THE BY-LAWS OF TH NEW-YORK DISPEJNSARY. INSTITUTED 1790. “ I WAS SICK, AND YE VISITED HE.” N E W-Y O R K : PRINTED BY WILLIAM OSBORN, Spruce, corner of Nassau-stree 1848. THE BY-LAWS or THE NEW-YORK DISPENSARY. INSTITUTED 1790. “ I WAS SICK, AND YE VISITED ME.” N E W-Y O R K : PRINTED BY WILLIAM OSBORN, Spruce, corner of Nassau-street. 1848. BY-LAWS. CHAPTER I. OF THE ANNUAL ELECTION. i. The annual election of the Trustees shall beheld on the 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 Secre- tary shall give public notice of every such election, in two of the newspapers, designating the time and place. 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 the election. The Secretary shall also attend and keep a poll-list in which he shall enter the names of the voters. hi. As soon as the poll is closed, the Inspectors shall examine the ballots and execute a certificate under 4 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. I. The stated meetings of the Board of Trustees shall be 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 be held at any time on the requisition of the President, or of any two Trustees. n. 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. hi. The President, or in his absence one of the Trustees to be chosen Chairman, shall preside at the meetings of the Board, and regulate the pro- ceedings and preserve order and decorum. In case of an equal division of the Trustees on any question, 5 he shall have an additional and casting vote. He shall appoint all Committees, unless otherwise di- rected by the Board. IV. The Secretary shall give special notice to each Trustee of all meetings of the Board, and shall at- tend the same, and keep accurate minutes of all the proceedings. v. 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 em- ploy a collector to receive in his name the sums due from annual subscribers, and may allow a commis- sion not exceeding five per cent, to such collector. The Treasurer shall keep an account of all moneys received and paid by him, and. once a year, in the month of January, or oftener if required by the Board, he shall render a statement of the same to the Trustees, who shall appoint two of their num- ber to audit his accounts. VI. There shall be a Visiting Committee, consisting 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 an- nual election ; and it shall be the duty of the Trus- tees so appointed to provide the attendance of ano- ther Trustee, in case of his inability to attend. 6 It shall be the duty of this Committee to visit the Dispensary at 9 o’clock 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 opera- tions, 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 the duty of the Committee to investigate the same, and if necessary, report the facts to the Board. VII. The Visiting Committee shall keep a minute book, 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. VIIJ. It shall be the duty of each of the Trustees to visit the Dispensary at least once in every month, and whenever so inclined they may visit the in-door patients, either in company with the Physician or not. IX. Annually, six Committees of two Trustees each, shall be appointed to visit all the district patients ; one district being assigned to each Committee. 7 X. At the first meeting of the Trustees, after the an- nual election, there shall be apointed : A Committee of Supplies, consisting of two Trus- tees, 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 Trus- tees, whose duty it shall be to confer with Commit- tees from the other Dispensaries on all subjects of interest to the Dispensaries in general, especially with regard to appropriations or donations from the Legislature or Corporation. XI. Annually in the month of May, the Trustees shall appoint two House, six District, and six Attending Physicians, six Consulting Physicians and Sur- geons, an Apothecary, an Assistant Apothecary, and a Druggist, from whom the supplies of medi- cine 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. XII. Immediately after the annual appointment of Phy- sicians, the names of those elected shall be publish- ed by the Secretary, in one or more newspapers. 8 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 Common Council. XIV. The President and Secretary shall constitute a Standing Committee, with power to publish such portions of the Monthly reports of the Physicians as they may judge expedient. xv. Unless by unanimous consent, no alteration shall be made in these By-Laws, until reduced to wri- ting and notice given at a previous meeting of the Board. XIII. CHAPTER III. GENERAL REGULATIONS. 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. 9 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 Dis- trict, and on the other sides by a line through Chatham, Division, 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 Division Streets, to Pike, in- cluding both sides of the boundary Streets. Fifth District—bounded by the Fourth District; 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 Dis- trict; West by Broadway; North by Fourteenth Street; East by the First Avenue and Allen Street, including both sides of the boundary Streets. ii. The office of the Dispensary shall be kept open daily, except on Sunday, from eight o’clock in the morning until sunset. On Sunday 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 dispens- ing of medicines. 