Armstrong – Table of Contents

A brief outline follows of modern information about the acquisition of knowledge
and the initiation of control measures for poliomyelitis derived from several sources (1);
this provides a time frame for Armstrong’s involvement in poliomyelitis investigation.
The crippling aftermath and limb atrophy resulting from poliomyelitis was probably
noted sporadically for many centuries. Dr. Jacob von Heine, a German orthopedist, first
described the disease clearly in 1840. He wrote the first book on the disease published in
Stuttgart, Germany. His writing described the acute paralytic disease among a few babies
or toddlers, usually non-fatal. He saw them many years later with chronic paralytic
disease and limb deformities that he occasionally tried to correct by surgery. In 1887, Dr.
Oskar Medin, a Swedish physician, first recognized poliomyelitis as an acute infection
during an epidemic in Stockholm; he published a report in 1890. He observed the initial
clinical manifestations including fever, malaise, and body aches often followed by
paralysis. Deaths occurred during this outbreak, and pathologists observed the pathology
in the spinal cords and lower brains of the victims. They noted the destruction of the
motor cells in the anterior horns (gray matter) of the spinal cord and in the motor nuclei
of the cranial nerves in the medulla and pons. In 1905, another Swedish physician, Dr.
Ivar Wickman, began the study of polio epidemics with careful epidemiological and
clinical observations. He described the various manifestations and outcomes of infection;
he postulated person-to-person spread and the existence of healthy carriers based on
epidemiology. In 1907 he commented on the wide prevalence of non-paralytic polio from
his observation of patients during the epidemics. He labeled the sicknesses he was seeing
as “Heine-Medin Disease” – its original eponym.