BY-LAWS, RULES AND REGULATIONS OF THE Johns Hopkins Hospital Adopted November e, 1889. BALTIMORE; John B. Kurtz Print. 103 LIGHT ST. TRUSTEES. GEORGE WILLIAM BROWN, JAMES CAREY, GEORGE W. CORNER, WILLIAM T. DIXON, GEORGE Wr. DOBBIN, JOSEPH P. ELLIOTT, CHARLES J. M. GWINN, LEWIS N. HOPKINS, FRANCIS T. KING, ALAN P. SMITH, M. D., C. MORTON STEWART, FRANCIS WHITE. BY-LAWS. 1. Ihe Officers of the corporation known as “The Johns Hopkins Hospital” shall be as follows, namely: A President, A Vice-President, A Secretary, A Treasurer. 2. The Board of Trustees shall meet at the Busi- ness Office of the Corporation, or at the Hospital, as may be required in the notice convening such meeting, on the second Tuesday after the first Monday in each month, excepting the months of July, August and Sep- tember. These shall be known as the Stated Meetings of the Board of Trustees. 3. The President shall be elected by the Board of Trustees at the February stated meeting in each year. He shall preside at all meetings of the Board of Trus- tees. He may convene special meetings of the Board at the Business Office of the Corporation, or at the Hospital, as often as he may think proper; but shall specify in any call for such special meetings the sub- ject which is to be acted upon. He shall appoint all Standing and Special Committees of the Board, except when the appointment of Special Committees is other- 4 wise provided for by order of the Board. He shall execute, in the name of the Corporation, all deeds, bonds, promissory notes, contracts, or other instru- ments of writing, pertaining to the business of the Corporation, which he may be required to execute by a vote of the Board of Trustees, duly entered upon its minutes. He shall countersign all checks upon de- posits of money in the name of the Corporation. He shall appoint, subject to the approval of the Board of Trustees, and at rates of salary prescribed by the Board, such clerk or clerks as may be necessary. 4. The Board of Trustees shall elect a Vice-Presi- dent each year when the President is elected. If for any reason the election of a Vice-President takes place before the expiration of the year for which the Presi- dent was elected, the term of the Vice-President so elected shall continue until the next ensuing election for the Presidency. Ihe Vice-President shall, at the request of the President, or during any absence of the President from the office of the Corporation, whether caused by sickness, leave of absence granted by the Board, or by any other contingency, act as and be President pro tempore, and exercise all the powers and discharge all the duties of the President. 5. The Secretary of the Board of Trustees shall be a member of the Board, and shall be elected annually when the President is elected. He shall make and keep an accurate record of the proceedings of the Board, and perform such other duties in connection with the business of the Corporation as may be re- quired of him by the President, Board of Trustees, or 5 By-Laws of the Corporation. In case of the absence or sickness of the Secretary, the President, or President pro tempore, shall designate some other member of the Board, or some officer of the Corporation, to act tem- porarily in his place. 6. There shall be a Treasurer of the Corporation, who shall be elected annually when the President and Secretary are elected. It shall be the duty of the Treasurer to cause to be collected, and to keep safely, all moneys payable to the Corporation ; to keep an ac- curate account of all property belonging to the Corpo- ration, and of all the receipts and disbursements of the Corporation. He shall submit a monthly balance sheet to the Finance Committee at such period in the month as may be designated by that Committee. The Treasurer shall sign all checks upon deposits of money in the name of the Corporation. He shall give a bond in the sum of twenty thousand dollars, with sufficient sureties, for the faithful performance of his duties, and shall receive such salary as the Board of Trustees shall determine. In case of the sickness or temporary ab- sence of the Treasurer, the President or Vice-President may appoint a member of the Finance Committee to act as Treasurer pro tempore; and in case of such ap- pointment of Treasurer pro tempore, the person so ap- pointed shall have the power to sign checks as Treas- urer, and shall have all the powers and perform all the duties of Treasurer. 7. The general business of the Board of Trustees shall be primarily referred to and be under the super- vision of three Committees, namely; 6 The Finance Committee, The Executive Committee, and The Building Committee. 8. The Finance Committee shall consist of three members of the Board of Trustees. It shall have ex- clusive charge and management, subject, however, to the approval and direction of the Board, of all proper- ty, real or personal, belonging to the Corporation. It shall report to the Board of Trustees, at each stated meeting of the Board, a summary of all matters upon which it has acted as such Committee since the last preceding stated meeting of the Board. 