Dorothea Dix 1802 - 1887

Dorothea Lynde Dix 1802 – 1887 was an American activist on behalf of the indigent insane who, through a vigorous program of lobbying state legislatures and the United States Congress, created the first generation of American mental asylums. During the Civil War, she served as Superintendent of Army Nurses.

Champion of humane treatment of the mentally ill, founded the Pennsylvania Hospital for the Insane at Harrisburg. About 1820, established a school for girls in Boston and served as its head for the next fifteen years. After visiting prisons in Massachusetts in 1841 and finding the insane jailed with common criminals, worked to improve conditions in almshouses and prisons.

… in her mid-thirties she suffered a debilitating breakdown. In hopes of a cure, in 1836 she traveled to England, where she had the good fortune to meet the Rathbone family, who invited her to spend a year as their guest at Greenbank, their ancestral mansion in Liverpool.

The Rathbones were Quakers and prominent social reformers, and at Greenbank, Dix met men and women who believed that government should play a direct, active role in social welfare. She was also exposed to the British lunacy reform movement, whose methods involved detailed investigations of madhouses and asylums, the results of which were published in reports to the House of Commons…

After she returned to America, in 1840-41, Dix conducted a statewide investigation of how her home state of Massachusetts cared for the insane poor. In most cases, towns contracted with local individuals to care for people with mental disorders who could not care for themselves, and who lacked family and friends to provide for them.

Unregulated and underfunded, this system produced widespread abuse. After her survey, Dix published the results in a fiery report, a Memorial, to the state legislature.

"I proceed, Gentlemen, briefly to call your attention to the present state of Insane Persons confined within this Commonwealth, in cages, stalls, pens! Chained, naked, beaten with rods, and lashed into obedience."

The outcome of her lobbying was a bill to expand the state’s mental hospital in Worcester.

Henceforth, Dix traveled from New Hampshire to Louisiana, documenting the condition of pauper lunatics, publishing memorials to state legislatures, and devoting enormous personal energy to working with committees to draft the enabling legislation and appropriations bills needed to build asylums.

In 1848, Dorothea Dix visited North Carolina and called for reform in the care of mentally ill patients. In 1849, when the North Carolina State Medical Society was formed, the construction of an institution in the capital, Raleigh, for the care of mentally ill patients was authorized. The hospital, named in honor of Dorothea Dix, opened in 1856.

She was instrumental in the founding of the first public mental hospital in Pennsylvania, the Harrisburg State Hospital, and later in establishing its library and reading room in 1853.

The culmination of her work was legislation to set aside 12,225,000 acres (49,473 km²) of Federal land (10,000,000 acres for the benefit of the insane and the remainder for the “blind, deaf, and dumb”), with proceeds from its sale distributed to the states to build and maintain asylums.

Dix’s land bill passed both houses of Congress, but in 1854 President Franklin Pierce vetoed it, arguing that the federal government should not commit itself to social welfare, which was properly the resonsibility of the states.

Stung by the defeat of her land bill, in 1854 and 1855 Dix traveled to England and Europe, where she reconnected with the Rathbones and conducted investigations of Scotland’s madhouses that precipitated the Scottish Lunacy Commission…

During the Civil War, Dix was appointed Superintendent of Union Army Nurses. Unfortunately, the qualities that made her a successful crusader—independence, single-minded zeal—did not lend themselves to managing a large organization of female nurses. At odds with Army doctors, she was gradually relieved of real responsibility and would consider this chapter in her career a failure. However, her even-handed caring for Union and Confederate wounded alike, which may not have endeared her to Radical Republicans, assured her memory in the South.

Her nurses provided what was often the only care available in the field to Confederate wounded.

“The surgeon in charge of our camp … looked after all their wounds, which were often in a most shocking state, particularly among the rebels. Every evening and morning they were dressed.” - Georgeanna Woolsey, a Dix nurse. “Many of these were Rebels. I could not pass them by neglected. Though enemies, they were nevertheless helpless, suffering human beings.” - Julia Susan Wheelock, a Dix nurse.

Over 5000 Confederate wounded were left behind, when Robert E. Lee retreated from Gettysburg, who were then treated by Dix’s nurses, like Cornelia Hancock who wrote about what she saw.

“There are no words in the English language to express the suffering I witnessed today …”

In 1881, Dix moved into the New Jersey State Hospital, Morris Plains, where the state legislature designated a suite for her private use as long as she lived.

An invalid, yet still managing to correspond with people from England to Japan, she died on July 17, 1887. Dix was buried in Mt. Auburn Cemetery, Cambridge, Massachusetts.

Dix knew William Henry Seward, and she organised her war effort alongside Clara Barton. She corresponded with Jessie Benton Fremont, alongside Horace Greeley, Abraham Lincon, John Greenleaf Whittier and Elizabeth Palmer Peabody.

Dix was obstructed in her campaign for Insane Asylums by orthodox doctors. Most asylums at this time were run by water cure and homeopathic specialists, a situation that had come about because people were horrified by the ineffective, dangerous medical practices of orthodox physicians and had set about bringing more humane methods to their treatment.

This in turn brought about more careful treatment by the orthodox profession and a fight broke out regarding the control of asylums. Dix called for non medical public asylums, and when Isaac Ray came out to support her suggestions, Amariah Brigham made sure she was defeated.

However in 1853, Dix managed to convince Moses Sheppard to found the Sheppard and Enoch Pratt Hospital, known to many simply as Sheppard Pratt, is a psychiatric hospital located in Towson, a northern suburb of Baltimore, Maryland.

Sheppard stipulated that the following conditions were to be imposed for the Asylum:

“Courteous treatment and comfort of all patients; that no patient was to be confined below ground; all were to have privacy, sunlight and fresh air; the asylum’s purpose was to be curative, combining science and experience for the best possible results; and that only income, not principal would be used to build and operate the asylum.”

Dix’s correspondence found its way into John Greenleaf Whittier’s archives:

John Greenleaf Whittier, Papers, 1829, 1892. Collection includes… Of particular note are his correspondence with Charles A. Dana, Ralph W. Emerson, Oliver W. Holmes, Lydia Maria Child, Dorothea Dix, Henry W. Longfellow, Henry B. Stanton (husband of Elizabeth Cady Stanton), and Frances E. Willard, regarding poems and abolition.