Dorothea Dix was born on
April 4, 1802 in Hampden, Maine that was part of the state of Massachusetts at
the time. Her parents were Joseph Dix
and Mary Bigelow; she was the eldest of three children. Joseph Dix was a traveling Methodist
minister; he journeyed throughout the New England frontier attempting to make
converts to the church. The family lived
in a one-room cabin. There were a total
of 150 people in the town; it was a harsh environment and a hard life in modern
terms. The physical environment
consisted of oil-paper windows, dirt floors and few amenities. The economy of the region supported such
industries as the timber trade, trapping of fur-bearing animals and agriculture
during the summer months. In such an
austere atmosphere there was little time to be a child and no time to play –
everything was geared towards survival.
Joseph Dix was one of
eight children; he was considered to be “delicate” in nature. His father, Elijah Dix, was an only surviving
son; he had six brothers who died prematurely.
Elijah moved his family to Boston in 1795. Initially, the family had inherited
wealth. Joseph Dix, Dorothea Dix’s
father, went to Divinity school but was eventually expelled and also failed in
medical school. He married Mary Bigelow
on January 28, 1801. Mary came from an impoverished
family.
When Joseph Dix
converted to Methodism, he suffered a serious and irrevocable break with his
father who considered this branch of Christianity to be crude and
doctrinaire. This family schism would
have a profound effect upon Joseph and his family.
During Dix’s young
years, she felt the oppressive impact of her father’s strict and unbending
religious beliefs. As a young child, she
was compelled to confess her faith, show repentance for all of her alleged sins
and was constantly punished whenever she became obstinate. Dix was, by nature, a strong-willed and
independently-minded individual. Given these
qualities, she needed to escape her father’s oppressive influence and find relief
from all the hardship and unhappiness she endured.
Dix remembered the
enjoyable time she had with her grandfather, Elijah Dix who taught her about
healing herbs and medicine; Elijah, however, was murdered in 1809. At the age of thirteen she left home and
moved to Boston, hoping to live with her paternal and wealthy grandmother in Boston. Once she was gone, she was never to see her
immediate family again. As a matter of
fact, she would often refer to herself as an orphan. Her father passed away in 1821.
When she arrived
unannounced, she pleaded with her grandmother to allow her to stay at Orange
Court – a stately mansion; her grandmother relented. Her new life at Orange Court was dramatically
different from her experience growing up.
Her grandmother tutored the young Dix in the ways of society and how to
be a “lady.” Dix found this somewhat
irritating, for she was stubborn and headstrong. Not only was she schooled in the social
graces of her time, but she also received an excellent education with
accomplished tutors.
In 1821, she opened a
charity school at Orange Court with the help of her grandmother. In that era in New England there was an open
intellectual environment with a free exchange of ideas. The role of women was in a state of flux and
the social causes that women became involved in included temperance and the
abolition of slavery. Dix devoted her
energies to education and at the age of 22 (1824) she published a manual for
teachers entitled, Conversations on
Common Things, or a Guide to
Knowledge that was published anonymously.
This book actually went into its sixth edition by 1829
In regards to her
spirituality, Dix gravitated towards Unitarianism and frequented sermons
delivered by Dr. William Ellery Channing – considered to be the father of
Unitarianism. He gave very moving and
charismatic sermons in which he encouraged his parishioners to help the poor. Channing
had a marked influence on her thinking.
He became her friend and mentor and she actually lived as a governess in
the Channing household (1827).
In 1831, she started a
school dedicated to young women in Boston.
This school existed for five years; until, Dix began to suffer from
health problems. As a consequence of her
ill health, Dix decided to find rest through travel – she journeyed to
England. There, she happened to meet
and befriend the Rathbone family and was invited to spend a year with them at
their mansion in Liverpool - referred to as Greenback.
The members of the Rathbone
family were devoted and practicing Quakers and were deeply immersed in social
welfare issues. In the company of the
Rathbones, Dix had an opportunity to meet many progressively-minded reformers
who felt that the government should play an active role in issues of social
reform. It should be remembered, that
Dix was a contemporary of Charles Dickens, who graphically revealed the extent
of social malaise that existed in England at the time. She also was exposed to the methodology
employed to detail the horrific conditions of mental asylums. The results of some of these investigations
were presented as reports to the House of Commons. The totality of this experience had a marked
effect on Dix and would help her choose the path she would take in regards to
social reform.
During her lifetime,
there was a very influential philosophical movement around Boston that
influenced Dix’s thinking and that was Transcendentalism. It was point of view that emphasized the
intellectual and spiritual life. Its
proponents were such notables as Ralph Waldo Emerson, Henry David Thoreau and
Margaret Fuller. She was also
influenced by the work of Rev. Henry Furness - a theologian, reformer and
abolitionist. He was responsible to a
considerable degree in the establishment of the public school system in
Philadelphia. Dix was also in the midst
of the abolitionist movement – the movement to end slavery – typified by the
work of William Lloyd Garrison. Paradoxically,
Dix had no interest in the issue of slavery.
