OF TIITC 
Hospital for the Insane, 
—AT— 
Io wa--, 
Adopted by the Trustees at their Annual Meeting, December, 1872, 
Revised January, 1879. 
WEST UNION, IOWA: 
REPUBLICAN GAZETTE BOOK AND JOB PRINTING HOUSE. 
1879. OF THE 
Hospital for the Insane, 
—AT— 
\ 
I@wa. 
Adopted by the Trustees at their Annual Meeting, December, 1872, 
Revised January, 1879. 
WEST UNION, IOWA: 
REPUBLICAN GAZETTE BOOK AND JOB PRINTING HOUSE. 
1879. OFFICERS OF THE HOSPITAL. 
BOARD OE TRUSTEES: 
Erastus G. Morgan, Fort Dodge. 
John G. House, M. D., .... Independence. 
Stephen E. Robinson, M. D., - - West Union 
Lewis H. Smith, Algona 
David Hammer, McGregor 
SUPERINTENDENT : 
ALBERT REYNOLDS, M. D. 
TREASURER: 
WM. (4. DONNAN. 
SECRETARY : 
john'g. house. BY-LAWS. 
CHAPTER I. 
Section i. The Board of Trustees shall, at their An- 
nual meeting, on the first Wednesday in October, elect 
one of their number President, and another Secretary, and 
shall also elect some person Treasurer, who shall hold their 
offices until their successors are elected and qualified. All 
elections shall be by ballot, unless otherwise ordered. 
Sec. 2. There shall be in each year four regular meet- 
ings of the Board, to be holden at the Hospital, on the 
first Wednesdays in October, January, April and July. 
Sec. 3. Upon the written application of two Trustees, 
the Secretary shall forthwith call a special meeting, and 
state, in the notice to the Trustees, as nearly as practica- 
ble, the business for,which such meeting is called. 
ORGANIZATION AND MEETINGS OF THE BOARD OF TRUSTEES, 
CHAPTER II. 
DUTIES OP OFFICERS. 
Section i. The President of the Board of Trustees 
shall preside at all meetings of the Board, and perform all 
such executive duties as the Trustees may, from time to 
time, direct. 
Sec. 2. The Secretary shall keep a full and true record 
of all proceedings of the Board, and sign all contracts 
made by them, and notify each Trustee of the time and 
place of all special meetings of the Board. 
Skc. 3. The Treasurer shall hold his office for the term 
of one year, and until his successor is elected and qualified, 
unless sooner removed. His compensation shall be one- 
half of one per cent, on all moneys paid out by him as 
such Treasurer. He shall execute a bond with sufficient 4 
n Y- LAWS. 
sureties, to be approved by the Board of Trustees, in the 
penal sum of Fifty Thousand Dollars—which sum may be 
increased at the discretion of the Board—conditioned that 
he will faithfully discharge the duties of his office, and 
pay over and account for all moneys that may come into 
his hands, belonging to the Hospital; which bond shall be 
executed in favor of the State of Iowa, and filed with the 
Secretary of State. All moneys due the Hospital shall 
be paid to the Treasurer, and for all sums paid to him, 
excepting the'sums drawn from the State Treasury, he shall 
give his receipt, which receipt shall be filed in the office of 
the Steward. The Treasurer shall keep an accurate ac- 
count of all moneys received by him,and from what source, 
and of all sums by him paid out, and from what fund, and 
shall make no payment excepting on the order of the 
Steward. At each quarterly meeting of the Board he 
shall present to the Board an abstract of his accounts, 
showing his receipts and payments for the last quarter, and 
■any balance in his hands, and shall, at the same time, ex- 
hibit to the Board, or its Committee, his vouchers and 
book of accounts. The Treasurer shall also perform such 
•other duties appropriate to his office, as may be assigned 
him by the Board of Trustees. 
CHAPTER III. 
COMMITTEES. 
Section i. There shall be a thorough visitation of the 
Hospital at least once a month, by one or more of the 
Trustees—a quarterly visitation by the Board of 'jfrustees 
at their regular meetings. Visitations may be made as 
much oftener, and by such number of the Trustees as the 
Board shall, by vote, determine. A record shall be made 
of each visit, in a book kept for that purpose. 
CHAPTER IV. 
Section i. The money appropriated by the Legisla- 
ture, for the purpose of defraying the deficiencies that 
may arise in the current expenses of the Hospital, shall be 
drawn from the State Treasury as follows: At each regu- 
EINANCE. lar meeting, the Board of Trustees shall make an order for 
the drawing of such sum as may be necessary for defraying 
the expenses of the preceding quarter; which order shall 
be entered upon the records of the Board, and the sum 
ordered may then be drawn from the State Treasury, by 
the Treasurer, as provided for in the law for the govern- 
ment of the Institution. 
Sec. 2. All money appropriated by the Legislature, and 
placed under the control of the Trustees, for building, 
finishing, furnishing, or for any purpose, other than the 
current expenses of the Hospital, shall be drawn by an 
order of the Board of Trustees, signed by the Secretary, 
at some regular or special meeting of said Board, directing 
the payment of the sum of money specified, to the Treas- 
urer or his order. 
Sec. 3. The Steward shall collect all sums due the Hos- 
pital from individuals for board or clothing furnished pa- 
tients, or due from other sources; and at each regular 
meeting of the Board he shall make report of the sum so 
received. 
Sec. 4. All contracts for supplies for the Hospital, and 
all purchases for the same, shall be made by the Steward, 
under direction of the Trustees and Superintendent. 
Sec. 5. All business transactions of the Hospital, where 
money is to be disbursed, shall be in writing, either by 
written contract or by a pass-book, properly minuted at 
the time of any purchase, and the Steward be able fully to 
inform the Trustees at any time of the financial condition 
of the Institution. 
Sec. 6. No account, that shall exceed the sum of one 
dollar, shall be paid unless accompanied by a bill of par- 
ticulars, giving dates, items and amounts. All accounts 
current against the Institution shall be called in quarterly, 
and shall be carefully compared with the written contract 
or pass-book, and if material errors are discovered in any 
bill, it shall be returned to the holder for correction. 
Sec. 7. Before making up the biennial report of the 
Institution, the Steward shall cause each bill paid during 
the two years previous to be entered.in its proper order of 
date in the financial record. Such entry shall be made to 
exhibit the name of the person to whom such payment is 
B Y-LA WS. 
5 6 
7IT-LA WS, 
made, its date and total amount; and the several items in 
such account shall be placed under appropriate heads, so as 
to show in the summary of expenditures the amounts dis- 
bursed for each class of supplies, as minutely as may be 
required for a clear understanding of the expenditures of 
the Institution. 
CHAPTER V. 
RESIDENT OFFICERS OF THE HOSPITAL. 
Section i. The resident officers of the Hospital shall 
consist of a Superintendent, Assistant Physician or Physi- 
cians, Steward and Matron, who shall reside in the Plospi- 
tal, and devote themselves entirely to its interests; and be 
subject to removal at the pleasure of the Board of Trustees. 
Sec. 2. None of the resident officers shall resign their 
office without first giving three months’ notice in writing 
of such intent, to the Secretary of the Board of Trustees. 
Sec. 3. The salaries of the resident officers shall be 
paid quarterly. 
CHAPTER VI. 
SUPERINTENDENT : 
Section' i. The Superintendent shall be the chief exec- 
utive officer of the Hospital. He shall appoint and exer- 
cise entire official control overall employees in its service. 
