Medicine: Polio Polemic

Out this week is Sister Kenny’s fast-moving, stormy autobiography, And They Shall Walk (Dodd, Mead; $3), in which the Australian nurse describes her 30-year struggle to get her treatment for poliomyelitis accepted. On doctors’ desks at the same time are two research reports claiming that Sister Kenny’s understanding of poliomyelitis is all wrong. No one now denies that Sister Kenny is good with her hands (in Minneapolis, where formerly about 85% of polio sufferers were left with paralysis, the Kenny method now makes all but 20% as good as new), but her critics insist that she does not really know how she does it.*

Sister Kenny believes that the chief symptom of infantile paralysis is spasm (involuntary muscle contraction), which bends joints and stretches the opposing muscles. She thinks the spastic muscles are the diseased ones, begins by treating the spasm, then re-educates the stretched muscles, which she says are merely “alienated,” not paralyzed. Her critics’ explanation of the disease is almost exactly the opposite:

—Drs. R. Plato Schwartz and Harry Bou-man at the University of Rochester (N.Y.) used an oscillograph (electrical impulse recorder) to test the muscles of infantile-paralysis patients. They found that while it is true that the contracted muscles are in spasm, the stretched muscles and other muscles all over the body are also in spasm, but to a lesser degree. In the stretched muscles they found both paralysis and spasm. They conclude: 1) the muscle weakness results from impairment or destruction of certain nerve cells in the spinal cord; 2) spasm, which is only temporary, results from lack of the nerve impulses that prevent involuntary contraction; 3) the paralysis, which may be permanent, results when contraction impulses fail to get through.

—Dr. Joseph Moldaver of Manhattan’s College of Physicians and Surgeons disagreed with Sister Kenny in last fortnight’s Journal of the A.M.A. He found that the nerves and muscle fibers of the contracted muscles were generally in good condition, while some or all of the fibers in the stretched muscles were degenerating. He claims that: 1)poliomyelitis destroys the nerves serving certain muscles; 2) such muscles are not merely “alienated” —they cannot respond to impulses they do not receive; 3) some nerveless muscles completely deteriorate.

The National Foundation for Infantile Paralysis, which sponsors Sister Kenny’s work, also financed these two skeptical experiments, intends to keep on financing both sides till it finds out which is right.

Sister Kenny’s theory and treatment are fully explained in another book published this year: The Kenny Concept of Infantile Paralysis and Its Treatment, by Dr. John F. Pohl and Sister Kenny (Bruce; $5).