CHAPTER VI 

 ACUTE ANTERIOR POLIOMYELITIS 



Acute anterior poliomyelitis, atrophic spinal paralysis, infantile 

 palsy, "spinale Kinderlahmung," is an acute infectious disease, 

 largely confined to the first three years of life, and characterized by 

 fever, destruction of cells in the gray matter of the central nervous 

 system, palsy and rapid atrophy of the palsied muscles. It is of 

 sporadic and occasionally of epidemic occurrence in all parts of the 

 world. Although infectious, its transmissibility is so slight as to 

 make contagiousness a matter of doubt. 



The essential cause is in doubt, though it is possible that it is a 

 minute coccoid organism that may be capable of artificial cultivation. 

 It is certain that there is an infectious agent and that it is filterable 

 through the Berkefeld filters. Probably the best account of the 

 history and epidemiology of the disease has been compiled by 

 Wickman.* 



The disease was investigated bacteriologically by various workers, 

 and it went through the usual experience of having various micro- 

 organisms isolated and described, to be afterward abandoned as 

 accidental and unimportant agents. The modern studies of the sub- 

 ject, by modern methods of investigation, were begun by Landsteiner 

 and Popper.f Their method of procedure was to emulsify the 

 spinal cord of a fatal case of the disease, in a nine-year-old child, in 

 physiological salt solution, and inject it into the peritoneal cavities 

 of monkeys. One monkey became ill and died on the eighth day; 

 the other became paralyzed on the seventeenth day after the inocu- 

 lation. A similar emulsion of the cord of the paralyzed monkey 

 failed to infect other monkeys into which it was injected. Knopfel- 

 macher,t and Strauss and Huntoon§ were also able to infect one 

 monkey with human virus, but could carry the infection no further. 



Flexner and Lewis|| made careful experiments upon 8r monkeys 

 inoculated with the disease. They found the incubation period to 

 vary from 4 to 33 days, the average being g.82 days. During this 

 period there were prodromal symptoms such as nervousness and 

 excitability, fatigue, tremor of the face and limbs, shifting gaze 



* "Beitrage zur Kentniss der Heine-Medinisclien Krankheit," Berlin, 1907. 

 J Zeitschrift fiir Immunitatsforschung," 1909, 11, 377. 



I Med. Klin.," 1909, V, 1671. 



S __ New York Med. Jour.," 1910, xci, 64. 



II "Journal of the Amer. Med. Assoc," 1909, liii, 1639, and "Tour. Medical 

 Kesearch," 1910, xn, 227. 



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