C II A R T E II, 
LAWS AND RULES, 
OF THE 
P ENNSYLV ANIA HOSPITAL. CHARTER, 
LAWS AND RULES, 
OF THK 
PENNSYLVANIA HOSPITAL. THE 
CHARTER, 
LAWS ANI) RULES, 
OF THE 
PENNSYLVANIA HOSPITAL. 
PHILADELPHIA: 
PRINTED BY KITE & WALTON, 
No. 50, North Fourth Street. 
1848. C H A R T E R. 
ANNO VIGESIMO QUARTO. 
GEORGII II. REGIS. 
At a General Assembly of the Province of Pennsyl- 
vania, begun and holden at Philadelphia, the four- 
teenth day of October, Anno Domini, 1750, and 
from thence continued by adjournments to the sixth 
day of May, 1751. 
An ACT to encourage the establishing of an Hospital 
for the relief of the sick poor of this Province, and 
for the reception and care of lunaticks. 
* Whereas the saving and restoring useful and 
4 laborious members to a community, is a work of 
4 publick service, and the relief of the sick poor is not 
4 only an act of humanity but a religious duty ; and 
4 whereas there are frequently, in many parts of this 
4 province, poor distempered persons, who languish 
4 long in pain and misery under various disorders of 
4 body and mind, and being scattered abroad in 
Preamble. 6 
* different and very distant habitations, cannot have 
‘ the benefit of regular advice, attendance, lodging, 
* diet, and medicines, but at a great expence, and, 
* therefore often suffer for want thereof; which incon- 
* veniency might be happily removed, by collecting 
‘ the patients into one common Provincial Hospital, 
‘ properly disposed and appointed, where they may be 
* comfortably subsisted, and their health taken care of 
‘ at a small charge, and by the blessing of God on 
‘ the endeavours of skilful physicians and surgeons, 
‘ their diseases may be cured and removed. And 
* whereas it is represented to this Assembly, that there 
* is a charitable disposition in divers inhabitants of 
‘ this province to contribute largely towards so good 
‘ a work, if such contributors might be incorporated 
‘ with proper powers and privileges for carrying 
‘ on and compleating the same, and some part of 
‘ the publick money given and appropriated to the 
* providing a suitable building for the purposes afore- 
‘ said. 
‘ Therefore, for the encouragement of so useful, 
‘ pious, and charitable a design, we pray that it may 
* be enacted, And be it enacted, by the honourable 
‘ James Hamilton, Esquire, Lieutenant-Governor under 
‘ the honourable Thomas Penn, and Richard Penn, 
‘ Esquires, true and absolute proprietaries of the pro- 
* vince of Pennsylvania, and counties of New-Castle, 
‘ Kent and Sussex, upon Delaware, by and with the 
‘ advice and consent of the representatives of the free- 
* men of the said province in General Assembly met, 
‘ and by the authority of the same, That it shall and 
‘ may be lawful to and for all persons, each of whom 
‘ shall have contributed or subscribed the sum of ten 
‘ pounds or more, towards founding an Hospital, for 
‘ the reception and relief of lunaticks, and other 
* distempered and sick poor within this province, or 
Subscrib- 
ers impow- 
ered to 
meet. 7 
* as many of them as shall think fit to assemble and 
‘ meet on the first day of the month called July next; 
* and for all persons who shall thereafter contribute 
‘ the like sum of ten pounds or more (together with 
‘ the said first subscribers) or so many of them as 
* shall think fit to assemble and meet on the second 
‘ day of the first week, in the month called May, 
‘ yearly forever, at some convenient place in the city 
‘ of Philadelphia, then and there to elect by ballot, 
‘ twelve fit and suitable persons of their own number 
‘ to be Managers of the said contribution and Hospital, 
‘ and one other person to be Treasurer of the same, 
‘ until the next election; and farther, to make such 
‘ laws, rules and orders, as shall appear to them the 
‘ said contributors met, or the major part of them, to 
* be good, useful and necessary, for the well govern- 
‘ ing, ordering and regulating the said Hospital, and 
‘ for the regulation of the future elections of man- 
‘ agers, treasurer and other necessary officers and 
‘ ministers thereof, and for limiting and appointing 
* their number, trust and authority, and generally for 
‘ the well ordering all other things concerning the gov- 
‘ ernment, estate, goods, lands, revenues, as also all the 
‘ business and affairs of the said Hospital: All which 
* laws, rules, and orders, so to be made as aforesaid, 
* shall be from time to time inviolably observed by all 
‘ concerned according to the tenor and effect of them, 
‘ provided they be not repugnant to the laws of Eng- 
‘ land or this government, and are approved by the 
‘ Chief Justice, the Speaker of the Assembly, and the 
‘ Attorney-general of this province for the time being, 
‘ under their hands and seals. And the said contribu- 
‘ tors shall be, and are hereby made a body corporate 
‘ in law, to all intents and purposes, and shall have 
‘ perpetual succession, and may sue, or be sued, 
‘ plead, or be impleaded, by the name of The Contri- 
And to 
Elect man- 
agers and 
make rules. 
Rules to be 
approved, 
&c. 
Contribu- 
tors incor- 
porated. 
