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August 13, 1938

EXPERIMENTAL POLIOMYELITIS BY THE TONSILLOPHARYNGEAL ROUTEWITH SPECIAL REFERENCE TO THE INFLUENCE OF TONSILLECTOMY ON THE DEVELOPMENT OF BULBAR POLIOMYELITIS

Author Affiliations

NEW YORK

From the Laboratories of the Rockefeller Institute for Medical Research.

JAMA. 1938;111(7):605-610. doi:10.1001/jama.1938.02790330025005
Abstract

The purpose of this communication is to present evidence (1) that the tonsillopharyngeal region is more highly sensitive to injections of poliomyelitis virus than are certain other regions of the body (e. g. the abdominal cutaneous or subcutaneous tissues) and (2) that the disease which results from infection by the tonsillopharyngeal route is, with few exceptions, bulbar or bulbospinal in type and different in its clinical course from that which follows nasal instillation of the virus. The present investigation was prompted by several clinical reports of cases of bulbar poliomyelitis following within a relatively short time operations of tonsillectomy and adenoidectomy. Ayer1 (1928) appears to be the first to have noted the development of bulbar poliomyelitis in nine individuals within five to ten days after tonsillectomy. In 1929 Aycock and Luther2 reported that, of thirty-six cases of poliomyelitis with a history of tonsillectomy within one year, the disease

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