Inhabiting the Atmosphere:
The Architecture of the Queen Alexandra
Sanatorium
tim altenhof
University of Innsbruck
W
hile scientific discussions around climate
change, air pollution, and the ozone layer
have drawn increasing attention to atmo-
spheric concerns, the natural science climate perspective
driving this process, with its emphasis on global weather
systems and the interconnected effects of rising tempera-
tures, has also downplayed the peculiarities of certain local-
ities.1 Today, as American environmentalist Bill McKibben
observes, “the climate is no longer in the background but is
increasingly the main drama.”2 Broadly speaking, weather
and climate are both expressions of the atmosphere, with
duration representing the distinguishing factor between
them. While weather is a set of short-term atmospheric
conditions at a given location, climate can be considered
the cumulative effect of these conditions over a longer
period of time. The word atmosphere is derived from the
Greek atmos (vapor) and sphaira (sphere, or globe), mean-
ing a sphere filled with vaporous air. We are immersed in
the atmosphere: it envelops us and everything else on the
planet. Emanuele Coccia stresses this ontological inter-
pretation in his philosophical investigation of plants, argu-
ing that atmosphere has less to do with the perception of
things than with their “mode of being.”3 The same notion
guides the present study. As Coccia writes, “We are not
inhabitants of the Earth, we inhabit the atmosphere.”4 This
idea of dwelling in the air goes back to French philosopher
Luce Irigaray’s critique of Martin Heidegger, in which she
Journal of the Society of Architectural Historians 82, no. 3 (September 2023),
314–334, ISSN 0037-9808, electronic ISSN 2150-5926. © 2023 by the Society
of Architectural Historians. All rights reserved. Please direct all requests for
­permission to photocopy or reproduce article content through the University
of California Press’s Reprints and Permissions web page, https://www.ucpress
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DOI: https://doi.org/10.1525/jsah.2023.82.3.314.
314
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wonders whether air is not “the whole of our habitation
as mortals?”5 As an early seventeenth-century Latin neol-
ogism, the term atmosphere also comprised “terrestrial
effluvia and emanations,” the by-products of all breath-
ing bodies.6 The atmosphere is what we inhabit through
breathing, and it produces a whole range of different cli-
mates. Not only is the atmosphere far from a stable state
of equilibrium, but our conceptions of it are also fluid.7
This was the case a century ago when a tension emerged
between two prominent conceptions of air, reflecting the
duality of austere countryside and bustling modern city,
as the direct result of the Industrial Revolution: on one
hand, contemporaries felt that the atmosphere, with its
important recuperative properties, should flow freely, but
on the other, they suspected that it required purification.
Air in such a context was a double-edged sword, capable of
bringing salvation or harm.8
This last point is of some importance in the context of
tuberculosis (commonly called TB), deemed one of the
world’s deadliest diseases at the beginning of the twenti-
eth century and still considered so today.9 The emergence
of alpine health resorts devoted to the treatment of TB in
the second half of the nineteenth century illustrates the
dual nature of air as an agent for both life and death. The
same air that sustains human life on earth can also transmit
infectious agents, including the often-lethal Mycobacterium
tuberculosis.10 Although breathing contributed to the trans-
mission of TB, until the discovery of streptomycin in 1943,
breathing was also an essential part of its treatment, espe-
cially the pulmonary version prevalent at the time.11 As a
response to the disease, the idea of relocating patients to
places where they could breathe better air became increas-
ingly institutionalized, and sanatoriums became the prime
locus for this kind of treatment.12 One such institution was

the Queen Alexandra Sanatorium, built from 1907 to 1909
by Otto Wilhelm Pfleghard (1869–1958) and Max Haefeli
Sr. (1869–1941) in Davos, a mountain village in the Swiss
canton of Graubünden (Figure 1). Although the Queen
Alexandra Sanatorium has appeared regularly in the his-
toriography of modern architecture, scholars have never
addressed it in depth. It first gained prominence thanks
to Sigfried Giedion’s small pamphlet Befreites Wohnen and
Richard Döcker’s book Terrassen Typ, both published in
1929, and it has since appeared in many prominent mono-
graphs, including Giedion’s Space, Time and Architecture
(1941), Stanislaus von Moos’s Le Corbusier: Elements of a
Synthesis (first published in German in 1968), Paul Overy’s
Light, Air and Openness (2007), and Beatriz Colomina’s
recent X-Ray Architecture (2019).13 While Colomina and
Margaret Campbell have traced the ramifications of san-
atoriums for modern architecture, and Annmarie Adams
has stressed the sanatorium’s potential as a form of medical
technology, this article argues that the Queen Alexandra
Sanatorium was designed as a device for atmospheric expo-
sure.14 By defining the atmosphere as a sphere to be inhab-
ited, the Queen Alexandra Sanatorium, like many related
institutions, did away with the idea of a building enve-
lope. Instead, it exploited what is termed here the “barrier
zone”—the threshold between inside and outside.
The firm of Pfleghard & Haefeli traced its origins to
1898, when the two architects decided to join forces after
studying at the polytechnic school at Zurich, the forerunner
of today’s Eidgenössische Technische Hochschule (Swiss
Federal Institute of Technology). They studied under Alfred
Friedrich Bluntschli (1842–1930), a former student of
Gottfried Semper (1803–79), and aspects of Bluntschli’s late
historicism imbued their early work.15 Considered among
the leading architects in German-speaking Switzerland for
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Figure 1 Pfleghard & Haefeli, Queen Alexandra
Sanatorium, Davos, 1907–9, photo ca. 1922
(Archiv Photoglob-Wehrli, Eidgenössisches
Archiv für Denkmalpflege, Schweizerische
Nationalbibliothek).
Figure 2 Pfleghard & Haefeli, Schatzalp Sanatorium, Davos,
1899, photo ca. 1905 (postcard, Künzli Tobler & Co., Zurich;
Dokumentationsbibliothek Gemeinde Davos).
more than twenty years, Pfleghard & Haefeli’s extensive
oeuvre included more than two hundred built works span-
ning a wide range of types, including country houses, vil-
las, office and residential buildings, hotels, schools, banks,
and churches.16 The architects also developed expertise in
the growing world of TB management, as attested by their
designs for the Schatzalp Sanatorium (1899) as well as the
Queen Alexandra Sanatorium.17 Conceived as cell-structure
designs opening toward the south, these two complexes dif-
fer in important ways. The palatial Schatzalp features a strict
neoclassical symmetry, with wooden balustrades screening
the façade (Figure 2).18 In contrast, the Queen Alexandra
Sanatorium exhibits a more modernist layout and design: a
small 1932 picture book about Davos celebrated it as “the
new face of the health resort” (Figure 3).19 In generating
this more rationalized modern form of Alpine architecture,
Pfleghard & Haefeli drew from a number of schemes.20
Where earlier designs evoked the “neoclassical hotel,” their
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I N H A B I T I N G T H E AT M O S P H E R E   

Figure 3 Spread featuring the Queen Alexandra
Sanatorium in Walter Kern, Davos: Die
Sonnenstadt im Hochgebirge, 1932 (Zurich: Orell
Füssli, 1932; Staatsbibliothek Berlin).
design for the Queen Alexandra Sanatorium drew inspira-
tion from modern construction techniques as well as med-
ical requirements for the tonic cure of TB.21 However, the
spatial organization of the Queen Alexandra Sanatorium
also recalled plans for hospitals designed in the first half
of the nineteenth century in the United States—thus,
European sanatoriums in the first quarter of the twentieth
century were in fact less innovative in terms of functional
design than we might assume. According to Jeanne Kisacky,
they employed “traditional hygienic hospital plans clothed
in modernist garb.”22 In that sense, while these sanatori-
ums sought to respond to their local environments, they
also reflected a longer tradition of hospital design: the cen-
tral volume with two adjacent wings. But one of the most
striking features of the Queen Alexandra Sanatorium plan,
besides the handling of its masses and the simplicity of its
details, was the building’s orientation toward the south to
maximize sun exposure in patient bedrooms, following the
recommendations of the German physician Karl Turban
(1856–1935).
Isolated mountain resorts came into fashion based
on empirical evidence compiled by physicians practicing
in elevated regions, who argued that they saw fewer TB
infections among people who lived at high altitudes.23 The
spectacular ascent of Davos from a small farming village
to an international health resort in the 1860s can be cred-
ited largely to Alexander Spengler (1827–1901), a German
physician and TB specialist.24 Spengler’s trailblazing work
set the stage for more advanced treatments in Davos, and
architects inevitably shared the same objectives as the med-
ical pioneers, with Turban leading the way.25 A pulmonary
specialist, Turban played a leading role in the invention of
Davos as a disciplined health colony regulated by an elab-
orate regime of spatiomedical supervision. Previously, TB
316 JSAH | 82.3 | SEPTEMBER 2023
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patients at Davos recovered with the assistance of local
doctors (like Spengler) and the natural alpine climate, but
Turban’s uncompromising methods soon translated into
material architectural form. In 1889, Turban opened his
own health care facility in Davos with an unusual internal
organization: all the rooms were oriented toward the south,
with circulation spaces relegated to the north (Figure 4).
This layout ensured that all rooms received maximum expo-
sure to sun and air, thereby amplifying alpine respiration.
In 1902, Turban’s collaboration with the Swiss architect
Jacques Gros (1858–1922) in a British competition gener-
ated a new model for sanatorium design (Figure 5).26
Loggias versus Balconies
According to medical consensus in Davos, all rooms in
a sanatorium required direct access to fresh air. Turban’s
1893 instructions for sanatorium design, “Normalien für
die Erstellung von Heilstätten für Lungenkranke in der
Schweiz” (General principles for the construction of sana-
toriums for lung diseases in Switzerland), provided essential
guidelines for a number of new institutions.27 In practice,
however, many of these institutions deviated from Turban’s
theories. The conflict crystallized around the individual
balconies that became iconic features of many later sanato-
riums, features that Turban deemed to be “of little value.”28
Instead, he favored opening up individual rooms to the air
and supplementing this with access to communal decks
(Liegehallen).29 The argument centered on the presence of
pristine mountain air. Turban called for the use of French
doors instead of conventional windows, with operable tran-
som windows above (stellbare Klapp-Oberfenster).30 He thus
proposed flipping open the exterior walls of the patient
bedrooms, a distinctly more radical move than that found