Corporate 
name. 8 
4 butcn's to the Pennsylvania Hospital, in all courts of 
* judicature within this province, and by that name, 
4 shall and may receive and take any lands, tene- 
4 ments, or hereditaments, not exceeding the yearly 
4 value of one thousand founds, of the gift, alienation, 
4 bequest, or devise of any person or persons vvhom- 
4 soever; and of any goods or chattels whatsoever ; 
4 and the said contributors are hereby impowered to 
4 have and use one common seal in their affairs, and 
4 the same at their pleasure to change and alter. 
4 Provided, nevertheless, That no general meeting 
4 of the said contributors, nor any persons acting un- 
4 der them shall employ any money or other estate, 
4 expressly given or added to the capital stock of the 
4 said Hospital, in any other way than by applying its 
* annual interest or rent towards the entertainment 
4 and care of the sick and distempered poor, that 
4 shall be from time to time brought and placed therein, 
4 for the cure of their diseases, from any part of this 
4 province, without partiality or preference. 
4 And for the further encouragement of this benefi- 
4 cent undertaking, Be it enacted by the authority 
4 aforesaid, That when the said contributors shall have 
4 met and chosen their managers and treasurer as 
4 aforesaid, and shall have raised by their contribu- 
4 tions, a capital stock of two thousand pounds value 
4 (the yearly interest or rent of which is to be applied 
4 to the accommodating of the sick poor in the said 
4 Hospital, free of charge for diet, attendance, advice 
4 and medicines) and shall make the same appear to 
4 the satisfaction of the Speaker of the Assembly for 
4 the time being; that then it shall and may be lawful 
4 for the said speaker of the Assembly, and he is hereby 
4 required to sign an order or orders on the provincial 
4 treasurer, or trustees of the loan-office, for the pay- 
* ment of two thousand pounds, in tw’o yearly pay- 
Limitation 
of estate. 
Money, 
&c., ex- 
pressly 
given to 
the capital 
stock not to 
be expend- 
ed, but its 
interest 
only. 
When 
2000*. 
is raised by 
subscrip- 
tion, 2000*, 
more to be 
ordered out 
of the trea- 
sury. 9 
* ments, to the treasurer of the said Hospital, to be 
‘ applied to the founding, building, and furnishing of 
‘ the same. 
* And be it further enacted by the authority afore- 
* said, That the accounts of the disbursements of the 
* said two thousand pounds, so ordered by the Speaker 
‘ of the Assembly aforesaid, or any part thereof that 
‘ shall be hereafter expended, as the case may be, and 
‘ of the rents, products and interests of any real or 
‘ personal estates or sums of money charitably given 
* to the use of the said Hospital, together with a list 
‘ of such donations, shall be fairly drawn out and pub- 
‘ lished annually in the Gazette, or other newpapers : 
‘ and the Managers of the said Hospital shall at all 
‘ times, when required, submit the books, accounts, 
* affairs, and ceconomy thereof, to the inspection and 
‘ free examination of such visitors as may from time 
‘ to time be appointed by the Assembly of this pro- 
‘ vince, to visit and inspect the same. 
‘ Provided always, and it is hereby further enacted 
* by the authority aforesaid, That if at any time here- 
‘ after, there should not be a constant succession of 
‘ contributors to meet yearly and chuse managers as 
‘ aforsaid, then the said Hospital, and the estate and 
* affairs thereof, shall be in the management, and 
‘ under the direction of such persons as shall be from 
‘ time to time appointed by act of General Assembly 
‘ of this province for that purpose.’ 
Accounts 
to be made 
up and 
published 
annually. 
Visiters to 
be appoint- 
ed. 10 
LYING-IN DEPART MEN T. 
Extract from an Act of the Legislature of the State 
of Pennsylvania, approved April 11th, 1793, enti- 
tled 
“ An Act, for extending the benefits experienced 
from the institution of the Pennsylvania Hospital. 
Section 6. ‘ And be it further enacted by the autlio- 
‘ rity aforesaid, (The Senate and House of Ilepresen- 
‘ tatives of tiie Commonwealth of Pennsylvania,) That 
‘ as the relief of unfortunate women labouring in 
‘ ehild-birth and not able to provide for the expenses 
‘ necessarily incident thereto, and also the misfortunes 
‘ of suffering and forsaken infancy, are objects very 
‘ deserving of some humane provision, it shall and 
‘ may be lawful for the Managers of the Pennsylvania 
* Hospital to provide commodious apartments for the 
‘ purpose of answering the ends intended by a Lying- 
‘ in and Foundling Hospital, whenever moneys shall 
‘ be placed in their hands for such a purpose, and that 
‘ they are hereby authorized to call for any such sums 
‘ as may now be destined for such an use, whenever 
* they shall be in a situation to carry the benevolent 
‘ design for which such moneys were granted into 
* full effect, any thing in the Constitution or Charter 
‘ of the said Hospital to the contrary thereof not- 
‘ withstanding. 11 
ELECTIONS BY THE CONTRIBUTORS. 
A Laic for regulating the Elections of the Managers 
and Treasurer of the Pennsylvania Hospital, and 
declaring their Trust, Duty, and. Authority. 
* Whereas by an Act of the General Assembly of 
4 the Province of Pennsylvania, intituled, An act to 
‘ encourage the establishing of an Hospital for the 
‘ relief of the sick poor, of this province, and for the 
* reception and cure of lunalicks, the contributors to 
‘ the said Hospital are made a body corporate, and 
4 impowered to meet, and to make such laws, rules, 
* and orders, as shall appear to them the said contri- 
4 butors met, or the major part of them, to be good, 
‘ useful and necessary, for the well governing and 
4 regulating the said Hospital, and for the regulation 
* of the elections of Managers, a Treasurer, and other 
4 necessary officers and ministers thereof, and for 
‘ limiting and appointing their number, trust and autho- 
‘ rity. 
