Acute poliomyelitis / by George Draper.

  • George Draper
Date:
1917
Catalogue details

Licence: Public Domain Mark

Credit: Acute poliomyelitis / by George Draper. Source: Wellcome Collection.

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    occurred between the previous evening and 1 A.M., when 320 cells were found. This patient received two doses of serum, 30 c.c. in all. The first treatment was not later than 7 hours after meningeal invasion. Case 42.—C. W. Boy. 41% years. Lawrence, L. I. September 6, 1916. Appetite poor but seemed to have no temperature. His bowels moved and he complained of no pain or other distress. His mother says he did not seem very ill during this period, though not quite himself. September 9, 1916. After eating tomatoes the child suffered an abrupt rise in temperature which has remained until he was seen by physician. September 10, 1916. Was seen by physician at noon. Temperature 103. Has vomited on three or four occasions after taking food. Bowels have been constipated. Has no cold in the head, cough, sore throat, pain in the chest, abdomen, or joints. He has had no earache. Mother thought the child favored his neck in movements. No history of a rise in temperature previous to 4 days ago. Physical examination shows temperature 103. Eyes, ears, nose and throat negative. Cervical glands normal. Neck slightly stiff and tender, cannot place chin on the chest. Suspension by head and buttocks shows the neck and back to be straight. Heart, lungs and abdomen normal. No paralyses are made out. Knee jerks are present. Kernig is absent. Spinal puncture, at 30 hours, 15 c.c. of cloudy fluid withdrawn. Cell count 280. No red cells. Globulin +. 5:c.c. of serum injected slowly. September 11,1916. ‘Temperature 104. Child had had a restless night. Has vomited incessantly. Bowels have not moved. Mother noticed much twitching of the eye, eyelids and hands; she thinks he is much worse. Physical examination shows the child looks worse, more toxic. Lips and tongue dry and cracked. Left eye seems to be turned slightly inward, although all movements of both eyes are obtainable. The neck is the same as on the last visit. Knee jerks very active. Kernig positive in both legs with pain. Paralyses other than the left external rectus are not present. Child is to be removed immediately to the hospital, and further serum treatment though indicated is postponed until his arrival there. A second dose of serum was given. Following this the patient became much worse, there being intense meningismus and opisthotonos. Child very toxic. Twenty-four hours after the second dose, the patient appeared to be going to die, but his condition changed and rapidly im- proved and he had a normal temperature in 5 days. There remained a weakness of the masseters and slight deglutition weakness. Discussion.—This patient seemed to become much worse following treatment, very toxic and showing intense meningismus. His ultimate recovery was good with slight weakness. The first treatment was about 30 hours following the second hump onset. The cells were then 280. *
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