He shall prescribe their several duties, and see to their 
faithful performance. Under the direction of the Trus- 
tees, he shall institute such police regulations as the good 
order of the Hospital may require; and he shall be respon- 
sible to the Trustees for the care of all buildings, furni- 
ture and fixtures appertaining thereto. He shall have the 
entire supervision of the patients, in their medical, moral 
and physical treatment. He shall visit them in their wards 
as frequently as may be necessary to kee]b himself fully 
advised of their condition, and to note the progress of 
each case; and shall give such directions to.the attendants 
as may be necessary. 
Sec. 2. At each Annual Meeting of the Board of Trus- 
tees he shall make a full report of the condition of the 
Hospital and its transactions for the past year, with such n Y-LA TPS. 
7 
observations, reflections and suggestions as he may deem 
important for the interests of the Institution, or of inter- 
est to the public generally, or the medical profession. And 
at each regular meeting he shall give such information to 
the Board as he may deem of importance. » 
Sec. 3. All correspondence of the Institution shall be 
conducted bv him or by his authority, and under his direc- 
tion. 
Sec. 4. For good cause, he mai' suspend any resident 
officer, but shall immediately give notice thereof to the 
Board of Trustees. He may, at pleasure, discharge any of 
the employees, attendants or assistants. 
Sec. 5. He shall cause to be kept a record of the names 
and residence of all persons employed in the Hospital, 
with the times and terms of their respective engagements, 
and the date and cause of their dismissal. 
Sec. 6. He shall provide a seal for the Hospital, with 
the proper device thereon, which shall be under his con- 
trol, and used by him whenever the seal of the Hospital is 
required. 
Sec. 7. He shall constantly observe the conduct of 
persons employed in subordinate stations, and see that in 
all respects they do their duty. 
CHAPTER VII. 
ASSISTANT PHYSICIANS. 
Section i. The Board of Trustees may elect Assistant 
Physicians whenever they deem it necessary, and who shall 
hold their office for the term of one year, unless sooner 
removed, and until their successors are elected. 
Sec. 2 The Assistant Physicians shall visit the Wards 
frequently and carefully note the condition and progress of 
individual patients. They shall see that the directions of the 
Superintendent are faithfully executed, and shall promptly 
report any case of neglect or abuse that may come under 
their cognizance. They shall assist in devising employ- 
ment and recreation for the patients, and endeavor in every 
way to promote their comfort and recovery. They shall 
keep such record of the cases as the Superintendent may 
direct, and assist him in preparing statistics, conducting 
correspondence and such other duties of his office as can 
be properly deputed. 8 
BY-LAWS. 
Sec. 3. In the absence of the Superintendent the First 
Assistant Physician shall exercise the duties of his office, 
unless the Trustees otherwise determine. 
CHAPTER VIII. 
STEWARD. 
Suction i. The Steward shall hold his office for the 
term of one year, unless sooner removed, and until his 
successor is elected and qualified. His salary shall be such 
sum as shall be determined from time to time by the 
Trustees. 
Sec. 2. He shall execute a bond with sufficient sureties, 
to be approved by the Board of Trustees, in the penal sum 
of five thousand dollars, conditioned that he will faithfully 
discharge the duties of his office, and pay over and account 
for all moneys that may come into his hands, belonging to 
the Hospital; which bond shall be executed to (he Hos- 
pital and filed in the office of the Secretary of the Board 
of Trustees. 
Sec. 3. He shall keep clear, methodical and exact ac- 
counts of all purchases and sales of the produce of the 
farm, and of all receipts and expenditures of money. He 
shall, when required, exhibit all his account books and 
vouchers to the Trustees; and shall furnish an abstract of 
the same to the Board quarterly. 
Sec. 4. He shall keep the accounts of all employees of 
the Hospital, and settle with them quarterly; and he shall 
draw orders on the Treasurer for the payment of the same, 
which orders shall be countersigned by the Superintendent 
and sealed with the seal of the Hospital. 
Sec, 5. The Steward shall open an account current 
with the farm, and at the close of each year furnish the 
Trustees a written statement of the various products, and 
an accurate account of the expenses incurred in its man- 
agement. 
Sec. 6. He shall purchase the necessary account books 
for his department, which shall always remain in the Hos- 
pital, and shall be at all times open to the inspection of 
the Superintendent and Trustees. 
Sec. 7. The Steward, under the direction of the Trus- 
tees and Superintendent, shall purchase either in open B Y-LA WS. 
9 
market or by advertising, as may from time to time be di- 
rected, all fuel, stores, implements, stock, and all other 
necessary articles for the farm and Hospital, and shall be 
accountable for the safe keeping and economical use of 
the same, and shall exhibit quarterly statements to the 
Board of Trustees for all such purchases made. 
Sec. 8. Under the direction of the Trustees and Super- 
intendent, he shall attend to the business of the farm, 
stock, garden, grounds, fences and out-buildings, and see 
that they are always kept in good order. 
Sec. 9. He shall constantly observe the conduct of 
persons employed in subordinate stations; see that in all 
respects they do their duty,and report immediately to the 
Superintendent any instance of negligence, misconduct or 
abuse that he may observe, or that may come to his knowl- 
edge. 
Sec. to. He shall assist in maintaining the police of 
the establishment; shall see to the opening and closing of 
the house; and see that the male attendants and assistants 
rise and commence business immediately after the ringing 
of the morning bell, and retire in proper season at night 
—that the bell be rung at proper times—the fires regularly 
kindled and extinguished,as directed; and that the warmth, 
cleanliness and ventilation of that part of the house occu- 
pied by the male patients be attended to. 
Sec. ir. He shall go in search of elopers; shall ob- 
serve the conduct of inmates at religious and other meet- 
ings; and shall perform all other services required of him 
by the Trustees or Superintendent; and at all times shall 
exert what influence he can to promote the comfort and 
recovery of the patients. - 
CHAPTER IX. 
Section i. The Matron, under the general direction 
of the Superintendent, shall have charge of the domestic 
concerns of the Institution, and an oversight of the female 
attendants and domestics. She shall be particular in en- 
forcing good order, discipline and faithful performance of 
duty in her department, and shall immediately reprove, or 
MATRON. 10 
report to the Superintendent, any material departure from 
rule, or anything censurable in moral deportment. 
Sec. 2. The bedding, table linen, furniture, -carpets, 
table covers and all similar property of the Hospital, as 
well as the clothing of the female patients, shall be under 
her care and supervision; and she shall see that it is ample 
in quantity and of a suitable kind. 
Sec. 3. She shall make daily inspection of the wards 
and rooms occupied by the female patients; and shall visit 
male wards as frequently as will satisfy her of the good 
order of the beds, table covers, towels, and such other 
furniture as is her province to supply and superintend. 
Sec. 4. The sick shall be under her special care, and 
she shall also see that they are supplied with everything 
needful for their comfort. In case of death, after receiv- 
ing the Superintendent’s directions, she shall see that the 
burial preparation is made with scrupulous care and de- 
cency. 
Sec. 5. She shall spend as much time as is consistent 
with general oversight, in the wards of the female division 
of the Hospital, and she shall fully satisfy herself that 
everything possible is done by attendants to promote the 
comfort and recovery of patients. 
