POLIO is a very old disease ,but mordern understanding, of it does not date back much further than 1905.(ELIZABETH KENNY)

    Polio strikes suddenly and often without any waning. It very often strikes children without regard to whether they are healthy, well fed and we'll housed,or sickly,malnourished and poorly-housed. When it strikes, the victim's family face several days or even weeks of uncertainty before they know how severely the patient will be affected by the disease. We often see
victims of polio crippled for life. When it kills, it often does so quickly, but usually after severe suffering.
     "Infantile paralysis"is one of the two most widely used names for the disease. This name fits two facts. First, babies and
young children used to be about the only victims, and the disease was named at that time. Second, paralysis has always been
an outstanding manifestation of the disease, though this frequently has not been permanent. The first word in this name,
however, has become less and less fitting, because during recent years at least a quarter of its victims have been past ten years of age, and the proportion of older people attacked has steadily increased.

    The other name for infantile paralysis is polio. This is a shortened form of the wotd poliomyelitis, which is a brief way
of saying acute anterior poliomyelitis.
This full name tells a person who understands the three words several things. The disease is an acute one-that is, it
comes on rather rapidly and is likely to be severe. The disease is inflammatory in nature. The inflammation hits the spinal cord or medulla or both. The regions most severely aftected are the forward-extending wings or "horns"of the H-shaped greyish
internal part of these two sections of the central nervous system. In these horns are located the nerve cells that control the action of all or nearly all of the voluntary muscles of the body. 

      The parts or regions of the central nervous system most likely to be attacked by polio are those which control the muscles of the limbs, the back, the chest, the neck, the throat, and to some extent the eyes. In most cases, not all of these muscles are affected. Quite commonly it may be only one arm or one leg that shows signs of paralysis. When the breathing muscles of the chest are put out of action, however, maintaining life obviously becomes the formost problem. But whatever outward
manifestations we may see, we should remember that in every case it is not the limbs or other paralysed muscles that are directly attacked. The damage comes first to the cells in the central nervous system controlling the action of these parts. Since there is no muscle action without nerve control, temporary or permanent
damage to the nerve cells may mean temporary or permanent paralysis of the muscles controlled by them, though in some cases some of the cells controlling a given muscle may escape serious damage and the result will be muscle weakness rather
than complete paralysis.

    when the muscles of the throat are involved, especially those of the soft palate or other muscles concerned with swallowing, it is a real danger sign. This is because these muscles are controlled by groups of cells in the medulla, which is sometimes called the bulb. This fact gives rise to the term bulbar polio ; and since the medulla is also much involved in keeping the breathing and many other vital processes in action, the development of bulbar polio indicates that life is in peril. 

    Polio is due to several strains of virus, but only three are capable of causing paralysis. Cultures of these can be grown in
the laboratory and viewed with the aid of the electron microscope.

Symptoms of the Disease 

     The onset od polio is marked by one or more of the following three symptoms :
1. It may resemble an ordinary cold with
Soreness of the throat, laryngitis and nasal congestion.
2. It may start as an ordinary case of influenza in which there is fever and generalized severe aching. While the onset of polio is usually marked by the above mentioned symptoms, cases sometimes occur where the initial sign is severe pain in the limb first involved. This is followed very soon with inability to move the 
aftected limb. Stiffness of the neck and back follows and the accompanying neutological symptoms form an accurate medical
picture of the disease. In nonparalytic polio the three above named types of mild illness are seen also, with even some Of the
neurological signs being present.
      If polio is really coming on, whether or not there is a preliminary digestive upset, it is likely that a headache and more or less fever, often with sore throat, will develop soon. In the average case, the headache is quite severe and pain and stiffness of the neck and upper part of the back follow before long. Thus any attempt to make the victim sit up in bed and bend his neck and back forward greatly increases his discomfort and makes him strongly resist the attempt. These are the most definite of the early symptoms, and when they develop in this way it is wise to treat the victim as if he had early polio unless and until proved otherwise.

     A physician should be called as a result of the appearance of these early symptoms. He may recommend that the fluid bathing the spinal cord be tested, to see whether it indicates polio infection.

    Among the cases reported as polio on the evidences just discussed, about half never progress any further, and within a few days the symptoms begin to disappear. In such cases, the patients are soon normally well again. But the other half develop a definite muscle weakness or paralysis to a greater or lesser degree. When the paralysis is of moderate extent, only one or a very few of the muscles of a shoulder, an arm, or a leg may be affected. In severe cases, all the muscles of the limbs and the muscles of the neck and trunk may be put out of action, so that the patient cannot move so much as a toe or finger, and can breathe only with the aid of a respirator, popularly called an "iron lung.'"

     In the early stages of muscular involvemmt, before true paralysis really begins, the affected muscles are very painful and sore, so that any motion of the involved limbs causes great distress. Nurses caring for polio patients at this stage of the
disease need to keep this fact in mind and to be especially kind to the sufferers. The inactivity of the painful muscles tends to
stagnate the blood circulation through them. This impaired circulation, and the fact that inactive muscles tend to wither,
mean that in some cases these muscles never recover their normal size or their normal ability to act. Then there is
permanent paralysis with wasting or shrinkage of the involved muscles.
This is one reason why the Kenny treatment is so important.




Post a Comment

Blog Archive

Follow by Email to Receive Every Post by Mail


Popular Posts