KULES 
AND 
REGULATIONS 
OP THE 
PENN’A STATE LUNATIC HOSPITAL, 
HARRISBURG, PA.; 
PREPARED 
BY ORDER OF THE BOARD OF TRUSTEES. 
HARRISBURG: 
m’KINEET & LESCURE, PRINTERS. 
1851. RULES AND REGULATIONS. 
OFFICERS. 
The officers of the Pennsylvania State Lunatic Hospital consist of 
the Superintendent and Physician, the Assistant Physician, the Stew- 
ard, and the Matron. 
By the by-laws, the Superintendent is invested with the entire con* 
trol over all subordinate officers and assistants in the Institution, and 
with the entire direction of their duties, and his instructions, respect- 
ing the patients, are to be implicitly obeyed by all persons about the 
establishment. 
The Assistant Physician shall exercise the duties of the Superin- 
tendent whenever the latter may be absent. 
GENERAL RULES. 
No intoxicating drinks of any kind shall be used by any one in the 
establishment, unless upon the medical prescription of the Superin- 
tendent ; and no one shall be employed who is known to use them, 
either at home or abroad. 
Nor shall there be any smoking of tobacco in or about the buildings. 
No non-resident shall remain in the Institution at night, without 
the knowledge of the Superintendent. 
No one belonging to the male departments, nor any male employed 
about the premises, shall enter the female departments or go upon the 
grounds appropriated to the females, except by express permission. 
No one employed about the Hospital shall report abroad the conduct 
or conversation of any of the patients. 
All persons employed to attend upon the patients shall give the 
Superintendent at least two weeks’ notice of their intention to leave. 
No person employed about the Hospital, in any other capacity than 
as an attendant, will be permitted to enter the wards, except by express 
permission of the Superintendent. 4 
VISITERS. 
Strangers and others may be permitted to visit such part3 of the 
Institution as are not occupied by patients, on any day, except Sun- 
day, (on which day visiters shall not be admitted) between the hours 
of 10 A. M. and 12 M., and between 2 and 4 P. M. 
But no visiter shall be admitted within the wards occupied by 
patients without express permission from the Superintendent, and espe- 
cial care is to be taken that no amount of visiting is permitted in the 
wards that might prove injurious to the patients. 
It is expressly forbidden to furnish any inmate of this Hospital with 
tobacco, in any form ; or to deliver to, or receive from, a patient any 
letter, parcel or package, without the knowledge and approbation of 
the Superintendent. 
Attendants are particularly enjoined to abstain from mentioning to 
visiters the names of patients, their peculiarities, or any other circum- 
stances respecting them, a knowledge of which might be painful 
to any persons connected with them. 
DUTIES OF THE SUPERVISORS. 
The Supervisors are expected to spend their time among the patients, 
to see that they are provided with everything necessary to promote 
their comfort and welfare, to observe carefully their condition and any 
changes which may occur, and to report the same, faithfully, to the 
Physician. 
They will carefully observe the conduct of the attendants, will give 
them advice and direction in the performance of their duties, and will 
see that the directions of the physician are faithfully executed. 
They will see that the rules are faithfully observed by the attend- 
ants, and will report any neglect or violation thereof to the Superinten- 
dent. 
The clothing of the patients will be carefully examined by them at 
the time of admission ; they will attend to having it marked, and 
shall at all times report any deficiency thereof to the proper officer. 
In cases of sickness, they will see that the sick are provided with 
whatever ma)r be needed, that their medicine and food are carefully 
and regularly given them, and the instructions of the Physician most 
scrupulously complied with. 
They will at all times be ready to perform any other services which 
may be required of them by the Superintendent. 
They will be expected to keep a journal of what may occur in their 
respective departments each day, and place the same in the Physi- 5 
cian’s office, each morning, for his inspection, before the regular morn- 
ing visit. 
DUTIES OF THE TEACHERS. 
Upon the Teachers will devolve the duty of directing, under the 
instructions of the Superintendent, the amusements and occupation of 
the patients. In the fulfillment of this duty, they will spend muchcf 
their time among the different classes of patients, assisting them, 
giving them advice and encouragement, and endeavoring in every way 
to promote the comfort and happiness of all. 
They will avail themselves of every opportunity to soothe the irri- 
tated, the restless and the discontented; and to endeavor to engage all 
in some occupation or amusement. 
