RULES 
OF THE 
CITY HOSPITAL 
OF THE 
CITY OF BOSTON 
WITH 
RULES OF THE TRUSTEES, THE ACT AUTHORIZING 
THE CITY TO ESTABLISH THE CITY HOSPITAL, 
THE ACT OF INCORPORATION, AND 
THE ORDINANCE OF THE CITY 
RELATING TO THE 
CITY HOSPITAL. 
[Revised, 1890.] ROCKWELL AND CHURCHILL, 
Citv Printers. CONTENTS. 
Acts of the Legislature relative to the City Hospital, s 
Ordinance of the City of Boston relative to the City 
Hospital 8 
Rules of the Trustees n 
Rules of the City Hospital 13 
Index to Rules of the City Hospital 43 ACTS AND ORDINANCE. 
An Act to Authorize the City of Boston to Establish 
a City Hospital. 
Section i. The City of Boston is hereby authorized to 
erect, establish, and maintain a Hospital for the reception 
of persons who by misfortune of poverty may require 
relief during temporary sickness. 
Sect. 2. The City Council of said city shall have power 
to make such ordinances, rules, and regulations as they 
may deem expedient for the appointment of trustees and 
all other necessary officers, agents, and servants, for man- 
aging said Hospital. 
Sect. 3. Said Hospital shall not be erected or located 
■within three hundred feet of any school-house or church 
now built. 
Sect. 4. This act shall take effect from and after its 
passage. 
[Approved March 27, 1858.] 
An Act to Incorporate the Trustees of the City 
Hospital of the City of Boston. 
Be it enacted by the Senate and House of Representatives 
in General Court assembled, and by the authority of 
the same, as follows : 
Section i. The Trustees of the City Hospital of the 
City of Boston for the time being are hereby made a cor- 
poration by the name of the Trustees of the City Hospital 
of the City of Boston; and said Trustees and their sue- 6 
Acts and Ordinance. 
cessors in office shall continue a body corporate for the 
purposes hereinafter set forth, with all the powers and 
privileges, and subject to all the duties, restrictions, and 
liabilities in the general laws relating to such corporations. 
Sect. 2. Said corporation shall have authority to take 
and hold real and personal estate to an amount not exceed- 
ing one million dollars, wffiich may be given, granted, be- 
queathed, or devised to it, and accepted by the Trustees 
for the benefit of the City Hospital of the City of Boston, 
or any purpose connected therewith. Money received by 
it shall be invested by the Treasurer of the City of Boston, 
under the direction of the Finance Committee of said city; 
and all securities belonging to said corporation shall be 
placed in the custody of said Treasurer; provided, always, 
that both the principal and income thereof shall be appro- 
priated according to the terms of the donation, devise, or 
bequest under the direction of said corporation. 
Sect. 3. The Trustees of the City Hospital shall be 
seven in number. In the month of April, in the year 
eighteen hundred and eighty, and annually thereafter in 
the month of January, the City Council shall elect, by 
concurrent vote of the two branches, one member of the 
Board of Aldermen and one member of the Common 
Council to be members of said Board of Trustees, to 
hold office during the remainder of the municipal year in 
which they are elected, and until others are elected in their 
places.* And in the month of April in the year eighteen 
hundred and eighty, the Mayor shall appoint, subject to 
the confirmation of the City Council, five citizens of Bos- 
ton, not members of the City Council, to be members of 
the Board of Trustees of the City Hospital, one of whom 
shall hold office for five years, one for four years, one for 
three years, one for two years, and one for one year; and 
upon such election, and such appointment and confirma- 
* Members of the City Council made ineligible as Trustees by Acts 
of 18S5, chap. 266, § 3. Acts and Ordinance. 
7 
tion, the terms of office of the Trustees of the City Hospital 
then holding office shall cease and determine. And an- 
nually thereafter, in the month of April of each year, the 
Mayor shall appoint, subject to the confirmation of the 
City Council, one citizen-at-large as a Trustee of the City 
Hospital, to serve for a term of five years from the first 
Monday in May in the year in which he shall be appointed. 
The Trustees shall, at all times, be subject to removal from 
office for cause, by a vote of two-thirds of each branch of 
the City Council present and voting thereon. Whenever 
any vacancy shall occur in said Board of Trustees by 
death, resignation, or otherwise, said vacancy shall be 
filled by the election or appointment, in the manner afore- 
said, of another Trustee, who shall hold office for the resi- 
due of the unexpired term. No member of said Board of 
Trustees shall receive any pecuniary compensation for his 
services. 
Sect. 4. The members of said Board shall meet for 
organization annually on the first Monday of May, and 
choose one of their number as President. They shall have 
power to make such rules and regulations relating to said 
City Hospital and its officers and servants, and to fix and 
enforce penalties for the violation of such rules and regu- 
lations as they may deem expedient; provided that the 
same shall not be inconsistent with the provisions of this 
act, and shall be subject at all times to such limitations, 
restrictions, and amendments as the City Council may 
direct. 
Sect. 5. The said Trustees shall, subject to the direc- 
tion of the City Council, by ordinance or otherwise, have 
the general care and control of the City Hospital, and of 
all branches thereof, which have been or which may here- 
after be established, together with the buildings and rooms 
containing the same, and the fixtures and furniture con- 
nected therewith, and also of the expenditures of the 
money appropriated therefor. 
Sect. 6. The said Board of Trustees may appoint a 8 
Acts and Ordinance. 
Superintendent, with such assistants and subordinate 
officers as they may think necessary or expedient, and may 
remove the same, and fix their compensation; proxfided 
that the amount thus paid shall not exceed the sum appro- 
priated by the City Council for that item of expense, and 
the income of any moneys which may lawfully be appro- 
priated for the same purpose from funds or property held 
by said Trustees under the provisions of this act. 
Sect. 7. The City Council shall have power to pass 
such ordinances, not inconsistent herewith or repugnant 
to other laws of the Commonwealth, as to the duties and 
authority of said Board, as they may from time to time 
deem expedient. 
Sect. 8. This act shall take effect upon its passage. 
[Approved April 7, ISSO.] 
The Ordinance of the City of Boston relating to the 
City Hospital. 
Section x. The Hospital department shall be under 
the charge of the Trustees of the City Hospital, consist- 
ing of five Trustees, who shall have charge of the City 
Hospital and of the care and maintenance thereof; shall 
purchase all fuel and other supplies required therefor; 
shall make all needful improvements in the lands and 
grounds connected with the City Hospital, but shall not 
make any change in the occupancy of the buildings in 
their charge; shall have charge of all real estate held for 
purposes connected with the City Hospital, and pay or 
cause to be paid to the City Collector the incomes thereof. 
[chapter 27.] 
Sect. 2. Said Trustees shall admit to the City Hospital 
only sick or injured persons requiring temporary relief, 
unless for good cause; and shall remove all sick or in- Acts and Ordinance. 
9 
jured persons as soon as their condition will permit of 
such removal; they may allow persons making compensa- 
tion therefor separate apartments, and special accommo- 
dations, and the compensation so received shall be paid 
over to the City Collector. 
Sect. 3. Said Trustees shall, in their annual report, 
include a statement of the condition of the Hospital, of 
the number of its inmates, of the admissions thereto and 
discharges therefrom, and the births and deaths therein 
during the year. 
\_Revised Ordinances, March //, 18 go.'] RULES OF THE TRUSTEES. 
1. The Trustees shall meet for organization annually 
on the first Monday in May, and shall choose a President 
and Secretary from their number. 
2. Regular meetings of the Trustees shall be held at 
the Hospital, on Wednesday following the sixteenth day 
in each month, at four and one-half o’clock in the after- 
noon, or at such other hour as may be fixed by the Presi- 
dent. 
3. Special meetings may be called by the President, 
and shall be called by the President or by the Secretary at 
the request in writing of tyro of the Trustees. 
4. The President shall preside at all meetings of the 
Trustees when present. In his absence the Trustees shall 
elect a President pro tempore. 
5. The President shall appoint the following standing 
committees for the year, consisting of two members 
each: 
(i.) On Rules. 
(2.) On Supplies 
(3.) On Finance. 
(4.) On Medical Department. 
(5.) On Service and Training School. 
(6.) On Buildings and Grounds. 
(7.) On Library. 
6. The President shall appoint Visiting Committees 
of two members each, one going out, and one being added 
each month, whose duty shall be to advise with the 
Physicians and Surgeons and Superintendent, determine 
matters of minor administration, and see that all require- 
ments are properly performed. 12 
Rules of the Trustees. 
7. All other committees shall be appointed by the 
President. 
8. A majority of the Trustees shall constitute a quo- 
rum. 
9. The order of business at each regular meeting shall 
be as follows : 
(i.) Reading of the Records. 
(2.) Examination and approval of bills and pay-rolls. 
(3.) Communications from the Superintendent. 
(4.) Communications from the Staff and others. 
(5.) Reports of Committees. 
(6.) Unfinished business. 
(7.) All other business. 
10. Motions shall be made in writing when requested 
by the President, or by a majority of the Trustees present. 
11. Reports of committees shall, if requested, be in 
writing. 
12. On all questions and motions whatsoever the 
sense of the Trustees shall be taken by yeas and nays upon 
request of any member. 
13. Questions of order shall be decided by the presiding 
officer, subject to appeal to the Board. 
14. When a vote has passed it shall be in order for any 
member to move a reconsideration thereof at the same or 
the succeeding meeting. 
15. All bills contracted for the Hospital shall be ap- 
proved by the Trustees. 
