Morning journal and courier., 1880-03-20
NIGHT MEDICAL SERVICE,

1l beVeral European citles 1s AOtk convenient and bensfeent. In this system the police stations are utilized as organizing csntsrs
 At each station register is kept in which all
 physicians within the limits of the precinct
 who are willing to pledge themselves to re- spond to calls at any hour of tho night upon
 the terms prescribed by the law enter their names and addresses. The candidates for registry must be medical men in good stand ing, regular graduates, and properly entitled to practice their profession but the service
 being public one no discrimination between
 schools of medicine is permissible. When a doctor is needed in the night application is
 made ct police station, where the applicant registers the name and address of the patient, and his own, with minute accuracy. A po- liceman is detailed as messenger, calls the nearest physician in the neighborhood of the patient, Cor any other on the precinct list, if so requested by ths applicant conducts him to the designated address, gives him printed form filled in with his (the physician's) name, the date of the visit, and the name and ad- dress of ths patient, duly signed and attested, and reports to the sergeant at the desk. This form, when presented by the physician, enti- ties him to specified fee from funds appro- priatsd for that purpose, whenever the pa tient is unable to pay; while if, though able, the patient evadss payment, ifs possession by the Board of Health, into whose custody it passes, is prima facie an evidence of indebt- edness, upon which the Board may take pro- ceedings if advisable. Lastly, if ths patient pays the fee, the form is surrendered to him as a receipt. Having given the case proper attention the physician fills up blank stating the age, sex, business of the patient, history and nature of the disease, and such other in formation as may be necessary to statistical fullness and accuracy. The Idea of this sys tenn seems to have originated ia Paris, but it was first put in operation in Berlin in 1872. In 1874 it wss adopted in St. Petersburg, in 1876 in Paris, and sinos then Moscow, Odes- sa, Warsaw, Rome, Milan, Turin and Lisbon have adopted the plan, while Lyons, Marseilles and Lille are about to adept it. It ia also in use in Algiers.
 The vnlue of such a medical ssrvieo is obvious. It is well knswn that the body is more likely to be attacked by disease in the night than in tho daytime, and that in epi- denaio diseases, levers, diarrhoea, dysentery, asthma, gout, croup, etc., the onset of the parexysm usually ooours during tho night. In cases of sudden attack, where time is of the highest importance, She nearest police station offers the readiess nsans of securing the imn sdiate services required. The police know what doctors are at home asd whore to find them, and no time Is lost in "falss mo fiTpe Tha MfAfSaf{ow 0f tha vice chow that the necessity to pass weeks in tho hospital Is often sverted hy the prompt response of ths night physician between the hours of and o'clock a. m, which are usually shs hsurs of attack. In Paris, from April to Sept. 30, the number of night wis its repaired has been, according to the latest returns, about 2,00O, or from nine to slsvsn per night. Ths diseases naturally group themselves into several classes, all distin- guished by alarming and urgent symptoms In the first class ars grouped all affections whose marked symptom is sufocation, such as angina, disease of the heart, pneumonia, pulmonary congestion, oroup and asthma; in the second, diseases whose predominating symptoms are abdominal, such as dysentsry, nephntis, collie, and strangulated hernia. The third class embraces hemorrhages of all kinds and types the fourth acute nervous troubles, such as oonvulsions, neuralgia and the various neuroses; the fifth, and ons of tho most ur- gent classes, embraces diseases whose pre- dominant symptom Is inssnsibilIty, such as cerebral congestion and apople1y. The sixth, seventh and eighth classes take in abortions accidents, and cases of poisoning. In all these groups the difference between life and death is often 8 question, not of hours, but of minutes, and the advantage of 8 syssemat- ic night medical service is very great.
 The cost of the system is in marked dispro- portion to its apparent value. The fees are fixed at moderate rates. In Paris the amount required to carry on the system for the first year was only 10, ,0oo francs. There were then 545 doctors in the night medical service There arc now 664, but ct no time have the annual expenditures added appreciably to the municipal budget
 Dr. Henri Nachtel, of Paris, Is now engaged in urging upon the medical men of New York city and Philadelphia She importance and ben eits of night medical service such ns is de- scribsd above. They are much interested in the subject, and it is possible that the system may be adopted in one or both of the cities named. It Is estimated that 1t can be carried out in New York city with an annual appro- priation not exceeding S1O.OOO.