They will impart instruction to certain patients, read and superin- 
tend amusements in the different wards, at stated periods, and perform 
such other duties as may be requested of them by the Superintendent. 
They will, while in the different wards, carefully observe the gen- 
eral treatment of the patients ; and they will suggest to the attendants 
whatever they may think will add to the comfort of the patients, or 
the tranquility of wards, and will report any neglect or improper con- 
duct that may come under their notice. 
DUTIES OF THE WATCHMAN. 
The Watchman will commence his evening duties at half past nine 
o’clock ; at which time he will visit the office, to receive his instruc- 
tions for the night. 
While on duty, he will be constantly awake, faithful and vigilant j 
will visit every part of the male apartments at least every hour during 
the night, making as little noise as possible, never conversing in a loud 
tone with any one, and opening and shutting all doors as quietly as 
he can. 
He must be kind, gentle and soothing in his manner to the patients, 
and take every means in his power to tranquilize those who are ex- 
cited, and to allay the fears and apprehensions of the timid. 
He will pay particular attention to those who are suicidal. He 
will see that the patients are promptly supplied with water, when it 
is asked for, and will attend to all their little reasonable wants. 
He will notice any particular or unusual noise in the patients’ rooms; 
will endeavor to ascertain the cause, and, if necessary, give notice to 
the attendant. 
He will be particularly attentive to those who are sick; will see 6 
that their medicine is given as directed by the Physician, and attend 
to their other wants. 
He will enter in a book, provided for the purpose, anything par- 
ticular occurring during the night, the condition of the sick, the suici- 
dal and of those recently admitted, and shall also report any irregu- 
larities, neglect of duty or violation of rules, which may come under 
his notice. 
He will be particularly watchful against fire, and, in case of its oc- 
currence, will report it immediately to the Superintendent, without 
giving general alarm. 
He will carefully attend to the kitchen fires ; will ring the bell at 
the regular hour for rising in the morning, and will be expected to per- 
form such other services as may be required of him. 
After 6 A. M. his services will not be demanded, until 2 P. M. ; 
between that hour and sunset he will be ready to attend to whatever 
may be required ; from sunset to 9| P. M, he will be released from 
duty. 
DUTIES OF THE WATCHWOMAN. 
The Watchwoman will have charge of the female apartments 
during the night, and will be guided by the same rules as are laid 
down for the Watchman. 
DUTIES OF THE ATTENDANTS. 
Attendants are expected to devote their whole time to the Hospital, 
in the performance of the duties enjoined by the by-laws, or such as 
may be required of them by the officers. 
No attendant will be permitted to leave the Hospital, without the 
consent of the Superintendent or other proper officer, and when leave 
of absence has been granted, they will be expected to return by nine 
o’clock in the evening. 
They must expect a constant observation of the manner in which 
their respective duties are performed ; they will strive unceasingly to 
promote the welfare of the Hospital, and use their utmost exertions 
to render all those entrusted to their care contented and comfortable. 
They will be careful at all times to set a good example, and will 
take every proper opportunity to inspire the patients with respect for, 
and confidence in the officers, and to convince them of the true char- 
acter of the Institution, and its leading object, the promotion of the 
restoration and comfort of its patients. 
In all their intercourse with the patients, the attendants will treat 
them with respect and civility ; will address them in a mild and gentle 
tone of voice, and avoid violence and rudeness of every kind. All civil 7 
questions are to be properly answered. All reasonable requests are to 
be promptly attended to. They are to keep cool under every provoca- 
tion ; are never to scold, threaten or dictate authoritatively ; but, when- 
ever they desire anything done by a patient, will make a request in 
a respectful manner. 
No attendant will be excused, under any circumstances, for strik- 
ing a blow or laying violent hands on a patient, except in the clearest 
case of self-defence. 
They will most carefully avoid talking to patients on the subject of 
their delusions, or in the hearing of other patients, and they will exert 
their influence to prevent others from talking to them or of them, on 
those subjects. 
They will never allow patients to be laughed at, ridiculed or harshly 
spoken to, on account of their delusions or the peculiarities of their 
conduct. 
Deception must always be avoided, and no promises must be made 
which cannot be performed. 
No attendant will be permitted to sell anything to a patient. 
Attendants will never give up their keys, nor allow any person to enter 
the wards without the permission of the Physician ; and no male at- 
tendant shall at any time enter the female apartments, without similar 
permission. 
