Poliomyelitis

Abstract

OWINGto the increasing knowledge of bulbar physiology and the improved methods of treatment of bulbar poliomyelitis, many more patients affected with severe bulbar poliomyelitis are surviving the acute illness and are returning home apparently recovered except for scattered weaknesses of bulbar musculature. However, many of these patients, although apparently recovered and comfortable in the protected environment of the hospital, encounter considerable difficulty when exposed to even moderate stress of everyday life. The slightest physical exertion, the routine environmental infections, or even mild daily excitements and problems precipitate many untoward physical discomforts, which indicate an instability of function of the nervous system. Even more serious is the occasional case in which the patient suddenly succumbs weeks, or even months, after an apparently complete recovery and no specific cause can be discovered for this tragic outcome.Since these patients are comfortable in the protected hospital environment and experience symptoms when exposed to stress situations, it would seem that some regulating mechanism within the nervous system must have been disturbed. A survey of the literature for investigations on the possible focus of damage imme¬ diately suggests a study of the diencephalon. It has long been known that the nuclear groups within the hypothalamus play an important role in maintaining the internal environment of the human organism and in preserving the stability of its visceral, somatic, and even emotional, functions. Dysfunction or irritation of the hypothalamus has been reported as resulting in disturbances of blood pressure, gastrointestinal function (