in most subsequent sanatorium designs. If on the one hand
this debate led to the creation of many balconied institu-
tions in Davos and beyond, on the other, it also encouraged
the creation of a protomodernist building skin with oper-
able curtain walls (Figure 6).31 Conceived essentially as a
shoebox opening to the south, Turban’s communal decks
were at least 8.2 feet (2.5 meters) deep, to allow for unob-
structed circulation; the roof and movable curtains blocked
direct wind and excessive sun.32 Eventually, however, the
collective performance of the rest cure, with multiple
patients reclining on rattan lounge chairs to take the air,
gave way to a more independent and ultimately exclusive
version of single bedrooms equipped with private balco-
nies.33 Despite these spatial divisions, patients were united
in breathing the same air, an idea in accord with recent
biological research. As evolutionary theorist Lynn Margulis
observes, “All organisms are touching because all are bathed
in the same air.”34
Sanatoriums equipped with private rooms and individ-
ual balconies responded less to the functional demands of
medical isolation than to patients’ desire for privacy as well
as dignity and domesticity.35 As Annmarie Adams has shown
in her work on Canadian hospitals, the use of domestically
inspired designs directly reflected issues of class. For one,
such designs helped to attract the middle class, while for the
Figure 4 Floor plan for a tuberculosis sanato-
rium from Karl Turban, Tuberkulose-Arbeiten
1890–1909: Aus Dr. Turbans Sanatorium, Davos
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(Davos: Buchdruckerei Davos, 1909; Medical
Historical Library, Yale University).
Figure 5 Floor plan for a tuberculosis sanato-
rium from Karl Turban, Tuberkulose-Arbeiten
1890–1909: Aus Dr. Turbans Sanatorium, Davos
(Davos: Buchdruckerei Davos, 1909; Medical
Historical Library, Yale University).
poor, castle-like structures evoked ideas of the European
aristocracy while also concealing any “associations with ill-
ness.”36 The preference for domesticity that Adams notes
holds true in part for the Queen Alexandra Sanatorium,
even if an allusion to aristocratic forms was undesirable for
a European institution catering to the poor. Indeed, as an
early report affirmed, the authorities’ aim with the sanatori-
um’s design was “to avoid a palace and to provide a home.”37
The Queen Alexandra Sanatorium, named for its
patron the British queen and consort of King Edward
VII, Queen Alexandra of Denmark (1844–1925), was ded-
icated to patients of little means who suffered from cur-
able forms of pulmonary disease.38 Former British prime
minister Lord Arthur Balfour (1848–1930) served as one
of the co-initiators and chair of the governing board of the
sanatorium.39 Thanks to the queen’s patronage as well as
ample support from British citizens, the institution broke
with class stratification, enabling those patients who could
not afford to pay for a Swiss alpine sojourn to experience
its avowed benefits.40 All patients admitted to the sanato-
rium had to meet certain criteria: in addition to their status
as TB patients, they were required to have either British
or American citizenship, and to demonstrate that they
could not afford temporary residence in Davos.41 Since
all patients arrived at the sanatorium in a similar state of
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I N H A B I T I N G T H E AT M O S P H E R E   

