Part 1

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RULES

AND

REGULATIONS

OF THE

INSANE ASYLUM OF CALIFORNIA.

PRESCRIBED BY THE RESIDENT PHYSICIAN, AUGUST 1, 1861.

STOCKTON: ARMOR & CLAYES, PRINTERS. 1861.

RESIDENT PHYSICIAN.

The Resident Physician, who shall also be the Superintendent, shall be the chief executive officer of the Asylum; he shall have the general superintendence of the buildings, grounds, and property, subject to the laws and regulations of the Trustees; he shall have the sole control and management of the patients; he shall ascertain their condition, daily prescribe their treatment, and adopt such sanitary measures as he may think best; he shall appoint, with the approval of the Trustees, so many attendants and assistants as he may think proper and necessary for the economical and efficient performance of the business of the Asylum, prescribe their several duties and places;--he shall, also, from time to time, give such orders and instructions as he may judge best calculated to insure good conduct, fidelity and economy in every department of labor and expense; and he is authorized and enjoined to maintain salutary discipline among all who are employed by the Institution, and uniform obedience to all the rules and regulations of the Asylum.--[_State Law of 1858._

ASSISTANT PHYSICIAN.

FIRST.

"The Assistant Physician shall perform" the "duties, and be subject to the responsibility of the Superintendent, in his sickness or absence, and" he "may call to his aid, for the time being, such medical assistance, as he may deem necessary"--"and perform such other duties as may be directed by the Superintendent and prescribed by the By-Laws."--[_State Law of 1858._

SECOND.

He shall prepare and superintend the administration of medicines, visit the wards frequently, and carefully note the condition and progress of individual cases; see that the directions of the Superintendent are faithfully executed, and promptly report any case of neglect or abuse that may come under his observation, or of which he may be informed.

THIRD.

He shall assist in devising employment and recreation for the patients, and endeavor in every way to promote their comfort and recovery; keep such records of cases as the Superintendent may direct, assist in preparing statistics, and conducting correspondence, and he shall perform such other duties of his office as properly belong thereto.

GENERAL RULES.

1. Persons employed in the service of the Asylum will learn that character, proper deportment, and faithfulness to duty, will alone keep them in the situations in which they are placed; and they should consider well, before entering upon service, whether they are prepared to devote all their time, talents, and efforts, in the discharge of the duties assigned to them. The Institution will deal in strict good faith with its employees, and it will expect, in return, prompt, faithful, and self-denying service.

2. No one can justly take offense when respectfully informed by the Superintendent, that his or her temperament is better adapted to some other employment; and those receiving such information should regard it as kindly given, that they may have opportunity to avoid the unpleasantness of being discharged.

3. Those employed at the Asylum be expected to hold themselves in readiness for duty when directed by its officers; and the neglect of any labor, or duty, on the ground that laboring hours are over, or to hesitate, after proper direction, on such pretexts, will be regarded as evidence against the fitness of the employee for the place he or she may hold.

4. It must be remembered by all the employees, that their duties are peculiar and confidential, and that there is an obvious impropriety in disclosing the names, peculiarities, or acts of the inmates. It should never be forgotten that the most cruel wounds may, by imprudent disclosures, be inflicted on those whose conduct and language, during their misfortune, should be covered with the veil of deepest secrecy. Conversations, in relation to the Asylum and its inmates, sought by the idle and mischievous, should be studiously avoided.

5. All persons employed in the Asylum are required to cultivate a calm and deliberate method of performing their daily duties--carelessness and precipitation being never more out of place than in an insane asylum. Loud talking, hurrying up and down stairs, rude forms of address to one another, and unsightly styles of dress, are wholly misplaced where everything should be strictly decorous and orderly.

6. In the management of patients, unvarying kindness must be strictly observed by all. When spoken to, mild, pleasant and persuasive language must never give place to authoritative expressions of any kind. All threats, taunts, or other kinds of abuse in language, are expressly forbidden. A blow, kick, or any other kind of physical abuse, inflicted on a patient, will be immediately followed by the dismissal of the person so offending.

7. Employees having charge of patients outside of the wards, whether for labor or exercise, will be held responsible for their safe return, unless, by the direction of an officer they shall be transferred to the charge of some other person; and when patients employed out of doors become excited, they must be immediately returned to the wards whence they were taken, and the fact reported at the office.

8. It will be expected of all employed in or about the Asylum, to check, as far as possible, all conversations or allusions, on the part of patients, to subjects of an obscene or improper nature, and remove, when in their power, false impressions on their minds, respecting their confinement or management; and any person who shall discover a patient devising plans for escape, suicide, or violence to others, is enjoined to report it to an officer without delay.

