Dec. 28th, 1871.

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HOSPITAL ELGIN.,

�--

1872.

BY-LA WS

RULES & REGULATIONS

OF THE

NOR·THERN ILLINOIS

Adopted Dec. 28th, 1871.

HOSPITAL, ELGIN.

1872.

Officers of the Hospital.

Irn_tttl1 :

C. N. ROLD�N, CHICAGO, President.

OLIVER· EVERITT, M.D., DIXON, ILL.

HENRY SHERMAN. ELGIN, ILL.

R. W. PADELFORD, ELGIN, Secretary.

ORLANDO D..AVIDSON,' ELGIN, Treasurer.

EDWIN A. KILBOURNE, M.D� Medical S'up't.

lUCHARD S. DEWEY, M.D., 1.yt Assis't Pltysician.

Orqomieaiion. and lJIeetIn,qs nf the Board. of Trustees.

1. The Board of Trustees shnll elect one of their number Pres­

ident, who 8hn11 continue in office until the organization of a new

Board, which shall immediately follow upon the appointment and

qualification of a new member They shall in like manner elect tt

Treasurer, who shall hold his office during the plessure of the Board,nnd also choose a Clerk, or Secretary, who shall attend all the meetingsof the Board, keep a full and trne record of their proceedings, and

notify by mail each Trustee of the time and place of all regular and

special meetings, and perform such other duties as may from time to

time be assigu-d him by the Board of Trustees.

2. There shall be in each year twelve regular meetings of the

Board, to be holden at the Hospital on the last Thursday in each month.Those occurring in the months of February, l\fay, August and Novem­ber shall be regarded as the quarterly meetings of the Board, the fiscal

yeRr closing on the last Thursday in November.3 Upon the written application of one Trustee, the Secretary

shall forthwith call a special meeting, and state, 8S nearly as possiblein the notice tn the Trustees, the business for which such meeting iscalled.

4 All questions brought forward for the consideration of theBoard shall, upon the request of one member, be submitted in writing.Charges against Officers (If the Institution shall also be submitted in

writing and a copy thereof shall be furnished to the Officer againstwhom the charge is made, at least one month before it is acted upon,

RY-J,AWK.

rI. The order of business at regular meetings of the Board shall

1. Reading and approval of the minutes of preceeding meeting.II. The consideration of unfinished business therein referred to.

lIf. The consideration of the minutes of the Visiting' Com-

mittee.

IV.V.

The consideration of the reports of the Finance Committee.The consideration of communications from the Medical

Superintendent.The consideration of communications from the Treasurer,

Reports of Special Committees.VI.

VII.VII£. General business.

DUTIES OF OFFICERS OF THE BOARD.

The President of the Board of Trustees shall preside at all the

meetings of the Board j shall sign all contracts made by the Trustees,and perform all such executive duties as the Trustees may from timeto time authorize, or direct.

2. The Treasurer shall execute a bond with sufflcient sureties, to

he approved by the Board of Trustees, in the penal sum of 'I'weuty­five Thousand Dollars. which may however, be increased at the discre­

tion of the Board, conditioned that he will faithfully discharge the

duties of his office and pay over, and account for, ail moneys that

come into his hands belonging to the Hospital, which bond shall be

executed in favor of the State of Illinois and filed with the Auditor ofState. All moneys due the Hospital shall be paid to the Treasurer,who shall keep an accurate account of the same and of their source,and ofall sums by him paid out, and from what fund. He shall make

a report in writing at each quarterly meeting of the Trustees, sho w iugin detail the receipts and disbursements of money, and such other reo

ports as are, or may be prescribed by the Legislature. The Treasurershall also perform such other duties appropriate to his office, as maybe assigned him by the Board of Trustees.

COMMITTEES.

1. There shall be an Auditing Committee consisting of two

Trnstees, who shall be elected by ballot at each annual meeting of the

Board, or otherwise if the Board shall so determine. It shall be the

duty of the Auditing Committee to carefully examine and compare the

books and vouchers of the Treasurer with the books and vouchers of

the Hospital, and to audit all accounts, and examine all reports touch-

t;'Y-LAW�.

ing the receipt and expenditure of moneys, and at each quarterly meet

ing or oftener if required, to lay he fore the Board an explicit and

eomprehensive statement of the financial condition of tbe Hospital.2. A Visiting Committee, consisting of one or more of the Trus­

tees, shall visit the Institution at least once a month ; the members ofsaid Committee acting in rotation or in concert as they shall determine.A book shall be kept in the Hospital in which tho visiting Trustee or

Trustees shall make an entry of the date of each visit, the conditionof the house, etc., with such remarks touching the efficient, wise andeconomical management of the Institution as may he deemed. advisable,and. all present shall sign it,

The Visiting Committee shall 1)(> an advisory body with whom the

�uperintendent. of the Hospital may from time to time confer.

GENERAL FINAN( lE.

1. The money appropriated hy the Logislatnre for the ordinaryexpenses of the Institution shall be drawn from the State Treasury IlS

follows: At each quarterly meeting and at other times when a necess­

ity may arise for drawing money from the State Treasury, the Treasurer,with the aid of the Superintendent, shall, after accounting for the dis­

bursements already made, present an estimate as much in detail as prac­ticable, of the sum of money needed for expenditure before the next

regular meeting of the Trustees and state for what purposei' it is ner-d­

ed, The Board shall then make an order for the drawing of such

sum or so mnch thereof as they may deem necessary; which order shall

be entered upon the records of the Board and the sum ordered maythen he drawn from time to time from the State Treasury, by the

Treasurer as provided for in the law for the government of the Inst i­

tution. All money appropriated by the Legislature for buil ding or for

any purpose other than the ordinary expenses of the Hospital, shall he

drawn by an order of the Board of Trustees, to be entered on record

at some regular or special meeting of the Trustees, directing the pay­ment of the sum of money specified to the Treasurer, or other personnamed therein; and a certified copy of such order shall be the warrant

of the person therein named for drawing such sum from the State

Treasury.2. The Superintendent is authorized each month to draw from

the Treasurer the amount required to satisfy the pay-roll.At each quarterly meeting of the Trustees, the Board may authorize the

Superintendent to draw from time to time, such amounts as may be

needed to meet the contingent expenses of the Hospital, within such

limit as the Board at each meeting' shnll prescrihe, and the Hnpprin­tendent shall, at the next quarterly meeting, account for all such

expenditures in a written report accompanied by the proper vouchers.:L The Treasurer, under the direction of the Superintendent,

shall collect all SUlPS due from counties or individuals for clothingfurnished to patients, or due from other similar sources, and shall

report the sums so received at each quarterly meeting of the Board.4. At each monthly or quarterly meeting of the Trustees, all

accounts and reports touching the receipts and expenditures of money,shall be referred to the Auditing Committee, and at such meetings be

reported upon in writing, and such report shall he entered upon the

records of the Board.

DOMESTIC FINANCE.

1. All contracts for supplies for the Hospital, and all purchasesfor the same shall he made under the direction of the Superintendent,who alone will be holden responsible for the faithful execution

of this duty, provided, that all contracts not terminating in three

months shall have the approval of the Board.