9, The Executive Committee shall consist of four members of the Board of Trustees. All matters or questions connected with the Corporation, not directly within the respective provinces of the Building or Fi- nance Committee, shall be primarily referred for exam- ination and report to this Committee, unless two-thirds of the whole number of the Board of Trustees shall, in any particular case or matter, determine to act thereon without such reference. 10. The Executive Committee shall be charged primarily with the duty of supervising the general management of the Hospital of this Corporation, and of enforcing, strictly, such rules and regulations, not inconsistent with these By-Laws, as may be made from time to time for its internal government. 11. It shall be the duty of the Executive Commit- tee to prepare, with the aid of the Superintendent and Medical Staff of the Hospital, such Rules and Regula- 7 tions as it may deem necessary for the internal gov- ernment of the Hospital, and to suggest such amend- ments thereof as may from time to time be considered expedient. Such Rules and Regulations shall not be- come operative until approved by the Board of Trus- tees. No departure from such Rules and Regulations shall be permitted, except in case of some exigency arising in the recess of the Board, between stated meet- ings, requiring to be provided for by a new or modified rule, or regulation In such case, the Executive Com- mittee shall have power to make such new or modified rule or regulation, as may in its judgment seem neces- sary ; but it shall report the same to the Board for its action thereon at its next stated meeting. 12. The Building Committee shall have charge of all matters relating to the construction, alteration, or repair of all buildings used in connection with the Hospital. 13. The President of the Board of Trustees, or the Vice-President in his absence, shall be officio a mem- ber of all Standing Committees, and of all Special Committees, when so designated by the Board. 14. Two members of the Board, serving in alpha- betical order, shall act each month as a Visiting Com- mittee to the Hospital, and shall visit and inspect the Hospital as often as they may see proper during such month of service; but not less than once a week in such month, and at such hours as said Visiting Com- mittee may from time to time determine for itself Each Visiting Committee shall report in writing, to the Board. 8 15. No vacancy, or vacancies, occurring in the Board of Trustees shall be filled except at a stated meeting of the Board; and the election to fill such vacancy or vacancies shall not take place earlier than the stated meeting of the Board next succeeding that at which such vacancy or vacancies may be announced. 16. The Officers of the Hospital shall consist of the following : A Superintendent, 'The Medical Staff of the Hospital, A Superintendent of Nurses and Principal of the Training School, A Purveyor, A Matron, A Comptroller of Accounts and of such other subordinate or minor officers as the Board of Trustees shall from time to time provide for 17. The duties of these various persons, except those of the Comptroller of Accounts, shall be defined as strictly as possible in the Rules and Regulations to be proposed by the Executive Committee for the govern- ment of the Hospital. 18, The principal Bookkeeper in the office of the Treasurer of the Corporation shall be the Comptroller of Accounts for the Hospital. All moneys which may be paid to the Hospital for the board of patients treated therein, or which may be received from transient visit- ors, and all expenditures made by any Officer of the Hospital authorized to make such expenditures, shall be primarily accounted for on Monday in e3ch week to the Comptroller of Accounts. Such accounting to the 9 Comptroller of Accounts shall always be accompanied by explanatory memoranda and proper vouchers. The accounts, explanatory memoranda, and vouchers so rendered, with a summary thereof, shall be reported by the said Comptroller of Accounts monthly to the Presi- dent, or Presidenttempore, of the Board of Trustees, and through such Officer to the Finance Committee of the Board of Trustees. The Comptroller of Accounts shall in all particulars perform the said duties, and such others as may be assigned to him by the Board of Trustees, in the manner directed by the President or President pro tempore, acting in conjunction with the Finance Committee, or as may be directed by the Board of Trustees. 19. Except in cases for which particular provision has been made, or may be made, either by the By-Laws of the Hospital, or by the Rules and Regulations for its internal government, the power of designating the uses to which all the various portions of the Hospital build- ing's and grounds shall be applied, and the terms upon which any chamber or bed in said Hospital shall be occupied, or the accommodations afforded by the Hos- pital shall be in any way used, shall be vested in the Superintendent, subject, nevertheless, to the approval of the Executive Committee of the Hospital. 