RULES AND REGULATIONS OF TIIE WESTERN PENNSYLVANIA HOSPITAL. PITTSBURGH: PRINTED BY W. 8, HAVEN, CORNER OF MARKET AND SECOND STREETS. 1 8 57. OFFICERS OF THE INSTITUTION. PRESIDENT. THOMAS HAKEWELL. VICE PRESIDENTS. JOHN GRAHAM, JAMES ANDERSON SECRETARY. JOHN HARPER. TREASURER. JOHN HARPER. MANAGERS. One Year. J. K. MOORHEAD, JACOB PAINTER, JOSEPH PENNOCK, CHARLES F. SPANG, WM. WILKINS, WM. W. WALLACE, .1. T. KINCAID. Two Years. JOHN GRAHAM, JOHN B1SSELL, WALTER H. LOWRIE, ALEX. LAUGHLTN, THOS. SCOTT, JOHN B. M’FADDEN, JNO. P. PEARS. Three Years. JOHN IRWIN, GEO. W. JACKSON, JAS. MARSHALL, WM. F. JOHNSTON, CHRISTOPHER ZUG, WM. WADE, LEWIS HUTCHINSON. J. H. SHOEXBERGER, DAVID SHIELDS, L'HOS. BAKEWELL, A. STEWART, E. W. H. SCHENLEY, LIFE MANAGERS, JAMES ANDERSON, CHARLES KNAP, Jr. ISAAC JONES. APPOINTED BY THE GOVERNOR. SAMUEL A. PURVIANCE, Sutler County. R. R. REED, Washington County. JOHN CURWEN, Dauphin County. Dr. ADDISON, Dr. GAZZAM, Dr. WM. F. IRWIN. CONSULTING PHYSICIANS AND SURGEONS. VISITING PHYSICIANS. Dr. JAMES KING, Dr. JOHN WILSON, (Peebles Tp.) Dr. T. J. GALLAIIER, Dr. W. C. REITER. VISITING SURGEONS. Dr. R. B. MO WRY, Dr. M. R. TREVOR, Dr. A. M. SPEER, Dr. F. HARDTMEYER. SUPERINTENDENT AND PHYSICIAN OF THE INSANE. Dr. J. A. REED. WARDEN. .IOHN P. LANGDON. MATRON. ISABELLA LANGDON. THE RULES AND REGULATIONS O F T H E WESTERN PENNSYLVANIA HOSPITAL. CHAPTER I. Officers of Board. ARTICLE I. The annual meeting of the contributors shall be held at the Hospital, on the second Saturday of January, for the election of Managers, and the transaction of such other business as may be desired; when reports shall be presented by the President, the Treasurer, the Superintendent, Physician of the Insane Department, and Warden of the General Hospital. ARTICLE II. The officers of the Board of Managers shall be a President, two Vice Presidents, a Secretary and a Treasurer, who may be the same person and all of whom shall be elected by ballot, at first meeting of the Board after the annual meeting of the contributors. ARTICLE III. Quarterly meetings of the Managers shall be held at the Hospital, on the first Saturdays of April, July, October and January in each and every year, at the last of which the reports of officers, directed in the first article, shall be presented for their examination and approval. Special meetings of the Board of Managers may be called by the President, or Executive Committee, at their discretion, and the Secretary shall call such meetings whenever three Managers shall make a written request for the same. 4 ARTICLE IV. It shall be the duty of the Secretary to give notice to the members, by- mail or otherwise, of all meetings, and, if special, to state the business for which they are convened, and the place where held; at such time previous as the President or the members calling the meeting may direct. ARTICLE V. At the annual meeting of the Board, an Executive Committee shall be appointed, to consist of five members, three of whom shall serve for one year, and the other two shall be chosen from the other members of the Board, to serve two months, but one to retire at the end of each month; and the duties of said committee shall extend alike to the General Hospital and the Insane Department. The President and Vice- President shall be ex officio members of Executive Committee. CHAPTER II. Executive Committee. ARTICLE I. The Executive Committee shall transact all business for the Board not otherwise ordered, during the time between the quarterly meetings, sub- ject, however, to the approval of the Board; and shall visit the Hospital monthly, and by one of their members weekly, a record of all of which visits and proceedings shall be entered in a book to be provided for the purpose, which book shall be presented at each meeting of the Board, and also to be open to the inspection of the members at all times. Any member of the Board of Managers, not of these committees, shall have authority to visit with them. ARTICLE II. The Executive or Visiting Committee shall at every visit examine every ward or room occupied by patients, and such others as pertain to their welfare, and shall receive from the Physician a list of the patients in the Insane Department, and from the Warden a list of those in the General Hospital, and shall see each of them if they deem it necessary; in which visits they shall not, unless at their own request, be accompanied by any officers of the Hospital, and shall ascertain whether the officers and attendants discharge their duties faithfully and humanely. 5 ARTICLE III. The Executive Committee shall decide upon the price of boarding of any patient in the General Hospital, and upon consultation with the Physician, also in the Insane Department, which shall in all cases be as low as the funds of the Institution will permit; and shall be graduated as nearly as possible by the circumstances of the patients, and the accom- modation they may require; they shall also designate which of the beds in each ward shall be reserved for free patients, after the Board has decided upon the number of beds to be so considered. ARTICLE IV. The said committee shall authorize the employment of such nurses and other assistants as the number and state of the patients may require ; and shall, upon representation of the Physician, or other proper officer, provide such articles of furniture, food and medicine as may be requisite for the establishment, and shall draw orders on the Treasurer for payment thereof, and of the current expenses of the Institution. ARTICLE V. The said committee shall give such directions to the officers of the Hospital, and establish such regulations for the management of the same from time to time, as they may consider best adapted to effect the objects •of the Institution; provided, the same shall not be repugnant to the Charter or the By-Laws of the corporation, or the rules and regulations ■of the Board; and in