Rules and Regulations, 1850

The following is a transcript of the Rules and Regulations for the hospital published in 1850.


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RULES AND REGULATIONS

FOR

THE DORSET COUNTY HOSPITAL

WITH SELECTIONS FROM THE BYE LAWS.

N.B. Bye-Laws are inserted in smaller type.

1. All the affairs of the Hospital shall be under the direction of a General Committee of Management, consisting of the Patron, Vice-Patron, Trustees, Treasurer, the Incumbents, or, if they be non-resident, the Curates, of the five Churches in Dorchester and Fordington (being Subscribers,) together with twelve elected Members. Donors of Fifty Pounds, or Subscribers of Five Guineas are Vice-Patrons.

2. The Property of the Hospital shall be vested in three Trustees, for the use of the Institution.

3. Annual Subscribers of One Guinea and upwards shall be Governors, during the continuance of their Subscriptions, with One Vote at all General Meetings and Elections, for each Guinea annually subscribed. *

4. Subscribers shall be entitled to recommend One In-Patient or Three Out-Patients each Year, for every Guinea annually subscribed, (see rule 21.) An Out-

* Subscriptions are due on the 1st January in every Year.

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Patient may be recommended at once by a Donor of Half a Guinea, for that special case.

5. Persons making, or having made, a Donation of Twenty-five Pounds to the Hospital shall be entitled to the same privileges of recommending Patients as Annual Subscribers of Two Guineas: and so on in proportion for every Donation of Twenty-Five Pounds: and those persons giving Donations and Subscriptions shall have a right to recommend in respect of both.

6. The Chairman pro tempore of the Board of Guardians of any Union, which subscribes annually, shall have the same rights of recommendation, as are allowed to Subscribers of a similar amount: and Collectors of £2. 12. 6. shall be entitled to recommend One In-Patient, or Three Out-Patients, from the Parish in which the collection is made: and so on for every £2. 12. 6. collected. Such privileges to continue for one year from the time of payment to the Treasurer.

7. The twelve Elected Members of the Committee of Management shall be chosen annually at an Anniversary Meeting of the Governors: – the Members to be capable of re-election, provided that one-third be new Members.

Any intermediate vacancies, occurring from death or resignation, are to be filled up by the Committee.

8. A General Anniversary Meeting of the Governors shall be held Yearly in the first fortnight of January: – the accounts of the Institution shall be made up to the 31st December inclusive, and audited previous to the Meeting by two Auditors, appointed the preceding year for that purpose: – a Report from the Committee of Management shall be read, containing an Abstract of their proceedings for the past year,

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with the number of Patients admitted and discharged, an account of the Funds, and the general state of the Hospital. The Election of the Committee of Management shall then take place and such vacancies as may occur in the other Honorary Offices of the Institution be filled up.

9. An Extraordinary General Meeting of the Governors may be called at any time, for any special purpose, by the Committee of Management, or by a Requisition from twelve Governors, after ten days’ notice.

10. No Patient, either In or Out, shall remain on the books longer than two calendar months, without a fresh Ticket of recommendation.

11. The Medical Officers of the Hospital shall be a Physician, two surgeons, and a House-Apothecary: and, if it be deemed expedient, a Consulting Physician, and a Consulting Surgeon.

12. The services of the Physicians and Surgeons of this Hospital shall be gratuitous.

13. Candidates for the office for Physician, Surgeon, and House-Apothecary shall produce, (if required,) satisfactory Testimonials of their moral character, and of their professional skill and qualification. Every Candidate for the office of Physician must have taken his regular professional Degree in some University of the United Kingdom, or be a Fellow, or Licentiate, of the College of Physicians. Every candidate for the office of Surgeon must be a Member of the College of Surgeons of London, Edinburgh, or Dublin.  Every Candidate for the office of House-Apothecary must be unmarried, and a Member of the Royal College of Surgeons of London, Edinburgh or Dublin ,and a Licentiate of the Apothecaries’ Company.  He must bind himself in writing to remain for three years in his situation, if his discharge of the duties should be

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so long satisfactory to the Committee: and also to give three months’ notice previous to his resignation.