2. All business transactions of the Hospital where money is to

be disbursed, shall be in writing, either hy written contract or hy a

pass-book, properly minuted at the time of any purchase, und the

Superintendent shall be able fully to inform the Trnst ees at [lny time

of the financial condition of the Institution,3. No account whose sum shall exceed one dollar, shall be paid

unless accempanied by a bill of items with the date of each purchase.All accounts current against the Institution shall h� called in quarterly.They shall then be carefully collated with written contracts or pass­

books, and if material errors are discovered in any hill, it shall be

returned to the holder for correction. Such bills 1'ha11 an he sub­

mitted to the Board for their approval- and when they have been

approved, the Superintendent shall issue his orders on the Treasurer

for their payment, and each bill shall he properly recciptcd , shall he

numbered to correspond with the order, and riled in the .oDllpeIintend·ent's office.

4. Before making up the biennial report of the Institution, the

;4l1perintendent l:111a11 rause each hill paid during the two yearR previous,to be entered in its proper order of date in the financial record.

Such entry shall he made to exhibit the name of the person to whom

such payment is made, its date and its total amount; and the severnl items

in such account shall be placed under appropriate beads to show, in the

BY.LAWS. 7

summary ofexpenditures, the amount disbursed for each class of suppliesas minutely as may be required for a clear understanding of the

expenditures of the Hospital as required by law.

SUPEHINTENDENT.

1. The Superintendent shall be the chief executive officer of the

Hospital. He shall appoint and exercise entire official control over allsubordinate officers and assistants in its service. He shall have the

general superintendence of the buildings, grounds and fanu, togetherwith the furniture, fixtures and stock ; and the direczion and controlof all persons employ ell, subject to the approval of the Trustees. It

shall be his special duty to see that all employees arc tlH'rgetic,industrious, punctual, exact, and in all respects, faithful in the perform­auce of their several duties.

2. lIe shall direct such medical, morul and physical t.reutuicnt as

in his judgment will he best adapted to the relief of the patients. He

shall arrange his visits so as to inform himselffully ill rt>fen'llce to their

eond it ion, and be assured of the exact correctness of t he daily rt'('o1'd.:;and 1'I'I)o1't::; uf the assistant physicians. He shall obtain aH far as

practicable, 11 c.uuplete history of every patient admitted into the

Hospital, and shall cause to be kept fin' the use of the Institut iou a

Regist C1' of the same and as full a record of the subsequent treatment

and results as he may deem likely to promote the interests of scienceand humanity.

o. All correspondence of the Institution shall be conducted byhim or by his authority, and under his direction,

4. He �ht111 cause to be kept a record of the, names and residenceof all persons employed in the Hospital, with the time and terms oftheir respective engagements, and the date and causes of their

dismissal.5. At each visit of the Trustees, he shall exhibit the records of the

Hospital, and inform them minutely of its affairs. Every quarter he

shall give a brief statement of its general condition, and the names of

patients admitted and discharged: At each anuual meeting of the

Board, he shall present a tabular view of the operations of the

Institution for the year, with full and minute details from the records,and accompany it with a condensed report of other interesting and

useful facts and circumstauces, experiments and opinions illustrativeof its management, condition and prospects.

6. He shall from time to time give to all persons employed in the

Hospital, or on the farm, such instructions as he shall judge best

8 BY-LAWS.

adapted to carry into effective operation all its rules and regulations.He shall cause such rules and regulations to be strictly and faithfullyobserved, taking care that all employed upon the premises performfaithfully and punctually their respective duties.

7. He shall keep clear, methodical, and exact accounts of all

receipts and expenditures of money. He shall, when required, exhibitall his account books and recent vouchers to the Auditing Committee,and shall furnish a quarterly abstract of the same to the Board ofTrustees whenever requested.

8. He shall keep the accounts of all employees, attendants andassistants of the Hospital, ana settle with them monthly.

9. He shall open an account current with the farm, and at the

close of each year furnish the Trustees a written statement of the

various products, and an accurate account of the expenses incurred in

its management.10. He shall provide the necessary account books for hi� de

partment, which shall always remain in the Hospital, and shall be at alltimes open to the inspection of the Trustees.

11. He shall keep himself fully informed in regard to the lawsof the State governing the admission of patients, and shall use his

powers respecting such admissio 11S in strict conformity thereto,subject only to such modifications as the Trustees may from time totime institute.

A�:3IS'l'ANT PHYSICIANS.

1. The assistant physicians shall act as the immediate medicalattendants of the respective departments as assigned them by the

Medical Superintendent, accompany him in his visits when requested,and shall see all his directions and suggestions in relation to the personalcare and medical and moral treatment of the patients faithfullyexecuted, and promptly and fully report all instances of misconduct,neglect or abuse.

2. They shall attend to the preparation of all prescriptions; see

that they are properly administered, ascertain the effects of the same,and in their daily reports to the Superintendent, note every symptomand such other circumstances and incidents as are necessary to keephim informed as to the daily condition of each patient.

3. ThEY shall assist in devising employment snd recreation for

the patients, and endeavor in every way to promote their comfort and

recovery.4. TIleY shall keep such records of the cases as the Superintendent

ttlay direct, and a.�sist him in preparing statlstrcs, and under' his-

1irections, shall assist in conducting thf. correspondenee'

with: the

friends of patients, and perform all other dutiesIn the medicalde­

partment which may be required of them,5. In the absence of the Medical � Superintendent, the nrst

A-ssistant Physician shall act in his stead,

HOUSEKEEPER.

1. The Housekeeper, under the general direction of the Superin­tendent, shall have charge of the domestic concerns of the Institution,and a general oversight of the whole house: She shall be particular­in enforcing good order, discipline and faithful performance of dutyin her department, arid �hall immediately reprove or report to the

Superintendent any material departure from rule, or anything censurablein moral deportment.

'

'2. She shall also superintend the kitchen and laundry, and see

tbat the cooking, washing and ironing are properly done; frequently'inspect every department, and have an eye to the neat appearance ofthe whole house. It is expected that she devote her whol « time to

the Institution, and spare no efforts to promote the comfort and

recovery of its inmates,

GENERAL CONSIDERATIONS.

ATTENDA1{TS AND ARSIHTANTB.

In: making engagements with ind iv iduals, it iR to .he ,distirictlyunderstood that. the Institution contracts for their �l.;)lc time, andth'at they a:e not to leave the premisesor their Hi'signect duties, nor

engage in any work of their own without express' permission fromthe Superintendent,

..

They must expect an unceasing observation of the manner in

,which their duties a: e performed, �nd kindly receive and pr,)mptlyheed every suggestion 'in regard to deflci. ncies or improvements,

The strictest �bedicnce to both spirit and letter of R11 the regula­tions of the establishment is enjoined upon all.

The duties devolving upon attendants and assistants are' alwR:Vs,arduous an'! responsible, requiring great self-denial and severe schoo l­

Il

10 n'f-tAWS.

ing of the temper and disposition, and it is to be hoped that no one

will accept a situation without feeling in honor bound to obey everyrequirement and heartily disposed, by the zealous and prompt per­formance of duty, to aid' to the utmost in carrying out the objects ofthe Institution.