case of indecent or immoral conduct, intemperance, or disobedience of the orders of the Physician, on the part of the patients in the Hospital, may direct the removal of such patients from the Hospital; and in case of such improper conduct on the part of the nurses or attendants, the committee shall forthwith dismiss the same from the employment of the Hospital. ARTICLE VI. The said committee shall examine the accounts of the Warden, every month, and certify to the Board whether the expenditures have been proper; and shall present at each quarterly meeting of the Board a full report of the proceedings of the Hospital, the number of patients received, cured or dismissed, the cases of disease in the Hospital, and other circumstances that have occurred during the three months previous to such report being made. 6 ARTICLE YII. The Executive Committee shall certify the admission of patients, and the time thereof, and shall require an obligation, with surety in such sum as the Managers may prescribe, for the payment of board, medical attend- ance, medicine, charges in case of death or removal, and other expenses incurred by or for the patient; or they may receive such security by the deposit of money as they may deem sufficient; the same, except in special cases, not to be less than six weeks board in the General Hospital and thirteen weeks in the Insane Department; the balance, if any, remaining in the hands of the committee, to be returned to the patient, in case of his removal with the consent of the Physician, or in case of his decease, to his heirs. CHAPTER III. Admission of Patients to the General Hospital. ARTICLE I. Application for the admission of pay patients must be made to a member of the Executive Committee, or the Warden, but no such patient shall be admitted without the certificate of the attending Physi- cian, nor until payment is made or security furnished as provided in the seventh article of the last chapter; but all patients received into the Insane Department (except those from the Courts or county authorities,) must be certified by the resident Physician, nor can any Insane patient be admitted on the free list. No infectious or contagious disease can be admitted under the provisions of the charter. ARTICLE II. All persons suffering from accident or injury, shall be received into the Hospital, within twenty-four hours of the occurrence of such accident, without the usual forms of application. ARTICLE III. Application for the admission of free patients must be made daily, at the Hospital, at 12, M. (Sundays excepted.) The patients, if able, should in all cases apply in person; if unable to attend, the application may be made by a friend, and if necessary, the patient will be visited by the attending Physician or Surgeon, who shall ascertain whether the ap- plicant be a fit subject for admission. Admission can only be obtained 7 when free beds are vacant, and by a certificate of the visiting Physician or Surgeon, and addressed to the Warden. Every applicant shall engage to comply with the rules and regulations governing free patients. No person shall be admitted to free beds, except cases of acute disease or chronic disease of a curable form, or recent accidents; but no cases of infectious or contagious disease, or syphilis, and no patients who have been inmates of other Hospitals within three months before their appli- cation, can be received; nor can any patients be retained longer than two months, without a special vote of the Board. ARTICLE IY. Each person who now is, or may hereafter become a Manager for life, shall have the right to a free bed, to be occupied by such person as he or she may from time to time designate: Provided, Such person may be adjudged by the attending Physician or Surgeon to fall within the pro- visions of the Charter and By-Laws of the Hospital, and shall comply with, and be subject to the rules and regulations governing free patients. Such free beds shall be designated by the name of such Manager for life, and shall not be occupied at any time without his consent. FORM OF PHYSICIAN’S CERTIFICATE FOE ADMISSION IN THE MEDICAL OK SURGICAL DEPARTMENTS. I have examined and consider to be a proper subject for admission into the Western Pennsylvania Hospital. M. D. Pittsburgh, , 185 ORDER FOR ADMISSION. The Steward of the Western Pennsylvania Hospital will admit the above named , as a patient in the Hospital, on payment of $ per week, for weeks. Visitiny Com. Pittsburgh, , 185 . 8 CHAPTER IV. Of the Hospital for the Insane The title of this department of the Institution shall he “ The Western Pennsylvania Hospital for the Insane.” ARTICLE I. The Physician of the Hospital for the Insane Department shall be the official head of the Institution; he shall be denominated the Superintend- ent of the Western Pennsylvania Hospital; he shall, under the instructions of the Board of Managers, exercise a general supervision and control of the Hospital, and of all persons employed on the premises, and shall have the exclusive charge and direction of the Insane Department. ARTICLE II. He shall reside upon the premises, and devote his whole time to the promotion of the interests of the Institution, and the welfare and comfort of the patients. ARTICLE III. He shall have the sole direction of the medical, moral and dietetic treatment of the patients; and his directions respecting them are to be implicitly obeyed by all persons about the establishment. ARTICLE IV. Subject to the general instructions of the Board of Managers, he shall determine what attendants and other assistants for the Insane are neces- sary to be employed. He shall select and dismiss them at his pleasure. He shall determine their duties, and arrange with them their rate of monthly wages. With the sanction of the Executive Committee, he shall, from time to time, make such regulations for the government of the attendants, and all others engaged in any way about the