At the beginning of 1936, when Hester’s health took a turn for the worse, Isaac and Robert drove her 100 miles southwest from Cross Plains to the town of San Angelo for treatment. This was shortly after they had returned from hospital trip to Marlin. Robert outlines the San Angelo visit for H. P. Lovecraft in this letter dated February 11, 1936.

After our return from Marlin we stayed at home for about two weeks, and then my mother’s pleura filled again, and we took her to a hospital in San Angelo, 105 miles southwest of Cross Plains. After a few days then we put her in a sanatorium about seventeen miles northwest of San Angelo,  where she stayed for six weeks, when her condition got so bad we put her back in the hospital at San Angelo. She remained there twelve days, and then we brought her home, since it seemed they had done all they could for her. Her condition is very bad, and she requires frequent aspirations, which are painful, weakening and dangerous. It is wonderful with what fortitude she endures her afflictions; in every hospital she has been, the doctors and nurses speak of her cheerfulness, her nerve, and her steadiness in the highest terms. But it is only what can be expected in a woman of the old pioneer stock.

This was the beginning of a slow decline for Hester and the desperation Robert expressed in this correspondence with HPL, having knowledge of the impending end of her life, is almost too devastating to read. Isaac was aware of this desperation as well, as he recounts Hester’s San Angelo stay and Robert’s frame of mind to Lovecraft in a June 29, 1936 letter.

[T]his year in February, while his mother was very sick and not expected to live but a few days, at that time she was in the Shannon Hospital in San Angelo, Texas. San Angelo is something like one hundred miles from here. He was driving back and forth daily from San Angelo to home. One evening he told me I would find his business, what little there was to it, all carefully written up and in a large envelope in his desk. Again I begged him not to do it but he possitively [sic] did not intend to live after his mother was gone.

The sanatorium where Hester stayed for six weeks was the State Tuberculosis Sanatorium, which was located sixteen miles northwest of San Angelo on U.S. Highway 87 in an incorporated town known as Carlsbad. The facility was so large, it had its own post office designated as “Sanatorium, Texas.”

Pulmonary tuberculosis caused more than 4,000 deaths a year in Texas during the first decade of the twentieth century. This led to the Texas Senate to pass a bill in 1909 creating a TB colony, but it was defeated in the House. Two years later, when the state congress met again, both houses passed a bill creating two colonies – one for advanced and one for early cases – dedicated to the treatment and education of people infected with TB.

Although plans for the former were abandoned, 330 acres was purchased near Carlsbad for the location of the Anti-Tuberculosis Colony No. 1. This colony was the first institution of its kind in Texas and provided the isolation to calm the fears of the public, as well as rest and clean air, the only known cure for TB sufferers. Admission to the facility was restricted to patients between the ages of six and sixty for a period no longer than six months.

On July 4, 1912 the fifty-seven-bed sanatorium opened with a cookout and celebration. The following year the facility was renamed the State Tuberculosis Sanatorium, and in 1914, Governor Oscar Colquitt named Joseph McKnight resident superintendent. Under McKnight’s guidance, the sanatorium expanded for the next thirty-five years.

In addition to low wages, and geographic isolation, the fear of TB made it difficult to recruit employees for the facility. To counter these issues, the Sanatorium School for Nurses in Texas was created in 1915 to train the needed staff. Nearly all the students who attended two-year training course, which focused on tuberculosis treatment, were recovering TB patients. The first class of four graduated in 1917 with a R.T.N. degree (Registered Tuberculosis Nurse).

Originally beginning with four buildings constructed at a cost of $10,000, the facility grew to thirty-five buildings valued at $1.5 million. In 1930 there were thirteen buildings with 662 patient beds, including 162 beds in the children’s Preventorium, and over 13,000 patients had received treatment. The grounds tripled in size to nearly 1,000 acres and included barber and beauty shops, a post office, library, dairy, hog farm, butcher shop, bakery, power plant, laundry, printing press with its own newspaper, four water wells, and a school for the children. Other on-site amenities included church services and organized meetings for the Masons, Order of the Eastern Star, bridge club, sewing club and stamp collectors’ club. Indeed, the complex had grown into a virtually self-sufficient community known as Sanatorium.