Under any and all circumstances, the law of kindness must be the

governing principle; and no individual not animated by this law, can

serve the Institution acceptably.The rule above all others appropriate and applicable in our contact

with the insane is, "AU things whatsoever ye would that men should do

to you, do ye even so to them."Force has unfortunately sometimes to be used in every Institution

for the insane, but tact and kindness will render the necessity for its

employment a comparatively rare one, and whenever it must beresorted to, the manner of its employment may be made to take awaymuch of its offensiveness.

A pleasant smile, a cheerful, kind and respectful manner and.

sympathizing words will go far to convince the most excited, that whatis done results from good motives, and that he has nothing to fearfrom those around him.

The opposition of patients, and much of their violence arisefrom delusions, Vihich lead them to suppose that they are to be

injured in some way, and every attempt to restrain them, to givefood, baths or medicine, if made with angry looks or cross words, onlytends to confirm their false ideas and make their resistance more

violent.The truth of these views is well-established and confirmed by

convalescent patients who remember and describe their motives and

feelings when.highly excited.Under no circumstances will an attendant be excused for striking

a blow or laying violent hands upon a patient unless in the clearestself-defense or for the prevention of serious injury to the patienthimself or to others.

Employees will be expected to fulfill scrupulously their engage­ments as to time of service, and duty to be performed in accordancewith agreement, and no one shall discontinue service without givingfour weeks' notice to the Superintendent.

Whenever the Hospital wishes to dispense with the services of

anyone, the same notice will be given or payment for that period willbe made, except in the case of persons discbarged for the violation ofrules or improper conduct

".

BY-LAWS. 1

As many very respectable and well-meaning persons do not possessthe peculiar natural qualifications necessary to render them useful inthe care of the insane, the right is expressly reserved to the Superin­tendent of at any time dispensing with the services of anyone bygiving four weeks' notice, or by paying for that period-and thiswithout assigning the reason for such dismissal.

The thorough cleanliness and order of all parts ofthe establishmentand all its detached buildings will be indispensably required of thosepersons to whom the duty appropriately belongs.

No person intrusted with a key shall ever relinquish for a momentthe possession, of it, nor admit any person but a patient to thewards without the permission of the Superintendent.

No peIson shall be employed in or about the Hospital who isknown to be addicted to any immoral habit.

A.ll persons employed in the Hospital will be expected to treatthe patients and each other with respect and courtesy.

They are to be neat in their dress, and avoid wearing hats or goingin shirt sleeves about the house, unless their work shall for the time

being make this proper.When officers or visitors are present in the wards, they will rise,

attend them and be prepared to give any required information.When abroad, they are to avoid reporting the conduct, conver­

sation or manner of patients.It is very desirable that patients should leave the Hospital with

pleasant recollections of their stay in it, and everyone coming incontact with them, can do much to promote this end:

'

A.lthough the testimony of an insane person, of course, is oftennot to be depended upon, and while a few; even after rec0very,seem to labor under delusions as to what happened during their

illness, still it is undeniable that in most cases patients who haverecovered are quite competent. to give a correct account of what occurred

during their sickness, and of the treatment they received from thoseabout them.

It is hoped that in all cases this testimony will be such as to

increase the standing and respect due to those having the immediatecare of the patients of this establishment.

VISITORS.

The introduction of miscellaneous company into the wards of the

Hospital, is apt to be attended with more or less detriment to individ

p.�ll'atie�ts, an� disturbance of the �eneral <luiet and qiscifli�e of the

12 BY-LAWS.

house. Yet it is due to the public to afford some opportunity of

examining such iusr itut.ions and acquiring correct views respectingtheir management. In order to regulate these visits for the best

advantage of . all concerned, the Hospital will be open to visitors, under

certain restrictions, on Tuesdays, Thursdays and Saturdays of each

week, between the hours of two and four o'clock p. lll. To partiescoming from a distance, "8pecial Permits" will be granted uponother days, at t be discretion of the officers. Visiting Permits lllay be

procured from anyone of the Trustees, or at the office of the Treas­

urer.

F'riends of attendants, assiatants, and 'officers, are requested as fat'

as possihle, to confine their visits to these hours, and will not he

allowed to enter the wards except under the prescribed restrictlons.Friends of patients and attendants cannot he entertained at the

Hospital . and when under any peculiar circumstances, the Superin­tendent feels at liherty to permit strangers to take meals or lodge in

the house, he shall cause a register thereof to be kept.Visitors are not to forget what is due to the f-elings of t\le

afflicted and their friends, No indelicate inquiries can be permitted,and all connected with the Instltution must abstain from mentioningthe names of patients, their. peculiarities, or any other circumstances,a general knowledge of which might be painful to any persons con­

nected with them. No one would be willing to have a friend, laboringnnder insanity, exhibited to strangers, and a hospital is bound to pro­ted, all its inmates from such exposure. Information in regard to the

c -ndition of patients, is to be given by the Superintendent only, andto none except immediate relatives, or to others by their written

request.Visits of friends to persoll>; engaged in the Hospital, must be

made in the parlor, and n.ust be brief.

TDIE.

The morning bell shall be rung for two or three minutes, at half­

past foul' o'clock from April to October, and from October to April, at

rive o'clock a, m. All persons who have duties to perform, shall rise

at the ril'ging of the bell.

Breakfast shall he served. at. precisely one .hour und a halfafter tile ringing of tho morning' hell. Dinner shall be served

uniformly at hul t-past. twelve, and tea at six o'clock p. 111., duringti,l: year.

The pospita.l shall be vlo�vq �t half-pass nine o'clock every �light,

BY-LAWS., 13

and no employee shall remain out after that hour unless by special per­mission of the Superintendent.

OBSERVANCE OF THE SABBATH.

Sunday shall be strictly observed as a day of rest and quiet, at the

hospital. No visitors, or friends of patients or attendants, can be

admitted, except in case of Illness, When public religious servicesare held, it shall be the duty of all persons employed by tile estab­

Iishmen t, to attend. The attendance of patients shall be under the

direction of the Superintendent.SUPERVISORS.

There shall be two Supervisors, whose duty it shall be to exercisea constant and thorough supervision of the m�e and female divisionsof the heuse respectively; to have a general charge of the whole

department : to see to the administration of medicine, and to commu­

nicate with the Physicians and Clerk in refere�ce to the wants and con­

dition of the patients in their respective departments.They shall attend specially to the sick, see that they are treated

with all possible care and kindness; receive the orders of the Physi­cians and see that they are faithfully executed.

It shall be their duty to instruct new attendants in their duties,and see that they are efficient, industrious and kind.

They shall assist in the arrangements for the burial of the dead,and be ready at all times to attend to any extraordinary services whichthe Superintendent may require of them.

They shall pay particular attention to new patients, see that theyare properly introduced, that their fears are quieted by kind attention

and friendly assurances, and that the violent and suicidal are carefullywatched.

They shall endeavor to encourage the attendants in any efforts to

attain a higher standard of duty in their relations with the patients and

with each other, and to cultivate in their dress, manners, and personalhabits, a feeling of self-respect and politeness.

