At the outset of the Civil War, Dorothea Dix was already well known to most Americans for her one-woman crusade to revolutionize the care of the mentally ill in the United States. During the 1840s and 1850s, she inspected almshouses, workhouses, prisons, and jails, and compiled graphic treatises documenting the horrors she witnessed. She presented them to state legislators and pressed them to institute reforms. As a self-acknowledged expert on hospital administration, in April 1861, hours after hearing the news that President Abraham Lincoln was mustering soldiers, she rushed to Washington, DC, to launch her mission to establish an army nursing corps of white female volunteers.
Dix was born in the town of Hampden in the Maine wilderness, the daughter of an itinerant Methodist minister. She received her education in Boston and established her first school for young children at the age of 14. Over the next 20 years, she taught and was headmistress of several of her own schools. Long spells of respiratory illness disturbed her work beginning in 1824. By the early 1830s, she was diagnosed with tuberculosis. Still frail and unwell at the age of 40 in 1841, Dix’s life was transformed when she taught a class for women in a local jail. She became outraged by the inhumane living conditions when she discovered that “lunacy” was the only crime of many prisoners. From that moment on, she devoted herself to reforming the care of the mentally ill.
In April 1861, with two decades of successful reform behind her, Dix used her political connections in Congress and in the president’s Cabinet to secure the volunteer position she wanted. On April 23, Secretary of War Simon Cameron appointed Dix to enlist female nurses, and to help supervise the organization of military hospitals and the requisition of supplies from the homefront. She received her official commission as Superintendent of Female Nurses on June 10. In delineating her powers and jurisdiction, Cameron helped set the stage for the series of misunderstandings and battles that ensued between Dix and the surgeons and officers of the Army Medical Bureau.
Cameron ordered her to maintain “diligent oversight” of her nurses, yet added that “all women nurses are under the direction of the Surgeons…” He gave her “the right and duty of visitor and inspector” in the military hospitals, yet ordered the Medical Corps to respect “her suggestions, wishes and counsels…[only] as far as is compatible with the order of the