EULES AND REGULATIONS 
OF THE 
CITY HOSPITAL, 
WITH 
THE ACT OF THE LEGISLATURE, ORDINANCES OF 
THE CITY COUNCIL, AND RULES AND ORDERS 
OF THE BOARD OF TRUSTEES. 
BOSTON s 
ROCKWELL & CHURCHILL, CITY PRINTERS, 
122 Washington Street. 
1 8 73. CITY OF BOSTON. 
AN ACT OF THE LEGISLATURE, 
AUTHORIZING THE ESTABLISHMENT OF THE CITY HOSPITAL. 
Section 1. The City of Boston is hereby authorized to 
erect, establish, and maintain a Hospital for the reception of 
persons who by misfortune or poverty may require relief 
during temporary sickness. 
Sect. 2. The City Council of said city shall have power 
to make such ordinances, rules, and regulations as they may 
deem expedient for the appointment of trustees and all other 
necessary officers, agents, and servants, for managing the 
said Hospital. 
Sect. 3. Said Hospital shall not be erected or located with- 
in three hundred feet of any school-house or church now 
built. 
Sect. 4. This act shall take effect from and after its 
passage. 4 
ORDINANCE RELATING TO THE CITY HOSPITAL. 
Section 1. In the month of January, in the year eighteen 
hundred and seventy, and annually afterwards in said month, 
the city council shall elect, by concurrent vote of the two 
branches, one member of the board of aldermen and two 
members of the common council, to be members of the 
board of trustees of the city hospital, to hold office during 
the remainder of the municipal year in which they are elected, 
and until others are elected in their place, unless sooner re- 
moved. In the month of March or April, in the year eigh- 
teen hundred and seventy, and annually thereafter in March 
or April, there shall be elected, by concurrent vote of the 
two branches of the city council, two members of the board 
of trustees of the city hospital, from the citizens at large, to 
hold their office for three years from the first Monday in 
May, in the year of their election, and until others are elected 
in their place, unless sooner removed. Said members 
elected from the city council, and from the citizens at large, 
shall at all times be subject to removal from office by the city 
council, for cause ; and vacancies from any cause may bo filled 
at any time for the unexpired term, in the same manner as 
the original appointment. 
Sect. 2. The persons elected from the city council shall 
enter upon their duties as members of said board of trustees 
forthwith; and the persons elected from the citizens at large 
shall enter upon their duties on the first Monday in May. 
On the first Monday in May, annually, the members shall 
meet and organize themselves into a board, by the choice of 
a president and secretary from their own number. The 5 
said board may appoint Such consulting and visiting physi- 
cians and surgeons as they may deem expedient; and they 
may also appoint such subordinate agents, assistants, and 
domestics, as they may consider necessary, and may remove 
the same, and shall fix the compensation to be paid to each. 
A majority of the whole board shall be necessary to consti- 
tute a quorum for the transaction of business. 
Sect. 3. The said board of trustees shall elect annually, 
in the month of May, and whenever a vacancy may occur, 
some suitable person as superintendent of the said hospital, 
who shall constantly reside at the institution. He may be 
removed at their pleasure, and shall receive such compensa- 
tion as the city council may from time to time determine. 
Sect. 4. The superintendent, under the direction of the 
board of trustees, shall have the control of all departments 
of the hospital, of all subordinate officers, attendants, domes- 
tics, and patients, and the charge of the grounds, buildings, 
and appurtenances. 
Sect. 5.* The said trustees shall also have charge of any 
buildings which are, or may be, established within the city 
limits, except upon the islands in Boston harbor, by the city 
council, for the admission of patients having the small-pox, 
or any other infectious disease. And they shall make such 
rules and regulations for the management and government of 
the patients and employes as they may deem proper and nec- 
essary, subject, however, to the approval of the city council. 
And the said trustees shall carefully guard against the intro- 
duction of any cases of infectious disease into any other 
buildings under their charge than those appropriated for the 
purpose by the city council. 
Sect. 6. The said board may make all necessary repairs 
and alterations in the several buildings under their charge, 
* By the 65th sect, of the ordinance relating to the public health, passed 
Dec. 2, 1872, it was provided that the Board of Health should exercise all 
the powers mentioned in this section. 6 
and improvements in the land and grounds connected with 
the institution ; provided, the expense thereof shall not ex- 
ceed the amount previously appropriated therefor by the city 
council. But they shall not make any change in the occu- 
pancy of said buildings without first obtaining the approval 
of the city council. 
Sect. 7. The city hospital is established for the reception 
of those only who require temporary relief during sickness. 
The trustees may, however, admit other persons to the insti- 
tution, temporarily, when necessity requires; but such per- 
sons shall be removed to other appropriate public institu- 
tions, as soon as their condition will permit. They may, 
when compensation therefor is made, afford separate apart- 
ments and moie accommodations than those which are cus- 
tomary when no compensation is made. Such extra com- 
pensation shall be credited to the appropriation for the 
hospital. 