Sec. 6. She shall hold her office for the term of one 
year, unless sooner removed, and until her successor is 
elected. 
BY-LA WS. 
CHAPTER X. 
Sectiox i. The Supervisors shall spend their whole 
time, not appropriated to other duties, in the oversight of 
their respective wards. They shall very frequently pass 
through the different wards, especially those containing 
excited patients, and see that all the patients are made as 
comfortable at all times as circumstances will permit, and 
see that the by-laws of the Institution and the directions 
of the resident officers are faithfully carried out by the at- 
tendants and all persons employed therein. 
Sec. 2. They will especially attend to the prevention 
of disturbances among the patients, to the preservation of 
order and quiet in the wards, and in all things assist in 
SUPERVISORS. B Y-LA WS. 
11 
carrying out the general views and instructions of the phy- 
sicians in reference to the treatment of patients 
Sue. 3. They shall particularly attend to the mainten- 
ance of personal cleanliness among the patients, and to 
the neatness and good order of their apartments, clothes 
and bedding; and shall see that such of their clothing and 
bedding as may need cleaning and repairing are collected 
every moriTng and sent to the laundry or sewing-room, 
or repaired in the ward. 
Sec. 4. In passing through the halls or dormitories, 
they shall observe whether the temperature and ventilation 
are such as are required; if not, immediately inform the 
Superintendent or Assistant Physicians. 
Sec. 5. The clothing of the patients will be carefully 
examined by them at the time of admission. They will 
attend to having it marked, and at all times report any 
deficiency to the proper officer. 
Sec. 6. They will see that the patients are provided with 
whatever may be needed; that their food and medicine are 
carefully and regularly given them, and the instructions of 
the physicians most scrupulously complied with. 
Sec. 7. They shall endeavor to encourage the attendants 
in their efforts to attain a higher tone of duty in their re- 
lations with the patients and each other, and to cultivate in 
their dress, manners and personal habits a feeling of self- 
respect and politeness. They shall endeavor to encourage 
in them a sentiment of respect for the officers of the Insti- 
tution, so that the patients may be inspired with confidence 
in them. They shall communicate freely with the Superin- 
tendent as to the fitness of attendants for special duties, and 
any want of faithfulness which they may observe; also as to 
any deficiencies in the food sent to his or her wards, or in 
the washing. And in general they shall be responsible for 
the proper deportment of attendants, to whom they shall 
be a guide and example. 
Sec. 8. They shall keep a minute in a book provided 
for that purpose, of the absence of attendants in their res- 
pective departments, and the length of time of such absence; 
the same to be preserved for the examination of the Super- 
intendent. And they shall know at all times, who of the 
attendants, if any, are off duty. 12 
B Y -LA I VS. 
Sec. 9. They shall also note, in a book provided for 
that purpose, any instance of neglect of duty or harsh treat- 
ment of patients, on the part of any of the attendants, which 
may come to their knowledge, all the wants of the Hospital 
in their respective departments, together with such facts 
and occurrences as they may deem in any degree important 
to the well-being of the Institution or the patients, and 
report the same daily, or as often as circumstances may 
require, to the Superintendent. 
Sec. 10. They will be present at the admission and dis- 
charge of their respective class of patients, examine them 
particularly for money and valuables, and especially every- 
thing that may be dangerous about their persons; attend to 
having them bathed as soon as practicable, and report to 
the Physicians any bruises, or indications of injury, or 
eruptive disorder that may be discovered, and whether or 
not they have been vaccinated. In case of death they will 
see that the burial preparation is made with scrupulous 
care and decency. 
CHAPTER XI. 
GENERAL RULES. 
Section i. In making engagements with indididuals to 
be employed in any department of the Hospital, it is to be 
distinctly understood that their whole time is to be devoted 
to the Institution; that the Hospital contracts for their 
whole time, and that they are not to leave their dudes or 
the premises without express permission of the Superin- 
tendent, one of the officers, or the supervisor of their wards. 
Sec. 2. They are expected to perform with alacrity and 
cheerfulness, and to the best of their ability, all duties that 
may be assigned to them by the officers of the Hospital; 
must expect an unceasing observation of the manner of 
performing their duties, and must receive suggestions and 
corrections kindly, and endeavor to profit by them; and at 
all times and under all circumstances endeavor to promote 
the welfare and happiness of the patients and the prosper- 
ity of the Hospital. 
Sec. 3. All persons employed in and about the Hospi- 
tal ar® expected to treat the patients, every one having business at the Hospital, and each other, with respect and 
courtesy. They are to be neat in their habits, and as neat 
in their dress as the nature of their duties will permit; avoid 
wearing their hats in the house; going in their shirtsleeves 
in the wards unless when specially at work; lounging on the 
settees, or reclining at all during the ordinary hours of 
work; all ungentlemanly and unladylike habits, and every 
act unbecoming their vocation. 
Sec. 4. No person employed in the Hospital shall buy 
of patients or sell to them anything whatever, nor receive 
gratuities or presents from patients or their friends, except 
by permission of the Superintendent. 
Sec. 5. When abroad they are to avoid speaking of the 
deportment, conversation, peculiarities, or even the names 
of patients, and are never to speak disrespectfully of the 
Hospital or any of its officers. 
Sec. 6. No male persbn except officers, employed on 
the premises, shall enter any portion of the building or 
grounds occupied by female patients, or that portion of the 
building occupied by female employees, without express 
permission. 
Sec. 7. No person—friends and acquaintances of em- 
ployees included — shall be admitted to the Wards, Kitchen, 
Bakery, Laundry, Wash-house, Engine-room, Carpenter- 
shop, or other department of the Hospital where they are 
not employed, without express permission, or in accordance 
with such rules as may be established by the Superintend- 
ent, and employees must not be absent from their posts 
longer than is absolutely necessary. 
Sec. 8. It is necessary for their highest welfare that pa- 
tients should, as far as possible, have some kind of employ- 
ment, either work, reading, driving, walking or amusements 
—and no proper opportunity is ever to be neglected to in- 
duce patients thus to occupy themselves. But it is to be dis- 
tinctly understood—and no infraction of this rule will be 
allowed—that patients shall be emplyed to assist only, and 
not to do the work that belongs to others, and for which 
they receive suitable compensation. 
Sec. 9. Cheerfulness is always desirable in the wards, 
but marked levity, and especially boistrous conduct, is very 
undesirable, and all should be careful to make this impor- 
tant distinction. 
B Y-LA WS. 
13 14 
B Y -LA WS. 
Sec. io. It is desirable, for many reasons, that patients 
should leave the Hospital with pleasant recollections of 
their residence and treatment in it, and every one who 
comes in contact with them can do something to promote 
this end. Patients who have recovered are generally quite 
competent to give an accurate account of what occurred 
during their disordered state, of the treatment received 
from those who had the care of them, and much other in- 
formation of importance to those in charge of the Hospi- 
tal. It is hoped that in all cases their testimony will be 
such as to increase the standing and respect due to those 
employed for their care and restoration. 
Sec. ii. When absent the hour for return in the even- 
ing is ten o’clock. At that hour the doors will be locked 
and no person admitted afterwards without being reported 
to the Superintendent. It is wished to allow as much re- 
laxation as possible to those who perform their duties faith- 
fully, and as much absence as is consistent with the service 
required and the welfare of patients will permit; but when- 
ever, as on public days, the absence of attendants and oth- 
ers is deemed likely to be prejudicial to the patients, they 
are expected to remain at their posts. Promptness in re- 
turning at the hour up to which leave of absence was granted 
is especially enjoined upon all, and no excuse but the occur- 
rence of unforeseen and unavoidable circumstances will be 
deemed satisfactory. 
