THE B Y - L A W S OF THE NEW-YORK DISPENSARY. INSTITUTED 1790. “I WAS SICK, AND YE VISITED ME.” NEW-YORK: HOLMAN, GRAY & CO., PRINTERS, COR: CENTRE AND WHITE STS. 1854. THE BY-LAWS OF THE NEW-IORK DISPENSARY. INSTITUTED 1790. “I WAS SICK, AND YE VISITED ME.” NEW-YORK: HOLMAN, GRAY & CO., PRINTERS, COR. CENTRE AND WHITE STS. 1854. B Y - LAW S. CHAPTER I. Article I.—The annual election of the Trustees shall be OF THE ANNUAL ELECTION. held on tlie second Monday in January in every year, at the session-room of the Trustees, and shall begin at four and close at five o’clock, p.m. The Secretary shall give public notice of every such election, in two of the news- papers, designating the time and place. Apt. II.—The election shall be by ballot, and under the inspection of three of the Trustees, to be appointed by the Board for that purpose, and who, or a majority of them, shall preside at and conduct tlie election, and keep a poll-list, in which they shall enter the names of the voters. Art. III.—As soon as the poll is closed, the Inspectors shall examine the ballots, and execute a certificate under their hands and seals, declaring who are the thirteen persons having a majority of the whole number of votes; and they shall report the same at the next stated meeting of the Board, to be entered on the records of the Society. The Secretary, immediately after the election, shall give notice to the persons so elected. CHAPTER II. DUTIES OF THE TRUSTEES. Article I.—The stated meetings of the Board of Trustees shall he held in their room in the Dispensary, corner of Centre and White streets, on the third Monday of every month, at half-past four o’clock, p.m. Special meetings may he held at any time, on the requisition of the President, or of any two Trustees. Art. II.—At the first meeting of the Trustees after every annual election, they shall, by ballot, elect one of their number as President, one as Treasurer, and one other as Secretary. A majority of the votes shall be necessary to a choice. Art. III.—The President, or in his absence one of the Trustees to be chosen President pro tern., shall preside at the meetings of the Board, and regulate the proceedings, and preserve order and decorum. In case of an equal division of the Trustees on any question, he shall have an addi- tional and casting vote. He shall appoint all Committees, unless otherwise directed by the Board. Art. IV.—The Secretary shall give special notice to each Trustee of all meetings of the Board, and shall attend the same, and keep accurate minutes of all the proceedings. DUTIES OF THE TRUSTEES. 5 Art. Y.—The Treasurer shall have authority to let such part of the building as the Trustees may direct to be hired out, and to collect and receive all moneys which may be due to the Institution, and may employ a collector to solicit subscriptions and donations, and to receive, in his name, the sums due from annual subscribers, and may allow a commission therefor. The Treasurer shall keep an account of all moneys received and paid by him, and once a year, in the month of January, or oftcner if required by the Board, he shall render a statement of the same to the Trustees, who shall appoint two of their number to audit his accounts. Art. VI.—There shall be a Visiting Committee, to con- sist of two Trustees, whose term of office shall be one month. The appointment and arrangement of this Committee shall be made for the year, at the first meeting of the Trustees after their annual election ; and it shall be the duty of the Trustee so appointed to provide the attendance of another Trustee, in case of his inability to attend. It shall be the duty of this Committee to visit the Dis- pensary on every Tuesday morning; and each member of the Committee, at least once more during the same week, at such time as he may choose, to examine into all the detail of the operations, and to see that the duties of the Physicians, Apothecary, &c., are faithfully performed. If complaints be made of neglect or misconduct on the part of any Physician or of the Apothecary, it shall be 6 DUTIES OF THE TRUSTEES. the duty of the Committee to investigate the same, and, if necessary, report the facts to the Board. Art. VII.—The Visiting Committee shall keep a minute- hook, in which they shall enter the time of each visit at the office, and any transactions or remarks they may think proper ; which book shall be produced and read at every stated meeting of the Board. Art. VIII.