14. In the event of the death or resignation of a Physician or Surgeon, or of a Consulting Physician, or Consulting Surgeon, the Committee of Management shall give notice of the Vacancy, and shall call a General Meeting of the Governors, to consider the expediency of filling up such Vacancy. Such Meeting to be held within a fortnight after the Vacancy occurs.

15. At all Elections, for the offices of Physician, Surgeon and House-Apothecary, the Votes of Governors shall be taken by signed* Polling Papers, and delivered to a General Meeting by some Governor present.

16. The Consulting Physician and the Consulting surgeon shall be appointed at a General Meeting of the Governors, to be convened after ten days’ notice in the public Papers for such purpose.

17. The Physician and Surgeons shall be entitled to the same privileges as Subscribers of One Guinea, whether they be actual Subscribers or not.

18. In case any Medical Officer of the Hospital shall wilfully absent himself from his duties, or shall be found incapable of discharging them, or shall in any way misconduct himself, the Committee of Management shall be empowered to call a General Meeting of the Governors, to consider the propriety of removing him from his situation, and of appointing a successor. But no Resolution recommending the removal of any Medical Officer shall be deemed to be carried, unless three-fourths of the Governors present shall be in favour of the measure.

* Bodies Corporate, Parishes, and other public bodies may vote by signature of their recognised Officers: and partnerships by that of one or more of the Firm.

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19. The House-Apothecary shall be appointed by the Governors, and have his Board, Lodging, and Washing in Hospital.

20. The Matron shall be appointed by the Committee of Management, and have her Board, Lodging, and Washing in the Hospital.

21. No Governor shall vote at any General Meeting or Election, or be qualified to recommend a Patient, who shall not have been a Governor one month, and whose Annual Subscription for the current Year, together with all arrears, shall not have been paid at the time of such Meeting or Election. Nor shall any Subscriber whose Annual Subscription for the current Year, together with all arrears, shall not have been paid, be allowed to recommend Patients.

22. No General Rule of the Hospital shall be altered, suspended, or annulled, except at a General Meeting of the Governors, duly convened after ten days’ notice. But the Committee of Management shall have the power of making and enforcing Bye-Laws for the Regulation of the Institution, provided that they be not inconsistent with the General Rules.

Powers and Duties of the Committee of Management.

23. The Committee of Management (of whom three shall form a Quorum) shall meet at the Hospital every THURSDAY, at Twelve o’clock.

24. They shall then appoint one or more of their Members Visitor, or a Visiting Sub-Committee, for the ensuing week – to attend on Monday mornings for the purpose of ordering what applicants are to be written for, – to inspect the Hospital at uncertain times,- to enquire into the Conduct of Patients and Servants, – to enforce attention to the Rules and Orders of the Hospital, and to report to the Committee. The Committee are empowered to employ a Clerk at a Salary of £15 per annum.

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25. (i.) The House-Apothecary may be suspended from discharging his duties in the Hospital by the Committee of Management (provided that two-third of the Committee shall so determine), until a General Meeting of the Governors, which shall be convened by the Committee within a fortnight, to take the subject of his dismissal into consideration.

(ii.) The Matron, Nurses and Servants may be appointed or removed by a majority of the Committee.

(iii.) The Committee of Management shall have the power of excluding any pupil from attendance at the Hospital for ill-behaviour, or any immoral or improper conduct.

26. The Committee of Management shall from time to time draw up Bye-Laws for the Government of the House, for the Order of Business on the days of Meeting, and for the Guidance of the Sub-Committees, and shall take care that the same be uniformly observed.

Rules for the Visitors.

27. The visitors shall visit the Wards and every part of the Building at least once a week, and more enquiries as to the conduct of the different officers, Nurses, Servants, the treatment and behaviour of the Patients, and all other such matters as they may think necessary: and they shall enter their report in a book to be kept for that purpose, and this report shall be read at the following Meeting of the Committee of Management: and all other Members of the Committee are requested to visit and inspect the Hospital, as often as is convenient to them, and to make their observations in the Report Book.

Rules for the Chaplain and provisions for other Religious attendance.

28. The Chaplain, or his licensed Curate, shall reside within the walls of the Hospital, but the Resident Clergyman shall not be restricted from the performance of such other occasional services as do not interfere with his duties in the Hospital.

