The first settlers came to Saranac Lake beginning in 1819 to make a living from the forests of the Adirondacks. In the 1870s, wealthy city dwellers discovered the hunting, fishing, boating, and hiking available in these beautiful mountains, and Saranac Lake became the hub for local tourism. By 1900, Dr. Edward Livingston Trudeau had established the fresh-air cure for tuberculosis, and Saranac Lake became America's "Pioneer Health Resort." A culture of excellent medical facilities, an active arts scene, and a great library and educational system combined with traditional Adirondack values to make Saranac Lake "the Little City of the Adirondacks," a special place to everyone who got to know it. Later in the 20th century, the focus shifted from health to scientific research, education, state government offices, and the more middle class tourist industry of the post-World War II era. This designated All-America City has retained that special character.