10 The two sexes shall be received and attended to in separate reception rooms. IV. No persons shall be deemed objects of this charity, but such as are unable to pay for the attendance of a Physician. Venereal cases may be prescribed for, but no medicines shall be furnished to any male patient; nor to any female patient after having been once cured of the said disease. Lying-in wo- men not being proper objects of this charity, if such apply, they should be recommended to the Lying-in Asylum. v. The House Physicians shall in November of each year, select one of their number, who, in connection with one of the District Physicians appointed in like manner by the latter, shall form a Committee, whose duty it shall be to prepare and present to the Board in January, a medical report, embracing the whole number of district patien ts under treatment during the year—the number affected by each dis- ease—the results, especially the number of deaths, with the diseases so resulting—the number cured, relieved, &c.—and the number remaining under treatment: the whole number of out-door patients —the number affected by each disease treated— and the results so far as ascertained. The Com- mittee will also state any facts of general interest ■’onnected with the practice of the Dispensary, such in. 11 as the prevalence at any part of the year, of pecu- liar diseases, the state of the weather at such time, or any other cause which may have given rise to such diseases, &c. The Physicians shall render the Committee any assistance they may call for. VI. No smoking of tobacco shall be allowed in any of the rooms occupied by the Dispensary. VII. No alterations shall be made in any of these regu- lations, or those prescribing the duties of the Physi- cians and Apothecary, without the sanction of the Board of Trustees. CHAPTER IV. DUTIES OF THE PHYSICIANS. I. The Consulting Physicians and Surgeons, as well as the Trustees, shall have the privilege of nomi- nating candidates for the station of Physicians : the nominations to be made in writing to a meeting of the Board, previous to that at which the appoint- ment is to be made. No candidate shall be consid- ered eligible unless he present to the Trustees a certificate signed by at least three of the Consulting Physicians or Surgeons, stating that they consider 12 him qualified for the office of a Physician of the Dispensary. ii. It shall be the duty of each of the Consulting Physicans and Surgeons to visit the Dispensary oc- casionally, to confer with the Physicians on the state of the Institution, and of their patients; to make any suggestion to the Visiting Committee which they may think will advance the interest of the Dispensary, and at all times to attend in con- sultation, when requested so to do by one of the Physicians. hi. 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, except by a Physician or Surgeon of this Institution. IV. The Physicians shall hold a consultation on every case that may require it, and may call upon the Consulting Physicians for their advice when- ever they think proper. v. Should indisposition, or any other reasonable cause, prevent a Physician from attending to the duties of the Dispensary, he shall immediately en- 13 gage the attendance of either of the Physicians of the Institution, and report the same to the Visiting Committee. The substitution must be for a short time, unless continued with the assent of the same Committee. VI. 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. VII. It shall be the duty of the Physicians to leave with the patients, particularly plain directions for using such medicines as they may prescribe. VIII. Patients, whether in or out-door, on application at the office, should be attended to as soon as pos- sible ; and the Physicians in their intercouse with them, are expected to exercise that forbearance and patience which their condition renders so pe- culiarly necessary. IX. A general Register shall be kept in each recep- tion room, in which it shall be the duty of the Phy- sicians to enter in separate columns, ruled for the purpose, the Date, Name, Age, Residence, Nativity, Condition, Disease, Result, Remarks, and Attend- 14 mg Physician of each patient. The Physicians are required to be particular to enter all patients in the Registers, to keep the book neat and clean, and to fill all the columns, including the result when ascertained. x. Each Physician shall report in writing monthly to the Trustees, the number of patients attended by him during the month, designating separately the number 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. XI. Any person accepting the office of Physician will be expected to perform the duties of his ap- pointment until the