BRONCHIAL ASTHMA AS A PHENOMENON OF ANAPHYLAXIS
Authors: S. J. MELTZER
Journal: JAMA (1910)

the majority of my cases to see such satisfactory results effected.In the other case the child was placed by the nurse on the Steps on a hot summer day and fell asleep; and when the nurse came to it again the child had no use of its lower limbs, but had not lost consciousness, had no mental Impair¬ ment, and no evidences of anything else except the involve¬ ment of the anterior horns of the spinal cord.That child recovered, and that is all the recoveries out of a good many ' cases that I might record.Notwithstanding the microbio invasion in poliomyelitis '••ufa, we generally believe that its attack is somewhat similar to that of pneumonia.Now the common impression is that the pneumonia develops the chill.My impression is that the chill permits the microbio invasion, and then we have the work done by the pneumococcus in pneumonia and the infective agent in this essential paralysis of children thus gets 111 its damaging work.Dk. H. E. Robertson, Minneapolis: In regard to the involve¬ ment of the pin mater I am unable to agree with the authori¬ ties who urge that such involvement is primary.I have always found the involvement, of the cord more marked in ftny particular region than that of the corresponding pía.The place of infection is the perivascular lymph-channels, extending to the interstitial portions of the gray matter of the "¡ord, and second, to the lymph-channels in the pia mater, and even to tlie gray and white matter of the posterior columns.Du. David Sn' .vuu,Pittsburg: My paper was intended as a review of the literature of the present-day surgical treatment of this affection.Regarding Dr. Hammond's results, cited by ])l'.Fry, one would naturally expect relapse, because, while muscular tissue was present, it was not sufficient to meet the demands of functional use.In such cases some procedure is obviously required to decrease the amount of work de¬ manded of the muscles, as for example, arthrodesis.A'i unusual amount of patience is required in dealing with «'ese cases. 1 mentioned several procedures which seem to me of distinct, yalue and I wish again to emphasize them.My f"'at point is that in a drop-foot, for example, it is obviously °f much greater value, early in the treatment, to fix the foot by taking out a skin flap or by making an artificial ligament, Which does not interfere with any subsequent operation, I ban to fix it with a brace', because the brace not only interferesWith the function of the part but its daily removal is a dis- "ilvantage; the part must be retained constantly in the Position of maximum relaxation, if a return of power in t'e weakened muselés is to be secured.The second point is t'iat in e\c,y (.lls0 deformity must be overcome a long time pfore any operation for the restoration of function is at¬ tempted.'Usually when the patient consults the surgeon, *0,>ie operation like nerve anastomosis or tendon transplanta-!i'°" is at once proposed, instead of preliminary treatment, "e'fg instituted to determine accurately the degree und the £xtcnt of the paralysis and to put the part in the most.'«vorable condition for such operation, if such preliminary 1"' ;l 1 men!, is carefully carried out, I am sure our results will fi very much more favorable.