16. Any alteration or amendment of these Rules may 
be made by a vote of two-thirds of the Trustees, notice of 
the same having been given one week previous to action. RULES 
OF THE 
CITY HOSPITAL. 
1. The Trustees shall annually, on the first Monday in 
May, elect by ballot a Superintendent, who shall also be the 
Resident Physician, and whose term of otfice shall begin 
on the first Monday of the following June, and shall con- 
tinue one year, and until his successor shall be elected. 
2. The Trustees shall annually, in the month of April, 
appoint the following, who shall, with the Resident Phy- 
sician ex officio, constitute the Medical and Surgical Staff, 
viz. : 
Six Consulting Physicians and Surgeons. 
Senior Visiting Physicians, not exceeding two, and 
Senior Visiting Surgeons, not exceeding two, as shall 
seem expedient. 
Visiting Physicians, not exceeding ten. 
Six Visiting Surgeons. 
Two Visiting Ophthalmic Surgeons, who shall also be 
Ophthalmic Surgeons to Out-patients. 
One Visiting Aural Surgeon. 
Three Assistant Visting Surgeons. 
Three Physicians to Out-patients. 
Three Surgeons to Out-patients. 
Three Physicians for Diseases of the Nervous System to 
Out-patients. 
One Physician for Diseases of Women to Out-patients. 
Two Physicians for Diseases of the Skin to Out-patients. 14 
Rules of the 
Two Physicians for Diseases of the Throat to Out- 
patients. 
Two Aural Surgeons to Out-patients. 
A Pathologist. 
A Medico-legal Pathologist. 
3. The Trustees shall also annually, in the month of 
April, appoint the following Medical and Surgical Assist- 
ants, viz. : 
A Registrar. 
Two Assistants to the Physicians for Diseases of the 
Nervous System. 
An Assistant to the Ophthalmic Surgeons. 
An Assistant to the Aural Surgeons. 
An Assistant to the Physicians for Diseases of the Skin. 
An Assistant to the Physicians for Diseases of the 
Throat. 
An Assistant to the Physician for Diseases of Women. 
An Assistant to the Pathologist. 
4. The terms of office of the above members of the Medi- 
cal and Surgical Staff and Assistants shall begin on the first 
Monday of the following May, and shall continue one 
year, and until their respective successors shall be ap- 
pointed. 
5. In case a vacancy shall occur in the Medical and 
Surgical Staff, or Assistants, the Trustees shall fill the 
same for the residue of the unexpired term on nomination 
of the Visiting Staff. The Visiting Staff shall present to 
the Trustees, upon notification of any such vacancy, the 
names of two or more persons, suitable in their opinion to 
fill the same, and who shall have received the degree of 
Doctor of Medicine at least three years previous to such 
nomination. 
6. The Trustees shall semi-annually, in the months of 
June and December, on nomination of the Visiting Staff, 
appoint eight House Officers. Such nominations shall 
be made to the Trustees on or before the second Wednes- 
day in May and November in each year, and such persons City Hospital. 
15 
shall be selected for nomination as shall, in the opinion of 
the Visiting Staff, after a rigid examination in the various 
branches of medicine and surgery, and upon careful in- 
vestigation as to character and fitness, seem most com- 
petent to fulfil the duties required of them. The terms 
of service of the House Officers shall begin respectively 
on the first Monday of January and July following their 
appointment. The term of one of the House Officers so 
appointed shall continue six months, and the terms of the 
remaining seven House Officers shall continue eighteen 
months. 
7. The Trustees shall annually, in the month of June, 
on nomination of the Superintendent, appoint an Assistant 
Superintendent, an Executive Assistant, a Steward, a Su- 
perintendent of Nurses, and a Chemist. The terms of 
service of these officers shall begin on the first Monday 
succeeding their appointment, and shall continue respec- 
tively until their successors shall be appointed. 
8. The Trustees shall also, from time to time, appoint 
such other officers as may be necessary. 
9, They may, at their pleasure, remove or discharge 
any officer or other person elected or appointed by them. 
10. They shall fill any vacancy which may occur, for 
the residue of the unexpired term, in the manner in which 
the original appointment was made. 
11. They shall fix the compensation of all officers so 
elected, appointed, and employed; but no compensation 
shall be given to members of the Medical and Surgical 
Staff, to the Assistants, or to the House Officers. 
12. They shall keep a record of all donations and be- 
quests to the Hospital. 
13. They shall make, from time to time, such minor 
rules for the general management of the Hospital as may 
seem expedient to them. 16 
Rules of the 
The Superintendent. 
14. The Superintendent shall reside at the Hospital, and 
shall, under the direction of the Trustees, have the control 
of all the departments thereof, of all subordinate officers, 
employes, and patients, and the charge of the grounds, 
buildings, and appurtenances; and under such direction 
shall make all regulations for the government thereof. 
15. He shall, from time to time, as vacancies shall 
occur, appoint and employ, subject to the approval of the 
Trustees, an Assistant Superintendent of Nurses, a Night 
Superintendent of Nurses, a House-keeper, a Settlement 
Clerk, a Store-keeper, Supervisors, Nurses, Ward-masters, 
and such other minor officers as may be necessary for the 
proper conduct and service of the Hospital. 
16. He shall have especial charge of all patients 
admitted to the Hospital until they are attended by the 
proper Physician or Surgeon. 
17. He shall, under the direction of the Trustees, have 
general charge of the Training School for Nurses, and, 
subject to their direction, shall, with the advice of the 
Superintendent of Nurses, decide upon the admission of all 
probationers to the school, and their acceptance as pupils; 
shall, from time to time, assign them to such wards as the 
service may demand; and shall supervise the course of 
study, appoint lectures and examinations, and decide all 
matters of discipline. 
18. He shall see that there is no waste or carelessness in 
any department, and shall report to the Trustees omissions 
of duty, or disorderly conduct, on the part of all officers, ap- 
pointees, and employes. 
19. He shall, under the direction of the Trustees, pur- 
chase the provisions, stores, fuel, and all other supplies, in- 
cluding all surgical instruments and appliances; shall 
examine all articles purchased as to their quality7, quantity, 
and price; and shall have the charge thereof, and shall be 
responsible for their proper and economical use. City Hospital. 
17 
20. He shall make no purchase exceeding in amount 
one hundred dollars, or of an unusual nature, without the 
sanction of the Trustees, or of the Committee on Supplies. 
21. He shall keep, or cause to be kept, a record of all 
contracts, and regular accounts of all moneys received and 
disbursed by him, on behalf of the Hospital, in books to be 
provided for the purpose, and shall submit the same to the 
Trustees at their regular meetings. 
22. He shall submit all bills and pay-rolls of the preced- 
ing financial month, with the vouchers for the payment 
thereof, to the Trustees, at their regular meetings of each 
month. 
23. He shall keep an inventory of all furniture, and 
other property, belonging to the Hospital, and shall keep 
a record of all articles destroyed or missing. 
24. He shall not permit any instruments, apparatus, 
books, or other property belonging to the Hospital, to be 
taken therefrom without his consent, and he shall keep a 
record of all things so taken. 
25. He shall provide the diet of patients, as may be 
directed by the Physicians and Surgeons, and shall furnish 
for the officers and employes such food as the Trustees 
may direct. 
26. He shall frequently visit and inspect the wards, 
kitchen, laundry, engine-room, and all other departments 
of the Institution. 
27. He shall receive all applications for admission to 
the Hospital, and shall admit such persons as in his opinion 
are proper cases for treatment therein, subject to the ap- 
proval of the Visiting Committee. 
28. He shall direct what disposition shall be made of 
each patient on admission, subject to the approval of the 
Visiting Committee; and no change or transfer of a patient 
to another ward or bed shall be made, unless by his direc- 
tion or that of the Visiting Committee. 
29. He shall keep, for the inspection of the Trustees, a 
record of the names of all patients, with their ages, resi- 18 
Rules of the 
dences, employments, dates of admission, discharge, or 
death, results of treatment, and dispositions of the bodies 
of those dying in the Hospital. 
30. He shall, under the direction of the Trustees, decide 
what patients shall be required to pay for their board in 
the Hospital, and what rates of board shall be paid, and 
shall collect all sums due to the Hospital. 
31. He shall take charge of money, or other property 
not in use, belonging to patients, and keep a record of the 
same. 
32. He shall see that all patients receive proper atten- 
tion on their admission and during their stay in the 
Hospital, and give all necessary directions for their care 
and comfort for the time being; and in all serious cases re- 
quiring it he shall send for the Physician or Surgeon in 
attendance, or, if such Physician or Surgeon cannot be 
found, for some other member of the Medical and Surgical 
Staff. 
33. He shall have charge of the correspondence of 
patients, and shall communicate to their friends informa- 
tion of their condition or decease. 
34. He shall, in case the condition of a patient becomes 
dangerous, forthwith notify the relatives or friends of such 
patient. 
35. He shall, at the end of each month, report to the 
Visiting Physicians and Surgeons, and to the Visiting Com- 
mittee, the names of all patients who have been in the 
Hospital two months. 
36. He shall discharge, as soon as practicable, all 
patients recommended for such action by the attending 
Physicians and Surgeons, and he may, if he shall think 
proper, discharge any patient who has disobeyed the rules 
of the Hospital, or whose conduct has been improper; but 
such cases of disobedience or improper conduct shall be 
reported to the Visiting Committee. 