* And whereas, in pursuance of the said law, the 
‘ contributors have met, and have chosen twelve 
4 Managers and a Treasurer, wliich Treasurer hath 
4 received considerable sums of money for the use of 
4 the said Hospital, and it is now become necessary, 
4 for the more orderly disposition and application of 
4 the said monies, and of such sums as may here- 
4 after be received, and for the more sure direction 
4 of the Manages and Treasurer therein, to declare 
and appoint their trust, authority and duty: There- 
Preamble. 12 
Disposition 
of money 
paid to the 
Treasurer. 
‘ fore it is enacted by the contributors to the Pennsyl- 
‘ vania Hospital, in general meeting duly assembled, 
* That the Managers of the said Hospital for the 
‘ time being, shall have the power of disposing of 
‘ all monies paid to the Treasurer for the building, 
‘ furnishing, support, use and service of the Hospital, 
‘ and for the hiring and furnishing a house or houses 
‘ for the reception of patients, until the said Hospital 
‘ shall be built, under the limitations and restrictions 
f of the before mentioned act of Assembly. And the 
* said Managers shall likewise have the power to 
‘ direct the manner and terms of receiving and 
‘ discharging of patients; and all officers and servants 
‘ belonging to the Hospital, other than the Treasurer, 
‘ shall be in the choice, and under the direction of the 
< Managers, who shall allow and order their respective 
‘ salaries, and may displace them, and appoint others, 
‘ as often as they shall think fit. And the said 
* Managers shall have the power of calling general 
‘ meetings of the contributors, as often as they judge 
‘ it necessary for the service and advantage of the 
‘ Hospital; and shall cause due and public notice to 
‘ be given of the time, place, and design or purpose of 
* such occasional meeting, at least ten days before the 
‘ same is to be held, and shall nominate some discreet 
‘ member to preside therein, and regulate the debates 
‘ thereof. And the said Managers shall have the 
‘ keeping, and power of affixing, the seal of the corpo- 
* ration, which seal shall be made nearly agreeable to 
‘ the form or draught hereunto annexed; and they 
« shall settle the accounts with the Treasurer from 
‘ time to time, and take care that all laws, rules and 
‘ orders made by the contributors, and legally ap- 
‘ proved, be duly and faithfully executed; for all 
‘ which, or any other services relating to the Ilospi- 
Patients. 
Officers 
and ser- 
vants. 
General 
meetings of 
the contri- 
butors. 
Corporate 
seal. 
Accounts 
of the 
Treasurer, 
&c. 
Managers 
to receive 
no fee or 
reward. 13 
‘ tal, they shall not claim, receive, or retain, any fee, 
4 gratuity, or reward whatsoever. 
‘ And for the more orderly execution of their duty 
‘ and trust, the Managers are hereby required to meet 
* at least once a month at the Hospital, or some other 
* fit place in the city of Philadelphia, to confer and 
‘ conclude concerning the matters hereby committed 
‘ to them; and shall cause fair minutes of their 
* proceedings to be kept by their clerk, in a book to 
‘ be provided for that purpose: in every of which 
‘ meetings of the Managers aforesaid, eight of their 
4 number met shall be a quorum, capable to consult, 
‘ confer and conclude of and upon all matters 
‘ appertaining to their trust, according to the aforesaid 
‘ act of Assembly, and the laws of this corporation; 
4 and whatsoever seven of the number so met shall 
4 so conclude, shall be deemed and taken for and as 
4 the resolution of the managers for the time, and 
4 accordingly entered in their minutes. To which 
4 minutes, and also to the Treasurer’s accounts, all 
4 persons concerned shall have free recourse at all 
4 seasonable times. 
4 And it is further enacted by the contributors afore- 
4 said, that every Treasurer hereafter chosen shall, 
4 before he take upon himself the execution of his 
4 office, enter into an obligation, with one sufficient 
4 surety, in double the value that doth, or probably 
4 may come into his hands, during the continuance of 
4 his office, as near as can be estimated by the Mana- 
4 gers, unto the Contributors to the Pennsylvania 
4 Hospital; conditioned that he will, once in three 
4 months, or oftener if required, render his accounts 
4 to the Managers of the said Hospital, and well and 
4 truly account, adjust and settle with them when 
4 required, for and concerning all monies that are or 
4 shall come into his hands belonging to the said 
To meet 
monthly. 
To keep 
minutes. 
Eight man- 
agers to be 
a quorum. 
And seven 
to agree. 
Treasurer 
to give se- 
curity. 
To account 
to the man- 
agers and 
pay to their 
order. 14 
To pay bal- 
ance and 
deliver 
books tohis 
su ccessor. 
