OUR BABIES

Dominion, Volume 10, Issue 2959, 23 December 1916, Page 14

OUR BABIES

fBY Htgeia.l

Published under the auspices of tho Royal New Zealand Society for tho Health of Women and Ohildron. "It is wiser to put ft fence at the top of a. prccipico than an ambulance at tho bottom." INFANTILE' PARALYSIS. L'he Nature, Manner of Conveyance, and Means of Prevention of Infantile Paralysis (tlio Kockefellcr Institute Report concluded). ?ractical Deductions and Applications. (Continued.) "Of those who survive, a part make :omplDte recoveries, in which no cripiling whatever remains. This number is ;reater tiian is usually supposed, because t includes not only the relatively large lumber of slight or abortive cases, but tlso a considerable number of cases in vhich more or loss of paralysis was pre;ent at one time. Tlie disappearance of ;he paralysis may be rapid or gradualnay be complete in a few days or may •equire several weeks or months. "The remainder, and, unfortunately, aot a small number, suffer some degrt* )f permanent crippling. But even in this <lass the extent to wnich recovery from ;'Ue paralysis may occur is very great. In many instances the residue of paralysis may be so small as not seriously tc iiamper tho life activities of the individual; .in others in whom it is greater t may be relieved or minimised by suitible treatment. But what it is lmpera;ivß to keep in mind is that the recovery if paralysed parts and the restoration if lost muscular power and function is i process which extends over a long oeriod of time-that is, over months, md even years. So that even a severely paralysed child, who ha 6 made little re>overy of function by tlio time the acute ;tage of the disease is over, maj' go on mining for weeks, months, and even i'ears, until in the end he has regained i large' part of his losses. Fortunately inly a very small number of t'lie attacked ire left severely and helplessly crippled. Lamentable as it is that even one should » so affected, it is, nevertheless, a reissurance to know that so many recover dtogether, and so much of what appears ;o be of permanent paralysis disapi«nr£ :n time. • . "There exists at present no safe netliod of preventive inoculation or vacsination, and no practical method 01 ipecific treatment. The prevention of ;he disease must be accomplished through 'eneral sanitary means; recovery from ;he disease is a spontaneous process, vhich can bo greatly assisted by proper nedical and surgical care. Infantile paralysis is an infectious disease, due tc i definite and specific micro-organism or rirus; recovery is accomplished by a pro:ess .of immunisation which takes place luring the acute period of, the disease. L'he tendency ot" the disease is toward •ecovery, and it is chiefly, or only, because the paralysis in some instances involves t'hose portions of the brain and ipinal cord -which control respiration or jreathing and tho heart's action, that leath results. '' "Finally, it should bo added that not iince 1907, at .which time the great epilemie of infantile paralysis appeared m his country (U.S.A.), bas the country or ;his State or city been free of the disease. Sack summer since lias seen, some degree )i accession in tlie number of the cases; ;he rapid rise in the number of cases ; his year probably exceeds that of any >revious year. But it must be remembered that in 1908 several thousand cases recurred in-the greater fy-poesib£ inleed many vcases of infantile paialjsis ind'of deaths duo to it were never rejorted as such. Hence the present experience, severe and serious as it is, is lot something ievorely epidemic before and was brought inder control. The knowledge regarding i now is faT greater than it was m 1308 and the forces of the city which are leafing with tho epidemic are probably letter organised and ln . ™ or ° T P n ®™ t •o-operation than ever before. Ihe out ook, therefore, should not be regarded as liscouraginfi." Abortive Cases. Dr Koplik,' of New York, gives the following aocount of P^P 1 / might be inclined ,to call threatened attads of Infantile' Paralysis," because the fever does'not produce paralysis; but in reality they are true cases of the disease which run a mild course. It . will be noted that the authorities now claim that probably nearly half the cases conic under this category. The Abortivo Type. ■\Ve owe to the keen insight of Wick man the recognition of the abortivo typi of the disease. It is through these case: that the disease is spread to others, ant tho recognition of such a type of disea6( is therefore extremely necessary m ordei to control tho spread ot the aUcction The abortivo type of tho disease is thai clinical type of infection which does not fo into paralysis, and, with recovery leaves tho host uninjured as to the mus cular motor apparatus. In the presen l epidemic this typo can be Recognised si as to leave no doubt as to its distmcl identity. j Illustrative Cases. ' A child of five.years of age is attacked with, headache, slight miUaise : and an attack of vomiting for five (lays She complains of intense pains in botfc lower extremities, radiating to tho sole: of tho ieet; the pains are especially marked at night, the child cries out witl the pains, so that remedies- mu6t be ap plied, such as heat, locally. On exuniin ation there is slight pain in the nape ol the neck, tho child prefers to lie down and when she walks she staggers, anc the child complains of a tired feeling and looks pale and weary. In 10 aayt the pains have disappeared, the child 11 well, and wants to go ,out and play. This is a case from the present epidemic—s form, I am certain, that is rarely recog nised as Infantile Paralysis. In othei words, here is a child who had all tlu threatening symptoms of an attack, anc still did not develop paralysis. It is sucl cases which we must recognise as s marked infection, and treat as such. Another case may illustrate tho abor tive form with gastric symptoms. child 21 months of ago, coming from tin epidemic district, is attacked with in. cessant vomiting after having been taker away from the infected area. This vom. iting persists for 18 hours without diarrhoea; there is also slight pain in the nape of the neck, drowsiness, and stupor In non-epidemics times, it is true, w« would hardly think this a form of Infantile Paralysis; but when a child haib from an epidemic region these symptoms in the absence of diarrhoea, must bi looked on with caution. This particula case recovered, but was carefully iso latcd The abortive cases, therefore, presen symptoms such as headache, weakness and pain in the nape of tho neck, witl or without vomiting and fever; bu paralysis docs not take place, and the] recover. Tho leading investigators esti mate that about half of the cases are o: this abortive type. Heneo it arises thai during an epidemic of Infantile Paralysis every case of fever, headache, vomiting, slight rigidity of the neck, etc. : must be regarded with suspicion and be carefully observed, lest tho trouble should turn out to be Infantile Paralysis. ! Apart from an epidemic of Infantile Paralysis few doctors would strongly sus poet tho disease on tho mere ground oi such indefinite symptoms.