patients, as he may deem salutary. ARTICLE V. He shall obtain, as far as practicable, a complete history of the case of every patient admitted into the Insane Hospital, and shall keep, or cause to be kept, for the use of the Institution, a register of the name, sex, age, place of nativity and residence, civil state, and profession or occupation of every patient; also the date and history of each patient’s disease; the 9 time when he was received, and when removed, and whether cured or improved; whether eloped or dead, and if dead, from what cause. ARTICLE VI. He shall furnish the Board of Managers annually at its stated meeting in January, in each year, a detailed report of the operations of the Hospital, with tabular statements of the cases treated during the preceding year, and of its actual condition ; with such other observations as he may deem useful or interesting. ARTICLE VII. He shall receive and answer, or cause to be answered, all communications respecting the Hospital •, and shall file all letters thus received, and keep in a book provided for the purpose, copies of all letters written in answer thereto, as he may deem necessary. ARTICLE VIII. At each visit of the Managers he shall exhibit the records of the Hospital, and at the quarterly meetings shall give a written statement of its condition. ARTICLE IX. He shall, in conjunction with the Executive Committee, decide upon the price of boarding for the Insane, which sum, however, shall not he for patients committed by order of Court, or Directors of the Poor, less than three dollars per week, and for all others not less than four dollars per week, with such additional charges as circumstances in particular cases may require, and shall notify the Warden of the rate to be charged to each Insane patient. ARTICLE X. He shall order whatever medicines may be necessary, and if any improvements or repairs are needed in his department, he shall report the same to the Executive Committee, who may, if they think proper, order the same to be done. ARTICLE XI. He shall be elected for a term of years, and shall not resign without giving three months notice to the Board, and shall be paid his salary by the Treasurer, quarterly, on a warrant drawn by the Executive Committee. ARTICLE XII. He shall at no time be absent from the Hospital more than one day without the consent of the Executive Committee. 10 CHAPTER V. Duties of Visiting Physicians and Surgeons. ARTICLE I. The Physicians and Surgeons on duty shall attend the Hospital at such times as they may deem necessary for the faithful performance of their duties. ARTICLE II. They shall not furnish admission certificates except agreeably to the rules of this Hospital regulating the admission of patients. ARTICLE III. Upon the occurrence of extraordinary cases, the practitioners in attendance shall call in two or more of the practitioners chosen for the service of the year (or if they think proper, the consulting Physicians,) to consult with. ARTICLE IY. No important surgical operation shall be performed without a previous consultation, and in such cases all the Surgeons shall have due notice. ARTICLE Y. The Physicians and Surgeons shall have power to establish rules for the regulation of their respective wards, to be framed and hung up therein, subject to the approval of the Managers. ARTICLE VI. Each Physician and Surgeon of the Hospital shall have the privilege of introducing his pupils to observe the practice of the Hospital, subject to the regulations of the attending Managers. CHAPTER VI. Of the Duties of the Assistant Physician. ARTICLE I. The Assistant Physician shall have charge of the shop, which he shall see is always kept in proper order, and shall prepare and superintend the administration of medicine. 11 ARTICLE II. He shall attend the Physician in his regular visits, and shall also visit all the patients each evening; shall carefully note their condition, and visit such as are under treatment as much oftener as may be necessary. ARTICLE III. He shall see that all the directions of the Physician are faithfully exe- cuted, and shall promptly report all cases of neglect, or abuse, on the part of the attendants. ARTICLE IV. He shall carefully study the character and peculiarities of the patients, make himself intimately acquainted with their disorder, exert over them all the moral influence in his power, and direct their exercises and amusements. ARTICLE V. He shall, at the request of the Superintendent, keep a record of the cases, and perform all other services in the medical department which may be required, and assist in keeping all other records of the Hospital. ARTICLE VI. He shall exercise the duties of the Superintendent whenever the latter may be absent. CHAPTER VII. Duties of the Warden. ARTICLE I. He shall, under the direction of the Executive Committee and the resident Physician, have the care of the medical and surgical wards, and general care of the buildings, furniture, &c. except of such parts as are occupied by the Insane. ARTICLE II. He shall, under the direction of the Executive Committee, purchase fuel, provisions, furniture and stores for the General Hospital, and (under the direction of the Physician,) for the Insane Department, and shall be responsible for the safe keeping, economical use and expenditure thereof, and shall keep an accurate account of the same, to be laid before 12 the committee at their monthly meetings, and shall procure all medicines, surgical apparatus and liquors, upon the written orders of the resident or visiting Physicians or Surgeons. ARTICLE III. In all cases of purchase by the Warden, he shall require bills, and shall copy the same into a book of general expenses, which, together with a monthly pay roll of the nurses, attendants and other persons in the employ of the Hospital, and a statement of the incidental expenses, shall be audited monthly by the Executive Committee, who, after examination and