July 21, 1916] 



SCIENCE 



81 



7. Of those who survive, a part make 

 complete recoveries, in which no crippling 

 whatever remains. This number is greater 

 than is usually supposed, because it in- 

 cludes not only the relatively large num- 

 ber of slight or abortive cases, but also a 

 considerable number of cases in which 

 more or less of paralysis was present at 

 one time. The disappearance of the paral- 

 ysis may be rapid or gradual — may be 

 complete in a few days or may require 

 several weeks or months. 



The remainder, and unfortunately not 

 a small number, suffer some degree of per- 

 manent crippling. But even in this class, 

 the extent to which recovery from the par- 

 alysis may occur is very great. In many 

 instances the residue of paralysis may be 

 so small as not seriously to hamper the 

 life activities of the individual; in others 

 in whom it is greater it may be relieved 

 or minimized by suitable orthopedic treat- 

 ment. But what it is imperative to keep 

 in mind is that the recovery of paralyzed 

 parts and the restoration of lost muscular 

 power and function is a process which ex- 

 tends over a long period of time — that is, 

 over months and even years. So that even 

 a severely paralyzed child who has made 

 little recovery of function by the time the 

 acute stage of the disease is over, may go 

 on gaining for weeks, months, and even 

 years until in the end he has regained a 

 large part of his losses. Fortunately, only 

 a very small number of the attacked are 

 left severely and helplessly crippled. 

 Lamentable as it is that even one should 

 be so affected, it is nevertheless a reassur- 

 ance to know that so many recover alto- 

 gether and so much of what appears to be 

 permanent paralysis disappears in time. 



There exists at present no safe method 

 of preventive inoculation or vaccination, 

 and no practicable method of specific treat- 

 ment. The prevention of the disease must 



be accomplished through general sanitary 

 means ; recovery from the disease is a spon- 

 taneous process which can be greatly as- 

 sisted by proper medical and surgical care. 

 Infantile paralysis is an infectious disease, 

 due to a definite and specific microorgan- 

 ism or virus; recovery is accomplished by 

 a process of immunization which takes 

 place during the acute period of the dis- 

 ease. The tendency of the disease is to- 

 ward recovery and it is chiefly or only 

 because the paralysis in some instances in- 

 volves those portions of the brain and 

 spinal cord which control respiration or 

 breathing and the heart's action, that 

 death results. 



Finally, it should be added that not 

 since 1907, at which time the great epi- 

 demic of infantile paralysis, or poliomye- 

 litis, appeared in this country, has the 

 country or this state or city been free of 

 the disease. Each summer since has seen 

 some degree of accession in the number 

 of the eases; the rapid rise in the number 

 of eases this year probably exceeds that of 

 any previous year. But it must be remem- 

 bered that in 1908 several thousand cases 

 occurred in the greater city — possibly in- 

 deed many cases of and deaths due to the 

 disease were never reported as such. 

 Hence the present experience, severe and 

 serious as it is, is not something new; the 

 disease has been severely epidemic before 

 and was brought under control. The 

 knowledge regarding it now is far greater 

 than it was in 1908 ; and the forces of the 

 city which are dealing with the epidemic 

 are probably better organized and in more 

 general cooperation than ever before. The 

 outlook, therefore, should not be regarded 

 as discouraging. 



Simon Flexner 



The Kockefelleb Institution foe 

 Medical Beseakch 