After Dix regained her
health, she began to investigate the treatment of the mentally ill in
earnest. She began by visiting the UK’s
most progressive insane asylum, York Retreat, built in 1796. It looked like a private residence. Within its walls, individual patients were
treated with dignity and respect for their person. Dix was struck by the compassionate care
provided and realized that patients when treated with care and compassion could
recover. Physical restrains were seldom
employed and isolation proved unnecessary.
She returned to Boston in 1837 with a passion for reform. As a result of an inheritance following her
grandfather’s death, Dix received $3000 a year – a substantial amount of money
for that time. With this resource in
hand she decided to travel.
She was encouraged to do
philanthropic work in Boston. However,
her impassioned belief in the role government should play in tackling the
problem of mental illness, inspired her to move to Washington DC . There, she visited schools, orphanages,
almshouses and jails meticulously recording her observations. When her brother Charles was lost at sea in
1839, she returned to Boston. The issues
that were on the public radar in those days were: a woman’s role in society,
abolition of slavery and temperance.
Unlike Jane Addams she did not view slavery as an issue that should
occupy her attention – this is somewhat perplexing given her affinity to issues
that gravitated around social reform.
She chose instead to focus entirely on the care and support of the
mentally ill. In this regard, she had
the support of Senator Charles Summer of Massachusetts, who played a key role
in the anti-slavery movement.
Dix continued her
travels throughout the New England States gathering information on the care and
treatment of the mentally ill. What she
discovered and reported was particularly disturbing. The institutions that housed the mentally ill
often left the patients under their care isolated, often under-nourished and
medically unattended. In the worst
cases, individuals were shackled; the sanitary conditions in such abysmal
settings were hard to imagine.
Her ability to gain the
attention of state legislators and persuade them to make substantial changes in
state policy regarding the mentally ill was quite extraordinary. As an example of the strategy she so
successfully employed, in Massachusetts she obtained letters of introduction
and credentials from Harvard Medical School with the help of Walter Channing. In this way, she gained admission to jails
and asylums throughout the state. As a
result of her efforts, The Boston Lunatic Hospital was opened in 1839, modeled
after the York Retreat in England that had so influenced her thinking. In 1841, Dix visited the Lowell Almshouse
outside Boston and recorded her observations.
In New England an almshouse was house for the poor and indigent
supported by the local town. In many
instances, the poor were required to work.
In 1842, she sent the following letter to the Massachusetts State
Legislature.
“About two years since
leisure afforded opportunity and duty prompted me to visit several prisons and
almshouses in the vicinity of this metropolis. I found, near Boston, in the
jails and asylums for the poor, a numerous class brought into unsuitable
connection with criminals and the general mass of paupers. I refer to idiots
and insane persons, dwelling in circumstances not only adverse to their own
physical and moral improvement, but productive of extreme disadvantages to all
other persons brought into association with them. I applied myself diligently
to trace the causes of these evils, and sought to supply remedies. As one
obstacle was surmounted, fresh difficulties appeared. Every new investigation
has given depth to the conviction that it is only by decided, prompt, and
vigorous legislation the evils to which I refer, and which I shall proceed more
fully to illustrate, can be remedied. I shall be obliged to speak with great
plainness, and to reveal many things revolting to the taste, and from which my
woman's nature shrinks with peculiar sensitiveness. But truth is the highest
consideration. I tell what I have seen--painful and shocking as the details
often are--that from them you may feel more deeply the imperative obligation
which lies upon you to prevent the possibility of a repetition or continuance
of such outrages upon humanity. . . .”
In 1843, Horace Mann and
Samuel Gridley Howe invited Dix to present a Memorial, petition, to the
Massachusetts legislature. Since, women
were not allowed to speak in the legislative chamber, Howe presented it for
her. The following is an excerpt from
that petition that graphically illustrates the treatment of the mentally ill
and Dix’s passion for reform.
“I come to present the
strong claims of suffering humanity. I come to place before the Legislature of
Massachusetts the condition of the miserable, the desolate, the outcast. I come
as the advocate of helpless, forgotten, insane, and idiotic men and women; of
beings sunk to a condition from which the most unconcerned would start with
real horror; of beings wretched in our prisons, and more wretched in our
almshouses. . . .
“I must confine myself
to few examples, but am ready to furnish other and more complete details, if
required.
“If my pictures are
displeasing, coarse, and severe, my subjects, it must be recollected, offer no
tranquil, refined, or composing features. The condition of human beings,
reduced to the extremist states of degradation and misery cannot be exhibited
in softened language, or adorn a polished page.
“I proceed, gentlemen,
briefly to call your attention to the present state of insane persons confined
within this Commonwealth, in cages, closets, cellars, stalls, pens! Chained,
naked, beaten with rods, and lashed into obedience. . . .
