How Asheville Became a City of Healing

Some people think it’s the chakras and vibrational energies. Others say it’s the altitude and clean mountain air. In Asheville, whether you’re talking to a TikTok influencer or a medical historian, everyone knows the idyllic Blue Ridge Mountains metropolis is ideal for rest and relaxation.

But a century ago, a trip to Asheville could mean a final and futile attempt to outrun death. At a time when “foul air” was thought to cause illness, Asheville attracted tuberculosis sufferers who thought the city’s “pure” mountain air would heal them. It didn’t always go as they hoped.

“If you had symptomatic tuberculosis, there was a 75% chance you’d be dead in five years,” said Dr. David Freedman, professor emeritus of infectious diseases at the University of Alabama at Birmingham.

Before infectious diseases were understood to be caused by pathogens like bacteria or viruses,  early tuberculosis treatments ranged from “beneficial but dangerous” to plain dangerous. One surgery involved purposefully collapsing or popping a patient’s lungs, the latter of which necessitated the removal of ribs. 

Writing in 1906, one doctor lamented that tuberculosis sufferers who felt that “physicians could give them no aid” often fell prey to “advertising quacks” who falsely promised cures that didn’t exist. Tuberculosis patients spent inordinate amounts of money traveling to healing resorts or buying unregulated, potentially toxic elixirs made with opium and alcohol.

Today, tuberculosis still hasn’t been eradicated, and neither has the disease’s legacy in Asheville. From wellness resorts to alternative medicine practitioners, the city remains a mecca for healers and the people who flock to them. According to Be Well Asheville founder Travis Richardson, whose directory of local wellness professionals has more than 200 members, Asheville attracts people looking to “redesign” their lives. “That redesign usually goes hand in hand with, ‘I want to feel better, and I want to be healthier,’” he said.

Today’s health seekers might find similar treatments that Asheville’s consumptives once turned to in desperation to heal. “They had equivalents of all the stuff that’s being advertised today,” Freedman said. “It’s exactly the same as a hundred years ago.”

Disease and Digestion

In 1875, German doctors chose Asheville as the location for America’s first sanitarium based on the belief that an ideal climate at about 2,000 feet could make breathing easier. Sanitariums were historic treatment centers often located in the countryside. They emphasized the importance of rest, exercise, and fresh air for recovery from a wide range of diseases.

By 1930, Asheville had 25 sanitariums, but not all welcomed tuberculosis patients. It wasn’t uncommon for sanitariums to refuse very sick patients “because they didn’t want it to look like everybody that came there was going to die,” according to Freedman.

Ottari Sanitarium, an all-inclusive medical spa, explicitly barred “surgical, insane, or tubercular” cases. Established by an osteopathic doctor who believed that the body had far-reaching powers to heal itself, Ottari offered luxury care complete with nurses, doctors, butlers, and maids. Guests could stroll along the natural footpaths of a forested 2,000-acre park, sunbathe on their private porches, or unwind in the library and music room. Therapies included rest, diet, exercise, baths, hands-on techniques, and, importantly, “no drugs.”

Ottari has since been converted into apartments, but the healing business is still alive and well in Asheville. 

SoHum Mountain Healing Resort is an all-inclusive 100-acre retreat center nestled in the Blue Ridge Mountains at an elevation of 3,100 feet. Rooms are outfitted with wood-burning fireplaces, soaking tubs, and private balconies overlooking the rolling hills. It offers therapeutic activities, including yoga, meditation, and walks through the forest on miles of old logging trails. Some treatments, like SoHum’s two-person massage, sound delightful. Others, like the weeklong “detoxification” process that involves consuming large amounts of ghee (a type of clarified butter used in Indian cooking) and using herbal enemas, seem hard to stomach.

“When you’ve had a fantastic poop, we say ‘clean colon and clean mind,’” said Mitesh Raichada,  executive vice president of the Ayurvedic Institute and a practitioner at SoHum. He said SoHum guests undergo a three-part purging process, which he claims releases suppressed negative emotions and leaves them feeling lighter. “It’s because you dropped literally a bag of potatoes of emotions that have been unprocessed your whole life,” he said.

As we sat in Adirondack chairs overlooking a breathtaking view of the ridge–Adirondack chairs borrow their design from outdoor “cure chairs” originally used by tuberculosis patients–Raichada elaborated on how flushing out “man-made toxins” like petrochemicals in processed foods could help prevent disease. “At that point, you’re tapping into the natural wisdom of the human body and not allowing those toxins to adhere to the organs through ghee intake and releasing and cleansing,” he said.

According to the peer-reviewed medical literature, there is no evidence that colon cleanses remove toxic substances from the body. But medical purging has been extremely popular since at least the Victorian era, and some sanitariums prescribed enemas to treat various conditions. “More people need washing out than any other remedy,” wrote sanitarium doctor (and future breakfast cereal magnate) John Harvey Kellogg in the early 1900s. Convinced that nearly all diseases started in the digestive system, Kellogg treated “autointoxication”—the since-discredited idea that one could be poisoned by food rotting in the body—by giving himself and his patients enemas every day. 