Figure 6 Illustration of the interior south façade of a tuberculosis
sanatorium from Karl Turban, Tuberkulose-Arbeiten 1890–1909: Aus
Dr. Turbans Sanatorium, Davos (Davos: Buchdruckerei Davos, 1909;
Medical Historical Library, Yale University).
illness, there was no medical reason to isolate them from
one another, but the availability of individual balconies gave
a sense of domesticity and privacy to an otherwise commu-
nal institution.
In the United States, ventilation concerns informed hos-
pital design throughout the nineteenth century, with differ-
ent layouts responding to the need for disease prevention.
In most hospital types, basic apertures (windows and doors)
induced passive air exchange, with the main objective of
separating patients’ inhalations and exhalations.42 Given
the limitations of contemporary technology, designers laid
out wards according to size, geometry, openings, and ven-
tilation technologies, seeking to create “specific patterns
of air flow.”43 Natural ventilation remained the preferred
way of providing fresh air, even if air flow was inconsis-
tent at times, following the established belief that air lost
its vital energy when it was mechanically provided.44 As
Bruno Moretti observed in his 1935 monograph on hos-
pitals, air-conditioning eventually overcame this resistance
to become the preferred mode.45 However, in Davos, there
318 JSAH | 82.3 | SEPTEMBER 2023
was no need to condition the local air except to heat it.46
The Queen Alexandra Sanatorium represented less a build-
ing designed for ventilation than a building designed to
expose its inhabitants to a climate believed to help patients
recover from respiratory diseases.47
The Local Climate of Davos
While current climate debates tend to address the atmo-
sphere as an objective, global phenomenon, this approach
tends to neglect the fact that various climatic factors, includ-
ing air qualities ranging from temperature to pressure to
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speed, influence the atmosphere at a given location. In her
Latourian reading of the atmosphere, Eva Horn argues that
the natural sciences have “robbed us of an experience-based
approach to climate” with their emphasis on statistics and
interrelated planetary systems.48 Yet climate as a local phe-
nomenon is often hyperspecific, shaping cultural practices
and routines as much as it influences architecture. The san-
atorium offers a case in point: it facilitated a special lifestyle
where passive patients sought redemption from a malady by
exposing themselves to a specific atmosphere. Even with
the benefit of hindsight, it is impossible to determine the
relative success of TB management in sanatoriums.49 But by
parsing the specific qualities of the air, we can better under-
stand the confluence of patient, building, and atmosphere.
Mountain climates in particular were considered ideal
for the treatment of pulmonary tuberculosis, provided
patients could tolerate their low atmospheric pressure, low
air humidity, and warm solar radiation with low tempera-
tures in the shade, as well as abundant sunlight. Experts
most frequently hailed air’s purity as key to its role in help-
ing patients recover from TB.50 According to the German
physician and expert on climatology Sir Hermann Werner
(1848–1918), by virtue of their “highly stimulant and tonic”
qualities, high altitudes could promote many physiologi-
cal benefits, including “amplification of the respiratory
movements,” “strengthening of the muscles of respiration,”
“strengthening of the heart and circulation,” “increase in
the amount of watery vapor and carbonic acid given off
from the lungs,” “increased activity of the skin,” “increase
of appetite and of the amount of food taken,” “improvement
of the digestive functions,” “improvement in the quality of
the blood, and in the nutrition of the organs, particularly
of the lungs,” and “increased activity of the nervous sys-
tem.”51 Nonetheless, Werner repeatedly stressed that cli-
mate in itself was insufficient without necessary medical
supervision and attention to hygiene and diet. To this end,
the sanatorium provided the spatial matrix for a highly con-
trolled exposure to the atmosphere, where climate could
do its magic only in conjunction with a tightly managed
medical regime. Thus at the Queen Alexandra Sanatorium
patients pursued their rest cure for three hours a day, split
into three sessions: from 12:00 p.m. to 12:45 p.m., 2:00 p.m.
to 3:30 p.m., and 6:00 p.m. to 6:45 p.m.52 In a sense, then,
the building itself represented “a form of medical technol-
ogy,” both embedded within unique climatic conditions and
engulfed by the atmosphere.53
Although high altitudes around the world exhibited
many similar qualities, Werner favored the Peruvian Andes
because of “the great dryness and rarefaction of the atmo-
sphere.”54 The remoteness of the Andes, however, made
that location inaccessible to most patients. Werner noted
that mountain climates were not uniform: he described
the Rocky Mountains, for instance, as “somewhat drier
and warmer than Davos and St. Moritz” but “also more
windy,” and physicians and patients considered wind a nui-
sance.55 Topography also informed climatic conditions, a
correlation particularly obvious in Davos, an alpine town
at a remarkable altitude that was also sited at the bottom
of a valley. The orientation of this valley, together with
its dimensions as well as its relationship to neighboring
valleys and mountains, created what medical specialists
regarded as a beneficial climate for tubercular patients,
especially in winter. Not only was the valley floor wide
and flat, but the peaks of the tallest surrounding mountains
rose to no more than 8,860 feet (2,700 meters), so that even
the low winter sun reached into most of the valley. Historic
weather data published in 1907 show how calm Davos
was, with a mostly northeasterly winter wind occasionally
entering the valley at speeds of around 1 on the Beaufort
scale (equivalent to 1–3 miles per hour, or 0.5–1.5 meters
per second). On average, between 1887 and 1904, wind
speeds registered only 0.3 on the Beaufort scale.56 While
this specific valley wind brought enough fresh air, it did
not affect patients seated on their south-facing balconies.
Even the prevalent southwesterly winter wind was so light
that it went virtually unnoticed. In fact, the majority of
winter days exhibited a complete absence of wind. At the
same time, there was little cloud cover to interfere with the
available solar warmth, which helped to protect patients
from the actual air temperatures.57 Because of the winter
calm, patients were able to withstand the low tempera-
tures, as the low level of water vapor in the atmosphere
reduced the air’s thermal conductivity, minimizing the loss
of body heat.
The amount of water vapor in the atmosphere at Davos
was so low that when inhaled air reached body tempera-
ture it lost much of its vapor pressure, which resulted in
the extraction of humidity from the lungs.58 In contrast
to Arosa, an adjacent resort with fifty foggy days per year,
Davos experienced virtually no fog.59 Summer days were
moderately warm, and the nights were cool, averaging
around 54 degrees Fahrenheit (12 degrees Celsius). Annual
sunshine duration averaged five hours per day. Beyond these
statistics, a firsthand account from 1913 provides valuable
insights into the life of a patient at the Queen Alexandra
Sanatorium:
Here one may carry out the fresh-air treatment in summer or
in the depth of winter amid surroundings that make the cure
a joy and not a hardship. Here are no wind-swept rooms or
corridors. The valley of Davos is free from wind. In winter,
so brilliant is the sunshine and so warm its rays that one may
lie out on the balconies in perfect comfort. Of course, when
the sun goes in the cold may be intense, but it is always a dry
cold, and the freedom from wind prevents us from feeling any
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discomfort, provided we are well wrapped up. Our doctors do
not expect us to live in draughts and icy rooms; each room
has its radiator and double windows. We dress and undress in
warm, cozy rooms, and once in bed with a hot-water bottle
we can enjoy the cold fresh air with our windows open wide.60
This blithe account attests to several key features of the
sanatorium, including the prevention of drafts throughout
the site, unobstructed access to fresh air even inside the
building, heated interiors, and ample sunshine.
The northeast wind, shaped by the local topography,
represented a blessing for Davos.61 The challenge of sup-
plying fresh air without drafts was still an architectural
enigma, and had it not been for the regional microclimate,
with its pleasant meteorological conditions, patients would
have had no other choice than to cope with a steady draft.62
At Davos, air was set into motion primarily by the scores
of breathing inmates, who were joined constantly by new
tubercular patients arriving from the plain. Located 5,120
feet (1,560 meters) above sea level, Davos was praised by
doctors for the recuperative qualities of its dry, glacial air.63
Whether the air was really pure is impossible to determine,
and looking back on this period, it is important to empha-
size that this analysis addresses not real effects, medical sci-
ence, or disease statistics, but the perceived effects of air
on TB patients and their hopes for recovery from illness.
A cursory review of contemporary reports reveals a pleth-
ora of superlatives applied to the Davos climate. In 1907,
one physician exalted the location’s “mild atmosphere” and
“the pure, cold, invigorating air” that is “perfectly still,”
and noted “the cold, absolutely very dry air” that improved
conditions for invalids.64 Another physician described the
Davos climate with similar enthusiasm:
The rarefaction of the air, the purity of the air, the inten-
sity and long duration of the sunshine, the abundance of
[ultra]violet rays and of Becquerel rays, the high electric
potential, the small amount of cloud and fog, the dryness and
coldness of the air, the calmness of the air, especially preva-
lent in winter—all these, together with some further factors,
make up the climate of high altitudes.65
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I N H A B I T I N G T H E AT M O S P H E R E   
 Thanks to these remarkable qualities, this author asserted,
the mountain climate offered far more than “a gigantic
pneumatic chamber with reduced atmospheric pressure”;
such a conception would not only have ignored countless
other attributes, from purity to dryness to oxygen levels,
but also vastly underestimated the uncertainty of physicians’
assessments of the time.66 Earlier medical debates centered
on the question of whether the beneficial properties of the
air derived from lower temperatures or higher altitude.67 In
the 1880s, physicians assumed that the thin mountain air
triggered deep breathing—that is, the “deep and full res-
pirations” that were held to strengthen the lungs; Werner
shared this assumption.68 These physicians also believed that
by stimulating the muscular movement responsible for the
passage of air to and from the lungs, mountain air aided in
the discharge of “watery vapor and carbonic acid.”69
Part of what Davos had to offer in terms of its climate
had already been written as a prerequisite into the source
code of Western architectural theory, given that Vitruvius
dedicated a number of paragraphs in the first of his Ten
Books on Architecture to the performance of winds. Vitruvius
argued that places with less wind were healthier, and he
established imperatives for architectural designs based on
this principle. He knew that wind resulted from a reac-
tion between heat and moisture.70 As he claimed, constant
temperature resulting from “the shutting out of the winds”
benefited not only patients suffering from all kinds of dis-
eases, such as “catarrh, hoarseness, coughs, pleurisy, con-
sumption, [and] spitting of blood,” but also healthy people.
Vitruvius conjectured that patients whose immune systems
were damaged by these diseases could be cured only in
places without wind, as wind further weakened them by
taking “all the sap of life out of their diseased bodies.” In
contrast, he identified “a mild, thick air” without drafts as
nurturing and invigorating.71 Leon Battista Alberti per-
petuated these ideas in his discussion of air, climate, and
atmosphere in On the Art of Building, observing that air
“when really pure may have an extraordinarily beneficial
effect on health.”72 Alberti directly linked purity as a prop-
erty of air with human health and well-being, asserting
that “the healthiest form of air is that which is the purest
and least polluted, the most easily pierced by sight, the
most transparent and light, and which is always serene and
largely constant.”73 In short, the best air is that which is not
there. Unlike earlier medical concepts of air—for instance,
in eighteenth-century French hospitals, which sought to
induce a “powerful draft”—the silent repose imposed on
patients at Davos corresponded to the ideally invisible and
still mountain air.74
320 JSAH | 82.3 | SEPTEMBER 2023
Planning and Funding
In 1905, the board of management of the planned British
sanatorium in Davos and the sanatorium’s council and
medical committee in London organized a competition
for the design of the facility. All invited participants were
required to demonstrate local experience, a criterion that
immediately limited the pool of architects to those in
Switzerland. From the four entries, the jury chose Pfleghard
& Haefeli’s scheme.75 Construction was already under way
on 23 February 1907 when the Schweizerische Bauzeitung
announced the delivery of approximately 58,124 square
feet (5,400 square meters) of reinforced concrete ceil-
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ing panels.76 On 6 August 1907, the British ambassador
to the Swiss Confederation, Sir George Francis Bonham
(1847–1927), laid the ceremonial foundation stone for the
sanatorium (Figure 7).77 Other preparations included pub-
lic fund-raising events such as a Christmas Eve bazaar in
1907.78 The council of the sanatorium estimated that initial
construction costs would be £22,000, and to help raise these
funds it appealed to the British citizenry.79 In spring of
1906, the Manchester Guardian noted, “The scheme is wor-
thy of full support,” drawing a direct comparison between
disadvantaged British and German patients by noting that a
modern sanatorium close to Davos already served German
patients; this was further incentive to embellish the British
sanatorium with the name of the British queen.80 By that
time, the sanatorium’s council had already acquired a choice
piece of property at Davos. Initial plans anticipated sixty
beds with the option to expand to eighty at a later time.81
Accommodation costs for a private bedroom were set at
thirty-eight shillings per week.82 The sanatorium received
many applications from patients seeking treatment, and in
early October 1909 the authorities expected to open the
institution’s doors at the end of the month. The inaugu-
ration ceremony was delayed, however, until later that
winter.83
Given its vaguely symmetrical massing, the sanatorium
as documented in photographs dating from 1909 appeared
to be missing one of its wings (Figure 8). As revealed in
the earliest drawings, from the outset the sanatorium was
designed for a future extension. A second wing devised in
1911 accommodated additional beds, together with a med-
ical department with a pharmacy, an X-ray room, waiting
rooms, and a laboratory (Figure 9). It operated for less
than four years in this capacity before shutting down on 15
April 1915, with the advent of World War I. The previous
August the entire male staff had been drafted for military
service, and almost all of the female staff departed soon
after. Patients who failed to return home before the onset
of winter transferred to a local hotel, leaving the sanatorium
vacant until 1922.84 Given that costs remained fixed during
those years, the building had to be sold to the cantons of
Figure 7 Laying of the foundation stone for the
Queen Alexandra Sanatorium, Davos, 6 August

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1907 (The Queen Alexandra Sanatorium, Davos:
A Short Account of the Building Reprinted
from the Annual Report of 1909–10 [London:
Waterlow and Sons, 1910]; Staatsarchiv Thurgau,
8’903’22 3/179).

Figure 8 Pfleghard & Haefeli, Queen

Alexandra Sanatorium, Davos, 1907–9,
photo ca. 1912 (postcard, Tomaszewski;
Dokumentationsbibliothek Gemeinde Davos).