ensuing regular election, unless prevented by reasons of an urgent and extraordi- nary nature, satisfactory to the Board. In case of omission or neglect to observe this regulation, the Physician so offending to forfeit his connexion with the Institution, and if he receive a salary, such salary shall be forfeited. XII. Pupils of the Physicians shall have the privilege of attending the patients with them, but are in no case whatever permitted to prescribe. No other student of medicine shall be allowed to visit the Dispensary, unless introduced by one of the Phy- sicians, who shall be responsible for his conduct; 15 but in no case shall such student be allowed to pre- scribe for, on any patient. CHAPTER V. HOUSE PHYSICIANS. I. The House Physicians shall attend at the Dis- pensary daily, from 9 to 2, except on Sundays, to prescribe, with the aid of the Attending Phy- sicians, for those patients whose disorders do not confine them to their houses. They shall vaccinate all persons applying; and also bleed, cup, leech, and draw the teeth of all patients requiring those operations. ii. Persons applying at the office to be vaccinated, who are able and willing to pay, the House Physi- cians may perform the operation, and receive in behalf of the Dispensary such compensation or fee as the patient may incline to give. hi. It shall be their special duty to obtain and al- ways keep on hand at the office, a full supply of Vaccine Matter, for the use of the Dispensary, for subscribing Physicians, and for sale. IV. The House Physicians shall account to the Trea- surer, quarterly, for all sums received by them under the second and third sections. 16 V. In all cases of vaccination at the Dispensary, they shall endeavor to ascertain whether the dis- ease has properly taken. VI. A Vaccine Register shall be kept in the office, in which it shall be their duty to enter in separate columns, the name and particulars of each case, whether in or out door, and by whom vaccinated. VII. They shall also keep a Vaccine Account Book, in which it shall be their duty to enter the quantity of Vaccine Matter sold and given away, and the names of the persons to whom it is so delivered, and whether they be subscribers or not. VIII. They shall report in writing, monthly, to the Trustees, the number vaccinated by them and the District Physicians; specifying the number at the office and at their houses. They shall report an- nually, in January, a summary of their monthly reports, the quantity of Virus sold, or given away, and any observations they may deem appropriate. They shall also report as to the number of patients, &c., as required by Sec. X. Chap. IV. IX. They shall keep an inventory of all the Chirur- gical instruments belonging to the Dispensary, and 17 shall be accountable for the same. They shall see that they are kept in order, and for that purpose they shall employ such person as they may deem it most for the interests of the Institution to em- ploy, reporting to the Trustees at their stated meet- ing, the person employed, with the name of the in- struments repaired, and the expense on the same. x. Immediately after the appointments of the At- tending Physicians, it shall be the duty of the House Physicians to arrange the hours of their at- tendance at the Dispensary, and to see that the duties assigned to them are faithfully performed. XI. Such regulations under other heads of the By- Laws as are applicable to the House Physicians, shall be observed by them. CHAPTER VI. ATTENDING PHYSICIANS. I. The Attending Physicians shall be at the Dis- pensary daily, at such times and under such regu- lations as shall be required by the House Physi- cians, to enable them to fulfil the duties of their office. 18 II. Immediately after their appointment, the arrange- ment of the hours of their attendance at the Dis- pensary shall be made by the House Physicians as required in Sec. X. Chap. V.; and the hours, with the attendance of each Attending Physician shall be stated in the monthly report of the House Phy- sician to the Trustees. hi. Such regulations under other heads of the By- Laws as are applicable to the Attending Physicians shall be observed by them. IV. The Attending Physicians shall, as they may prove qualified, have the preference over any Phy- sicians not in the Institution, to any of the offices that may be vacant. CHAPTER VII. DISTRICT PHYSICIANS. I. Each of the six Districts shall 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 19 require by the Physician in whose District they reside. ii. A separate Register for district patients, similar to those for out-door patients, shall be kept in the office, in which the House Physician shall enter the names, residence, &c., of all applicants. hi. The District Physicians shall call daily at the office, once before 12, and once after 3 o’clock, to take from the register the names, &c., of new ap- plicants in their several districts, on whom they shall forthwith call. They shall complete the en- tries in the Register commenced by the house Phy- sician as soon as possible, and