approval of same, shall draw a warrant on the Treasurer for the aggre- gate amount thereof, in favor of the Warden, and shall record in a book to be kept for that purpose, the date, number and amount of said warrant, and shall at the same time draw warrants in favor of the Warden and Matron for their respective salaries. ARTICLE IV. As soon as the amount of the warrant is received by the Warden, from the Treasurer, he shall pay whatever bills are unreceipted, so that no debt shall remain longer than a month unliquidated; and it shall be the duty of the Executive Committee to inspect the receipts of the preceding month, before a warrant is drawn for the bills of the current month, which bills shall be regularly docketed to file away. ARTICLE V. The Treasurer may from time to time advance to the Warden on his own order, countersigned by the Superintendent, (specifying that it is to pay incidental expenses,) a sum not exceeding two hundred dollars, for the purpose of paying cash purchases and incidental expenses, which sum shall be refunded out of the next monthly warrant of the Executive Committee. ARTICLE VI. The books of the Warden shall be kept so as to exhibit under distinc- tive heads the amount of his receipts and expenditures, and showing as far as practicable the business operations of the two departments of the Hospital, together with the state of the account of each patient received into either department of the Hospital. ARTICLE VII. The Warden shall pay over weekly to the Treasurer, all amounts re- ceived by him for board and expenses of patients, distinguishing between 13 the sums received for those in the General Hospital and those in the Insane Department, and also designating such amounts as may be received for patients in advance. ARTICLE VIII. Under the direction of the Executive Committee, and subject to the authority given to the Physician, he shall hire, pay and discharge all persons employed about the premises, and shall particularly see that they are kind and attentive to the patients, obedient to the directions of the Physicians and Surgeons, and decent, moral and sober in deportment. ARTICLE IX. He shall visit all the wards of the Hospital every morning and evening,, and oftener if necessary, and see that they are clean and in good order; and shall take care that no wine, spirits or tobacco be used by the patients, unless by express direction of the medical attendant. It shall be his duty to appoint for each patient in the General Hospital the bed and ward he or she shall occupy, and change the same from time to time, as occasion may require; but always subject in this respect to the orders- of the Physician or Surgeon under whose care the patient may be. ARTICLE X. On the death of any patient, he shall cause the body to be conveyed to a room provided for that purpose, there to remain until delivered to- the friends of the deceased, or to the sexton or undertaker to be decently interred, for which he shall be particularly responsible. He shall also, in all cases, give immediate notice of the decease to the attending Physician, from whom he will take directions respecting the notice ta be given to the friends, which must be, when practicable, before the interment; and nobody must be removed or interred until twenty-four hours have elapsed after death, except by the instructions of Physicians, or at the express request of the relations. He shall forthwith report to the Executive Committee whether the deceased left any clothes or articles of value, and shall follow their directions relative to the same. ARTICLE XI. He shall see that all orders and prescriptions of the Physicians and Surgeons, concerning the diet, conduct and exercises or bathing of the patients, are exactly and punctually observed; and shall see that a bath is administered, in all cases where it is practicable and safe, before a patient is admitted into the wards. 14 He shall also assist in maintaining the police of the establishment; shall see to the opening and closing of the house, and that the attendants and assistants rise and commence business immediately after the ringing of the morning bell, and that they retire in proper season at night; that the bell is rung at proper times, that the fires are regularly kindled and extinguished as directed, and that the warmth, cleanliness and ventila- tion of the house is attended to. He shall observe the conduct of the inmates at the religious and other meetings, and when in the wings, and at all times shall exert what influence he can to promote the comfort and recovery of the patients. ARTICLE XII. ARTICLE XIII He shall keep the account of the clothing of the male patients when they enter and leave the Hospital, and see that it is properly marked and preserved by their attendants. ARTICLE XIV. He shall also receive visitors, give them all suitable information, and accompany them to such parts of the building and grounds as are open for examination. ARTICLE XV. In the absence of an Assistant Physician, he shall perform all the duties of an apothecary. ARTICLE XVI. He shall not absent himself from the Hospital for more than part of a day, without notifying the Executive Committee. He shall be elected annually, and shall be paid his salary in accordance with Article III., Chapter VII. ARTICLE XVII. CHAPTER VIII. Duties of the Matron. ARTICLE I. The Matron, under the general direction of the resident Physician, shall have charge of the domestic concerns of the Institution; frequently 15 inspect every department, and thus assist to secure the neat and orderly arrangements of the whole house, as well as faithfulness in the discharge of duty of all persons engaged in subordinate trusts. ARTICLE II. She shall have the general oversight and direction of the domestics, and shall superintend and direct the cooking and distribution of food; and in conjunction with the Warden, shall see that the supply is abundant, varied, well