055 Discover Saranac Lake NY - The Adironck Village Where Fresh Air Became Medicine
Discover New York Towns & Villages
Sometimes the history of a community is written in factories, canals or railroads.
In Saranac Lake, part of its history is written in porches.
Walk through this Adirondack village and you may notice houses with unusually large porches, enclosed sleeping areas and architectural features designed to put people outdoors.
They weren't built simply for enjoying the mountain scenery.
Many were built to help people recover from tuberculosis.
For decades, Saranac Lake became one of America's best-known centers for tuberculosis treatment and research.
It was a place where fresh air became medicine.
Start With the Adirondacks
Saranac Lake developed in the Adirondack Mountains of northern New York, surrounded by forests, lakes, rivers and mountains.
Like many Adirondack communities, its early economy was connected to natural resources and the people who worked in the woods.
Logging was important. Hunting and guiding became important. Tourism followed as increasing numbers of visitors traveled into the Adirondacks seeking wilderness, recreation and escape from growing cities.
Then something unusual happened.
The same environment attracting vacationers began attracting people for an entirely different reason:
Health.
Tuberculosis
During the nineteenth and early twentieth centuries, tuberculosis was one of the world's most feared diseases.
Often called consumption, tuberculosis commonly attacked the lungs and could spread from person to person through the air.
Before effective antibiotics became available, doctors had few reliable ways to treat it.
Rest, nutrition and exposure to fresh air became important parts of tuberculosis treatment.
That made the Adirondacks seem promising.
Cool mountain air, forests, open spaces and distance from crowded cities helped create an environment that doctors and patients believed could aid recovery.
Dr. Edward Livingston Trudeau
No person is more closely associated with Saranac Lake's transformation into a health center than Dr. Edward Livingston Trudeau.
Trudeau was a young physician when he developed tuberculosis himself.
At a time when the disease often meant a grim prognosis, he traveled to the Adirondacks.
He spent time outdoors, rested, ate well and gradually improved.
His personal experience changed the direction of his life.
Trudeau eventually settled in Saranac Lake and began treating other tuberculosis patients.
The Adirondack Cottage Sanitarium
In 1884, Trudeau established the Adirondack Cottage Sanitarium near Saranac Lake.
Rather than placing patients in one enormous hospital building, the institution used smaller cottages in an Adirondack setting.
Patients followed carefully controlled routines involving rest, nourishing food and large amounts of fresh air.
The institution eventually became known as the Trudeau Sanatorium.
Its influence extended far beyond the Adirondacks.
Fresh Air — Even in Winter
The fresh-air treatment was taken seriously.
Patients rested outdoors for hours.
And this was the Adirondacks.
Winter did not mean the treatment stopped.
Patients bundled themselves beneath blankets and continued resting on porches even when temperatures dropped well below freezing.
Imagine arriving from New York City or another crowded urban area while seriously ill and being told that part of your treatment involved spending hours lying outdoors during an Adirondack winter.
It sounds remarkable today.
But before antibiotics, physicians were working with the limited tools available to them.
The Cure Cottage
As increasing numbers of tuberculosis patients came to Saranac Lake, the entire village began adapting to them.
Homes became boarding houses for patients.
Existing buildings were modified.
New houses were designed with treatment in mind.
The most recognizable feature was the cure porch.
These porches were designed so patients could spend long periods resting in fresh air while remaining protected from rain and snow.
Some were open.
Others were enclosed with large windows.
Many homes had multiple porches so several patients could take the cure at once.
Eventually, the cure cottage became a distinctive part of Saranac Lake architecture.
When Medicine Changes Architecture
This is one of the most fascinating parts of Saranac Lake's story.
Medical thinking changed the buildings.
A house was no longer designed simply around kitchens, bedrooms, parlors and entrances.
It also needed spaces where patients could spend hours breathing outdoor air.
Porches became treatment rooms.
Windows became part of ventilation systems.
Sunlight and exposure to the outdoors influenced how spaces were arranged.
The architecture became part of the medicine.
A Village Becomes a Health Center
Saranac Lake's tuberculosis economy eventually extended throughout the community.
Patients needed housing.
They needed doctors and nurses.
They needed food, clothing, transportation and entertainment.
Families visited them.
Businesses served them.
Some patients remained in Saranac Lake after recovering and became permanent residents.
The disease that brought people to the village ultimately helped shape the village itself.