‘ contributors, and pay the balance that shall appear 
‘ on such settlement to be in his hands, unto such 
! 4 person or for such service as a Board of Managers 
‘ for the time being shall order and appoint, and not 
‘ otherwise; and that he will at the expiration of his 
4 office, well and truly deliver up and pay the balance 
‘ of the monies then remaining in his hands, together 
4 with the books of accounts concerning the same, 
4 and other the papers and writings in his keeping be- 
* longing to the contributors, unto his successor in the 
‘ said office; and that he will do and execute all other 
* things as Treasurer to the contributors aforesaid 
‘ according to the true sense and meaning of this 
* law. And he is hereby authorised immediately upon 
4 entering into his office, to demand and receive of 
4 the preceding Treasurer, his heirs, executors or 
4 administrators, the cash, books of accounts, writ- 
4 ings and other effects belonging to the corporation 
4 giving his receipt for the same. 
4 And for the more regular and satisfactory con- 
4 ducting of future elections, and the preventing of 
4 disputes and misunderstandings among the contri- 
4 butors, concerning the same, it is hereby farther 
4 enacted, That the place and hour of the election 
4 shall be appointed by the Managers of the current 
4 year, and notified bv their clerk, at least twenty days 
4 before the election, by printed advertisements; and 
4 the said Managers shall and are hereby required and 
4 impowered to nominate three discreet members of 
4 this corporation to inspect and judge of the said 
4 election, and declare who are the persons elected; 
4 and the Managers shall cause their clerk to enter 
4 in their book of minutes the names of the persons 
4 elected according to the tickets. 
4 And if any person elected Manager, shall refuse 
4 or neglect to act, or shall be absent from three sue- 
Elections, 
place, hour, 
and notice 
of. 
Judges of. 
Managers 
may supply 
vacancies 15 
‘ cessive monthly meetings of the Managers, in any 
* of the first ten months of the year for which he 
‘ shall be elected Manager; or if within the same 
‘ year or term of his office, he shall be confined by 
‘ sickness, or otherwise rendered incapable of execute 
‘ ing the office of a Manager, according to the true 
‘ meaning of this law, or shall die, the rest of the 
‘ Managers, as often as occasion shall require, in 
‘ any of the cases aforesaid, shall proceed in their 
‘ duty and office without him; or if they think fit 
‘ they shall nominate another of the contributors to 
‘ supply his place of a manager until the then next 
* ensuing election. 
‘ And if any person so elected Treasurer, shall 
* absent himself from his said office for the space of 
‘ thirty days, or shall be otherwise rendered incapa- 
‘ ble, or neglect his office or duty of Treasurer, it 
‘ shall and may be lawful for the Managers for the 
‘ time being, to displace him from the said office; 
‘ and the Managers causing their clerk to make a 
‘ minute for the purpose, containing their reasons for 
‘ displacing him, he shall thereupon, and from hence- 
‘ forth, cease to be the treasurer aforesaid, and 
‘ shall, upon notice thereof, adjust and settle with 
‘ the Managers, and pay and deliver the money, 
‘ books, writings, accounts, and all other effects what- 
‘ soever in his hands belonging to this corporation, 
‘ to such person or persons as the Managers shall 
‘ order and appoint, and in that case, and so often, 
‘ and also if the treasurer shall depart this life, the 
‘ Managers shall nominate another of the members 
‘ of this corporation, but not of their own number, 
* to be Treasurer until the next meeting for the annual 
* election, or other general meeting of the contri- 
* butors. 
‘ Provided always, any thing herein contained to 
in their 
Board. 
May dis- 
place the 
Treasurer. 
Building 
must be 16 
sanctioned 
by the con- 
tributors. 
‘ the contrary notwithstanding, That before the Man- 
‘ agers for the time being proceed to erect any build* 
‘ ing for the said Hospital, a plan of such proposed 
‘ building, with an estimation of the expense shall be 
* prepared and laid before a general meeting of the 
‘ contributors for their consideration; and their ap- 
* probation shall be obtained before the same is 
* carried into execution.’ 
Signed by order of a general meeting 
of the contributors. 
Joshua Crosby, President. 
January 17, 1752, The above bill was read 
three times at a general meeting of the 
contributors to the Pennsylvania Hospital 
and passed by a very great majority. 
B. Franklin, Clerk. 
We approve this law, 
William Allen, Chief Justice. 
Isaac Norris, Speaker of the Assembly. 
Tench Francis, Attorney-General. RULES 
OF THE 
PENNSYLVANIA HOSPITAL 
OF THE MANAGERS. 
• 1. The stated meetings of the Board of Managers 
shall be held at the Hospital, on the last Second-day (Mon- 
day) of every month: to assemble at 4h o’clock p. m. Fine 
for non-attendance at any stated or special meeting, fifty 
cents ; and for absence at the hour of meeting, twenty- 
five cents. 
2. The Managers shall at their first meeting after their 
election in the Fifth month (May) every year, choose by 
ballot three Doctors of Medicine, as Physicians, three 
Doctors of Medicine, as surgeons, and two Doctors of 
Medicine as obstetricians, to visit and prescribe for the 
patients in the Hospital in the City; and one Doctor of 
Medicine as Physician of the Hospital for the Insane, and 
one Doctor of Medicine as assistant Physician thereof; 
all of whom, except the last, shall be members of this cor- 
poration, and not less than thirty years of age. 
They shall also at the same time, choose by ballot, a 
Steward, Matron, Apothecary, Clerk and Librarian, for 
the Hospital in the City; and a Steward and Matron for 
the Hospital for the Insane. 18 
3. No Physician shall act as a Manager during the 
term for which he is chosen to serve the Hospital in a pro- 
fessional capacity. 
