PROCEEDINGS 
OF THE 
NATIONAL ACADEMY OF SCIENCES 
Volume 6 MARCH 15, 1920 Number 3 
ENCEPHALITIS AND POLIOMYELITIS 
By Simon Flkxner 
Rockefeller Institute for Medical Research, New York 
Read before the Academy, November 10, 1919 
In 1916 there arose in Vienna and possibly in other places in the Austrian 
Empire, cases of a peculiar disease a prominent symptom of which is 
lethargy. Because of this feature, which amounts at times to a condition 
of profound and prolonged "sleepiness," the disease receives the popular 
name of sleeping sickness. And yet it was quickly recognized as being 
wholly distinct from the well-known African sleeping sickness, the inciting 
microorganism of which is a trypanosome. 
The structural or histologic basis of the Austrian disease is an inflamma- 
tion, chiefly located in the gray matter of the base of the brain, or tech- 
nically an encephalitis. Because of the peculiar symptoms and of the 
lesions, von Economo of Vienna who first described the disease gave it the 
name of lethargic encephalitis. 
About two years later, that is, in 1918, outbreaks of the same disease 
were reported from England and France. A little later the disease appeared 
in the United States, and published reports now indicate that it has a 
wide distribution over the world. 
The total number of cases which have been observed and reported now 
run into the hundreds. Indeed, some writers prefer to call the disease 
"epidemic encephalitis." Up to the present time no great epidemic 
outbreak has been reported. However, the conditions with reference to 
the disease are more or less disquieting. 
It is interesting to note that when the disease was first recognized in 
Vienna, it was supposed to be a form of food (sausage) poisoning; and the 
early cases in England were attributed to botulism. This mistake is 
quite explicable: among the prominent symptoms are paralyses of the 
ocular and facial muscles, which arise also in food poisoning. Because 
of war conditions, both the countries mentioned were using preserved foods 
to an unusual degree; hence the inference. 
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