37. He shall allow no autopsy to be made unless con- 
sented to in writing by the immediate relatives of the de- City Hospital. 
19 
ceased, or, if there be no known relatives, by the Visiting 
Committee. 
38. He shall cause the bodies of deceased patients to be 
delivered to their friends, or, if not claimed by them, to 
the proper authorities. 
39. He shall see that the title of each book taken from 
the Medical Library shall be recorded, with the date, name 
of person borrowing, and date of return, in a book to be 
provided for the purpose, and that no book shall be allowed 
to be carried out of the Hospital. 
Visiting Physicians and Surgeons. 
40. The members of the Visiting Staff shall be divided 
into services as follows : 
First Medical Service. 
Second Medical Service. 
Third Medical Service. 
First Surgical Service. 
Second Surgical Service. 
Third Surgical Service. 
Ophthalmic Service. 
Aural Service. 
The members of the Visiting Staff shall, directly after 
their appointment, meet and arrange their respective places, 
terms, and orders of service, which arrangement shall 
forthwith be communicated to the Trustees, and be sub- 
ject to their approval, and when so approved shall be 
printed. 
Contagious Service. 
41. The beds of the Hospital shall be divided among 
the various services, according to the regulations from time 
to time established by the Trustees, services being given 
separate wards, or well-defined portions of wards, so far as 
practicable. Patients, upon admission, shall be assigned 
to beds in services, accordingly as their condition and the 
nature of their diseases or injuries and the vacancies in 20 
Rules of the 
the respective services shall seem to the Superintendent 
to require, under the regulations of the Trustees. If a 
Physician or Surgeon having made examination of a pa- 
tient previous to his admission shall, while on duty in a 
service, request in writing that the patient be assigned to 
such service, the patient may be so assigned, provided there 
are suitable vacant beds in the service, or there is not already 
a preponderance of patients in that service. Patients when 
so assigned to a service shall not be transferred therefrom, 
except by order of the Superintendent, and for the purpose 
of making better classification or provisions for treatment, 
or for the advantage of other patients. 
42. There shall always be one Physician or one Surgeon, 
as the case may be, on duty in each service, except the 
Contagious Service. In the Contagious Service there 
shall always be on duty both one Physician and one 
Surgeon, who may be selected both from the Physicians 
and Surgeons assigned to the other services, and from the 
Physicians and Surgeons to out-patients. Surgeons, and, 
so far as practicable, Physicians shall be assigned for duty 
in the Contagious Service, at periods when not on duty 
in other services; but in no event shall a Physician or 
Surgeon visit patients in other parts of the Hospital 
directly after attending his service in the contagious w'ards. 
43. Any Physician or Surgeon who shall be prevented 
from attending for a period exceeding one week in the 
term appointed for him shall give notice to the Trustees, 
who shall assign one of the other Physicians or Surgeons, 
as the case may be, to attend his service in his stead. 
44. The Visiting Physicians and Surgeons shall make 
their regular morning visits to patients between the hours 
of eight and one o’clock. Any Physician or Surgeon finding 
himself unable to make his regular daily visit shall im- 
mediately send notice of his inability so to do to the Superin- 
tendent, and, if possible, shall procure the attendance of 
one of the other Physicians or Surgeons in his stead. 
Record shall be made of the Physician or Surgeon making City Hospital. 
21 
each regular visit, which record shall be open to the in- 
spection of the Trustees. 
45. They shall keep or cause to be kept by the House 
Officers, in permanent volumes, in such form as may be 
prescribed by the Trustees, full records of the cases and 
treatment of all patients, in both medical and surgical de- 
partments. No volume of such records shall be taken from 
the premises except by permission of the Trustees, and no 
extracts shall be made from them by any one, except with 
the approval of the Trustees and the approval, also, if still 
members of the staff, of the Physicians or Surgeons by 
whom the cases were treated. 
46. They shall forthwith report to the Superintendent 
the names of all patients who in their opinion have re- 
ceived all the benefit which they will probably derive from 
treatment in the Hospital, and who should be discharged 
or transferred to some other public institution. The 
recommendation for discharge or transfer shall, in each 
case, be noted upon the bed-card of the patient, with a 
statement of the condition, whether cured, relieved, or not 
relieved, and with such other suggestions as each case 
may require. Such recommendations shall be made at the 
time of the regular morning visit, and shall be acted upon 
as soon as practicable after they are made; but every case 
shall be carried upon all the records of the Hospital as 
still under treatment until the patient is discharged. 
47. The Physicians and Surgeons shall daily visit all 
patients in their respective departments, shall make all 
necessary prescriptions, and give all necessary orders for 
the care, treatment, and diet of the patients, and shall see 
whether such prescriptions and orders are promptly con- 
veyed and precisely and carefully executed by the House 
Officers and attendants; and they shall forthwith notify 
the Superintendent of any neglect or inefficiency on the 
part of any such officer or attendant. 
48. No capital operation shall, except in case of emer- 
gency, be performed without a previous consultation. 22 
Rules of the 
Physicians and Surgeons to Out-patients. 
49. The Surgical Department for out-patients shall be 
under the supervision of the Visiting Surgeons, and shall 
be attended by the Surgeons to out-patients. 
50. The Physicians and Surgeons to out-patients shall, 
directly after their appointment, arrange their respective 
terms and orders of service, which arrangements shall be 
communicated to the Trustees, and be subject to their 
approval. 
51. The Physicians and Surgeons to out-patients shall 
be in attendance in their respective departments for the 
treatment of such out-patients as shall be unable to pay 
for medical or surgical treatment at their homes, in each 
week, as follows, viz. : 
Medical. —Tuesday, Thursday, and Satui'day, between 
the hours of 9 and 11 A.M. 
Surgical. Evex-y day, except Sunday, between the hours 
of 9 and 11 A.M. 
Ophthalmic. —Monday, Wednesday, and Friday, between 
the hours of 9 and 11 A.M. 
For Diseases of the Skin.—Monday, Wednesday, 
and Friday, between the hours of 10 A.M. and 
12 M. 
For Diseases of the Ear.—Monday, Wednesday, and 
Friday, between the hours of 9 and 11 A.M. 
For Diseases of the Nervous System.—Monday, 
Wednesday, and P'riday, between the hours of 9 and 
11 A.M. 
For Diseases of Women.—Tuesday, Thux-sday, and 
Saturday, between the hours of 9 and 11 A.M. 
For Diseases of the Throat. —Tuesday, Thursday, 
between the hours of 9 and 11 A.M. City Hospital. 
23 
52. Any Physician or Surgeon to out-patients, who 
shall be prevented from attending for a period exceeding 
one week in the term appointed for him, shall give notice 
to the Trustees, who shall assign one of the other Physi- 
cians or Surgeons to out-patients, as the case may be, to 
attend his service in his stead. 
53. Any Physician or Surgeon to out-patients, finding 
himself unable to fulfil his regular daily appointment, 
shall immediately send notice of his inability so to do to 
the Superintendent, and, if possible, shall procure the 
attendance of one of the other Physicians or Surgeons in 
his stead. Record shall be made of the Physician and 
Surgeon to out-patients making each regular visit, which 
record shall be open to the inspection of the Trustees. 
54. No incisions shall be made and no operations shall 
be performed, nor shall any important dislocations be 
reduced, in the surgical departments for out-patients, 
except at the request of the Visiting Surgeons on duty. 
Whenever an out-patient requires such an operation as 
may confine him for a time in the Hospital, his case shall 
be referred to the Superintendent. 
55. No medicines shall be given to persons treated in 
the departments for out-patients, to be carried from the 
Hospital, except in emergencies, and in such cases as may 
be approved by the Superintendent, under the direction of 
the Trustees. 
Pathologist. 
56. The Pathologist shall have the charge of the casts, 
models, and anatomical preparations belonging to the 
Hospital, under such regulations as may be prescribed by 
the Trustees. 
57. He shall make the autopsies with the assistance of 
the House Officers, and shall cause reports of every such 
examination to be recorded by the House Officers. 
58. He shall preserve and arrange all morbid speci- 
mens for the Pathological Museum. 24 
Rules of the 
59. The Medico-Legal Pathologist shall, when re- 
quested so to do by the Superintendent, make post-mortem 
examinations of the bodies of persons dying in the 
Hospital by w'ounds, injuries, poison, or other forms of 
violence, all such examinations to be subject to the regu- 
lations relating to autopsies in ordinary cases, and to the 
provisions of law concerning inquests; and he shall 
perform such further service as may be required by the 
Trustees. 
Medico Legal Pathologist. 
Registrar, 
60. The Registrar shall, subject to such regulations as 
may be adopted by the Trustees, have charge of the 
Medical Library, and of all medical and surgical books 
and periodicals received, and shall have supervision of the 
making and preservation of the clinical records of the 
Hospital. 
61. The Medical and Surgical Assistants shall perform 
such service in their respective departments as they shall 
be called upon to do by the Physicians or Surgeons to 
whom they are subordinate, or by the Superintendent. 
Assistants. 
House Officers. 
62. The House Officer for the term of six months shall 
be appointed as the Ophthalmic and Aural House Officer, 
and shall serve in the Ophthalmic and Aural Visiting and 
Out-patient Services. 
The House Officers for terms of eighteen months shall 
be appointed respectively as the First Medical House Offi- 
cer, the Second Medical House Officer, the Third Medical 
House Officer, the First Surgical House Officer, the Sec- 
ond Surgical House Officer, the Third Surgical House 
Officer, and the Medical and Surgical House Officer. City Hospital. 