20. The By-Laws of the Board of Trustees shall not be changed, except at a stated meeting of said Board, and any change made therein shall not be operative unless confirmed at the next stated meeting of said Board. Adopted October 8, 1889. Geo. W. Corner, Sec’y pro tem. Francis T. King, Pres’t. RULES AND REGULATIONS. I. SUPERINTENDENT. i. The Superintendent of the Hospital is the author- ized means of communication between the Board of Trustees and the various Officers and departments of the Hospital. It is his duty to visit every department regularly, and to consult with all Officers respecting the conduct and management of their respective branches of Hospital or administrative work. In all matters relating to the welfare of the Hospital, he shall consult frequently with the Executive and Visiting Committees, and he shall attend the meetings of the Board of Trustees. In case any sudden emergency arises in Hospital administration in the interval between the meetings of the Executive Committee, the Superin- tendent is authorized to act as its representative, but must report his actions to the Committee for approval at the next regular meeting. He shall see that all regulations of the Executive Committee and Board of Trustees are carried into effect, and shall perform such other duties as they may direct. 2. He shall keep or cause to be kept, for the inspec- tion of the Executive Committee, a record of the names of patients, with their age, residence, employment, re- ligion, nativity, date and terms of admission, date of discharge, elopement or death, and result of treatment. 11 3. He shall cause an inventory to be kept of all fur- niture and other property belonging to the Hospital, and an annual report made of articles injured, de- stroyed or missing. 4. He shall hire and dismiss or authorize the hiring and dismissal of all employes, subject to the approval of the Executive Committee. He shall discharge any who are guilty of drunkenness or any immoral con- duct. 5. It shall be his duty to discharge, as soon as prac- ticable, all patients who are recommended for such action by the Physician, Surgeon or Gynaecologist; also, if he deem proper, any patient who is guilty of gross misconduct. 6. He shall supervise all expenditures. He shall examine all bills and authorize their payment before they are reported to the Comptroller of Accounts. 7. He shall collect and receive all dues from patients, and shall deposit immediately in the vault all moneys coming into his hands. Money and other valuables belonging to patients, shall be placed in the vault for safe-keeping, and a receipt given to the owner therefor. 8. On the death of a patient, he shall cause the name and time of decease of such patient to be entered upon the register. He shall notify the friends, if practicable, and shall cause the body of the deceased to be kept safely until they can be heard from. He shall author- ize the post-mortem examination in every case when one is held. 12 9- He shall keep a press copy of all important offi- cial correspondence, including notices to the relatives and friends of deceased patients. 11. i. The Medical Staff of the Hospital shall consist of a Board of Consulting Physicians and Surgeons, of a Physician, a Surgeon, a Gynaecologist and Obstetrician, and a Pathologist; also a Resident Physician, a Resi- dent Surgeon, a Resident Gynaecologist and Obstetri- THE MEDICAL STAFF. • cian, and a Resident Pathologist, who shall act as Assistants in Medicine, Surgery, Gynaecology and Pathology; also as many Resident Assistants as may be required for the proper performance of the work of the Hospital—the number of Assistants being recom- mended by the Medical Board and approved by the Executive Committee and Board of Trustees; also as many Assistants as may be required for the proper performance of the medical work of the Dispensary. 2, All members of the Medical Staff shall be ap- pointed by the Board of Trustees. 111. The number of Consulting Physicians and Surgeons shall not exceed thirteen. CONSULTING PHYSICIANS AND SURGEONS. PHYSICIAN, SURGEON AND GYN/ECOLOGIST. IV. I. There shall be one Physician, one Surgeon and one Gynaecologist. Each of these Officers shall have 13 as many Assistants as are required by the work of the Hospital. 2. The Hospital shall be divided into one medical, one surgical and one gynaecological division. 3. The Physician, Surgeon and Gynaecologist shall have entire responsibility for the care and treatment of patients in their respective divisions. They shall exer- cise a supervision over the wards and observe the be- havior of the nurses and orderlies, and report to the Superintendent whatever they deem wrong. They may give clinical instructions in their special divisions. V. PATHOLOGIST. I. The Professor of Pathology in the Johns Hopkins University shall be the Pathologist of the Hospital. 2. The Assistants in Pathology in the Johns Plop- kins University shall be the Assistant Pathologists of the Hospital. 3. The Pathologist or Assistant Pathologists shall make all post-mortem examinations of persons who have died in the Hospital. 