xii, B, 2 Proceedings of the Manila Medical Society 113 



regards these organisms as of secondary importance, playing 

 a role in poliomyelitis similar to those streptococci found in 

 scarlet fever, but which are not regarded as the cause of scarlet 

 fever. 



The examination of the spinal fluid in the early days of the 

 disease and especially before the onset of paralysis usually shows 

 an increased cell count with a low or normal globulin content. 



At this early stage the polymorphonuclear cells may amount 

 to 90 per cent of the total. Most specimens show lymphocytes 

 and large mononuclear cells almost exclusively. 



After the first two weeks the cell count drops to normal or 

 nearly so, and the globulin content is frequently increased. 



The examination reveals no specific diagnostic information, 

 but should nevertheless be made, as it is of value as an aid in 

 diagnosis. 



DISCUSSION 



Interest in the discussion centered chiefly in the reports of 

 other cases, which indicate that poliomyelitis is sporadic in the 

 Philippine Islands. Doctor Musgrave saw a case from Cebu in 

 1911 and reports a second case occurring about the same time 

 as Major Rutherford's. Doctor Saleeby has treated three cases 

 in the last five years. Doctor Reed believes that he has encoun- 

 tered several cases, one of them a Japanese child who was able 

 to walk about until five days before being paralyzed. Doctor 

 Reed calls attention to the fact that peripheral neuritis must 

 be considered in making a diagnosis of poliomyelitis in the 

 Philippines. Doctor Gonzalez reports four cases in his practice ; 

 he states that the paralysis associated with beriberi is never 

 as complete as that for poliomyelitis. Major Billingslea saw 

 two cases in the Philippines in 1908 with the typical flaccid 

 paralysis of poliomyelitis; the children were the offspring of 

 white men and native women. 



R. B. Gibson, 

 Editor of the Proceedings, 



Manila Medical Society. 



