A reference hand-book for nursesBeck, Amanda K. (Amanda Kathryn)
Science
A reference hand-book for nurses
Beck, Amanda K. (Amanda Kathryn)
Nursing
=Summary Results from Public School Reports.=—1. A large number of
children with poliomyelitis show pathologic conditions of the nose and
throat, either diseased and hypertrophied tonsils and adenoids, or both.
2. A large number show marked hyperemia of the nasopharynx and throat,
often resembling a scarlet or streptococcus throat.
3. Only a small percentage of cases previously operated for tonsils
and adenoids were found to be affected with the disease, and in this
group of cases the percentage of recovery was very much higher than
in unoperated cases. The number of cases in this group is, of course,
rather small to draw from it any definite conclusion, but it is at
least suggestive. In another investigation of 1404 children in the
public schools, made to determine whether any of them whose tonsils
had been removed had been ill with poliomyelitis during the recent
epidemic, a similar result was obtained. Of the 1404 children whose
tonsils had been operated upon not one developed poliomyelitis during
this epidemic, although in 18 instances cases developed in the family,
and in 93 instances cases developed in the same house.
Poliomyelitis defined: _Polio_ (gray), _myel_ (marrow), _itis_
(inflammation), meaning inflammation of the gray matter of the spinal
cord.
=Pathology= of the disease: Infantile paralysis is a general infection,
with lesions most marked in the central nervous system. Clinical
manifestations exhibit a wide-spread and scattered motor paralysis or
weakening. The large majority of all cases are of the central nervous
system, but there are variations in which the symptoms are not of the
usual kind.
=Classification.=—1. _Non-paralytic or Abortive Type._—These are
cases in which the nerve-cells are not sufficiently injured to
produce paralysis; and those classed as meningitis cases, tuberculous
meningitis without motor disturbances, often called encephalitic; in
these cases the motor cortical areas are not involved, but there is
evidence of disturbance of the sensorium.
2. _Ataxic Type._—Here the motor cells are evidently not involved, but
there is a lack of co-ordination—ataxia, nystagmus.
3. _Cortical Type._—The upper motor neuron is here affected, with
resulting spastic paralysis.
4. _Ordinary Spinal or Subcortical Type._—Here the lower motor neuron
is affected, with resulting flaccid paralysis; a manifestation of
poliomyelitis difficult to classify is blindness. The most important
symptoms of the disease may be described under the _non-paralytic_ or
_abortive_ cases and those of _ordinary spinal form_.
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