4. The Pathologist shall also act as Curator of the Hospital Museum, and shall accurately label all speci- mens contained therein. THE MEDICAL BOARD VI. i. The two Consulting Physicians, representing the Trustees of the Johns Hopkins Hospital and the Johns Hopkins University respectively, the Superintendent, Physician, Surgeon, Gynaecologist and Pathologist of the Hospital, shall constitute the Medical Board, which shall meet regularly once a week. 2. It shall be the duty of the Medical Board to ad- vise the Trustees in all matters relating to the welfare of the Hospital. 3. Leaves of absence for members of the Medical Staff, for a longer period than twenty-four hours, shall be granted only by the Superintendent with the ap- proval of the Medical Board, after provision has been made for the proper performance of the duties of the absentee. VII. RESIDENT MEDICAL STAFF. i. The Resident Medical Staff shall consist of a Res- ident Physician, a Resident Surgeon, and a Resident Gynaecologist, and as many Assistants as may be re- quired to be appointed to do the work of the Hospital and Dispensary properly and efficiently. 2, The Resident Physician, .Surgeon and Gynaecolo- gist shall visit each patient in his respective wards, at least every morning and evening. He shall record all prescriptions and directions for their administration in books to be kept for that purpose—of which there shall be one in each ward—and shall send the same to the Apothecary at or before 12 m. and 8.30 p. m., of each day. He shall note whether the medicines prescribed are promptly administered and regularly taken. He shall also order all stimulants and articles of extra diet. 3. In any medical or surgical emergency the Resi- dent Physician, Surgeon or Gynaecologist shall request the immediate attendance of the Physician, Surgeon or 15 Gynaecologist, or if he be absent from the city, of any of the Consulting Physicians or Surgeons of the Hospital. 4. The Resident Physician, Surgeon or Gynaecolo- gist may substitute his Assistants in the performance of any duty specially incumbent upon himself, in case of sudden illness or other emergency, by permission of the Physician, Surgeon or Gynaecologist, or the Super- intendent. 5. The Physician, Surgeon or Gynaecologist, or their respective Assistants, shall examine patients for admission, each to his own department of Hospital service. 6. The Resident Physician, Surgeon or Gynaecolo- gist shall never be absent from the Hospital unless notice has been given to the Physician, Surgeon or Gynaecologist, or Superintendent, and an assistant has been provided to fill his place. 7. The Assistants in each division shall, under the direction of the Physician, Surgeon or Gynaecologist keep a record of all medical, surgical or gynaecological cases which are in the Hospital. In this record shall be entered the name, occupation, age, sex, civil con- dition, nativity and race of each patient, the probable cause and history of the disease and the line of treat- ment pursued, the termination either in relief, recovery or death, and such facts as tend to illustrate the character of the disease. 8. The Assistants shall not be absent without giving- notice to the Physician, Surgeon, Gynaecologist or 16 Superintendent, and shall not be absent at the same time as their respective Residents. 9. The Resident Physician, Surgeon and Gynaecolo- gist, or any member of the House Staff who may tem- porarily discharge the duties of these Medical Officers, shall report promptly to the Superintendent the serious illness or sudden failure or death of any patient, or any other fact of importance which should be communi- cated to friends. VIII. SUPERINTENDENT OF NURSES AND PRINCIPAL OF THE TRAINING SCHOOL. i. The oversight of the Head Nurses, Assistant Nurses, Probationers and Orderlies is committed to the Superintendent of Nurses. 2. She is charged with the responsibility of the Nurses’ Home, and the instruction of Nurses in the Training School, and is authorized to prescribe courses of study, to select and accept Probationers, to keep their accounts, and to make contracts with them for their respective terms of service. She is empowered to make, with the approval of the Superintendent, all necessary rules for the government of Nurses. 3. She shall constantly supervise all nursing-work, and shall observe carefully the manner in which. Nurses and Orderlies care for the sick. 4. It shall be her duty to approve of requisitions for ward supplies. She shall see that proper economy is exercised in the distribution of the food ; in the use of all materials for surgical operations and dressings, and in all ward supplies and furnishings. 17 5* She shall have charge of *the surgical store-room, and give due notice to the Superintendent when further supplies are required. IX. PURVEYOR. i. The purchase and delivery of- provisions, and the furnishing, cooking, distributing and serving of food, are committed to the Purveyor. He is responsible for the general kitchen, bakery, officers’ and employes’ dining-rooms and store-rooms, and other rooms in the kitchen building, and is given oversight over the store-keeper, cooks, bakers, waiters and assistants, and all who are employed in any capacity in the kitchen building. 