Pharyngeal paralysis associated with difficulty in swallowing is not unusual in bulbar poliomyelitis, but this condition seldom persists more than a few days. Wilson1 states that "difficulty in swallowing is transitory and the worst is usually over in one week." Physicians treating large numbers of poliomyelitis cases have, however, experienced situations on rare occasions when pharyngeal paralysis has persisted well over the week.
It has been shown that if life can be sustained through the acute phase of the disease there is practically always a 100 per cent recovery of the pharyngeal muscles. As a rule tube feeding is not too difficult, but dangers associated with this procedure are always present and must be avoided whenever possible. The three main hazards are (1) aspiration of mucus or vomitus with resulting bronchial obstruction and sudden cessation of respiration, (2) choking attacks with temporary severe anoxemia and cyanosis and (3) excessive fatigue.