25 
The First Medical House Officer shall serve as Externe, 
during the first six months, in the Out-Patient depart- 
ments, as follows : the first, second, and third months in 
the Surgical department; the fourth month in the Ner- 
vous and Medical departments; the fifth month in the 
Ophthalmic and Medical departments; and the sixth 
month in the Aural, Skin, and Medical departments. He 
shall serve as Junior Interne, in the First Medical Service, 
during the succeeding six months, and as House Physi- 
cian in that service, during the last six months, except 
that he shall be assigned to the Contagious Service during 
the seventh and sixteenth months. 
The Second Medical House Officer shall serve as Externe, 
during the first six months, in the Out-Patient depart- 
ments, as follows : the first, second, and third months in 
the Surgical department; the fourth month in the Aural, 
Skin, and Throat departments; the fifth month in the 
Nervous and Throat departments ; and the sixth month in 
the Ophthalmic and Throat departments. He shall serve 
as Junior Interne, in the Second Medical Service, during 
the succeeding six months, and as House Physician in 
that service during the last six months, except that he 
shall be assigned to the Contagious Service during the 
eighth and seventeenth months. 
The Third Medical House Officer shall serve as Externe, 
during the first six months, in the Out-Patient Ophthalmic 
department and department for Diseases of Women. He 
shall serve as Junior Interne, in the Third Medical Service, 
during the succeeding six months, and as House Physician 
in that service during the last six months, except that he 
shall be assigned to the Contagious Service during the 
ninth ard eighteenth months. 
The First Surgical House Officer shall serve as Externe, 
during the first six months, in the Out-Patient depart- 
ments, as follows: the first month in the Nervous and 
Medical departments; the second month in the Ophthal- 
mic and Medical departments; the third month in the 26 
Rules of the 
Aural, Skin, and Medical departments; and the fourth, 
fifth, and sixth months in the Surgical department. He 
shall serve as Junior Interne in the First Surgical Service 
during the succeeding six months, and as House Surgeon 
in that service during the last six months, except that he 
shall be assigned to the Contagious Service during the 
tenth and thirteenth months. 
The Second Surgical House Officer shall serve as Externe, 
during the first six months, in the Out-Patient depart- 
ments, as follows: the first month in the Aural, Skin, 
and Medical departments; the second month in the 
Nervous and Medical departments; the third month in 
the Ophthalmic and Medical departments; and the fourth, 
fifth, and sixth months in the Surgical department. He 
shall serve as Junior Interne in the Second Surgical Ser- 
vice, during the succeeding six months, and as House 
Surgeon in that service, during the last six months, 
except that he shall be assigned to the Contagious Service 
during the eleventh and fourteenth months. 
The Third Surgical House Officer shall serve as Externe, 
during the first six months, in the Out-Patient depart- 
ments, as follows : the first month in the Ophthalmic and 
Throat departments; the second month in the Aural, 
Skin, and Throat departments; the third month in the 
Nervous and Throat departments; and the fourth, fifth, 
and sixth months in the Surgical department. He shall 
serve as Junior Interne in the Third Surgical Service, 
during the succeeding six months, and as House Surgeon 
in that service during the last six months, except that he 
shall be assigned to the Contagious Service during the 
twelfth and fifteenth months. 
The Medical and Surgical House Officer shall serve as 
Externe, during the first six months, in the Out-Patient 
departments, as follows: the first, second, and third 
months in the Surgical department; the fourth month in 
the Ophthalmic and Medical departments; the fifth month 
in the Aural, Skin, and Medical departments; and the City Hospital. 
27 
sixth month in the Nervous and Medical departments. 
He shall serve as Junior Interne during the succeeding six 
months, as follows : the seventh month in the First Medi- 
cal service; the eighth month in the Second Medical Ser- 
vice ; the ninth month in the Third Medical Service; 
the tenth month in the First Surgical Service; the 
eleventh month in the Second Surgical Service; and the 
twelfth month in the Third Surgical Service. He shall 
serve as House Physician and Surgeon during the last six 
months, as follows; the thirteenth month in the First 
Surgical Service; the fourteenth month in the Second Sur- 
gical Service; the fifteenth month in the Third Surgical 
Service; the sixteenth month in the First Medical Service; 
the seventeenth month in the Second Medical Service; 
and the eighteenth month in the Third Medical Service. 
House Officers, while on duty in the Contagious Wards, 
shall not enter any other wards or operating-rooms, except 
by permission of the Superintendent, and shall not enter 
other parts of the Hospital except as permitted by special 
regulations. House Officers, while on duty in other ser- 
vices, shall not enter the Contagious Wards, except by 
permission of the Superintendent. 
63. No person who has received the degree of Doctor 
of Medicine shall be eligible to hold the position of House 
Officer, except that of Ophthalmic and Aural Interne; 
provided, however, that after service of nine months, a 
House Officer may, by special permission of the Trustees, 
be allowed to receive such degree. A person who has 
received the degree of Doctor of Medicine, or who has 
served as House Officer, may be chosen to the position of 
Ophthalmic and Aural Interne. 
64. House Officers shall, before entering upon their 
duties, sign an agreement that they will faithfully perform 
their duties and observe the rules of the Trustees; and 
they shall be under the immediate control of the Superin- 
tendent, subject to the orders of the Medical and Surgical 
Staff. 28 
Rules of the 
65. Externes shall not reside or, except as specially 
peimitted, take their meals at the Hospital. They shall 
be in attendance at 9 o’clock A.M. on each day of the 
week, except Sunday, and shall remain as long as their 
services may be required. They shall assist the Physicians 
and Surgeons in the departments for out-patients, in their 
respective duties, as they shall he assigned. 
65. The House Physicians and Surgeons and Junior 
Internes shall reside at the Hospital, and shall not be ab- 
sent without the consent of the Superintendent. 
67. If House Physicians or House Surgeons shall be 
temporarily absent, by reason of sickness or other cause, 
the vacancies shall be filled by the respective Internes. If 
an Interne or Externe shall be so absent, the Superin- 
tendent shall, with the approval of the Committee on 
Medical Department, provide a substitute; such substitute 
having been, whenever practicable, previously nominated 
by the Visiting Staff. Permanent vacancies shall be filled 
by the Trustees, on nomination of the Visiting Staff. 
68. No change shall be made in the respective depart- 
ments of the House Officers without the consent of the 
Visiting Physicians or Surgeons under whom they serve, 
and the sanction of the Committee on Medical Depart- 
ment. 
69. The House Physicians and Surgeons and Internes 
shall perform such duties, and carefully and promptly 
obey and execute all such instructions and directions in 
regard to the observation, care, and treatment of the pa- 
tients as shall be assigned and given them by the Superin- 
tendent, or by the Visiting Physicians and Surgeons. 
70. They shall accompany the Visiting Physicians and 
Surgeons in their daily visits, and shall make the neces- 
sary records of the condition, treatment, and diet of the 
patients. 
71. They shall report every instance in which a pa- 
tient fails to receive proper attention, and every neglect of 
duty, and all improper conduct, on the part of nurses, or City Hospital. 
29 
wardmasters, or other attendants; but they shall refer all 
matters relating to the government of the attendants and 
the patients, and requiring reprimand or discipline, to the 
Superintendent or Superintendent of Nurses. 
72. They shall note any important change in the con- 
dition of a patient, and shall inform the Superintendent 
thereof, and shall at once notify him if a patient is in a 
serious condition, or if there is doubt in regard to the con- 
dition or symptoms of a patient. 
73. They shall not administer ether, make any in- 
cision, or perform any surgical operation, except by the 
express direction of the Surgeon or Physician in attend- 
ance, or of the Superintendent. 
74. They shall not publish any report, or other commu- 
nication in regard to any case in the Hospital, except with 
the approval and in the name of the Physician or Surgeon 
in whose service such case has been treated. 
75. They shall, when called upon, render assistance in 
making autopsies and other pathological examinations, 
and the Internes shall, in their respective departments, 
keep records of all pathological cases. 
76. They shall, when requested by the Superintendent, 
investigate the claims of applicants for admission, whether 
such applicants shall apply in person at the Hospital, or 
their cases shall require visits to be made at their homes. 
77. No House Officer shall engage in private practice 
during his term of service, nor receive, directly or indirectly, 
any fee or emolument from a patient. 
78. House Officers shall, at the satisfactory expiration 
of their complete terms of service, receive diplomas stating 
the periods of their service in the various departments. 
Assistant Superintendent. 
79. The Assistant Superintendent shall assist the 
Superintendent in the performance of his duties, and, dur- 
ing the absence or disability of the Superintendent, or any 30 
Rules of the 
vacancy in that office, shall discharge its duties, under the, 
title of Acting Superintendent. He shall perform such 
other duties as the Trustees may require. He shall reside 
at the Hospital. 
80. The Executive Assistant shall assist the Superin- 
tendent in the admission, treatment, and discharge of 
patients, the receiving of visitors, the keeping of accounts 
and correspondence, and the medical care of employes, 
and shall perform such other duties as the Trustees and 
the Superintendent may require. 
Executive Assistant 
Steward. 
81. The Steward shall, under the direction of the Trus- 
tees and the Superintendent, have the general care of the 
grounds, buildings, and appurtenances, and shall see that 
they are kept in good order and repair. 
82. He may, under the direction of the Trustees and 
the Superintendent, purchase provisions, stores, fuel, and 
other necessary articles, and shall have the immediate 
charge thereof, and shall be responsible for their safe-keep- 
ing and economical use. 
