• Born: 4 April 1802
• Birthplace: Hampden, Maine
• Best Known As: The 19th-century woman who improved treatment of the insane

Dorothea Dix is known for her tireless work in the 1800s to improve the treatment of the mentally ill. Dix grew up in Maine and Massachusetts and was only 19 when she opened a school for girls in Boston in 1821. An 1841 visit to a local jail, where she saw insane inmates chained naked to stone walls, spurred her to begin a crusade to improve the housing, clothing and treatment of mentally ill inmates and patients across Massachusetts. At the time, there were no such things as state hospitals or mental health programs; Dix visited prisons, talked with doctors, wrote reports, and pushed successfully for new laws protecting the insane. After hard-won successes in Massachusetts, she travelled widely to repeat her approach in other states. Dix didn't stop there: she toured Europe and Asia in the 1850s, influencing Italy and other countries to build new hospitals and improve their treatment of the insane. Among her triumphs was the opening of the first state hospital for the mentally ill, the New Jersey State Lunatic Asylum, in Trenton in 1848. She spent her last years in a special apartment there, where she died in 1887. Her 1845 publication Remarks on Prisons and Prison Discipline in the United States is considered a landmark document in the history of public health.

Her full name was Dorothea Lynde Dix... Dix worked closely with Dr. Thomas Kirkbride, a Philadelphia physician whose philosophy for building and running hospitals to treat the insane was known as "“The Kirkbride Plan." The New Jersey State Lunatic Asylum was the first Kirkbride Plan hospital to be built; it is now known as the Trenton Psychiatric Hospital... Dix never married and had no children... She served as Superintendent of Nurses for the Union Army during the Civil War.

Dorothea Dix was born in 1802 in a rural section of Maine. After moving to Boston at the age of fourteen to live with her wealthy but austere grandmother, Dix became a schoolteacher and writer. In 1835, however, she suffered a physical and psychological collapse. She traveled to England, where under the care of philanthropists William and Elizabeth Rathbone, Dix regained her health. In England, she also came into contact with new ideas about social reform and government responsibility.

After returning to the United States, she initiated a public health movement to reform the treatment of the indigent mentally ill. At the time, paupers who were mentally ill were incarcerated alongside convicted criminals and often housed in unheated, unfurnished, and squalid quarters. After conducting an extensive investigation throughout Massachusetts, Dix wrote her most influential tract, Memorial to the Legislature of Massachusetts (1843). Dix's thirty-two page report humanized the plight of the mentally ill residing in state institutions, and Massachusetts responded with legislation.

As an antisuffragist and antiabolitionist, Dix appealed for her causes to male politicians as well as southerners, and she prompted cities and states throughout the nation to create better facilities for the mentally ill. Motivated by her success, Dix proposed placing a large land grant in the custodial care of the federal government to provide perpetual funding for the care of the indigent mentally ill of America. Her plan, however, fell to a presidential veto in 1851. Dix took on a new challenge during the Civil War, accepting the position of Superintendent of Women Nurses, but her personality was ill suited for this administerial position. Towards the end of her life, Dix chose to reside in Trenton, New Jersey, at the first complete hospital built through her efforts, where she died in 1887.

(SEE ALSO: Homelessness; Mental Health)

Bibliography

Brown, Thomas J. (1998). Dorothea Dix: New England Reformer. Cambridge, MA: Harvard University Press.

Gollaher, David. L. (1995). Voice for the Mad: The Life of Dorothea Dix. New York: The Free Press.

— JENNIFER KOSLOW

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(1802–1887), humanitarian, Union Superintendent of Women Nurses in the Civil War

Born in Hampden, Maine, Dix spent her life as a social activist, dedicated to improving the care and treatment of the insane. Beginning in 1841, she spearheaded the movement to establish asylums—as a social responsibility and financed by public funds—to replace the jails and alms houses in which the mentally impaired were confined. She was responsible, through her remarkable ability to influence people and legislatures, for the founding or enlarging of more than thirty mental hospitals in the United States and abroad.

With the outbreak of the Civil War she offered her services, gratis, to the secretary of war in April 1861. She was given the responsibility “to select and assign women nurses to general and permanent military hospitals.” Two months later, she was named Superintendent of Women Nurses.

Dix rented a house in Washington at her own expense, advertised nationally for volunteers, and weeded out those she thought physically or morally unsuitable. She accepted only nurses over thirty years of age and refused to allow Roman Catholic nuns or other religious orders to serve. Independent, autocratic, eccentric, working outside of established lines of authority and assuming powers beyond her responsibility, she antagonized the medical establishment. Military doctors, supported by the U.S. Sanitary Commission, resented her domineering intrusions. Although her authority was reaffirmed by Surgeon General William A. Hammond in July 1862, in October of that year Secretary of War Edwin M. Stanton issued an order that gave the appointment, assignment, and control of nurses to hospital surgeons and medical directors. Dix was left without authority. She continued to work in the hospitals in the Washington area, however, and did not relinquish her title as superintendent until September 1866.