2. He shall make, with the approval of the Superin- tendent, all necessary rules for the proper conduct and efficient service of all employes in his department. 3. He shall see that the kitchens, bakery, store- rooms, dining-rooms and kitchen employes’ rooms are kept in the proper state of cleanliness, and that all gar- bage is promptly removed. 4. He shall keep an accurate account of all rations issued and the cost of the same, and shall present monthly statements of his expenses, and itemized bills of all supplies purchased. X. MATRON. 1. The purchase of bedding, dry goods, clothing, household and laundry supplies, their proper custody and economical use, are assigned to the Matron. She shall have general charge and oversight of the deanli- 18 ness of the whole establishment; of the work of the laundry; of the collection, washing and distribution of clothing ; and of the household and laundry employes. 2. She shall make, with the approval of the Superin- tendent, all necessary rules for the proper conciuct and efficient service of all employes in her department. 3. She shall keep in a book, prepared for the pur- pose, a correct account of all supplies purchased and a statement of the amount of stock on hand. These sup- plies shall be given out upon requisitions, and proper entries shall be made thereafter. She shall keep her store-rooms in a neat and orderly manner. She shall present weekly, to the Superintendent, all bills for pur- chases made by her. 4. She shall have charge of the general sewing of the establishment and the manufacture of bedding, clothing and other supplies. She is authorized to pro- cure material for nurses’ uniforms and to supply Nurses with such material at cost price. XI. COMPTROLLER OF ACCOUNTS, To the Comptroller of Accounts is committed the supervision of the receipt of moneys and payment of bills at the Hospital. It shall be his duty to prepare pay-rolls for Officers, Nurses and other employes; to inspect the books and accounts; to see that all entries are properly made; that satisfactory vouchers are on file for all payments, and that all moneys received are duly receipted for and paid to the Treasurer. He shall also audit and balance petty cash books each month. XII. Ihe Apothecary shall prepare all medicines pre- scribed by the Physicians and Surgeons. He shall deliver no medicines or other articles which are not regularly prescribed. He shall exercise economy in everything relating to his department. It shall be his duty to procure all supplies at the lowest market price, consistent with the purchase of drugs of good quality. He shall exhibit his bills weekly to the Super- intendent. He shall keep the accounts of the Phar- macy, Dispensary, Pathological Laboratory, Clinical Laboratory and Hygienic Laboratory separately, so that the outlay for each may be accurately determined. THE APOTHECARY. XIII. SUPERVISOR OF BUILDINGS AND GROUNDS. The care of the buildings and grounds is committed to a Supervisor, who shall act as the Superintendent’s assistant in the charge of the gate-keeper, messengers, night-watchmen, gardener, driver, painters, carpenters and laborers, and shall supervise their labor and service. He shall be responsible for the care of the stable, grounds, drains, walks, drives and pavements, and shall perform such other duties as may be assigned to him by the Superintendent, XIV. THE ENGINEER. The care and oversight of the engines, boilers, filters, pumping apparatus, machinery, warming and ventila- ting apparatus, water tanks, sewers, water-closets, lava- tories, waste-pipes, steam-cooking apparatus, laundry 20 machinery, water, gas, electrical and steam distribu- tion, are committed to the Engineer. He is made re- sponsible for the proper conduct and fidelity of those associated with him as assistants. He is expected to exercise strict economy in the consumption of fuel, water and gas, and all supplies. He is further expect- ed to regulate his hours of duty according to the re- quirements of his position. XV. THE CLERK The Clerk is charged with keeping the Hospital records and accounts, and the collection of moneys due from pay patients. He shall also perform such other duties as may be assigned to him by the Superintendent. XVI. HOSPITAL EMPLOYES. i. Hospital employes shall be hired, with the approval of the Superintendent, in such numbers as the service of the Hospital may require, subject to the action of the Executive Committee and Board of Trustees. 2. They shall be under the control of the Superin- tendent and of the heads of the several departments where they are employed. 3. As far as practicable, they shall have assigned to them regular duties, but they will be expected to com- ply with any reasonable request for unusual service. 4. They shall not leave the Hospital during hours of duty without permission from the heads of their respec- tive departments. 