The treatment of infantile paralysis / by Robert W. Lovett.

  • Lovett, Robert W. (Robert Williamson), 1859-1924.
Date:
[1916], ©1916
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Licence: Public Domain Mark

Credit: The treatment of infantile paralysis / by Robert W. Lovett. Source: Wellcome Collection.

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    two exceptions, one right and one left. This paralysis may occur as the only perceptible one in the entire muscular sys¬ tem. When associated with paralysis of other parts, the as¬ sociation was always with leg muscles. The tibialis anticus and gastrocnemius are the leg muscles most commonly found to be affected by themselves without paralysis occurring elsewhere in the body. Of the former muscle, there were five cases of paralysis, of the latter, three. Deltoid paralysis may occur alone in the arm. Fraser1 has called attention to the frequency of involvement of the facial muscles in cases of the ordinary type of paralysis affecting the limbs, a fact generally not recognized. In a series of ninety cases thirty-one showed involvement of facial muscles. In five cases the facial muscles alone were involved while in the other twenty-six other parts of the body were also affected. In the lower extremity analysis shows that the paralysis is severest in the foot, next most severe at the knee and least severe at the hip while in the arm it is severest at the shoulder, lighter at the elbow and least severe in the hand.2 With regard to distribution of the motor disturbance, the more exact the method of examination the more will the clinical phenomena be found to correspond with the modern patho¬ logical findings from experimental and human post-mortem data. The muscle test to be described (page 152) shows that the distribution of the paralysis is more widespread than ordinarily supposed and confirms the observation that the loss of motor function is much more often partial than total. The conception of the disease from these findings would rather indicate a general infection accompanied by a widespread and irregular loss of power, in most muscles of a mild grade. This corresponds to the modern pathological findings of a generally distributed myelitis accompanied by punctate hemorrhages as well as by more serious lesions through extensive areas in the cord and pons and an accompanying meningitis. Given the paralysis of one muscle or muscular group it can- 1 “Am. Jour. Med. Sci.,” July, 1914. 2 R. W. Lovett: “ The Treatment of Infantile Paralysis,” “ Jour. A. M. A.,” June 26, 1915.