83. He shall take charge of all the records of the Hos- 
pital, excepting those relating to the medical and surgical 
treatment of the patients, and shall keep an account of all 
articles and supplies purchased and issued, and of all 
money received and expended for the Hospital. 
84. He shall perform such other duties as the Trustees 
and Superintendent may require. He shall reside at the 
Hospital. 
85. The Chemist shall reside at the Hospital, and shall 
not be absent except at such hours as may be authorized 
by the Superintendent. 
Chemist. City Hospital. 
31 
86. He shall keep the dispensary open between the 
hours of 6.45 A.M. and 8 P.M. 
87. He shall, under the direction of the Trustees and 
the Superintendent, have immediate charge of the dispen- 
sary, laboratory, and medical store-rooms; he shall have 
the care of all drugs, medicines, liquors, and other articles 
belonging to his department, and shall keep account of the 
receipt and dispensing of the same, as may be required. 
He shall compound medicines, prepare prescriptions, and 
perform chemical analyses, and shall do such other work 
as shall be required by the Medical and Surgical Staff. 
88. He shall purchase no drugs, medicines, liquors, or 
other articles for his department, except as may be ordered 
in each case by the Trustees or Superintendent. 
89. He shall deliver no medicines or other articles for 
nse in the Hospital unless they have been ordered in writ- 
ing by the Physicians and Surgeons in attendance, or by 
the Superintendent, and shall deliver none to be carried 
out of the Hospital except when prescribed for patients 
"with the approval of the Superintendent. 
90. He shall at once report to the Superintendent every 
mstance of misappropriation, waste, or neglect of duty 
which shall come to his knowledge. 
91. He shall perform such other duties as may be re- 
quired by the Trustees and the Superintendent. 
Superintendent of Nurses. 
92. The Superintendent of Nurses, who shall also be 
Matron, shall, under the direction of the Superintendent, 
have immediate charge of all the nursing of the Hospital, 
of all persons employed in the wards, and of the instruc- 
tion and management of Nurses in the Training School. 
She shall see that the studies of the Nurses are diligently 
pursued; that the work of all such employes is properly per- 
formed, and their deportment is correct; and that the rules 
pertaining to their duties and conduct are carefully obeyed. 32 
Rules of the 
She shall direct Head Nurses in the principles and practice 
of nursing and ward management. 
93. She shall see that the directions for the nursing and 
care of all patients given by the Visiting Physicians and 
Surgeons are carefully obeyed and executed by the nursing 
force under her charge. 
94. She shall perform all the duties of Matron, and 
shall be responsible for the neatness and cleanliness of all 
parts of the Hospital which are placed under her charge. 
95. She shall have charge and direction of the House- 
keeper, and see that her work is properly performed. 
96, She shall superintend and shall daily visit the wards, 
the diet kitchen, linen store-rooms, dining-rooms, and 
laundry, and see that these several places are well con- 
ducted and kept in order; that all food is properly and 
economically prepared and served, both for the patients, 
and for the family and employes’ tables; and that there is 
no unnecessary waste in any part of the house. 
97. She shall perform such other duties as the Trustees 
and Superintendent may require. 
Assistant Superintendent of Nurses. 
98. The Assistant Superintendent of Nurses shall assist 
the Superintendent of Nurses in the performance of her 
duties, and during the absence or disability of the incum- 
bent of that office she shall discharge its duties. She shall 
perform such other duties as the Superintendent and the 
Superintendent of Nurses may require. 
99. The Night Superintendent of Nurses shall, under 
the direction of the Superintendent of Nurses, have general 
charge of all the nursing in the Hospital between the hours 
of 8 P.M. and 7 A.M. She shall see that all Nurses and 
Ward-masters on night duty are prompt, faithful, and 
watchful in the discharge of their duties; shall attend to 
Night Superintendent of Nurses. City Hospital. 
33 
the warmth and ventilation of the wards, and to the proper 
use of the gas : shall be w'atchful against accidents from 
fire; and she shall give special attention to patients dan- 
gerously ill, and to all exigencies which may arise. 
100. She shall instruct the night Nurses and Ward- 
masters in nursing, especially as to night duties, and shall 
otherwise assist in the instruction of the pupils of the 
Training School, as shall be required by the Superintend- 
ent of Nurses. 
101. She shall discharge such other duties as the 
Superintendent, or the Superintendent of Nurses, shall 
require. 
Supervisors. 
102. The Supervisors shall, under the direction of the 
Superintendent, have the general supervision of the wards 
and buildings in their respective departments, and shall 
see that the duties of all Ward-masters and employes are 
properly performed. 
103. They shall see that all the orders and instruc- 
tions of the Superintendent, regarding the care and man- 
agement of the wards, are carried out, and shall see that 
there is no waste or improper use of any articles of 
hospital property. 
104. They shall take charge of the clothing and other 
Property, not in use, belonging to patients, shall keep a 
record of the same in a manner prescribed by the Superin- 
tendent, and shall deliver to the Superintendent, for safe- 
keeping, all money and other valuables belonging to 
patients. 
105. They shall attend to all business transacted 
between the executive officers of the Hospital and the 
■wards under their charge, and shall have charge therein 
of the execution of all orders relating to the reception of 
patients, the assignment of patients to beds, the transfer 
from one ward or bed to another, and of the discharge of 
patients. 34 
Rules of the 
106. They shall make daily morning reports concern- 
ing their respective departments, containing such matters 
of information as shall be required by the Superintendent. 
107. They shall report all instances of neglect of duty 
or misconduct of employes or patients. 
108. They shall perform such other duties as the 
Superintendent shall require. 
Nurses. 
109. The members of the Training School for Nurses 
shall, subject to the supervision of the Trustees and Super- 
intendent, be under the charge of the Superintendent of 
Nurses. 
110. The members of the Training School shall reside 
at the Hospital, and shall be subject to the rules like other 
officers and employes. 
111. They shall be classified as Head Nurses, Senior 
Assistant Nurses, Junior Assistant Nurses, and 
Probationers . 
Head Nurses. 
112. The Head Nurses shall, under the supervision of 
the Superintendent and Superintendent of Nurses, have 
charge and care of the wards respectively assigned them 
and of the nursing of the patients therein. 
113. They shall be responsible for the obedience and 
deportment of the Assistant Nurses, Ward-masters, and 
Ward-maids, and shall be obeyed and respected by 
them. 
114. They shall promptly and carefully carry out all 
the orders that may be given by the Physicians and Sur- 
geons for the treatment, diet, and care of the patients, and 
shall report at once every instance of failure, or inability 
from any cause, to fulfil such orders. 
115. They shall give, or allow to be given, to patients 
only such articles of food or drink as may be permitted by 
the Physician or Surgeon. City Hospital. 
35 
116. They shall keep a ward book, containing an 
inventory of all Hospital property, furniture, bed linen, 
and other articles in each ward, and shall be responsible 
for the proper use and care thereof. 
117. They shall see that all clothing and other prop- 
erty belonging to the patients under their care are properly 
cared for on the admission of the patients, shall decide 
what clothing and other articles are to be retained by the 
patients in the wards, and shall see that all other clothing 
and property are placed in charge of the Supervisors for 
safe-keeping. 
118. They shall see that the wards are kept clean and 
in good order at all times. 
119. They shall report to the proper officer every in- 
stance of inattention or neglect of duty on the part of their 
assistants. 
120. They shall instruct their assistants in the princi- 
ples and practice of nursing. 
121. They shall perform such other duties as the 
Superintendent and Superintendent of Nurses shall re- 
quire. 
Assistant Nurses. 
122. The Assistant Nurses shall be designated as 
Junior Nurses during the first year of their service, and as 
Senior Nurses during the second year; they shall be as- 
signed to wards either for day or night duty, and shall, 
in the various duties relating to the nursing of the sick and 
the care of the wards, assist the Head Nurses, whose in- 
structions and orders they shall carefully obey, as well as 
the directions of the Superintendent of Nurses and of the 
Physicians and Surgeons. 
123. They shall also be subject to all special rules 
which may be made for the government of the wards and 
of the Training School. 
Probationers. 
124. Candidates for admission to the Training School 36 
Rules of the 
shall serve on probation in the wards two months. During 
the first month of service they shall serve without pay and 
at the end thereof if found satisfactory they shall be per- 
mitted to wear the cap and enter upon the regular course 
of training. During the second month they shall receive 
the pay of Junior Nurses; and if satisfactory at the end of 
that month shall be admitted as pupils of the Training 
School. 
125. They shall be subject, in all respects, to the rules 
of the Hospital and of the Training School, and shall 
perform such duties of Assistant Nurses as maybe assigned 
them by the Head Nurses. 
Ward-Masters. 
126. The Ward masters shall act as assistants to Head 
Nurses in the male wards, and shall perform such duties 
therein as shall be assigned them by the Superintendent, 
under the direction of the Head Nurses, whom they shall 
respectfully obey. 
127. They shall perform such other duties as the 
Superintendent and Superintendent of Nurses shall re- 
quire. 
Settlement Clerk. 
128. The Settlement Clerk shall, under the general 
direction of the Superintendent, ascertain the settlement 
and residence of all patients, and shall cause record of all 
non-paying patients belonging to places other than 
Boston to be kept, and report thereof to be made to the 
Trustees for transmission, as they shall direct, to the 
Overseers of the Poor. He shall perform such other du- 
ties as the Trustees and Superintendent may require. 
Store-keeper. 