They shall communicate freely with the Superintendent as to the

fitness of attendants for special duties, as to any neglect or deflcieur-yin attendants, and also aQ to defects ill the quantity or quality of foodserved to the patients under their charge, and as to the condition inwhich clothing i:l returned from th e wash j and in general, they shall

be responsible for the pl'Oper d eportment of attendants, to whom

they shall be � guide and exampIe!

14 BY-LAWS.

They shall note in a book provided for that purpose, any instancof neglect of duty or harsh treatment of patients on the part of an'

attendants which may come to their knowledge, together with such

facts and occurrences as they may deem in any degree important tothe well-being of the patients or the Hospital, and report the same

daily or as often as circumstances may require, to the Superintendent.The clothing of the patients shall be carefully examined by them

at the time of their admission to the Hospital.They shall see that it is properly marked, and shall frequently

inspect clothing, bedding, &c., to see that they are well-aired, clean,and in good order, and shall be responsible..

for the general neat

appearance of their respective departments,The Supervisors shall attend to having all patients bathed as soon

as practicable after admission, and shall report to the Physician anybruises or indications of injury or eruptive disorder that may be dis­covered, and whether or not patients have been vaccinated.

They shall in all things endeavor to carry into successful operation the plans of the Superintendent, and shall constantly study to pro­mote the comfort, content and welfare of' the patients, and for 'these

purposes they shall visit every part of their respective departmentsseveral times each day. They shall also see to the changes of patientsfrom one ward to another.

All communications from the wards shall be made through the

Supervisors.On the Sabbath day, the Supervisors shall see that the patients are

ushered into the Chapel at the time for service, and that they are appro­priately dressed for the occasion.

They shall also see that the warns are properly supplied withfurniture and articles for' use, and shall often communicate with the

Physicians respecting the patients under their charge, and informthem of any change in their condition that requires attention, and of

those likely to be benefited or injured by exercise, labor, amusement,or religious services.

ATTENDANTS AND THEIR DUTIES.

1. INTERCOURSE WITH PATIENTS. In all their intercourse with

patients, the attendants are to treat them with respect and civihty, are

to address them in a mild and gentle tone of voice, and avoid most

scrupulously all viotence and rudeness.Such civil questious as are addressed them are to be properly

answered,

'!lV-LAWS.

All reasonable requests are to be promptly attended to.. .

They are to keep cool under every provocation! are never _t? �cd'\:threaten 01 dictate authoritatively; but are to make all requirements of

patients in a respectful manner.

Under no circumstances will an attendant be excused for strikinga blow or laying violent hands upon a patient unless self-defense shall

clearly make it necessary, or unless some serious injury to the patienthimself or to others is to be prevented.

Attendants are never to manifest fear of patients, yet, while treat­

ing them with firmness and decision, must not omit mildness and

kindness of manner.

They must take every proper opportunity to inspire the patientswith respect for and confidence in the officers, and to convince them of

the true' character of the Institution and of its leading object-thepromotion of the restoration and comfort of its patients.

They are to interfere promptly when patients are disposed to

quarrel, and by kind words and engaging their attention with other

objects, prevent difficulty.A kind word fitly spoken will obviate many a scene of excitement,

just as a harsh remark, an angry look, an unkind allusion, or a rude act,on the part of an attendant, may be the origin of difficulties whichwill last for hours.

They are carefully to avoid talking to patients on the subject of

their delusions, or to others in the hearing of the patients, and, as

much as lies in their power, they should endeavor to prevent cithers

from doing so.

They must never allow patients to be laughed at, or ridiculed, or

harshly spoken to, on account of their delusions or the peculiarities oftheir behavior. No greater proof of a want of correct feeling could

be given than an indulgence in levity in reference to the misfortunesof our fellow-beings.

Deception is always to be avoided, and particular care is to be

taken that no promises are given which cannot be fulfilled.

Attendants are not to furnish writing materials, or books, to

patients, or make purchases for them without consulting the

physicians.Each attendant is responsible for every patient under his or her

care, and is expected to be able at any moment to say where each ind i­

vidual can be found One attendant must always be present with the

patients in each ward.

When patients remain much in their own rooms, the attendants are

H1

ttl �'r:�9:1�ntl1 tina "('HoHl)ii"l for calling til sell how they are engaged or if

tlH'y �(tqni"'l particular attention.2. MORNING DUTIES. The attendants will rise punctually at the

ringing of the bell, and take charge of the wards before the night­watch goes off duty.

They will then open the sleeping-room doors, give the patients a

kind greeting; at least wish them a "good morning," and see tbat

that they are properly dressed, well washed, and have their hair and

clothes neatly brushed.

Immediately after opening the doors, the attendants shall re­

move the chamber utensils and have the bedding laid well apart for

airing,They will then commence putting the rooms and corridors in good

order, and after the beds and bedding have been sufficiently aired,have them neatly made up for the day.

Every part of each ward is to be prepared for inspection at the

morning visit of the physician.3. CLEANLINESS AND VENTILATION OF THE WARDA. Every part of

the ward is to be kept scrupulously neat, clean, and well-aired at all

tunes,

Whenever any unpleasant effluvia is discovered, the cause of it is tobe searched for and promptly removed by night as well as by day.

When any part of a parlor, chamber, or hall is accidentally soiled,it is tv be cl eaned at once.

Whenever a bed or the furniture of a room has been disarranged,it is t« be promptly put in order.

The halls and parlors must be swept as often during each day as maybe necessary to keep them perfectly tidy.

If an attendant from one ward, in passing through anothervspillsoil, medicine, &c., he is bound at once to clean the place. Unlessdirections are given. to the contrary, the chambers, wards, corridors,and halls, are t" be scrubbed at least once a week, and as muchoftener as may be required.

The spittoons are to be kept clean and frequently emptied.The water closet», urinals, &c., are to be carefully watched, and pre·

vented from rendering impure, in any degree, the air of the ward .

.i.V'ntldn.q i« clean enough, so lung GAl it can be made cleaner.

All beds that are soiled are to be removed from the wards imme­

diately after the patients rise in the morning, and after breakfast, cleanones an' to be substituted.

If only wet, the wet straw or hair is to be entirely removed and

nY-LAWS.

boiling water poured upon the soiled part, after which it is to be

thoroughly dried before it is returned to the chamber.A clean sheet and pillow-case are to be put upon each bed at

least once a week, and when. the spreads become soiled, they are to be

sent to the wash.

When patients wish to lie down during the day, they are to goto their own rooms for the purpose, and attendants will see that the

bedding is not soiled, and that it is put in order as soon as the patientsrise,

. The health and comfort of many patients require this indulgenceevery day.

4. MllJALS AND DISTRIBUTION OF' FOOD. The attendants will see

that the patients are always up and ready for breakfast at the pre­scribed hour.

They will carefully observe that they pass to and from the table in

good order, returning directly to the wards when they leave the

dining-rooms.Those patients who take their meals in their own rooms, are to be

served promptly, and especial care is to be taken that their food is

brought to them warm and in good order, and whenever necessary an

attendant is to remain with them while they are eating.Care is to be taken that no knife, fork, or other article which

could be used as a weapon, is left in the ward or taken from the tables.When any such instrument is missed, prompt measures are to be

taken for its recovery. ,

Patients are never to be forced to take food except in the presenceof one of the physicians, or the Supervisor, and never but by the

express directions of one of the medical officers.No conversation must ever be held with patients through the

windows, nor must anything btl thrown away through a window.5. ADMINIS'l'UATION OF, MEDICINE. The trays containing the

medicine will be called for at the dispensary by the Supervisor or bysuch person, and at such times as m<ty be directed by the physician.