Figure 9 Pfleghard & Haefeli, Queen Alexandra

Sanatorium, Davos, south elevation, June 1911
(gta Archives, ETH Zurich, Pfleghard & Haefeli).
Thurgau and St. Gallen in the summer of 1922.85 The orig-
inal British governing board nevertheless maintained the
sanatorium’s services, subsidizing the treatment of tuber-
cular patients in the Swiss Alps. The Hotel Frei at Davos
Platz provided the patients with temporary lodging, which
included “separate rooms, central heating, and electric
light.”86 Although the relocation from sanatorium to hotel
happened for pragmatic reasons, this attests to the close
relationship between such institutions: just as the Queen
Alexandra Sanatorium relocated its services to a local
hotel, so too did several sanatoriums restyle themselves as
hotels following the discovery of streptomycin, the new

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antibiotic that effectively brought the rest cure to a halt.87
Contemporary architects noted the similarities between the
two building types.88 The key distinction was the length of
stay, with patients residing in a sanatorium much longer
than guests stayed in a hotel (most of the Queen Alexandra
Sanatorium’s patients stayed for approximately one year).89
Figure 10 Pfleghard & Haefeli, Queen Alexandra Sanatorium, Davos,
1907–9, view from rear (The Queen Alexandra Sanatorium, Davos: A
Short Account of the Building Reprinted from the Annual Report of
1909–10 [London: Waterlow and Sons, 1910]; Staatsarchiv Thurgau,
8’903’22 3/179).

The Design of the Sanatorium

The Queen Alexandra Sanatorium occupied the slopes of
the Grüeni Alp, described in the institution’s annual report
as “the last good sanatorium site” in the valley (Figure 10).90
Standing at the edge of a ravine, the sanatorium commanded
a stunning prospect toward the Albula Alps. Thanks to its
elevation, the site enjoyed morning sunshine, free “from
smoke and river mists.”91 Setting the building against a back-
drop of twinkling, snowy hills and pine forest, Pfleghard &
Haefeli staged the spectacle of the rest cure at the Queen
Alexandra Sanatorium like a theater performance for
approaching guests. Doctors considered the pine forest to
be a therapeutic landscape ideally suited for a sanatorium.92
Pine trees offered both shade and scented emanations con-
Figure 11 Laying of the foundation stone for the Queen Alexandra
sidered beneficial for the treatment of TB.93 According to
Sanatorium, Davos, 6 August 1907 (The Queen Alexandra Sanatorium,
Sir Hermann Werner, “There are also exhalations from
Davos: A Short Account of the Building Reprinted from the Annual
the trees to be taken into account, especially in pine for- Report of 1909–10 [London: Waterlow and Sons, 1910]; Staatsarchiv
ests, where the aromatic substances in the air may possess Thurgau, 8’903’22 3/179).
an antiseptic influence.”94 Trees and patients inhaled and
exhaled in unison, a process mediated by the architecture of ongoing effort to distribute sanatoriums across the nation.98
the sanatorium and facilitated by the atmosphere.95 Compared to several other sanatoriums in Davos, with their
The Queen Alexandra Sanatorium, with its rusticated neoclassical three-winged designs dominated by a central
base emerging from the rocks, appeared deeply rooted in avant-corps, the Queen Alexandra Sanatorium seemed
local geology. Its builders used glacial debris for its con- slightly irregular, even off-kilter.99 The tripartite organiza-
struction, as well as quarry stone from the mountain tor- tion of the Schatzalp, for example, appeared far more rig-
rent nearby, which they then covered with plaster and paint orous than the asymmetrical details and undulating terrain
(Figure 11).96 Although recalling Turban’s ideal plan, the of the Queen Alexandra Sanatorium. However, the general
complex appeared much more a design that had been care- layout of the plan of the Queen Alexandra Sanatorium
fully coordinated with local materials and the environment recalled Turban’s principles:
than a standardized type.97 By contrast, contemporary san-
atorium designs in Germany already followed generic plans Although the main elevation of the house should be directed
that did not acknowledge individual sites, in response to an to the south, slight turns to the southwest or southeast are

322 JSAH | 82.3 | SEPTEMBER 2023

 not excluded, as long as careful attention is given to the local
sun and wind conditions. . . . For larger buildings, it is advis-
able to choose a center section with two side wings attached
at an obtuse angle, with the Liegehallen facing south.100
Compared to the evenly gridded lattice of the Schatzalp
façade, vertical elements extending from plinth to roof
articulated the individual volumes of the Queen Alexandra
Sanatorium (Figure 12). The load-bearing walls bookend-
ing the three main volumes terminated in the same plane
as the horizontal slabs to form a taut geometric grid. The
piers flanking individual bedrooms were in turn set back by
about 33 inches (85 centimeters). This subdivision gener-
ated a secondary higher-resolution grid spanning all parts,
where the staggering of elements and the hierarchy of the
primary vertical structure, the horizontal floor slabs, and
the recessed pillars produced a sense of depth. Despite the
building’s predominantly horizontal arrangement, its pro-
nounced vertical members recalled the tectonic organiza-
tion of baroque compositions, with their vertical emphasis
joining plinth to crown.101
Porous Metaphors
Different metaphors abound for sanatoriums. Thomas
Mann described the Schatzalp Sanatorium as a “porous
sponge,” and the Queen Alexandra Sanatorium has been
compared to “an enormous hive.”102 But does the orthogo-
nal grid on the south façade of the latter actually resemble
a hexagonal honeycomb? Does the Schatzalp display the
fibrous structure of a sponge? These metaphors serve to
highlight the performative aspects of these buildings’ bar-
rier zones as both inhabited and porous. Porosity results
from the numerous cavities formed in homogeneous
materials such as rock and sponge, which contrast with
the sharp, linear tectonics of the sanatorium. But by the
same token, porous voids allow for the flow of water and
air. Living sponges maintain a constant water flow through
their pores to receive nutrients and oxygen. Unlike human
beings, they lack central respiratory organs; instead, they
operate through diffusion, which facilitates the movement
of gases from areas of high concentration to areas of low
concentration. Just as most sponges rely on a constant flow
of water, sanatorium patients relied on the constant flow of
imperceptible air.
Reinforced concrete balconies and an abundance of
openings ensured access to this supply of air both inside
and outside. As a contemporary commentator noted, “The
outer wall of each patient’s room is nearly all window, the
construction having been evidently carefully devised with
that end in view.”103 Operable windows provided the only
means to direct mountain air into the patient rooms.104
At the Queen Alexandra Sanatorium, each patient room
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Figure 12 Pfleghard & Haefeli, Queen Alexandra Sanatorium, Davos,
south elevation without extension, 1907 (Staatsarchiv Thurgau, 9’11,
5.0.0.1/1).
featured two sets of casement windows and double doors
measuring roughly 4 feet (120 centimeters) wide, fitted
with corresponding hopper transom windows above; these
swiveled both inward and outward, operated by iron pull
handles. This simple and conventional system permitted
various levels of exposure to the outside air, depending
on the many possible different arrangements of the four
individual door leaves and four casements. The window
frames made of larch wood featured parapets connected
by mortise-and-tenon joints (Figure 13). The designers
sandwiched the only interior ventilation shaft between the
northern exterior wall and the toilets, offsetting it inward to
protect it from the severe winter climate. This shaft “com-
municated” with “sanitary offices” on every floor, allowing
warm air heated by steam pipes to circulate upward into
every room (Figure 14).105
Evolution of the Scheme
As the project developed, Pfleghard & Haefeli introduced
alterations to their initial schemes, and to the south eleva-
tion in particular (Figure 15). Although in February 1905
they created drawings that showed a central tower topped
by a swirling flag, evoking a medieval castle more than a
medical institution, the management board preferred “as
simple and convenient a building as possible,” according to
a report in the Manchester Guardian.106 The architects soon
adopted an increasingly modernist stance, and their later
schemes bore no trace of these earlier picturesque features.
The set of drawings dating from February 1905 presented
a tower-like structure flanked by a three-story wing on the
right and a six-story wing to the left, rising from a heav-
ily rusticated ground floor. Cascading down the slope, the
scheme anticipated a future extension, with dashed lines on
the left margin of the elevation ghosting in volumes that
maintained the overall architectural rhythm (Figure 16).
By July 1906, the design had matured significantly, with
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I N H A B I T I N G T H E AT M O S P H E R E   
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Figure 13 Pfleghard & Haefeli, different window
types for the Queen Alexandra Sanatorium,
Davos, including opening directions, 1907 (gta
Archives, ETH Zurich, Pfleghard & Haefeli).

Figure 14 Pfleghard & Haefeli, Queen

Alexandra Sanatorium, Davos, second and third
floors, 1907 scheme (Staatsarchiv Thurgau, 9’11,
5.0.0.1/0).

