Infantile Paralysis

New York City, where one-third of the Nation's 13,000 infantile paralysis cases occurred during this year's epidemic, last week offered the Nation four important suggestions concerning the disease.

1) Dr. Simon Flexner, director of the Rockefeller Institute for Medical Research, long ago assigned the infantile paralysis problem to himself. He announced that what he suspected is almost certainly true--the virus of the disease gets into the system through the mucous membranes of the nose and upper throat.

2) Dr. William Hallock Park, bacteriologist for the City, State and Nation in the Manhattan area and mainstay of the city's health activities, declared that serum taken from the blood of people convalescing from infantile paralysis was not especially valuable in preventing the disease in others. Said he: "We found that the percentage of cases which developed the paralytic symptoms was about the same as in the cases in which the serum was not used. No harm resulted from the treatment. But it was apparent that no benefits resulted."

Dr. Flexner put Dr. Park's statement aside as merely representing an opinion. Dr. Thomas Parran Jr., State commissioner of health, sensing a controversy, protected himself thus: "In the absence of any better known method of combating infantile paralysis, the New York State Department of Health will continue to recommend the use of human serum unless its usefulness should be completely disproved."

3) Dr. Park gave his belittling comment on convalescent serum a heartening companion comment. His staff had improved Dr. Marcus Neustaedter's technique of developing infantile paralysis serum in horses. The new horse serum protected monkeys from attack, "promises definite human immunization."

4) Infantile paralysis is a nerve disease. The virus destroys nerves. Hence muscles become useless. But in only a small proportion of cases does the disease progress to paralysis, and comparatively few of the paralyzed remain that way long.

In the opinion of Dr. Armitage Whitman who succeeded his retired father at New York Hospital for the Ruptured & Crippled, few people know this. Their ignorance made him cry out to the New York Academy of Medicine: "Once they have an understanding of the nature of the disease, when it no longer seems the utterly mysterious thing that it does now, the people will no longer rush frantically from quack to quack, sacrificing the fortunes of the family to any one who promises a cure."

For the comparatively few who remain permanently paralyzed he recommended orthopedic surgery. A skilled surgeon can often correct sound muscles in such fashion that a wobbly joint becomes stiff and the limb useful. Often he can get some controlled motion back into a limb. Many a rehabilitated person moves his jaw with a muscle from his neck.

Said Dr. Whitman: "All these patients are entitled at least to a chance of relief. In favorable cases surgical treatment may entirely mask the effects of the disease. In worse cases it may enable the patient to discard apparatus. In the worst cases it can hold out the possibility of independent locomotion. . . . Only a very small number need expect to look, feel, or act like a cripple."

Dr. Whitman flayed parents who tell children that the "doctor won't hurt." Said he: "Tell children the truth. The screaming terrified ones who are so hard to handle are those who have been assured that the doctor would not hurt them, and then have had their fracture reduced without an anesthetic.

"The average child wants to be brave, and given a fair opportunity he will be. But he bitterly resents being lied to."

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