Dorothea Dix was the most effective advocate of humanitarian reform in American mental institutions during the nineteenth century. Born in Maine, she lived in an unhappy home until the age of ten. At that time she showed the same initiative that characterized her later work by moving to her grandmother’s, and by fourteen she had already started on a teaching career as a means of achieving further independence. Within a few years she established a school for young girls, Dix Mansion, in Boston, in which the major emphasis was placed on character building and natural science. Chronic lung trouble forced her to retire from the school in 1833 and live as an invalid until 1841.In 1841 a more or less chance incident occurred which was to change the face of American psychiatry. Miss Dix was instructing a Sunday school class at a house of correction in East Cambridge when she noticed that several so-called “lunatics” were confined with the prisoners but had no stoves to keep them warm. When she asked the reason, a jailer told her that lunatics do not need heat because they are insensitive to cold. This was the stock answer at the time, since the attitude toward the mentally ill had “progressed” to a point where they were no longer believed to be possessed by the devil, but instead were regarded as a lower form of life, a species of wild beast.Outraged by the cruel and inhumane treatment she witnessed, Miss Dix started to make a further investigation on her own. During the next two years she visited almshouses, jails, and houses of correction throughout the state. Then she wrote a clear, well-documented account of her findings, and presented it in the form of a memorandum to the Massachusetts Legislature under this title: “The Present State of Insane Persons Within This Commonwealth, in Cages, Closets, Cellars, Stalls, Pens! Chained, Naked, Beaten with Rods, and Lashed into Obedience!”With these words Dorothea Dix launched a relentless, indefatigable campaign that was to have a remarkable effect on the mental institutions not only in this country but in Europe as well. Her Memorandum to the Legislature was followed by letters to the press in an effort to arouse public interest. Although many people greeted her revelations with scorn and disbelief, her zeal and spirit led to the passage of a bill that helped to correct the overcrowded conditions in the Worcester State Lunatic Hospital.