—It shall be the duty of each of the Trustees to visit the Dispensary at least once in every month; and the time of such visit, with any remark they may think proper, shall be entered on the book of the Visiting Committee; and whenever so inclined, they may visit the in-door patients, either in company with the Physician or not. Art. IX.—At the first meeting of the Trustees, after the annual election, there shall be appointed : A Cornmittec of Supplies, consisting of two Trustees, whose duty shall be to purchase, on the most advantageous terms, all articles wanted for the use of the Institution. They shall also have a general care of the house and premises, and keep them in repair. A Committee of Conference, consisting of two Trustees, whose duty it shall be to confer with Committees from the other Dispensaries on all subjects of interest to the Dis- pensaries in general, especially with regard to appropria- tions or donations from the Legislature or Corporation. DUTIES OF THE TRUSTEES. 7 A Nominating Committee, consisting of three Trus- tees, whose duty it shall be to nominate to the Board Physicians to fill such vacancies as may occur in the Medical Department. Art. X.—Annually, in the month of May, the Trustees shall appoint one House Physician and Assistant House Physician, six District, and twelve Attending Physicians, six Consulting Physicians and Surgeons, an Apothecary, an Assistant Apothecary, and a Druggist, from whom the supplies of medicine shall be obtained. These officers shall be removable at any time by the Trustees, for sufficient cause. The Physicians must be nominated at a meeting previous to their election. Art. XI.—Immediately after the annual appointment of Physicians, the names of those elected shall be pub- lished by the Secretary, in one or more newspapers. Art. XII.—A Report on the state of the Institution shall be prepared and published annually, in the month of January, copies of which shall be presented to the Legis- lature and Common Council. Art. XIII.—The President and Secretary shall con- stitute a Standing Committee, with power to publish such portions of the monthly reports of the Physicians as they may judge expedient. CHAPTER III. GENERAL REGULATIONS. Article I.—The portion of the city pertaining to the New York Dispensary shall be divided into six Districts, as follows, viz.: First District—includes all that portion of the city below a line from Hudson River through Barclay Street, across the Park, through Frankfort, Pearl, and Dover Streets to the East River; including both sides of the boundary streets, except Barclay. Second District—bounded south by Barclay Street; West by Hudson River; north by Spring Street, and east by Broadway ; including the south side of Spring, and both sides of the other boundary Streets. Third District—bounded south by the first District; and on the other sides by a line through Chatham, Divis- ion, and Pike Streets to the East River; not including either side of the boundary Streets. Fourth District—bounded West by the second District; South and East by the third District; and North by a line from Broadway, through White, Orange, Bayard, and Di- vision Streets, to Pike; including both sides of the bounda- ry Streets. Fifth District—bounded South by the Fourth District; GENERAL REGULATIONS. 9 "West by the Second District; North and East by a line from Broadway through Spring, Bowery, Delaney, and Allen Streets, to Division; including both sides of the boundary Streets. Sixth District—bounded South by the Fifth District; West by Broadway; North by Fourteenth Street; East by the First Avenue and Allen Street; including both sides of the boundary Streets. Art. II.—The office of the Dispensary shall be kept open daily, except on Sundays and Holidays, from eight o’clock in the morning until sunset. On Sundays and Holi- days, the office hours shall be from nine to ten, a.m., and from half-past one to half-past two o’clock, p.m. for the dispensing of medicines. The Fourth of July, Thanksgiving, Christmas, and New Year’s day, are to be considered as Holidays. Art. III.—The two sexes shall be kept separate in the reception-rooms, and patients, when prescribed for and fur- nished with medicines, shall retire without delay. Art. IV.—All applicants for medical advice, with the exception of lying-in women, shall be deemed objects of this charity ; and no Physician shall receive any compen- sation from Dispensary patients for services rendered. Lying-in women, not being proper objects of this charity, should be recommended to the Lying-in Asylum. 10 DUTIES OF PHYSICIANS, ETC. Art. Y.