129. The Store-keeper shall assist the Steward in the 
receiving, care, and issuing of stores and supplies, and City Hospital. 
37 
shall perform such other clerical duties as the Superintend- 
ent or Steward shall require. 
House-keeper. 
130. The House-keeper shall assist the Matron in 
the duties of house-keeping. She shall have the imme- 
diate charge of the sewing-room, the linen-room, and the 
issuing of all supplies therefrom, and shall also have 
charge of such sleeping-rooms, corridors, stair-ways, and 
other places, as shall be assigned to her care. She shall 
perform such other duties as shall be assigned her. 
House Rules. 
131. The doors and gates of the Hospital will be closed 
at io o’clock P.M., at which time all inmates shall be 
quiet, and all not on duty shall be in their rooms. 
132. A record shall be kept of all persons entering the 
Hospital between the hours of io P.M. and 7.30 A.M. 
133. No employes shall be absent from the Hospital, ex- 
cept as permitted by special rules or by the Superintendent. 
134. No officer, nurse, ward-master, or other employe 
shall directly or indirectly receive money or other gifts 
from patients, except with the approval of the Superin- 
tendent. 
135. The use of tobacco, wine, and intoxicating liquors 
18 prohibited within the Hospital, unless prescribed by 
the Physicians or Surgeons. 
136. All profane and improper language, loud talking, 
and incivility are prohibited. 
137. All employes shall observe such further rules and 
directions for their conduct as may from time to time be 
established. 
Admission of Patients. 
138. Applications for admission of patients may be 
rnade at the Hospital, on each day of the week, Sunday 
excepted, between 9 and 12 o’clock A.M. 38 
Rules of the 
139. Whenever able, a patient shall apply in person 
for admission ; when not able to apply in person, a patient 
may be admitted on application made in his behalf, or 
upon visit at his residence by the admitting Physician. 
140. Any Trustee, or either of the Physicians or 
Surgeons in attendance, may, in case of emergency, send 
a patient in the first instance to the Hospital by written 
permit. 
141. Persons accidentally wounded, or otherwise disa- 
bled or injured, shall be received at all hours. 
142. Patients may be admitted to the privileges of the 
Hospital at such rates of board as the Trustees may, from 
time to time, determine, payment for such board being 
secured by the friends of the patients or by the authorities 
of the cities or towns to which the patients belong. 
143. Whenever, in the opinion of the Trustees, the 
circumstances of the patient will warrant it, the whole 
or a part of the board shall be paid. If separate apart- 
ments, or articles not usually furnished at the Hospital, 
are provided, such payment shall be made therefor as the 
Trustees shall deem reasonable. 
144. No person having acute venereal disease, or alco- 
holism, shall be admitted, except as a paying patient. 
145. No person shall be admitted to the Hospital whose 
case is judged to be incurable, unless there be urgent 
symptoms, which are deemed capable of being relieved. 
Government of Patients. 
146. Patients shall implicitly observe all the rules of 
the Hospital. 
147. Patients shall be in their proper places in the 
wards during the visits of the Physicians and Surgeons, 
and always before 7.30 o’clock P.M., unless specially ex- 
cused by the Superintendent. 
148. Such free patients as are able shall assist in nurs- 
ing, and perform such other services as maybe reasonably 
required of them. City Hospital. 
39 
149. No patient shall leave the Hospital Grounds 
without a pass from the Superintendent, nor leave his 
ward without the consent of the Nurse in charge. 
150. No patient shall purchase, or cause to be pur- 
chased for him, any article of food whatsoever, nor any 
other article, without the consent of the Superintendent. 
151. Profane and obscene language, loud talking, and 
incivility are prohibited. 
152. Patients may be visited by clergymen of their 
own selection, and any wish for the performance of a par- 
ticular religious rite shall be indulged when practicable. 
153. Complaints, for whatever cause, may be made to 
the Superintendent or Visiting Committee, and when 
reasonable shall be by them reported to the Trustees. 
Discharge of Patients 
154. Patients shall be discharged by the Superintend- 
ent. 
155. Patients discharged on the recommendation of 
the Visiting Physicians or Surgeons shall be provided 
With a certificate, stating their condition at the time of 
discharge, whether cured, relieved, or not relieved, which 
certificate shall be signed by the Superintendent. 
156. Whenever a patient is removed from the Hospital 
Without the approval of the Superintendent, a written 
statement to that effect shall be required from any person 
assuming the responsibility of the removal. 
157. In case of the decease of a patient the Superin- 
tendent shall sign the death certificate. He shall also keep 
a record, state the time and cause of death, disposi- 
tion made of the body, and, if buried from the Hospital, of 
the place of interment. 
158. The body of any person dying at the Hospital 
shall not be delivered without a written receipt from the 
Parties taking the same. 40 
Rules of the 
Students and Instruction. 
159. Members of the Surgical Visiting Staff may, on 
regularly appointed days, perform operations in the amphi- 
theatre, and members of both the Medical and Surgical 
Visiting Staff may likewise give instruction there in their 
respective departments; and, for the purposes of instruc- 
tion they shall, subject to such restrictions as the Trustees 
may deem necessary, have the privilege of introducing 
patients, provided that in every case the attending Sur- 
geon or Physician shall certify, in writing, that the patient 
may undergo such examination and treatment without det- 
riment, and that the Superintendent and the patient con- 
sent thereto. Due notice of the nature of such operations 
or instruction shall, so far as practicable, be posted in 
the Entrance Office. 
160. When the amphitheatre is so opened for opera- 
tions and instruction, Physicians having received a degree 
of Doctor of Medicine, and students of one year’s stand- 
ing of any duly incorporated College or School of Medi- 
cine or Surgery, may be admitted in such numbers and on 
such regulations as the Trustees may from time to time 
determine. Whenever the Operating Surgeon or the 
Physician shall deem a case improper for consideration 
in the presence of students of both sexes, he may reserve 
such case for the close of his operation or lecture, and re- 
quire the withdrawal of all male or female students, as the 
case may be. No female patient shall be taken into the 
amphitheatre without the attendance of a Nurse (female), 
and no operation upon a female patient requiring the ex- 
posure of the genital organs shall be performed in the 
presence of male visiting students. 
161. Physicians and medical students, accompanying 
on his invitation a member of the staff in his Hospital 
visits or examinations, shall be limited to such number 
not exceeding twenty, and shall conform to such regula- 
tions, as the Trustees may from time to time determine, City Hospital. 
41 
and shall further observe all such requests as to order and 
propriety as the attending Physicians, or Surgeons, or the 
Superintendent may make. 
162. Students and Physicians coming to the Hospital 
for instruction shall be admitted only at the regular hours 
of operations, lectures, or visiting. Such persons shall, 
"when required, show to the attendant at the Entrance 
Office cards of admission or of invitation, issued in accord- 
ance with the above rules, and all cards or invitations so 
issued may at any time be revoked or suspended by the 
Trustees. All such cards or invitations shall be forfeited 
if transferred to or used by persons other than those to 
whom they are issued. The Superintendent may compel 
the withdrawal of any person who violates the rules of 
the Trustees or good older, or refuses to conform to the 
requirements of the Physician or Surgeon in attendance, 
and he shall report all such violations, and all breaches of 
the rules to the Trustees. 
Visitors. 
163. No person shall visit any part of the premises, 
except on business, or at such times as may be fixed for 
the reception of visitors, without the permission of the 
Superintendent, or of some one of the Trustees. 
164. On Monday, Tuesday, Thursday, and Saturday of 
each week, from 2 to 3 o’clock P.M., friends may be per- 
mitted to visit patients, though no patient shall receive 
more than two visitors on the same day. In all cases, 
however, the Trustees or Superintendent may exercise 
discretionary powers as to excluding or admitting visit- 
ors. 
165. All visitors shall leave the Hospital when the bell 
rings at the expiration of the visiting hour. 
166. No visitor shall take any meal in the Hospital, or 
Pass the night therein, without permission of the Super- 
intendent or one of the Trustees. 42 
Rules of the City Hospital. 
167. No visitor shall be allowed to give any article of 
food or drink to a patient, unless by permission of the 
Nurse; and any article sent to a patient shall be left at the 
Entrance Office. 
Amendments. 
168. Any alteration or amendment of these Rules may 
be made by a vote of two-thirds of the Trustees, notice of 
the same having been given one week before action on the 
same. Tabular View of tche Services of House Officers, for Terms beginning- the First Monday in January. 
Out-Patient Services. 
Kxtfiiif. 
House Services. 
Junior. 
Senior. 
Service in 
Order of Months. 
1 
3 S 
4 
5 
6 
7 
8 O 
| 
1« 
11 
13 
,13 
14 
15 
1« 
17 
18 
Service by 
Calend ar Months. 
January. 
Februa'y. 
March. 
April. 
May. 
Ji 
71 e. 
July. 
A ugust. 
September. 
October. 
November. 
December. 
January. 
February. 
March. 
April. 
May. 
June. 
First Medical 
House Officer. 
Surgical. 
Surgical. 
Surgical. 
Nervous 
and 
Medical. 
Ophth’c 
and 
Medical. 
Au 
Skirt 
Med 
ral, 
, and 
leal. 
Contagious. 
1st Medical. 
1st Medical. 
1st Medical. 
1st Medical. 
1st Medical. 
1st Medical. 
1st Medical. 
1st Medical. 
Contagious. 
1st Medical. 
lf»t Medical. 
Second Medical 
House Officer. 
Surgical. 
Surgical. 
