Reports and papers on epidemic poliomyelitis.

Date:
1912
Catalogue details

Licence: In copyright

Credit: Reports and papers on epidemic poliomyelitis. Source: Wellcome Collection.

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    Copy of Memorandum on Acute Poliomyelitis. Circulated to Sanitary Authorities, December, 1911. This disease has long been known under the name “ Infantile paralysis ” as a form of paralysis of which sporadic cases occur, chiefly in children and less frequently in adults. In recent years it has occurred in epidemic form in America, in Australia, and in some parts of Europe. A number of local outbreaks have also occurred in this country. The virus of the disease has not been identified; but it passes through the finest filter; and the filtrate when inoculated into monkeys produces poliomyelitis in them. The virus attacks the nervous system, causing inflammation of the grey matter of the spinal cord, especially of its anterior cornua. Microscopically the characteristic lesions found are hyper-aemia, a well-marked exudation of lymphocytes around the blood vessels and degeneration of the large motor cells in the anterior horns. Less often the whole cord, grey and white matter, may become in- volved and a transverse myelitis result. In some cases the brain may be primarily or secondarily affected. Hence the suggested name of Polio-encephalo-myelitis. The meninges also may become implicated in the morbid process. The symptoms vary with the localization of the virus, and may be very diverse in character: in certain cases of the disease the difficulty of diagnosis is great. There is no characteristic skin eruption. Usually an initial febrile attack occurs, the temperature seldom rising above 102°- 103° Fah.: commonly there is malaise and drowsiness, accom- panied by headache and occasionally by vomiting: there may be nasal and pharyngeal catarrh. The patient is fretful, and objects to being moved. Rigidity of the muscles of the neck and spine frequently occurs and the head may be retracted: there may be pain or tenderness over the spine. Kernig’s sign is often present. Plantar, patellar or abdominal reflexes are commonly absent; the patellar reflex may, however, be exaggerated in the early stage. Paralysis, mainly of the flaccid type, supervenes shortly after the appearance of these primary symptoms. It affects one or more groups of muscles, especially of the limbs, but may involve any part of the muscular system. This is the common form of the disease, but occasionally a child may go to bed apparently well and be found in the morning to be suffering from paralysis. There is little difficulty in recognising the above forms of the disease. But apart from the above symptoms or in addition to them, there may be symptoms caused by implication of the medulla, brain, meninges or special nerves; and in such cases, especially when the meninges are implicated, confusion in the differential diagnosis between poliomyelitis and cerebro- spinal fever is apt to occur. The meningeal type may also be confused with tuberculous meningitis or septic meningitis. In such cases the previous medical history of the patient, and the
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