9. The place of duty of those having charge of patients is in the wards, or in the yards, or in the garden with the patients. During the day and while the patients are out of their sleeping apartments, they have no business in their rooms, except for a momentary errand to adjust their own clothing; and any employee who shall enter his or her room, and engage in reading, writing, entertaining visitors, or be otherwise off duty, will be acting in violation of rule.

10. The employees are not permitted to correspond with the friends of patients; and all letters or packages to, or from, patients, must pass through the hands of the Superintendent or Assistant Physician. All making of dresses, working of embroidery, or any mechanism, for the use of employees, is prohibited, unless by the special permission of the Superintendent; and no employee of the Institution shall ever make any bargain with any patient, or his or her friends, or accept of any fee, reward or gratuity from any patient, or his or her friends, without the Superintendent's consent.

11. Employees will not be permitted to leave the Asylum without the consent of the Superintendent or Assistant Physician, and, when allowed to leave, they will be expected to return by 9 o'clock P. M.--unless expressly permitted to remain out longer. Before leaving they must hang up their keys in the place, in the office, provided for that purpose. Non-residents will not be permitted to remain in the Institution at night without the knowledge and consent of the Superintendent or Assistant Physician.

12. No person will be employed in or about the Asylum who is intemperate in habits, or who engages in gambling or any other immoral or disreputable practice; and as the patients are not allowed the use of tobacco, within the Asylum, the employees are expected not to use it, in any form, in their presence.

13. While employees are not prohibited from _occasionally_ visiting each other in their wards, it should never become a habit, and the indulgence is only allowed in view of the spirit of emulation, which may thus be encouraged by sometimes inspecting each other's sphere of duty. When it is discovered that the permission is abused, or that visits are being spent in idle conversation, it will be held as a violation of rule.

14. The two departments of the Institution--male and female--must always be separate to its employees, and no person, whose post of duty is exclusively in the one, shall ever be permitted to enter the other, unless some express or proper occasion shall demand it; and any one who shall discover, and not disclose, or who shall in any way encourage, an acquaintance between two patients, of opposite sex, will be held highly culpable for such misdemeanor, and will be forthwith dismissed from service.

15. No employee will be permitted to appropriate to his or her use any article belonging to the Asylum, or purchased for the use of the patients, however small or comparatively valueless it may be. From the salary of the person so offending, the cost of the article will be deducted, and he or she dismissed from service.

STEWARD.

1. The Steward shall have a general oversight of the business of the farm, garden, grounds, fences and buildings; he shall assist in maintaining the police regulations of the Asylum, observe the deportment of those employed in subordinate positions, see that they do their duty, and report to the Superintendent any instance of neglect or misconduct, that he may observe, or of which he may be informed; he shall see to the opening and closing of the house; that the employees rise and commence their duties at the ringing of the bell, and return at proper season at night; that the bell is rung promptly at such hours as may be designated, from time to time, by the Superintendent. He shall have a general care of the male patients, see that they are kindly treated, that their clothes are taken care of, that their food is properly cooked, served and distributed, that the rooms, passages and other apartments are kept clean and properly warmed and ventilated, and that every thing pertaining to the Asylum property is kept in order and in good repair.

2. The Steward shall receive and store all provisions, fuel, clothing, etc. provided by contracts, and, also, all supplies purchased under the direction of the Superintendent, and he will be held responsible for the safe-keeping and economical distribution of the same.

3. He shall keep just, accurate and methodical accounts of all articles received, and all articles purchased by him, together with all distributions of supplies to the several departments of the Institution--each and every day's accounts exhibiting, in detail, the number, quantity weight or measurement, as the nature of the case may be, of each and every article received, and from whom, and distributed, and to whom.

4. On the receipt of supplies, whether obtained under contract, or purchased by order of the Superintendent, the Steward shall require a bill or invoice of the same, and if, upon a careful examination of the quality, quantity, weight or measurement of the article or articles, they shall be found to correspond with the item or items of the bill, he shall enter the aggregate amount, with the date and number of the invoice, in a book provided for that purpose, after which he shall endorse the bill _correct_, and file it, together with an abstract of his daily disbursements, in the office of the Superintendent.

5. The Steward will be expected to devote his whole time to the interests of the Institution, assist, in every way in his power, to preserve order in the house, and faithfulness among the employees, and see that all the rules and regulations of the Asylum are fully observed.

MATRON.