Figure 15 Pfleghard & Haefeli, Queen

Alexandra Sanatorium, perspective, early
scheme, pencil on paper, 14 February 1905 (gta
Archives, ETH Zurich, Pfleghard & Haefeli).

the changes coinciding in large part with the building as
realized. Traces of the initial tower survived in the east ele-
vation, where a bulging stairwell appeared in plans as early
as January 1907. The distinctive layout of rooms and their
subdivided balconies remained consistent throughout the
design process, as did the designs for the Liegehallen on the
ground floor (Figure 17).
324 JSAH | 82.3 | SEPTEMBER 2023
Swiss engineer Robert Maillart (1872–1940) devised
the sanatorium’s slabs based on the Hennebique method of
building with reinforced concrete, exploiting the compres-
sive tendency of horizontal structural elements in their
upper regions and using a reinforcing lattice of steel rods
to absorb tensile stresses (Figure 18).107 A haunch medi-
ating the different construction members, a characteristic

detail of most Hennebique structures, appears in an inte-
rior view of the drawing room (Figure 19). Maillart, who
also supervised construction at the Schatzalp, left his
mark in the structural horizontality evident in the exte-
rior façades of the Queen Alexandra Sanatorium, intro-
ducing innovative crosswise reinforcements as elegant
cantilevers for the balconies.108 The designers lifted the
floors of the sanatorium upon two basement levels and
crowned the roofline with the medical superintendent’s
penthouse. Vertical piers rising to the roofline separated
the east wing’s three outer bays, creating a subvolume that
corresponded to the central block, with its three arched
windows at the ground floor and its rusticated exterior
wall, a recalibrated façade behind which stood the grand
dining hall.
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Figure 16 Pfleghard & Haefeli, Queen
Alexandra Sanatorium, Davos, south elevation,
cross section, and floor plans, February 1905
(gta Archives, ETH Zurich, Pfleghard & Haefeli).
Figure 17 Pfleghard & Haefeli, Queen Alexandra
Sanatorium, Davos, ground floor, 1907 scheme
(Staatsarchiv Thurgau, 9’11, 5.0.0.1/0).
The south façade, with its balconies, contrasted with
the north façade, where they were completely absent. Sized
generously at 6.4 feet (1.95 meters) deep and 9.4 feet (2.85
meters) wide, each balcony was approximately half the size
of the adjacent patient bedroom (Figure 20). As a contem-
porary source observed, “The patient with bronchitis may
rest upon his balcony when the sun shines down, but at
night he must sleep in a warm room. It is true he must
have fresh air, but the latter can be supplied in sufficient
quantity through well-ordered ventilators and the radiator
keeps the air he breathes at a comfortable temperature.”109
Unlike later hospitals and sanatoriums, which used wheeled
beds to transport patients outdoors, the Queen Alexandra
Sanatorium provided patients with special reclining chairs
on their balconies.
325
I N H A B I T I N G T H E AT M O S P H E R E   
Internal Organization
Each level of the Queen Alexandra Sanatorium included
nine bedrooms in the east wing, five in the central volume,
and eight in the west wing (Figure 21). Linoleum flooring
was used throughout, and Salubra, a washable hygienic paint
capable of producing a hermetically sealed surface resistant
to disease, coated the interior walls to a height of 7 feet.110
The location and orientation of the internal bend in the hall-
way (commended by Giedion for preventing the impression
of an endless bleak corridor) were consistent with Turban’s
tenets.111 The subsequent addition of sunscreens, adjustable
according to individual patient needs, further animated the
façade. With its main entrance facing almost due south, the
building pledged healing upon arrival (Figure 22). The main
Figure 18 Pfleghard & Haefeli, Queen Alexandra Sanatorium, Davos,
concrete work in progress, September 1907 (The Queen Alexandra
Sanatorium, Davos: A Short Account of the Building Reprinted from
the Annual Report of 1909–10 [London: Waterlow and Sons, 1910];
Staatsarchiv Thurgau, 8’903’22 3/179).
Figure 19 Pfleghard & Haefeli, Queen
Alexandra Sanatorium, Davos, 1907–9, drawing
room (gta Archives, ETH Zurich, Pfleghard &
Haefeli).
326 JSAH | 82.3 | SEPTEMBER 2023
access road followed the route of an older cart track, mak-
ing an S curve as it rose up the hill. First heading toward
the facility, it then turned sharply to the left, directing the
patient’s gaze, along with the incoming traffic, away from the
sanatorium, only to turn right again on the final approach
to the building. The ground floor incorporated a vestibule,
a concierge room, office spaces, a generous kitchen, and,
adjacent to the promenade balcony, a procession of spaces: a
general hall, an austere living hall, and a noble dining hall. A
main stairwell wrapping around the hydraulic passenger lift
and two additional staircases in the wing provided vertical
circulation. The 1911 extension offered five additional single
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bedrooms, two suitcase rooms, and a new, full-fledged health
station, including a lab, a pharmacy, a surgery, and waiting
rooms on the second floor (see Figure 21).112
Rudolf Gaberel (1882–1963), a Swiss architect and prom-
inent local player in Davos, supervised enhancements to the
sanatorium during the 1920s, including the addition of a solar-
ium on the roof of the southwest wing.113 Further changes took
place in the early 1950s. Although the designers planned the
bedrooms for single patients, soon they were used to accommo-
date two patients, which in turn required enlarging the balco-
nies to make room for two beds. The extension and renovation
of the south façade occurred in 1955, along with the addition
of new hot and cold water systems. This work also included the
construction of a new staff amenities building for employees
formerly housed in the main building.114 In 1966, the institu-
tion finally began admitting nontubercular patients, who were
strictly separated from TB patients. The continuing decline in
patient numbers was interpreted as evidence that doctors were
winning their battle against TB, and following intermittent use
as a medical center, the Queen Alexandra Sanatorium perma-
nently closed its doors in 2005.115
Figure 20 Pfleghard & Haefeli, Queen
Alexandra Sanatorium, Davos, 1907–9, view

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from a bedroom looking onto the balcony (The
Queen Alexandra Sanatorium, Davos: A Short
Account of the Building Reprinted from the
Annual Report of 1909–10 [London: Waterlow
and Sons, 1910]; Staatsarchiv Thurgau, 8’903’22
3/179).

Figure 21 Pfleghard & Haefeli, Queen

Alexandra Sanatorium, Davos, floor plan includ-
ing the extension of 1911 (author’s drawing).

Figure 22 Pfleghard & Haefeli, Queen

Alexandra Sanatorium, Davos, site plan, ink and
watercolor, 1905 (Staatsarchiv Thurgau, 9’11,
5.0.0.7/0).

Figure 23 Page from Richard Döcker’s
Terrassen Typ, 1929, with two misidentified
images of the Queen Alexandra Sanatorium,
Davos (Stuttgart: Julius Hoffmann, 1929;
Staatsbibliothek Berlin).
Reception of the Sanatorium in Modern
Historiography
In 1929, two publications by ardent supporters of the mod-
ern movement depicted the Queen Alexandra Sanatorium:
Richard Döcker’s Terrassen Typ and Sigfried Giedion’s
Befreites Wohnen. Döcker (1894–1968), a German architect
and member of the collective Der Ring, served as construc-
tion manager of the Weissenhof Housing Estate (1927),
where he contributed two single-family houses; he was also
the designer of a hospital northeast of Stuttgart. Giedion
(1888–1968), a Swiss engineer who studied art history under
Heinrich Wölfflin (1864–1945), abandoned academia after
earning his doctorate in 1922 to address what he identified
as more pressing contemporary challenges.116 Giedion’s first
book on modern architecture, Bauen in Frankreich, Bauen
in Eisen, Bauen in Eisenbeton (1928), analyzed the historical
passage from vernacular iron construction in France to Le
Corbusier’s architecture of the 1920s, which he interpreted
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to be bathed in air.117 Befreites Wohnen, a small pamphlet
that he published the following year, echoed this narrative.
Döcker’s discussion of the Queen Alexandra Sanatorium
in Terrassen Typ was both brief and slightly imprecise; it
was accompanied by two incorrectly identified images of
the sanatorium (Figure 23).118 The caption below the first
of these images presented the sanatorium as “Kurgauisch
Schaffhausische Volksheilstätte Davos 1907” instead of
“Thurgauisch Schaffhausische Heilstätte” (after the two Swiss
cantons Thurgau and Schaffhausen). Although the second
image showed patients resting in lounge chairs at the same
institution, the caption called it merely “a sanatorium,” leaving
it anonymous. Surely neither the atmosphere nor the climate
of Davos interested Döcker.119 The preceding page showed
two photos of unnamed Swiss sanatoriums, including one
of the Schatzalp, implying a somewhat negative evaluation
of its balconies as blocking out the sun (Figure 24). Given
Döcker’s focus on the terraces, he considered the top floor

of the Queen Alexandra Sanatorium—Gaberel’s addition—
the only one worth mentioning, although he criticized this as
well: “The roof terrace is entirely covered, the rooms behind
receive no sun.”120 He also noted, not unlike Giedion, the
architects’ use of a flat roof, which went against the general
assumption of the time that only a pitched roof is qualified for
a location known for its heavy snowfall. Where Giedion was
fascinated by the way the plan exploited sunlight and elimi-
nated long corridors, Döcker felt the near symmetry of the
building was old-fashioned.121 For him, in the end, both the
Schatzalp and Queen Alexandra Sanatoriums occupied a mid-
dle stage in the morphological evolution toward the terraced
building as the purest expression of modernist architecture.
Giedion also featured the rooftop solarium of the
Queen Alexandra Sanatorium in Befreites Wohnen, as well
as in a 1929 article where he described the building as
“still the best Swiss sanatorium” (Figure 25).122 Both
Giedion’s photographs and the taut and poetic wording
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Figure 24 Page from Richard Döcker’s
Terrassen Typ, 1929, showing two Swiss
sanatoriums, unnamed in the caption (Schatzalp
Sanatorium in Davos appears in the top
photo) (Stuttgart: Julius Hoffmann, 1929;
Staatsbibliothek Berlin).
of his caption bore witness to his elated response to the
building:
Solarium. Subsequently added on top of the People’s san-
atorium (by [Rudolf] Gaberel). The photograph far from
reproduces the charm that arises from the interpenetration
of landscape; the point of view (which hovers above the
ground); and architectural firm framing.123
Here Giedion suggested that atmosphere’s oft-invisible
quality—as the medium in which everything is immersed
and thus connected—escaped the camera’s lens to enter
instead an altogether different register, that of cognition,
the critical point of embodied entanglement where land-
scape and architecture meet the perceiving subject. 124
Another photograph by Giedion (not included in Befreites
Wohnen) rendered the atmosphere visible while also call-
ing attention to its engulfing presence. Shot at the Queen
Alexandra Sanatorium on a rare hazy day in winter, this
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I N H A B I T I N G T H E AT M O S P H E R E   

