PARALYSIS IN CHILDREN.

Otago Witness, Issue 2840, 19 August 1908, Page 62

PARALYSIS IN CHILDREN.

THE MELBOURNE EPIDEMIC.

SOME FACTS OF INTEREST.

The epidemic of paralysis in children which the cables show to be at present •existent in Melbourne is of singular interest locally, inasmuch as an epidemic of the very same nature spread itself over New Zealand, being more prevalent in Otago than in the early part of the year 1894. Singularly enough, in the very same year a wave of infantile paralysis spread over the State of Vermont, United States of America, 120 people being affected. The New Zealand epidemic of that year, however, concerns us meet, and some interesting information thereon was obtained on -ohe 17th by a Times reporter from a Dunedin physician. About 30 cases in all were reported, and of these as many as 11 were under the direct control of the doctor in question. Being so struck with the disease and the obscurity of its origin and so forth, the matter was taken up, and a special study made of the epidemic. Every doctor under whose observation a case of paralysis in children bad come was oircula<rised, and a fund of comparative information thus obtained on the subject. As a rule cases occur in children when cutting their teeth, between one and two yeans of age. With the New Zealand oases the ages of the sufferers varied from six months up to as high as 20 years, or an average of about five years. The case of a sufferer at the ago of 20 years is a very exceptional 6ne. The causes of fche palsy are at present unknown, but it is quite possible that barometric pressure has something to do with it. For instance, a careful investigation of the barometric pressures at corresponding periods over six yoars showed that in 1894, when the outbreak occurred here, there was a greater rsjige between the maximum and. iniruimum barometric pressxires than in any of the previous six years. In regard to barometric pressures, Thomas Whltelaw, M.D. Edin., in the British Medical Journal of May, 1896, writing on " Heamorrlmges : their Relation to Barometric Pressure," says that from the observations he has made from time to time -be had come to the conclusion/^iat there was a marked affinity between a high barometer and haemorrhages of various kinds, Andrew Macphail, 8.A., M.D.. M.R.C.S., professor of pathology and diseases of ohildiren. University of Bi&hop's College, Montreal, in the Montreal MedicaJ Journal, gives some of his observations of 120 cases of paralysis in children in the Starte of Vermont in 1894. At first, he states, the belief was held that the outbreak was one of oerebro-spinal meningitis, and there were several cases presenting the characteristics of this dicease. But on examination it appeared tliat such oases were very few, and In many there were no symptoms at all beyond paraly«Li There was a general absence of retraction of tn« head and plexing of the trunk. The aeasory symptoms were not prominent, tho headache was chiefly frontal, and beyond some slight delirium of the ordinary febrile n*pe there were no physical manifestations. From an examination of the records of all the epidemics of cerebro -spinal meningitis it would appear that the eye symptoms alone were sufficient to differentiate th© present malady from cerebral-spinal meningitis. The following may be taken as a type of fatal case : —An Italian boy of four years old, on July 21, became sleepy, and complained of headache. He was found to • have no fever, but with a pufee of 45 'slow, hobbling in oharaoter, and intermitting every fifth beat. Tihia continued for four daye, when a slight improvement was noticed. Internal strabismus occurred, but the child made a complete recovery, to far as symptoms were concerned, on the seventh day. He was then allowed to divert himself' in the hot sun In company with a goat, when all the original symptoms returned. Headaohe, squint, halting pulse, and drowsiness. Thte was the last of August. By th© flrot of September he was worse than at any previous time, but yet had no fever. The legs now became paralyeed t and by the 3rd of September the paralysis -was general, the eyes half-olosed and the pupils dilated and unequal, with a temperature of 104 degrees. The- child died at 3 o'clock the same afternoon. In other oases the mußtflea were variously affected. In come caßes the wnole arm wfie paralysed, in some only the Jntrlnsio muscles of the palni, but the combinations of the different groups ajfected

were endless. The paralysis in every case was motor. As to the New Zealand outbreak in 1894, the Dunedin physician, whom our reporter interviewed on the 17th, said that in a great number of the cases be found that- tuberculosis was a factor, but whether it had anything to do with the disease was nor certain. Infantile paralysis was, however, strictly a disease of the nerve cells, which affected the motor nerves, and, consequently the muscles they supplied. It was essentially a disease of childhood. It was rarely hereditary, and there were but few cases where several members of the same . family were affected. In some cases, howover, there was found to be a distinct hereditary influence. To quote from an eminent authority on the disease, Byrom , Bramell. An example is given of where three children in one family were affected with the ataxia. A fourth child had well marked infantile paralysis. An uncle of this child had also suffered from infantile paralysis. The subject of the disease some 1 time came from a nervous shock, but this was probably a mere coincidence. The j previous state of the health of the parent i was not a factor of much importance, and ' the disease attaoked robust and healthy ■ children, who were enjoying perfect health : at~the time of fche attack It was questiont able whether the cutting of the teeth had j anything to do with it. One of the most important factors to be remembered was that the disease occurred mor© frequently in summer time than in winter. The age-, at which the majority of cases occur (bei tween the ©nd of the first and the end ; of the third and fourth -years) suer-eested 1 that the active development of the grey matter of the spinal cord and the active j process of training that is going on in the I nerve celte of the spinal cord may have ' something to do with the development of , the disease. During tlr> second and third ; year the child is learning and perfecting 1 itself in the use of -its limbs, and a strain lis thrown upon the nerves. The following facts quoted are highly suggestive of the ' vein that the disease is febrile and due to ; defined toxic causes : (1) The age at which the disease occurs; (2) the extreme rarity of second attacks; (3) the greater frequency of the disease during hot than cold weather ; (4) the occurrence of " runs of coses *' ; so far as is known the disease is never infectious or contagious: <5) the fact tha-t the fever and tho symptoms which usher in the attack are in many cases more marked than one would expect from i the severity of the actual lesion in the 1 cord. So far no orgv»nisms have been discovered i in the inflamed tissue. The disease is I so rarely fatal that there is no opportunity lof a ocst movten. The disease is rarely caused by parents iiftinpr their children roughly, although manly often suppose so. I Such cases are of rare occurrence. i