The Saint Paul globe., 1901-05-26
Medical Notes.


1t sometimes, though fortunately snol
often, happens that a child of from six
months to four years of age, suddenly
becomes paralyzed' in one or more limbs
without any apparent cause. rEe
natural conclusion of the friends and
parents is that the nurse has let the child
fall and thus injured its head or spine,
and. many trained nurse has had her
reputation ruined by such unjust CEN
sure.
Physicians attribute this sudden paral-
ysis TO an Inflammation of the anterior
horns Of the spinal cord, calling it tech
nically polio myelitis anterior acuta, but
tney are in the dark as to the cause of
the Inflammation. In some cases it
seems to be due to difficult tecthing; in
other cases it follows an attack of
scarlet fever, measles, and the like;
sometimes, but rarely, it may be- due to
an injury; but in all cases there seems
to be history Of sudden chilling, such
as might be due to exposure TO current
Of cold air lying or damp ground.
Whatever the cause it occurs most fire.
qucntly in the summer months or in the
autumn, but it is no respecter of sex
girls and boys are alike attacked, nor
is there any proof of hereditary trans
mission
Sometimes it is preceded by fever, and
perhaps delirium, but the fever is Of
short duration; perhaps only few
nours. and usually not more than one or
two days at most Sometimes the child
Is put to bed at night in comparative and
apparent good health, but taken up in
the morning paralyzed in one or more
limbs or perhaps the paralysis is not
noticed If the child is very young, until
some one remarks that 1t does not kick
as usual or use the hands freely
striking thing. too, about It is that the
paralysis is at its greatest extent at the
very outset; it occurs as quickly as the
lightning flash. Usually, too, it occurs
lii the legs, and if other members are in
VOWED IT creeps upwards attacking the
arms and sometimes, but not often, the
neck and chest. Usually it affects both
legs and both arms together, but some
uincs only one and sometimes only an
arm ard leg on one side.
Another peculiar phase of the disease
is that 1t Affects groups Of muscles when
nave the same action or act in concert.
"hlle other- muscles having an opposing
actlon may he left intact this peculiar
lty having marked influence in causing
the deformities which occur as result
OF ms disease. This is explained by the
lact that the cells of the spinal cord
overlap each other hut not regularly
named some of the cells controlling the
action certain muscles are rendered en-
! tlrCly poWerleSS while Others are onlv
partially aftected and monentarNy weak
AS the disease progresses action is re-
stored TO some Of the paraiy7t d muscles.
IN part. If not wholly, and the little
! patient improves more or less rapidly.
leading the parents to believe, falsely,
ened.
tnat the child will soon entirely recover
This phase gives the disease another of
lts names, that of regressive or receding
paralysis, but while it goes from bad to
better 1t seldom reaches the best again.
Inc permanently paTaIyzed muscles
soor become faccid. the so-caIled reac-
tiop Of degeneration sets in, the muscles
/ waste away and ares subject to a con-
tinuous twitehing, normal movement or
! use Of the muscles being. impossible The
bones, involved in the disease, become
/ friable and thin, while the Joints are
! loose and may even become like the
joint of fail, the limb hanging use
less and Topping about as If tied to the
! body with string. In extreme cases
! the legs become utterly~useless, so that
the poor child must creep about dragging
/ them after him like the legs of doll
and, II he chance to reach maturity. the
limbs still remain infantile in size and
form.
| The atrophy of the muscles leads to de-
formity, most commonly club-foot and
permanent bending OF the limb at the