THE PERIPHERAL DISEASE OF POLIOMYELITIS

Considerable doubt has arisen that the peripheral symptoms of poliomyelitis can be satisfactorily or wholly explained on the basis of the observed pathological process in the nervous system. From clinical studies, there is reason to suspect, in addition, that the disease directly assaults the peripheral tissues of the body. So devastating are the eventual changes in the peripheral structures, and so damaging to locomotion, that it is most. neces-sarv to consider every possible origin of such effects and to ascertain the means by \lhich these local changes take place, in order that effective preventive measures may be utilized. By comparison ll’ith the voluminous reported stud!ies of the disease in tile nervous system, the peripheral tissues have i)een practically neglected. The studies of Carey and his associates ‘ indicate that motor-nerve endings in muscle may be primarily affected. Know’ledge that tissue of the central nei’vous system has a favoi’ahle attraction for the virus of poliomyelitis has beguiled most investigators from serious consideration of the disease process directly affecting the peripheral tissues. The dearth of objective findings in the peripheral tissues, reported in the literature, does not. necessarily prove an absence of primary changes in these parts. It is entirel