OWING to the increasing knowledge of bulbar physiology and the improved methods of treatment of bulbar poliomyelitis, many more patients affected with severe bulbar poliomyelitis are surviving the acute illness and are returning home apparently recovered except for scattered weaknesses of bulbar musculature. However, many of these patients, although apparently recovered and comfortable in the protected environment of the hospital, encounter considerable difficulty when exposed to even moderate stress of everyday life. The slightest physical exertion, the routine environmental infections, or even mild daily excitements and problems precipitate many untoward physical discomforts, which indicate an instability of function of the nervous system. Even more serious is the occasional case in which the patient suddenly succumbs weeks, or even months, after an apparently complete recovery and no specific cause can be discovered for this tragic outcome.
Since these patients are comfortable in the protected hospital environment and experience symptoms when exposed