Sanatorium continued to grow to 970 beds with 300 patients on the waiting list. In 1949 McKnight proposed additional expansions, including a new seventy-five bed dormitory, increased space for employee living quarters, and a twenty-five bed surgery unit to supplement the existing surgical building constructed in 1947–48. Surgeon Raymond F. Corpe, who was on loan from the United States Public Health Service, had begun to perform thoracoplastic operations.

The 1950s brought dramatic change to the institution. McKnight, who had become synonymous with the battle against TB, retired in 1950. In June 1951, the Texas legislature renamed the institution the McKnight State Sanatorium in his honor. The ancillary operations such as the dairy, hog farm, and the Preventorium were systematically closed during the decade.

The nursing school was renamed the State Tuberculosis School of Nursing in 1938 and continued operating until 1961, graduating a total of 501 nurses.

The number of TB beds was gradually reduced to 550 and the length of treatment continued to shorten due to new drugs and surgery techniques. Unfortunately, Hester lived in a time before the development of anti-tuberculosis antibiotics, which did not come into the picture until the late 1940s.

From 1912 through 1969, approximately 50,000 adult and 5,000 juvenile patients were treated at the McKnight State Tuberculosis Hospital. By 1969 medical techniques and drugs were successful in more than 90 percent of tuberculosis cases, making Sanatorium and related TB institutions unnecessary. So the institution was tasked with a new mission — serving the needs of mentally challenged men and women, which it continues to do today.

This entry was posted on Monday, November 22nd, 2010 at 7:33 am and is filed under Dr. Isaac M. Howard, H. P. Lovecraft, Hester Jane Ervin Howard, Howard's Texas, Howard's Travels. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
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23 Comments(+Add)

1   Richard    
December 3rd, 2010 at 5:45 pm

Thanks for sharing this! I can attest that caring for a sick mom is very, very stressful! I had to take my 82 year old mom to ER with chest pains and she has dementia. It changes everything!

2   Juan
May 25th, 2011 at 9:18 am

Thanks so much for this information. It is very soothing to read that such a facility existed to care for our loved ones with this disease at that time period. My mother was a patient there and I am curious as what happened to her records. Your help is much appreciated. Thank you for this important information on this horrendous disease.

3   Betty    
July 2nd, 2011 at 3:35 pm

I, too am curious as to what happened to the records of the patients. My husband’s great Aunt was a patient, she passed away at the sanatorium in 1933. Any help would be greatly appreciated.

4   Damon C. Sasser
July 2nd, 2011 at 5:57 pm

Betty, you might start by contacting the Texas Department of State Health Services via their website.

5   Vickie Webb    
October 28th, 2011 at 6:56 pm

I was a patient there. Back in the early 60’s (I was 4 years old and had my fifth birthday there). I remember so little about that time. Thanks for this – do you know where I can find out anything else about the old Sanatorium?

6   Damon C. Sasser
October 30th, 2011 at 9:03 am

Vickie, you might check the Texas Dept. of Health website. Also, try some general searches on the internet.

7   Brian Hausman    
June 4th, 2012 at 2:24 pm

Our Law Firm represents the family of a deceased person whose parents worked at the sanatorium (1940’s – 1970’s). His father worked maintenance and mother was a nurse. Any past employees out there? Please call Brian Hausman 1-800-479-9533.

8   Minerva Garcia    
July 11th, 2012 at 2:39 pm

Hi everybody I am so glad I found you all like Vickie i would like to find out more about the Sanatorium my mom was patient in the early 60’s I am so grateful for this hospital it saved my mother’s life and today she is with us. If any one knows how to get the records or any information please let me know my email address is

9   Minerva Garcia    http://royed
July 11th, 2012 at 3:40 pm

If you are looking for patient records of the Sanatorim of Tuberculosis near San Angelo, Texas it is 210-531-4505 They have destroyed lots of records, but may be one of you may be able to get some records. My mother was a patient around 1961-1962 and all the records of the 1960s have been destroyed. Good luck

10   Chevy Montemayor    
August 14th, 2012 at 9:21 pm

My mother was there in 1948 & kept a diary of her experience there. It’s not a good scenario. It makes me cry when I read it. She also never did have T.B.! She was misdiagnosed!