Sec. 12. All letters, or other writing, parcels, or pack- 
ages to or from the patients, must shown to the Super- 
intendent, without previous examination. Attendants and 
all others must never retain any writing of patients. All 
money found on patients, and all sums left or sent for their 
especial benefit, are to be kept and disbursed by the 
Superintendent. 
Sec. 13. All damages done by patients to clothing, fur- 
furniture, glass, or anything of value, must be promptly 
reported to the Superintendent or Supervisor. 
Sec. 14. No conversation should be held with patients 
through the windows by any person whatever. 
Sec. 15. All personsholdingkeys,—with such exceptions 
as the Superintendent may make,—shall, before leaving the 
Hospital, put their keys in a place designed for that pur- 
pose. They are never to lend their keys to any person, B Y- L A WS. 
15 
without directions to that effect from the Superintendent. 
Sec. i6. Visitors to persons employed are not to be 
taken through the wards and grounds without permission 
and it is desirable that these visits be as brief as possible. 
Sec. 17. Attendants and others will in no case visit the 
friends of patients to report their condition, without the 
express permission of the Superintendent. 
Sec. 18. No resident officer, attendant or assistant,while 
connected with the Hospital, shall at any time drink intox- 
icating liquors of any kind, at home or abroad; nor smoke 
a cigar or pipe about the premises, nor procure them for 
any patient, except by direction of the Superintendent in 
each case. 
Sec. 19. Whenever persons employed wish to give 
up their situation they shall be required to give four weeks’ 
notice of their ihtention, but they may be allowed to leave 
sooner if it is practicable. 
Sec. 20. As some worthy and well-intentioned persons 
do not possess the requisite qualifications for success in such 
a sphere of duty, th* officers of the Hospital expressly re- 
serve the right at any time to dispense with the services of 
any one without assigning their reasons therefor. When- 
ever any persons are not likely to gain credit or give satis- 
faction in a situation, it is no mark of disrespect to give 
them an opportunity to engage in some other pursuit bet- 
ter calculated to advance their own interests. 
CHAPTER XII. 
DUTIES OP THE ATTENDANTS. 
Section i. There shall be one or more attendants in 
each ward who will especially attend to die prevention of 
disturbances among the patients, to the preservation of 
order and quiet in the wards, and in all things assist in 
carrying out the general views and instructions of the phys- 
icians in reference to the treatment of patients. 
Sec. 2. They shall particularly attend to the mainte- 
nance of personal cleanliness among the patients, and to 
the neatness and good order of their apartments, clothes 
and bedding; and shall see that such of their clothing and 
bedding as may need cleaning and repairing are collected 16 
TJ Y- LA W S. 
every morning and sent to the laundry or sewing room, or 
repaired in the ward. 
Sec. 3. They shall observe whether the temperature and 
ventilation are such as are required; if not. immediately 
inform the Superintendent, Assistant Physician or Super- 
visor. 
Sec. 4. They will assist in the administration of the 
medicine prescribed. The utmost gentleness is to be used 
in the administration of medicine and every proper means 
employed to induce patients to take it willingly. 
Sec. 5. The attendants shall have the immediate and 
constant care and supervision of patients. A few general 
facts and principles should be constantly kept in mind by 
all persons connected with the management of the Insane, 
but more especially by their attendants, into whose never- 
ceasing care and keeping they are entrusted: 
I. It is clearly demonstrated as any mathematical truth 
that Insanity in all its forms is a disease. 
II. There is usually a loss or perversion of the sense of 
moral obligation, and inability to distinguish between right 
and wrong, and, therefore, irresponsibility for words .and 
actions. 
III. There is a full appreciation of all acts of kindness 
or cruelty, and in general a perfect recollection of thorn 
after restoration, and in after life. 
IV. There is usually a morbid or exalted sensitiveness 
in relation to what is due to them in attention and general 
deportment, and, consequently, irritation, excitement or 
anger at either real or imagined neglect or improprieties 
of teatment. 
V. The frequent recurrence of excitements aggravates 
and perpetuates the disease. 
VI. The more the mind dwells upon, or is reminded of 
hallunciations or delusions, the more permanently are they 
fixed; so is the reverse true, that the more they are driven 
from the mind, by occupation, with other thoughts and 
ideas, the sooner do they disappear altogether. These 
few principles are the basis of the following rules and 
regulations for attendants. 
Sec. 6. In all their intercourse with the patients, the 
attendants must treat them with respect and civility; are 
to address them in proper tones of voice, and avoid B T-LA WS. 
17 
violence and rudeness of every kind. All questions are to 
be kindly and properly answered; all reasonable requests 
are to be properly attended to. They should keep cool 
under the severest provocations, and never scold or dictate 
authoritatively. Whenever they desire anything done by a 
patient the request is to be made in a respectful manner. 
Skc. 7. The opposition of patients, and perhaps much 
of their violence, very often arises from delusions that lead 
them to suppose that they are to be injured in some way, 
and every attempt to give them food, medicine, or perform 
any necessary office for them, if done in an improper man- 
ner, only tends to confirm their false notions and make 
resistance more obstinate and determined. The truth of 
these views is too well established to be questioned, and is 
often confimed by convalescent patients who are able to 
describe their motives and feelings when in their state of 
greatest mental disturbance. 
Skc. 8. Force unfortunately has sometimes to be used in 
every institution for the insane, but tact and kindness may 
render its employment comparatively rare, and whenever 
it must be resorted to, a kind, respectful manner, and sym- 
pathizing words, may go far to convince even the most ex- 
cited patients that what is done is from good motive, and 
that they have little to fear. . 
Skc. 9. Under 710 circui/istances will an attendant be ex- 
cused for inflieti?ig a kick or a blow unless in the clearest case 
of self defense, or to preve7it cofnmitting self-hurt or injury to 
others. 
Sec. 10. If patients engage in controversy or improper 
or exciting discussion, the attendants shall gently and 
promptly interfere and $heck them: and if the quiet and 
good order of the wards cannot otherwise be preserved, 
the disorderly patients may be placed in their rooms at the 
discretion of the attendant, care being taken to avoid all 
violence; and in such cases the Supervisor or officers shall 
be notified as soon as possible. A kind word fitly spoken 
at such a time will prevent many a scene of excitement, 
just as dictation, harshness, anger or unkindness, or any 
rude act on the part of the attendant, may be the origin of 
trouble that may last for days. 
Skc. 11. They are to avoid talking to patients about 18 
B T-LAWS. 
their delusions, and, as much as lies in their power, should 
prevent others from doing so. 
Sec. 12. They must never allow patients to be laughed 
at, or ridiculed on account of their delusions, or the pecul- 
iarity of their disorder. 
Sec. 13. They must take every proper opportunity to 
inspire the patients with respect for and confidence in the 
officers, and to convince them of the true character of the 
Institution, and its leading object—the promotion of the 
restoration and comfort of its subject. 
Sec. 14. Deception should always be avoided, and 
promises should not be made that cannot be performed. 
Sec. 15. Writing materials, books, or reading matter of 
any kind must not be furnished patients without the sanc- 
tion of the Superintendent. Letters, parcels, or packages 
of any kind, are to pass through the hands of the officers. 