—Medical Students shall have the privilege of attending at the Dispensary, but arc in no case whatever permitted to prescribe or operate on any patient. Their attendance may be interdicted at any time, for suf- ficient cause, by the Visiting Committee. Art. VI.—No smoking of tobacco shall be allowed in any of the rooms occupied by the Dispensary. Art. VII.—Unless by unanimous consent, no alteration shall be made in the By-Laws or Regulations, until they are reduced to writing, and notice given at a previous meeting of the Board. CHAPTER IY. DUTIES OF THE PHYSICIANS, ETC. and Surgeons, as well as tlie Trustees, sliall have the priv- ilege of nominating candidates for the station of Physi- cians : the nominations to he made in writing to a meeting of the Board, previous to that at which the appointment is to be made. No candidate shall be considered eligible unless he presents to the Trustees a certificate signed by at least three of the Consulting Physicians or Surgeons, stat- ing that they consider him qualified for the office of a Phy- sician of the Dispensary. Article I.— Candidates.—The Consulting Physicians HOUSE PHYSICIAN. 11 Art. II.—Consulting Physicians.—It shall be the duty of each of the Consulting Physicians and Surgeons to visit the Dispensary, occasionally, to confer with the Physicians on the state of the Institution, and of their pa- tients ; to make any suggestion to the Visiting Committee which they may think will advance the interest of the Dis- pensary, and at all times to attend in consultation, when requested so to do by any of the Physicians. Art. III.—When any important operation is to be per- formed upon a patient of the Dispensary, one or more of the Consulting Surgeons shall be called in consultation ; and no operation shall be performed upon any such patient, ex- cept by a Physician or Surgeon of this Institution. CHAPTER V. HOUSE PHYSICIAN. Article I.—The House Physician, besides his duties specified in the following articles, shall be charged with the general supervision of the business of the Dispensary, em- bracing the duties of the Attending and District Physicians, and also those of the Apothecary and his Assistant. He shall attend daily at the Dispensary (Sundays and holidays, as specified Art. ii., Chap. 3, excepted), from 9 to 2 o’clock. 12 HOUSE PHYSICIAN. Art. II.—He shall have a general care of the Dispensa- ry ; shall see that the offices and rooms are kept clean and in good order; shall keep an inventory of all surgical instruments; be accountable for the same, and shall see that they are kept in serviceable condition. For these purposes he shall, with the consent of the Visiting Com- mittee, incur such current expenses as the good of the Institution may require ; reporting to the Trustees at the next stated meeting the objects of the outlay, its amount, and the persons employed. Art. III.—He shall facilitate, as much as possible, the business of the Physicians, and in the absence of any Attending Physician, shall prescribe for the patients of his hour, until a substitute is provided ; shall see that the books are neatly and regularly kept, and that the entries are made accurately, and without inconvenience to the patients. He shall also keep a Scratch-book in which to enter any complaint on the part of patients against their Attending Physician. This book shall be submitted to the Visiting Committee, and also to the Board of Trustees at its monthly meeting. Art. IV.—He shall vaccinate, bleed, cup, leech, and draw teeth, wdien required. Art. V.—He shall at all times have access to the Apothecary’s Shop, and supervision over this department. HOUSE PHYSICIAN. 13 He shall sign all orders for articles for the Apothecary’s Shop in the “ Order-book,” when satisfied of their propriety and necessity, and shall keep in his possession the Apothe- cary’s Pass-book. Art. VI.—He shall endeavor to ascertain, in all cases of vaccination, that the disease has properly taken. He shall therefore be authorized to require from all vaccinated a deposit of 25 cents, as a guaranty of their return to the Dispensary on the 7th day after the operation is performed, when the above sum shall be refunded. If the persons vaccinated should not return, this sum shall be forfeited to the Dispensary. The House Physician is also authorized to receive, in be- half of the Dispensary, any fee that patients may be in- clined to give for vaccination or any medical or surgical treatment derived from the Dispensary. Art. VII.