The attendants will assist the Supervisor in administering the

medicine, and see that it is all properly taken..

The utmost gentleness is to be used in giving medicine and everyproper means employed to induce the patient to take it willingly.

When it is positively refused, and the physician believes itsadministration important, either the assistant physician or supervisormust always be present before any force is used.

When an attendant infers that any mistake has been made in the

g

1S BY-LA.WS.

medicine 'sent, he is to assure himself upon the point before adminis­

tering it, and should a patient complain of falling sick or having anyunusual symptoms, his medicine should be retained in the cup until a

physician can be seen upon the subject.Any striking or unexpected effect in the operation of medicine is

to be at once reported..

When a patient complains of becoming suddenly unwell, or is

supposed to be so, the fact should be reported without delay.The person charged with carrying the medicine from the dis­

pensary to the wards, cannot select a substitute on any occasion with­out the consent of one of the physicians.

6. SHA.YING. The shaving of patients is to be done by the attend­ants in each ward at stated intervals, or by such other person or per­sons as the Superintendent may designate, and patients who desire to

be shaved more frequently, are to be gratified in this particular.Great care is to be taken that no injury is done with the razors, all ofwhich are to be carefully kept by the proper attendants.

When the physician has allowed a patient to shave himself, an

attendant must always be present, and no other patient in the room at

the time.7. WALKING OUT WITH PATIENTS. It is desirable that every

patient, not too feeble or too sick, should walk out in the grounds at

least once in each morning and once in each afternoon, when the

weather is not such as to interfere.'

Immediately after; the morning visit of the physician, in suitable

weather, one attendant in each ward should prepare to go out with as

many patients as it is proper to take at once.

Upon the return of the first company, a second should go ont, andso on, until all in the ward have had a proper amount of exercise.

In the afternoon, the same plan should be adopted and continueduntil near tea-time.

When walking out with patients, the .attendants will walk as faras possible; consult their wishes in regard to the direction of the

walk; will be vigilant to keep them together and prevent their stroll­

ing; take care that those from different wards mix as little as possible,and that no more are taken in one company than can be properlyattended to.

When patients' habits are careless, the att end ants will see that theydo not lie on the ground, or expose themselves unduly to the sun, &c.

Attendants when abroad with patients, will avoid entering into

conversation with any others than those in their charge, reading, or

BY-LAWS. 19

other occupation by which their proper supervision may be prevented,No patient ean remain out after tea in summer, or after sun-set in

winter, without special permission from the physician.When walking with patients, attendants will be especially

careful to avoid crowds, railroads, and all other dangerous places.They will strictly avoid paying any visits when they have patients

with them, or entering any house or any public resort for an.y purpose.8. PATIENTS AT WORK AND OUT-DoOR ATTENDANTS. Such'

patients as are deemed suitable, will be allowed by the physicians to

go out to work under the care of the out-door attendants, gardener or

farmer; but no one is to be taken out of the wards for this purpose,unless permission of the kind has been previously given.

The attendants will take especial care that the patients do not

engage in improper kinds of labor, or over-exert themselves in anyway.

These patients must always be kept under observation, and whena strong disposition to escape is manifested, they must be constantlynear the attendant.

No patient should be taken out of a ward for work, or for other

purposes, by an officer, or by any person, without mentioning the factto the proper attendant.

All attendants are expected to go out and work with the patients,whenever it is deemed desirable for them to do so; and when thus

engaged, they will carefully avoid every appearance of superintendingthe patients, instead of working with them ..

They should induce them to employ themselves by persuasion and

example, and not by any peremptory order.

9. RETIRING AT NIGHT. Patients are not to retire for the nightbefore 8 o'clock, p. m., unless by special permission.

Those in the convalescent wards may remain up according to their

wishes, so that they retire in time to allow the attendant to close theirdoor at half past nine o'clock. The attendants will hence not beallowed to light the gas in their own rooms until after the retiring hour.

Attendants are expected to be in their rooms at a quarter beforeten o'clock, and after ten no light can be kept burning, unless in case

of sickness.In each ward, however, one light may be kept burning, to be used

in case of emergency.After patients have commenced retiring, all persons are to be care­

ful to avoid making any noise which might disturb those who are in'bed.

20 BY-LAWS.

The clothing of patients, unless otherwise directed, is to be keptoutside the rooms, always neatly folded and placed on a chair or settee

near the door, and is to be handed to the patient when the door is

opened in the morning.When patients lodge in a different ward from that in which they

pass the day, it is the duty of the attendant having them in chargeduring the day, to take them to their rooms and see them comfortablyin bed, unless otherwise directed, and it will always be the duty of

the attendant of the ward in which they sleep, to see them up and

dressed in the morning, and returned in proper time to the ward from

which they came the previous evening.Before closing the door, the attendant should wish the patient a

"good-night," and be sure that he is actually in the room.

The door is then to be locked and tried, to ascertain that the bolt

has been properly slipped.No patient's door is ever to be left unlocked at night, unless special

permission is .conveyed from the physician to the attendant and the

night-watch.10. SECLUSION OF PATIENTS IN 'l'HEIR ROOMS. ,Whenever a patient

becomes so noisy or so violent that the attendants, after trying all

proper means, believe it necessary to place him in a private room, he

should provide such assistance as will convince the patient that resist­ance will be of no avail.

The seclusion must then be effected in the most mild and quiet,manner possible.

When the patient is in the room, the attendant should sit down

quietly by him, and tell him why he has been placed there, and that

he will he released as soon as he is able to control himself. No matter

how unreasonable the patient appears, this should be done.Under no circumstances will an attendant be justified in forcing a

patient into a room and closing the door upon him without a properexplanation.

.

A room having a wire or close shutter, is always to be selected forthe seclusion of an excited patient.

As soon as the patient is in the room, the fact is to be stated to one

of the physicians or a memorandum of it left at the office.When .it is necessary that patients should be secluded in their

rooms, the attendants should be careful to see them frequently, to

ascertain that they have everything proper that can minister to their

comfort, and to know in what manner they are occupied.When a patient is very violent, one person on each side taking an

BY-LAWS. 21

arm, and a third at his back, can almost always convey any ordinaryindividual to his room, or remove him from ward to ward, with no dif­

ficulty or injury to anyone.11. RESTRAINING ApPARATUS. Restraining apparatus will not be

permitted to be applied in any case except by the express direction ofone of the medical officers.

"IfSeclusion in a private room, and the personal care of the attend­

�Jnts, must be relied on until the physician can be found, and his direc­tions in reference to future proceedings given.

Seclusion is in most cases much better for several hours, than to

put on any restraining apparatus, although the latter may ultimatelybe necessary and even beneficial.