cooked, and neatly served in all the dining rooms of the Institution. ARTICLE III. She shall also see that the bedding, clothing, &c. of the patients are always kept clean and in good order. She shall frequently visit and inspect all parts of the Institution, in order to secure the faithful service of all persons employed, the neatness and good order of their respective departments, and the comfort and welfare of the whole household. CHAPTER IX. Duties of the Supervisors. ARTICLE I. It shall be the duty of the Supervisors to look carefully after the com- fort of the Insane patients. They shall observe the manner in which the attendants perform their duties, and report to the Physician any instances of neglect or improper conduct coming under their notice. ARTICLE II. They shall have frequent intercourse with the patients of the Insane Department, and devise judicious occupation and amusement for them; attend particularly to the wants of the sick, and in every way endeavor to promote their comfort and recovery. ARTICLE III. They shall see that the attendants arise and commence business im- mediately after the ringing of the morning bell; that they are diligent in the discharge of their duties; often instruct them in the manner of their performance; that they are uniformly kind and pleasant to the patients, discreet and regular in their deportment, and that they observe all the regulations of the Hospital. 16 ARTICLE IV. That the Physician may be acquainted with the character and wants of each case under their care, they shall communicate their knowledge of any fact or circumstance important to the medical or moral treatment of the patient; they shall be present on their admission to the Institution, and learn from their friends, the Physician, and from personal observa- tion, the general character of their disease and symptoms. They shall enter, or cause to be entered in a book kept for that purpose, a list of the articles bought, and see that they are properly marked and preserved by the attendants. CHAPTER X. Duties of the Watchman. ARTICLE I. He shall commence his duty at nine o’clock, P. M., and pass hourly through the building, (except the women’s wards,) until day light. He is strictly enjoined to attend to the safety of the fires, and shall extinguish all light in the wards not directed by the Physician. He is to admin- ister such medicines as may be entrusted to him by the resident Physician, attending Physician or Surgeons, to be given in the night to patients in the men’s wards. ARTICLE II. He will enter in a book provided for the purpose, anything particular occurring during the night, the condition of the sick, the suicidal, and of those recently admitted, and shall also report any irregularities, neg- lected duty, or violation of rules, which may come under his notice; he will be particularly watchful against fire, and in case of its occurrence, will report it immediately to the Physician and Warden, without giving gen- eral alarm. ARTICLE IV. He will carefully attend to the kitchen and furnace fires; will ring the bell at the regular hour for rising in the morning, and will be expected to perform such other services as may be required of him. ARTICLE V. After six, A. M., his services will not be demanded until two, P. M.; between that hour and sunset he will be ready to attend to whatever may be required; from sunset till nine and a-half, P. M. he will be released from duty. 17 Duties of the Watchwoman. The watchwoman will have charge of the female department during the night, and will be guided by the same rules as are laid down for the watchman. GENERAL RULES. No intoxicating drinks of any kind shall be used by any one in the es- tablishment, unless upon the medical prescription of the Physicians; and no one shall be employed who is known to use them either at home or abroad. Nor shall there be any chewing or smoking of tobacco in or about the buildings. No non-resident shall remain in the Institution at night, without the knowledge of the Physician. No one belonging to the male department, nor any male about the pre- mises, shall enter the female department, or go upon the grounds appro- priated to the females, except by express permission. No one employed about the Hospital shall report abroad the conduct or conversation of any of the patients. All persons employed to attend upon the patients shall give the Physi- cian or Warden at least two weeks’ notice of their intention to leave. No person employed about the Hospital in any other capacity than as an attendant, will be permitted to enter the Insane wards, except by express permission of the Physician. Friends of the patients can be admitted to visit them at such times as the Warden or Physician may deem expedient ; and strangers and others may be permitted to visit those parts of the Institution that are not occupied by the patients, on any day, except Sunday, (on which day visitors will not be admitted,) between the hours of 10, A. M. and 12, M., and between 2 and 4, P. M., but no visitor shall be admitted within the wards occupied by Insane patients, without express permission from the Physician; and especial care is to be taken that no amount of visiting is permitted in the wards that might prove injurious to the patients. It is expressly forbidden to furnish any inmate of this Hospital with tobacco, or any intoxicating drink; or to deliver to, or receive from a patient, any letter, parcel or package, without the knowledge and ap- probation of the Physician. Attendants are particularly enjoined to abstain from mentioning the names of patients, their peculiarities, or any other circumstance respecting them; a knowledge of which might be painful to any person connected with them. 18 ADMISSION OF PATIENTS TO INSANE DEPARTMENT. 