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The appointment of the Chaplain shall be vested in the Committee, subject to the approbation and confirmation of the Bishop. He shall give the Committee three months’ notice of his intention to relinquish the duties of his office. A Book shall be kept for him to enter any remarks that may occur to him in the performance of his duties.

29. He shall perform the following public Services in the Chapel.
On every Sunday Morning (except the third Sunday in the month) at Ten o’clock, the Ordinary Daily Service, together with the Epistle and Gospel, but without either Litany or Sermon.
On Sunday Afternoon at Two o’clock, the Evening Service together with a Sermon.
On Wednesdays and Fridays at Ten o’clock, the Litany only.
On every Morning and Evening a Service of Family Prayers, (to be selected only from the Book of Common Prayer,) at half-past Nine A.M and Seven P.M.
On the Morning of the third Sunday in every month, The Holy Sacrament of the Lord’s Supper to be administered, and the whole of the ordinary Communion Service to be read.

30. At all such other times as are necessary and as he sees fit, he shall administer the consolations of Religion to the sick and dying, conforming himself all things to the Laws and Bye-Laws of the Hospital.

31. The Clergyman of any Parish may visit a Parishioner, entering his name, and that of his Parishioner in the Visitor’s Book.

32. Any Patient not a Member of the Established Church of England, may upon special request made by him or her to the Nurse of the Ward, who shall signify the same to the Matron or House Surgeon, be attended by any licensed Minister of his or her own persuasion; but such Minister shall alone communicate with the patient sending for him, and every

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Minister so officiating shall, previously to seeing the Applicant Patient, enter his name, residence, and denomination, the day of his attendance, and the name of the patient to be visited, in the Visitor’s Book.

33. No Books or Publications shall at any time be admitted into the Hospital, either by the Patients or any other persons without the permission of the Chaplain, except devotional Books for any Patient upon his or her request, such Books to be used solely by the Patient making the application.

The Auditors.

34. The Auditors shall examine the Accounts once every Quarter, and report the result of their examination to the Committee on the next Board Day, and they shall Audit the Treasurer’s Statement on some day in the week previous to the Annual General Meeting.

The Treasurer.

35. He shall keep all accounts and pay all Cheque signed by the Chairman of the Committee; he shall furnish Auditors with an Annual Statement of the Accounts for the General Meeting, and he shall aid the Auditors and the Finance Committee in their several duties, and shall be an ex-officio Member of such Committee.
36. The Charity Box shall be opened by the Treasurer at the first Committee Meeting in every Month.

Of the Admission and Discharge of Patients.

37. Thursday shall be the day appointed in every week for the admission of both In and Out-Patients, and for the discharge of In-Patients; who are not, however, expected to leave the Hospital till the following Saturday, and their vacancies shall not be filled up till the following Thursday.

38. Any Subscriber wishing to obtain admission for an In-Patient, (except in cases of accident or

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emergency), is required to forward to the House Apothecary, an account of the case, drawn up, if possible, by some Medical Gentleman, in order that an answer may be returned as to whether, and when, such Patient can be received.

N.B. The House-Apothecary is to enclose in every reply, which notifies the probably admission of the Patient, one of the printed Tickets.

39. Patients shall be admitted only by Tickets of Recommendation from Subscribers or Donors, on Thursdays, between the hours of Ten and Twelve:- except in cases of emergency, which may be admitted at any time by Tickets, or in cases of severe Accident which may be admitted at any time without Tickets.

40. All Candidates for admission, bringing proper Tickets of recommendation, shall attend at the Hospital on Thursday mornings, between the hours of Ten and Eleven, in order that the Medical Gentlemen present may examine them and report to the Committee of Management, with whom it shall rest to determine whether they are fit objects, and whether they shall be received as In or Out Patients.

41. Such persons only as are in Indigent circumstances shall be considered as proper objects to be admitted In-Patients; but preference shall be given to those who do not receive Parochial Relief.

42. The Out-Patients shall be confined to persons in indigent circumstance, not receiving Parochial Relief, in connection with Medical-attendance.

43. The Committee of Management shall be careful not to admit to retain as In-Patients any persons, who,

* No cases are admitted with Tickets which have received Medical attendance, or been carried to their own houses, subsequently to the accident.