11   Carroll McCaleb    
December 1st, 2012 at 5:02 pm

My father died of TB in October 1940.
His brother was a patient at the Sanatorium at the time.
At age 6 I was sent to the Preventatorium around Janurary 1941.
Best I can remember I was there for six months. I have some fond memories of the place. Because of small classes I went from the first grade to the upper 3rd grade when we moved to San Antonio. I also had the mumps while there. I have never figured out why covering your eyes with a diaper to shut out the light was called ‘chasing”.
Carroll McCaleb

12   Teri Grijalva    
June 11th, 2013 at 2:46 pm

Would like to know who I can talk to about getting records for my mom that was there around 1940/1941. Am trying to put a little family history together for the women in my family.

13   Eloise    
December 17th, 2013 at 9:52 pm

My mother was at this hospital in 1948. But she never told me anything about her stay. My family received a Christmas picture she took with 11 other women in front of a Christmas tree that I will share with anyone who would like to see if their relative is one of the ladies. If anyone has any details about this particular group of patients I would love to have it.

14   Jennifer Sedwick    
May 9th, 2014 at 1:26 pm

Hi, I realize this thread is a little old but I am researching my genealogy and found out that my great grandmother was a patient there from April to July 1948. She was only there 3 months as she died while she was there…so I suspect her TB case was quite advanced. Her name was Essie Maxwell Jones, so if anyone who has stated that their relative has a diary or picture that might have her name in it, I would be interested in speaking with you. Thank you.

15   Ron Jewell    
July 21st, 2014 at 8:16 pm

Spent 5th grade there (I was 10 years old) in 1943. Many memories to this day. Wonder if anyone is still around from that time.

16   Linda    
February 5th, 2015 at 9:53 am

I too am looking for records my grandfather lost his father in 1916, his mother 1917, 2 sisters in 1915, another sister in 1931. And a brother around that time. Any help as to where these records are located would be greatly appreciated.

17   Damon C. Sasser
February 9th, 2015 at 8:38 am

I wish I could provide an answer to everyone’s inquiry, but I don’t have any additional information, particularly about individual patients.

Surprisingly, this post has generated more comments than any other single post in the eight year history of this blog.

I can only repeat that I posted in 2011: you might start by contacting the Texas Department of State Health Services via their website.

Of course there are the issues of the passage of time, how long the records are required to be kept and HIPAA regulations to consider.

I wish everyone luck in finding the answers they are looking for.

18   Frances Alvarado    
June 2nd, 2015 at 11:17 pm

I was a patient there from May 1961 to Feb 1962. I was in Bldg. 16 and across the street from the front entrance was a church. I remember quite a number of the patients there and often wonder what happen to them. I had my 20th birthday there. there was one other girl younger than me her name was Martha. I would like to hear from anyone.

19   Jan Batson    
June 5th, 2015 at 1:02 pm

I believe my grandmother was at this sanatorium in the mid 1920’s. My mother was only around 5 and taken to a Methodist adoption place-maybe in Abilene? We don’t know because mom would never talk about it.

20   Thomas Jones    
September 10th, 2015 at 10:01 am

My Paternal Grandmother Ruth Lightfoot Jones spent some months at the Sanitorum in the early 1940’s. I have a photo album she made while there- of nurses, doctors, and some patients as well as postcards from the facility………. Thanks for the story. it adds to our family knowledge of the place.

21   Jim McCoy    
March 4th, 2016 at 10:26 am

You consistently misspelled Sanitorium!!

22   Damon C. Sasser
March 4th, 2016 at 3:39 pm

There are several different spellings of sanitoriam, including sanitorium and sanitarium. Howard himself spelled it sanatorium.

23   Teri Grijalva    
January 12th, 2017 at 2:02 pm

Is it possible to get a message to Thomas Jones. My mom was there anywhere between 1941-1943. She was 16 yrs old and was there 6 mths +/-. Wondered if Mr. Jones may be able to share patient pics. Understood, if not.

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