1. The Matron shall have charge of the female department of the Asylum. It will be expected of her to be with the female patients, in all the wards, as much as possible; see that they are kindly treated; that their food is properly cooked, served and distributed; that their apartments are kept clean and in good order, and properly warmed and ventilated; that the female employees attend to their duties in all respects, and report to the Superintendent any departure, on their part, from the rules and regulations of the Institution.

2. The bedding, table linen, napkins, and drapery furniture, carpets, table covers, and all similar property of the female department, as well as the clothing of the female patients, shall be under her general care and supervision. She shall direct the employment and amusements of all the inmates of the female wards; in short, it will be expected of her to look frequently and carefully into every interest connected with her department; and thus, by devoting her whole time to the Institution, aid in every way in her power, in securing the comfort and recovery of the patients, and the general welfare of the Asylum.

CLERK.

1. It shall be the duty of the Clerk to keep a correct account, in a book provided for that purpose, of all supplies received by the Steward under contract, or purchased by him under direction of the Superintendent. He shall keep a careful account of all articles used and consumed in the Asylum daily, and at the end of every month, he shall make an exhibit of the receipts, expenditures, and disbursements--arranging the different articles used under appropriate headings, that the actual cost and consumption of each article, for each day, shall be correctly shown. He shall keep the ASYLUM ACCOUNT, the PHYSICIANS' DWELLING ACCOUNT, the GARDEN ACCOUNT, the OFFICE ACCOUNT, the FARM ACCOUNT, and the IMPROVEMENT AND REPAIRS ACCOUNT, each separate and distinct from the other, and make out separate and distinct monthly exhibits of each. He shall also make out, in connection with the exhibits of the above accounts, a table showing the combined total cost per day, and the combined total cost per month, with an average cost per day; and the average cost of each patient per day, and the average cost of each patient per month, together with any other items that may be of interest and utility to the Asylum. He shall make out a table showing what bills are to be paid on the last month's expenditures, and, also, a table exhibiting the Superintendent's estimate for the expenditures of the ensuing month.

2. It shall be the duty of the Clerk to keep a correct account of the patients received--entering, at the time of their admission, in a book provided for the purpose, a condensed copy of each commitment, with the facts set forth in the certificate of the examining physicians accompanying the same. He shall also note, in the same connection, the condition of the patient, as found by the Superintendent or Assistant Physician, at the time of admission.

SUPERVISORS.

1. The Supervisors shall have a general oversight of the duties of the Attendants; they shall spend their time chiefly in the wards, and they shall see that the rules prescribing the duties of the Attendants, towards the patients, are faithfully observed, that the patients are well treated, and in all respects properly cared for; they shall, in an especial manner, have the oversight of the sick, and see that watchers are detailed for such as require it.

2. They shall have the care of the clothing of the patients, and the bedding, table linen, towels, etc., of their respective divisions. On the arrival of a patient at the Institution, whatever clothing is brought shall be committed immediately to the Supervisor of the division to which the patient is sent. A clothing account shall be opened for each patient, in a book provided for the purpose, in which shall be entered every article brought to the Institution, including what may be on the patient's person, and, also, whatever may afterwards be received or purchased for the patient's use.

3. Money, jewelry, or other valuables, shall be brought to the office for safe keeping--except where their retention by the patient is expressly permitted by the Superintendent or Assistant Physician. On the discharge, or removal, of a patient, the clothing in his or her possession, shall be carefully compared with the clothing account of said patient, that any losses may be discovered or accounted for.

4. The clothing belonging to the patients, in each division, shall be deposited in a room, set apart for the purpose, the key of which shall be in custody of the Supervisor, and, at some particular hour of the day, the Supervisors shall be in attendance in their respective clothing rooms, to exchange, or supply, such clothing as the wants of patients may require, and Attendants are enjoined, not to call on the Supervisors, for that purpose, at any other times, if avoidable. Clothing required for daily use, shall be kept in the ward closets.

5. The Supervisors shall have charge of the sewing rooms, and when any patient is in want of new clothing the fact shall be reported to the Supervisors, who will receive instructions from the Superintendent in regard to its supply. No clothing shall be purchased out of the Asylum, if it can be manufactured in the sewing rooms.

6. The Supervisors shall be careful that the clothing of patients is adapted to the season, and especially to see that patients are not suffered to go out, either for exercise or labor, without a careful inspection of what is worn.

7. All articles belonging to patients, shall be legibly marked, and the Supervisors are expected to see that the clothing of each patient is devoted to his or her use, and to the use of no other.

8. The Supervisors shall see that each patient is supplied with a full change of under clothing once a week, and that their outer clothing, and all bed clothing, is changed as often as their strict cleanliness shall require.

