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To the Editor:—
The reason for recommending that lumbar puncture be performed in cases of doubtful infantile paralysis is in order to arrive at the earliest practical moment at a correct diagnosis. We are still very ignorant of the real extent of the epidemics of poliomyelitis and are therefore, prevented from exercising due caution in limiting its spread. What we need especially to learn is the frequency with which cases of poliomyelitis that do not develop paralysis occur, and what the leading symptoms are in these instances, since the socalled abortive cases may be found to be the insidious means of the transmission of the infection. Moreover, there occurs, not uncommonly, a form of anterior poliomyelitis which simulates epidemic meningitis so closely as to be frequently confused with that disease. I can speak with certain knowledge on this point because of the frequency
Flexner S. Lumbar Puncture in Poliomyelitis. JAMA. 1910;55(16):1397. doi:10.1001/jama.1910.04330160065028