Sect. 8. In the month of May, annually, said board of 
trustees shall present to the city council a report made up to, 
and including, the thirtieth day of the preceding April, con- 
taining a statement of receipts and expenditures, the condi- 
tion of the hospital, the number of its inmates, the number 
of admissions thereto, discharges therefrom, births and 
deaths during the year; and such other information or sug- 
gestions as they may deem proper. 
Sect. 9. All moneys which have been or shall hereafter 
be received, directly or indirectly, by gift or bequest, for the 
benefit of the city hospital, shall, unless conditions are con- 
nected with the gift or bequest inconistent therewith, be re- 
ceived by the board of trustees of the said hospital, and be 
by them deposited in the city treasury ; and city scrip shall 
be issued therefor, bearing interest at the rate of six per centum 
per annum, payable semi-annually, which said scrip shall be 
deposited with the auditor, who shall receive the interest as 
the same shall become due thereon, and add it to the moneys 7 
appropriated for tiie use of the hospital. And all real estate 
and other property not converted into money by sale, and all 
evidences of title thereto, shall be received by the said 
board; and all such real estate and other property shall be 
leased, let, or otherwise improved, by the said board of 
trustees, and the rent and income thereof added in like man- 
ner to the moneys appropriated as aforesaid to the use of the 
hospital. All evidences of title thereto shall be deposited 
with the auditor. 
Sect. 10. All moneys, property, and estate given or be- 
queathed to the city, for the use of the hospital, unless the 
donors thereof may have otherwise directed, shall constitute 
a permanent fund, the principal of which shall not be dimin- 
ished, and the income of which shall be devoted to the uses 
of the hospital. 
Sect. 11. The board of trustees of the city hospital shall 
exercise a careful supervision of all property, funds, and 
estate given or bequeathed for the use of the hospital, so as 
to prevent any loss or diminution of the value thereof; and 
in the expenditure of the interest and income thereof they 
shall, in all cases in which conditions and directions have 
been attached to the gift or bequest, strictly observe and 
conform to such conditions or directions. 8 
RULES AND REGULATIONS OF THE HOSPITAL. 
The Board of Trustees, under the Statutes, Ordinances, 
and these Rules and Regulations, shall have the charge, man- 
agement, and custody of the Hospital, as -well as the control 
and direction of its employes and inmates. 
A meeting of the Board shall be held at least once in each 
month at the Hospital, and records of their proceedings shall 
be kept, which shall always be open to the inspection of the 
City Council. 
Annually, in the month of February, the Board shall elect 
by ballot three consulting physicians, three consulting sur- 
geons, eight visiting physicians, six visiting surgeons, two 
ophthalmic surgeons, two physicians to out-patients, two 
assistant surgeons to out-patients, one physician for skin 
diseases of out-patients, one physician for diseases of the 
ear for out-patients, pathologist, and such other officers as 
they may think necessary, whose term of service shall expire 
in one year from the first Monday of the following April, 
or as soon thereafter as their successors shall be chosen; and 
in the month of June they shall elect by ballot seven house 
officers, an ophthalmic externe, and such other officers as 
they may think necessary, whose term of service shall con- 
tinue for one year from the first Monday of July following, 
or until their successors shall be chosen. 
In the month of May annually a superintendent and a 
resident physician shall be chosen by ballot, whose term of 
office shall expire on the first Monday of the following May, 
or as soon thereafter as their successors shall be chosen. 
Also in the month of May they shall elect by ballot a stew- 9 
ard, a matron, an assistant matron, and an apothecary, and 
such other officers as they may think necessary, whose term 
of service shall expire on the first Monday of the following 
May, or as soon thereafter as their successors shall be 
chosen. 
They may remove any officer so chosen at their pleasure; 
and shall till vacancies, from whatever cause, for the residue 
of the term. 
They shall appoint and discharge all subordinate officers, 
attendants, and domestics, and shall fix the compensation 
of all persons employed excepting that of the Superintendent. 
Annually, in the month of May, the Board shall make a 
report of their proceedings to the City Council, and shall 
furnish statistics of the Hospital, embodying in such blanks 
as may be adopted details concerning the operations of the 
year, and also a statement of the various items of expense. 
The Board of Trustees shall keep a book containing an 
account of all donations and bequests to the Hospital, and 
shall manage such property in accordance with the jirovisious 
of the City Ordinance relating to that subject. 
The Trustees shall establish from time to time such minor 
rules for the government of persons on the premises, for 
the regulation of the internal police of the wards, and 
other parts of the Hospital, the appointment of hours, and 
the arrangement of diet tables, as may to them seem expe- 
dient. 
They shall designate each ward in the Hospital by a letter, 
or by the name of some benefactor, and shall number the 
beds in order. 
SUPERINTENDENT AND RESIDENT PHYSICIAN. 
The Superintendent, under the direction of the Board of 
Trustees, shall have the general control of all departments 
of the Hospital, and the charge of the grounds, buildings, 10 
and appurtenances. He shall have control of all subor- 
dinate officers, attendants, domestics and patients, and shall, 
under the direction of the Board of Trustees, make such 
minor rules for their government as may be necessary. 