—The House Physician shall enter, in a book kept for the purpose, all sums received, and account for the same to the Trustees monthly. Art. VIII.—He shall obtain, and always keep on hand at the office, a full supply of vaccine matter for the use of the Dispensary for subscribing Physicians, and for sale. He shall keep a vaccine register, in which shall be en- tered, in separate columns, the names and particulars of each case, whether in or out door, and by whom vaccinated. 14 HOUSE PHYSICIAN. He shall also keep a vaccine account book, in which he shall enter the quantity of matter sold and given away, the names of the persons to whom it is delivered, and whether they be subscribers or not. Art. IX.—The House Physician shall make in writing a Monthly Report to the Trustees upon the general condi- tion of the Dispensary, specifying the number of persons vaccinated at the Dispensary and at their houses, the quan- tity of virus sold or given away, &c. He shall prepare and present to the Board, in January, an Annual Report, which shall be a summary of the Month- ly Reports, and shall also embrace the whole number of patients under treatment during the year; the number af- fected by each disease; the results, especially the deaths, with the disease, so resulting; the number cured, relieved, &c., whether attended at the Dispensary or in the Districts. He shall also state any facts of general interest connected with the practice of the Dispensary, such as the prevalence at any part of the year of peculiar diseases, the state of the weather at such time, or any other cause which may have given rise to such diseases, &c. In preparing the Annual Report, the Physicians shall give the House Physician any assistance he may call for. The Annual Report shall be read to the Physicians, for their approbation, before it is submitted to the Board of Trustees. ATTENDING, ETC., PHYSICIANS. 15 Art. X.—It shall be his duty to bo present at the Dispensary during the Monthly Meetings of the Trustees. Art. XI.—The Assistant House Physician shall be under the direction of the House Physician, aid him in his several duties, and in the absence of the House Physician, supply his place. CHAPTER VI. ATTENDING AND DISTRICT PHYSICIANS. Art. I.—It shall be the duty of the Attending Physi- cians to attend daily at the Dispensary, except on Sundays and holidays, as already specified, and prescribe for all patients during their respective hours. It shall be the duty of the District Physicians to visit and attend upon all, in their respective districts, who may require a physician at their houses. Should indisposition or any other reasonable cause pre- vent a physician from attending to his duties, he shall im- mediately engage the services of some other physician of the Institution, and report the same to the House Physi- cian. The substitution must be for a short time only, unless continued by the assent of the Visiting Committee. 16 ATTENDING PHYSICIANS. No physician, in accepting office at the Dispensary, shall resign the same without giving one month’s notice to the Trustees. Art. II.—It shall be the duty of the Physicians to give their patients particularly plain directions for using such medicines as they may prescribe. Art. III.—Patients, whether in or out-door, on appli- cation at the office, should be attended to as soon as pos- sible ; and the Physicians in their intercourse with them, are expected to exercise that forbearance and patience which their condition renders so peculiarly necessary. Art. IV.—In cases of emergency, where the Physician in whose district such case may occur, cannot be found, it shall be the duty of any Physician of this Institution, who may be first met with, to visit such sick person. CHAPTER VII. ATTENDING PHYSICIANS. Art. I.—The Attending Physicians, in the order of their appointment, shall have choice of hours of attendance. In case of vacancy among the District Physicians, they DISTRICT PHYSICIANS. 17 shall (if the post is not filled by the Trustees), in the order of their appointment, be eligible to fill such vacancy. Art. II.—A general register shall be kept in each re- ception room, in which it shall be the duty of the Physi- cians to enter in separate columns, ruled for the purpose, the date, name, age, residence, nativity, condition, disease, result, remarks, and Attending Physician of each patient. Art. III.—They shall furnish their patients with pre- scription papers, who shall present the same when return- ing for further advice. CHAPTER VIII. DISTRICT PHYSICIANS. Article I.