Surgical 
Aural, 
Skin, and 
Throat. 
Nervous 
and 
Throat. 
Opl 
a 
Th 
ith’c 
nd 
roat. 
2d Medical. 
Contagious. 
2d Medical. 
2d Medical. 
2d Medical. 
2d Medical. 
2d Medical. 
2d Medical. 
2d Medical. 
2d Medical. 
Contagious. 
2d Medical. 
Third Medical 
House Officer. 
Ophth’c 
and 
Women. 
Ophth’c 
and 
Women. 
Ophth’c 
and 
Women. 
Ophth’c 
and 
Women. 
Ophth’c 
and 
Women. 
*3 
Wo 
ith’c 
d 
nen. 
3d Medical. 
3d Medical. 
Contagious. 
3d Medical. 
3d Medical. 
3d Medical. 
3d Medical, 
i 
3d Medical. 
3d Medical. 
3d Medical. 
3d Medical. 
Contagious. 
First Surgical 
House Officer. 
Nervous 
and 
Medical. 
Ophth’c 
and 
Medical. 
Aural, 
Skin, and 
Medical 
Surgical. 
Surgical. 
Su rj 
fical. 
1st Surgical. 
1st Surgical. 
1st Surgical. 
Contagious. 
1st Surgical. 
1st Surgical. 
Contagious. 
1st Surgical. 
1st Surgical. 
1st Surgical. 
1st Surgical. 
1st Surgical. 
Second Surgical 
House Officer. 
Aural, 
Skin, and 
Medical. 
Nervous 
and 
Medical. 
Ophth’c 
and 
Medical. 
Surgical. 
Surgical. 
Surf 
ticai. 
I 
2d Surgical. 
2d Surgical. 
2d Surgical. 
2d Surgical. 
Contagious. 
2d Surgical. 
2d Surgical. 
Contagious. 
2d Surgical. 
2d Surgical. 
2d Surgical. 
2d Surgical. 
Third Surgical 
House Officer. 
Ophth’c 
and 
Throat. 
Aural, 
Skin, and 
Throat. 
Nervous 
and 
Throat. 
Surgical. 
Surgical. 
Surf 
!|ieal. 
3d Surgical. 
3d Surgical. 
3d Surgical. 
3d Surgical. 
3d Surgical. 
Contagious, 
3d Surgical. 
3d Surgical. 
Contagious. 
3d Surgical. 
3d Surgical. 
3d Surgical. 
Medical and 
Surgical House 
Officer. 
Surgical. 
Surgical. 
Surgical. 
Ophth’c 
and 
Medical. 
Aural, 
Skin, and 
Medical. 
Nervjous 
arid 
Medical. 
1st Medical. 
2d Medical. 
3d Medical. 
1st Surgical. 
2d Surgical. 
3d Surgical. 
1st Surgical. 
2d Surgical. 
3d Surgical. 
1st Medical. 
2d Medical. 
3d Medical. 
Ophthalmic and 
Aural House 
Officer. 
Ophthalmic and Aural Visiting and Out-Patient Service^. Tabular View of the Services of House Officers, for Terms beginning the First Monday in July. 
Out-Patient Services. 
House Services. 
Extern©,. 
Junior. 
Senior. 
Service in 
Order of Months. 
1 
a 
3 
4 
1 
6 
7 
8 
O 
io 
11 
13 
13 
14 
15 
16 
17 
18 
Service by 
Calendar Months. 
July. 
August. 
Septem’r. 
October. 
Hovem’r. 
Decern’r. 
January. 
February. 
March. 
April. 
May. 
June. 
July■ 
August. 
September. 
October. 
November. 
December. 
First Medical 
House Officer. 
Surgical. 
Surgical. 
Surgical. 
Nervous 
and 
Medical. 
Ophth’c j 
and 
Medical. 
Aural, 
Skin, and 
Medical. 
Contagious. 
1st Medical. 
1st Medical. 
1st Medical. 
1st Medical. 
1st Medical. 
1st Medical. 
1st Medical. 
1st Medical. 
Contagious. 
1st Medical. 
1st Medical. 
Second Medical 
House Officer. 
Surgical. 
Surgical. 
Surgical. 
Aural, 
Skin, and 
Throat. 
Nervous 
and 
Throat. 
Ophth’c 
and 
Throat. 
2d Medical. 
Contagious. 
2d Medical. 
2d Medical. 
2d Medical. 
2d Medical. 
2d Medical. 
2d Medical. 
2d Medical. 
2d Medical. 
Contagious. 
2d Medical. 
Third Medical 
House Officer. 
Ophth’e 
and 
Women. 
Ophth’e 
and 
Women. 
Ophth’c 
and 
Women. 
Ophth’c 
and 
Women. 
Ophth’c 
and 
Women. 
Ophth’c 
and 
Women. 
3d Medical. 
3d Medical. 
Contagious. 
3d Medical. 
3d Medical. 
3d Medical. 
3d Medical. 
3d Medical. 
3d Medical. 
3d Medical. 
3d Medical. 
Contagious . 
First Surgical 
House Officer. 
Nervous 
and 
Medical. 
Ophth’c 
and 
Medical. 
Aural, 
Skin, and 
Medical. 
Surgical. 
Surgical. 
Surgical. 
1st Surgical. 
1st Surgical. 
1st Surgical. 
Contagious. 
1st Surgical. 
1st Surgical. 
Contagious. 
1st Surgical. 
1st Surgical. 
1st Surgical. 
1st Surgical. 
1st Surgical. 
Second Surgical 
House Officer. 
Aural, 
Skin, and 
Medical. 
Nervous 
and 
Medical. 
Ophth’c 
and 
Medical. 
Surgical. 
Surgical. 
Surgical. 
2d Surgical. 
2d Surgical. 
2d Surgical. 
2d Surgical. 
Contagious. 
2d Surgical. 
2d Surgical. 
Contagious. 
2d Surgical. 
2d Surgical. 
2d Surgical. 
2d Surgical. 
Third Surgical 
House Officer. 
Ophth’c 
and 
Throat. 
Aural, 
Skin, and 
Throat. 
Nervous 
and 
Throat. 
Surgical. 
Surgical. 
Surgical. 
3d Surgical. 
3d Surgical. 
3d Surgical. 
3d Surgical. 
3d Surgical. 
Contagious. 
3d Surgical. 
3d Surgical. 
Contagious. 
3d Surgical. 
3d Surgical. 
3d Surgical. 
Medical and 
Surgical House 
Officer. 
Surgical. 
Surgical. 
Surgical. 
Ophth’o 
and 
Medical. 
Aural, 
Skin, and 
Medical. 
Nervous 
and 
Medical. 
1st Medical. 
2d Medical. 
3d Medical. 
1st Surgical. 
2d Surgical. 
3d Surgical. 
1st Surgical. 
2d Surgical. 
3d Surgical. 
1st Medical. 
2d Medical. 
3d Medical. 
Ophthalmic and 
Aural House 
Officer. 
Ophth 
ahnic and 1 
Vural Visit 
ing and Oi 
t-Patient Services. INDEX 
TO 
RULES OF THE CITY HOSPITAL. 
Admission of Patients see Patients. 
Amendments to Rules : 
Rule 
how made 16S 
Assistant Nurses see Nurses. 
Assistants to Out-Patient Departments : 
when and how appointed 3 
vacancies, how filled g 
terms of office 4 
shall receive no compensation 11 
duties gj 
Assistant Superintendent; 
appointment and term of office 7 
duties 79 
Assistant Superintendent of Nurses; 
how appointed 15 
Assistant Visiting Surgeons—see, also, Visiting Physicians 
and Surgeons : 
general duties 98 
how and when appointed 2 
Aural Surgeon: 
how and when appointed 2 
assistants 3 
Aural Surgeons to Out-Patients 
hours of service gi 
Autopsies ; 
how and when appointed 2 
how permitted 27 
how made 27 
House Officers shall assist in 72 
l2 44 
Index. 
Chemist : 
Rule 
appointment and term of office 7 
residence and attendance 85, S6 
general duties 87, 88, 89, 90, 91 
Clerk ; Settlement see Settlement Clerk. 
Consulting Physicians ; 
Contagious Service : 
appointment 2 
Physicians and Surgeons on duty 42 
regulations as to House Officers . 62 
Dead : 
disposition of 38, 158 
Donations 12 
certificate of record of death 157 
Ear see Aural, etc. 
Employ4s : 
employment and discharge 8, 9, 14, 15 
Executive Assistant: 
neglect of duty, etc., to be reported iS 
rules of government 131, 132, 133, 134, 135, 136, 137 
appointment and term of office 7 
general duties So 
Externes see House Officers. 
Fees : 
shall not be received by House Officers 77 
shall not be received by officers or employes, except, etc. . . . 134 
Plead Nurses see Nurses. 
Housekeeper: 
how appointed 13 
under direction of Superintendent of Nurses 95 
general duties 130 
House Officers : 
nomination, appointment and service 6 
shall receive no compensation 11 
duties as to medical records 45 
duties as to out-patients 47 
classification of services 62 
regulations as to duty in contagious wards 62 
eligibility as to medical degrees 63 
shall sign agreement, etc 64 
duties of externes 63 Index. 
45 
House Officers continued. 
Rule 
residence and absence 66 
vacancies 67 
shall not exchange departments 68 
attendance and duties 69, 70, 71 
shall notify Superintendent when patients are dangerously ill . 72 
shall not administer ether or perform operations 73 
shall not publish reports, etc 74. 
shall render assistance in making autopsies, etc 37, 73 
shall examine applicants for admission when requested .... 76 
shall not engage in practice or receive gifts 77 
diplomas 78 
House Physicians see House Officers. 
