18 Dorothea Dix
Dorothea Lynde Dix (April 4, 1802 – July 17, 1887) was an American advocate on behalf of the indigent mentally ill who, through a vigorous and sustained 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 a Superintendent of Army Nurses.
Early life
Born in the town of Hampden, Maine, she grew up in Worcester, Massachusetts among her parents’ relatives. She was the first child of three born to Joseph Dix and Mary Bigelow, who had deep ancestral roots in Massachusetts Bay Colony.[1] Her mother suffered from poor health, thus she wasn’t able to provide consistent support to her children.[2] Her father was an itinerant bookseller and Methodist preacher.[3][a] At the age of twelve, she and her two brothers were sent to their wealthy grandmother,[2] Dorothea Lynde (wife of Dr. Elijah Dix)[4] in Boston to get away from her alcoholic parents and abusive father. She began to teach in a school all for girls in Worcester, Massachusetts at fourteen years old and had developed her own curriculum for her class, in which she emphasized ethical living and the natural sciences.[2] In about 1821 Dix opened a school in Boston, which was patronized by well-to-do families. Soon afterward she also began teaching poor and neglected children out of the barn of her grandmother’s house, but she suffered poor health.[5]
In 1831, she established a model school for girls in Boston, operating it until 1836, when she suffered a breakdown.[4] Dix was encouraged to take a trip to Europe to improve her health. While she was there she met British social reformers who inspired her.
Antebellum career
Reform movements for treatment of the mentally ill were related in this period to other progressive causes: abolitionism, temperance, and voter reforms. After returning to America, in 1840-41 Dix conducted a statewide investigation of care for the mentally ill poor in Massachusetts. Dorothea’s interest for helping out the mentally ill of society started while she was teaching classes to female prisoners in East Cambridge.[13] She saw how these individuals were locked up and whose medical needs weren’t being satisfied since only private hospitals would have such provisions.[13] It was during her time at the East Cambridge prison, that she visited the basement where she encountered four mentally ill individuals, whose cells were “dark and bare and the air was stagnant and foul”.[14]
The Civil War
During the American Civil War, Dix, on June 10, 1861, was appointed Superintendent of Army Nurses by the Union Army, beating out Dr. Elizabeth Blackwell.[citation needed]
Dix set guidelines for nurse candidates. Volunteers were to be aged 35 to 50 and plain-looking. They were required to wear unhooped black or brown dresses, with no jewelry or cosmetics.[29] Dix wanted to avoid sending vulnerable, attractive young women into the hospitals, where she feared they would be exploited by the men (doctors as well as patients). Dix often fired volunteer nurses she hadn’t personally trained or hired (earning the ire of supporting groups like the United States Sanitary Commission).[30]
At odds with Army doctors, Dix feuded with them over control of medical facilities and the hiring and firing of nurses. Many doctors and surgeons did not want any female nurses in their hospitals. To solve the impasse, the War Department introduced Order No. 351 in October 1863.[31] It granted both the Surgeon General (Joseph K. Barnes) and the Superintendent of Army Nurses (Dix) the power to appoint female nurses. However, it gave doctors the power of assigning employees and volunteers to hospitals. This relieved Dix of direct operational responsibility. As superintendent, Dix implemented the Federal army nursing program, in which over 3,000 women would eventually serve.[32] Meanwhile, her influence was being eclipsed by other prominent women such as Dr. Mary Edwards Walker and Clara Barton. She resigned in August 1865[31] and later considered this “episode” in her career a failure. Although hundreds of Catholic nuns successfully served as nurses, Dix distrusted them; her anti-Catholicism undermined her ability to work with Catholic nurses, lay or religious.[33][34]
But her even-handed caring for Union and Confederate wounded alike, assured her memory in the South. Her nurses provided what was often the only care available in the field to Confederate wounded….
She was well respected for her work throughout the war because of her dedication. This stemmed from her putting aside her previous work to focus completely on the war at hand. With the conclusion of the war her service was recognized formally. She was awarded with two national flags, these flags being for “the Care, Succor, and Relief of the Sick and wounded Soldiers of the United States on the Battle-Field, in Camps and Hospitals during the recent war.”[36] Dix ultimately founded thirty-two hospitals, and influenced the creation of two others in Japan.[28]
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