Sec. 16. Any damages done by the patients should be 
promptly reported to the Superintendent. 
Sec. 17. Each attendant is responsible for every patient 
under his or her care, and is expected to be able at any 
moment to say where each individual can be found. An 
attendant allowing a patient to go out of a ward is consid- 
ered responsible for his or her safe return, unless the per- 
mission has been given by an officer. 
Sec. 18. In those wards where there are two attendants 
one attendant must always be present with the patients in the 
ward, and endeavor to prevent violence, disorderly con- 
duct, destruction of clothing, defacing of the ward or its 
furniture, or anything but the most correct deportment, 
which must be inculcated with the utmost patience. When 
it is necessary to leave, except for a very temporary pur- 
pose, it must be known that a substitute fills the place. 
Sec. 19. When patients remain more or less in their 
own rooms, the attendants are expected to find reason for 
frequently calling at their rooms,without exciting suspicion 
if possible, to see how they are engaged, or if they require 
any particular attention. 
Sec. 20. On certain conditions, one attendant may 
guard two contiguous wards for a short period, but not 
otherwise, unless by special permission or direction of the 
Physicians. B Y- LA W S. 
19 
Sec. 2 i. The attendants will rise punctually at the ring- 
ing of the bell and take charge of their wards before the 
night watch goes off duty. They will then open the doors 
of all patients’ rooms, and give them access to the ward ex- 
cept in cases of high excitement, give them a kind greeting 
or at least a “good morning,” and see that they are prop- 
erly dressed and washed, and have their hair and clothes 
neatly and properly brushed before breakfast 
Sec. 22. Immediately after opening the doors and the 
rising of the patients, attendants will see to the removal of 
the chamber utensils from the rooms and that they are well 
cleansed, and the bedding laid off for airing. They will 
then commence putting the rooms and wards in good or- 
der, and after the beds and bedding have been properly 
aired, have them put up properly for the day. 
Sec. 23. Every part of the wings must be prepared 
for inspection at the Physician’s visit, which will be com- 
menced not later than nine o’clock every morning. Extra 
work, such as cleaning and scrubbing, may be carried on 
at a later hour, and through the fore part of the da}'. 
Sec. 24. Every part of the wards is to be kept scrupu- 
lously neat, clean and as well ventilated as circumstances 
will permit. If an unpleasant odor is discovered the cause 
of it is to be searched for and removed if possible at once, 
or reported to the superior officers. If any part of a ward, 
private room or dormitory becomes soiled, it is to be 
cleaned at once, without regard to the time of day. If 
other than the regular attendant is in charge of a ward and 
any part becomes accidentally soiled, they are not to wait 
for the return of the proper attendant, but proceed at once 
to restore the ward to its proper condition. 
Sec. 25. If a bed or the furniture of a room has been 
deranged, it is to be promptly put >n order. The rooms 
and corridors are to be scrubbed or rubbed as often as 
necessary to preserve scrupulous neatness. Spittoons are 
to be frequently looked after, and kept clean. The water 
closets, urinals, etc., are to be carefully watched, and pre- 
vented from impairing the purity of the air of the ward. 
Sec. 26. Nothing is clean enough if it can be made cleaner. 
Sec. 27. All beds that are soiled are to be removed 
from the wards as soon as possible after the rising of the 20 
BY-LA W S. 
patients in the morning, and as soon as convenient after 
breakfast, clean ones substituted. If only a portion of 
the straw is wet or soiled that portion only is to be re- 
moved and fresh straw put into its place, and if a mattress 
is wet or soiled it must be cleaned as well as possible, boil- 
ing water poured through the soiled and wet portions, and 
then thoroughly dried before being returned to the room. 
Sec. 28. As the health of some patients require diat 
they be indulged in lying down some portion of the day 
they are to be allowed to do so, and their rooms must be 
put in order as soon as they get up. 
Sec. 29. Attendants will see that patients are up and in 
proper condition for breakfast, at the prescribed hour. 
They will carefully observe, as they pass from the dming- 
room to the wards, that they do not take any food with 
them, nor any of the table furniture, especially knives and 
forks, or any tin ware. Knifes and forks and spoons should 
be carefully counted before and after each meal, and if any 
be missing, prompt measures must be taken for its recovery, 
by instituting search and giving information to the proper 
officer. 
Sec. 30. If directions are given by the Physicians or 
officers that certain patients take their meals in their rooms, 
or at the table in the ward, especial care is to be taken that 
their food is brought to them as warm as possible, and in 
good order, and if necessary the attendant is to remain 
with them while they are eating. 
Sec. 31. Any instructions which the officers may give 
about the manner in which meals shall be served, are to be 
strictly and promptly attended to and complied with. 
Sec. 32. Patients are not to be forced to take food but 
in the presence of one of the officers—and never but by the 
express direction of one of the Physicians. 
Sec. 33. In cases of epilepsy every fit so far as known 
shall be recorded. When a patient complains of being 
sick, or is known or supposed to be so, especially if there 
is diarrhoea or vomiting, the facts should be reported with- 
out delay to the Physicians, and no food administered till 
the patient has been seen by one of the officers. Any un- 
expected effect in the operation of medicine is to be 
promptly reported. Sec. 34. Unless a special exception is made by the 
Physician, every patient will take a warm bath once a week, 
and as much oftener as may be necessary for proper clean- 
liness. The temperature is to be such as is most grateful to 
the patient. Other baths shall be given as directed by the 
Superintendent. No patient is to bathe or to be bathed 
later than 9 o’clock p. m., unless by special permission or 
direction. 
Sec. 35. Shaving is to be done by the attendants once 
a week unless in some cases of high excitement, and pa- 
tients who desire to be shaved more frequently are to be 
gratified in this particular. Great care should be taken 
that no injury is done with the razors, all of which are to 
be carefully kept by the attendants. No patient is to be 
allowed to shave himself. 
Sec. 36. It is desirable that every patient, not too sick 
or feeble, should walk out upon the grounds or take a r>de 
every day. As soon as possible after the Physician’s morn- 
ing visit, in suitable weather, such attendants as may be 
spared should prepare to go out with as many patients as it 
is proper to take at once; other attendants caring for pa- 
tients that may remain in the wards. Upon the return of 
one company another may go out, so that by turn all may 
enjoy the privilege. 
Sec. 37. When walking with patients the attendants 
will direct where and how far they shall go—care being 
taken to avoid localities favorable to escape;—be vigilant to 
keep them together and prevent strolling, and taking care 
that no more are taken in one company than can be pro- 
perly attended to. Patients must not be allowed to lie or 
sit on damp ground, or improperly expose themselves to 
the sun. Attendants, when out with patients, will avoid 
entering into conversation with each other, reading, etc., 
by which their proper supervision may be prevented. 
Sec. 38. No patients are to be out after sunset, without 
special permission. Under no circumstances are patients 
to be taken beyond the boundary of the premises without 
permission. 
Sec. 39. If any patient, having the privilege of the 
grounds, or absent by special permission, does not return 
at any appointed time, the attendant in charge will at once 
report the fact to the Physicians. 
B T -LAW 8. 
21 22 
B 7 -LA W S. 
Sue. 40. New patients are not to be taken out of the 
house except by direction of the Superintendent. 
