F.D.R.'s Case History

In tiny Hartsville, S.C. (pop. 5,000), Dr. William Egleston worried over an infantile paralysis patient. Uncertain how to treat the disease--then (1924) relatively unexplored--Dr. Egleston, general practitioner, sent off a letter to a prominent polio victim, asking his advice.

Last week the Journal of the South Carolina Medical Association printed the reply, penned by Franklin Delano Roosevelt, who was then undergoing treatment at Warm Springs.

In clear and detached fashion, F.D.R. told his own case history:

"First symptoms of the illness appeared in August, 1921, when I was thoroughly tired from overwork. I first had a chill in the evening which lasted practically all night. The following morning the muscles of the right knee appeared weak and by afternoon I was unable to support my weight on my right leg. That evening the left knee began to weaken also and by the following morning I was unable to stand up. This was accompanied by a continuing temperature of about 102 and I felt thoroughly achy all over. By the end of the third day practically all muscles from the chest down were involved. Above the chest the only symptom was a weakening of the two large thumb muscles making it impossible to write. . . .

"For the following two weeks I had to be catheterized and there was slight, though not severe, difficulty in controlling the bowels. The fever lasted for only six or seven days, but all the muscles from the hips down were extremely sensitive to the touch and I had to have the knees supported by pillows. This condition of extreme discomfort lasted about three weeks."

The Mistake. Then F.D.R. was moved to a Manhattan hospital, after "the mistake was made for the first ten days of giving my feet and lower legs rather heavy massage." Five months after the first paralysis seizure, doctors found the back-of-the-knee muscles had contracted and the right foot dragged dangerously.

As a corrective, the physicians put both legs in plaster casts for two weeks, then fitted their patient with seven-pound steel braces from hips to heels. Gentle exercises on a bedboard were begun.

"The recovery [from] muscle paralysis began at this time," F.D.R. wrote, "though for many months it seemed to make little progress."

Then Franklin Roosevelt, almost by himself, discovered the curative value of swimming. With all weight removed from his blighted limbs, he found that he could stand in fresh water to his chin. Half a year later he could stand erect with the water only at his shoulders; in another six months he could make it at armpit-level.

Such tests helped him determine how fast his big thigh muscles were reviving. In time, four-pound duraluminum braces replaced the heavier steel frames.

Summarizing his case, the man who reached the White House despite his crippling disease could not help but give his inquirer a series of "Dos" and "Don'ts." The "Don'ts": heavy massage, overexercise, exposure to cold, growing fat.

The "Dos" were points all now recognized as standard treatment for polio: 1) gentle exercise, 2) skin massage for circulation, 3) swimming in warm water, 4) sun bathing. But more important than most therapy, thought F.D.R., is a "belief on the patient's part that [he] will eventually recover."

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