Dorothea Dix – a summary

Known primarily as an activist for the indigent insane, Dorothea Dix spent much of her life working on behalf of mental institutions and their inmates.  During the American Civil War, she served as Superintendent of Army Nurses.

Born 4 April 1802, the 12-year-old Dorothea Dix left her abusive father in Worcester, Massachusetts, and went to live with her grandmother in Boston.

In 1821 she opened a school for girls in Boston, but poor health obliged her forced her to abandon her position. She spent two years with a Quaker family in England which opened her eyes to the work of social reform.

Dorothea Dix and the insane

Returning to Boston, despite receiving a generous inheritance, Dix was determined to work. She took up a post working in a Sunday School within a prison, and there was shocked at how abused and badly treated were the patients deemed insane. She spent two years visiting similar institutions and observing the same state of affairs in each. When she enquired into the harsh treatment, she was told, ‘the insane do not feel heat or cold’.

A detailed report submitted to the Massachusetts State paved the way for legislation to enlarge and improve facilities for the insane. She toured other states, pushing for reform in each, and continued her work in Britain and in Italy, where she even urged the pope, Pius IX, to see for himself the conditions suffered by Rome’s insane.

Civil War

With the outbreak of the Civil War in 1861, Dorothea Dix, aged 59, worked for the Union Army as the superintendent of Union Army Nurses. Introducing women into what had been another male preserve, she used her organizational skills and determination to greatly improve army nursing care. Dix established guidelines for nurses that insisted that they be between the ages of 35 and 50, and be plain-looking.  She required her nurses to wear dowdy black or brown dresses with no jewelry or cosmetics.  (One such nurse, employed by Dix, was Louisa May Alcott, who would later write the perennial favorite, Little Women). Dix was of the opinion that younger, attractive women would be vulnerable to exploitation by the patients and doctors.

Constantly at odds with Army doctors over control of medical facilities and nursing staff, she also had to deal with doctors who were opposed to female nurses.  The War Department issued an order giving Dix and the Surgeon General shared responsibility for hiring and firing of nurses, but put control of the assignment of employees in the hands of the doctors.  This left Dix as little more than a figurehead and she resigned in August 1865.  She later referred to the episode as a failure.

She was known for treating Union and Confederate patients equally, which did not sit well with many. When Robert E Lee retreated from his defeat at Gettysburg, more than 4,000 Confederate wounded had to be left behind.  It was Dix’s nurses who looked after them.

After the war, Dix resumed her campaign to help prisoners, the disabled and the mentally ill.  But in later years, her health began to fail.  In 1881, she moved into the New Jersey State Hospital at Morris Plaines where the state had provided her with private rooms.  She remained there as an invalid until her death on July 17, 1887.

Kat Smutz
Read more about the Civil War in The American Civil War In An Hour available in various digital formats and audio.
See also Clara Barton – Civil War nurse and founder of the American Red Cross