“It is the Commonwealth,
not its integral parts, that is accountable for most of the abuses which have
lately and do still exist. I repeat it, it is defective legislation which
perpetuates and multiplies these abuses. In illustration of my subject, I offer
the following extracts from my Note-book and Journal:--
“Springfield. In the
jail, one lunatic woman, furiously mad, a State pauper, improperly situated,
both in regard to the prisoners, the keepers, and herself. It is a case of
extreme self-forgetfulness and oblivion to all the decencies of life, to
describe which would be to repeat only the grossest scenes. She is much worse
since leaving Worcester. In the almshouse of the same town is a woman
apparently only needing judicious care, and some well-chosen employment, to
make it unnecessary to confine her in solitude, in a dreary unfurnished room.
Her appeals for employment and companionship are most touching, but the
mistress replied she had no time to attend to her. . . .
“Lincoln. A woman in a
cage. Medford. One idiotic subject chained, and one in a close stall for
seventeen years. Pepperell. One often doubly chained, hand and foot; another
violent; several peaceable now. Brookfield. One man caged, comfortable.
Granville. One often closely confined; now losing the use of his limbs from
want of exercise. Charlemont. One man caged. Savoy. One man caged. Lenox. Two
in the jail, against whose unfit condition there the jailer protests.
“Dedham. The insane
disadvantageously placed in the jail. In the almshouse, two females in stalls, situated
in the main building; lie in wooden bunks filled with straw; always shut up.
One of these subjects is supposed curable. The overseers of the poor have
declined giving her a trial at the hospital, as I was informed, on account of
expense...
“Besides the above, I
have seen many who, part of the year, are chained or caged. The use of cages
all but universal. Hardly a town but can refer to some not distant period of
using them; chains are less common; negligences frequent; willful abuse less
frequent than sufferings proceeding from ignorance, or want of consideration. I
encountered during the last three months many poor creatures wandering reckless
and unprotected through the country. . . . But I cannot particularize. In
traversing the State, I have found hundreds of insane persons in every variety
of circumstance and condition, many whose situation could not and need not be
improved; a less number, but that very large, whose lives are the saddest
pictures of human suffering and degradation.”
Dix’s petition was
ultimately successful: the Worcester Asylum received an additional $65,000 – a
substantial sum of money in that era. Invigorated
by this kind of success, she traveled throughout New England and New York with
her notebooks. She garnered the support
of NY Governor William Seward. She
spent a considerable amount of time and energy in Rhode Island where no
facilities existed for the mentally ill.
In 1844, Nicholas Brown, founder of Brown University, left the state of
Rhode Island $30,000 upon his death for the establishment of an asylum for the
Insane. Dix encouraged the state
legislature to establish a “lunacy commission” in order to review and address
the plight of the mentally ill.
Following her persuasive testimony, they did so. Building considerable momentum, Dix had
appreciable success in Tennessee, Kentucky and Pennsylvania as well.
In 1847, Dix took her
quest to the federal government in Washington D.C. There she petitioned the U.S. in 1848 to
dedicate 5 million acres of federal land for the exclusive use of asylums for
the mentally ill; this would include a parcel of land for each state. The states, for their part, would be required
to build and operate their own facilities.
Dix had the support of Daniel Webster from Massachusetts and Vice
President Millard Fillmore. A bill
addressing her petition came out of the Congress – revised bill H.R. 383. A month earlier, President Zachery Taylor
died and was succeeded by Vice President Fillmore. In 1851, the bill passed in the Senate but
was defeated in the House.
Despite this setback,
Dix continued her reform efforts in
Canada, especially Nova Scotia, Prince Edward Island and Montreal. After repeated efforts to pass the bill that
she worked so hard for in DC failed, she left for Europe feeling
disheartened. She carried her reform
efforts to the U.K., France and even visited Pope Pius IX, distressed by the
conditions of mental health institutions in Rome. She subsequently returned to the US in March
of 1857 with James Buchanan as President; civil war looked imminent. John Brown attacked the arsenal at Harper’s
Ferry in West Virginia and attempted to incite a massive slave rebellion. In 1860, Abraham Lincoln was elected
sixteenth President of the US and soon thereafter, the Civil War began.
In order to assist in
the war effort and relieve the suffering of the wounded, Dix enlisted as a
nurse for the War Department. She
ultimately became the First Supervisor of women nurses in the US army. She wished to emulate the selfless service as
exemplified by Florence Nightingale’s work as a nurse during the Crimean War
between Russia and Turkey. Louisa May
Alcott, famous author of Little House on
the Prairie, worked alongside Dix. By
1872, Dix, at the age of 72, was stricken with malaria. She recovered from this illness and began her
travels once again. On July of that
year, Dix died.
Dix was undoubtedly a
remarkable woman who was not dissuaded by the societal constraints placed upon
the women of her generation. She was
driven by a singular and consuming passion – addressing the horrific treatment
of individuals suffering from mental illness.
She was remarkably eloquent, persuasive and successful. By the time of her death, Dix helped found 32
state-run mental hospitals and one federal institution, St. Elizabeth’s in
DC.
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