Neatness and cleanliness will be most scrupulously attended to by 
attendants, not only in regard to their own appearance, but in the pa- 
tients and wards under their charge ; and any failure in these will be 
considered a neglect of duty. 
Visiting from one ward to another, except on business connected 
with the patients, is not permitted. 
They will see that the doors of the wards and of the rooms are 
carefully locked at bedtime,and such lights only are to be kept burning 
as are directed by the Superintendent. 
Each attendant is responsible for every patient under his or her 
care, and is expected to be able, at any moment, to say where such 
patient may be found. 
One attendant shall always be in each ward with the patients, and 
shall never leave, under any circumstances, until relieved. 
Attendants will never retire to their rooms while the patients are 
in the wards. 
The attendants will rise in the morning at the ringing of the bell, 
and will see that the patients under their charge are washed, their 
hair combed, and that they are properly dressed for the day, before 
breakfast. 8 
They will also see that the patients are neat and tidy during 
the dav, adjusting their clothes whenever they see them disordered, 
and changing them whenever, for purposes of cleanliness, it becomes 
necessary. 
The beds and bedding are to be well aired in the morning, and the 
beds well made ; if soiled, they are to be removed and clean substi- 
tuted. The rooms, halls and stairs to be carefully swept, and the 
floors, walls and windows to be washed whenever required. 
The wards are expected to be ready for inspection in every part by 
ten o’clock. 
No restraining apparatus of any kind shall ever be applied by an 
attendant to a patient, except by order of the Superintendent; and 
whenever it may be necessary to lock a patient in his or her room, 
the fact must be immediately reported to the Supervisor and Assistant 
Physician. 
At meals, one or more attendants shall always be present to carve, 
to distribute the food, and to see that each one has a proper supply, 
and that they take it in a proper manner. 
Care must also be taken that no patient carries away from the table 
a knife, fork or any other article; and the knives and forks shall be 
counted after each meal, to prevent any from being lost. 
Attendants must never place in the hands of patients, or leave where 
they can obtain, any razor, knife, rope, cord, medicine, or any dan- 
gerous weapon or article. Neither shall they deliver any letter or 
writing from or to a patient without permission of the Superintendent. 
No patient will be allowed to leave the ward without the permission 
of the Superintendent. 
Attendants will go to the office for medicine at 6 A. M., 12 M., 
and 7 P. M., and will see that the whole is taken at the time and in 
the manner directed. The cups are to be washed and returned to the 
office as soon as the medicine has been taken. 
When any objection is made by the patient to the medicine, the 
fact must be at once reported to the Supervisor, and no patient is ever 
to be forced to take medicine unless the Assistant Physician or Super- 
visor is present. 
Any striking or unexpected effect in the operation of medicine is to 
be promptly reported. 
When a patient complains of being sick or is supposed to be so, 
the fact must be reported without delay to one of the Physicians. 
The shaving will be done by the attendants, and no patient will be 
allowed to shave himself except by special permission from the 
Superintendent. 9 
All damage done by patients will be entered in a book, provided 
for the purpose, which is to be handed to the Steward every Saturday 
morning. Whenever clothing or other articles are needed for the 
patients, it must be reported to the Steward or Matron. 
Where a patient manifests a disposition to suicide, the utmost 
watchfulness must be exercised. The time most apt to be chosen for 
such attempts is on rising in the morning or just after retiring at night, 
at dusk, at meal time, or whenever the attention of the attendant is 
thought to be diverted. No plausible excuse in such cases must be 
allowed to throw the attendant off the guard. A moment’s neglect 
may lead to as serious consequences as a whole hour. At night the 
room should be carefully examined and the clothing of the patient re- 
moved. 
Whenever a patient escapes, immediate notice is to be given to one 
of the Physicians in order that proper measures may be taken to over- 
take the individual. When it is clearly ascertained that a patient has 
escaped through the negligence or carelessness of the attendant, the 
expense incurred in bringing back such patient will be charged to the 
attendant. Where a patient manifests a strong disposition to escape, 
the vigilance of the attendant must never be relaxed for a moment. 
Before closing the door of a patient’s room for the night, the at- 
tendant must be certain that the patient is actually in the room; this 
ascertained, he or she should wish the patient a good night, then lock 
the door and be sure that the bolt of the lock has properly slipped. 
When patients engage in controversy or any improper or exciting 
topic of discourse, the attendants shall, in the gentlest manner, inter- 
fere and check them ; should other means fail, and if the quiet and 
good order of the ward cannot otherwise be preserved, one or two ol 
the loudest talkers may be placed in their rooms for a short time ; and 
in such cases, the Superintendent or the Assistant Physician must be 
informed immediately. 