5. No nurse or other employe shall receive any com- 21 pensation, gift or bequest from any patient, unless authorized to do so by the Executive Committee through the Superintendent. XVII. ADMISSION OF PATIENTS. The Hospital is designed for the treatment of acci- dents, of acute and subacute diseases, and of chronic curable diseases. Cases of incurable disease are not admitted. Patients suffering from severe accident or serious illness can be admitted to the Hospital at any hour of the day or night. Other patients are to be admitted between 9 a. m. and sp. m. They must apply in person at the Dis- pensary, or at the office of the Hospital,,to be examined by the Physician, Surgeon or Gynaecologist on duty; if unable to apply in person, they are to be visited at their homes by a Physician, Surgeon or Gynaecologist, or one of their Assistants. Application by letter for the admission of patients should be addressed to the “Superintendent of the Johns Hopkins Hospital',' Baltimore, Md. XVIII. RULES FOR PATIENTS. i. Patients are expected to conduct themselves quietly and decorously, and to avoid everything calcu- lated to interfere with the quiet and comfort of sick people. 2. No male patient shall enter any of the women’s wards, and no female patient shall enter any of the men’s wards. No patient shall enter the Pathological 22 Building, the boiler vaults, the kitchen, amphitheatre, or any nurses’ or other employes’ room, except by per- mission of an Officer. 3. No patient shall leave the house without permis- sion. He must obtain a permit card from the House Physician, Surgeon or Gynaecologist, which, when countersigned by the Superintendent, will serve as a pass, and must be surrendered to the gate-keeper when the patient goes out of the gate. 4. Patients, upon admission, must leave in the office, to be deposited in the safe, any money or other valua- bles, and in the failure to do so, the Hospital will not be responsible for any loss which may occur. A receipt will in every instance be given for the same. 5. No patients may purchase or procure through a nurse or employe any articles without the permission and approval of a Medical Officer. XIX. VISITORS. Visits from the immediate relatives of a patient will be allowed on Tuesdays, Thursdays, Saturdays and Sundays, between 4 and 5 o’clock. Not more than two persons will be allowed to visit a patient on the same day. Visitors will not remain more than one hour on any day, and will not converse with any patient who is not a relative or near friend. In cases of alarming illness, of which due notice will always, if practicable, be given to the immediate rela- 23 tives or friends of a patient, visits will not be restricted to the regular days or hours. Patients are not allowed to receive from their friends food of any kind, unless by special permission of the Physician or the Nurse in charge. XX. THE DISPENSARY. i. There shall be a Chief of the Dispensary, who shall have general supervision of the executive work of the Dispensary, namely; of the registration of patients; the keeping of their histories; their proper classification and assignment to physicians ; their hours of attend- ance ; also the assignment of duty of Physicians to the Dispensary, and their hours of attendance. 2. The Dispensary shall have the following Depart- ments : (a) General Medicine. (b) General Surgery. (c) Gynaecology. (d) Ophthalmology and Otology. (e) Laryngology. (f) Dermatology. (g) Neurology. (h) Diseases of Children. (i) Genito-urinary Surgery. (j) Orthopaedic Surgery. 3. The Departments of General Medicine, Neurology and Diseases of Children shall be under the supervision of the Physician to the Hospital. The Departments of General Surgery, Genito-urinary Surgery and Ortho- paedic Surgery shall be under the supervision of the Surgeon to the Hospital. 'The Department of Gynae- 24 cology shall be under the supervision of the Gynecolo- gist to the Hospital. The Departments of Ophthal- mology and Otology, Laryngology and Dermatology, shall be under the supervision of Specialists selected to take charge of these Departments. As many Assist- tants as may from time to time be required shall be appointed upon the nomination of the Medical Board. 4. Patients able to pay for medical attendance are not entitled to treatment at the Dispensary. 5. Patients will be received daily, except Sunday, as follows; General Surgery, Genito-Urinarv Surgery, Orthopce- dic Surgery, and Diseases of the Skin: from 10 a. m. to 11.30 p. m. Diseases of the Eye and Ear: from 2.30 to 3.30 p. m General Medicine, including Diseases of the Chest, Abdomen and Kidneys: from 1 p. m. to 2 p. m. Diseases of the Nervous System: from 1 p. m. to 2 p. m. Diseases of Children : from 1 p. m. to 2 p. m. Diseases of the Throat and Nose: from 2 to 3 p. m. Diseases of Women : from 3 to 4 p. m. 6. The name, age, race, sex and address of each patient will be entered by the Clerk in the registry book, and a history card will be issued by him to every patient to be presented to the Physician of the Depart- ment. 7, Every prescription must be given or operation performed by the Physician or Surgeon of the De- partment, or a duly appointed Assistant.