Reports and papers on epidemic poliomyelitis.

Date:
1912
Catalogue details

Licence: In copyright

Credit: Reports and papers on epidemic poliomyelitis. Source: Wellcome Collection.

    107/180 (page 95)
    split pea, some cherry red, others dark mulberry, not fading on pressure ; October 8th, absolute regurgitation of food necessitating nasal feeding ; definite opisthotonos ; rosy spots appearing on shoulders, rash on lower part of trunk fading ; October 10th, signs of paresis, both lower limbs ; “ Cheyne Stokes” breathing ; October 13th, all active and acute symptoms have passed off, but there is still some weakness of the back and lower limbs, especially of the right leg. December 13th, recovery apparently complete. 70. W. M., a next-door neighbour and playmate was attacked on August 18th, and it is not improbable that L. G. contracted the disease from this child ; on the other hand L. G. has five brothers and sisters, one of whom, a boy of four, is his bed-fellow ; none of them contracted the disease. 74. A. 67., 33, F.—Was rather “run down” previously to her acute attack. August 31 st, acute febrile onset, temperature 102° ; headache and pain in the back of the neck ; vomiting ; febrile symptoms lasted about three days; September 3rd, inability to articulate or to swallow food ; regurgitation of food through nostrils ; no Kernig’s sign ; no loss of knee-jerks ; right facial paralysis ; palate insensitive ; December 21st, can swallow liquids with difficulty, but not solids. Has three children, none of whom were affected. 76. H. E., 16, F.—Mentally deficient since birth. September 13th, headache, pain in back ; vomiting ; inability to swallow food ; September 19th, admitted to Melton Isolation Hospital; drowsy and stupid ; brows knitted ; left internal squint ; pupils unequal, left dilated and sluggish ; twitching ; Kernig’s sign ; taclie cerebrate ; marked opisthotonos, lumbo- dorsal arch accentuated ; patellar reflexes exaggerated ; hypersesthesia ; inability to articulate or to swallow food ; loss of control over sphincters. September 23rd, all reflexes normal, but Kernig’s sign persists. Discharged convalescent at the end of four weeks. December 21 st. Recovery complete. Has two brothers, neither of whom was affected. It has been already stated that the outbreak was originally regarded by most of the medical practitioners in the areas affected as one of cerebro-spinal fever, and that cerebro-spinal fever was at an early stage made notifiable, under the provisions of the Infectious Diseases Notification Act, in the Bingham and Melton Mowbray Rural and the Melton Mowbray Urban Districts. This circumstance together with the fact that cases were simultaneously occurring in Nottingham which appear to have been cases of true cerebro-spinal fever, and in which a “ gram-negative ” diplococcus was discovered in the spinal fluid withdrawn by lumbar puncture, has probably prejudiced the view taken of the nature of the outbreak. I have already indicated that nine cases—viz., eight cases occurring in Nottingham and one at Barlestone—may be regarded as presumably cases of true cerebro-spinal fever, leaving 74 cases— occurring for the most part outside the city of Nottingham, which seem to belong to a different category. Of these 74 cases, those that proved rapidly fatal and some of the more severe non-fatal cases could not on clinical grounds alone be readily differentiated from cases of true cerebro-spinal fever, but the large majority (say 65) were of a milder type, which if occurring sporadically certainly would not have been so regarded. These latter cases were characterized by a brief febrile onset followed by paralyses of longer or shorter duration, but were associated, both in respect of time and of circumstances affording chances of infection, with the more severe cases (resembling cerebro-spinal fever) in such a manner as to make it appear highly probable that both types were due to the same infection. I regard these 74 cases