1. Preparatory to the admission of a patient, unless when committed hy order of Court, the Superintendent shall be furnished with the cer- tificate of a Physician that he has seen and examined the individual, and "believes him or her to be insane, with a request from a near relative or friend, that the patient may he received into the Hospital, and a bond, with satisfactory security, for the payment of board and other expenses while in the Institution. All private patients thus received, shall make a payment of thirteen weeks’ board in advance, when brought to the Hospital; and if taken away uncured and against the advice and consent of the Physician within that period, no part of said payment shall be refunded. 2. Whenever a patient is sent to the Hospital by the order of any Court, Justice or Judge, or Directors of the Poor, the order or warrant, or a copy thereof, by which such person is sent, shall be lodged with the Physician. 3. Each patient, before admission, shall be made perfectly clean, and he free from vermin, or any contagious or infectious disease. 4. Each male patient shall be provided with at least three new shirts, a new and substantial coat, vest and pantaloons of strong woolen cloth, three pair of woolen socks, a black stock or cravat, a good hat or cap, and a pair of new shoes or boots, together with a comfortable outside garment. 5. Each female patient, in addition to the same quantity of under garments, shoes and stockings, shall have a flannel petticoat, two good dresses, also a cloak or other outside garment. In case the patient is. so much excited as not to admit of being thus clothed, other clothing that can he kept on, that is comfortable and in sufficient quantity, with a change thereof, may be substituted. G. It is very desirable that extra and better apparel should be sent with those accustomed to it, that when their health is improved, and when they attend religious worship, walk or ride out, their self-respect may be preserved. In all cases, the patient’s best clothing should be sent; it will he care- fully preserved, and only used when deemed necessary for the purposes above mentioned. Jewelry, and all superfluous articles of dress, knives, &c. should be left at home, as they are liable to be lost. 7. A written history of the case should be sent with the patient, and if possible, some one acquainted with the individual should accompany him to the Hospital, from whom minute, but often essential particulars, may be learned. 19 8. The price of board, including washing, mending and attendance, for all who are supported at the public charge, is three dollars per week. For private patients, or those supported by themselves or their friends, the price varies from four to ten dollars, according to the trouble and expense incurred, and according to their ability to pay. Higher prices are paid by a special agreement with the Physician, for extra attention and accommodations. Payments are required to be made quarterly, in advance, on the fifteenth of March, June, September and December. 9. A bond, with satisfactory sureties, will be required for the payment of the board and expenses, and for the removal of the patient when discharged, of all persons, excepting those sent at the expense of the counties or townships. Those who bring friends, should be prepared to give such a bond, and if strangers, bring evidence of their responsibility. The friends of Insane patients making application for admission into the Western Pennsylvania Hospital, at Pittsburgh, are requested, with the assistance of the family physician, to annex full and complete answers to the following questions : 1. What is the patient’s name ? What is the age ? Is single or married ? 2. Where was horn ? Where is present residence ? 3. What is occupation ? If a female, that of the husband or father. 4. When did the first symptoms of insanity occur, and in what manner ? 5. Is this the first attack ? if others, when and what were their duration ? G. Has the patient any permanent hallucination ? and what is its nature ? 7. Has the patient any disposition to injure others ? if so, is it from premeditation or sudden passion ? 8. Does the propensity to suicide exist ? Has the patient ever made an attempt ? if so, in what manner ? 9. Has the patient a disposition to destroy clothing, furniture, &c. ? Is the patient cleanly in habits ? 10. What was the patient’s natural disposition? Was there any peculiarity or eccentricity ? 20 11. Have any members of the family ever been insane? On the father’s or mother’s side ? 12. Has the patient ever been addicted to the intemperate use of in- toxicating drinks, opium or tobacco ? Hoes the patient indulge in any improper habits ? 13. Has the patient ever had an injury of the head, epilepsy, or any hereditary disease, sudden suppression of any eruption or accus- tomed discharge ? 14. What is the cause of this attack ? 15. Has any restraint or confinement been resorted to ? if so, of what kind, and for how long ? 16. Has the patient received any medical treatment? has been bled, cupped or blistered ? IT. State any other particulars of the patient’s history, which may have a bearing on the present attack. FORM OF PHYSICIAN’S CERTIFICATE, FOR ADMISSION IN THE INSANE DEPARTMENT. I, of , do hereby certify that I have this day seen and examined , of , in the county of , and believe to be insane, and a proper patient to be sent to the Western Pennsylvania Hospital. M. H. REQUEST FOR ADMISSION. I, , of , hereby request that , of , the patient above named, may be admitted as a patient into the Western Pennsylvania Hospital. 