Acute Poliomyelitis
HEINE-MEDIN'S DISEASE
CHAPTER I
Introduction
Historical Review.—Acute poliomyelitis, for many years known as infantile paralysis, has so often of late appeared in epidemic form that our knowledge of it has been considerably amplified. We have learned that acute poliomyelitis is much more protean in its manifestations than was formerly taught. So variable has it shown itself, that even clinicians of wide experience doubt the identity of epidemic infantile paralysis with the classical malady in which only sporadic cases appeared.
Wickman has suggested that all forms of disease arising from the same virus as acute poliomyelitis should be grouped under the one term—Heine-Medin's Disease. This nomenclature has been adopted, especially in Germany and Austria, by many with considerable experience in the recent epidemics.
Infantile paralysis was mentioned first by Underwood at the end of the eighteenth century. The credit of differentiating the disease from more or less similar conditions of cerebral origin belongs to Heine, who in 1840 published his masterly article on this disease. Duchenne, later, demonstrated the behavior of the affected muscles to faradic, and Erb, to galvanic stimulation. Surprisingly little further progress in our clinical knowledge was made until Medin published his celebrated observations on the Stockholm epidemic of 1887. Medin recognized, in addition to the already familiar spinal form, a bulbar, a polyneuritic, an ataxic and an encephalitic type. The last, from theoretical considerations, had previously been foreshadowed by Strümpell and Pierre Marie. The clinical significance of Medin's work re-