Sec. 41. Such patients as are deemed suitable will be 
allowed and advised by the officers to assist in the work 
about the premises, under the care of the attendants,gard- 
ener or farmer; but no one is to be taken out of the wards 
for this purpose unless some general permission is given by 
the Superintendent or other officers. Persons in charge of 
working parties will keep a close observation of the pa- 
tients, to prevent escape and see that they do not overwork 
themselves; and they will carefully avoid every appearance 
of superintending the patients, or giving orders, but should 
induce them to labor by persuasion, and if necessary by 
example, and instruct them so far as possible in the proper 
manner of doing the work. 
Sec. 42. On Sunday afternoons, and on the evening of 
entertainments, or lectures, as many attendants as the su- 
perintendent or officers shall direct must accompany the 
patients, and no ordinary engagement will be allowed to 
interfere with this arrangement. 
Sec. 43. The attendants designated to remain in the 
wards must exercise constant vigilance to prevent elope- 
ments, suicide, or mischief of any kind. 
Sec. 44. As the entertainment of dancing is provided 
chiefly for the benefit and welfare of patients, and some 
other persons seem to be constantly forgetting that this is 
the object for which it is established, and that such occa- 
sions ought not to degenerate into an amusement for the 
employees chiefly, it must be understood that male attend- 
ants and employes are to first endeavor to fill up “sets” 
with patients, aid, encourage and teach them as far as pos- 
sible to go through with the various figures. Female at- 
tendants and employees will be similarly engaged with 
male patients. During the evening, however, proper occa- 
sion may be taken to dance with each other. In all re- 
spects on these occasions, it is expected that the proprieties 
and usages of the best society shall prevail. 
Sec. 45. It is recommended as pleasant and profitable 
to both, that the attendants of each ward read, or under 
their supervision engage some patient to read aloud each 
evening for the benefit of all, from some book or magazine B Y-LA ITS'. 
23 
in the Hospital library. To this end they will be aided by 
the officers in making selections. 
Sec. 46. The various games of amusement are to be 
encouraged; but attendants are positively prohibited from 
games of amusement where there is not an equal'number 
of patients engaged with them. 
Sec. 47. Patients who are chiefly in the wards during 
the day are not to retire before 7 o’clock r. m. without 
permission, unless in case of sickness or fatigue. After 8 
p. m. patients may retire in any part of the house; but all 
must retire so as to allow the attendants to close their 
doors by 9:30 p. m. 
Sec. 48. Attendants are expected' to retire at 10 o’clock 
p. m., and af'er that hour no lights must be kept burning in 
any room except in case of sickness In each ward, how- 
ever, one light may be kept burning as may be directed, to 
be available in case of emergencies. 
Sec. 49. After patients have retired, all persons should 
avoid making any noise that might disturb patients or others 
who are in bed. 
Sec. 50. Unless otherwise directed, all clothing is to 
be kept ontside of the rooms, neatly folded, and if possi- 
ble laid on a chair or settee; and, except in case of high 
and destructive excitement, is to be given to the patient 
when his door is opened in the morning. 
Sec. 51. Upon closing the door the attendant is desired 
to wish the patient “good night,” and certainly ascertain 
that he is in the room, and the door locked. 
Sec. 52. No patient’s door is to be left unlocked during 
the night, without special permission of the Superintend- 
ent, and notice being given to watchman or watchwoman. 
Sec. 53. If patients lodge in a different ward from that 
in which they pass the day, it is the duty of the attendant 
having them in charge during the day to take them to their 
rooms and see them comfortably in bed, at the same time 
informing the attendants of the gallery where they sleep, 
that he has done so. unless otherwise directed; and it will 
also be the duty of the attendant of the ward in which 
they sleep to see them up and dressed in the morning, and 
return in seasonable time to the, ward from which they 
came the previous evening, notice being given to the at- 
tendant of that ward of their being returned. 24 
B Y-LA WS. 
Sec. 54. Whenever a patient becomes so noisy or vio- 
lent that the attendant, after trying all proper means, be- 
lieves it necessary to place him in a private room, he should 
provide such assistance, if possible,—if he is so situated 
that he cannot call one of the Physicians—as will convince 
the patient that resistance will be useless, and then let it be 
done in the mildest and gentlest manner possible. When 
the patient has been placed in a room, the attendant or 
the Physician should, if possible, certainly tell him why 
he has been placed there, and that he will be permitted, as 
soo as he is able to control himself, to go back to the ward. 
No matter however unreasonable the patient appears, let 
this always be done. Let no patient be forced into a room 
and then the door closed without a word of explanation. 
Sec. 55. A room having a wire or close shutters, or 
wicket door, is always to be selected for the seclusion of 
an excited patient. As soon as the patient is in a room, 
the fact is to be stated to the Superintendent or Physicians, 
who will without delay enquire into the facts of the case. 
Sec. 56. When it is necessary that patients should be 
secluded in their rooms, the attendants should be careful 
to see them frequently, and ascertain that they have every- 
thing proper that can minister to their comfort, and to 
know in what manner they are occupied. 
Sec. 57. When a patient is violent, one person on each 
side taking an arm, and a third at his back, can almost al- 
ways carry him to his room, or remove him from ward to 
ward, with but little, difficulty, or injury to any one. 
Sec. 58. As the use of restraining apparatus may be 
productive of serious evils, and as it is desirable to dis- 
pense with its use as far as possible, it must not be applied 
in this Hospital in any case except by the express direc- 
tion of the Superintendent or the assistant physicians. 
Sec. 59. Personal care, and that failing, seclusion to a 
private room, must be relied on till the direction of the 
Superintendent or assistant physicians can be obtained. 
Personal attention, it is well known, may, in a great de- 
gree, take the place of mechanical restraint, though the 
latter may ultimately be necessary, and even beneficial. 
Sec. 60. Whenever patients are confined to the bed 
by restraining apparatus used for that purpose, attendants must remember that thus situated they may require even 
more attention than when able to assist themselves, and in 
the discharge of their duties under such circumstances, they 
must sit with such patients when not engaged in other 
imperative duties. 
Sec. 6i. The escape of patients must never be allowed 
to occur from neglect. An attendant’s eye should always 
be kept on a patient known to be disposed to escape. 
Sec. 62. When patients go out for exercise, amusement 
or work, care must always be exercised to avoid, as far as 
possible, those places favorable for hiding, and they must 
not be allowed to separate widely under any pretence what- 
ever. If any patient gives trouble to the attendant or per- 
son in charge, the facts should be early reported to the 
superior officers. 
Sec. 63. Instant, prompt and faithful search should be 
made as soon as possible after a patient has escaped. 
Sec. 64. If a patient has escaped through the careless- 
ness, neglect, or want of proper vigilance of a person or 
persons in charge of them, it will be considered a sufficient 
cause for dismissal. 
Sec. 65. When patients who have escaped are recov- 
ered and brought back no offensive allusion is to be made 
to their escape; they are to be treated in all respects as if 
nothing of the kind had occurred, but they are to be watched 
more carefully in the future. 
Sec. 66. Watchfulness should always be exercised that 
patients do not make false keys or provide themselves or 
each other with the means of making them, and that they 
do not plot together for the purpose of effecting an escape. 