18 21 BOND. Know all men by these presents, tnat we , of in the county of , are held and firmly bound unto , Superintendent of the Western Penn- sylvania Hospital, and his successors in office, in the sum of five hundred dollars, for the payment of which, we jointly and severally bind ourselves firmly by these presents. Sealed with our seals, and dated the day of 18 Whereas , of in the county of , and who is insane, has been admitted a patient in the Western Pennsylvania Hospital, at Pittsburgh : Now, therefore, the con- dition of this obligation is, that if the said obligors shall pay to the said Superintendent, or his successors in office, the sum of dollars and cents per week, for the board of said patient, so long as he shall continue in said Hospital, with such extra charges as may be occasioned by requiring more than ordinary care and attention, and shall provide for suitable clothing, and shall pay for all such necessary articles of clothing as shall be procured for by the Steward of said Hospital, and shall remove from said Hospital whenever required to do so by the Superintendent, and if he shall be removed by the request of either of us, or by any one, before the expiration of three calendar months after reception, then if said obligors pay board for thirteen weeks, unless should be sooner cured, and if they also pay, not exceeding fifty dollars, for all damages may do to the furniture, or other prop- erty of the Hospital, and for reasonable charges in case of death; such payments for board and clothing to he made in advance quarterly, on the fifteenth day of March, June, September, and December, in each year, and at the time of removal, with interest on each bill, from and after the time it becomes due, then this obligation to be void, otherwise to remain in full force. [L. s.] [l. s.] Signed and sealed in presence of 22 DUTIES OF THE ATTENDANTS ON INSANE. Attendants are expected to devote their whole time to the Hospital, in the performance of the duties enjoined by the by-laws, or such as may be required of them by the officers. No attendant will be permitted to leave the Hospital, without the con- sent of the proper officer, and when leave of absence has been granted, they will be expected to return by nine o’clock in the evening. They must expect a constant observation of the manner in which their respective duties are performed; they will strive unceasingly to promote the welfare of the Hospital, and use their utmost exertions to render all those entrusted to their care contented and comfortable. They will be careful at all times to set a good example, and will take every proper opportunity to inspire the patients with respect for, and confidence in the officers, and to convince them of the true character of the Institution, and its leading object, the promotion of the restoration and comfort of its patients. In all their intercourse with the patients, the attendants will treat them with respect and civility; will address them in a mild and gentle tone of voice, and avoid violence and rudeness of every kind. All civil questions are to be properly answered. All reasonable requests are to be promptly attended to. They are to keep cool under every provocation ; are never to scold, threaten or dictate authoritatively; but, whenever they desire any- thing done by a patient, will make a request in a respectful manner. No attendant will be excused, under any circumstances, for striking a blow or laying violent hands on a patient, except in the clearest case of self-defense. They will most carefully avoid talking to patients on the subject of their delusions, or in the hearing of other patients, and they will exert their influence to prevent others from talking to them or of them, on those subjects. They will never allow patients to be laughed at, ridiculed or harshly spoken to, on account of their delusions or the peculiarities of their conduct. Deception must always be avoided, and no promises must be made which cannot be performed. No attendant will be permitted to sell anything to or buy anything from a patient. Attendants will never give up their keys, nor allow any person to enter the wards without the permission of the Physician; and no male attend- ant shall at any time enter the female apartments, without similar per- mission. 23 Neatness and cleanliness wil be most scrupulously attended to by attend- ants, not only in regard to their own appearance, but in the patients and wards under their charge; and any failure in these will be considered a neglect of duty. Visiting from one ward to another, except on business connected with the patients, is not permitted. They will see that the doors of the wards and of the rooms are care- fully locked at bedtime, and such lights only are to be kept burning as are directed by the Physician or Warden. Each attendant is responsible for every patient under his or her care, and is expected to be able, at any moment, to say where such patient may be found. One attendant shall always be in each ward with the patients, and shall never leave, under any circumstances, until relieved. Attendants will never retire to their rooms while the patients are in the wards. The attendants will rise in the morning at the ringing of the hell, and will see that the patients under their charge are washed, their hair combed, and that they are properly dressed for the day, before breakfast. They will also see that the patients are neat and tidy during the day, adjusting their clothes whenever they see them disordered, and changing them whenever, for purposes of cleanliness, it becomes necessary. The beds and bedding are to be well aired in the morning, and the beds well made; if soiled, they are to be removed and clean substituted. The rooms, halls and stairs to be carefully swept, and the floors, walls and windows to be washed whenever required. The wards are expected to be ready for inspection in every part by ten o’clock. No restraining apparatus of any kind shall ever be applied by an attend- ant to a patient, except by order of the Physician; and whenever it may be necessary to lock a patient in his or her room, the fact must be immediately reported to the Physician. At meals, one or more attendants shall always be present to carve, to distribute the food, and to see that each one has a proper supply, and that they take it in a proper manner. Care must also be taken that no patient carries away from the table a knife, fork or any other article ; and the knives and forks shall be counted aftfir each meal, to prevent any from being lost. Attendants must never place in the hands of patients, or leave where they can obtain, any razor, knife, rope, cord, medicine, or any dangerous weapon or article. Neither shall they deliver any letter or writing from or to a patient without permission of the Physician. No patient will be allowed to leave the ward without the permission of the Physician. 