House Rules : 
for general government I 31> J37 
House Surgeons see House Officers. 
Instruments : 
how purchased 19 
inventory of 23 
Internes see House Officers. 
Library see Medical Library. 
Matron see Superintendent of Nurses. 
Medical Library : 
no books shall be carried out of Hospital 39 
Medical and Surgical Staff see Staff. 
under charge of Registrar 60 
Medico-Legal Pathologist: 
how and when appointed 2 
duties 39 
Medicines : 
medicines not to be given to out-patients, except, etc 55 
Museum, Pathological : 
duties of Pathologist 
Nervous System, Diseases of: 
Physicians, how and when appointed 2 
Night Superintendent of Nurses: 
Assistants to Physicians 
how appointed 
general duties 100, 101 
Nurses : 
how appointed 
under direction of Superintendent of Nurses and Night Super- 
intendent 99, 100 Index 
Nurses continued. 
Rule 
supervision 109 
residence no 
classification in 
duties of Head Nurses as to Assistant Nurses, Ward-masters, 
and Ward-maids 112 
Head Nurses responsible for all persons employed in wards . , 113 
duties as to care of patients 114, 115 
shall keep inventory, etc n6 
shall have charge of property, clothing, etc.... 117 
general duties 118, 119, 121 
shall instruct assistants 120 
Assistant Nurses, assignment and general duties 122,123 
Probationers, how admitted 124 
general duties 124,125 
Officers 
sundry, appointed, and how 8 
how removed . 9 
vacancies, how filled 10 
Operations 4§> 54. 73. is9> 160 
compensation, how fixed 11 
Ophthalmic Departments : 
Surgeons, how appointed 3 
Assistant 2 
Out-Patient Departments see, also, Staff: 
Physicians and Surgeons, how and when appointed 2 
hours of service to out-patients 51 
Physicians and Surgeons may be assigned to contagious service, 42 
Surgical department under supervision of visiting Surgeons . . 49 
Physicians and Surgeons shall arrange orders of services and 
report to Trustees 50 
hours for treatment of out-patients 51 
Physicians and Surgeons shall notify the Trustees as to absence, 52 
Physicians and Surgeons shall notify as to inability to make 
daily visits S3 
record of regular visits of Physicians and Surgeons shall be 
kept S3 
operations S4 
no medicines to be carried away 5S 
duties of House Officers 65 
Pathologist : 
how and when appointed 2 
assistants to 3 
duties 56,57.58 
Pathological Museum under charge of 58 Index. 
47 
Pathologist, Medico-Legal see Medico-Legal Pathologist 
Patients: 
Rule 
under charge of Superintendent 14, 16 
diet, how provided 25 
how admitted 27 
as to transfer or change 28 
record of, as to history, etc 2g 
paying, etc 142, 143, 144 
money and property 32 
attention and treatment immediately after admission 32 
correspondence 33 
friends, how notified 34 
patients in Hospital longer than two months 33 
how discharged 35 
discipline 36 
how assigned to services 
as to discharge and transfer 
as to care, treatment, and diet 
House Officers must notify cases of neglect y1 
House Officers must notify changes in condition 72 
clothing in charge of Supervisors io^ 
rules for admission I3§f 243 
cases not admissible ,^3 
shall observe rules 
must be in their proper places during visits of Physicians and 
Surgeons 
shall not leave the Hospital except by permission 149 
free patients shall assist in nursing 248 
shall not purchase food or other articles 130 
rules for conduct 131 
may be visited by clergymen 132 
how complaints may be made 133 
rules for discharge IS4> 3SS 
removed without approval \ 235 
regulations for examinations or operations ffio, 161 162 
visits from friends, how regulated 263, 267 
articles received for jgy 
Physicians see Staff, Visiting Physicians and Surgeons, and 
Out-Patient Departments. 
Probationers see Nurses. 
Records, Medical and Surgical : 
shall not be taken from premises 
regulations as to making extracts from 43 
under supervision of Registrar 60 48 
Index. 
Registrar ; 
Rule 
how and when appointed 2 
duties 60 
Resident Physician see Superintendent. 
Rules see House Rules. 
Senior Visiting Physicians and Surgeons: 
appointment 2 
Services: 
of Visiting Staff assigned 40 
beds divided and patients assigned 41 
Settlement Clerk : 
assignment of House Officers 62 
how appointed 15 
general duties 12S 
Skin, Diseases of: 
Physicians, how and when appointed 2 
Staff, Medical and Surgical see, also, Physicians and 
Surgeons. 
Assistants to Physicians 3 
hours of service 51 
of whom constituted and how appointed 2 
terms of office 4 
vacancies, how filled 5 
Steward : 
shall receive no compensation 11 
appointment and term of office 7 
Store-keeper; 
general duties 81,82,83,84 
how appointed 15 
general duties 129 
Students : 
Superintendent : 
visits to Hospital 159-162 
election and term of office 1 
shall nominate officers 7 
shall reside at the Hospital 14 
shall make rules for government and have general control ... 14 
shall appoint subordinate officers 15 
shall have charge of patients, etc 16 
shall have charge of Training-School for Nurses 17 
duties as to discipline of officers, employes, etc 18 
shall purchase stores, fuel, and other supplies 19, 20 
shall purchase surgical instruments and appliances 19 
shall keep record of all contracts 21 
disbursement of money, accounts, etc 21 Index. 
Superintendent continued. 
shall submit accounts, vouchers, etc. 22 
Rule 
shall have charge of instruments, books, and property .... 24 
shall keep inventory of property, etc 23 
shall provide diet of officers, patients, etc 25 
inspection of wards, kitchens, etc 26 
shall decide as to admission of patients 27 
shall direct disposition on admission and transfer of patients . 28 
shall keep record and history of patients . . 29 
shall decide rate of board of paying- patients, collect same, etc. 30 
shall keep all money and property of patients . 31 
shall have professional charge of patients until seen by the Vis- 
iting Staff 32 
shall send for Physician or Surgeon in emergencies 32 
shall have charge of correspondence of patients 33 
shall notify relatives when patients are dangerously ill ... . 34 
concerning patients who have been in Hospital two months . . 35 
shall discharge patients, how, etc 36, 154 
duties as to permitting autopsies 37 
disposition of the bodies of patients who die ......... 3S 
duties as to Medical Library 39 
shall receive notification from Physicians and Surgeons to out- 
patients, when unable to attend Out Patient Department . . 53 
shall be notified when out-patients require operations confining 
them to the Hospital 54 
duties as to giving medicines to out-patients SS 
may compel the withdrawal of persons violating rules .... 163 
Superintendent of Nurses ; 
appointment and term of office 7 
shall advise as to admission of probationers and acceptance of 
pupils 1' 
duties 92. 93. 94. 95. 96, 97 
Supervisors : 
how appointed *5 
Supplies: 
as to waste and carelessness t8 
duties 102, 103, 104, 105, 106, 107, 10S 
Surgeons see Staff, Visiting Physicians and Surgeons, and 
Out-Patient Department. 
Throat, Diseases of : 
Physicians for discuses of, how and when appointed 2 
Assistants to Physicians 3 
Training School for Nurses see, also, Nurses. 
under general supervision of Superintendent 17. 109 
hours of service S1 50 
Index 
Training School for Nurses—continued.. 
Rule 
course of study 17 
lectures, how appointed 17 
examinations, how appointed 17 
matters of discipline 17 
Trustees see, also, Rules of Trustees: 
supervision and residence of members 109, no 
service and duties 124, 125 
shall elect Superintendent 1 
shall appoint Medical and Surgical Staff 2 
shall appoint Medical and Surgical Assistants 3 
shall fill vacancies in Staff and Assistants 5 
shall appoint House Officers . .... 6 
shall appoint Assistant Superintendent, Executive Assistant, 
Steward, Superintendent of Nurses, and Chemist 7 
may remove and discharge officers and employes 9 
shall fill vacancies in sundry offices 10 
shall fix compensation of all officers and employes 11 
shall keep record of donations and bequests 12 
Vacancies : 
shall make minor rules and regulations 13 
in Staff and Assistants 5 
among House Officers 67 
Visiting Committee 27, 2S, 35, 36, 37 
Visiting Physicians and Surgeons: 
how and when appointed 2 
may direct as to diet of patients 26 
services, how divided 40 
shall arrange terms and order of service 40 
shall report arrangement of service to Trustees 40 
may request assignment of certain patients 41 
number on duty 42 
shall notify Trustees of absence from service 43 
time of making their visits 44 
inability to make regular daily visits, etc 44 
record of regular visits shall be made 44 
shall cause records of patients to be kept 45 
shall recommend patients for discharge or transfer 4.6 
shall make daily visits to the patients 47 
duties as to care, treatment, and diet of patients 47 
duties as to capital and other operations, except, etc 4S, 54 
may perform operations before students and others .... 159, 160 
Visitors : 
may give clinical instruction 161 
general regulations 163-167 Index. 
51 
Rule 
Ward-Masters : 
how appointed ig 
under direction of Superintendent of Nurses, Night Superin- 
tendent, Supervisors, and Head Nurses , . . 92, 99, 100, 102, 113 
general duties 126, 127 
Women, Diseases of: 
Physicians, how and when appointed 2 
Assistants to Physicians 3 
hours of service 51