Sec. 67. Special care must be taken at all times that 
patients do not become possessed of dangerous weapons of 
any kind. When any one is known or suspected of having 
any knife, fork, razor, false key, &c., and will not give it 
up, every possible means must be used to obtain it without 
delay, care being taken in the mean time that the article is 
not secreted where it cannot be found. Whoever may see 
anything lying about the wards or grounds that might prove 
dangeous.in the hands of a violent or mischievous patient 
is requested to remove it. 
Sec. 68. When patients manifest a propensity to com- 
mit suicide there is no certain security but by constant 
BY-LA WS. 
25 26 
watching. Usual care and vigilance should be exercised 
over their persons, they must be treated with great kindness 
and sympathy, and their attention diverted as much as pos- 
sible from the delusions and fancies that prompt them to 
commit the act. Particular care should be taken to watch 
such persons about twilight or meal times,and at such times 
as the general attention is likely to be distracted from them. 
Sec. 69. In case of a suicide, the attendants should main- 
tain perfect composure, give prompt relief by cutting the 
noose, in case of suspension; stop the bleeding by tightly 
bandaging the part with a handkerchief or a strip of cloth 
in case of a wound, care being taken that in a wound of 
the throat, the bandage shall not impede respiration. 
Sec. 70. Care should always be exercised that a knowl- 
edge of death in any form be kept from patients, and tact 
used to direct their minds from the subject, il it becomes 
one of discussion. 
Sec. 71. The same care is necessary for the best welfare 
of all, that patients are kept, as far as possible, from a 
knowledge of what transpires in different wards, and in 
different parts of theHospital, and attendants and all others 
are enjoined to be guarded in their conversation in the 
hearing of patients. 
Sec. 72. The attendants will be careful to see that pa- 
tients change their clothes regularly, and gratify their rea- 
sonable requests in this particular as far as possible. Soiled 
clothes are not to remain in the patient’s rooms, but must 
be put among those to be sent to the wash house. Clothes 
badly soiled must be rinsed, or partially cleansed before 
being sent from the ward. 
Sec. 73. The clothing of patients is to be kept as neat 
and clean as possible, and well sponged and brushed at all 
times. If buttons, suspenders, stockings, slippers, or other 
necessary articles of clothing, or furnishing of a ward are 
needed, the}7 are to be asked for till they are furnished. 
Clothing should be kept buttoned and fitted at all hours of 
the day. When patients wet their clothes they should be 
change often to make them comfortable. The wet part of 
the clothing may be dipped in hot water and dried, but it 
is not to be worn again without undergoing this process. 
Sec. 74. The attendants, under the instructions of the 
Superintendent or other officers, are expected to do what 
B T- LAWS. B Y- L A WS. 
27 
they can to preserve patients’ clothing and keep it in prop- 
er repair as far as they can, and avoid sending articles to 
the sewing room unnecessarily. Attendants will take charge 
of any work sent to the ward and encourage the patients to 
assist in its accomplishment. Attendants can do no pri- 
vate work except putting their own clothes in order, dur- 
ing the hours of duty; norwillthey employ patients to work 
for them, without permission. 
Sec. 75. When officers or visitors are in the wards the 
attendants are expected to be present, and prepared to 
give such information and assistance, as may be required 
of them. 
Sec. 76. As the duties of the attendants, with such ex- 
ceptions as have been indicated, are confined almost exclu- 
sively to single wards, they can have but rare calls in any 
other unless specially directed by the proper authority. 
Attendants are not positively prohibited from vdsifing each 
other, but it must not become a habit, and it will be far 
better to obtain permission from the Superintendent, and 
assure this officer that their wards are suitably attended dur- 
ing such time as they may wish, or as it may be proper for 
them to be absent. Any marked infringment of either the 
letter or the spirit of this rule will not be allowed. 
Sec. 77. In going to and from the center building, they 
will avoid passing through wards not necessarily in their 
way. 
Sec. 78. Patients are not to visit from ward to ward 
without permission from one of the Physicians, and no pa- 
tient is to be transferred from one ward to another except 
as herein provided, without the sanction of the Superin- 
tendent or in his absence the Assistant Physician; 
CHAPTER XIII. 
DUTIES OF SPECIAL ATTENDANTS. 
Section i. Special attendants are governed by the 
same rules as other attendants. They are not to leave alone 
the patients under their care without permission,—are to 
be courteous and patient,—prompt in attentions to the 
rooms, clothing, &c., and, like others, to all reasonable 
requests, not inconsistent with the general regulations of 
the Hospital. 28 
B 7-LA WS. 
CHAPTER XIV. 
DUTIES OF THE WATCH. 
Section t. The Outside Watchman will commence his 
duty at nine o’clock in the evening, at which time he wdl 
visit the Physician’s office for any special instructions for 
the night. He will visit the kitchens, bakery, ironing-room, 
boiler-room, gas house, barns, and such parts of the base- 
ment as may be designated, and go all around the Hospital 
every hour, carefully observing if anything is wrong and 
noting it in a book kept for the purpose. He will be con- 
stantly vigilant to guard against fire and the escape of pa- 
tients from the windows. He must take no notice of being 
spoken to by patients from the windows. Ide is to ring 
the bell at the prescribed hour, start the fires in the kitch- 
ens and perform such other duties as may be assigned to 
him. 
Sec. 2. The Inside Watchman will commence duty at 
half past nine o’clock in the evening, at which time he will 
visit the medical office for special instructions for the night. 
At ten o’clock he will lock the outside doors and make a 
record of the time of admission of any person after that 
hour. He must keep moving about from ward to ward till 
the attendants rise and take charge of ther patients in the 
morning, and report to them anything they ought to know 
that transpired in their respective wards during the night. 
He will also make a written report to be left in the medi- 
cal office. 
Sec. 3; He will know if all the attendants of theWings 
are in their rooms at ten o’clock and. after that hour thro’ 
the night, and report any deviation from this rule. 
Sec. 4. He shall especially look after the sick and sui- 
cidal, guard against the escapes, notice unusual sounds in 
patient’s rooms and ascertain their cause, and endeavor, as 
well as he may be able, to tranquilize thosewho are excited 
or allay the apprehensions of the timid. Pie may give water 
where it is needed, and attend to any reasonable wants. 
In going about he will make as little noise as possible, and 
at once awake the attendant in an emergency. 
Sec. 5. He will faithfully report all irregularities, or B Y-LA WS. 
29 
violation of rules, and how new patients and the sick have 
passed the night. 
Sec. 6. The Watchwoman will confine herself to the 
wards occupied by the female patients and be governed by 
the rules prescribed for the watchman. 
Sec. 7. All will be constantly vigilant and perform their 
responsible duties with strict fidelity. Any want of fidel- 
ity attaching to these officers must instantly disqualify them 
for their stations. 
Sec. 8. The attendants and other employes being up 
and in charge of their duties, the duties of the watch will 
cease till 2 p. m., after which they may be called upon for 
various services till supper is over, from which time they 
will be relieved till the usual hours of duty. 
Sec. 9. If fire is discovered that cannot be readily ex- 
tinguished, the attendants and officers should be aroused 
without causing a general alarm if possible. 
CHAPTER XV. 
Section i. The Seamstress will have charge of the sew- 
ing room, under the direction of the Matron. She will 
have the care of, and be responsible for all material and 
apparatus belonging to her department. She will have the 
care and oversight of the patients who may be allowed to 
come from the wards to work under her direction, and will 
endeavor to make their time and work useful, and at the 
same time as much a pastime and pleasure as possible. 