4. The Managers shall, from time to time, elect, by ballot, 
three Doctors of Medicine as Resident Physicians of the 
Hospital in the City; who shall each serve two years from 
the period of his election. 
THE ATTENDING MANAGERS. 
1. A Committee of two Managers to be called the 
Attending Managers, shall be appointed monthly, whose 
duty it shall be, generally to supervise the affairs of the 
Hospitals, and who shall have the sole power to admit and 
discharge patients except as hereinafter mentioned. 
2. They shall attend at the Hospital in the City on the 
Fourth and Seventh days (Wednesdays and Saturdays) of 
the week, at 10 o’clock, a. m., for the above purposes ; and 
shall visit the Hospital for the Insane, on the afternoon 
of the Seventh-day (Saturday) of every week. 
3. They shall keep regular minutes of the admissions 
and discharges of patients, in both Hospitals; and shall 
insert thereon all orders given by them for the expenditure 
of money. 
OF THE HOSPITAL IN THE CITY. 
I. Of the Physicians, Surgeons, and Obstetricians. 
1. The medical practitioners chosen to serve this Hos- 
pital shall be classed with each other, and give their atten- 
dance at such seasons, as shall be concluded and agreed 
upon by themselves and the Managers. 19 
2. The physician, surgeon, and obstetrician on duty, 
shall attend at this Hospital on the Fourth and Seventh- 
days (Wednesdays and Saturdays) of every week through- 
out the year, from 10 to 12 o’clock, a. m., and at all such 
other times as may be necessary for the faithful perform- 
ance of their duties. The physician and surgeon on duty 
shall also make daily visits to this Hospital on all the other 
days of the week. 
3. They shall not furnish admission certificates, except 
agreeably to the rules of this Hospital regulating the 
admission of patients. 
4. Upon the occurrence of extraordinary cases, the 
practitioners in attendance shall call in two or more of 
the practitioners chosen for the service of the year, to con- 
sult with. 
5. No important surgical operation shall be performed 
without a previous consultation ; and in such cases, all the 
surgeons shall have due notice. 
6. Every infant born in the house shall be vaccinated, if 
practicable. 
7. The physicians, surgeons and obstetricians shall have 
power to establish rules for the regulation of their respec- 
tive wards, to be framed and hung up therein—subject to 
the approval of the Managers. 
8. Each physician, surgeon and obstetrician of the 
Hospital, shall have the privilege of introducing, not 
exceeding eight of his pupils at one time, to observe the 
practice of the Hospital, and have the use of the Library ; 
subject to the regulations of the attending Managers. 
II. Of the Resident Physicians. 
1. The Resident Physicians shall have charge alternately 
of the medical, surgical, and lying-in wards, for such 
terms, and in such manner, as shall be agreed upon by the 20 
physicians and surgeons. They shall regularly visit the 
patients under their charge, at least every morning and 
evening, and to the best of their skill, administer to their 
relief. They shall accompany the attending physicians 
and surgeons in their daily visits, report to them all new 
cases which may have been admitted in their absence, 
and regulate the practice according to their orders. They 
shall keep records of such cases as may be required by the 
physician or surgeon on duty, and (permission of the 
friends of the decedent being first obtained) make such 
autopsies as may be desired. They shall also have a gen- 
eral superintendence of the nurses, and shall promptly 
report to the Steward and Attending Managers all instan- 
ces of neglect. 
2. It shall be the duty of the Resident Physicians to 
suspend over the bed of every patient in their respective 
wards, his or her name, and the date of admission, neatly 
and plainly written on a paper of a size suitable to the tin 
frames provided therefor; the same to be done as soon 
after admission as practicable. 
4. It shall be the duty of the Resident Physicians to report 
to the Clerk and Librarian, as soon as practicable after 
admission, the name, age, disease or accident, place of 
nativity, occupation, and whether married or single, of 
every patient who may be admitted without the usual cer- 
tificate (such as custom house patients and recent acci- 
dents) in their respective wards. 
4. The Resident who has charge of the Men’s Surgical 
Ward, shall have the instruments kept in order, and 
be accountable therefor, during his term of service. He 
shall preserve an inventory of them, which, together with 
the instruments, he shall deliver to his successor. No 
instrument of any kind is to be loaned to any one without 
the written order of the Attending Surgeon on duty. 21 
5. The Resident Physicians shall not be absent from this 
Hospital at the same time. 
6. The Physician or Surgeon on duty, as the case may be, 
shall have the sole power of appointing a substitute for a 
Resident Physician who may be unable to attend to his 
duties from sickness or leave of absence, subject to the 
approval of the Attending Managers. Such appointment 
and approval, in all cases to be entered on the minutes of 
the latter. 
III. Of the Steward and Matron. 
1. The Steward shall have the general care of the 
buildings of this Hospital and lots attached thereto. Subject 
to the direction of the Attending Managers, the fuel, fur- 
niture, food and stores of all kinds shall be purchased by 
him; and he shall keep regular accounts of receipts and 
expenditures to be vouched and laid before the Board as 
at present. He shall hire the gate-keeper, all the nurses 
and domestics, and discharge them when he thinks proper. 
He shall attend to the proper warming of the house in 
wdnter, and see that the nurses generally do their duty. 
2. The Matron shall have particular supervision of the 
w7ards and buildings as to their cleanliness, and good order 
of the bedding and clothing used therein, and the prepa- 
ration of the food and diet of the patients, subject to the 
direction of the Attending and Resident Physicians. 