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in the opinion of the Medical Officers, are likely to receive equal relief as Out-Patients.

44. No children under eight years of age, (except in cases where an operation is necessary), nor pregnant women, nor persons of unsound mind, or subject to violent fits, or who have the small pox, scarlet fever, measles, syphilis, confirmed consumption, old ulcers, or any infectious disorders, shall be admitted In-Patients.

45. Household Servants shall only be admitted In-Patients, on payment of Seven Shillings per week for their board, and they shall never be allowed to be Out-Patients.* This rule will not, however, apply to a case in which a satisfactory assurance should be given to the Committee, that the Master or Mistress, in whose house he applicant is living, are incapable of meeting the Medical expenses of the applicant.

46. Every In-Patient shall be sent into the Hospital in decent Clothing, and with a proper change of Linen.

47. Every In-Patient upon admittance to this Hospital, (except in cases of accident or emergency), shall deposit Two Pounds in the hands of the Treasurer, or bring security from some substantial person, to defray the expenses of removal or burial.

Every Out-Patient shall deposit on admittance to the Hospital, the sum of One Shilling in the hands of the House-Apothecary, to be returned on his or her discharge.

48. When there shall be want of room for all duly recommended and qualified Patients, preference shall be given first, to those cases which admit of least delay; secondly, in case of equal exigency, to those from the greatest distance.

49. Patients duly recommended and qualified, who

* Extraction of Teeth is permitted gratuitously to all applicants.

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cannot be admitted into the Hospital for want of room, may be in the meantime treated as Out-Patients.

50. In all cases, where a Patient cannot be admitted, either from want of room, or from the case being considered improper according to the Rules, a letter, signed by the Chairman of the Committee, shall be sent to the Subscriber, who recommended him, stating the reason for his non-admission. And a similar notice shall be sent to the Subscriber, when a Patient is discharged for irregularity of conduct.

51. All Patients who shall be discharged cured or greatly relieved, shall be enjoined by the Chairman to return thanks to Almighty God in their respective places of Worship, and a printed form shall be given them at the time of their discharge, to be presented to their respective Ministers for that purpose.

Rules for the Physician and Surgeons, also of Medical Pupils and Professional Gentlemen.

52. The Physician shall attend at the Hospital every week, and the Surgeons in weekly rotation, on Thursdays, at Eleven A. M. to examine the persons, who may be recommended as Patients; and those Patients and all others, who may be admitted, on account of accident or emergency, previous to the next receiving day, shall be under the care of the Physician, if the case be Medical; or under the care of the receiving Surgeon of the succeeding Thursday, if the case be Surgical; or under the united care of the Physicians and Surgeon, if the case be of a mixed nature. The beds are to be appropriated amongst the Medical Officers, in such proportions as shall, from time to time, seem fit to the Committee.

53. The Physician and Surgeons shall visit their respective Patients three times a week, on fixed days (before the hour of One, P. M. if practicable), and at other times, as often as they may severally deem it

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necessary, or shall receive notice from the House-Apothecary, that their Aid is required.

54. Any Physicians or Surgeon, whom illness or urgent engagements may oblige to be absent, shall engage one of the other Medical Officers of the Hospital to attend for him.

55. A general Consultation shall be held by the Physician and Surgeons of the Establishment, as often as they may consider it necessary, and always previous to the performance of any important Surgical operation, unless the urgency of the case render it impossible.

56. In all cases (except operations) where either the Surgeons requires a Consultation, it is to be had with the other Surgeons of the Establishment, previous to the Consulting Surgeon being called in.

57. The preceding rule shall apply also to the Physician, where the case is partly Surgical, (i.e.) in such case the Surgeons of the Hospital are to be consulted before the Consulting Surgeon is called in.

58. Whenever a Surgeon in charge of a case thinks it likely that an important Surgical operation may be necessary, one general Consultation shall (for sake of avoiding frequent painful examinations) be held with all the Physicians and Surgeons attached to the Hospital, previous to the operation being decided on.

59. Notice of the Consultation shall (see last rule) be sent to all the Medical Officers of the Hospital, when the Surgeon in charge of a case shall make a request to that effect in writing.

