The Clinical Manifestations of Poliomyelitis. Treatment with Neostigmine and the Kenny Method.

During recent years much controversy has centered around the introduction of the Kenny 1 concept of poliomyelitis, which forms the rationale for the treatment which she advocates for the manifestations of this disease. Kenny describes three cardinal symptoms of poliomyelitis: muscle spasm, mental alienation and incoordination. She considers muscle spasm an early and important manifestation of the disease, present in all cases and underlying most of the disability associated with the disease. Mental alienation she describes as the mode whereby the function of a muscle opposed to a muscle in spasm is disturbed although no organic lesion exists in the motor pathways to the muscle. Rather the muscle is dissociated from, or "forgotten" by, the central nervous system. This she considers a more important cause of disability than paralysis due to destruction of motor cells in the anterior horn. Finally, Kenny describes incoordination as the dysrhythmic or inefficient contraction of