Editor’s Note: It’s EHN’s four-year anniversary this week! Like in previous years, we’ll be celebrating all week long by featuring new and exciting work every day to mark the occasion. Today, Rebecca Le Get, one of our very first contributors, reflects on the difficulties of defining mountains and in turn montane tuberculosis sanatoria.
Tuberculosis in the nineteenth century was a big business in the British Empire. Similar to the development of mineral spa towns in Australia, the promulgation of localities deemed to be the most suitable for the treatment of tuberculosis “meant there was no slow accretion of legend or folk medicine… it was always self-consciously scientific” in how sites were appraised and described. People with financial means in the United Kingdom could peruse works such as Bruck’s Guide to the Health Resorts in Australia, Tasmania, New Zealand, and see potential localities classified by “their therapeutic indications” where they could permanently relocate to and, hopefully, be cured of disease. Bruck recommended the Macedon Ranges region in the then-Colony of Victoria as being suitable for the tuberculous.
The Macedon Ranges loom over the surrounding plain. Its highest mount is Macedon/Geboor, which stands about 1,000 metres above sea level, and is frequently enrobed in clouds and fog. From an ecological perspective, their upper reaches include montane grassy woodlands, and iconic flora such as the snow gum, an indication of the climactic extremes that can be experienced in this place, from snow and ice in winter, to bushfires in summer.
In a milieu of late nineteenth-century medical climatology, and a desire for physicians to identify the best climates to treat specific diseases, the role of mountain air in treatment rose to prominence. Unsurprisingly, a tuberculosis sanatorium opened on Mount Macedon in 1898, at about 780 metres above sea level. The site was described at the time as being “at a high elevation.” A doctor during this time claimed the institution was inspired by the “mountain cure” offered by the Swiss sanatoria of Davos Platz and St. Moritz, at elevations between ~600 to 1500 metres. It also clearly drew from predecessor institutions such as Görbersdorf (today Sokołowsko), in the Sudeten Mountains of Poland, at about 590 metres above sea level. These images of a bucolic tuberculosis sanatorium, set in a mountain range where patients were exposed to fresh air and sunlight, was fixed in European people’s minds by the early twentieth century with the publication of Thomas Mann’s Der Zauberberg, better known to Anglophones as The Magic Mountain, set at a sanatorium in Davos.
While I had argued during my PhD research, that such montane climates and geographies were not the only ones considered suitable for tuberculosis treatment in the nineteenth century, I had taken for granted that sanatoria such as Görbersdorf and Mount Macedon were located in mountain ranges. By exploring how the discipline of architectural history has examined this idea, it was possible to re-examine mountains in a different context, that I had inadvertently overlooked. Literature on the location of tuberculosis sanatoria in Europe indicates that other researchers have very different understandings of what a mountain is, and at what elevations a montane sanatorium should be built.
In his research into the sanatoria of the Swiss Alps, Dave Lüthi described the Görbersdorf sanatorium as being “in lowlands,” and similar to the sea-level coastal sanatorium of Berck-sur-Mer in northern France. Their relatively low-storey structures with generous floor plans were compared to other institutions in the Alps, where steep cliff faces and few flat areas required very different architecture. Here, buildings needed smaller footprints and therefore these high-altitude sanatoria developed into multi-storey structures with balconies, that not only utilised the pure mountain air, but also sunlight as a key aspect of tuberculosis treatment. As I scrolled through photographs of European sanatoria, trying to gain a sense of how places I had considered to be mountainous could be understood so differently, I became increasingly aware of how different, steep, and rocky the surroundings of the Alps truly were, as well as their sheer size. Physicians and architects when faced with this topography, constructed buildings and gardens that impacted how patients experienced this environment, whilst searching for an effective, scientific treatment for tuberculosis.
Some tuberculosis sanatoria in Australia, such as at Mount Macedon, Belair in the Adelaide Hills, and the Tubercular Soldiers’ Settlement at Angorichina, in the Flinders Ranges, were built in areas are generally considered to be elevated, if not mountainous, in an Australian context. But on a global scale, should these places be considered montane at all? The Australian continent has an average elevation of mere 330 metres, the lowest on the planet, due to much of the land being geologically stable and deeply weathered, so that the mountains have been ground down over millions of years.
Its mountainous terrain is also low compared to other places recommended for 19th century tuberculosis treatment in geologically active, neighbouring New Zealand/Aotearoa. Part of the difficulty in considering these places montane stems from the lack of an agreed-upon, universal definition for a mountain. In between discussions of angles of slope, topography, and elevation, Christian Körner et al. pithily summarise the issue: some people’s mountain “may appear to others as a hill.”
If agreement amongst locals is all that is needed for hills to be considered mountains, then these elevated sanatoria sites in Australia could still be montane. At the time, institutions such as Mount Macedon claimed direct influence from the Alpine treatment localities of Europe, and were compared to them in a positive light. The implicit assumption these Australian localities are mountains has continued into the present, and is reflected in their colonial English names that use the term “Mount.” This assumption contrasts with the perspective of architectural historians such as Lüthi, who did not consider these places to be similar to famous sanatoria such as Davos. But it seems that in the Australian colonies, collective agreement overrode the use of objective measurements to identify local mountains.
This is, in many ways, a reflection of the adaptability of the sanatorium system to diverse geographies. Despite the emphasis on science and medical climatology in determining what locations had curative properties, a wide variety of places were utilised to treat tuberculosis. This malleability in sanatorium placement and construction allowed for European models of healthcare to be adapted by European colonists on a very flat continent and utilise regions that would have been considered to be lowlands in almost any other territory of the British Empire, but locally fulfilled a montane niche in the landscape.
 Richard White, “From the Majestic to the Mundane: Democracy, Sophistication and History Among the Mineral Spas of Australia,” Journal of Tourism History 4, no. 1 (2012): 85-108.
 Ludwig Bruck, Guide to the Health Resorts in Australia, Tasmania, and New Zealand (Sydney: Australasian Medical Gazette, 1888): 137.
 Rebecca Le Get, “A Home Among the Gum Trees: The Victorian Sanatorium for Consumptives, Echuca and Mount Macedon,” Landscape Research, 44 no. 2 (2019): 186-199.
 Duncan Turner, “Treatment of Consumption,” The Argus (August 8, 1892), 3.
 Thomas Mann, The Magic Mountain, trans. H.T. Lowe-Porter (London: Secker & Warburg, 1969).
 Anonymous, “Die neueren Curorte gegen Lungenschwindsucht, besonders Görbersdorf und Davos,” Die Gartenlaube 25 (1880): 400-402.
 Le Get, “A Home Among the Gum Trees,” 186-199.
 David Lüthi, “The influence of Good air on architecture. A «Formal Cure»? The appearance of the Alpine sanatorium in Switzerland, 1880-1914,” Revue de géographie alpine 93, no. 1 (2005): 53-60.
 Christian Körner, Davnah Urbach, & Jens Paulsen, “Mountain definitions and their consequences,” Alp Botany 131 (2012): 213-217.
*Cover image: A panoramic photo of the Tubercular Soldiers’ Settlement at Angorichina, at approximately 320 metres above sea level, this former sanatorium site is in semi-arid southern Australia. This image has no known copyright restrictions, courtesy of the State Library of South Australia, B 6011.
[*Cover image description: A semi-arid environment with cleared paddocks in the foreground, low buildings in the centre, and sparsely treed, rocky hillocks in the background.]