Hidden History: Tuberculosis in Mammoth Cave

Portrait of Dr. John Crogan from the shoulders up
Dr. John Croghan

A Quest for a Cure


Mammoth Cave National Park in central Kentucky is home to the world’s longest known cave system. The system of chambers and subterranean passageways reflects the park’s extensive and varied history. In 1839, Dr. John Croghan of Louisville, Kentucky, who suffered from tuberculosis, purchased the Mammoth Cave property for $10,000. At a time when minimal medical knowledge of or treatments existed for the “white plague,” a leading cause of death in the nineteenth and early twentieth centuries, Dr. Croghan was interested in the cave in part as a possible sanitarium.

Visitors and miners had reported feeling distinctly well after spending time in the cave and Horace Carter Hovey wrote that “the air is slightly exhilarating, and sustains one in a ramble of five or ten hours, so that at its end he is hardly sensible of fatigue.” Further, having observed that timber and animals did not decay within the cave, Dr. Croghan hoped the environment would be restorative and therapeutic for tuberculosis patients and subsequently established an experimental hospital treatment facility within the cave.

"I used to stand on that rock and blow the horn to call them to dinner. There were fifteen of them and they looked more like a company of skeletons than anything else.”

Page from 1877 Harper's Weekly with drawings and text showing tuberculosis patients in Mammoth Cave
Illustrations of Mammoth Cave in Harper's Weekly are titled "House Formerly Used by Consumptive Patients" and "Crossing the River Styx" (H. Linton, 1877; Illus. in: Harper's weekly, v. 21, 1877 Feb. 10, supplement, p. 118).

Source: Library of Congress. Reproduction Number: LC-USZ62-119566.

Believing the uniform temperature and humidity held curative properties, Dr. Croghan invited 15 patients under his care to take up residence in the cave in the winter of 1842. Patients resided within a series of buildings constructed by enslaved individuals, including two stone cabins and eight simple wooden structures measuring 12 x 18 feet with tongue and groove flooring and canvas roofs.

Away from the rhythms of natural light, patients synced their watches with the outside world and managed their daily underground routines accordingly. Living within the cave, patients initially seemed to improve and Dr. Croghan enthusiastically began to draw up plans for a hotel to be established within the cave to house the anticipated masses that would flock to the cave for healing.

However, as winter progressed, it became clear that the dank, dark conditions worsened the patients’ symptoms. Smoke and ash from lard oil lanterns and a large fire used to light the cave continuously filled the chambers while the dampness of the air further degraded damaged lungs. Cedar trees and bushes brought in to lighten the atmosphere quickly withered. While some cooking was completed within the cave, other meals were prepared off-site by enslaved individuals and brought into the cave. A server named Alfred noted, “I used to stand on that rock and blow the horn to call them to dinner. There were fifteen of them and they looked more like a company of skeletons than anything else.”

A Public Attraction


Tours of Mammoth Cave had begun in 1816. The tourist infrastructure developed over the next several decades, including the expansion and remodeling of the existing hotel and creation of new roads by Dr. Croghan. These improvements and public tours of the cave system continued during the medical experiment. Unsuspecting visitors would occasionally encounter ghastly patients in hospital gowns shuffling along passageways or hear hollow coughing echoing in the distance.

In a letter, patient H.P. Anderson wrote that “There are many things to be done to render this place entirely pleasant and to give its virtues a fair test; we are pioneers under all the disadvantages of such and after generations will reap benefits of our experiments.” As complaints and requests to leave arose, Anderson was the only individual to return to the surface while Dr. Croghan convinced the remaining patients to stay.

Tuberculosis Hut
Ten young women and one man posed on and around a small stone building inside Mammoth Cave. A low, square stone structure in Mammoth Cave with thick limestone walls.
Consumptive's Room, Mammoth Cave, Kentucky, circa 1912. Library of Congress, Reproduction Number LC-USZ62-64952
The Tuberculin Huts were documented in 1991 as part of the National Register nomination for Mammoth Cave Historic District. NPS Photo, National Register of Historic Places Collection
One of the two remaining stone in Mammoth Cave, built in 1842-43 to accommodate patients with tuberculosis.




As the weeks wore on, five patients ultimately died inside the cave, their bodies laid out on what is now known as corpse rock. Dr. Croghan despondently returned to the surface with the remaining survivors. The experiment was not repeated and the wood frame huts were dismantled, while the two stone cottages remain along Broadway within the Mammoth Cave Historic District.

The experiment lasted no more than five months, from autumn 1842 to early 1843. While the cool cave setting conformed to the treatment standards of the times, the unventilated, damp environment made the disease worse. Like his patients, Dr. Croghan ultimately passed of tuberculosis in 1849.


Sources:

Forwood, W. Stump, An Historical and Descriptive Narrative of the Mammoth Cave of Kentucky (Philadelphia, J.B. Lippincott and Co., 1870).

“Groping for Health in Mammoth Cave,” Filson Club History Quarterly, 20: 4, 302-307, Louisville, Oct., 1946.

Hovey, Horace Carter, Guide Book to the Mammoth Cave of Kentucky (Cincinnati: The Robert Clarke Company, 1895).

Lally, Kelly A. National Register of Historic Places Registration Form, Mammoth Cave Historic District. Kentucky Heritage Council, June 1989. Entered into the National Register, May 8, 1991.

“Physician, Heal Thyself,” Mammoth Cave National Park, US Department of the Interior, accessed October 10, 2017, https://www.nps.gov/maca/learn/historyculture/physicianhealthyself.htm.

Summers Engel, Anette, ed., Microbial Life of Cave Systems (Knoxville: University of Tennessee, 2015).