She shall have the general control of the domestics, and 
in conjunction with the Steward take care that the patients 
are well treated and attended to by the nurses. 
IV. Of the Apothecary. 
1. He shall reside in the Hospital and perform all the 
duties, appertaining to his department. He shall regularly 
preserve every prescription of the physician ; and no medi- 22 
cine or other article shall be delivered by him to any per- 
son, unless prescribed in due form. 
2. He shall keep a pass book in which all medicines 
purchased by him, shall be duly entered. 
3. He shall not absenthimself from the Hospital, without 
notifying one of the Resident Physicians; nor shall he 
permit patients or others, (except the officers of the In- 
stitution) to occupy the shop. 
V. Of the Clerk and Librarian. 
1. He shall prepare the monthly, annual and other 
accounts; and generally, perform such duties as appertain 
to his office or may be assigned to him by the Managers. 
2. He shall have the care of the Medical Library, sub- 
ject to the Rules for the management thereof. 
VI. Of the Nurses and Servants. 
1. It is the duty of the nurses faithfully to attend to 
the patients under their charge, and to obey implicitly the 
directions of the Attending and Resident Physicians and 
Surgeons in regard to them ; to see that they behave 
with propriety, and observe all the regulations of the insti- 
tution, and to report any irregularity or breach of rule to 
the Steward. 
2. Any nurse who shall refuse or neglect to follow 
the directions of the Attending and Resident Physicians 
and Surgeons, as above, or who shall be negligent or 
inattentive in his or her duties generally, shall be at once 
discharged by the Steward, on a request to that effect by 
the Attending Physician or Surgeon on duty, as the case 
may be. 
3. None of the nurses or domestics employed in the 
Hospital shall absent themselves from their duties therein 23 
without having first obtained permission from the Steward. 
And in all cases they are to go and return through the gate 
on Pine Street. 
VII. Of the Watchman. 
He shall commence his duty at nine o’clock p. m., and 
pass hourly through the buildings (except the women’s 
wards) until daylight. He is strictly enjoined to attend 
to the safety of the fires, and shall extinguish all lights 
in the wards, not directed by the Physicians, Steward or 
Matron. He is to administer such medicines as may be 
entrusted to him by the Resident Physician or Surgeons, to 
be given in the night to patients in the men’s wards. He 
is also required to report to the Steward all irregularities 
he may observe during the night. 
VIII. Admission and Discharge of Patients. 
1. Persons accidentally wounded or otherwise injured, 
shall be received at all hours, subject to such rules on the 
matter, as the Managers shall from time to time enact; 
provided always, that the accident or injury happen in 
Pennsylvania, and the patient is brought to this Hospital 
within twenty-four hours after such accident or injury. 
2. All pay patients shall be admitted by the Attending 
Physicians and Managers as at present. 
3. The number of patients to be admitted on the charity 
of the institution in this Hospital is now limited to eighty, 
exclusive of recent accidents as above, and of infants 
born in the lying-in ward. 
4. These shall be distributed as follows, 
The men’s medical ward shall be limited to twenty beds 
for poor patients. 24 
The women’s medical ward shall be limited to twenty 
beds for poor patients. 
The men’s surgical ward shall be limited to eighteen 
beds for poor patients, exclusive of recent accidents 
as above. 
The women’s surgical ward shall be limited to thirteen 
beds for poor patients, exclusive of recent accidents 
as above. 
The lying-in ward shall be limited to nine beds for 
poor patients, exclusive of infants born therein as 
above. 
5. The physician, surgeon and obstetrician on duty, 
shall have the power of admitting poor or charity patients 
in their respective wards, to the numbers above respect- 
ively allotted to each ward, subject to the general rules 
governing the admission of patients into this Hospital. 
The admission in all cases to be by printed certificate of 
name, age, place of nativity, occupation, whether married 
or single, and of the disease ; under the signature of the 
doctor admitting. Whenever practicable, the doctor 
admitting shall also require security for the clothing of 
the patient, and his or her removal when discharged, 
from some friend or relation of the applicant, as at 
present practised. 
6. The admissions as above made shall be registered 
by the Clerk and Librarian as at present, and reported to 
the Attending Managers, on their semi-weekly visits as 
now practised, to be entered by them on their minutes. 
7. No patient shall be admitted on the charity of the 
institution whose case is judged to be incurable. 
8. Patients afflicted with incurable diseases may be 
admited at the rate of board established below. 
9. No person having any infectious or contagious dis- 
ease shall be admitted into this Hospital. 25 
10. No unmarried woman shall be admitted as a patient 
in the lying-in ward. 
11. No person having gonorrhoea, syphilis, or mania-a-potfi 
shall be admitted as a charity patient; or at a lower rate 
of board than four dollars per week. 
12. The lowest rate of board for patients (except as 
above) in the Hospital is 
for inhabitants of Pennsylvania $3.00 per week. 
for all others 3.50 “ 
13. All pay patients shall give good security for the 
payment of their board. 
14. All patients shall be discharged as soon as they are 
cured ; and all charity patients whose cases, after a rea- 
sonable time of trial, shall be judged incurable, shall be 
discharged. 
IX. Of Patients. 
1. The patients shall conduct themselves with decorum 
towards each other, the officers of the Hospital, nurses 
and servants. They shall not smoke tobacco or play at 
any game of chance in the Hospital, on pain of immediate 
expulsion therefrom. 