12. ESCAPES. The escape of patients is always exceedinglyannoying, and although such events will occasionally occur, it must

never be as a result of neglect.Patients are more apt to escape when passing from one part of the

building to another, or when allowed to pass out for some particularpurpose, or if near a crowd, or about twilight.

At such times and in such places therefore, they must be particu­larly watched.

An attendant's eye should always be kept on a patient known to

be disposed to escape.When it is clearly established that a patient has escaped from the

carelessness of an attendant, the expense of recovering the patient maybe charged to the attendant at the discretion of the physician.

When a patient is found to he missing, a search should at once be

instituted where the patient was last seen, and if any traces are discov­ered, pursuit should at once be made.

But if not discovered at once, the fact of the escape should be

promptly communicated to one of the physicians, or other officers or

supervisors, and any other attendant that may be met with. The

officers shall then give directions what course is to be adopted to

recover the patient.The attendant following the patient, should, if possible, leave word

in what direction he proposes going, and should know that some one

takes special care of the patients he leaves.

When a patient is brought back, no offensive allusion is to be made

to the escape j but he is to be treated in all respects as if nothinghad occurred, except that he is in the future to he more carefullywatched.

13. SUICIDAL CASES. When patients are disposed to commit injury

'22 BY-LAWS.

upon their own persons, all experience shows that there is no certain

security except by constant watching.Care should be taken to place out of reach all the means that

would be likely to be resorted to, and the patient must be kept con­

stantly in sight, treated with great kindness and sympathy, and hisattention drawn as much as possible from the subject.

It must never be forgotten that in a bad case, a single minut€- ofneglect may be as serious in its consequences as a whole hour. id

Before placing such a patient in his room, it shall be carefull,inspected, and when the clothing is removed, it, as well as the patient,should be examined.

Especial care' is to be taken of such patients about twilight, or

while others are going to or passing from meals, and at all times whenthe general attention is likel y to be distracted, as these are the hourswhen attempts are most likely to be made.

In case the attendant should ever discover that such an accident has

occurred, he must maintain his coolness, give prompt relief if any can

be rendered, then loc'k the door, quietly inform one of the physicians,or other officers, but give no alarm which will excite the patients, or

do anything which could lead them to discover what had occurred.

14. DANGEROUS WEAPONS. Especial care must be taken at all

times that patients do not become possessed of knives, razors or other

dangerous weapons of any kind.

Frequent search for such articles must be made i>o wards, and when

the existence of any is suspected, every possible means must be usedto discover them.

Anything seen lying about the wards, yards, or grounds, that

might prove dangerous in the hands of a violent patient, should be

carefully and promptly removed.No patient is to have in his possession any razor, knife, or other

article, that in his own hands or the hands of others, might he used as

a dangerous weapon.Patients are not to receive or forward any packages, parcels 01'

letters of any kind without the knowledge and approbation of the

physician.15. PATIENTS' CLO'£HING. The clothing of every new patient is to

be examined at the earli.-st opportunity after admission, to ascertainwhether there are knives, weapons of any kind, money or tobacco, or

other forbidden artie] es npon his person.If any are found, they are to be promptly given to the clerk.

The clothing of a patient is not to be taken into a ward until it

BY-LAWS. 28

has been examined, and a list of articles taken by the Supervisor or hisassistant.

All new clothing lent to a patient, should pass through the same

hands and be registered in the same way before it is used.No unmarked clothing should go to the wash, or be used by any

patient.The attendants will carefully see that patients change their clothes

t�mJarly, and all reasonable requests in reference to changing clothes,J

r to be gratified.oSoiled aLothes are never to be allowed to remain in a patient's room,

»ut are to be put at once among those to be sent to the wash.

The clothing of patients is to be kept neat and clean and well­

brushed at all times.If buttons are found to be missing, or holes seen in a garment, it

is to be at once repaired.If articles necessary in the wards are found wanting, they are to

be asked for until furnished.Shoes are to be kept tied, stockings gartered, clothing buttoned or

fastened, at all hours and on all patients.When patients soil their clothing, it is to be changed as often as is

necessary to make them dry and comfortable, even if this is everyhour.

The wet part of a garment may be dipped in boiling water and

dried, but is not to be returned to the ward without undergoing this

process.Pains are to be taken to induce patients to be neat in their dress,

to wear slippers when within doors, and in wet weather, to change theirshoes after walking out.

The female attendants are expected, under the instructions of the

Supervisor, or superior officers, to do what they can, in their sphere of

duty, to preserve patients' clothing and keep it in proper repair as faras possible, and avoid unnecessarily sending articles to the sewing­room.

All attendants will take charge of such work as is sent to their

wards, and encourage the patients to give such aid as may accomplishthe work.

Attendants can do no private work except putting their own

clothes in order, during the hours of duty; nor will they employpatients to work for them when any work is required for the house.

16. VISITING BETWEEN WARDS. As the duties of each attendantare confined almost exclusively to a single ward, they can have but

24 BY-LAWS.

rare calls in any other, unless specially directed by the proper authorityto go there.

In going from one part of the building to another, they will avoid

passing through wards not necessarily in their way.Patients are not to visit from ward to ward, without especial per­

mission in each instanee, from one of the physicians, and no patient is

to be transferred from one ward to another, without special direction.17. LEAVE OF ABSENCE. To those who perform their dnt

faithfully, it is desired to allow as much relaxation and as muc

absence as are consistent with the kind of service required, and as the

welfare of the patients will permit; but whenever the absence ofattendants is deemed likely to be prejudicial to the patients, they are

expected to remain at their posts.Leave of absence is granted only by the chief medical officer.If he is absent more than an entire day, the assistant physician

may be applied to, but not under other circumstances unless tneir

nature is extreme.

The usual time for absence will be from half past one o'clock p.m., or after the dinner is entirely finished, till the ordinary hour ofreturn in the evening.

Promptness in returning at the hour up to which leave of absencewas given, is always to be carefully observed.

If unforseen circumstances positively prevent this for any lengthof time, word should be sent to the hospital.

Without special permission, no one is to leave the premises at anytime or for any purpose except walking with the patients .

.

Attendants will be careful always to be inside the enclosure before

half-past nine, and in their own rooms at a quarter before ten.

On returning to their own rooms in the evening, care must betaken not to disturb those who have already retired, either by noise of

walking or conversation.Permission must be sent to the ward before an attendant can be

permitted to leave it to see any visitor, and the absence shall then be

short and visitors are never to be taken through the house or groundswithout permission.

On the Sabbath, leave of absence is always to be for the purposeof attending Divine worship.

.

If granted for the morning, attendants are always expected to return

before dinner.When about to leave, attendants will call at the office and put their

keys on the hooks provided for that purpose, and report themselves

1ft-tAWs'.

either to one of the physicians, or leave their names and the hour of

going out, on a slate provided for that purpose, and in like manner

report themselves on their return.

They are never on any occasion to lend their keys to any personwithout directions to that effect from a medical officer.

When attendants are absent from their duties for any length of

time on their own private business or pleasure, they will have the loss

sP�f time deducted on the settlement of their accounts at the discretionof the Superintendent.

Attendants and others employed in the house, are not allowed to

visit the friends of patients unless requested to do so by the Superin­tendent.