ATTENDANTS.

1. Those employed in the wards in the care of the patients, as their Attendants, should remember that their first duty is to treat them with unvarying kindness, respect and attention. Feelings of mutual good will, can, with few exceptions, be successfully cultivated between Attendants and those under their immediate care, and doubts may be justly entertained of an Attendant's fitness, when these are wanting.

2. The first effort on the part of an Attendant, on receiving a patient, should be to win his or her confidence, however insensible the patient may be to kindly advances. Patients generally enter the wards with the thorough conviction that evil is intended them, and the first show of harshness or force, however slight, will confirm that impression, while kind assurances, and manifestations of sympathy, quickly disarm them of their false impressions, and the first great step in the way of cure is begun. The Attendant should regard the patient as an honored guest, who comes, tarries for a short time, and goes on his way, to give to the world a good or evil report of his entertainer.

3. When a patient manifests opposition to the will of the Attendant, the point should never give rise to protracted discussion, as opposition may be only increased thereby. Patients will usually yield when mildly and kindly informed that they are only asked to comply with a rule binding on all, and that the request is not merely arbitrary. Whenever continued resistance is anticipated, it is better to yield the point to the patient, if the request made is one of no great importance, and report the case to the Superintendent or Assistant Physician.

4. The muffs, sleeves, wristbands, or other means of confinement, are never to be used unless by order of the Superintendent or Assistant Physician; and the Attendant shall never, under any circumstances, use greater force than is sufficient to secure the patient, himself, or others, from the efforts of his or her violence, and after the patient is secured in his or her room, the Superintendent or Assistant Physician shall be informed of what has occurred.

5. During the evening, after patients have retired, one Attendant or Assistant, shall always be present in each ward, to discover any disturbance, and administer to any necessity that may arise, and no Attendant shall ever leave the ward in which he or she is engaged, without informing an Assistant of his or her intended absence. During the day Attendants are expected to make the patients, and the patient's clothing, and sleeping apartments, the objects of their most careful attention.

6. On rising in the morning, Attendants shall see that the patients are properly dressed, washed, hair combed, and otherwise in good condition to appear at breakfast. The beds shall be made, rooms, halls, dining rooms, water closets and stair-ways put in good order by 9 o'clock, from April to September inclusively, and by 10 o'clock from October to March inclusively. All soiled clothing, bedding, etc., shall be taken from the building, at the earliest possible hour, before the air of the wards becomes contaminated thereby. A straw bed once soiled or wet, shall be immediately emptied and the tick sent to the laundry. The wards and stair-ways shall be washed and swept as often as necessary to secure perfect cleanliness. Attendants will be assisted by the patients in the discharge of these duties, but are themselves alone responsible for their prompt and faithful performance; when Attendants or Assistants are engaged with their patients in any kind of outside labor, they shall keep a correct account of the time of the patient employed, and report the same at the office at the close of every week.

7. Attendants, in this Institution, are considered the companions, not "keepers," of the patients, and, regarding themselves as such, they shall strive to keep every one, whose physical health will admit of it, engaged in some kind of amusement or employment in labor, as designated, from time to time, by the Superintendent, or Assistant Physician. The cultivation of fruits and flowers, the use of the library, reading room, gymnasium, bowling alleys, and other means for mental, moral and physical training, should be in every way encouraged.

8. The Attendants should see that the patients indulge in no pernicious practices; those given to solitary habits must receive special attention, and, as far as possible, induced to participate in the pursuits and amusements of others. Indolent patients should be led about the wards and yards, and induced to join in exercises; those, on the contrary, who are weak, and restless, should be induced to take repose.

9. Attendants are forbidden to make walking out with their patients a pretext for doing errands, or making calls for themselves, and they must not go to town with the patients, when the state of the roads and fields allow exercises in other directions, and they must be especially vigilant that patients, when out, do not obtain possession of any dangerous implements, matches, or other articles improper for them to have, and strict search must be made for such immediately on their return to the Asylum, and before they shall have time to secrete them in the wards.

10. On the morning of Wednesday and Saturday of every week, each patient shall receive a tepid bath, unless by reason of sickness or otherwise, exceptions shall be made by the Superintendent, or Assistant Physician; the male patients shall be shaven, and an inspection shall be made that their hair and nails may be suitably trimmed, and the person generally in cleanly condition. In trimming the hair, no more should be taken off than necessary to secure a better appearance of the patient--the practice, of cutting the hair of the insane close to the head, being positively forbidden, unless, for some special reason, it shall be so ordered by the Superintendent or Assistant Physician.