Figure 25 Two-page spread from Sigfried
Giedion’s Befreites Wohnen, 1929, featuring
the Queen Alexandra Sanatorium, Davos
(Zurich: Orell Füssli, 1929; Universitätsbibliothek
Technische Universität Berlin).
Figure 26 Sigfried Giedion, photograph taken
from the rooftop of the Queen Alexandra
Sanatorium, Davos, ca. 1922 (gta Archives, ETH
Zurich, Sigfried Giedion).
image presents the atmosphere itself as the envelope for an
otherwise exposed structure, as a metonymic building body
(Figure 26). Here a translucent, vaporous substance func-
tions as infill, occupying screen-like the open spans between
roof, posts, and floor. In a literal sense, the sanatorium’s
rooftop solarium and balconies, as later additions, formed
frames through which breathable air could waft slowly like
fog. With Giedion’s photograph in mind, it is easy to imag-
ine how the atmosphere effectively formed an envelope
for patients and building alike, thereby exemplifying the
main objective of the sanatorium movement: to immerse
patients within the calm, invigorating mountain air. Much
as Giedion’s image reveals the otherwise immaterial atmo-
sphere, the gridded structure of the sanatorium registers
the presence of air by dividing it into equal portions to be
inhaled and exhaled by each patient. If architecture often
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serves as a “protective cocoon” against the weather, the
Queen Alexandra Sanatorium design inverted this equation,
as a structure built not to protect its occupants from the
weather but to expose them to it.125
What conclusions might we draw from this study? Close
analysis of the Queen Alexandra Sanatorium planning pro-
cess and design drawings reveals that through a combina-
tion of large- and small-scale formal moves—most notably
in the building’s orientation to the south—the architects
maximized sun and air exposure for the patients. In addi-
tion, the strategic layout of interior spaces, window glazing,
and window operating mechanisms all worked in unison to
transform a highly climate-specific structure into a device
for atmospheric exposure, even if the merits of that exposure
for TB management proved dubious. This history shows
how contemporaries understood a spatiomedical regime for
TB treatment as working in tandem with the atmosphere, a
medium that has yet to be interpreted not only in terms of
weather data but also in conjunction with categories such
as pine forests and their aromatic emanations. Pine trees
and patients inhaled and exhaled jointly, the by-product
of the former enriching the well-being of the latter, and
the location and layout of the sanatorium facilitated this
therapeutic exchange. The sanatorium appeared to evolve
from rocks, yet as an interface between patients, mountain
climate, and medical regime, it belonged to the atmosphere
rather than to the landscape: it was the architectural reifi-
cation of atmospheric exposure. Leading experts asserted
that fresh mountain air could generate a range of positive
physiological effects for the human respiratory system, but
the air alone was judged insufficient without proper medical
supervision and spatial framing. Only a closely monitored
medical regime together with the stillness and rarefaction of
the atmosphere could yield the TB cure. Mirroring its exte-
rior windless conditions, the Queen Alexandra Sanatorium
promised its patients draft-free recovery.
Tim Altenhof is an architect and scholar whose research focuses
on the close ties among modern architecture, body, and atmo-
sphere. An international fellow at the Institute for Advanced
Study in the Humanities, KWI Essen, he has been awarded
the Bruno Zevi Prize and has published essays in 21: Inquiries
into Art, History, and the Visual, Log, Engramma, and Süddeutsche
Zeitung. tim.altenhof@uibk.ac.at
Abstract
Drawing on both archival research and recent scholarship, this article
examines how medical thinking and a scientific understanding of the atmo-
sphere shaped the design of the Queen Alexandra Sanatorium in Davos,
Switzerland, designed by Pfleghard & Haefeli from 1905 onward. While the
sanatorium is noteworthy in terms of both its construction and its reception
in the historiography of modern architecture, this study reassesses the ratio-
nale behind the design. Proposing an environmental cure, the institution
did away with the idea of architecture as a protective wrapper, and instead
presented the atmosphere itself as the primary realm for human habitation.
This study thus situates the sanatorium in the atmosphere rather than in
the landscape, even though the building appeared to grow from the ground.
Conceived with the atmosphere as its proxy envelope, the sanatorium was
designed to expose its patients to the celebrated air of Davos, praised for
its purity and perfect stillness.
Keywords: breathing; air; atmosphere; environmental studies; climate
studies; sanatorium; Davos, Switzerland; Pfleghard & Haefeli; Sigfried
ID:p0070
ID:ti0015
Giedion; modernist architecture
Notes
1. Eva Horn, “Air as Medium,” Grey Room, no. 73 (Fall 2018), 6–25.
2. Bill McKibben, “Climate,” in Connectedness: An Incomplete Encyclopedia of
the Anthropocene, ed. Marianne Krogh (Copenhagen: Strandberg, 2020), 113.
3. On this aspect in particular, see Emanuele Coccia, The Life of Plants: A
Metaphysics of Mixture, trans. Dylan J. Montanari (Cambridge: Polity Press,
2019), 65.
4. Coccia, 35.
5. Luce Irigaray, The Forgetting of Air in Martin Heidegger, trans. Mary
Beth Mader (Austin: University of Texas Press, 1999), 8. The book first
appeared as Luce Irigaray, L’oubli de l’air chez Martin Heidegger (Paris:
Editions de Minuit, 1983).
6. Craig Martin, “The Invention of Atmosphere,” Studies in History and
Philosophy of Science 52 (Aug. 2015), 52. Martin provides a useful discussion
of the history of this concept.
7. Jorge Otero-Pailos, “The Atmosphere as a Cultural Object,” in
Climates: Architecture and the Planetary Imaginary, ed. James Graham and
Caitlin Blanchfield (Zurich: Lars Müller, 2016), 243–50.
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8. For the former conception of the atmosphere, see the children’s book
Heidi by Johanna Spyri, published in 1880 and 1881. For the latter, see
Friedrich Engels, The Condition of the Working-Class in England in 1844,
trans. Florence Kelley Wischnewtzky (London: S. Sonnenscheinn, 1892).
9. See World Health Organization, Global Tuberculosis Report 2019
(Geneva: World Health Organization, 2019), https://www.who.int/public
ations/i/item/9789241565714 (accessed 8 Feb. 2023). For a discussion of
different attitudes about TB and its use as a figure of speech, see Susan
Sontag, Illness as Metaphor (New York: Farrar, Straus and Giroux, 1977).
10. The tubercle bacillus was identified by the German microbiologist and
founder of modern bacteriology Robert Koch in 1882. Previously, it was
held that tuberculosis was an inherited disease and not disseminated by
bacteria.
11. A sweeping account is offered in Thomas Dormandy, The White Death:
A History of Tuberculosis (New York: New York University Press, 2000).
12. This movement’s origins go back to antiquity. Dormandy, 147.
13. Sigfried Giedion, Befreites Wohnen (Zurich: Orell Füssli, 1929); Richard
Döcker, Terrassen Typ (Stuttgart: Julius Hoffmann, 1929); Sigfried Giedion,
Space, Time and Architecture: The Growth of a New Tradition (Cambridge,
Mass.: Harvard University Press, 1941); Stanislaus von Moos, Le Corbusier:
Elements of a Synthesis (Rotterdam: 010 Publishers, 2009); Paul Overy,
Light, Air and Openness: Modern Architecture between the Wars (London:
Thames and Hudson, 2007); Beatriz Colomina, X-Ray Architecture (Zurich:
Lars Müller, 2019).
14. Colomina, X-Ray Architecture; Margaret Campbell, “What Tuberculosis
Did for Modernism: The Influence of a Curative Environment on
Modernist Design and Architecture,” Medical History 49, no. 4 (2005), 463–
88; Annmarie Adams, Kevin Schwartzman, and David Theodore, “Collapse
and Expand: Architecture and Tuberculosis Therapy in Montreal, 1909,
1933, 1954,” Technology and Culture 49, no. 4 (2008), 908–42.
15. Daniel Weiss, “Pfleghard & Haefeli,” gta Archives, ETH Zurich,
May 2011, https://www.archiv.gta.arch.ethz.ch/nachlaesse-vorlaesse/
pfleghard-haefeli (accessed 7 Feb. 2023).
16. Weiss.
17. From 1901 to 1903 the architects worked on the conversion of the for-
mer hotel Schweizerhof into a sanatorium and designed an extension to the
so-called Deutsche Heilstätte für Lungenkranke. See Hanspeter Rebsamen
and Werner Stutz, “Davos,” in INSA, Inventar der neueren Schweizer
Architektur, 1850–1920: Städte, vol. 3, ed. Gesellschaft für Schweizerische
Kunstgeschichte (Zurich: Orell Füssli, 1982), 355. While the Schatzalp has
since been transformed into a hotel, the Queen Alexandra Sanatorium is cur-
