Abstract
Dissemination of the virus of poliomyelitis is widespread, but the paralytic disease is limited; exposure tends to be uniform, while the occurrence of the frank disease is variable; infection tends to be general in the population, paralysis is selective.
The varying frequency with which paralytic poliomyelitis results from exposure to the virus indicates that autarceologic factors in the host largely determine the occurrence of paralysis. There are epidemiologic indications that autarcesis varies with climate and season, in different individuals in the same locality, and in the same individual. Other observations suggest that autarceologic susceptibility is dependent upon some inherent endocrine fault, which operates through its effect on a barrier to the virus (upper respiratory mucous membrane) or through some change in cellular affinities for the virus. That the former may be the case in the monkey and the latter in man is suggested by the fact that animals failing to develop the frank disease following repeated intranasal instillations of virus do not acquire subclinical immunity; whereas, there is epidemiologic evidence that this is the common occurrence in man.
Observations suggestive of the endocrine fault involved are the occurrence of the disease in certain types of individuals indicative of endocrine differences, as described by Draper; the familial occurrence of poliomyelitis 1 ; its occurrence following tonsillectomy 2 ; and the frequency of the disease during pregnancy. 3 Perhaps the single observation of a case in a castrate male is likewise suggestive in this connection.
In a discussion 4 of the rôle of autarcesis in the epidemiology of poliomyelitis, it was suggested that some knowledge might be gained of the mechanism of this form of resistance by testing the influence of appropriate endocrine alterations upon the outcome of intranasal instillations of virus in the monkey.
Get full access to this article
View all access options for this article.