During my conversation with Raichada, two men in chef’s aprons arrived with glasses filled with Tulsi tea and small bowls in which a single date ball had been carefully plated. Food at SoHum is prepared with local or home-grown ingredients, and a vegetarian meal is customized for each guest. At Ottari, guests used call bells to summon waitstaff for “individual tray service.”

To sanitarium founders, diet was of the utmost importance. When combined in the right way, served at the ideal time of day, and masticated properly, food was believed to have curative properties. “You haven’t had your medicine,” Raichada said, pointing to my uneaten date ball. 

Is Food Medicine?

Lifestyle choices like diet and exercise are widely understood to help prevent disease. Some research has linked minimally processed plant foods to a lower risk of cancer.  According to the American Institute for Cancer Research, “vegetarian diets as a whole are consistently linked to lower risk of cancer compared to diets that include meat and fish more than once a week.” 

Health professionals agree that eating well has proven benefits, but some worry that the relationship between diet and disease is being overstated, especially on the Internet, where disinformation can be difficult to distinguish from evidence-based data. Repeated claims from Health and Human Services Secretary Robert F. Kennedy Jr. that “you can heal yourself with a good diet” could lead people to self-medicate with food alone.

“Food is medicine, but if you have a heart condition, you might need a prescription, too,” said Madie Zimmerman, a dietitian in Asheville who works primarily with women who are pregnant or have recently given birth.

Zimmerman has seen an uptick in diet fads in Asheville, including drinking raw milk, which can be especially dangerous during pregnancy. “They want to get health benefits,” Zimmerman said, recalling an instance in which a family told her that they were drinking raw milk from goats they owned. “But that doesn’t make it any safer. There’s a reason we pasteurize.” Tuberculosis is among them. Although an eradication program for bovine tuberculosis has been underway for nearly a century, the disease persists in some parts of the country. It can be transmitted to humans by drinking raw milk.

Still, Zimmerman emphasizes that eating fresh food can have extraordinary health benefits. The problem is that not everyone can afford to change how they eat. In Asheville, segregation and discriminatory lending practices have led to four USDA-designated food deserts where primarily Black residents have low access to fresh food. In Southside, one of Asheville’s historically segregated Black neighborhoods, Chloe Moore manages the nonprofit Southside Community Farm that improves community wellness by giving people the opportunity to grow and harvest their own healthy food.

“We’re bringing people together to heal, to learn from each other, and teaching skills that our ancestors knew but that haven’t been as accessible to us in just the last couple generations. That includes harvesting our own food,” Moore said. “The other day I was putting radishes in the free fridge and thinking about how fantastic they are for supporting healthy blood sugar levels, and how important that is in a community that experiences a lot of diabetes.”

Not far from the farm, one of the country’s first tuberculosis sanitariums for Black people was established in 1915 by Dr. John Wakefield Walker. At the time, Black people died of consumption at two to three times the rate of white people, but physicians and hospitals, especially in Southern towns like Asheville, refused to treat them. However, by 1917 the sanitarium had gone out of business. 

As John Green explains in Everything Is Tuberculosis, American doctors long believed that tuberculosis could not affect Black people, with one writing that tuberculosis was a “disease of the master race, not of the slave race.” And while whites traveled across the country to receive treatment, traveling in the Jim Crow South could be prohibitively dangerous for Black tuberculosis sufferers.

“We know that the medical system consistently fails us as Black people,” Moore said. “So it always goes back to sovereignty for Black communities—believing that we’re the ones who know our bodies, our ways, our technologies, and are best suited to healing ourselves.”

Asheville’s First Anti-Vaxxer

In the late 1800s, a group of alternative physicians called osteopaths wrote extensively about their distrust of medical providers who used drugs and surgical techniques to treat disease. Invented in 1874 by Andrew Taylor Still, whose father was born in Asheville’s Buncombe County, osteopathy was founded on the idea that the body has self-healing capacities that can be stimulated by hands-on manipulation of internal organs and their connective tissue.

In 1916, the founder of Asheville’s Ottari Sanitarium became president of the American Osteopathic Association. W. Banks Meacham lambasted “drug doctors” and critiqued vaccines, claiming that the body’s immune response could “be more effectively invoked by osteopathic measures than by vaccine products.”

Today, doctors of osteopathic medicine (DOs) receive training similar to that of physicians who graduate from traditional medical schools (MDs), and prescribe drugs, perform surgery, and administer vaccines. But in 1921, even as the smallpox vaccine was helping to eradicate the disease across the globe, the association declared in no uncertain terms: “We are opposed to vaccination.”

Today, some Asheville residents take a similar stance. Buncombe County has one of the highest kindergarten vaccine exemption rates in North Carolina, at 6.3%. The state average is 3.12%.