rently vacant.
18. In fact, the Schatzalp featured an innovative flat roof with an internal
drainage system, as well as a hydraulic elevator and other modern build-
ing systems. Beatriz Colomina describes the Schatzalp as “brutally mod-
ern in its horizontality and abstraction.” Colomina, X-Ray Architecture, 89.
In 1929, Sigfried Giedion described the Queen Alexandra Sanatorium as
having been constructed of iron and concrete in the Hennebique system.
331
I N H A B I T I N G T H E AT M O S P H E R E   
The architects chose ferroconcrete because it was easy to carry up the
slopes. Sigfried Giedion, “Bauen in der Schweiz 1929,” Das neue Frankfurt:
Internationale Monatsschrift für die Probleme kultureller Neugestaltung 3, no. 6
(1929), 105–12.
19. Walter Kern, Davos: Die Sonnenstadt im Hochgebirge (Zurich: Orell
Füssli, 1932), plates 67 and 68, my translation. Unless otherwise noted, all
translations are my own.
20. Christof Kübler, “Davos, die Sonnenstadt im Hochgebirge wider
den ‘hermetischen Zauber,’ ” Bündner Monatsblatt: Zeitschrift für Bündner
Geschichte, Landeskunde und Baukultur, no. 4 (1989), 237–61. Harbingers
of change were already present; the Schatzalp, for instance, had flat roofs
and lacked the remarkable cupola described by Thomas Mann in his 1924
novel Der Zauberberg (The Magic Mountain).
21. Dave Lüthi, “The Influence of Good Air on Architecture: A ‘Formal
Cure’? The Appearance of the Alpine Sanatorium in Switzerland, 1880–
1914,” Revue de Géographie Alpine 93, no. 1 (2005), 53–60.
22. Jeanne Kisacky, Rise of the Modern Hospital: An Architectural History of
Health and Healing, 1870–1940 (Pittsburgh: University of Pittsburgh Press,
2017), 332.
23. William Richard Huggard, A Handbook of Climatic Treatment Including
Balneology (London: Macmillan, 1906), 266–87.
24. Spengler settled in Davos in 1853 and detected an absence of TB
among the citizens. See Peter Warren, “The Evolution of the Sanatorium:
The First Half-Century, 1854–1904,” Canadian Bulletin of Medical History
23, no. 2 (2006), 457–76.
25. For a good discussion of the evolution of Swiss sanatoriums around
that time, see Jean-Bernard Cremnitzer, Architecture et santé: Le temps du
sanatorium en France et en Europe (Paris: Éditions A. et J. Picard, 2005), 39.
26. Turban and Gros submitted two schemes to meet different topo-
graphical conditions. See Miller Quintus, Das Sanatorium: Entstehung
eines Prototyps der modernen Architektur (Lausanne: Ecole Polytechnique
Féderale de Lausanne Department d’Architecture, 1992), 14.
27. Karl Turban, “Normalien für die Erstellung von Heilstätten
für Lungenkranke in der Schweiz: Von K. Turban (1893),” in
Tuberkulose-Arbeiten 1890–1909: Aus Dr. Turbans Sanatorium, Davos (Davos:
Buchdruckerei Davos, 1909), 234–43.
28. Turban, 238.
29. Turban, 240.
30. Turban, 237–38.
31. Campbell alludes to this connection in “What Tuberculosis Did for
Modernism,” 478. See also Margaret Campbell, “Strange Bedfellows:
Modernism and Tuberculosis,” in Imperfect Health: The Medicalization of
Architecture, ed. Giovanna Borasi and Mirko Zardini (Montreal: Canadian
Centre for Architecture, 2012), 133–51.
32. Turban, “Normalien,” 240.
33. This transition took place around 1900. See Kübler, “Davos, die
Sonnenstadt im Hochgebirge,” 246.
34. Lynn Margulis, Symbiotic Planet: A New Look at Evolution (New York:
Basic Books, 1998), 2.
35. The imitation of hotel qualities was common in North American sana-
toriums. See Julie Willis, Philip Goad, and Cameron Logan, Architecture and
the Modern Hospital: Nosokomeion to Hygeia (London: Routledge, 2019), 27.
36. Annmarie Adams, Medicine by Design: The Architect and the Modern
Hospital, 1893–1943 (Minneapolis: University of Minnesota Press, 2008), 39.
37. “The Queen Alexandra Sanatorium, Davos: Annual Report, 1909–
1910,” 1910, 25, Wellcome Collection, London.
38. The majority of patients initially admitted were between twenty-one
and thirty years old and were more severely ill than expected. “Queen
Alexandra Sanatorium, Davos: Annual Report, 1909–1910,” 40.
39. See Rebsamen and Stutz, “Davos,” 332.
40. M. B. Noble, “Institutions for the Tuberculosis: The Queen Alexandra
Sanatorium Davos Platz, Switzerland,” British Journal of Tuberculosis 5,
332 JSAH | 82.3 | SEPTEMBER 2023
no. 1 (Jan. 1911), 46–48; H. H. C., “Life in a Sanatorium,” letter to the
editor, The Spectator, 23 Aug. 1913, 18.
41. Noble, “Institutions for the Tuberculosis,” 48.
42. For discussion of concerns about air circulation and health and their
influence on hospital designs in eighteenth-century France, see Anthony
Vidler, The Writing of the Walls (New York: Princeton Architectural Press,
1987), 57–72.
43. Kisacky, Rise of the Modern Hospital, 43.
44. Kisacky, 43.
45. Bruno Franco Moretti, Ospedale, 3rd ed. (Milan: Editore Ulrico Hoepli
Milano, 1951), 36.
46. The Queen Alexandra Sanatorium used radiators with low-pressure
steam provided by boilers. The Queen Alexandra Sanatorium, Davos: A Short
Account of the Building Reprinted from the Annual Report of 1909–10 (London:
Downloaded from http://online.ucpress.edu/jsah/article-pdf/82/3/314/790810/jsah_82_3_314.pdf by University of Auckland user on 25 March 2024
Waterlow and Sons, 1910), 31.
47. Unlike nineteenth-century structures famous for their ventilation sys-
tems, such as the Palace of Westminster, with its complex interplay of archi-
tectural elements (horizontal and vertical shafts, and towers conducive to
ventilation) as well as mechanical fans and central heating, the sanatorium
was not geared toward ventilation. See Henrik Schoenefeldt, Rebuilding
the Houses of Parliament: David Boswell Reid and Disruptive Environmentalism
(London: Routledge, 2021).
48. Horn, “Air as Medium,” 17.
49. See, for instance, O. R. McCarthy, “The Key to the Sanatoria,” Journal
of the Royal Society of Medicine 94, no. 8 (2001), 413–17.
50. Purity mattered “especially in regard to microbes, to which the bright
sunlight and free access of air are antagonistic.” Hermann Werner, “Climate
and Sea Voyages in the Treatment of Tuberculosis,” Boston Medical and
Surgical Journal, 8 June 1899, 553. Ultimately theology underlies ideas of
purity, but that subject goes beyond the focus of this article.
51. Werner, 553.
52. According to the rules included in the sanatorium’s 1909–10 annual
report, patients had to return to their rooms by 9:30 p.m., and all lights
were switched off half an hour later. “Queen Alexandra Sanatorium, Davos:
Annual Report, 1909–1910,” 32.
53. Adams et al., “Collapse and Expand,” 911.
54. Werner, “Climate and Sea Voyages,” 553.
55. Werner, 553.
56. Hugo Bach, Das Klima von Davos nach dem Beobachtungsmaterial der eid-
genössischen meteorologischen Station in Davos (Zurich: Druck von Zürcher &
Furrer, 1907), 87.
57. Bach, 80.
58. Bach, 55.
59. G. Riedel, Singularitäten des Davoser Klimas (Berlin: Julius Springer,
1936), 4.
60. H. H. C., “Life in a Sanatorium,” 18.
61. Another meticulous report on local wind conditions and their for-
mation can be found in K. Mühle, “The Davos Climate,” in Davos as
Health-Resort: A Handbook (Davos: Davos Printing, 1907), 136–37.
62. See, for example, David Fraser Harris, “The Pioneer in the Hygiene of
Ventilation,” The Lancet 176, no. 4542 (17 Sept. 1910), 906–8.
63. Kübler, “Davos, die Sonnenstadt im Hochgebirge,” 243. See also F.
Jessen, “The Fear of Infection at Davos,” in Davos as Health-Resort, 287.
64. Mühle, “Davos Climate,” 107, 110, 123.
65. H. J. A. van Voornveld, “The Physiology of the Davos Climate,” in
Davos as Health-Resort, 160–61.
66. Van Voornveld, 160.
67. Warren, “Evolution of the Sanatorium,” 464.
68. Werner, “Climate and Sea Voyages,” 553. As noted in an 1886 discus-
sion in The Lancet: “The first effect of rarefied air upon the lungs is to pro-
voke deep and full respirations, thus promoting pulmonary expansion and
affording a favourable condition for the absorption of morbid deposits.”
The Lancet 128, no. 3284 (7 Aug. 1886), 258.
69. Werner, “Climate and Sea Voyages,” 557.
70. Vitruvius mentioned a so-called aeolipile, a kind of proto–steam engine
that already existed in his time. Vitruvius, The Ten Books on Architecture,
trans. Morris Hicky Morgan (Cambridge, Mass.: Harvard University
Press, 1914), 25.
71. Vitruvius, 25, 26.
72. Leon Battista Alberti, On the Art of Building in Ten Books, trans. Joseph
Rykwert, Neil Leach, and Robert Tavernor (Cambridge, Mass.: MIT Press,
1988), 9.
73. Alberti, 9.
74. Vidler, Writing of the Walls, 64.
75. Queen Alexandra Sanatorium, Davos: A Short Account, 25.
76. “Submissions-Anzeiger,” Schweizerische Bauzeitung 49–50, no. 8 (23
Feb. 1907), 106.
77. “The Alexandra Sanatorium at Davos,” The Field, the Country
Gentleman’s Newspaper, 17 Aug. 1907, 321.
78. A letter to The Lancet in 1906 promoted a fund-raiser shortly before
