MECHANISM OF SUFFOCATION IN SPINOBULBAR POLIOMYELITIS AND EXPERIENCES WITH OPERATIVE TREATMENT

Abstract

DURING the last five years a wave of enthusiasm for tracheotomy in bulbar poliomyelitis has swept over the United States. At the First International Poliomyelitis Conference,¹ held in New York from July 12 to 17, 1948, it was generally agreed that in certain cases tracheotomy must undoubtedly be considered as directly lifesaving. Already in 1931 Wilson recommended tracheotomy and cited a few successful cases. Well over a decade afterward the idea was taken up anew, and in 1943 Galloway² published reports on 3 tracheotomies, with 1 death. In 1946 a great epidemic raged in Minneapolis. Diagnosis was made in about 400 bulbar cases, and Priest, Boies and Goltz³ reported 75 cases of tracheotomy with survival in 29. In 1948 Davison⁴ reported 15 cases without fatal issue, and in September 1949 Galloway also reported 15 cases, likewise without fatal issue. In Stockholm the problem became acute in an almost frightening and