60. All important Surgical Operations shall be performed on a fixed day and hour every week, except in cases of accident or urgency.

Professional Gentlemen of the Town and Neighbourhood shall be permitted to attend at important opera-

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tions, but shall not be allowed to assist, except at the particular request of the operating Surgeon, and with the consent of the Medical Officers of the Institution present.  And any person present during an operation, but not actually engaged in it, shall observe strict silence, under the penalty of exclusion from the room.

61. When a Patient dies in the House of any unknown or uncommon complaint, the body may, with the consent of the Relatives, be examined, if his Physician or Surgeon shall deem it expedient. But in every such case, all the Medical Officers of the Institution shall be invited to attend: and no such examination shall take place without the presence of at least one of them, besides the House-Apothecary, who shall take minutes, of the Particulars of its appearance, and report the same to the next meeting of the Committee of Management, and give a Copy to the Relatives of the Deceased, if they shall desire it.

62. Any Medical Gentleman, though not a Governor or Officer of the Institution, shall be permitted to visit the Hospital, if accompanied by the Physician or one of the Surgeons of the Establishment, or by the House-Apothecary; but no person whatever shall give an opinion on any case, unless requested to do so by the Physician or Surgeon attending the Patient.

63. The Physician and Surgeons shall form a Medical Committee, and meet at the Hospital on the first Wednesday in every month, to enquire into the state of the Dispensary, inspect the Apothecary’s Books, and report to the Committee of Management what Drugs or Surgical Instruments, &c. they may find to be wanting: and no Instruments or Drugs whatever shall be obtained, except by their written order, countersigned by the Chairman of the Committee. The Medical Committee shall not be competent to act, unless two Members be present.

64. Medical Pupils shall be permitted to attend the practice of the Hospital, but shall give a Donation of Ten Pounds, or a Subscription of Two Guineas per

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annum to the Charity. Such Subscription not to entitle them to recommend Patients. But no such Donation or Subscription shall be required from the private Pupils of the Medical Officers of the Institution.  No Pupil, however, under penalty of exclusion, shall prescribe Medicines for the Patients, or apply or remove any local dressings, bandages, &c,. without the superintendence or direction of the Medical Officer in attendance.

65. Resident Apprentices may also be received into the Hospital, under the following conditions:-

i. That their Indentures shall contain be made to the Surgeons and House-Apothecary in their capacity of Medical Officers of the Hospital, and not in their character of private Practitioners.
ii. That the Indentures shall contain a provision (in the event of any Medical Officer vacating his office by resignation or otherwise) for the mutual release of such Medical Officer and the Pupil from the effect of the Indenture; and a further provision, enabling the successor of such Medical Officer by Postscript to, or Indorsement on such Indenture, to enter into similar relations with the Pupil in the place of his Predecessor.
iii. That the Governors of the Dorset County Hospital shall, by the Chairman of the Committee of Management, be parties to all such indentures, and shall bind themselves on the election of any surgeon or House-Apothecary to make it part of the condition of his election, that he shall stand in the same relation to the Pupils of the Dorset County Hospital that his predecessor would have done, if he had remained in that office.
iv. That whatever may be the premiums payable for such Pupils, the same shall be paid over at once to the Treasurer of the Hospital, to be placed to a separate account. That of every such premium the sum of £12. 10. 0. Shall be paid half-yearly in advance, to the maintenance fund of the Hospital, during the residence of the Pupil in the Hospital; that of the remainder, the proportions after-mentioned shall be paid over to the Medical Officers named in the Indentures, or their successors, viz; at the expiration of six months – of the first year, six-twentieths; of the second year, five-twentieths; of the third, fourth, and fifth years respectively, three-twentieths in each’ subject, however, to any proviso contained in the Indentures

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for the repayment of a proportion of the premium to the relatives of the Pupil, in the event of his dying, or otherwise determining the Apprenticeship. That, subject to this last provision, whatever part of any premium remain in the Treasurer’s hands, when the Pupil finally ceases to reside in the Hospital, shall be paid over to the then Surgeons, and House-Apothecary of the Hospital.

Rules for the House-Apothecary and Secretary.

