ACUTE ANTERIOR POLIOMYELITIS 917 



recently recovered children into patients in early stages of the dis- 

 ease has recently been advocated and is though well of by a number 

 of observers. This work, however, has not reached completion and 

 final judgment must be withheld. 



Flexner and Amoss have paid particular attention to the problem 

 of passive immunization and found that in protecting monkeys if the 

 quantity of virus injected into the brain is not too great paralysis can 

 be prevented in some cases and delayed in others, by injecting the 

 serum of recovered monkeys into the subarachnoid space by lumbar 

 puncture. Immunizing sera cannot be produced by treatment of in- 

 susceptible animals with virus, but Flexner and his associates have 

 occasionally succeeded in immunizing actively by injecting, sub- 

 cutaneously, graded doses of crude virus. This method, however, is 

 not very useful, nor is it very safe since some of the animals 

 so treated do not develop a strong immunity and others may 

 become paralyzed. It appears, therefore, that the neutralizing 

 principle, whatever it may be, is present only in animals and man that 

 have recovered from actual infection, and the only method of passive 

 immunization or serum treatment, therefore, available at the present 

 time is that in which the blood serum of individuals who have re- 

 covered from an attack is used. 



Epidemiological Facts. To summarize the important epidemio- 

 logical facts in poliomyelitis we may say that the work of Flexner 

 and his group, as well as that of European workers, has shown that 

 the poliomyelitis virus is present in the mucous membranes of the 

 nose and throat, in the excretions from these membranes and in the 

 intestinal contents. It may also be present in the tonsils. It leaves 

 the infected body with the discharges from the nose and throat and the 

 intestines, and when swallowed from the throat can pass into the 

 intestines, resisting the action of the gastric and intestinal secretions. 

 Flexner, Clarke and Dochez 14 have injected monkeys with filtrates 

 from washings of the intestines after feeding monkeys with spinal 

 cord material from infected monkeys and taking the intestinal fluid 

 two hours after feeding. Outside the human body the virus probably 

 can survive for some time, though the exact period is not known. 

 Neustaedter and Thro 15 claim to have been successful in infecting 

 monkeys with dust taken from a sick room. 



14 Flexner, Clarke and Dochez, Journ. A. M. A., vol. 59, 1912. 



15 Neustaedter and Thro, N. Y. Med. Journal, 94, 1911, p. 613, 813. 



