Surgeon General’s Office

When news of the outbreak of the Civil War reached Dorothea Dix, she immediately headed for Washington to volunteer her services. Miss Dix was already well known for her efforts to secure humane treatment for the mentally ill, and Secretary of War Simon Cameron gladly accepted her offer to organize women nurses for the Union cause.

In her rented quarters, Miss Dix became a one-woman bureaucracy, organizing and dispatching nurses as the tides of battle changed. On June 10, 1861, she was officially commissioned the nation’s first Superintendent of Women Nurses.

In the early days of the war, confusion reigned. Lack of coordinated action and shortages of supplies, along with an abundance of willing but untrained volunteers, presented enormous challenges. Some way was needed to select volunteers who could withstand the rigors of wartime nursing. Miss Dix wanted particularly to discourage women whom she suspected of wishing only to be near husbands or sweethearts on the battlefield.

The featured document, Circular Order No. 8 of July 14, 1862, was intended as much to limit volunteers as to recruit them. It reflected Miss Dix’s own preference for simplicity and stoutheartedness. It emphasized plain looks, plain manner, and maturity. Ability to care for the wounded was one desirable qualification, but, strangely, not the foremost one. In the early 1860s, nursing was not yet a profession for which women formally trained.

All inquiries about nursing service and all women seeking to volunteer were referred by the Surgeon General’s Office to Dorothea Dix.

The letter books of the Surgeon General at the National Archives contain handwritten copies of these letters as well as requests that Miss Dix locate and dispatch supplies and nurses immediately to new scenes of action. Some women who failed to pass her scrutiny sneaked aboard troop trains and served gallantly on the front lines. Others, like Clara Barton, acted on their own.

One of Miss Dix’s best-known nursing recruits was Louisa May Alcott, later the famous author of Little Women. Miss Alcott had only served briefly in a converted Washington hotel when she became seriously ill. Dorothea Dix helped nurse her back to health, and Miss Alcott thanked her in "Hospital Sketches," a series of newspaper articles describing her Civil War experience, later published in book form.

Ironically, Dorothea Dix could not have met the standards she outlined in her circular order. At the start of the Civil War she was already 60 years old. Born in 1802, she had grown up in Massachusetts, taught school, and written a number of popular books for children. Despite chronic ill health, she had then spent two decades traveling all over the country visiting the mentally ill, publicizing their plight, and persuading state legislatures to furnish money to build clean, modern, restful institutions for the insane.

A major figure in the period of antebellum reform, she is credited with prompting the establishment of more than 20 state hospitals. Although she had strong views onthe other reform issues of her day—temperance, slavery, and votes for women—she did not speak on them publicly for fear of distracting attention from the cause of better care for the mentally ill.

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The Civil War presented Dorothea Dix with a new opportunity for service, as it did for many women. Although she lacked nursing experience or training, she knew a great deal about hospitals and had high standards for patient care. She found it hard to adjust those standards to the difficult conditions of wartime and was often frustrated by inevitable delays and inefficiency. She clashed with doctors who resented her interference and her surprise inspections. By the war’s end she retained her title but little of her once absolute authority over women nurses.

With characteristic dedication, she had labored for years without a day off. She remained in Washington after the war to secure a suitable memorial for Union soldiers buried in the National Cemetery at Fort Monroe, Virginia. She refused all honors and compensation, asking only for the flag of the nation she had served so long.

Secretary of War Edwin Stanton responded with a set of flags and a letter praising her work. Among her bequests, Miss Dix left the flags to Harvard College and $100 to Hampton Institute, located near the site of the Union soldiers’ memorial.

The featured document is found in the Records of the Surgeon General’s Office, Record Group 112, Volume 1, Circulars and circular letters, 1861-85.

Teaching Activities

1. Ask your students to discuss what qualifications are necessary for a nurse today. How do these compare with the requirements set out by Dorothea Dix in Circular Order No. 8? Consider what factors might account for the differences.

2. Women writing to the Surgeon General about service as a nursing volunteer were advised to contact Miss Dorothea Dix at 505 12th Street, Washington, D.C. Today’s volunteers for emergency services (firefighting, nursing service, rescue squad) must be prepared to convince professionals of their suitability for service. Ask your students to draft a letter either to Miss Dix or a contemporary figure, describing their qualifications and reasons for wanting to serve.

3. Dorothea Dix interviewed all women who came to Washington to volunteer before approving them for service as nurses for the Union army. Volunteers for emergency services today must also go through interviews. Ask students to dramatize such an interview, either in a contemporary situation or between Miss Dix and an eager nursing recruit (using the information provided in the article and in the circular).

4. Ask students to locate evidence to support or to disprove the following statement: The Civil War was the bloodiest war in American history because the technology to kill was on the threshold of the 20th century while medicine was still in the Middle Ages.

5. Following the Civil War, Dorothea Dix raised money to complete a memorial to Union soldiers who had died in the conflict. She personally selected items for a time capsule sealed in the base of the monument at Fort Monroe, including Civil War mementos, pictures of U.S. presidents, coins, maps, a Bible, and a copy of the Constitution. Discuss with your class what they would put in a time capsule today.

Compile a list of items or gather together things in a two-foot square box to be used as a time capsule to show what is noteworthy about American life in the late 1980s.