Davos – from high-altitude sanatorium to world-renowned holiday destination and economic capital
A LETTER FROM: Davos, Switzerland
– Written by Walter Bäni, Switzerland
– Translated by Katharina Grimm, Qatar
The history of Davos spanning the last 150 years is an exceptional tale of a sleepy, remote mountain village in the Swiss canton of Grisons, growing from strength to strength to finally become the capital of the World Economic Forum, where the foremost political, business and societal leaders meet to improve the state of the world. Along the way, it employed its climatic conditions to combat one of the largest epidemics of the last century – tuberculosis – and then the diverse clientele attracted by these healing powers, to create a fertile breeding ground for both artists and businessmen. This letter describes the key figures that have inscribed Davos’ name in the history of medicine, commerce and literature.
ALEXANDER SPENGLER, THE PHYSICIAN WHO DISCOVERED DAVOS’ HEALING CLIMATE
Davos’ ascent from sleepy mountain village to 19th century world-renowned spa is intrinsically tied to the medical practice of Dr Alexander Spengler. As a refugee from Germany in 1853, he had accepted a little sought-after position as general practitioner for the community living in and around Davos. In the early years of this career, he spent his days travelling on foot or horseback, defying wind, rain and storms to reach patients who lived dispersed all over the high valley. Then he started experimenting with different treatment modalities for tuberculosis, one of the most feared and deadliest epidemics of the time – and this changed his life and Davos forever.
Spengler had observed the healing power of the high-altitude climate in natives who returned from living at sea level to their home in Davos. These observations convinced him that the high-altitude climate not only protected from tuberculosis, but also cured it. He made sure his conviction became more widely known by telling his patients’ stories to visitors.
His recommendations were simple, yet revolutionary: “First of all, we need to encourage patients to spend as much time as possible outside. Depending on the stage of their disease, we then need to combine rest and physical activity in the best way to exploit the healing power of the diluted mountain air.” According to Spengler, diet as a further pillar of treatment had to be nutritious, but easily digestible. Meat, milk, eggs and fat made up the foundation. Wine, when consumed moderately, was considered a remedy for the disease.
In 1862, the Zurich physician and balneologist Dr Conrad Meyer-Ahrens wrote an extensive report on his visit to Davos and published the discussions he had with Spengler on that occasion in the German medical journal Deutsche Klinik. The article caused a storm among the medical community, who either made fun of Spengler’s regimen or forthrightly condemned his attempts to attract patients to altitude as criminal. Too powerful still was the dogma that cold air was the worst enemy of diseased lungs. The dominating medical theory of the time was that patients had to seek the mild climate of the Mediterranean.
THE HEALING POWER OF HIGH ALTITUDE
Despairing patients were more inclined to follow Spengler’s call. Imagine a freezing cold winter day in the snow-covered, small alpine village back in February 1865. On a day like this, the very first patients arrived at Davos, seeking treatment. Physician Friedrich Unger, 32, and his companion, 24-year-old Hugo Richter, had spent several years at a German tuberculosis sanatorium. Their treatment to that point had been in vain – both were still severely ill. Having heard rumours about Spengler’s observations, they were desperate enough to undertake the arduous journey to the remote mountain destination in the middle of winter.
At that time, the tiny village was in no way prepared for winter guests. In fact, only the ‘Strela’ guest house offered rooms with heating. But, to the utmost astonishment of the native population, the two patients – unperturbed – proceeded to submit to Spengler’s regimen on makeshift beds. Surprisingly to everyone, their health improved quickly, demonstrating that the high-altitude climate exhibited healing powers not only in summer, but also in winter. The cure of Unger and Richter, and consequently of more and more winter spa guests, soon became common knowledge and sparked a construction boom in Davos – spa hotels and guest houses started to spring up like mushrooms all over the village.
These spa hotels were open to healthy guests and tuberculosis patients alike, without any strict rules imposed on them. Spa guests consulted privately with physicians in the village, who provided them with treatment instructions, which the patients either followed – or not. Motivation and self-discipline in following these instructions was discussed, with patients otherwise left to their own devices. Soon though, there were widespread calls for the stricter controls and regimens of a regulated sanatorium.