He shall see that there is no waste or carelessness in any 
department, and shall report to the Trustees omissions of 
duty, or disorderly conduct on the part of the employes. 
He shall, under the direction of the Trustees, purchase the 
provisions, stores, fuel, and all other supplies, including all 
surgical instruments and appliances, and shall have the 
charge thereof, and shall be responsible for their proper and 
economical use. 
He shall examine all articles purchased as to their quality, 
quantity, and price. 
He shall make no purchase exceeding one hundred dollars, 
or of an unusual nature, without the sanction of the Trustees, 
or of the Committee on Supplies. 
He shall keep, or cause to be kept, regular accounts of all 
the moneys received and disbursed by him, on behalf of the 
Hospital, in books provided by the Trustees, with a record 
of all contracts, and shall submit the same to the Board at 
their regular meetings. 
All bills, together with the pay-rolls, shall bo submitted 
to the Board on the third Tuesday of each mouth. 
He shall keep an inventory of all furniture, and other 
property belonging to the Hospital, and shall make a 
quarterly report of articles injured, destroyed, or missing. 
The instruments, apparatus, books, and other property, 
shall not be taken from the Hospital without his consent. 
He shall provide the diet of patients, as may be directed 
by the physicians and surgeons, and for the persons em- 
ployed shall furnish such provisions as the Trustees may 
direct. 
He shall daily visit and inspect the wards, kitchen, laun- 11 
dry, engine room, and all other departments of the insti- 
tution. 
He shall keep, for the inspection of the Trustees, a record 
of the fiamcs of all patients, with their age, residence, 
employment, date of admission, discharge, elopement or 
death, result of treatment, and disposition of remains. 
He shall, under the direction of the Trustees, decide what 
patients shall be required to pay for their board in the Hos- 
pital, and what rate of board shall be paid, and shall, when 
required, collect all sums due to the Hospital. 
He shall take charge of money or other property not in 
use belonging to patients, and keep a record of the same. 
It shall be his duty to ascertain the settlement or residence 
of patients, and when belonging to other places than Boston, 
to correspond with the authorities of such places, and maue 
the necessary arrangements for the reimbursement ot ex 
penses incurred. 
He shall discharge, as soon as practicable, all patients 
recommended for such action, by the attending Physicians 
and Surgeons, and he may, if he think proper, discharge 
any patient who has disobeyed the rules of the Hospital, or 
whose conduct has been improper, and such cases must be 
reported to the Visiting Committee at their next visit. 
He shall at the end of each month, report to the Visiting 
Physicians and Surgeons, and to the Visiting Committee, 
the names of all patients who have been in the Hospital 
three months. 
He shall have charge of the correspondence of patients, 
and shall communicate to their friends information of their 
condition or decease. He shall allow no autopsy to be made 
unless consented to in writing by the immediate relatives of 
the deceased. He shall cause the bodies of the deceased to 
be delivered to their friends, or, if not claimed by them, to 
the proper authorities. 
The Resident Physician shall receive all applications for 12 
admission to the Hospital, and shall admit such persons as in 
his opinion, are proper cases for treatment therein, subject to 
the approval of the Visiting Committee. Whenever it is 
necessary, he shall visit at their residences, such patients as 
are unable to apply at the Hospital in person. 
He shall see that all patients receive proper attention on 
their admission and during their stay in the Hospital, and 
give all necessary directions for their care and comfort, 
lor the time being; and in all serious cases requiring it, he 
shall send for the physician or surgeon in attendance, or if 
he cannot be found, for some other member of the staff. 
He shall direct what disposition shall be made of each 
patient on admission, subject to the approval of the Visiting 
Committee ; and no change or transfer of a patient to another 
ward or bed shall be made unless by his direction or that of 
the Visiting Committee. 
As soon after their election as possible, the Physicians and 
Surgeons shall meet for the purpose of arranging their term 
and order of service, which arrangement shall be made sub- 
ject to the approval of the Trustees. 
PHYSICIANS AND SURGEONS. 
The Hospital year shall be divided into four terms of three 
months each for the physicians, and three terms of four 
months each for the surgeons, and there shall always be 
two physicians and two surgeons on duty at the same time. 
All medical and surgical cases shall be alternately assigned to 
them by the Kesident Physician, and no preference shall be 
given to any one of them, except that, if any physician or 
surgeon on duty has treated or made an examination of any 
case previous to its admission to the Hospital, and shall so 
desire, the case may be assigned to him ; or if any patient be 
readmitted to the Hospital, the case may be assigned to the 
Physician or Surgeon who formerly treated it, if he be then 
on duty. 13 
If any Physician or Surgeon shall be prevented from at- 
tending- in his term, he shall procure, subject to the approval 
of the Trustees, one of the other Physicians or Surgeons to 
attend in his stead. The regular morning visit to patients 
shall be made between the hours of eight and twelve. 