be careful in stating the result of each ease. IV. If district patients apply at the Dispensary after the Physician in whose district they reside has visi- ted the office for the day, one of the House Physicians or the Apothecary, if the case appears to require immediate attention, shall give the applicant a writ- ten direction to the residence of the District Phy- sician, and ii shall be the duty of said Physician, to visit the patient forthwith. v. The District Physicians shall keep records of all 20 cases attended by them, noting any circumstances worthy of peculiar observation. They shall each present to the Trustees a monthly report, stating the number of patients under their care during the month, designating separately the number of new cases, the number vaccinated, &c., with remarks on any cir- cumstances deserving of special notice. Their re- cords shall be subject to the inspection of the Trus- tees. VI. It shall be the duty of the Physicians to make diligent inquiry, from time to time, in their respective 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 Physicians with pure virus, as far as circumstances may enable them. VII. Such regulations under other heads of the By- Laws as are applicable to the District Physicians shall be observed by them. 21 CHAPTER VIII. DUTIES OF THE APOTHECARY, ETC. I. The Apothecary and his Assistant shall attend in the office during the hours specified for its being kept open in Sec. II. Chapter III. except one hour to each, separately, for dinner, that of the Apothe- cary not until after two o’clock. ii. The Apothecary shall have a general care of the Dispensary, and premises appertaining thereto. He shall keep the office, rooms, and all things con- nected therewith, clean and in good order. He shall carefully observe economy in all things pertaining to his department; be particularly careful and ac- curate in the delivery of medicines, and permit no persons to enter or remain in the office unneces- sarily. hi. He shall prepare and compound the medicines prescribed by the Physicians; but no medicine shall be dispensed to patients without written directions from the Physicians. IV. He shall keep an inventory of all the utensils, and other property, excepting chirurgical instruments, belonging to the Dispensary, and shall be account- able for the same. 22 V. He shall not be allowed to pursue any private medical practice. VI. All medicines shall, so far as may be practicable, be purchased in their simple state, and be com- pounded by him. VII. He shall cause all articles purchased on credit for his department, to be immediately entered, by the person of whom they are bought, in a pass-book, designating the date, quantity, kind, and price of the articles. VIII. He shall keep a book, in which the Committee of Supplies shall enter their directions for the purchase of medicines, or other articles necessary in his de- partment, and which they may wish him to procure; with the date and quantity to be purchased, and signed with the initials of his or their name. IX. The Assistant Apothecary shall perform all ser- vices connected with the operations of the Dispen- sary, which may be required of him by the Trustees or Apothecary. 23 CHAPTER IX. ATTENDANCE AND DUTIES OF PATIENTS. I. Any person applying for the benefit of the Dis- pensary, shall be attended to, unless in the opinion of the Physician he or she is an improper object; in which case reference must be made to the Visiting Committee, who shall decide thereon. ii. All and every of the patients shall conform to the directions and prescriptions of the Physicians of the Dispensary, in regard to medicine, diet, and other matters necessary to their recovery ; and shall take care of, cleanse and return to the Dispensary, all phials, gallipots aud utensils delivered to them, as soon as they have done with the same ; and in case of neglect or disobedience, shall no longer be entitled to thebenefits of the Dispensary, unless a satisfactory excuse be made to the Committee of Visitation for such delinquency. hi. If any of the out-door patients shall continue ab- sent from the Dispensary for the space of two weeks, he or she being so absent shall be considered as dis- charged, unless a reason shall be given by such absent patients, as in the judgment of the Committee, for the time being, shall be deemed satisfactory. 24 IV. All persons, whether able or not to pay, applying at the office will be vaccinated without charge, but the House Physicians are authorized to receive such compensation or fee as those who are able and willing to pay, may incline to give. v. It shall be the duty of all persons vaccinated at the Dispensary, to return to the office at such time as the House Physicians shall direct, in order that they may ascertain if the disease has properly taken. VI. No male patient shall enter the female depart- ment, and no female that of the men. No smoking shall be allowed in any of the rooms. VII. As soon as the patients have been prescribed for and furnished with medicines, they shall retire.