2. No syphilitic patient shall be placed in any other 
ward than those especially appointed to that class of 
patients, to which they are to be strictly confined ; and no 
such patient shall have leave of absence. 
3. No liquors, provisions or medicines of any kind, shall 
be furnished to any of the patients by their friends; and 
no patient shall be permitted the use of any diet prepared 
in the house other than that which may be ordered by the 
proper officers. 
4. No patient shall be allowed to leave the Hospital 
while under treatment, except by special permission of the 
Physicians and Attending Managers. 26 
5. Such charity patients as are able, shall give assistance 
in nursing or otherwise, when required to do so by a Resi- 
dent Physician or the Steward or Matron. 
6. If any breach occur in any of the above rules, the 
offender shall be liable to be discharged by the Attending 
Managers. 
7. When any patient shall desire to see a minister, or 
teacher of religion, the same is to be communicated to a 
Resident Physician: and if it be deemed proper in a medi- 
cal point of view, the Steward shall notify the individual 
whose presence is required; but, except in such case, 
religious exercises are not to be conducted in the wards of 
the Hospital. 
X. Of Visiters. 
1. Visiters to patients, nurses and domestics, will be ad- 
mitted on the Second, Third, Fifth and Sixth days of the 
week, (Mondays, Tuesdays, Thursdays, and Fridays,) be- 
tween the hours of 3 r. m. and sunset; on all other days a 
special order for admission from a Manager will be 
required. 
2. Those admitted to visit patients shall not be permitted 
to ramble over the house and grounds, but shall have the 
patient brought to them, or be directed to the apartment in 
which he or she may be ; and after a reasonable time, they 
shall withdraw from the premises. 
3. No visiter shall lodge in the Hospital without per- 
mission of the Steward. 
XI. Gatekeeper. 
1. The Gatekeeper shall admit no person into the Hospital 
after ten o’olock p. m. except in case of recent accident. 27 
2. He shall allow no patient to pass from the Hospital 
without an order from the Steward. 
3. He shall immediately report to the Steward all cases 
of persons attempting to bring in liquor, or coming in intox- 
icated, and all other irregularities falling under his notice. 
4. He shall allow no person to take into the Hospital 
any liquor, provisions or medicines for any patient, nurse 
or domestic therein. 
GENERAL RULES OF ORDER. 
1. The Resident Physicians, Apothecary and Clerk and 
Librarian are enjoined to be regular at their meals. 
As punctuality in this matter is considered essential to the 
discipline of the Hospital, the Steward is required to re- 
port frequent breaches of this rule to the Attending Mana- 
gers. 
2. All lights, except in the wards, entries, Steward’s rooms, 
and Physicians’ rooms, are required to be extinguished at half 
past ten o’clock p. m. at the latest. Noreading in bed at night 
is to be allowed either by patients or any person connected 
with the establishment in any capacity. A second breach 
of this rule will render the offender liable to immediate 
expulsion. 28 
OF THE HOSPITAL FOR THE INSANE. 
The title of this department of the Institution shall be 
“ The Pennsylvania Hospital for the Insane.” 
I. Of the Physician. 
1. The Physician of the Hospital for the Insane, shall 
be the official head of that department; and under the 
instructions of the Board of Managers, shall have the 
general superintendence and control thereof, and of all 
persons employed on the premises. 
2. He shall reside upon the premises and devote his 
whole time to the promotion of the interests of the institu- 
tion and the welfare and comfort of the patients. 
3. He shall have the sole direction of the medical, moral 
and dietetic treatment of the patients; and his directions 
respecting them are to be implicitly obeyed by all persons 
about the establishment. 
4. He shall have the power to select and dismiss at his 
pleasure all the attendants upon the Insane, and the sole 
direction of their duties. With the sanction of the At- 
tending Managers, he shall from time to time make such 
regulations for the government of the attendants, and all 
others engaged in any way about the patients, as he may 
deem salutary. 
5. He shall have the general direction of the farm, 
garden and grounds of the Hospital; and he shall make 
contracts with the farmer and tenants, (subject to approval 
by the Board of Managers.) 
6. He shall obtain as far as practicable a complete his- 
tory of the case of every patient admitted into the Hos- 
pital, and shall keep or cause to be kept for the use of the 29 
institution a register of the same, and as full a record of 
the subsequent treatment and results as he may deem likely 
to promote the interests of science, and tend to improve 
the treatment of the Insane. 
7. He shall furnish to the Board of Managers, annually 
at its stated meeting in the First month, (January) in each 
year, a detailed report of the operations of the Hospital, 
with tabular statements of the cases treated, during the 
preceding year, and of its actual condition; with such 
other observations as he may deem useful or interesting. 
II. Of the Assistant Physician. 
1. The Assistant Physician shall reside in the Hospital, 
and under the direction of the Physician, shall devote his 
whole time to its service, and carry out to the best of his 
ability all the instructions of that officer. 
2. He shall prepare and superintend the administration of 
all medicines prescribed for the patients; preserving in a 
book provided for the purpose, every prescription, with 
the name of the patient, and shall keep or assist in keeping 
such records, &c., as may be required by the physician. 