They shall keep, or cause to be kept by the house officers, 
in permanent volumes, in such form as may be provided by 
the Trustees, full records of the cases and treatment of all 
patients in both medical and surgical departments. No vol- 
ume of such records shall be taken from the premises, 
except by permission of the Trustees, and no extracts shall 
be made from them by any one, except with the approval 
of the Trustees and of the Physician or Surgeon by whom 
the cases were treated. 
They shall daily report to the Resident Physician the 
names of such patients as they think have received all the 
benefit they will probably derive from treatment in the Hos- 
pital, and who should be discharged or transferred to some 
other public institution. 
The recommendation for discharge or transfer may, in 
each case, be noted upon the bed-card of the patient, with 
a statement of the condition, whether cured, relieved or not 
relieved ; also such other suggestions as each case may require, 
and this should be done at the time of the regular morning 
visit. Such recommendations for discharge will be acted 
upon as soon as practicable, after they are made, but every 
case should be carried upon all the records of the Hospital, 
as still under treatment, until the patient is discharged. 
The directions of the Physicians and Surgeons in regard 
to the patients shall be complied with by all the officers and 
attendants of the Hospital, under the direction of the Board 
of Trustees. 
They should pay particular attention to the manner in 
which their orders for the c ire, treatment, and diet'of the 
patients, are conveyed to the attendants ; and should require 
the important duty of writing their prescriptions and orders 14 
in the manner prescribed for the purpose, to be promptly 
and carefully performed by the house officers. Precision 
and regularity in the discharge of this duty are essential 
to the exact and orderly execution of orders on the part of 
the attendants. 
They should inform the Resident Physician of any neglect 
or inefficiency on the part of the attendants, and for this 
purpose may note in the ward order-books, in which their 
directions for the sick are written, every instance of neglect 
or failure to carry out their orders. 
Except in case of emergency, no capital operation shall 
be performed without a previous consultation. 
In all cases of emergency the Superintendent shall send 
for the Physician or Surgeon in attendance, and if he cannot 
be found, for some other member of the staff. • 
The surgical out-patients’ department shall be under the 
care and supervision of the Visiting Surgeons. The Assist- 
ant Surgeons shall be appointed solely for service in this 
department, and on the nomination of the Visiting Surgeons, 
which nomination shall be reported to the Trustees before 
the first Tuesday of February of each year, or at any other 
time when a vacancy occurs ; and such Assistant Surgeons 
shall have graduated, and shall not be eligible for a second 
term of service. 
HOUSE OFFICERS. 
The House Officers shall be chosen on the nomination of 
the Board of Visiting Physicians and Surgeons, whose duty 
it shall be to report such nomination to the Trustees before 
the first Tuesday in June of each year. The names thus 
reported shall be those of the persons who, in the opinion 
of the said Board, after a rigid examination in the various 
branches' of medicine and surgery, shall seem most compe- 
tent to fulfil the duties required of them. 15 
The house officers shall reside constantly at the Hospital, 
and shall not absent themselves without the consent of the 
Resident Physician, and in no case shall all of the medical 
or surgical house officers be absent from their post at the 
same time. 
If any one of them be absent by reason of sickness or 
other cause, the vacancy shall be filled by the Ophthalmic 
Extcrne. If more than one be absent, the Visiting Commit- 
tee shall appoint a substitute on the nomination of the phy- 
sicians and surgeons in attendance. 
They shall in no case make an exchange of their respective 
departments without the consent of the Visiting Physician 
or Surgeon under whom they serve, and the sanction of the 
Visiting Committee. 
Their duties shall be assigned to them by the Visiting 
Physicians and Surgeons, and Resident Physician, all of 
whose instructions and directions in regard to the observation, 
care, and treatment of the sick, they must promptly and 
carefully obey. They shall accompany the Physicians and 
Surgeons in their daily visits, shall make the necessary record 
of the condition, treatment, and diet of the patients, and 
shall see that their directions are complied with. 
They shall begin their regular morning visit to the wards 
of the Hospital as early as eight o’clock, and shall have com- 
pleted the visit in time to be prepared to report to the Visit- 
ing Physician or Surgeon with whom they are serving, the 
condition of each one of the patients under his care. Their 
regular evening visits to the wards, shall be made between 
the hours of four and six o’clock. 
They shall receive from .the physicians and surgeons their 
prescriptions and orders for the treatment, diet, and care of 
the patients, and shall write their orders plainly in the man- 
ner prescribed for the purpose, for the use and guidance of 
the nurses. It shall be the duty of the nurses and ward- 
masters to carry out all such orders of the physicians and 16 
surgeons as may be thus given them, and they will be 
held responsible for the prompt and exact execution of all 
these orders; and it shall be the duty of the house officers 
to report every instance in which any patient fails to receive 
proper attention, and of neglect of duty in any respect, on 
the part of any nurse or ward-master, and their assistants. If 
the fault is of minor character and committed by an assistant 
ward-master or nurse, complaint may be made to the ward- 
master or head nurse, as the case may be, but all complaints 
of any importance should be made to the Matron or the Res- 
ident Physician. The house officers shall not, in any case, 
overlook or excuse any failure to perform all the necessary 
services for the sick, or any improper conduct or neglect of 
duty on the part of the ward-masters and nurses, and their 
assistants; but all matters relating to the government of the 
attendants and the patients, and requiring reprimand or 
discipline, must be referred to the Matron or Resident 
Physician. 
