INFANTILE PARALYSIS


INFANTILE PARALYSIS.
  [Read before the Annual Meeting of The International Hahnemannian Association, Philad…


  [Read before the Annual Meeting of The International Hahnemannian Association, Philadelphia, July, 1926.].

Acute poliomyelitis, also called infantile paralysis, regressive paralysis, or acute atrophic paralysis, is an acute in infectious disease affecting mainly children under five years of age, It is caused by a filterable virus which attacks the central nervous system, the parenchymatous organs and the lymphoid tissues. The most prominent symptom of the disease is a rapidly developing flaccid paralysis which improves after two or three weeks, leaving as a rule a few muscles permanently paralyzed. These last muscles undergo rapid atrophy.

The disease occurs sporadically and in epidemics, and during the last twenty-five years the epidemics have increased in frequency and severity. In 1909 Landsteiner and Popper succeeded in innoculating the disease in monkeys by intra-abdominal injections of a bacterium-free emulsion from a boy who had died from the disease. Other workers confirmed these observations, notable among them Flexner. I shall quote in substance from his writings for paragraph or two.

The virus or microbic agent consists of minute globules, capable of being viewed under the high powers of microscope. It is carried by persons, not insects. Animals, except monkeys, do not seem to be susceptible to the virus, and are therefore only passive carries. This virus is not injured by a 5-10 cent. solution of carbolic acid or freezing. It is more sensitive to heat, and can be destroyed in one-half hour by a temperature of 40-50 degrees C. Hydrogen peroxide in a 2 per cent. solution also kills it, as do also menthol and bichloride of mercury. When enclosed in an albuminous envelope, it will withstand drying for several weeks and therefore saliva or nasal mucus can convey the infection by means of a spray produced by a cough, sneeze or loud conversation.

Careful investigation points almost conclusively to the upper respiratory tract as the site of the ingress and egress of the virus. The lymphatics of the nasal mucosa are in almost direct connection with the sub-arachnoid space; they pass with the filaments of he olfactory nerve through the cribriform plate of the ethmoid bone.

The virus of poliomyelitis has been demonstrated in the nasopharynx of infected monkeys and successful innoculation of monkeys by the virus has been done via the pharyngeal mucosa. Large quantities of the virus can be introduced into the stomach or duodenum without producing spinal paralysis if only peristalsis be preserved. In the nasal secretions the virus is extremely persistent.

It was found in a monkey five months after recovery, but it human beings it does not live so long. However, as long as it persists in one who has had an attack or in a passive carrier, that person is a menace to those around him. Ordinarily the disease is communicable for about six days before the development of an attack and ten days after the onset-that is, the period of incubation is usually from five to seven days. However, extremes of two days, and thirty days have reported.

Incidence.

The most susceptible age is the latter half of the second year, and 90 per cent. of cases are in children under five years, 95 per cent. in those under ten. However, no age is exempt; a case is on record of a child twelve days old, and another of a person forty-six years of age.

As a rule, epidemics occur in summer and early fall; that is, in warm weather, but sporadic cases are seen at any time of year. The disease seems to be independent of surroundings. It appears in the country as well as in city and attacks persons in good circumstances as often as those who are very poor-those in previous sound health as well as the more delicate. Dr.Erastus Case reported three case of poliomyelitis, all in persons of tuberculous inheritance, and he wondered if the disease were always dependent on a tubercular root.

Grace Stevens