3. He shall be as much as possible among the patients 
and do all in his power to contribute to their comfort and 
welfare ; he shall have a general supervision of the atten- 
dants and shall promptly report all instances of neglect 
or of improper conduct that may come to his knowledge. 
4. He shall not absent himself from the Hospital without 
the knowledge and consent of the physician. 
III. Of the Steward. 
!• The Steward shall have a general oversight of the 
buildings, grounds and farm, and see that they are at all 
times kept in perfect order and repair. 30 
2. Subject to the instruction of the Attending Managers 
he shall purchase furniture, fuel, stores, and other neces- 
sary articles, and shall be responsible for their safe keep- 
ing and economical use. 
3. He shall collect all moneys due the institution for 
board of patients, &c., as they become due, and shall keep 
fair and accurate accounts of the receipts and expenditures. 
He shall furnish transcripts thereof, approved by the attend- 
ing Managers to be laid before the Board at each of their 
stated meetings. He shall also keep a regular register of 
the names and of the dates of admission and discharge 
of every patient. 
4. Subject to the authority given to the Physician, he 
shall hire, pay, and discharge all persons employed about 
the premises. 
5. He shall pay particular attention to the quality of 
the provisions provided for the use of the institution. He 
shall see that all things appertaining to the dining rooms of 
the male patients are disposed in a neat and becoming 
manner, that good order and perfect cleanliness are pre- 
served in every part of the house coming under his notice, 
and, as far as practicable, that the warming and ventila- 
tion of the house are properly regulated. 
IV. Of the Matron. 
It shall be the duty of the matron to look carefully after 
the comfort of the female patients. She shall observe the 
manner in which the female attendants perform their duties 
and report to the Physician any instances of neglect or 
improper conduct coming under her notice. She shall 
have the general oversight and direction of the domestics, 
and shall superintend and direct the cooking and distribu- 
tion of food, and in conjunction with the steward, shall 31 
see that the supply is abundant, varied, well cooked, and 
neatly served, in ail the dining rooms of the establishment. 
She shall also see that the bedding, clothing, &c. of the 
patients are always kept clean and in good order. She is 
expected to devote her whole time to the service of the 
institution, and under the instructions of the Physician, to 
spare no efforts to promote its prosperity. 
V. Of the Admission of Patients. 
1. Before any patient can be admitted into this Hospital 
a request in writing to that effect of some neat relative or 
friend and a certificate of said patient’s insanity signed by 
a respectable graduate of medicine shall in all cases be 
required. 
2. Neither Idiots nor persons having mania-a-potfi, 
shall be received into this Hospital. 
3. A limited number of Insane persons in indigent cir- 
cumstances, whose cases are recent, and such as are be- 
lieved to offer a fair chance of cure, shall be admitted as 
patients by the Attending Managers for a period not 
exceeding six months for each case, and shall be treated 
without any charge. Security for the removal of such pati- 
ents when discharged, and for their clothing whilst in the 
Hospital, shall be required of some responsible resident of 
the city or county of Philadelphia. The number of these 
patients shall from time to time be regulated by the Board 
of Managers, and is now fixed at 40. 
4. Patients paying board may be admitted by any mem- 
ber of the Board of Managers, under the following rules. 
5. The rate of board shall be regulated by the pecuniary 
ability of the patient, or of the friends of the patient, and 
the class of accommodations required. The lowest rate 
shall be 32 
for residents of Pennsylvania $3.50 per week. 
for all others 5.00 
They shall not be admitted for a less period than three 
months, for which time the board shall be required to be 
paid in advance at the time of admission; and if taken 
away uncured before the expiration of that period, con- 
trary to the advice and consent of the Physician of the 
Hospital, the amount as above paid in advance, shall be con- 
sidered forfeited, and no part thereof shall be returned. 
Security of some responsible resident of the city or county 
of Philadelphia shall in all cases be obtained, for the 
payment of board and all other expenses whilst in the 
institution, and for the performance of the foregoing con- 
dition. 
6. When special attendants are desired they are always 
to be provided by the Physician of this Hospital and the 
charge therefor is to be added to the board. 
REGULATIONS FOR THE ADMISSION OF VISITERS. 
Visiters are not to be admitted before 10 o’clock, a. m., 
after sunset, nor on the First day of the week. They are 
not to be admitted on the afternoon of Seventh-day, (Satur- 
day) unless on special business with the Attending Mana- 
gers, or one of the officers of the house. 
All parts of the Hospital not occupied by patients mav 
be shown and explained during the hours for the admission 
of visiters. 
No visiter, unless in company with a Manager, can be 
taken into the wards, without permission from the physi- 
cian to the Hospital, or in his absence, from the Assistant 33 
Physician; and when visiters are allowed to enter the 
wards, they must always be accompanied by one of these 
officers, or by the Steward or Matron. 
As this Hospital cannot be allowed to become a resort 
for idle curiosity, it is hoped that the friends of patients, 
and all others, will carefully avoid prolonging their visits 
unnecessarily. 
The Pleasure Railroad and other contrivances for the 
amusement of the patients, are not to be used by visiters. 
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, with- 
out the knowledge and approbation of the Physician. 
Funds for the use of the patients are to be placed in the 
hands of the Steward, to be used under the direction of the 
Physician. 
Under ordinary circumstances, carriages are not to 
enter the enclosure. When for any purpose they have 
been taken to the centre building, they are never to be left 
standing there; and drivers are always expected to remain 
with their vehicles outside of the gateway.