—Each of the six Districts shill be placed under the charge of one of the District Physicians; and patients whose cases render them unable to attend at the Dispensary, shall be regularly visited at their respective places of abode, as often as their cases require, by the Phy- sician in whose District they reside. Art. II.—A separate Register for District Patients, 18 DISTRICT PHYSICIANS. similar to those for Out-door Patients, shall be kept in the office, in which the House Physician shall enter the nam s, residence, &c., of all applicants. Art. III.—The District Physicians shall call daily at the office, between 12 and 2 o’clock, to take from the Regis- ter the names, &c., of new applicants in their several dis- tricts. They shall complete the entries in the Register, commence I by the House Physician, as soon as possible, and be careful in stating the result in each case. Art. IV.—If District Patients apply at the Dispensary, after the Physician in whose district they reside has visited the office for the day, the House Physician, or the Apothe- cary, if the case appears to require immediate attention, shall give the applicant a written direction to the residence of the District Physician, and it shall bo the duty of said Physician to visit the patient without delay. Art. V.—Each District Physician shall report in writing monthly to the Trustees, the number of patients attended by him during the month, designating separately the num- ber of old and new cases, with any remarks he may deem appropriate. Such reports shall be made out on the Saturday previous to the stated meeting of the Board, and confided to the care of the House Physician. Art. VI.—It shall be the duty of the Physicians to DUTIES OF APOTHECARY, ETC. 19 make diligent inquiry, from time to time, in their respec- tive districts, for subjects for vaccination, and to perform the operation in all cases where permitted so to do; and to report the name and particulars of each case, including the result, to the House Physician, who shall enter the same in the Vaccine Register. They shall also procure and furnish the House Physician with pure virus, as far as circum- stances may enable them. Art. VII.—The District Physicians shall have choice of districts according to the order of their appointment. Art. VIII.—They shall visit the children, placed at nurse by the Alms House Department, when they are sick. CHAPTER IX. DUTIES OF THE APOTHECARY, ETC. Art. 1.—The Apothecary and his Assistant shall attend in the office during the hours specified for its being kept open in Art. II. Chapter III., except one hour to each, separately, for dinner; that of the Apothecary not until after two o’clock. Art. II.—He shall carefully observe economy in all 20 DUTIES OF APOTHECARY, ETC. things pertaining to his department, and be acurate in the delivery of medicines. In no case is he to change or alter the prescriptions of the Physicians, or substitute one med- icine for another, without their knowledge and consent. He is to permit no one but the House Physician to enter or remain unnecessarily in the office. Art. III.—He shall prepare and compound the medi- cines prescribed by the Physicians ; but no medicine shall be dispensed to patients without written directions from the Physicians. Art. IY.—He shall in January, take an inventory of all the medicines and other property belonging to his depart- ment, and submit the same to the Board at its next stated Meeting. Art. Y.—He shall not be allowed to pursue any private medical practice. Art. VI.—All medicines shall, so far as may be practi- cable, be purchased in their simple state, and be compounded by him. Art. YII.—He shall canse all articles purchased on credit for his department, to be immediately entered by the persons, of whom they are bought, in a Pass-book, desig- nating date, quantity, kind, and price. The Pass-book shall be placed in the custody of the House Physician. 21 Art. VIII.—He shall keep an Order-book, and shall enter therein all articles required from time to time, for the supply of the Apothecary’s Shop. The signatures o f one or both members of the Committee of Supplies, and of the House Physician to each order in the book, shall be requisite to render the same valid. Art. IX.—He shall report monthly to the Trustees upon the general condition of his department, and shall confide this report to the custody of the House Physician. Art. X.—The Assistant Apothecary shall perform all services connected with the operations of the Dispensary, which may be required of him by the Trustees or Apothe- cary. DUTIES OF APOTHECARY, ETC.