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Am J Public Health. 2006 April; 96(4): 622–624.
PMCID: PMC1470564
I Tell What I Have Seen”—The Reports of Asylum Reformer Dorothea Dix
Dorothea Dix
MEMORIAL, TO THE LEGISLATURE OF MASSACHUSETTS.

Gentlemen,

I respectfully ask to present this Memorial, believing that the cause, which . . . sanctions so unusual a movement, presents no equivocal claim to public consideration and sympathy. Surrendering to calm and deep convictions of duty my habitual views of what is womanly and becoming, I proceed briefly to explain what has conducted me before you unsolicited and unsustained, trusting, while I do so, that the memorialist will be speedily forgotten in the memorial.

About two years since leisure afforded opportunity, and duty prompted me to visit several prisons and alms-houses in the vicinity of this metropolis. I found, near Boston, in the Jails and Asylums for the poor, a numerous class brought into unsuitable connexion 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 been 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 as 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. If I inflict pain upon you, and move you to horror, it is to acquaint you with suffering which you have the power to alleviate, and make you hasten to the relief of the victims of legalized barbarity.

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 Alms-Houses. And I cannot suppose it needful to employ earnest persuasion, or stubborn argument, in order to arrest and fix attention upon a subject, only the more strongly pressing in its claims, because it is revolting and disgusting in its details.

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 extremest 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!

As I state cold, severe facts, I feel obliged to refer to persons, and definitely to indicate localities. But it is upon my subject, not upon localities or individuals, I desire to fix attention; and I would speak as kindly as possible of all Wardens, Keepers, and other responsible officers, believing that most of these have erred not through hardness of heart and willful cruelty, so much as want of skill and knowledge, and want of consideration. Familiarity with suffering, it is said, blunts the sensibilities, and where neglect once finds a footing other injuries are multiplied. This is not all, for it may be justly and strongly be added that, from the deficiency of adequate means to meet the wants of these cases, it has been an absolute impossibility to do justice in this matter. Prisons are not constructed in view of being converted into County Hospitals, and AlmsHouses are not founded as receptacles for the Insane. And yet, in the face of justice and common sense, Wardens are by law compelled to receive, and Masters of Alms-House not to refuse, Insane and Idiotic subjects in all stages of mental disease and privation.

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.’

Northampton.
In the jail, quite lately, was a young man violently mad, who had not, as I was informed at the prison, come under medical care, and not been returned from any hospital. In the almshouse, the cases of insanity are now unmarked by abuse, and afford evidence of judicious care by the keepers.

Williamsburg.
The almshouse has several insane, not under suitable treatment. No apparent intentional abuse.

Rutland.
Appearance and report of the insane in the almshouse not satisfactory.

Sterling.
A terrible case; manageable in a hospital; at present as well controlled perhaps as circumstances in a case so extreme allow. An almshouse, but wholly wrong in relation to the poor crazy woman, to the paupers generally, and to her keepers.

Burlington.
A woman, declared to be very insane; decent room and bed; but not allowed to rise oftener, the mistress said, ‘than every other day: it is too much trouble.’

Concord.
A woman from the hospital in a cage in the almshouse. In the jail several, decently cared for in general, but not properly placed in a prison. Violent, noisy, unmanageable most of the time.

Lincoln.
A woman in a cage.

Medford.
One idiotic subject chained, and one in a close stall for 17 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. . . .

I may here remark that severe measures, in enforcing rule, have in many places been openly revealed. I have not seen chastisement administered by stripes, and in but few instances have I seen the rods and whips, but I have seen blows inflicted, both passionately and repeatedly.

I have been asked if I have investigated the causes of insanity? I have not; but I have been told that this most calamitous overthrow of reason, often is the result of a life of sin; it is sometimes, but rarely, added, they must take the consequences; they deserve no better care! . . .

Could we in fancy place ourselves in the situation of some of these poor wretches, bereft of reason, deserted of friends, hopeless; troubles without, and more dreary troubles within, overwhelming the wreck of the mind as ‘a wide breaking in of the waters,’—how should we, as the terrible illusion was cast off, not only offer the thank-offering of prayer, that so mighty a destruction had not overwhelmed our mental nature, but as an offering more acceptable devote ourselves to alleviate that state from which we are so mercifully spared. . . .

Men of Massachusetts, I beg, I implore, I demand, pity and protection, for these of my suffering, outraged sex!—Fathers, Husbands, Brothers, I would supplicate you for this boon—but what do I say? I dishonor you, divest you at once of Christianity and humanity—does this appeal imply distrust. If it comes burthened with a doubt of your righteousness in this Legislation, then blot it out; while I declare confidence in your honor, not less than your humanity. Here you will put away the cold, calculating spirit of selfishness and self-seeking; lay off the armor of local strife and political opposition; here and now, for once, forgetful of the earthly and perishable, come up to these halls and consecrate them with one heart and one mind to works of righteousness and just guardians of the solemn rights you hold in trust. Raise up the fallen; succor the desolate; restore the outcast; defend the helpless; and for your eternal and great reward, receive the benediction . . . “Well done, good and faithful servants, become rulers over many things!”

Figure 1Figure 1
Dorothea Lynde Dix (courtesy of the National Library of Medicine)
Notes
Excerpted from Dix, Dorothea, Memorial to the Legislature of Massachusetts. Boston: Munroe & Francis, 1843.