“A lot of that comes back to the lack of people feeling like they have a source of truth in the medical world,” said Dr. Chad Krisel, who runs an integrative medicine practice in Asheville. Integrative medicine is an alternative approach that embraces treatments like acupuncture, meditation, and herbal remedies alongside conventional medicine. Krisel, who says he prescribes “evidence-based herbal remedies” as well as pharmaceutical drugs, sees medical distrust as the result of a system that incentivizes physicians to provide rushed, depersonalized care. 

In January, the Centers for Disease Control and Prevention overturned recommendations for several childhood vaccines, including two required by North Carolina’s childhood vaccination schedule: hepatitis and meningococcal disease. The American Academy of Pediatrics filed a lawsuit against the Trump administration, resulting in a federal judge temporarily blocking the CDC’s new vaccine schedule. But these battles—and the competing ideologies that surround them—are sure to continue.

Krisel says that when his patients are thinking of forgoing vaccines for themselves or their children, he tries to help them understand misinformation. “All in all, next to antibiotics and sanitation, vaccines have been one of the major boosts to health worldwide,” he said.

Wellness to Change the World

In the 19th century, bed rest was one of the primary ways to treat various illnesses. According to Kamryn Pigg, research associate at the New Orleans Pharmacy Museum, this treatment was at times taken to comical extremes. “They were to lie perfectly still as much as possible, to not bend over, to not reach,” Pigg said. “To ‘lead the life of a log,’ as one report put it.” 

For a chance to rest, visitors to Asheville’s Ottari in 1920 paid a starting rate of $40 per week, or roughly $800 today, with “suites and choice rooms at higher rates, and private and semiprivate nurses” at an extra cost. Today, wellness retreats can be even pricier, with a week at SoHum starting at $6,500 and going up to nearly $13,000. Marisol Jiménez, founder of a new mission-driven wellness retreat center called Tepeyac Mountain Sanctuary, says that the people in Asheville who most need rest—like Hurricane Helene survivors and the first responders who helped them—are the ones least able to afford it.

“People are living displaced from this hurricane, and they’re exhausted,” said Jiménez, who was a first responder after Helene hit. “They’re not in the position to pay $1,000 for a really wonderful four-day retreat in a beautiful setting. Nor are the people who have just thrown their entire lives into making sure people have housing.”

When it opens later this year, Tepeyac Mountain Sanctuary will be a healing space for activists, artists, and public sector workers, including teachers and frontline workers. Jiménez envisions the cooperatively owned 34-acre retreat center as a place where community members can experience equine therapy and massage without the high price tag.

“As a nonprofit, we can develop programming that is grant-funded and doesn’t require people to pay to play, so to speak,” Jiménez said. In addition to grants, Tepeyac is developing a fee-based membership model so that local nonprofits or wellness practitioners can host conferences or workshops on the property. The goal is to create a natural space for collective healing and climate resilience that will last for generations.

‘I Live On Faith’

Ultimately, anyone with any ideology can find a home in the world of wellness, but some people might be more likely to turn to wellness when access to doctors is limited. “Nationally, there’s a huge shortage of primary care doctors,” Freedman said. “And Asheville has just not attracted as many primary care doctors.”

Others are influenced by their distrust of America’s health care system. “We are in a system that is completely broken, and everyone agrees that it’s broken,” said Richardson, the Be Well Asheville founder. “Wellness is having alternatives to that broken paradigm.” 

In Western North Carolina, medical distrust sometimes stems from years of discriminatory care.  In a 1986 oral history project cataloging the experiences of Black mountain families, one woman recounted how her teen brother’s death from tuberculosis in the first half of the century changed her opinion of doctors. “Honey, I done been dead if I had messed with doctors,” she said. “I live on faith.”

Perhaps wellness services are popular because they are advertised as more spiritual than the care one might find at a hospital. Ottari is derived from a Cherokee word meaning foothill. SoHum is a phonetic spelling of a Sanskrit term that implies humanity’s connection to the cosmic. Tepeyac, a Nahuatl word, is the hill where the Virgin of Guadalupe appeared in Mexico City in 1531, and before that, where the Aztecs worshipped ancient goddesses. According to Raichada, SoHum was attracted to Asheville in part because the mountains help people feel closer to the divine. 

For over a century, people have been putting their faith in Asheville to heal from various ailments. “Asheville has saved many lives and will save many more,” said a 1931 postcard that stated that President Herbert Hoover’s son Herbert Jr. recovered from tuberculosis in Asheville.

Asheville native Thomas Wolfe wasn’t among the faithful—and when he was diagnosed with tuberculosis in 1938, he went to Baltimore hoping to recover. He died there at 37 years old, but today he is buried in Asheville’s Riverside Cemetery. Although the age of sanitariums is long over, the ill and exhausted keep coming to Asheville—and who’s to say they won’t find respite? In the end, Wolfe didn’t find a cure in Asheville. But he did find somewhere lovely to rest.