Dix returned to her interest in the insane. In 1881, ill, she accepted an apartment offered to her at the New Jersey State Hospital in Trenton, where she lived until her death.

[See also Sanitary Commission, U.S.]

Bibliography

• Francis Tiffany, Life of Dorothea Lynde Dix, 1890.
• David Gollaher, Voice for the Mad: The Life of Dorothea Dix, 1995

Dix, Dorothea Lynde (1802-87) superintendent of U.S. Army nurses during the Civil War, born in Hampden, Maine. Dix was responsible for training young women for medical duty, but was known primarily for her advocacy, both before and after the war, of humane treatment of prisoners and the mentally ill, for which she traveled throughout the United States, Canada, Great Britain, Europe, and Japan.

See the Introduction, Abbreviations and Pronunciation for further details.

Dorothea Lynde Dix (1802-1887) was an American reformer whose pioneer efforts to improve treatment of mental patients stimulated broad reforms in hospitals, jails, and asylums in the United States and abroad.

On April 4, 1802, Dorothea Dix, the daughter of Joseph and Mary Dix, was born in Hampden, Maine. When Joseph failed at farming, he became an itinerant preacher and wrote, printed, and sold tracts, which his wife and daughter laboriously sewed together. Dorothea remembered her childhood in that bleak, poverty-stricken household as a time of loneliness and despair. At the age of 12 she ran away from home and made her way to Boston, where she persuaded her grandmother to take her in. Two years later Dorothea went to Worcester to live with a great aunt and opened a school, which she maintained for 3 years. She returned to Boston in 1819 to attend public school and to study with private tutors.

Teaching Career

In 1821 Dix opened an academy for wealthy young ladies in her grandmother's house. She also conducted a free school for poor children. As a teacher, she was a strict disciplinarian, a rigorous moralist, and a passionate explorer of many fields of knowledge, including the natural sciences. Her contagious joy in teaching made her schools highly successful. During convalescent periods from attacks of chronic lung disease, she wrote children's books.

In 1835 ill health forced Dix to abandon teaching; she went abroad for 2 years. When she returned to America, she was in better health but irresolute about her future. Four years of indecision ended when she volunteered to teach a Sunday school class for young women in the East Cambridge, Mass., jail. She discovered that the quarters for the insane had no heat, even in the coldest weather. When the jailer explained that insane people did not feel the cold, and ignored her pleas for heat, she boldly took the case to court and won.

Mental Institution Reforms

For 2 years Dix traveled throughout Massachusetts, visiting jails, workhouses, almshouses, and hospitals, taking notes on the deplorable conditions she observed. In 1845 Dr. Samuel Gridley Howe presented her "Memorial to the Massachusetts Legislature." The address began, "I proceed, gentlemen, briefly to call your attention to the present state of insane persons confined within the Commonwealth, in cages, closets, cellars, pens; chained, naked, beaten with rods, and lashed into obedience." This dramatic presentation caused a public controversy which won the support of Charles Sumner and other public figures in the resulting newspaper debate. Despite bitter opposition, the reform bill passed by a large majority.

Dix went on to other northeastern states and then throughout the country, state by state, visiting jails, almshouses, and hospitals, studying their needs, and eliciting help from philanthropists, charitable organizations, and state legislatures for building and renovating facilities and for improving treatment. During these years she founded new hospitals or additions in Massachusetts, Rhode Island, New York, New Jersey, Pennsylvania, and Canada and received approval to found state hospitals by the legislatures of Indiana, Illinois, Kentucky, Tennessee, Missouri, Maryland, Louisiana, Alabama, South Carolina, and North Carolina.

European Crusade

In 1848 Dix took her fight to Congress in an attempt to win appropriation of 12,500,000 acres of land, which would provide tax revenue for asylums. The bill finally passed both houses only to be vetoed by President Franklin Pierce. The discouraged reformer then traveled through England, Ireland, and Scotland, inspecting mental hospitals. English and Irish institutions were not bad, but Scottish facilities were appalling, and Miss Dix set about to improve them, taking her case finally to the lord advocate of Scotland.

Perhaps Dix's most significant European accomplishment was in Rome, where she discovered that "6,000 priests, 300 monks, 3,000 nuns, and a spiritual sovereignty, joined with the temporal powers, had not assured for the miserable insane a decent, much less an intelligent care." She negotiated an audience with Pius IX, who was moved by her appeal and personally verified her reports. He ordered construction of a new hospital and a thorough revision of the rules for the care of mental patients. Before her return to the United States, Dix evaluated hospitals and prisons in Turkey, Greece, Italy, France, Austria, Russia, Scandinavia, Holland, Belgium, and Germany and recommended reforms.

