Excerpts from...
SEVENTH ANNUAL REPORT
OF THE
TRUSTEES, SUPERINTENDENT, AND TREASURER
OF THE
ILLINOIS STATE HOSPITAL FOR THE INSANE,
AT JACKSONVILLE
_______________

DECEMBER, 1860.

TABLE III.
Showing the supposed cause of insanity in the cases admitted.

Ill Health..........................................40 Puerperal........................................31 Vicious indulgences.......................26 Religious excitement.......................18 Business perplexities.....................15 Domestic trouble.............................14 Death of a friend............................14 Intemperance.................................13 Uterine disease..............................12 Over exertion.................................10 Popular delusions.............................9 Disppointed love ..............................6

Sun stroke.........................................5 Injury of head....................................5 Epilepsy.............................................4 Fright.................................................2 Old age..............................................2 Concussion of brain..........................2 Injury of spine................................... Use of tobacco................................. Hysteria.............................................1 Paralysis............................................1 No satisfactory cause given............91 Total...............................................323

APPENDIX.
BY-LAWS, GENERAL RULES, &c.

CHAPTER VI.
RESIDENT OFFICERS OF THE INSTITUTION.
   SECTION 1. The resident officers of the institution shall consist of the superintendent, assistant physicians, matron, clerk, and such supervisors as the wants of the institution may require. They shall reside in the institution, and devote themselves entirely to its interests.
   SEC. 2. The superintendent shall not resign his office without giving three months' notice in writing of such intent to the president of the board of trustees, and no subordinate officer shall resign without giving the superintendent similar notice.

CHAPTER VII.
SUPERINTENDENT.
   SECTION 1. The superintendent shall be the chief executive officer of the institution. He shall appoint and exercise entire official control over all subordinate officers and assistants in its service. He shall prescribe their several duties and see to their faithful performance. Under the direction of the trustees he shall institute such police regulations as the good order of the hospital requires; and he shall be responsible to the trustees for the care of all the buildings, grounds, stock, furniture and fixtures appertaining hereto. 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 keep himself fully advised of their condition, and to note the progress of each case, and shall give such directions to their supervisors and attendants as may be essential to meet the ends of their treatment.
   SEC. 2. He shall keep himself fully informed in regard to the laws of the state governing the admission of the patients, and shall use his powers respecting such admissions in strict conformity thereto, subject only to such modifications as the trustees may, from time to time, institute.

CHAPTER VIII.
ASSISTANT PHYSICIANS.
   SECTION 1. The assistant physicians shall prepare and superintend the administration of medicines. THey 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 andy cases of neglect or abuse that may come under their cognizance. They shall assist in devising employment and recreations for patients, and endeavor, in every way, to promote their comfort and recovery. They shall keep such records of cases as the superintendent may direct, and assist him in preparing statistics, conducting correspondence, and such other duties of his office as can properly be deputed.
   SEC. 2. In the absence of the superintendent, the assistant physician who is senior by appointment shall exercise the duties of his office, unless the trustees shall otherwise determine.

CHAPTER IX.
MATRON.
   SECTION 1. 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 enforcing good order, discipline and faithful performance of duty in her department, and shall immediately reprove, or report to the superintendent, andy material departure from rule, or anything censurable in moral deportment.
   SEC 2. The bedding, table linen, napkin and drapery furniture, carpets, table covers, and all similar property of the hospital, as well as the clothing of female patients, shall be under her care and supervision; and she shall see that it is ample in quantity, and of a kind proper for its designed use.
SEC. 3. She shall make daily inspection of the wards and rooms occupied by female patients, and shall visit the male wards as frequently as will satisfy he of the good order of the beds, table covers, towels and such other furniture as it is her province to supply and superintend.
   SEC. 4. The sick among the female patients shall be under her especial care, and she shall see that their wants are often attended to, and supplied with everything needful for their full comfort. In cases of death, after receiving the superintendent's directions, she shall see that the burial preparation is made with care and decency.
   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 shall fully satisfy herself that everything is being done by the attendants possible to promote recovery of those confided to them.

