. The Journal of nervous and mental disease. Associated with this was a mild febrile syndrome, and acatarrhal rhinopharyngitis which continued for four or five days. Onthe eighth day after the onset, she rather suddenly lost power in thelower extremities, so that she could neither walk nor stand. Theparalysis of the left lower extremity was complete, of the right onlypartial. Previous Medical History.—At the age of three years, there was anattack of acute anterior poliomyelitis, with febrile onset, paralysis ofboth upper extremities, and transient weakness of both lower extremi-ties. Several m
. The Journal of nervous and mental disease. Associated with this was a mild febrile syndrome, and acatarrhal rhinopharyngitis which continued for four or five days. Onthe eighth day after the onset, she rather suddenly lost power in thelower extremities, so that she could neither walk nor stand. Theparalysis of the left lower extremity was complete, of the right onlypartial. Previous Medical History.—At the age of three years, there was anattack of acute anterior poliomyelitis, with febrile onset, paralysis ofboth upper extremities, and transient weakness of both lower extremi-ties. Several months after this attack, almost complete recovery of theleft upper extremity had taken place, and on the right side there waspartial return of function, with, however, a well-marked residual paraly-sis of the deltoid, forearm supinators, and the intrinsic muscles of thehand. her contagious diseases, during childhood, comprised measles,diphtheria, pertussis, and varicella. Tonsillectomy was done in. 1916. SECOND ATTACK OF POLIOMYELITIS 275. Right hand of patient showing residuals of old paraly: FRANCIS /». FRANCIS AND W. r. MONCREIFF ral health, except for the illnesses recorded, has been good;habits and bodily functions normal. The family history was negative. Physical Findings.—The temperature on admission was ioo° F., pulserate Il6, respiration 24. The patient was well nourished and well de-veloped, comfortable, and not acutely ill. There was a hypotonicity ofthe posterior cervical musculature, and fairly marked flaccid paresis ofthe abdominal recti. Except for the extremities, the remainder of thephysical examination was negative. The right upper extremity was 3centimeters shorter than the left, and generally underdeveloped. Therewas a marked weakness and atrophy of the deltoid and the supinatorsof the forearm. The right hand was smaller than the left, with sub-normal grip, marked atrophy of all the intrinsic muscles, and a laterallyextended thumb. These changes in the
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