The treatment of infantile paralysis / by Oskar Vulpius ; translated by A. H. Todd.

  • Vulpius, Oscar, 1867-1936.
Date:
1912
Catalogue details

Licence: Public Domain Mark

Credit: The treatment of infantile paralysis / by Oskar Vulpius ; translated by A. H. Todd. Source: Wellcome Collection.

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    larger and larger epidemics in our own country. The increasing frequency of the disease will tend to enlighten us concerning its aetiology, and ortho¬ paedists will vie with one another in investigating the diagnosis and the treatment of the malady. One very important fact that has recently come to light, as the result of carefully studying an epidemic, is that recorded by Medin, and later by Wickmann, in Sweden. These observers maintain that the cerebral and spinal palsies of children are really one and the same disease, differing only in the anatomical structure which they chance to affect. It would be well, therefore, to adopt some comprehensive name for the disease, but it is difficult to find one that satisfactorily describes its aetiology. Wickmann speaks of it as “ Heine-Medin’s disease,” and so pays a graceful tribute to the value of their researches. Krause prefers the name “ acute epidemic infantile paralysis,” describing the disease by its chief symptom. It may be that the condition with which we are concerned is only one of a group of epidemic paralyses in children, but its symptoms and its after-effects are so clearly defined that there is no difficulty in treating it as a separate and distinct complaint, especially in a book such as this, which is almost entirely devoted to treatment. Cerebral paralysis differs from spinal, not only in the different treatment that is required, but also in the success that results. SYMPTOMATOLOGY AND COURSE OF THE DISEASE. Onset.—As a rule, the onset of the disease is very acute, but sometimes vague prodromal symptoms are present for several days, before the well- known clinical features of the illness manifest themselves. The temperature rises sharply to 102° F. or so, remains at this level for a few days, and then gradually falls. Sometimes there is an initial rigor. Neither the pyrexia nor any of the other early symptoms have any prognostic value. Profuse sweating is not uncommon, and drowsiness or even coma is fairly frequently observed. Headache is almost always present; it is often occipital. Later on, pain in the nape of the neck and backache set in, and some stiffness of the spine, indicative of meningeal irritation. The pain may be so severe that the patients dread the slightest movement or dis¬ turbance. Hypersesthesia of the extremities is not uncommon, and the patients complain of severe pain in the arms and legs when they are touched. The muscles and nerves are peculiarly susceptible to pain, and this hyper- sesthesia has lately been emphasized as an early symptom. Sometimes it is so prominent a feature that a wrong diagnosis of polyneuritis may be made and the hypersesthesia may persist for many weeks or even months. Excepting occasional decrease of cutaneous sensibility to electrical stimula¬ tion, these are the only sensory signs that are at all constant.