When Drs. Billings and Hurd created a short pamphlet with suggestions for Boards of Hospital and Asylum Visitors (see last post), they were anxious to help these independent “eyes and ears” of the public understand what they should look for during their inspections. Though they urged these visitors not to come in with preconceived ideas or to be excessively judgmental, the doctors did urge them to take their responsibilities seriously and really look at conditions.
One detailed admonition was for visitors to “rub or press a surface [such as the tops of cabinets and shelves or the valves of fresh air registers] with the tips of the fingers, or with a white handkerchief,” to see whether the surface had been actually cleaned, rather than merely dusted. Visitors were to take note of odors and try to discover what caused them: “. . . iodoform or some other drug; to a recent discharge from the bowels; . . . or is it merely a vague, slightly dusty odor, which gives a sense of oppression, indicating insufficient ventilation?” The authors asked them to note whether rooms were neat and clean, if bedside tables were in the proper position, whether dishes or clothes were ever rinsed in the bathroom tubs, etc. First-time offenses should be brought to the attention of the superintendent so he could have a chance to correct them, rather than immediately to outside authorities.
When Billings and Hurd moved on specifically to asylums, their concern for the well-being of patients was evident. Many questions concerned attendants. Besides asking if they were well-trained, tactful, and respectful, the doctors asked: “Do they have the manner of nurses upon the sick, or of guards in a house of detention?”
The answer to this question would have likely made all the difference in the world to patients.