Civil War Nurse

In 1861 Dix volunteered her services for wartime duty in the Civil War. Appointed "superintendent of women nurses," she set up emergency training programs, established temporary hospitals, distributed supplies, and processed and deployed nurses. Despite wartime hardships she never relaxed her standards of efficient service, proper procedure, and immaculate hospital conditions. Her inspections of army hospitals did not make her popular with authorities, and her stringent ideas of duty and discipline were not shared by the relatively untrained nurses and jealous officials, who resented her autocratic manner. Although she was often discouraged by petty political opposition and the ever present problems of inadequate facilities, supplies, and staff, she carried out her duties until the end of the war.

Dix resumed her reform efforts until age forced her to retire. Until her death in 1887 she made her home in the Trenton, N.J., hospital, which she had often referred to affectionately as her "first child."

Further Reading

The most commonly cited biographies of Dorothea Dix are early ones. Francis Tiffany, The Life of Dorothea Lynde Dix (1890), is a standard work which contains copious quotations from letters and reports. More recent is Helen E. Marshall, Dorothea Dix: Forgotten Samaritan (1937). Additional details are provided in Gladys Brooks's concise and popular Three Wise Virgins (1957). See also Albert Deutsch, The Mentally Ill in America: A History of Their Care and Treatment from Colonial Times (1937; 2d ed. 1949), and Norman Dain's brief but scholarly Concepts of Insanity in the United States, 1789-1865 (1964).

For more information on Dorothea Lynde Dix, visit Britannica.com.

(1802-1887), social reformer. Born into a family of modest means in rural Maine, Dix spent her early years with family members in Boston. She opened her own dame school there in 1821. During these years she published a primary reader in science, Conversations on Common Things (1824), and Hymns for Children (1825). Her pupils were the children of influential Bostonians, including William Ellery Channing, who became her sponsor as well as friend. She spent a winter with his family in the Virgin Islands in 1830-1831 in an effort to restore her failing health. In 1836 her condition had so deteriorated that she abandoned teaching and went to England for a prolonged visit. During her time abroad Dix traveled in British reform circles, which stimulated her interest in humanitarian causes.

She returned to Boston in 1837 and lived on the income from an inheritance. For a time she neither fulfilled her early promise as an educator nor sought other outlets for her abilities. But in 1841 she visited a Cambridge jail to teach a Sunday school class and was shocked to encounter mentally incompetent women--or "lunatics," as their jailer called them--confined with common criminals in unsanitary cells. Dix's pleas to the local court combined with a newspaper campaign against these conditions resulted in reforms. Channing and philanthropist Samuel Gridley Howe championed Dix's cause, as she undertook a survey of poorhouses and jail facilities throughout the state of Massachusetts. When Dix reported what she had found to the legislature, the government responded with a plan for separate facilities for the mentally ill. After her success in Massachusetts, she turned her attention to other states.

From the Mid-Atlantic states of Pennsylvania, New York, and Rhode Island to the Gulf states of Mississippi and Alabama, from the Upper South of Maryland and Kentucky to the interior of Tennessee and Ohio, Dix found everywhere shameful conditions and neglect of the mentally ill. Her campaign spurred legislatures into appropriating funds to establish and improve state hospitals. Overcoming her initial reluctance, Dix became an effective speaker. She campaigned tirelessly, demanding that criminals be separated according to the seriousness of their crimes and that prisoners be offered education. Her work led to the establishment of a school for the blind in Illinois in 1848. Eventually she abandoned these state-by-state crusades and lobbied for federal reforms.

The Civil War interrupted these activities, and in 1861 she was appointed superintendent of nurses for the Union army. Although there was some friction over her imperious style, Dix successfully trained a legion of young women to serve during wartime. When she retired after the war she shifted her interests to the defeated South.

Dix in no small way fostered a revolution in mental health care. Although she threw herself into many other campaigns (for orphanages, for example), she remains best remembered for the central role she played in forcing the government to reckon with the problem of widespread mental illness. During her lifetime, the number of state mental hospitals grew from a handful of custodial centers to over 120 thriving medical facilities where the insane received sympathetic professional treatment.

Author:

Catherine Clinton

1802–87, American social reformer, pioneer in the movement for humane treatment of the insane, b. Hampden, Maine. For many years she ran a school in Boston. In 1841 she visited a jail in East Cambridge, Mass., and was shocked at conditions there, especially the indiscriminate mixing of criminals and the insane. After inspecting other Massachusetts institutions, she wrote (1842) a famous memorandum to the state legislature. Her crusade resulted in the founding of state hospitals for the insane in many states, and her influence was felt in Canada and Europe. Dix also did notable work in penology. During the Civil War she was superintendent of women war nurses.

Bibliography

See H. E. Marshall, Dorothea Dix: Forgotten Samaritan (1937, repr. 1967); S. C. Beach, Daughters of the Puritans (1967); F. Tiffany, Life of Dorothea Lynde Dix (repr. 1971); D. C. Wilson, Stranger and Traveler: The Story of Dorothea Dix, American Reformer (1975); D. Gallaher, Voice for the Mad (1995).

Nineteenth-century reformer who protested the practice of confining the mentally ill in prisons and whose labors led to the expansion and improvement of mental hospitals.

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