Located in the Smyth County town of Marion, the Southwestern State Hospital Tubercular Building is on the campus of what is now known as the Southwestern Virginia Mental Health Institute. The hospital opened in 1887 as one of Virginia’s four historic-period mental health care hospitals. The classically inspired brick and stone Tubercular Building was designed in the mid-1930s by the Roanoke-based architectural firm Eubank and Caldwell to harmonize with adjacent hospital buildings. Built as two wings connected by a kitchen, the building exterior features quarry-faced limestone foundations, round-arched and square-headed windows and entries, and parapeted gables with lunettes. Each wing centers on a sun porch where tuberculosis patients recuperated, and the east wing also has glass-fronted bedrooms opening onto the sun porch. The interior features include an axial corridor which links together the three parts of the building: the east wing, placed in service in 1937; the west wing, placed in service in 1939; and a connecting kitchen, placed in service in 1937. The Tubercular Building’s site is at some remove from the hospital core, reflecting its use for the treatment of an infectious disease and the need to isolate its occupants from the general hospital population. The facility historically served as an important component of Southwestern State Hospital, the principal health care facility serving Southwest Virginia’s white population (the first African American patient was admitted in 1967). The period of significance extends from 1937, the year a portion of the building was placed in service, until 1969, the year tuberculosis-care use of the building was discontinued. At the time of its listing in the registers, the Southwestern State Hospital Tubercular Building was being considered for a new use as the Appalachian Center for Hope — a residential drug treatment center.