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the kitchen in the men's, and another for the kitchen in the women's division, with a suitable number of assistants; the diet for each ward shall be fixed before nine o'clock A. M. of each day, in order to allow time for the preparation of the articles of diet, and no food shall enter the wards, except by the direct order of the physicians having charge of the wards.
The gates separating the yards of the different departments of the institution from those of the men's and women's Almshouses, shall be kept constantly closed and locked.
The keeper of the outside Hospital gate is directed not to suffer ingress or egress to any person, except a sick pauper, and the person accompanying, without a special order from a Guardian, attending Physicians of the Medical Board, Steward, or Matron.
The wines and liquors used for medical purposes in the Hospital Department shall be placed under the charge of the Storekeeper, and given out only on prescription from the attending Physicians of the medical department, and the Storekeeper is to keep a book to show the quantity and kind of liquor received and distributed by him, and lay the same before the Committee on Hospital, weekly.
The convalescent patients, and those afflicted with chronic diseases, shall not be permitted to visit the other paupers in the establishment, and all intercourse between the two classes is strictly prohibited.
With a view to uniformity and certainty in regard to medicines, all preparations of a standing kind shall be according to the formulæ of the United States Pharmacopoeia.
All pauper patients in the Hospital or Insane Department, who are capable of performing labor, shall be sent daily to the House of Employment.
There shall be attached to the Hospital a drunkard's ward, for the reception of mania-à potú cases, and such others as the attending Physician of the Medical Board shall direct.
Physician of the Insane Department.
The Physician of the Insane Department shall reside on the premises, and have, under the direction of the Committee on In
sane Department, the charge and general supervision of that department; and every person and thing therewith connected shall be subjected to, and at all times under his immediate control. He shall enforce all the rules and regulations, grant liberty to, and preserve strict order among the patients and assistants in his department. He shall suspend and report pauper assistants, who do not conduct themselves in an orderly, sober, and submissive manner, to the Steward for punishment. All persons under his charge receiving salary shall obey his orders.
He shall visit the patients morning and evening, and at other times when it may be necessary. He shall keep a register, in which the name, age, birthplace, habits, etc., of each patient, together with as full a history of his or her disease as can be obtained, shall be recorded.
It shall be his duty, whenever he deems it advisable, to request the attendance of the Consulting Physician or Surgeon of the Hospital.
He shall prevent any unnecessary use of medicines, and shall see that all medicines ordered for use in the wards, are securely kept by the nurses under lock and key, and administered personally by them, or by a reliable assistant, according to his directions.
He shall supervise the general diet of the Insane Department, and see that all necessary provisions are supplied; he shall rearrange the housekeeper's diet book at least once a month, and in order that the diet books shall always exhibit a fair statement of the diet of the wards, it shall be the duty of the Physician to write out, at large, the diet of the medical wards every day, and of the other wards every Tuesday and Friday, and revise and date these on the intermediate days.
He shall have power to grant liberty to such of the patients in the Insane Department as he may think proper (unless such patients are debarred leave of absence), such liberty not to extend beyond one month.
He shall make a weekly report in writing to the Committee, of the names of all patients received during the preceding week, together with their birthplace, age, social condition, causes of
insanity, and such other information as is attainable. He shall in like manner report the names and condition of those leaving the Institution.
In the month of January, of each year, he shall communicate to the Board of Guardians the number of patients who have been under treatment during the preceding twelve months; this statement shall be in tabular form, and give in detail the results of treatment, and it shall be accompanied by such observations and suggestions as in his judgment may seem called for.
No insane patient who has not a legal residence within the limits of the Poor District of the city of Philadelphia shall be admitted into the Insane Department of the Almshouse as a pay patient.
The Medical Board of the Philadelphia Hospital consists of five Physicians, five Surgeons, and five Accoucheurs.
annually, by ballot, a President and a Secretary.
The Meetings of the Medieal Board are stated and special; the former are held quarterly, and the latter at any time by a call of two members.
The Hospital is divided into three departments, viz., Medical, Surgical, and Obstetrical.
All the members of the Attending Medical Staff are on duty continuously, and visit the Institution at least four times in each week.
No capital operation may be performed contrary to the will of the patient; nor then, until a consultation of all the Surgeons shall be called, unless delay imperil the life of the patient, in which case the Surgeon on duty may dispense with a consultation.
No autopsy may be made without an order, signed by a majority of the class of the Medical Board in whose department the death may have occurred, and countersigned by the Steward, or by the Chairman of the Hospital Committee.
Each Attending Officer may introduce four pupils to observe the practice of the Hospital.
At least one member of each Staff must meet the Hospital Committee at least once a month, for conference in regard to the Hospital Department.
There shall be elected from time to time, semi-annually, at a stated meeting of the Board of Guardians, from the applicants recommended by the Medical Board, five Resident Physicians, who shall serve for fifteen months, from the time they begin their duties.
Every Resident Physician elect, before entering upon the duties of his office, must deposit the sum of one hundred dollars in the hands of the Treasurer, to be forfeited to the use and benefit of the Institution in case of dismissal or resignation, but to be returned to those who serve their full term in a satisfactory manner.
The Resident Physicians are provided with rooms, board, washing, fuel, and lights, in the Institution, under the direction of the Steward, free of expense.
Each department of the House has two Residents, who remain in each three months, and pass in rotation, as directed by the Medical Board; it being understood that the male and female medical wards are separate and distinct departments, to have each two Resident Physicians.
The Resident Physicians must visit their respective wards twice daily, morning and evening, at the hours designated by the Medical Attendant, and must so arrange among themselves that both of the Physicians in the same ward shall never be absent from the House at the same time.
No surgical operation, except such as may be designated by the Attending Surgeon, may be performed by the Resident Physicians, nor may they employ any obstetrical instruments with a view to delivery unless under the supervision of the Accoucheur on duty.
It is the duty of the Residents to accompany the respective Medical Officers during their official visits to the Institution, and to be provided with ward books, furnished by the Board of Guardians, in which they shall carefully record all medical, dietetic, and
other directions of the visiting Medical Attendant, under their appropriate heads.
The Residents attend alternately in the receiving ward, each having his day of service fixed, which may be determined among themselves, and no resident shall, under any excuse, leave the Hospital on his receiving day.
It is the duty of the Resident Physicians of each ward to make out a Quarterly Report, which, after being signed by the Medical Attendant, is handed to the Secretary of the Medical Board within two weeks after the expiration of the quarter.
The Residents of each ward have charge of the instruments belonging thereto, and are responsible for them to the Hospital Committee. One of those on duty in the Women's Medical Ward, selected by the Microscopist, must take charge of the Microscope Room and Microscope.
It is the duty of the Residents in the several wards, to make all autopsies which may be directed by the members of the Medical Board, and they must always, in such cases, inform the other Residents of the House, of the examination, that they may participate in any advantages which may be derived therefrom.
The Residents must, if required, copy all prescriptions from the ward books, and hand them with the least possible delay to the Apothecary. They must cup, bleed, and superintend the application of leeches. In the absence of both Apothecaries, they are to act as assistant Apothecaries.
Two Resident Physicians serve in the out-wards alternately for three months, the time for such service being determined among themselves.
In case of accepted resignation or death of a Resident Physician, the vacancy shall be filled from those previously recommended by the Medical Board, when practicable.
No Resident Physician is allowed to engage in teaching, or in the practice of his profession, during his term of service; nor to publish any record connected with the cases in the Hospital, without previously obtaining the consent of the Attending Medical Officer having charge of the case in each instance.