By the late 1800's, the majority of physicians viewed tuberculosis (TB) or the “White Plague” as hopeless. The disease was widely dreaded as the great plague of the times; it was incurable and the number one cause of death. When Dr. Trudeau was told in 1872 that he had contracted TB, he felt that he too was lost. Many efforts were made during the 1880's and 1890's to develop an immune serum against TB and Trudeau himself began experimenting with serums without satisfactory results. Medical leaders advocated rest, fresh air and good food as tuberculosis therapy.

Facilities for treatment were few. Doctors recognized that TB was contagious and that isolation of TB patients was necessary to prevent spreading the disease; consequently, sanatoriums were built to isolate, and treat, tuberculosis patients. The American sanatorium movement began, for all practical purposes, at Trudeau's “Little Red Cottage” at Saranac Lake in 1884. By 1910, there were nearly 400 TB hospitals and sanatoriums in the country. Doctors first focused on the salutary effects of marine or mountain air, but over time this view gave way to the belief in fresh air in general. Rest was recognized as more beneficial than exercise. From the late 1800s to the 1940s, the primary method of TB control remained isolation of infected individuals in these sanatoriums until death or the disease went into remission.

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