They shall note all important changes in the condition 
of patients, and inform the Resident Physician thereof, and 
they must at once notify him if the patient is in a serious 
condition, or when there is any doubt in regard to the con- 
dition or symptoms of any patient, in order that he may 
send for the Physician or Surgeon in charge, or give such 
orders for the care of the patient as may bo necessary for 
the time being, or that the friends of the patient may be 
notified. 
All patients admitted to the Hospital shall be, until they 
can be seen by their regular medical or surgical attendant, 
under the charge of the Resident Physician, and under his 
direction the house officers shall attend to them on their 
admission, and give the necessary directions for their com- 
fort. The Resident Physician will be notified at once of the 
admission of every case of accidental or other injury, or of 
special urgency from any other cause. 17 
The house officers will not be allowed to perform any 
surgical operation in any case, except by the express direction 
of the Surgeon or Physician in attendance, or of the Resident 
Physician. 
No report, or other communication in regard to cases in 
the Hospital, shall be published by the house officers, ex- 
cept by permission, and with the approval and in the name 
of the Physician or Surgeon in whose service the case has 
been treated. 
They shall, when requested by the Pathologist, ren- 
der assistance in making autopsies and other pathological 
examinations. 
They shall, when requested by the Resident Physician, or 
Visiting Committee, investigate the claims of applicants for 
admission, whether they apply in person at the Hospital, or 
require to be visited at their homes. 
The second house officer on the surgical side will be re- 
quired to till notices for meetings of the Surgeons, annexing 
a list of operations, and deposit them with the Superintend- 
ent for distribution, at least twenty-four hours prior to the 
time appointed for such meeting. 
The junior house officer on the medical side will be re- 
quired to fill notices for meetings for consultation by the 
medical board, and deposit the same with the Superintend- 
ent in due time for distribution. 
The Consultation Rooms of the physicians and surgeons 
are appropriated for their especial use, and must not be occu- 
pied during their visits by the house officers. 
When operations are being performed, the house offi- 
cers who are not immediately employed, must not intrude 
themselves upon the space set apart for the operators. 
The title of each book taken from the Library shall be 
recorded, with the date, name of person borrowing, and 
date of return, in the book provided for that purpose, 18 
and "no book shall be allowed to be carried out of the 
Hospital. 
The house officers shall neither graduate nor engage in 
private practice during their term ot service. 
STUDENTS. 
Students and other persons shall be admitted to the 
wards and the amphitheatre of the Hospital, in such numbers 
and with such restrictions as the Trustees may from time to 
time deem expedient. 
PATHOLOGIST 
The Pathologist shall have the charge of the casts, 
models, and anatomical preparations belonging to the 
Hospital, under such regulations as may be prescribed by 
the Trustees. 
He shall perform all autopsies with the assistance of the 
house officers, and shall cause reports of every such exam- 
ination to be recorded by the house officers. 
He shall preserve and arrange all morbid specimens for 
the Museum. 
APOTHECARY. 
The Apothecary shall be chosen annually by the Trustees, 
on the nomination of the Superintendent, and shall be under 
his control and follow his directions. He shall reside at the 
Hospital, and shall not absent himself except at such hours 
as may be authorized by the Superintendent. 
He shall have the immediate care of all drugs, medicines, 
and other articles belonging to this department, and shall 
compound medicines, prepare prescriptions, perform chem- 
ical analysis, and such other duties as may be prescribed by 
the Trustees or the Superintendent. 
He shall deliver no medicine or other articles for use in 
the Hospital, unless they have been ordered in writing by 19 
the Physician or Surgeon in attendance, and shall deliver 
none to be carried out of the Hospital unless prescribed for 
out-patients. 
He may purchase medicines and medical supplies only 
when directed to do so by the Superintendent, or the Com- 
mittee on the medical department, and upon written orders, 
and shall keep exact accounts of quantities, qualities, and 
prices. 
DISPENSARY. 
Out-patients, who are unable to pay fees for medical attend- 
ance at their houses, shall be treated under the following 
restrictions and regulations : 
Medical.— Tuesday, Thursday, and Saturday. 
Surgical.— Every day except Sunday. 
Ophthalmic.— Monday, Wednesday, and Friday. 
Diseases of the Skin.— Every day except Sunday. 
Diseases of the Ear.— Monday, Wednesday, and Fri- 
day. 
Hours from 9 to 11 A. M. 
Medicines may be provided for out-patients if deemed 
desirable by the Trustees. 
Whenever an out-patient requires such an operation as 
may probably confine him for a time in the Hospital, his 
case shall be referred to the Resident Physician. 
The surgical out-patients’ department shall be attended by 
the Assistant Surgeons to out-patients, and shall be under 
the care and supervision of the \ isiting Surgeons. 