Sec. 2. She will report promptly any improper conduct 
on the part of patients. Such patients as may be allowed 
may be taken daily from the wards, provided no new pa- 
tients, or patients who have been guilty ot misbehavior, 
shall be taken from the wards without permission. 
Sec. 3. As her duties will call her from time to time to 
all parts of the female wards, it is enjoined upon her that 
she spend no unnecessary time in the wards when called 
there upon a proper errand. 
Sec. 4. The Supervisors or Clerk may take patients to 
and from the sewing room if so directed by the Supt. 
Sec. 5. Neither the sewing machine or any article or 
DUTIES OF THE SEAMSTRESS. 30 
B Y-LA W S. 
material belonging to the sewing room are to be used for 
any other purpose than the necessary work of the Hospital 
or its patients, without permission from the Matron. 
CHAPTER XVI. 
DUTIES OF THE CARPENTER. 
Section i. The Carpenter will have the immediate care 
and charge of the carpenter shop, lumber, tools and mate- 
rial of all kinds, belonging to that department of the In- 
stitution, and is enjoined to be careful of their use. He 
will not allow any one to make use of the tools or lumber 
without permission of the Superintendent; and if tools are 
taken from the shop for any purpose and are not promptly 
returned, he will report the fact to the Superintendent. 
Sec. 2. He will prevent attendants, patients and others 
from remaining in the shop without permission from the 
Superintendent, or unless they have been sent there to 
work or for special service. 
CHAPTER XVII. 
DUTIES OF THE GARDENER. 
Section i. The Gardener, under the direction of the 
Steward, will have the care of the garden, pleasure grounds 
and green-house, and will see that they are kept in good 
order, and that those who aid him in his duties perform 
their work faithfully. He will take care of all implements 
belonging to his department and see that they are properly 
preserved. 
Sec. 2. He will consult the Steward in reference to such 
seeds as may be required, and the amount and variety of 
vegetables and fruit it is desirable to raise. 
Sec. 3. He will see that the kitchen is promptly sup- 
plied each morning or at other times of day, if so directed, 
with such vegetables as may be required. 
Sec. 4. He will, if possible, prevent any depredations 
being committed in the garden or nursery, and keep a cor- 
rect account of all the products of the garden and nursery, 
which shall be exhibited as often as desired. B Y - L A W 8. 
31 
CHAPTER XVIII. 
DUTIES OF THE ENGINEER. 
Section r. The Engineer, under the direction of the 
Superintendent, shall have charge of the engine and boiler 
rooms, engine, pumping and steam apparatus, and the fire- 
man and jiersons employed under him shall be subject to 
his directions. It shall be his duty to furnish steam for the 
whole building and for cooking and washing; keep the 
tanks supplied with water, and sufficient hot water for all 
use for which it may be needed. 
Sec. 2. He will have charge of all tools and stock in 
his department, see that they are properly preserved and 
that good order and system prevail. 
Sec. 3. He will make such repairs and alterations as 
may be needed of the apparatus under his care. 
Sec. 4. He is instructed to prohibit visits to the boiler 
and engine rooms, and patients and visitors shall not be 
allowed to enter except by special permission, or when 
accompanied by an officer. 
CHAPTER XIX. 
FI R K. 
For the preservation of the property of the Hospital from 
fire, and to organize effectually for its prompt extinguish- 
ment. all persons connected with the Institution are en- 
joined to follow the directions given below: 
Precaution.—Always keep a supply of water in the 
tank, and fill the tank the last thing before closing the fires 
at night. Keep all attic doors locked, and never enter the 
attic with ari open light, and allow no open light in the 
basement of the wing. 
In Case of Fire sound the alarm by ringing the bell 
rapidly. 
The Steward will direct all movements toward put- 
ting out fire, and all employes, not otherwise designated, 
will report at once to him, and be directed by him. 
The Engineer will see that the pumps and all other 
machinery are in order, that the tank is fully supplied with 32 
BY -LA WS. 
water, and detail one fireman to take charge of the hose in 
the center of rear buildings, under direction of theSteward. 
The Assistant Physicians will proceed at once to the 
wards and be considered responsible for the personal care 
and safety of the inmates. They will see that the patients 
are moved into the hall, with such articles of bedding and 
clothing as they can carry, direct the attendants hi each 
ward to examine each room, so that no patient may be left 
concealed behind the doors or under the beds, and cause all 
doors to be locked after such examination, and all patients 
ready to move off the hall, should it become necessary. 
Th,e Female Supervisor will see that all female patients 
are dressed and kept in readiness to move out, when neces- 
sary, observing the precaution to have all room doors locked 
after the rooms have been examined. 
The Male Supervisor will have detailed one male 
attendant from each ward whose duty it will be to have the 
hose at all times in readiness, and on alarm will proceed 
at once to adjust it. If the fire is not in the wing he 
will report to the Steward. The other attendants will 
remain with the patients, keep them together in the hall, 
but will not remove them from the building until directed 
by the Superintendent or Assistant physicians. 
The female employes in the main and rear center 
building will, if not otherwise directed at the time, pro- 
ceed to the female wards and assist in the care and removal 
of the patients. 
These regulations, while aiming to define specific 
duties for each person connected with the Hospital, are 
intended toso co-operate that if the emergency arises, there 
shall be entire harmony and concurrence of action. 
CH APT FIR XX. 
MISCELLANEOUS PROVISIONS. 
Section i. All persons employed on the premises not 
mentioned in the foregoing rules and regulations are ex- 
pected to be governed by their general spirit, in the per- 
formance of whatever duties may be assigned them. 
Sec. 2. In order that all may be made as familiar as B Y - LA W S. 
33 
possible with the duties belonging to their situation, a copy 
of these rules and regulations will be furnished to each per- 
son mentioned herein when entering upon their duties, 
which shall be preserved and given up whenever they leave 
or are discharged. Each attendant must give his copy to 
the Supervisor every Saturday to be sent to the medical 
office, and a memorandum of its having been received will 
be made in it by the Assistant Physicians. It ;s hoped this 
measure will insure the frequent careful reading of the 
rules, and ignorance of the details will not be admitted as 
an excuse for their not being observed. 
Sec. 3. Strangers and others may visit such parts of the 
Institution as are allowed by the Superintendent, on any 
day except Sunday (when no visitors shall be admitted), 
between the hours of 2 and 4 p. m.; but special care is 
to be taken that no amount of visiting is permitted in the 
wards which might prove injurious to patients. Visits of 
friends to persons engaged in the Hospital must be made 
in the reception rooms and must be brief. 
Sec. 4. The Sabbath shall be observed as a day of rest 
and quiet at the Hospital. 
Sec. 5. The Superintendent may procure the attend- 
ance of some clergyman on each Sabbath day, to perform 
such services as he may direct; and may also provide for 
lectures and such other literary exercises, during the week, 
as he may deem of advantage to the patients. 
Sec. 6. These By-Laws can be amended or repealed .at 
any regular meeting of the Board by a vote of a majority 
of the Trustees. 
I certify that the foregoing By-Laws were adopted by the Board 
of Trustees of the Iowa Hospital for the Insane at Independence, 
at their regular meeting held on the first Wednesday in January, 
A. I). 1879, and are now in full force and effect. 
JOHN G. HOUSE, 
Secretary of the Board of Trustees. 
Independence, Jan. 9th, 1879.