried out to the letter). It would be difficult to imagine any public institution more scrupulously clean or in more perfect order than this sanatorium. As to precautions, in the first place patients are forbidden to expectorate anywhere but in pocket flasks provided for the purpose. Should this rule be broken and a patient seen expectorating about the grounds he is liable to instant dismissal. The sputum (wherein the deadly microbe lies), the first rinsings of the flasks, or anything that may hold germs of the disease is “packed” in sawdust and daily burned in a furnace or small “crematorium” within the hospital grounds. Added to this disinfectants, carbolic, and formalin, are freely used. As a further protection rubber gloves are provided for those who are obliged to handle infected articles, though it appears it is seldom thought necessary to use those when ordinary precautions are taken.

Number of nursing staff

I inquired whether there was a large nursing staff employed, and was told that the whole establishment was managed by but two nurses together with the matron and doctor, and of course the usual house staff. I was greatly interested in and surprised at the wonderful simplicity of the “new cure.” which through the medium of this sanatorium has already restored to health several victims of the dread disease, who under the old-fashioned treatment may not only have succumbed to the disorder themselves, but have spread it abroad or handed it down to their children.

Benefit to the community

The benefit of such an institution to the whole community cannot be too highly rated when it is remembered that the microbe of consumption may be communicated from one person to another in a railway carriage, a tram car, or in public thoroughfares, where victims of this insidious disease are met with day after day. by removing the sufferer to a hospital where all precautions are taken the spread of the disease is materially lessened. A few years ago it could scarcely have been credited that so tenacious and fatal a disease as consumption could be stamped out at all, much less in the short space of five months. The cures effected at our Tuberculosis Sanatorium go a long way to prove that even this deadly microbe must at length succumb to science, which it is strange to note that modern science has here reverted to the simple weapons of fresh air, warm clothing, sunlight, and a wholesome and liberal diet to battle with and conquer one of the most deadly diseases our race is heir to.”

This photo shows Wentworth Falls in flood. It is amazing that a waterfall with a quite small catchment could have a flow this size.

Conclusion

Perhaps I should add the caveat for the treatment for patients meted out at the Sanatorium “Do not try this at home”.