Often poliomyelitis develops in adults and children in communities where there are no hospitals or where the nearby hospitals are not equipped for their care. Many of these patients are transported long distances to hospitals especially equipped and staffed for the treatment of poliomyelitis. For the past two decades we have had the impression that the disease was severer in patients who were transported long distances. To determine whether this impression was correct, we reviewed the case records of patients admitted to the Willard Parker Hospital during the poliomyelitis epidemic of 1949.
BASES OF ANALYSIS
The diagnosis of poliomyelitis was made on accepted criteria: namely, characteristic changes in the spinal fluid in conjunction with either stiffness of the neck and back muscles or the presence of weakness or paralysis. We determined the community in which each patient became ill with symptoms referable to the central nervous system. This was done