The most constant symptom of poliomyelitis—and the one which should always lead us to think of the possibility of that disease, especially during epidemics—is an alteration in the reflexes accompanying or following a short febrile period.
Various changes in the normal reflex response have been described by numerous investigators, more especially by Wickman, Muller, Zappert, Foerster, Neurath, and recently by Draper, Peabody and Dochez.1 In studying the large number of cases admitted during the epidemic of 1916 to the Kingston Avenue Hospital, we have encountered some interesting facts to which we shall take the liberty of drawing attention.
The Condition of the Patellar Reflex.—The knee jerks are the most frequently affected of all reflexes. This is no doubt to be attributed to the common paralytic involvement of the quadriceps extensor group of muscles. In order to show the frequency of alterations in this reflex