Attendants will, in no case, visit the friends of patients except by 
special permission of the Superintendent. 
The conduct and conversation of patients must never be spoken of 
to visiters, nor reported by attendants when absent from the Hospital. 
In addition to keeping their wards scrupulously neat and clean, the 
attendants will be careful that every unpleasant effluvium is removed 
promptly whenever discovered, and the air of the ward be kept pure 
and free. It is expected that every part of the wards will be at all 
times prepared for the closest scrutiny. 
The clothing of every new patient is to be examined at the earliest 
opportunity, after admission, to ascertain whether there are knivei. 10 
weapons of any kind, money, tobacco, or other forbidden articles 
upon the person. If any are found, they are to be promptly given 
to the Steward for safe keeping. 
The clothing of a patient is not to be taken into a ward until it has 
been examined, and a list of articles taken by the Steward or Matron. 
All new clothing sent to a patient should pass through the same 
hands, and be registered in the same way, before it is used. No un- 
marked clothes should be sent to wash, or be used by a patient 
When about to leave, the attendants will call at the office and put 
their keys on the hooks provided for the purpose, and report them- 
selves either to one of the Physicians, or leave their names and the 
hour of going out on a slate provided for the purpose, and in like 
manner report themselves on their return. 
Two weeks’ notice of the intention of giving up their situation will 
be required of every attendant. 
In sending articles of clothing, bedding, &c., to the wash, the at- 
tendants will make out two lists, one of which will be sent with the 
articles and the other kept to be referred to when the articles are re- 
turned. The articles to he washed will be placed in a place desig- 
nated, so that they may be removed by the Overseers of the Laundry. 
DUTIES OF THE OVERSEERS OF THE 
LAUNDRY. 
Under the direction of the Steward and Matron they shall collect 
all the clothes ready for washing, from the family apartments and 
from the wards, on such days as shall be designated, and see that they 
are properly washed and ironed, and returned to the places from which 
they were brought, without loss or injury, and in a suitable condition 
for immediate use. 
They shall take care of the house and furniture and keep them in 
good order, and secure all the doors at night before retiring to rest. 
They shall observe all the regulations of the Hospital, and see that 
they are observed by all persons employed in the Laundry, and shall 
immediately report any instance of remissness or neglect of duty to 
the Steward or Matron. 
A list of the articles sent from each ward will accompany them, 
and the Overseers will see that these lists are correct and will return 
the articles according to the lists furnished. 
They will not permit attendants, or any company or visiter what- 
ever, into their departments, except by the direction of one of the 
officers of the Hospital. 11 
The Engineer shall have charge of the steam apparatus for heating 
and ventilating the Hospital, of the steam engine in the Laundry and 
ot the steam pump, and will see that they are kept in proper order. 
He will also attend to supplying steam for cooking purposes and for 
heating water for bathing and for the Laundry. 
He will carefully attend to the regulation of the heat so as to adapt 
it to the changes of the temperature, and will keep all the parts of the 
Hospital intrusted to his care as neat and cleanly as possible. 
He will be assisted by the Fireman, who will, under his direction, 
attend to the fires under the boilers, and also to the fires in the kitchens, 
and will give him whatever assistance may be in his power. 
All persons employed about the Hospital, in any capacity, are ex- 
pected to be governed by the general spirit of the rules and regula- 
tions herein contained, and to do all in their power to promote the 
best interests of the Institution. 
DUTIES OF THE ENGINEER AND FIREMAN. 
STATED HOURS FOR MEALS, &e. 
The bell will be rung at five, A. M. 
Breakfast will be served at half-past six, A. M. Dinner at half- 
past twelve, and Supper at six o’clock from October to April, and at 
half-past six from April to October. 
The Hospital will be closed at half-past nine o’clock, at which time 
all lights in the wards will be extinguished, except those directed to 
be kept burning during the night; and attendants and others employed 
in the Hospital are expected to be in their rooms. INDEX. 
Officers, 
General Rules, 3 
Visiters, 4 
Duties of the Supervisors, 4 
Teachers, 5 
Watchman, «r> 
Watch woman, 6 
Attendants, 6 
Overseers of the Laundry, 10 
Engineer and Fireman, 11 
Stated hours for Meals, &c, 11