18. RECREATION OF PATIEN TS. Attendants are considered in this

Institution, the guardians and companions rather than the keeperssimply, of the patients.

Strictly regarding themselves as such, they shall endeavor thattheir patients are supplied with books, papers, and all other methodsof diversion which the Hospital affords.

They should devise and carryon proper amusements, and strive to

keep all patients engaged and interested, so far as their condition ofmind makes it possible.

They should see that patients during the day, are indulging in no

pernicious practices.Those given to solitary habits, especially, must receive especial

attention, and, so far as possible, be induced to participate in the pur­suits f!.nd amusements of others.

Indolent patients should occasionally be led about the wards andinduced to give themselves some exercise.

Those on the contrary, who are weak and restless, should be per­suaded to take repose.

SUPERVISORS' ASSISTAN'l'S.

There shall be a special clerk or assistant in each division, whoseduty it shall be, under the direction of the Supervisor of that division,to receive the clothing of patients on. their arrival and see that eacharticle is neatly and plainly marked, entered upon a book kept for that

purpose, and properly disposed of and preserved.Money, jewelry, and other articles not needed in the wards, shall

be carefully tied up, labeled and deposited in the office fer safe keeping.Said assistants shall keep a watchful eye upon the clothing of

patients, for which purpose they shall frequently visit the clothes­D

BY-LAWS.

rooms and see that they are in proper order and that any lost or strayarticles are promptly returned to the store-room.

When patients are discharged, they shall see that all articles

belonging to them are carefully packed up and brought to the office

ready for delivery.When not necessarily employed elsewhere, they shall remain in

some designated ward within sound of the office-bell, and be ready at

all times to attend to the orders of the physicians.If not otherwise engaged, they shall assist in the ordinary duties

of attendants.

SEAMSTRESS.

The Seamstress will have charge of the sewing-room.She will have the care of and be responsible for all materials and

apparatus belonging to her department.She will have the care and oversight of the patients who may be

allowed to come from the warns to work under her direction, and will

endeavor to make their time and work useful , and at the same time as

much a recreation and pleasure as possible.She will report promptly any improper conduct on the part of

patients.Such patients as shall be directed, may he taken daily from the

wards, hut no new patient or patient, who has behaved improperly,ShRU be taken from the wards without permission.

The Supervisor, or Clerk, may take patients to and from the

sewing-room, if Su directed by the Superintendent.The Seamstress shall depend for her supplies and for specification

of articles to be manufactured from day to day, upon the Supervisor,or such other officer as the Superintendent shall designate.

DUTIES OF THE ENGINEER.

The care and oversight of the engines, boilers, machinery, pump­ing, warming and ventilating apparatus, tanks, sewers, stearn-oookingapparatus and dumb-waiters, are committed to the engineer.

He is instructed to prohibit visits to the boiler and engine-rooms �

and patients, attendants and visitors shall not be allowed to enter

except by special permission or when accompanied by an officer.He shall also be responsible for the proper conduct and fidelity of

those associated with him as assistantsHe will be expected to devote his whole time to the Institution,

and regulate his hours according to the necessity of the case.

BY-LAWS. 27

OVERSEERS OF KITCHENS, ETC.

The kitchens, laundry, bakery, shops, &c., shall each have an

overseer whose duty it shall be to see to the safe-keeping and econom­

ical use of the supplies furnished to those departments,No attendant, assistant, patient, or visitor, will be allowed to enter

the kitchen, laundry, or ironing-rooms, engine-room, or shops, without

special permission.Whenever patients or attendants are sent to assist in the ironing­

room, they will be provided with a written order which the overseer ofthe Ironing-room is to return to the clerk.

Those persons employed in the kitchens, laundry, shops, &c,must not visit the wards unless by permission in each case.

No meals are to be furnished to visitors in these departments or inthe wards, and no extra or unusual articles of food cooked or furnishedwithout a written order.

All violations of rule, or instances of bad conduct on the part ofthose employed, are to be reported to the Superintendent immediately.

In such an establishment, where there are large quantities of pro·visions and many hands employed, constant vigilance will be necessaryto guard against the feeling on the part of many that it is of no c.m se­

quence if some things ale lost or squandered: "That they belong tothe Slate, and there are enough left."

Any remark of this kind, or conduct which indicates such feelings,should be at once made known to the Superintendent.

In short, the overeeers are expected to know, from their personalobservation, that the articles of every sort entrusted to them, are safelykept, economically used, and that good order and cleanliness prevail inall the departments under their care.

It will be their duty to Bel! that those employed rise early, and are

attentive and faithful throughout the day and hours of labor.The overseer of the laundry, shall collect the clothing and other

articles to be washed and dried : especial care must be taken that none

are lost.For this purpos e, he must see that he receives all the articles in

the list given him, and that they are marked, and that he furnishes thesame with the lists to the ironing-room.

The overseer of the irouing-rooen shall see that the clothes andother articles delivered, are properly and correctly distributed accord­

ing to the lists.

When patients assist, they must be carefully attended, and not

,28 lll'LAWS.

suffered to go away; and at al l times and under all circumstances, theyare to be treated with respect and kindness, and particular pains taken

to promote their comfort and cheerfulness.'Whenever articles are needed in an v of these departments, written

lists mnst he prepared and left at the office.

DUTIES OF THE WATCH.

THE NIGHT ,VATeH will commence his duty at nine o'clock p. m.,at which time he will visit tl�e office for any special instructions forthe night.

He will then visit the public rooms, male wards, kitchens, bakery,boning-mom, boiler-room, and such parts of the basement as may be

designated, and make 'the rounds of the Hospital every hour from thecommencement till the close of his watch, carefully observing if every­thing is right, and noting his ob��rvatioDs in a book kept for that pur­pose.

At half-past nine o'clock he will lock the outside doors and makea record of. the time of admission of any person after that hour.

He will be constantly vigilant to guard agltinst danger from. flre,the least suspicion of which in any part of the establishment, or inthe buildings, lumber or wood around it, shall draw his immediateattention.

He shall especially look after the sick, suicidal, and excited; guardagainst escapes j notice unusual sounds in patients' rooms and ascertaintbeir cause, and endeavor, as well as he may bp, able, to tranquilizethose who are excited, and allay the apprehensions of the timid.

He may give water where it is needed, and attend to any reason­

able wants.

In going about, he will make as little noise as possible, and at

once awake the attendant in an emergency.He will faithfully report all irregularities, or violation of rules,

and the manner in which new patients and the sick have passed the

night.He will ring the:bell at tha'prescribedjhour, start tile fires in the

kitchen, and perform suchother duties as may be assigned him.

The watchw oman will confine herself to the wards occupied by fe�male patients, and be governed by the rules prescribed for the watchman.

Both will be constantly vigilant to perform their responsible duties

with strict fidelity.Any want of fidelity in these officers, must instantly disqua.lify

them for their stations.

The attendants and other employees being up, and in charge oftheir duties, the duties of the watch shall cease till 12 m., efterwhieh

they may be called upon for various services till supper is over. fromwhich time they will be relieved. until tbeir usual hour of duty "om­

menees.

If fire is discovered that cannot be readily extinguished, theattenaants and officers should be aroused without causing a generalalarm, if possible.