CHAPTER X.
ATTENDANTS AND ASSISTANTS - GENERAL RULES.
   SECTION 1. No person should engage in the service of the hospital who is not willing to exercise all his time, talent, and efforts in the discharge of his or her duties. Those employed will learn that character, proper deportment, and faithfulness to duty will alone keep them in the situation in which they are placed. The institution will deal in strict good faith with its employees, and will, as far as practicable, promote their true interests. It will expect, in return, prompt, faithful, and self-denying service. Duty will sometimes press hard on those employed; but those over-taxed will not be forgotten when pressing exigences are over.
   SEC. 2. No one can justly take offense when mildly informed by the superintendent that his or her temperament is better fitted to some other employment; and those thus told will have the opportunity to discontinue their service, by a proper notice and withdrawal.
   SEC. 3. Persons employed at the hospital will hold themselves in readiness for duty whenever directed by its officers. While for some hours no active duty may call for their attention, yet, at such times, they cannot hold themselves beyond prompt response should their services be required; and to neglect any laboring hours are over, or to hesitate, after proper direction, on such pretext, will stand as as objection to the fitness of the employee for the place he holds.
   SEC 4. Persons employed at this institution will remember that their duties are peculiar and confidential; that there is an obvious impropriety in disclosing the names, peculiarities, or acts of its inmates; and that, when abroad, strict silence should be observed regarding the institution, and all its affairs. They should not forget 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. Conversation in regard to the hospital should be studiously avoided in the many instances in which it will be sought by the idle and mischievous.
   SEC. 5. All employed should cultivate a calm and deliberate method of going about their daily duties, Carelessness and precipitation are, of all places, most to be avoided in an institution like this. Loud talking, hurrying up and down the stairs, rude forms of address to one another, unsightly styles of dress, &c., are wholly misplaced where every thing should be strictly decorus and orderly. Doors shutting with a spring lock should always be closed with the key. By this means the lock will be spared, and a great amount of unnecessary noise avoided.
   SEC. 6. No person will be employed in or about the institution, in any capacity, who is known to be a user of intoxicating drinks, or who engages in gambling, or any other immoral or disreputable practice.
   SEC. 7. Those who wish to deserve the confidence of the institution will do well to be careful observers of the Sabbath, by regular attendance on some place of public worship-those attending on the patients relieving each other by turns, on each alternate Sabbath. Attendance on the regular chapel service is especially enjoined.
   SEC. 8. In dealing with patients, the greatest care should be used that they be always treated with unvarying kindness. They should always be addressed in persuasive language-all authoritative expressions being strictly avoided, All threats, taunts or other kinds of abuse in language, are expressly prohibited; and no one will be retained in service who habitually indulges therein. A blow, kick, or any other form of physical abuse, inflicted on a patient, will be sufficient reason for the prompt dismissal of the individual so offending.
   SEC. 9. When a patient employed out of doors, either in exercise or labor, shall grow excited, ha shall immediately be returned to the ward from whence he was taken, and the fact reported at the office.
   SEC 10. When a patient is taken from the wards, for labor or exercise, the person taking such patient out will always be responsible for his or her safe return, unless, by the direction of an officer, such patient is transferred to the charge of some other person.
   SEC 11. The two divisions of the institution shall always be separate to its employees; and no person, whose post of duty is exclusively in the one, shall ever be found in the other, unless some express and proper occasion shall demand it.
   SEC 12. Any person who shall encourage, or discover without disclosure, an acquaintance between two patients of opposite sex, will be held highly culpable for such misdemeanor.
   SEC 13. It shall be strictly duty, on the part of every person employed, to check, do far as possible, all conversation, or allusions, on the part of patients, to subjects of an obscene or improper nature and false impressions on the minds of patients respecting their confinement or management should be removed whenever possible. Any person discovering that a patient is devising plans for escape, suicide, or violence to others, should report it to an officer without delay.
   SEC 14. No employee of the institution shall every engage the services of any patient in the performance of any labor for him or herself without the consent of the superintendent or matron; and any permission granted shall extend no further than the single instance specified in the request.
   SEC 15. No person employed shall ever make any bargain with any patient, or accept any gratuity or present from any patient, or his or her friends, without the superintendent's consent; and any employee will be placed under the severest penalties who shall connive at the escape of a patient, or assist in any clandestine correspondence, or in any way conspire with any patient in acts counter to the purposes of the institution or the patient;s true well-being.