KARL TURBAN – FROM OPEN-MINDED SPA TO DISCIPLINED CLOSED SANATORIUM
Dr Karl Turban established the first closed sanatorium in Davos. He transformed the rather casual, holiday-like feeling at the destination into a disciplined sanatorium atmosphere. Turban is considered the seminal figure of tuberculosis treatment, through implementing a strict regimen on patients coming to Davos.
As a general practitioner in Germany, he contracted tuberculosis and thought he could find the cure in the Riviera. Here, he made the acquaintance of Zurich clinician Gustav Huguenin, upon whose recommendation he was later charged with the management of a planned sanatorium in Davos.
However, arriving at his future place of work, he was anything but impressed with the state of affairs: “Febrile and blood-coughing patients are promenading in the mountains. At the regular beer concerts in the therapy centre, those with laryngeal disease sing at the top of their voice. On the different festive occasions in the hotels, severely ill gentlemen and ladies dance in a dazed state whatever is considered as modern. And the physicians? They watch.”
On 15 July 1889, Turban opened the first closed, high-altitude sanatorium for tuberculosis patients, the ‘Sanatorium Turban’ with 70 beds. Turban’s sanatorium became a model for the many sanatoria that developed in Davos over time. All rooms were directed south and the previous narrow terraces were replaced with large balconies for beds and deckchairs. ‘Plenty of light, sun and fresh air’ was the maxim. The sanatorium was governed by an almost military discipline. Any patient who failed to comply with the rules had to leave. This effectively amounted to a death sentence, since no other sanatorium would accept a patient who had been ‘banned’ by Turban.
To counter scepticism against the strict concept of laying down and to motivate patients to consistently succumb to it, Dr Turban laid down next to them in the hall – motionless – in any weather, wrapped in woollen blankets if necessary. Turban was a physician of great authority – none of his patients would have dared to read a newspaper, let alone attempt to talk to other patients. His model function played a critical role in the success story of his cure regimen and soon patients from all over the world flocked to his sanatorium.
WILLEM JAN HOLSBOER, THE FOUNDER OF THE ‘RHAETISCHE BAHN’ RAILWAY
Dutch businessman Willem Jan Holsboer, who had worked his way from sailor to captain to banker, became one of the most influential personalities in the development of the spa and holiday destination Davos. He is commonly seen as the founder of the railway connecting Davos with the lowland, the ‘Rhaetische Bahn’. Establishing this convenient access from the outside world in the years 1888 to 1889 heralded a new era in Davos’ spa history.
In 1865, Holsboer married an 18-year-old English woman who 2 years later contracted tuberculosis. Holsboer travelled with his severely ill wife from London to Davos. He witnessed how much of a trial the long journey was for his sick wife. The last leg through the valley climbing up to their final destination was particularly exhausting. This experience instilled in him the conviction that a railway was needed in Grisons.
In 1871, Holsboer founded the spa association of Davos. On 31 December 1885, the association counted 1184 guests, 484 of them German, 322 British, 92 Swiss, 84 Dutch, 38 American, 35 French, 29 Russian and 60 guests from various other countries. Around the turn of the century, 600,000 overnight stays were registered per year – the farming village had irrevocably turned into a world-renowned spa destination. Holsboer in the meantime also became President of the Davos Electrical Society.
‘ST JOSEPH’S HOME’ – FROM SANATORIUM TO HOTEL
The ‘St Joseph’s Home’ has a long and rich history. In 1888, the physicians there called for nurses of the Dominican Order to assist with the treatment of tuberculosis patients. Even though the institution was chronically short of money, the owners took the risk of buying a piece of land of 4900 square metres to build new facilities that were occupied in 1901. The interior and outer design was entirely devoted to the care of tuberculosis patients. In the same year, with about 60 Dominican sisters living on site, the Order took ownership of the sanatorium. Patients came from England, Germany, Russia, France, Malta and Italy. However, in the 1950s, when high-altitude care for patients with lung disease became obsolete with the progress made in treatment, the house was converted into a holiday retreat. The most prominent of the regulars there was the imperial Habsburg family.
More recently, extensive efforts were made, particularly in Switzerland and neighbouring countries, to polish the image of the guest house, marketing it as a Christian hotel. Yet the aspiration to run the hotel self-sufficiently failed, aggravated by a massive lack of young sisters willing to dedicate their life to the Order. With a heavy heart, the mother of the house finally decided to sell the property. In 2007, the last sisters left and the Davos-Klosters mountain railway became the new owner. The name was changed to ‘Joseph’s House’ and to date it has been run as a two star hotel with single and double rooms.