THE DAY WATCH commences and ends in alternation with the

night-watch.The beating and lighting of the center bul1lding belong te the day­

watchman.He shall see that the windows and doors are kept secure during

the day, especially on the approach of high winds and storms.He shall see that visitors about the premises do not transgress

rules of propriety by talking with patients at windows, and that theentrances to the enclosure of the Institution are kept shut.

,

He shall keep wit bin the sound of the office-bell during the day,and shall hold himself in readiness to perform such other duties as are

,

allotted him by the Superintendent.

DUTIES OF THE FARMER.

The Farmer, under the Superintendent, will have the general care

and direction of the farm and the men employed in his department.He will have special care and oversight of all farming tools and

implements, the stock of all kinds, see that they are properly cared for,keep a correct account of all articles raised on the farm, and preserveorde:r and system in all that pertains to his charge.

He will make such arrangements for conveying patients to ride, as

may be desired by the Superintendent, and designate the persons whose

duty it shall be to carry this regulaHon into effect.He will perform any other duties which the Superintendent may

assign him..

DUTIES, OF THE GARDENER.

The Gardener, under the direction of the Superintendent, willhave the care (If the garden, pleesure-grounds and green-house, and

wil� that they are kept in good order, and that those who aid himin t

.sduties perform tbeir work faithfully.

He will take care of all implements belonging to his department,and see that they are propeJ ly preserved.

,

He will see that the kitchen is promptly supplied each morning,

,,

BY-LAWS.

or at other times of day if so directed, with such vegetables as may be

required.' ,

He will guard carefully against the counnission of any depreda­tions upon the garden or nursery, and keep these departments at alltimes in readiness for exhibition.

CLOTHING.

On the arrival of a patient at the Institution, a list of the clothingbrought..and upon the patient's person, shall be made and entered in �a

book kept by each Supervisor for that purpose, into which also shall be

entered whatever may afterwards be received or purchased for the

patient's use.

Whenever any article of clothing belonging to any patient, shallbecome so worn-out. or be so destroyed, as to be of no further use, thefact shall be noted in the list of sucli patient's clothing, together withthe date.

On the discharge of the patient, the clothing in bis or her posses­sion shall be carefully compared with the list, that aoy losses may bediscovered and accounted for or explained.

The clothing belonging to patients in each division of the

Hospital, shall be deposited in a room set apart for that purpose, the

key of which shall be in the custody of the Supervisor.Clothing required for the daily use of the patients, shall be kept

in the ward closets.At some particular hour of each day, Supervisors shall be in

attendance in their respective clothing-rooms to change or supply such

clothing a s the wants of the patients may require; and attendants are

enjoined not to call on the Supervlsors at any other times, if .such call

can be avoided.

When any resident patient is in want of clothing; the fact shallbe reported to the Supervisor, 'who shall receive the instructions of the

Superintendent in regard to its purcbase or supply.No clothing shall be purchased out of the Hospital, if it can be

manufactured in the sewing room.

All articles of clothing obtained for patients, shall be charged on

the Supervisor's books, which shall be handed into the office everySaturday noon, and posted into the clerk's book of accounts.

Attendants shall be careful that the clothing of patients is adaptedto the season, and especially to see that patients are" not suffered to goout either for exercise or labor, without a careful inspection of what isworn.

Especial attention at such times must be paid to the covering of

BY-LAWS. It,

the head and the feet; t'lat the hat or bonnet be suited to the weather,and that the shoes are whole and properly tied.

,

It' will be considered a culpable negligence on the part of the

attendant, if one of his patients is found wearing any article belongingto another.

'

AU articles worn by patients. are to be legibly marked, and the

Supervisor is expected to see that the clothing of each patient h

devoted to his use and to the use of no other.'

MISCELLANEOUS PROVISIONS.

All persons employed on the premises, and not mentioned in the

foregoing rules and regulations, are expected to be governed by their

general spirit in the performance of whatever duties may be assignedthem.

'

In order that employees, both male and female, may be madeas familiar as possible with the duties belonging to their stations, It

copy of these rules and regulations will be furnished to each personmentioned therein upon entering upon their duties, which shall be

preserved and given up whenever they leave or are discharged, and itis hoped that a frequent, careful perusal of the regulations of the

Hospital will prevent employees from.making the inadmissable excuse

of ignorance, as a plea for non-observance of the same.

The Superintendent may procure the attendance of some Clergy­man on each Sabbath day, to perform such services as he may direct;and may also provide for lectures and such other literary exercises'during the week as he may deem of advantage to the patients.

These By-Laws can be amended or repealed at any regularmeetingof the Board by a majority of the Trustees, notice thereof having been

given at a previous meeting.The words "he" and "she," as used in the laying down of the

duties of employees, are convertible terms which apply in aeeordancewith the obvious sense.

A copy of these rules and regulations shall be kept in each attend­ant's room and in each employees' dining-room, and so often as the

Superintendent shall give notice, they are to be read aloud to those inthe service of the Institution, at some appointed place; and it shall bethe duty of all to attend unless specially excused.

CONCLUSION.

These rules and regulations have been prepared for the purposeof enabling all connected with the Hospital, to know the principles.

32 BY-LAWS.

upon. which it is desired it should be managed, and that all persons in.

Its service may so conduct themselves as most effectually to advance the

best interests of the Institution, promote the restoration and happinessof the patients, and it is believed contribute to their own comfort andsatisfaction.

A few general facts and principles should be kept constantly inmind by all persons connected with the management of the insane, butmore especially by the attendants into whose keeping they are

intrusted.,

1. Insanity is very generally associated with, and frequentlydependant upon, some bodily disease or infirmity.

2 .. There is usually a loss or serious impairment of the sense ofmoral obligation I and inability to distinguish between right and

wrong, or sufficient control to act upon such a distinction, and there­

fore irresponsibility for words and actions.3. There is usually a full appreciation o'f all acts of kindness or

courtesy, and in general a recollection of them after restoration and in

after life.4. There is usually a morbid and exalted sensitiveness in relation

to what is due to them in attention and general deportment, and conse­

quently irritation, excitement, or anger, at either real or imaginedneglect or impropriety of treatment; and the recurrence of any par­oxysms or outbursts of excitement and anger, aggravates the diseaseand postpones recovery.

5. The more the mind dwells upon or is in any way reminded of

delusions or hallucinations, the more permanently are they fixed; so isthe reverse true, that the more entirely they are excluded from the mind

by occupation with other thoughts ani ideas, the sooner do they alto­

gether disappear.

I CERTJ]'Y that the foregoing By-LAws, RULEH

'and R�X+ULA'rIONS, were adopted by the BOARp OJ!' I

'l'RrsTEEs OJ!' THE NOR'l'HERN ILI.INOIS HOSPITAL FOl:

THE INSANE, at their Regular Meeting, held on THURS­

DAY, THE 28TH DAY OJ!-' DJWEMBEJ�, 1871, and they are

declared to hp hinding on an persons in the service

of the Institution.

U. W. PADELJ!'OUD,Secretary.

C. N. HOLDEN,President,

-:0:-

Approved,JOHN M. PALMER,

Governor (!f llHlloh:.

UNIVERSITY OF CHICAGO

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