No incisions will be made, no operations be performed, 
nor any important dislocation be reduced in the out-patients’ 
department, except at the request ot the Visiting Surgeons 
on duty. 20 
STEWARD. 
The Steward shall be chosen annually by the Trustees, on 
the nomination of the Superintendent. He shall reside at 
the Hospital, and shall, under the direction of the Trustees 
and the Superintendent, have the general care of the grounds, 
buildings, and appurtenances, and see that they are kept in 
good order and repair. 
Under the direction of the Trustees and the Superintend- 
ent he may purchase provisions, stores, fuel, and other nec- 
essary articles, and shall have the immediate charge thereof, 
and be responsible for their safe-keeping and economical 
use. 
It shall be hi- special duty to take charge of all the records 
of the Hospital, excepting those relating to the medical and 
surgical treatment of the patients, and to keep the accounts 
and inventories of all property purchased and issued, and of 
all money received and expended for the Hospital. He shall 
perform, such other duties as the Trustees and Superintend- 
ent may require. 
MATRON. 
The Matron shall be chosen annually by the Trustees, on 
the nomination of the Superintendent. Under his direction, 
she shall have the general supervision of the female nurses 
and servants, and shall report all instances of inattention and 
neglect of duty. She shall be responsible for the neatness 
and cleanliness of every part of the establishment; shall 
superintend and daily visit the kitchens, store-rooms, dining- 
rooms, and laundry, and aid the Superintendent and Stew- 
ard in seeing that these several places are kept in order, that 
all food is properly and economically prepared and served, 
both for the patients and the family tables, and that there is 
no unnecessary waste of provisions or utensils, in any part 
of the house. She shall frequently visit the wards and ser- 21 
vants’ sleeping apartments, and see that the house is kept 
thoroughly swept and cleansed. 
It shall be her special duty to take charge of and look 
after the bedding, table-linen, towels, and other household 
articles, and see that they are properly used, and taken care 
of. 
She shall perform such other duties as may be required. 
WARD-MASTERS. 
The Ward-master in charge of each pavilion of the Hospi- 
tal, shall, under the direction of the Superintendent, have 
the general supervision of all departments of the building, 
and of the nurses and all other persons employed therein, 
and shall see that their duties are properly performed. 
He will see that all the orders and instructions of the Su- 
perintendent, regarding the care and management of the 
pavilion, are carried out, and will have charge of all matters 
relating to its order and cleanliness, and he will see, also, 
that there is no waste or improper use of any articles of Hos- 
pital property. 
. He shall take charge of the clothing and other property, 
not in use, belonging to the patients, and keep a record of 
the same in the manner prescribed for the purpose, and he 
shall deliver to the Superintendent, for safe keeping, all 
money and other valuables belonging to the patients. 
He will attend to all business transacted between the offi- 
ces of the Hospital and the pavilion, under his charge, and 
will also have charge therein of the execution of all orders 
relating to the reception of patients, their assignment to beds, 
transfer from one ward or bed to another, and of their dis- 
charge. 
He will report all instances of neglect of duty, or miscon- 
duct of employes or patients. 
The Ward-masters and their assistants shall not absent 
themselves from the Hospital without the permission of the 22 
Superintendent, and shall perform such other duties as may 
be required. 
NURSES. 
The nurses in charge of the wards shall each be respon- 
sible for the proper attendance upon all the patients placed 
in her care, and for the proper management and care of her 
ward in all respects, in obedience to the orders and instruc- 
tions given her by the Superintendent and Matron, and other 
officers of the Hospital. The nurses will promptly and care- 
fully carry out all the orders that may be given them by the 
Physicians and Surgeons, for the treatment, diet, and care of 
the sick, and must report, at once, every instance of failure, 
or inability from any cause, to fulfil such orders. 
Each head nurse shall keep a ward book, containing an 
inventory of all Hospital property, furniture, bedding, and 
other articles in her ward, and shall be responsible for their 
being properly used and taken care of. 
She shall see that all clothing and other property belonging 
to the patients under her care, if in a female ward, is prop- 
erly taken care of on their admission, and that it is placed in 
the charge of the Ward-master for safe keeping. She shall 
decide what clothing or other articles patients are to retain 
in the ward, and shall give or allow to be given to patients, 
only such articles of food or drink as may, be permitted by 
the Physician or Surgeon in attendance. 
She must see that her ward is kept cleanly and in good 
order at all times, and must report every instance of inatten- 
tion or of neglect of duty on the part of her assistants. 
The nurses shall not absent themselves from the Hospital 
without permission of the Superintendent or the Matron. 
The night nurses must be in their wards at eight o’clock 
every evening, and remain on duty till five o’clock in the 
morning, and they must leave the wards in good order for 
the day nurses to begin their duties at that hour. 23 
GATE KEEPER. 
The gate keeper shall allow no one to enter or leave the 
premises, unless duly authorized. 