24 Attendants will go to the office for medicine at 6, A. M., 12, M. and 7, P. M., and will see that the whole is taken at the time and in the man- ner directed. The cups are to be. washed and returned to the office as soon as the medicine has been taken. When any objection is made by the patient to the medicine, the fact must be at once reported to the Physician, and no patient is ever to be forced to take medicine unless the Physician is present. Any striking or unexpected effect in the operation of medicine is to be promptly reported. When a patient complains of being sick, or is supposed to be so, the fact must be reported without delay to the Physician. The shaving will be done by the attendants, and nc patient will be allowed to shave himself except by special permission from the Physician or Warden. All damage done by patients will be entered in a book, provided for the purpose, which is to be handed to the Warden every Saturday morn* ing. Whenever clothing or other articles are needed fur the patients, it must be reported to the Warden or Matron. Where a patient manifests a disposition to suicide, the utmost watch- fulness must be exercised. The time most apt to be chosen for such attempts, is on rising in the morning or just after retiring at night, at dusk, at meal time, or whenever the attention of the attendant is thought to be diverted. No plausible excuse in such cases must be allowed to throw the attendant off the guard. A moment’s neglect may lead to as serious consequences as a whole hour. At night the room should be carefully examined and the clothing of the patient removed. Whenever a patient escapes, immediate notice is to be given to the Physician, in order that proper measures may be taken to overtake the individual When it is clearly ascertained that a patient has escaped through the negligence or carelessness of the attendant, the expense in- curred in bringing back such patient will be charged to the attendant. Where a patient manifests a strong disposition to escape, the vigilance of the attendant must never be relaxed for a moment. Before closing the door of a patient’s room for the night, the attendant must be certain that the patient is actually in the room • this ascertained, he or she should wish the patient a good night, then lock the door, and be sure that the bolt of the lock has properly slipped. When patients engage in controversy or any improper or exciting topic of discourse, the attendants shall, in the gentlest manner, interfere, and check them ; should other means fail, and if the quiet and good order of the ward cannot otherwise be preserved, one or two of the loudest talkers may be placed in their rooms for a short time; and in such cases, the Physician must be informed immediately. 25 Attendants will, in no case, visit the friends of patients, except by special permission of the Physician or Warden. The conduct and conversation of patients must never be spoken of to visitors, nor reported by attendants when absent from the Hospital. In addition to keeping their wards scrupulously neat and clean, th. attendants will be careful that every unpleasant effluvium i.s removed promptly whenever discovered, and the air of the ward be kept pure and free. It is expected that every part of the wards will be at all times prepared for the closest scrutiny. The clothing of every new patient is to be examined at the earliest opportunity, after admission, to ascertain whether there are knives, weapons of any kind, money, tobacco, or other forbidden articles upon the person. If any are found, they are to be promptly given to the Warden for safe keeping. The clothing of a patient is not to be taken into a ward until it has been examined, and a list of articles taken by the Warden or Matron. All new clothing sent to a patient, should pass through the same hands, and be registered in the same way before it is used. No unmarked clothes should be sent to wash, or be used by a patient. When about to leave, the attendants will call at the office and put their keys on the hooks provided for the purpose, and report themselves either to the Physician, or leave their names and the hour of going out on a slate provided for the purpose, and in like manner report themselves on their return. Two weeks’ notice of the intention of giving up their situation will be required of every attendant. In sending articles of clothing, bedding, &c. to the wash, the attend- ants will make out two lists, one of which will be sent with the articles and the other kept to be referred to when the articles are returned. The articles to be washed will be placed in a place designated, so that they may be removed by the Laundress. STATED HOURS FOR MEALS, &c The bell will be rung at five, A. M. Breakfast will be served at half-past six, A. M.; dinner at half-past twelve 5 and supper at six o’clock, from October to April, and at half-past six, from April to October. The Hospital will be closed at half-past nine o’clock, at which time all lights in the wards will be extinguished, except those directed to be kept burning during the night; and attendants and others employed in the Hospital are expected to be in their rooms. 26 Contributions to this charity are received by Thomas Bake well, President, John Harper, Treasurer, either of the Managers, the Superintendent or Warden. BEQUESTS. Bequests should be made in the Corporate name, to “ The Western Pennsylvania Hospital.”