Respiratory Failure and the Drinker Respirator in Poliomyelitis

During and following the epidemic of poliomyelitis in 1931, numerous additions have been made to the literature of this subject. My purpose in this paper, based on a study of thirty-six cases, is to record observations made in cases of poliomyelitis culminating in paralysis of the respiratory muscles, to delineate the clinical picture when respiratory paralysis is fully established, to outline the results of treatment with the use of the respirator, and, finally, to describe the indications for removing the patients from the Drinker apparatus. TYPES OF PARALYSIS AFFECTING THE RESPIRATORY APPARATUS 1. Ascending Paralysis. —Most of the cases of poliomyelitis leading to respiratory involvement begin with paralysis of one or both of the lower extremities. Thirty-five of the thirty-six patients in this series presented an initial weakness of the lower extremities, followed by absent knee jerks and complete flaccidity of these limbs. Several hours later the cremasteric and abdominal