ACUTE POLIOMYELITIS. 305 



opale&cenee also just appears in the immediate vicinity of the tissue and 

 then gradually disseminates throughout the medium. This condition soon 

 gives rise to macroscopically visible, grayish colored colonies. These colonies 

 may obtain the size of 3^ millimeter in diameter. In the cultivation of 

 the virus of Poliomyelitis ascitic fluid, fresh sterile tissue, anaerobic condi- 

 tions, and 37° C. are essential. Examination of these colonies under the 

 dark-field microscope revealed the presence of small globular bodies which 

 are often in pairs or small groups. The forms described by Flexnor and No- 

 guehi are .15 to .3 microns in diameter and are similar to the bodies found 

 by Noguchi in spinal cord obtained from eases of Poliomyelitis. Similar 

 bodieo were observed by these investigators and others by examining Berke- 

 field filterates of brain and spinal cord emulsions. The bodies stain with the 

 polychrome dyes, and Loffler's flagella and Gram's method is applicable. 



Infection of monkeys was obtained by injecting with the fifth, sixth, 

 and even the twentieth generation. From the infections thus produced true 

 poliomyelitis symptoms develop and the virus can be recultivated from such 

 culture infected animals, thus positively demonstrating the casual relation- 

 ship of this organism to the disease. However, the virulence of the organ- 

 ism is not well retained. Considerable difficulty is met with in inoculating 

 monkeys with material from human source. Several times monkeys were 

 inoculated with original human material without effect; likewise passage 

 of the virus from monkey to monkey failed. Levaditi calls attention to the 

 fact that the virus from sporadic cases is less virulent than the epidemic 

 form. Flexnor by continuous animal passage obtained a. so-called "Fixed- 

 virus" which would infect in a dilution of .001 cc. 



Because of the similarity between Rabies and Infantile paralysis it would 

 seem possible that "negri-like" bodies might be found. Bonhoff reports find- 

 ing small round or oval bodies having a diameter of about 2 microns, although 

 the size varies considerably in the nucleus of the neuroglia cells. According 

 to Bonhoff these bodies are specific for Poliomyelitis. 



The disease may present different clinical pictures, depending upon the 

 different parts of the central nervous system that may be attacked. The 

 disease, therefore, may be divided into several forms according to the parts 

 affected which are as follows: 1, the spmal; 2, the ascending or descending 

 Landry's type; 3, the bulbar, pontine, and midbrain; 4, cerebral; 5, the cere- 

 bellar (ataxic); 6, neuritic; 7, meningitic; and 8, abortive forms. 



Excluding the latter type because of lack of definite data, the spinal 

 form is most common. The symptoms of the disease may be of great va- 

 riety. Clean-cut cases will usually occur suddenly, often with fever (102- 

 103.5° F.), general weakness, gastro-intestinal trouble, vomiting, and severe 

 headache and pains in the neck, spine and extremities. 



Flexnor, Lewis, Levaditi, Landsteiner, Leiner'and Wiesner observed that 

 one attack of the disease usually brings about a condition of active immunity 

 and the insusceptibility thus conferred includes the various forms of the 

 disease. This has been demonstrated in monkeys and similar conclusions 



