Tuberculosis (1860-1960) : Slovenia’s Golnik Sanatorium and TB in Central Europe

An account of the socioeconomic disease of tuberculosis in the second half of the nineteenth century and in the twentieth century, up to the discovery of the successful combination of anti-tuberculosis medicines in the 1950s that relegated tuberculosis to the margins of medicine in the developed world.

This book is an epic story of the efforts by conscientious Slovenian and international communities, public healthcare, and healthcare policy to prevent the illness and death engendered by tuberculosis. It is a universal account of the socioeconomic disease of tuberculosis in the second half of the nineteenth century and in the twentieth century, up to the discovery of the successful combination of anti-tuberculosis medicines in the 1950s that relegated tuberculosis to the margins of medicine in the developed world. The book is based on an analysis of the Slovenian tuberculosis sanatorium at Golnik, which set the foundations for a uniform doctrine of treating and containing (especially pulmonary) tuberculosis among the twenty million people living in Yugoslavia at that time. The Slovenian struggle against tuberculosis in this period is also contextualized through comparison with similar overviews for Austria, Italy, and Croatia.
This work also synthesizes the dynamics of this socioeconomic disease, which is not only combated by the effectiveness of medical treatment, but also depends on social, economic, political, and numerous other factors that currently contribute to the spread of other socioeconomic diseases. The anti-tuberculosis struggle in Slovenia is also contextualized within two different political systems. Following the First World War, elements of Austro-Hungarian healthcare came to the forefront due to Slovenia’s several centuries as part of the Austro-Hungarian Monarchy. At that time socialized medicine also began to be introduced in the Kingdom of the Serbs, Croats, and Slovenes. Its originator was Andrija Štampar, who introduced measures to make healthcare more universally accessible. Štampar established the idea that the community must take care of every citizen and especially work towards disease prevention. Preventive measures including patient quarantines, residential sanitation, outpatient and home-care monitoring of infected people, and patient education significantly reduced tuberculosis morbidity and mortality even before effective antibiotics were discovered. After 1945, a publicly funded healthcare system was introduced in Yugoslavia, which supported mass healthcare campaigns against tuberculosis. Starting in 1946, rights to state-funded medical treatment and rehabilitation were regulated by social security laws. During the 1960s, detecting tuberculosis in the field, mass preventive campaigns, and effective hospital treatment reduced Slovenia’s tuberculosis rates close to those in more developed European countries.