CHAPTER XLIX 



ACUTE ANTERIOR POLIOMYELITIS 



The disease known as acute anterior poliomyelitis has long been 

 recognized as an acute infectious condition, both because of the charac- 

 teristics of its clinical manifestations and of its epidemic occurrence. 

 For these reasons it was classified with acute infectious diseases by 

 Marie and by Striimpell long before any experimental evidence of in- 

 fection was obtainable. 



Its contagiousness, while not a proven fact, seemed very likely from 

 the evidence of its mode of spreading and has been removed from the 

 sphere of mere conjecture by the careful study of a Swedish epidemic, 

 comprising one thousand cases, made by Wickman.' 



While acute anterior poliomyelitis is almost exclusively a disease of 

 childhood, it is assumed by clinicians that it is etiologically closely re- 

 lated to, possibly identical with, certain diseases of the adult, character- 

 ized by bulbar paralysis and acute encephalitis. Into this category, 

 also, some observers place the condition known as " Landry's paralysis." 

 The basis for the identification of these conditions with poliomyelitis 

 lies chiefly in the similarity of the pathological lesions and upon the 

 fact that the last-named diseases occur most often during the course of 

 poliomyelitis epidemics. 



In consequence of the emphatically expressed opinion as to the infec- 

 tious nature of acute poliomyelitis, the efforts to isolate specific micro- 

 organisms from cases have been many, and numerous microorganisms 

 have been described as the causative agents of this disease. The out- 

 come of all these investigations has been purely negative and the infec- 

 tious agent of acute poliomyelitis still remains undiscovered.^ 



An important advance in the study of this disease was made in 1908 

 when Landsteiner and Popper' succeeded in transmitting it to two 

 monkeys (Cyanocephalus hamadryas and Macacus rhesus) . The trans- 



1 Wichman, quoted from Landsteiner and Popper, Zeit. f. Imnmnitatsforch., ii, 

 1909. 



2 For literature, see Landsteiner and Popper, loc. cit. 



»Loe. cit. 



664 