He shall examine all permits, and shall record the names 
of all persons passing the gate between 10 P. M. and 5 
A. M., and perform such other duties as may be required 
of him. 
ADMISSIONS AND DISCHARGES. 
Applications for admission of patients shall be made to 
the Resident Physician at the Hospital, on each day of the 
week, Sunday excepted, between 9 and 11 A. M. 
Whenever able, the patient shall apply in person. When 
not able to appear in person, application may be made by a 
friend, and the patient shall be visited at his residence. 
Any Trustee, or either of the Physicians or Surgeons in 
attendance may, in case of emergency, send a patient in the 
first instance to the Hospital by written.permit, and the Vis- 
iting Committee shall decide, as soon as may be afterwards, 
whether such patient shall remain. 
Persons accidentally wounded or otherwise disabled or 
injured, shall be received at all hours. 
Permits for admission shall be subject to the approval of 
the Visiting Committee, and they shall have the power at 
any time to require the Resident Physician to report to them 
the names of apjfiicauts before admitting them, and may 
dismiss any patient whom they think improperly admitted, 
or change the terms of admission. 
Patients discharged onthe recommendation of the physicians 
or surgeons, shall be provided with a certificate stating their 
condition at the time of discharge, whether cured, relieved 
or not relieved, which certificate shall be signed by the Super- 
intendent and Resident Physician. 
Whenever a patient is removed from the Hospital without 
the consent and approval of the Superintendent and Resident 24 
Physician, a written statement to that effect shall be required 
from any person assuming the responsibility of the removal. 
The body of any person dying at the Hospital shall not 
be delivered without a written receipt from the parties taking 
the same. 
In case of the decease of any patient, the Resident Physi- 
cian shall sign a certificate to that effect, and shall furnish the 
City Registrar with a copy of the same. He shall also state 
the time and cause of death, the disposition made of the body, 
whether delivered to friends or buried from the Hospital. 
In the last case he shall mention the place of interment. 
Patients may be admitted by the Trustees to the privileges 
of the Hospital, at such rates of board as they may from 
time to time determine ; such board being secured by their 
friends, or by the authorities of the place to which they 
belong. 
In all cases where, in the opinion of the Trustees, the cir- 
cumstances of the patient will warrant it, the whole or a part 
of the board shall be paid. If separate apartments or arti- 
cles not usually furnished at the Hospital are provided, such 
payment shall be made therefor as the Trustees shall deem 
reasonable. 
On or before the twentieth day of each month, the Super- 
intendent shall submit to the Trustees the bill book, and all 
bills approved by any of the committees, with a schedule of 
the same, and also the pay-roll for salaries and wages, con- 
taining the names of the persons entitled to payment, with 
the amounts due to them respectively; and if approved by 
the Board, said schedule shall be signed by the President, 
and with the pay-roll and bills shall be sent, on or before the 
twentieth day of each month, to the Auditor of Accounts for 
payment by the Treasurer. 
DISBURSEMENTS. 25 
Any alteration or amendment of these Rules and Regula- 
tions may be made by a vote of two-thirds of the members 
of the Board, notice of the same having been given one 
week before action on the same. 26 
HOUSE KULES. 
Patients must be in their proper places in the wards dur- 
ing the visit of the physicians and surgeons, and always by 
8 P.M., unless specially exempted by the Superintendent. 
Those free patients who are able, are expected to assist in 
nursing, and in such other services as may be reasonably 
required of them. 
Patients shall not leave the Hospital Grounds without a 
pass.from the Superintendent, nor their respective wards 
without the consent of the nurse in attendance. 
No patient shall purchase, or cause any member of the 
household to purchase for him, any article of food whatso- 
ever, nor any other article, without the consent of the Super- 
intendent ; nor shall any officer or servant of the Hospital 
receive a gift or fee from a patient. 
Profane or obscene language, loud talking, and incivility, 
are prohibited. 
No patient having acute syphilitic disease, or mania-a- 
potu, shall be admitted as a charity patient, or at a lower 
rate than twenty-five dollars a week for the ’ former, and 
fifteen dollars for the latter. 
No person shall be admitted to the Hospital whose case is 
judged to be incurable, unless there be urgent symptoms, 
which in the opinion of the Physician or Surgeon are capable 
of being relieved. 
Patients may be visited by clergymen of their own selec- 
tion, and where there is a wish for the performance of any 
particular religious rite, it shall be indulged when practicable. 
It is expected that patients will implicitly obey the rules 
if the Hospital. Complaints, for whatever cause, may be 
made to the Superintendent or Visiting Committee, and when 
reasonable shall be by them reported to the Trustees. 
All employes must be in their respective places during their 27 
hours of duty. The doors and gates of the Hospital will be 
closed at 10 P. M., at which time all are expected to be quiet, 
and those not on duty, in their own rooms. 
The use of tobacco, wine and intoxicating liquors is pro- 
hibited within the Hospital, unless prescribed by a physician. 
VISITORS. 
No person shall visit any part of the premises, except on 
business, or at such times as may be fixed for the reception 
of visitors, without the permission of the Superintendent, or 
of some one of the Trustees. 