Science Comes to Saranac Lake
Trudeau was not satisfied simply treating patients.
He wanted to understand tuberculosis.
In 1894, the Saranac Laboratory opened.
It became the first laboratory in the United States built specifically for tuberculosis research.
That distinction is remarkable when you consider its location.
Important medical research was being conducted not in New York City, Boston or another major metropolitan center, but in a small Adirondack village.
Saranac Lake had become both a treatment community and a center for scientific investigation.
Fire and Rebuilding
The original Saranac Laboratory was damaged by fire in 1927.
It was rebuilt and continued to be associated with medical research.
Today, the historic laboratory survives as the Saranac Laboratory Museum, operated by Historic Saranac Lake.
The building helps preserve the story not only of Trudeau but of the thousands of people whose lives brought them to Saranac Lake seeking treatment.
Everybody Had a Story
One thing makes the history of Saranac Lake especially personal.
Tuberculosis affected people from every part of society.
Some patients were wealthy.
Others had very little money.
Some stayed in comfortable private cottages.
Others lived in inexpensive boarding houses.
Some recovered and went home.
Some stayed and built new lives in the Adirondacks.
Others died there.
Behind every cure cottage was a collection of individual stories involving illness, hope, uncertainty and recovery.
The Antibiotic Revolution
Everything changed during the twentieth century as effective drug treatments for tuberculosis were developed.
Streptomycin became available during the 1940s, followed by additional antibiotics that could be used in combination to treat the disease much more effectively.
Suddenly, spending months or years resting on an Adirondack porch was no longer the primary treatment strategy.
The tuberculosis economy that had supported much of Saranac Lake began disappearing.
The village had to adapt again.
The Porches Remained
The patients left.
The sanitariums closed or changed purpose.
But many of the buildings remained.
That is what makes Saranac Lake particularly interesting today.
You can walk through neighborhoods and still see evidence of a medical system that largely disappeared generations ago.
The cure cottages became ordinary houses, apartments, businesses and other buildings.
But their architecture still tells the story.
More Than Medical History
Of course, Saranac Lake is much more than its tuberculosis history.
The surrounding Adirondack landscape remains central to the community.
Lakes and waterways provide paddling and fishing.
Nearby mountains offer hiking and winter recreation.
The village has developed a strong arts community and retains a distinctive Adirondack character.
And although nearby Lake Placid became internationally identified with Olympic winter sports, Saranac Lake developed a very different identity.
Two Adirondack communities only a short distance apart ended up telling remarkably different stories.
What to Notice When You Visit Saranac Lake
Begin by looking at the houses.
Don't simply admire an old porch.
Ask why it is so large.
Look for enclosed porches with rows of windows.
Look for houses with porches on multiple floors.
Imagine beds or reclining chairs arranged there while patients spent hours taking the fresh-air cure.
Then visit the historic Saranac Laboratory.
Think about scientists studying tuberculosis inside while patients throughout the surrounding village were living with the disease.
Walk through downtown and imagine a time when patients, doctors, nurses, family members and visitors were all part of an economy centered around health.
Then look beyond the buildings.
Notice the mountains.
Feel the air.
Look at the forests and water.
Those natural surroundings weren't simply scenery.
They were part of the treatment.
Architecture as a Historical Record
Saranac Lake teaches us something important about exploring old communities.
A building doesn't have to be a museum to contain history.
A porch can tell a story.
A row of windows can reveal how people once thought about health.
A strangely shaped addition may make perfect sense once you understand what happened there.
Sometimes the best historical evidence is still standing right in front of us.
Every Town Has a Story
Saranac Lake began as an Adirondack community surrounded by forests, lakes and mountains.
Then one physician arrived while suffering from tuberculosis.
His recovery helped inspire a new approach to treatment.
A sanitarium followed.
Then a laboratory.
Patients came from around the country and beyond.
Homes changed.
Businesses changed.
The village changed.
Eventually medicine changed again and the patients stopped coming.
But the buildings remained.
The next time you visit Saranac Lake, look at the porches.
Once you understand why they are there, you will never look at them quite the same way again.
Discover New York Towns & Villages
This article is part of the Discover New York Towns & Villages series from Zehr Discover NYS. Together we'll explore communities across New York State and discover the geography, history, architecture, industries, transportation and people that helped make each place unique.
Learn the place. Explore the story. Discover New York.