66. The House-Apothecary shall not practice as Surgeon and Apothecary out of the House, nor attend to any other business than that of the Hospital.
67. He shall attend Divine Service whenever it is performed in the Hospital, except his presence in the Wards be absolutely necessary. He shall not be absent from the Hospital without acquainting the Matron where he may be found, and he shall not at any time be absent for more than three hours, without the consent of one of the Committee, (who shall previously make an entry of such permission in the Visitors’ Book), nor at any time when the Matron is absent. In all things he shall act under the direction of the Committee, and in conformity with the Bye-Laws, except in matters purely medical entrusted to him by the Medical Officers.
68. As Secretary he shall attend all Meeting of the Governors, and, whenever required, the Meetings of the Committee, and he shall keep an account of all such matters as are required of him by the Committee.

Rules for the Matron.

69. The Matron shall see that the Patients, Nurses and Servants do their duty and obey the Rules of the House, and in case of any misbehaviour either by absence without leave or otherwise, she shall acquaint the Committee or House Visitors therewith.
70. She shall never be absent for a day together without the permission of the Committee of Management, except in cases of extreme necessity, when leave may be given her by the Visiting Sub-Committee.
71. She shall attend Divine Service whenever it is performed in the Hospital, except she be detained from it by actual necessity.
72. She shall take care of all the Household goods and Furniture, and of all Provisions, and in all things she shall act under the direction of the Committee, and in conformity with the Laws and Bye-Laws of the Hospital.
73. She shall either read over herself, or appoint a person in each Ward to read over aloud, on every Friday morning, the Rules concerning the conduct of the Nurses, Servants, and Patients, and she shall take care that they are enforced.

Rules for Nurses and Servants.

74. The Nurses and other Servants shall be very diligent in complying with the orders of the Medical Officers and the Matron; they shall behave themselves with tenderness to the Patients, and with civility and respect to all strangers, and in all things conformably to the Laws and Bye-Laws of the Hospital.
75.The Nurses and Maid Servants shall not presume to go out of the Hospital on any account without the leave of the Matron; nor the Porter without the leave of the House-Apothecary, or in his absence, of the Matron, except he be sent out upon the business of the Hospital by any of the Officers of it; or by a Member of the Committee.

Of the Conduct and Attendance of Patients.

76. No In-Patients shall go out of the Hospital, without leave from their Physician or Surgeon, or in their absence, from the Apothecary; nor sleep out without authority from the Committee; and all who are capable of so doing, shall attend the Family Prayers and other Services of the Hospital, except they conscientiously object on the ground of their religious opinions and professions: and except their absence be sanctioned by the Chaplain or Committee.
77. They shall conform themselves to the Rules of the House, and, as far as they are able, assist the Nurses and Servants, and their fellow Patients in such matters as the House-Apothecary or the Matron require.

78. The Out-Patient shall attend regularly at the Hospital on the days, and precisely at the hours appointed: and if they absent themselves twice, without leave from their Physician or Surgeon, they shall be liable to be discharged.

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79. No Patient discharged for irregularity or misconduct shall be received again, unless by special consent of the Committee.

Of the Admission of Friends and Strangers.

80. No stranger shall be allowed to visit the Hospital without an order from the Committee of Management, or unless accompanied by some Governor, or by the House-Apothecary. And all Visitors shall be requested to enter their names, together with their observations on the state of the Institution, in a book kept for that purpose.

81. The friends of Patients shall be permitted to visit them at the Hospital, on Wednesdays and Saturdays, between the hours of Two and Four P.M provided the Medical Officer in attendance on each Patient do not consider it improper. But no person shall be allowed to visit them on other occasions, without an order from the House-Apothecary. (See the head “Chaplain.”)

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     The outer Gates of the Hospital are to be at all times kept locked, except the following, when they are to be left open for the convenience of Out-Patients, and friends of the In-Patients, On WEDNESDAY and SATURDAY, From a Quarter before Eleven, a.m. till Four p.m.
     No person in the Service of the Hospital shall at any time give to or take from any Tradesman, Servant, Patient, Stranger, or other person, any Fee, Reward, or Gratuity of any kind directly or indirectly for any service done or to be done on account of the Hospital.

 

 

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