Est. 1910 · Largest US Tuberculosis Sanatorium · Pre-Antibiotic Era Medicine · National Register Historic District · Jim Crow Era Medical Segregation
The Arkansas Tuberculosis Sanatorium was established by act of the Arkansas legislature in 1909 to address the state's tuberculosis epidemic, which was particularly severe in the Mississippi Delta and Ozark regions. The site, three miles south of Booneville in Logan County, was selected for its dry mountain air and elevation — both believed to be therapeutic for pulmonary tuberculosis under the prevailing medical theories of the early 20th century.
The facility opened in 1910 with a single building and 64 beds. It expanded rapidly through the 1910s and 1920s, ultimately growing to 76 buildings across approximately 896 acres. The campus included staff dormitories, a fire station, post office, general store, chapel, laundry, water treatment plant, and independent telephone system — effectively functioning as a self-contained town. The architectural inventory reflects the evolution of tuberculosis treatment theory, with extensive south-facing porches, sleeping pavilions, and the gradual addition of more conventional hospital-style buildings as drug therapy replaced rest cure protocols after the 1940s.
Until 1931, the sanatorium served only white Arkansans. In that year, the Thomas C. McRae Memorial Sanatorium opened at Alexander, Arkansas, to treat African-American patients under separate-but-unequal Jim Crow medical infrastructure. The two facilities operated in parallel until integration of state medical facilities in the 1960s.
At its peak in the 1940s, the Booneville facility was the largest tuberculosis treatment hospital in the United States, with up to 5,000 patients in residence at a time and a staff of approximately 300. The medical staff published research that was consulted internationally, including by sanatoria in Italy. The introduction of streptomycin in the mid-1940s and subsequent antibiotic protocols in the 1950s reduced both the patient census and the typical length of stay. By the 1960s, the facility's primary patient population had shifted, and on June 30, 1973, the sanatorium officially closed.
In the years following closure, portions of the campus were repurposed by the Arkansas Department of Human Services. The active facility, the Booneville Human Development Center, continues to operate on portions of the historic campus serving adults with developmental disabilities. The historic district, listed on the National Register of Historic Places in 2006, encompasses 60 contributing buildings and the original landscape design. A museum operates in one of the surviving structures, interpreting the sanatorium's history.