In March 1856, the Insane Hospital of North Carolina officially opened its doors to 11 patients. Though there had been several failed attempts beginning in 1825, it took the tenacity and smart politics of reformer Dorothea Dix to have a state institution for the mentally ill built in North Carolina.
Dorothea Lynde Dix was born in Hampden, Maine, in 1802. Her young years were spent toiling on the rural frontier of Maine until she fled to her wealthy grandparents in Boston when she was 12 years old. Dorothea, named for her grandmother, first encountered “enlightened” reformers on a trip to England at the age of 36. Ostensibly, she was on her way to Italy to recover from tubercular problems and exhaustion, but after befriending William Rathbone III and his colleagues William Tuke and Elizabeth Frye, she decided to stay at Rathbone’s country estate to recover.
Tuke had founded the York Retreat for mentally ill patients, and Frye was a prison reformer. Like others inspired by the Age of Enlightenment, the English reformers felt that science and progress could help perfect people and their world.
William Tuke, a Quaker, applied the French scientist Phillipe Pinel’s theory of “traitment moral” for his patients. “Traitment moral,” which literally means “treatment of the well-being” but came to be called “moral treatment,” theorized that the insane needed to be removed from the environment that caused their insanity in the first place (hence the word “retreat”). Then discipline and kind encouragement was applied to help the patient behave better.
Dix became an admirer of pioneering physicians in mental illness like Pinel and Benjamin Rush of the Pennsylvania Hospital in Philadelphia. Though Rush still employed the previous generation of treatments for the mentally ill including blood lettings, blistering and forced vomitting, he also invented new remedies, like the strapping a patient into a chair until they calmed down, or spinning them around on a board to improve their circulation.
It was during a Sunday School lesson at a prison in Cambridge, Massachusetts, in March of 1841, that led Dix to become an activist herself. She had volunteered to teach twenty female inmates that day, then insisted on touring the facility. Though the warden did not want to permit her, she traveled all the way to the bottom of the prison where she discovered a dungeon with naked and chained men and women. These were the mentally ill inmates.
The prevailing wisdom of the early nineteenth century was that the insane could not feel heat or cold or even pain. But Dix was horrified at what she saw, and she decided to tour the prisons of Massachusetts to observe the conditions for the mentally ill. The “Memorial” she presented to the Massachusetts legislature resulted in the establishment of the first state hospital for the insane in the United States.
With her extremely effective skills of writing and lobbying in tow, she set about to reform conditions for the mentally ill across the country. In 1848, she arrived in North Carolina.
Dix’s memorial did not do much to sway the North Carolina legislature, who were far more interested in rail roads at the time. The legislature had already resolved to look into founding such an institution in 1825 to no ends, and Governor Morehead in 1844 had asked for and not received a state institution for the mentally ill. Why not put it off a third time?
But Dix had been successful in creating most of the nineteenth century state hospitals for the mentally ill east of the Mississippi River and was not going to give up on North Carolina. While staying at the Mansion Hotel in Raleigh, she made friends with the wife of state representative James Dobbin of Fayetteville. Louisa Dobbin was on her deathbed, and Dorothea attended to her side every day. As a dying wish, Louisa asked her husband to support Dorothea’s bill for a state hospital.
After Louisa’s funeral in Fayetteville, James Dobbin traveled directly to Raleigh and made an impassioned speach on the General Assembly floor. His colleagues were moved, and they passed the bill.
Although the hospital came to be known as Dorothea Dix Hospital, Dix never intended for it to be named after her. The spot where the Insane Hospital of North Carolina was built was called “Dix Hill” after her grandfather, Dr. Elijah Dix.
In fact, Dorothea Dix had shunned publicity throughout her life and did not want people to write about her. She once told a would-be biographer, “I feel it right to say to you frankly that nothing could be undertaken which would give me more pain and serious annoyance.”