Abstract
THE PROBLEM of severe bulbar poliomyelitis is largely one of secretional obstruction of the respiratory tract, with secondary anoxia. The satisfactory result of management based on that idea and the rapid change in the aspect of apparently hopeless cases on clearing the airway suggest that anoxia is more important than the virus infection itself. Poliomyelitis occurs chiefly in sporadic epidemics, and the physician who meets it for the first time is likely to find the respiratory complications bewildering. In this discussion, based on four years' experience of poliomyelitis and previous experience of respiratory obstruction, an attempt will be made to visualize the mechanisms involved and to present in some detail the measures that will give relief. The prevention and the relief of anoxia are the urgent indications. The statistics accumulated by Priest, Boies and Goltz1 in the course of their fine management of a large series of cases indicate that

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