. Medical diagnosis for the student and practitioner. ly from the somnolence butfrom the paralyses as well. The Spinal Fluid.—The spinal fluid in these cases is quite unlike that inmeningitis, being clear, showing but a slight increase in the number of cellsper cubic millimeter, and no pathologic globulin content. The cells presentare both mononuclear and polymorphonuclear. A factor leading to errors in diagnosis is the occasional appearance ofKernigs sign in this disease. Diagnosis.—Obviously, in this disease the diagnosis is one of , brain tumor, typhoid or paratyphoid fe
. Medical diagnosis for the student and practitioner. ly from the somnolence butfrom the paralyses as well. The Spinal Fluid.—The spinal fluid in these cases is quite unlike that inmeningitis, being clear, showing but a slight increase in the number of cellsper cubic millimeter, and no pathologic globulin content. The cells presentare both mononuclear and polymorphonuclear. A factor leading to errors in diagnosis is the occasional appearance ofKernigs sign in this disease. Diagnosis.—Obviously, in this disease the diagnosis is one of , brain tumor, typhoid or paratyphoid fever are the three condi-tions most likely to cause confusion. The application of the usual test fortyphoid and paratyphoid would serve to exclude that disease; the historyand the examination of the fundus oculi would usually suffice to excludebrain tumor; and the normal spinal fluid content would exclude meningitis. Prognosis.—The death rate is not as yet definitely established, but ishigh, the reports varying from 20 to 40 per cent. PLATE Microorganism causing epidemic poliomyelitis. (Flexner and Noguchi.)Fig. i.—Culture in ascitic fluid tissue medium of Noguchi, showing translucent zone above is paramne. Fig. 2.—Solid culture showing colonies and line of demarcation, between the opalescentcolony-filled medium below and the unaffected upper level. {From the Journal of Experi-mental Medicine, Vol. XVIII, 1913.) ACUTE INFECTIOUS POLIOMYELITIS 1089 ACUTE INFECTIOUS POLIOMYELITIS (Acute Anterior Poliomyelitis, Infantile Paralysis) Through the brilliant work of Simon Flexner and his colleague, Noguchi,the cause of this immunity-conferring, but deadly and disabling, scourge ofchildren and young adults is proven to be an extremely minute, filtrablecultivable, non-motile, virus, for which Barker has proposed the name,Flexneria noguchii. The resistance of this virus is extremely great both to cold anddrying, though it is readily destroyed by heating, and,
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