July 21, 1916] 



SCIENCE 



79 



selves injure those sensitive parts. The 

 ideal means to accomplish this purpose is 

 through the employment of an immune 

 serum, since serums are among the least 

 injurious therapeutic agents. The only 

 drug which has shown any useful degree 

 of activity is hexamethylenamin which is 

 itself germicidal, and has the merit of en- 

 tering the membranes, as well as the sub- 

 stance of the spinal cord and brain in 

 which the virus is deposited. But experi- 

 ments on monkeys have shown this chemical 

 to be effective only very early in the course 

 of the inoculation and only in a part of the 

 animals treated. Efforts to modify and im- 

 prove this drug by chemical means have up 

 to the present been only partially success- 

 ful. The experiments have not yet reached 

 the point where the new drugs are applica- 

 ble to the treatment of human cases of in- 

 fantile paralysis. 



Practical Deductions and Applications 

 1. The chief mode of demonstrated con- 

 veyance of the virus is through the agency 

 of human beings. Whether still other 

 modes of dissemination exist is unknown. 

 According to our present knowledge, the 

 virus leaves the body in the secretions of 

 the nose and throat and in the discharges 

 from the intestines. The conveyers of the 

 virus include persons ill of infantile par- 

 alysis in any of its several forms and irre- 

 spective of whether they are paralyzed or 

 not, and such healthy persons who may 

 have become contaminated by attendance 

 on or association with the ill. How nu- 

 merous the latter class may be is unknown. 

 But all attendants on or associates of the 

 sick are suspect. These healthy carriers 

 rarely themselves fall ill of the disease; 

 they may, however, be the source of infec- 

 tion in others. On the other hand, the fact 

 that infantile paralysis is very rarely com- 

 municated in general hospitals to other per- 

 sons, whether doctors, nurses or patients, 



indicates that its spread is subject to ready 

 control under restricted and supervised 

 sanitary conditions. 



2. The chief means by which the secre- 

 tions of the nose and throat are dissemi- 

 nated are through the act of kissing, 

 coughing or sneezing. Hence during the 

 prevalence of an epidemic of infantile par- 

 alysis, care should be exercised to restrict 

 the distribution as far as possible through 

 these common means. Habits of self-denial, 

 care and cleanliness and consideration for 

 the public welfare can be made to go very 

 far in limiting the dangers from these 

 sources. 



Moreover, since the disease attacks by 

 preference young children and infants, in 

 whom the secretions from the nose and 

 mouth are wiped away by mother or nurse, 

 the fingers of these persons readily become 

 contaminated. Through attentions on other 

 children or the preparation of food which 

 may be contaminated, the virus may thus 

 be conveyed from the sick to the healthy. 

 The conditions which obtain in a house- 

 hold in which a mother waits on the sick 

 child and attends the other children are 

 directly contrasted with those existing in a 

 well-ordered hospital : the one is a menace, 

 the other a protection to the community. 

 Moreover, in homes the practise of carrying 

 small children about and comforting them 

 is the rule, through which not only the 

 hands, but other parts of the body and the 

 clothing of parents may become contami- 

 nated. 



3. Plies also often collect about the nose 

 and mouth of patients ill of infantile par- 

 alysis and feed on the secretions, and they 

 even gain access to the discharges from the 

 intestines in homes unprotected by screens. 

 This fact relates to the domestic fly, which, 

 becoming grossly contaminated with the 

 virus, may deposit it on the nose and mouth 

 of healthy persons, or upon food or eating 

 utensils. To what extent the biting stable 