ADVERTISING IN THE OLDEN DAYS – THE HISTORIC BROCHURE OF ‘SANATORIUM MONTANA’
In Davos, it was realised early on that advertising was critical to attract well-heeled, paying guests to the village. Particularly intriguing in this regard is the 36-page promotional brochure of the Sanatorium Montana Dr Dannegger, written in French and comprehensively illustrated. From our perspective today, it contains a number of amusing and remarkable details.
The facilities and entertainment options are described as follows: “The lobby with its modern English style is comfortably furnished, bright and welcoming. There is a reading room with a number of Swiss and international newspapers and a music hall. The sanatorium has cooling rooms and the spring water is of excellent quality and pure. The kitchen possesses a special air conditioning to eliminate all smells. All sewage is disposed of through the communal canalisation. There is a darkroom for photographic works. The sanatorium further owns a superb piano that guests are free to use. Once a week, a concert by the spa association orchestra entertains the house guests.” People came from far and wide to undergo the regimen at Davos.
Russian patients in Davos
From 1890 onwards, there was a sudden influx of Russian patients. At the time, there were hardly any well-established spa facilities or sanatoria in Russia. Patients therefore had to resort to travelling abroad to find a cure and Switzerland became a favourite destination for the Russian nobility. Prior to the First World War, there were more Russians in Davos than in any other Swiss town.
In 1902, a Russian Society was founded in Davos. Its main objectives were to nurture the typical lifestyle of the Russian community and the financial support of poor patients. The Society’s charity concerts and balls exuded the glamour of the Russian tsar empire and in fact became very popular among the non-Russian community. In 1909, the Russian House for tuberculosis patients was founded, which soon offered 35 beds to those in need. There were also a few private Russian sanatoria. From 1911, there was even a Russian consulate and a year later, a Russian theatre opened which staged plays at the ‘Belvedere’ twice a month. At this time, authorities counted 3422 Russians, which corresponded to about 11% of all patients. Russians formed the third-largest national group after Swiss and German citizens.
However, with the outbreak of the First World War, the number of Russian guests started to decrease, and the October Revolution in 1917 led to a sudden end of Swiss-Russian relations. Money transactions between both countries practically came to a halt, preventing Russian patients and guests from paying their bills. The Russian House had to close down due to lack of resources.
Lifted to literary fame
Tuberculosis not only stimulated the economy in Davos, but also a rich cultural life. Many poets, writers, painters, musicians and other artists who visited Davos for treatment subsequently promoted the destination through their work. Sir Arthur Conan Doyle accompanied his wife to Davos and embarked on ski tours, heralding the later ski sports boom in Davos. He predicted “the time will come when hundreds of Englishmen will come to Switzerland for a skiing season.” Robert Louis Stevenson overcame severe writer’s block in Davos and was able to finish his novel Treasure Island in the village.
However, it was the famous novel The Magic Mountain by German author and later Nobel Prize winner Thomas Mann, that elevated the mountain village to literary heights. The novel, first published in November 1924 and widely considered to be one of the most influential works of 20th century German literature, described life in Davos from the perspective of a healthy visitor. Mann had visited his sick wife at Dr Friedrich Jessen’s Waldsanatorium in 1912. He met the medical team taking care of her at this truly cosmopolitan resort. In The Magic Mountain, the main character visits a friend in a Davos sanatorium – and ends up staying for 7 years. The acclaimed novel quickly made the village known all over the (healthy) world.
New medications – tuberculosis becomes curable
The emergence of effective medications to treat tuberculosis ended Davos’ zenith as a renowned spa resort. With the detection of streptomycin by the American biochemist Selman Abraham Waksman in 1944, tuberculosis became curable. Even though the bacteria rapidly became resistant to the antibiotic, further effective medications followed. The significance of Davos quickly diminished – fewer patients came and the sanatoria soon remained empty. In the 1950s, they were increasingly converted to hotels.
Today, Davos continues to thrive on three pillars: winter sports, conferences and research (orthopaedic surgery, allergy research and the World Radiation Centre).
Freelance Photographer and Journalist
Translated by Katharina Grimm M.D., M.Sc. (Med) Sportsmed SA
Director of Medical Affairs
Aspetar - Orthopaedic and Sports Medicine Hospital