Christmas. William R. Huggard, “The Queen Alexandra Sanatorium,
Davos Platz,” The Lancet 168, no. 4347 (22 Dec. 1906), 1749.
79. In 1910, £22,000 would have been roughly equivalent to £1.72 mil-
lion in 2017. Calculation made with the online currency converter of
the British National Archives, https://www.nationalarchives.gov.uk/
currency-converter (accessed 23 Feb. 2023).
80. “Queen Alexandra Sanatorium,” Manchester Guardian, 25 Apr. 1906, 12.
81. “Opening of Queen Alexandra Sanatorium, Davos,” British Medical
Journal 2, no. 2545 (9 Oct. 1909), 1091.
82. This was equivalent to approximately £150 in 2017. Calculation made
with the online currency converter of the British National Archives, https:/
/www.nationalarchives.gov.uk/currency-converter (accessed 23 Feb. 2023).
83. See Noble, “Institutions for the Tuberculosis,” 47; “Opening of Queen
Alexandra Sanatorium, Davos,” 1091.
84. “Alpine Treatment of Phthisis: Queen Alexandra Sanatorium Fund,”
The Lancet 200, no. 5172 (14 Oct. 1922), 830.
85. The sanatorium was sold for 800,000 francs. See “The Queen
Alexandra Sanatorium Fund: Annual Report, 1922–1923,” 1923, Wellcome
Collection, London. For the institution’s late history, see Mathieu
Sunjoy, “Der Kampf gegen die Tuberkulose im Wandel der Zeit: Die
Thurgauisch-Schaffhausische Heilstätte,” Davoser Revue 88, no. 3 (2013),
42–47.
86. “Alpine Treatment of Phthisis,” 830.
87. Dormandy, White Death, 148. Owing to the wartime economic situa-
tion in Davos, the hotel business increasingly accommodated tubercular
patients. But as soon as the town began to recover financially, boards like
that administrating the Queen Alexandra Sanatorium Fund had to adjust
their services to changing conditions. “Queen Alexandra Sanatorium
Fund,” The Lancet 208, no. 5379 (2 Oct. 1926), 727.
88. A review from 1933 considers the sanatorium as a building type sim-
ilar to the hotel and the hospital. The author argues that while previous
sanatorium designs sought to imitate the luxuriousness of hotels, often
at the expense of medical requirements, this rapport went into reverse
with a new generation of sanatoriums informed by strict hygienic
requirements, setting a precedent for future hotels. W. B., “Sanatorium
Bella Lui in Montana (Wallis),” Das Werk: Architektur und Kunst 20,
no. 3 (1933), 74–88.
89. This information relates to the building after its renaming in 1921.
Staatsarchiv Thurgau, https://staatsarchiv.tg.ch (accessed 20 July 2022).
A register of patients from 1909–58 is held at Wellcome Collection in
London but remains restricted from public view until 2059 because of the
sensitive material it contains.
90. Queen Alexandra Sanatorium, Davos: A Short Account, 21. See also “The
Queen Alexandra Sanatorium, Davos Platz, Switzerland,” Hospital 47, no.
1231 (1910), 668–69.
91. Queen Alexandra Sanatorium, Davos: A Short Account, 22.
92. Turban emphasized the crucial importance of fir forest, especially at
the montane level, a biogeographic zone below the tree line. At the alpine
level, it was at least “desirable.” Turban, “Normalien,” 237.
93. On the importance of pine scent at the intersection of medical and
environmental histories around the beginning of the twentieth century,
see Clare Hickman, “Pine Fresh: The Cultural and Medical Context of
Pine Scent in Relation to Health—from the Forest to the Home,” Medical
Humanities 48, no. 1 (2021), 104–13.
94. Werner, “Climate and Sea Voyages,” 554.
95. That pine trees were more than accessories to the atmosphere is fur-
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ther corroborated by the fact that in 1899, Dr. Simon von Unterberger,
surgeon and director of the military hospital in Zarskoje-Selo, advocated
for what he called the Haus Sanatorium, which integrated “domesticated
pine trees” as part of a finely calibrated interior environment resembling
an alpine resort. See Eva Eylers, “Planning the Nation: The Sanatorium
Movement in Germany,” Journal of Architecture 19, no. 5 (2014), 667–92.
96. Queen Alexandra Sanatorium, Davos: A Short Account, 26. For a terres-
trial reading of architecture and the ways in which it interacts with the thin
crust of the planet, see Kiel Moe, Unless: The Seagram Building Construction
Ecology (New York: Actar, 2020).
97. Adams, Medicine by Design, 120.
98. Eylers, “Planning the Nation.”
99. In Turban’s prototype, the two wings accommodated the separation
of patients based on gender. Most sanatoriums in the Alps, however, com-
pletely ignored Turban’s suggestion. See Cremnitzer, Architecture et santé,
40.
100. Turban, “Normalien,” 237.
101. The general distinction around the time between late baroque and
romantic classicism especially with regard to the articulation of walls was
made on the basis of vertical and horizontal dominance. See, for instance,
Sigfried Giedion, Spätbarocker und romantischer Klassizismus (Munich:
F. Bruckmann, 1922), 32–44.
102. For the key passage describing Hans Castorp’s first approach toward
the Schatzalp Sanatorium, see Thomas Mann, Der Zauberberg, 2nd ed.
(Frankfurt: S. Fischer, 2003), 17. Dave Lüthi evokes the image of a hive in
a paragraph about the Queen Alexandra Sanatorium in “The Influence of
Good Air on Architecture,” 56.
103. “Queen Alexandra Sanatorium, Davos Platz, Switzerland,” 668.
104. Willis et al., Architecture and the Modern Hospital, 35.
105. “Queen Alexandra Sanatorium, Davos Platz, Switzerland,” 668.
106. “Queen Alexandra Sanatorium,” 12.
107. For a recent overview of Maillart’s work, see Cyrille Simonnet, Robert
Maillart et la pensée constructive (Gollion, Switzerland: Infolio, 2013). On
the Hennebique technique, see Gilles Ragot, “The Hennebique Archives:
Toward a New Corpus for Contemporary Architectural History,” American
Archivist 59, no. 2 (Spring 1996), 214–20.
108. For discussion of Maillart’s role in this scheme, see D. Korwan, “On
Horizontality in Architecture: Robert Maillart, the Queen Alexandra
Sanatorium and the Evolution of the Slab,” in History of Construction
Cultures, vol. 1, ed. João Mascarenhas-Mateus and Ana Paula Pires (Boca
Raton, Fla.: CRC Press, 2021), 706–11.
109. H. H. C., “Life in a Sanatorium.”
110. “Queen Alexandra Sanatorium, Davos Platz, Switzerland,” 669.
111. Giedion, Befreites Wohnen, caption 64.
112. According to information from the Dokumentationsbibliothek
Davos, the extension was not completed until 1913, although archival plans
date from 1911.
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I N H A B I T I N G T H E AT M O S P H E R E   
113. For a discussion of Gaberel’s influence on modern architecture in
Davos, see Kübler, “Davos, die Sonnenstadt im Hochgebirge.”
114. “Ausbau der Thurgauisch-Schaffhausischen Heilstätte in Davos,”
Schweizerische Bauzeitung 76, no. 30 (26 July 1958), 446–48.
115. Sunjoy, “Der Kampf gegen die Tuberkulose,” 42–47.
116. On the intellectual relationship between Wölfflin and Giedion, see
Tim Altenhof, “The Aesthetics of Blurred Boundaries: From Wölfflin’s
Baroque to Giedion’s Interpenetration,” 21: Inquiries into Art, History, and
the Visual 3, no. 4 (Dec. 2022), 817–61.
117. Sigfried Giedion, Bauen in Frankreich, Bauen in Eisen, Bauen in
Eisenbeton (Leipzig: Verlag Klinkhardt & Biermann, 1928). For an English
translation, see Sigfried Giedion, Building in France, Building in Iron,
Building in Ferroconcrete, trans. J. Duncan Berry (Los Angeles: Getty Center
for the History of Art and the Humanities, 1995).
118. Döcker, Terrassen Typ, 70.
119. There are, of course, medical motivations for architecture, some
of which directly implicate the air. In a discussion promoting his own
hospital, Döcker referred to one of the modern tropes of his time, that
334 JSAH | 82.3 | SEPTEMBER 2023
bodies—human and architectural—should be immersed in air: “The more
area of contact a building also has with the outside air, the quicker and
more complete can its ventilation take place. It is known that an influx
of natural air refreshes, invigorates, and makes the body more resistant
against the disease. Many years of experience have shown that the type of
air plays a subordinate role in chemical terms compared to the factor of the
body being washed with moving air.” Döcker, 16.
120. Döcker, 70.
121. Döcker, 70.
122. Giedion, “Bauen in der Schweiz 1929,” 106.
123. Sigfried Giedion, Befreites Wohnen / Liberated Dwelling, ed. Reto
Geiser, trans. Reto Geiser and Rachel Julia Engler (Zurich: Lars Müller,
2018), 87. For the German original, see Giedion, Befreites Wohnen, 65.
124. This is one of the main themes in Giedion’s Bauen in Frankreich, sub-
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sequently discussed, for instance, in Detlef Mertins, “Walter Benjamin’s
‘Tectonic’ Unconscious,” ANY: Architecture New York, no. 14 (1996), 22–35.
125. Colomina, X-Ray Architecture, 71.