On Monday, Tuesday, Thursday and Saturday of each 
week, from two to three o’clock, P. M., friends may be per- 
mitted to visit patients, though no patient shall receive more 
than one visitor on the same day. In all cases, however, the 
Trustees or Superintendent may exercise discretionary powers 
as to excluding or admitting visitors. 
All visitors must leave when the bell rings at the expiration 
of the visiting hour. 
No visitor will be permitted to take any meal in the Hos- 
pital, or pass the night therein, without permission from the 
Superintendent or one of the Trustees. 
No visitor shall be allowed to give any article of food or 
drink to a patient, unless by permission of the nurse; and 
any article sent to the patients shall be left with the Super- 
intendent. t 
STUDENTS. 
The Trustees may grant any practitioner or student of 
medicine of one year’s standing, on the recommendation of 
the Board of Physicians and Surgeons, a ticket of admission 
to follow the practice of the Hospital for not more than one 
year. Before receiving this ticket, the applicant shall sign 
an obligation to obey in all respects the By-Laws and Regu- 
ations of the Hospital. The privilege thus granted may be 
or revoked. 28 
No student shall be entitled to admission except at the 
regular hours for visiting, operation, or lecture. 
Every student, when requested, shall show his ticket to 
the porter at the gate, and shall conduct himself with deco- 
rum and propriety. It shall be the duty of the Superinten- 
dent to report any infringement of the rules to the Visiting 
Committee. 
FORM OF APPLICATION. 
The form of application for admission shall be as fol- 
lows : 
The undersigned, inhabitant of for the last 
BOSTON CITY HOSPITAL. 
and now residing at Born in 
being years of age, by employment a 
married and ill of requests to be admitted 
to the City Hospital. 
Boston, 
, 187 
Having examined the condition of the said applicant, I 
find it a suitable case for admission to the City Hospital. 
certificate OF RESIDENT PHYSICIAN. 
, M. D. 
TO BE SIGNED BY SUPERINTENDENT. 
Admit to the Hospital.^ 
Said is assigned to ward bed 
Extra payment, | Transferred to ward bed 
Said 
is discharged, 187— 
Superintendent. 
Any alteration or amendment of these Rules may be made 
by a vote of two-thirds of the members of the Board, notice 
of the same having been given one week before action on the 
same. 29 
RULES AND ORDERS OF THE TRUSTEES. 
Ojst the first Monday in May, annually, the members shall 
meet and organize themselves into a Board by the choice of 
a President and Secretary from their own number. 
Stated meetings of the trustees shall be held at the Hos- 
pital each Tuesday, at four o’clock, P.M., unless otherwise 
ordered, and special meetings shall be called by the Presi- 
dent at the request of two of the Trustees. 
They shall be governed in their action as a Board by the 
following rules and orders : 
The President shall preside at all meetings of the Board 
when present, and in his absence the Board shall elect a 
President 'pro tern. 
A majority of the Board shall constitute a quorum. 
Motions shall be made in writing when requested by the 
President or a majority of those present. 
On all questions and motions whatsoever, the sense of the 
Board shall be taken by yeas and nays, if any member 
requires it. 
Questions of order shall be decided by the presiding 
officer, subject to appeal to the Board. 
When a vote has passed it shall be in order for any mem- 
ber to move a reconsideration thereof at the same or the 
succeeding meeting. 
The order of business shall be as follows : 
1. Reading of the records. 
2. Reports of Committees. 
3. Examinations of admissions and discharges, purchases 
and expenditures, and books of the Superintendent. 
4. Approval of bills. 
5. Choice of officers and employes. 
6. Unfinished business. 
7. Motions and resolutions. 30 
There shall be appointed by the President, after the first 
organization of the Board, the following standing committees, 
to consist of two members each : 
1. On Rules and Regulations. 
2. On supplies aud furniture. 
3. On finance and auditing accounts. 
4. On Medical and Pathological departments. 
5. On service. 
6. On grounds and buildings, healing and ventilation. 
7. On Library. 
8. A committee on conference with the Association of 
Physicians and Surgeons to consist of the President and two 
other members. 
Also a Committee on Bequests, to consist of the President 
and two members, who shall have the charge and manage- 
ment of the Goodnow and Nichols bequests and of such 
other projaerty as may be given or devised to the Hospital 
during the year. 
The Trustees shall be arranged in visiting committees of 
two members, one going out and» one added each month, to 
advise with the physicians and Superintendent, determine 
matters of minor administration, and see that all duties are 
properly performed. They shall record their names, with the 
date of each visit, in a book kept for the purpose, with such 
remarks as they may deem advisable. 
Committees shall be appointed by the President. 
AH bills contracted for the Hospital shall be approved by 
the Board of Trustees. 
Reports of committees shall be in writing. 
These rules may be suspended by vote of six members of 
the Board of Trustees. 
Any alteration or amendment of these Rules may be made 
by a vote of two thirds of the members of the Board, notice 
of the same having been given one week before action on the 
same.