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Memorial Of Miss D. L. Dix To the Senate And House Of Representatives Of The United States
For years, Dorothea Dix collected information on the abuse and neglect of people with cognitive and psychiatric disabilities. Her efforts resulted in the construction of numerous insane asylums at the state level, but she began to believe that the states needed help in financing these projects. Beginning in 1848, Dix used this information to submit a memorial to the United States Congress seeking federal support for the maintenance of insane asylums. Her proposal called for the distribution of five million acres of federal land to the states. This land was to be sold as a means of raising the necessary funds to care for the indigent insane. Her memorial, excerpted here, was successful in persuading Congress to pass a law in 1854 by which the federal government would provide ten million acres according to Dix’s plan. It would have been the first time that the federal government assumed responsibility for its destitute citizens. Because of President Franklin Pierce’s veto, Dix’s plan was never put into effect, and it would be over a century before the federal government would be involved in the care of people with mental disabilities.
Illinois, visited also in its whole extent in 1846, has more than four hundred insane, at the most moderate estimate. Passing into a confined room, in the poorhouse at G--, I saw a cage, constructed upon one side of the room, measuring six feet by three. "There," exclaimed the keeper, with emotion, "there is the best place I have to keep a madman; a place not fit for a dog; a place where they grow worse and worse, and, in defiance of such care as I can give, become a nuisance to themselves and every one in the neighborhood. We want hospitals, Miss; we want hospitals, and more means for the crazy everywhere." I found crazy men and women in all sorts of miserable conditions; sometimes, as in Georgia, &c., &c., strapped upon beds with coarse, hard strips of leather; sometimes chained to logs, or to the floor of wretched hovels; often exposed to every vicissitude of the climate; but I limit myself to one more example. It was an intensely hot day when I visited F.-- He was confined in a roofed pen, which enclosed an area of about eight feet by eight. The interstices between the unhewn logs admitted the scorching rays of the sun then, us they would open way for the fierce winds and drenching rains and frosts of the later seasons. The place was wholly bare of furniture -- no bench, no bed, no clothing. His food, which was of the coarsest kind, was pushed through spaces between the logs; "fed like the hogs, and no better," said a stander-by. His feet had been frozen by exposure to cold in the winter past. Upon the shapeless stumps, aided by his arms, he could raise himself against the logs of the pen. In warm weather this wretched place was cleansed once a week or fortnight; not so in the colder seasons. "We have men called," said his sister, "and they go in and tie him with ropes, and throw him out on the ground, and throw water on him, and my husband cleans out the place." But the expedient to prevent his freezing in winter was the most strangely horrible. In the centre of the pen was excavated a pit, six feet square and deep; the top was closed over securely; and into this ghastly place, entered through a trap-door, was cast the maniac, there to exist till the returning warm weather induced his care-taker to withdraw him; there, without heat, without light, without pure air, was left the pining, miserable maniac, whose piteous groans and frantic cries might move to pity the hardest heart.
In Missouri, visited in 1846 and 1847, multiplied cases were found in pens, in stalls, in cages, in dungeons, and in cells; men and women alike exhibited the most deplorable aspects. Some are now dead -- others still live only to experience renewed troubles of mind and tortures of the flesh.
Let these examples suffice; others daily occur. Humanity requires that every insane person should receive the care appropriate to his condition, in which the integrity of the judgment is destroyed and the reasoning faculties confused or prostrated.
Hardly second to this consideration is the civil and social obligation to consult and secure the public welfare; first, in affording protection against the frequently manifested dangerous propensities of the insane; and second, by assuring seasonable and skillful remedial cases, procuring their restoration to usefulness as citizens of the republic and as members of communities.
Under ordinary circumstances, and where there is no organic lesion of the brain, no disease is more manageable or more easily cured than insanity; but to this end special appliances are necessary, which cannot be had in private families, nor in every town and city; hence the necessity for hospitals, and the multiplication, not enlargement, of such institutions. The citizens of many States have readily submitted to increased taxation, and individuals have contributed liberal gifts, in order to meet these imperative wants. Hospitals have been constructed, and well organized. The important charge of these has been in most instances confided to highly responsible and skilful physicians -- men whose rank in morals and in intellect, while commanding the public confidence, has wrought immeasurable benefits for hundreds and thousands of those in whom, for a time, the light of reason had been hidden.
But while the annual reports emanating from these beneficent institutions record eminent successes in the cure of recently developed cases, the provision for the treatment of this malady in the United States is found wholly insufficient for existing necessities, as has been already demonstrated in preceding pages.
To confide the insane to persons whose education and habits do not qualify them for this charge, is to condemn them to a mental death. The keepers of prisons, the masters of poorhouses, and most persons in private families, are wholly unacquainted with bodily and mental diseases, and are therefore incapable of the judicious application of such remedial measures, moral, mental, and medical, as are requisite for the restoration of physical and mental health. Recovery, even of recent cases, not submitted to hospital charge, is known to be very rare -- a fact readily demonstrable by examples, and by figures if necessary. It may be more satisfactory to show the benefits of hospital treatment, rather than dilate upon the certain evils of prison and almshouse neglects or abuses and domestic mismanagement.