Section 53, Polio by J.I. Rodale, Editor in Chief,
Rodale Books Inc. 1962
Treatment of Polio Victims Like it or not, the polio figures have been rising and, of course, with the incidence of the disease, comes the need for treatment and rehabilitation of the victims. In the earlier days, polio victims had their affected limbs splintered and bandaged into complete immobility until, even if there were a return of muscle power, the function had been partially or completely lost by atrophy of the limb. With the treatment devised by the gallant and forceful Australian nurse, Sister Kenny, a new attitude toward polio-paralyzed limbs was adopted. She proved that action, not immobility was the key to bringing affected arms and legs back to usefulness. Massage and whirlpool baths, etc., all aimed at the patient's earliest possible attempt to use the affected part, became standard procedure in the treatment of paralytic polio. As a result, the National Foundation reports that, of every 100 new cases: 50 recover completely, 30 are left with some muscle weakness, but not enough to interfere with normal life; 14 have more or less severe paralytic involvement; and 6 die.
Dr. George Boines, whose article on the subject appeared in the Virginia Medical Monthly (June, 1956), told of how he improved on the recovery rates given above by using a unique course of treatment which includes:
controlled and prolonged medical observation to attain maximum recovery and function of neuromuscular power still retained,
special nutritional program. As can be imagined, we were especially concerned with the final part of the program-special nutritional program.
Polio Presents Added Nutritional Needs Dr. Boines believes that the problem raised in the body by polio is a, disturbed nutritional absorption by the muscles and a loss of protein. He feels that both of these conditions can be remedied by improved diet and supplementary feedings. Dr. Boines even suggests that susceptibility to polio may be the result of the shortage of protein. As he sees it, the fundamental defenses of the body depend upon the presence of antibodies in the tissues and body fluids. The antibodies are protein, so if the protein intake goes down, the number of fighting antibodies is lessened and the chances for infection increase.
If the disease should strike, the protein situation becomes even worse. A negative nitrogen balance occurs with the usual high fever, and this results in a waste of the body's protein - the worse the infection, the greater the protein destruction. Now, with essential protein low to begin with, and further lowered by the fever, it must be replenished as quickly and generously as possible, if recovery is to take place. This will not occur on a regular diet. A special effort must be made to insure sufficient protein intake.
General Diet Inadequate
Dr. Boines believes it is necessary to institute a nutritional program as soon as the patient is admitted to the hospital. Even if he is too weak to eat, the protein and glucose are poured into him intravenously. At this stage, the shortages are most acute and the body is in its most desperate need of continuing nourishment to arrest weight loss and to restore the size and strength of muscles. It is alarming to note that Dr. Boines is of the opinion that the general diets in hospitals are often inadequate in protein for any patient. They definitely do not furnish enough protein to supply a polio patient's needs, so supplementary protein must be furnished. If we cannot depend upon an adequate diet in a hospital, where can we expect to find such a diet? "Adequate" protein is not enough when one is so ill as to be hospitalized, for then the body needs super amounts of all nutrients just to "keep up." And what of the polio patients whose doctors are not conscious of the need for extra nutrition? If they must subsist on the general hospital fare, how much is their recovery hampered? How much do they lose in the process due to insufficient nutrition supply?
The Importance of Capillaries Added to Dr. Boine's special interest in a sufficient supply of protein for the polio patient is his concern for the proper condition of the patient's capillaries. This he insures by prescribing a daily dosage of 600 milligrams of vitamin C and 600 milligrams of hesperidin, a bioflavonoid, for each patient. The importance of capillary health is best realized by an enumeration of the functions of these tiny tubes that transport blood between the main blood vessels of the body:
They are part of the structure that supports the nerve tissue.
They hold the mechanism for maintaining a balance between blood plasma and cerebrospinal fluid.
They provide channels for the supply of nutrition and oxygen.
They regulate the mechanism for control of the intestinal functions.
They are a protective mechanism against disease.
They are avenues for the evacuation of dead materials from centers of soreness or infection.
They are sources of material for body repair. It is not surprising to find that one researcher has said that an "intact capillary system means a solvent body."
When polio strikes, as with any strong infection, the strength of the capillary walls is found to be diminished. The infection, which is more safely contained in them, tends to "leak" through the walls, attacking the more susceptible nerve cells. Vitamin C and the bioflavonoids have long been known to increase the strength of the capillaries so their use here is strongly indicated.
Other Polio Theories
In the light of the importance of firm capillary strength in preventing and controlling infection, the theories of several distinguished scientists concerning vitamin C and polio make more sense than ever. C. W. Jungblat in the 1939 Proceedings of the Third International Congress on Microbiology in New York said, ". . . a study of the natural history of poliomyelitis suggests a vitamin C deficiency as one of the chief predisposing agencies. The tissues of the susceptible do not seem able to destroy the virus when it enters as they should." Dr. Jungblat, at another time, remarked that extremely small doses of ascorbic acid (vitamin C) are capable of inactivating many times the fatal dose of polio virus-two or three milligrams of vitamin C are enough to inactivate 10 to 20 thousand fatal doses of polio virus. Dr. W. J. McCormick has said (Archives of Pediatrics, 69: 151), "There is an unusually broad spectrum of antibiotic action in this therapy (ascorbic acid), including all bacterial and viral infections." H. Scarborough (Edinburgh Medical Journal, 50: 85) says that ascorbic acid helps the vitamin P activity of hesperidin to increase the capillary resistance of man when given by mouth.
Doesn't it all add up to make one wonder if a careful support of vitamin C intake for everyone wouldn't cut down the polio rate without any vaccine? If there is such a thing as sectional areas of polio epidemic in our cities and states, can't it be that these poorer areas suffer, not from a lack of Salk vaccine, but a lack of vitamin C-rich foods and C supplements?
Dr. Boines' Record Dr. Boines has used all this information to good advantage in treating his polio patients. He does not claim that the actual paralysis or permanent stiffness of limbs is decreased by his treatment. However, his methods do improve considerably over what the national statistics would lead one to expect. He has 1/3 fewer deaths among his patients than the expected average and 90 per cent less severely disabled. Only 17 of 474 patients in 8 years have had to use braces or crutches.
Food supplements are given and a check-up on the tray as it leaves the patient's room reveals whether or not they have eaten. If not, they turn up on a special fourth-meal tray. It is considered normal for the polio patient to have a weight loss of 10 to 40 pounds in the first 3 to 6 weeks. Many of Dr. Boines' patients maintain a normal weight, or even gain weight. The added protein and natural vitamin C and hesperidin are continued throughout the hospital stay and into the home life. The family is instructed on how best to prepare high protein foods and warned to withhold sweet drinks and candy from the patient.
It appears that Dr. Boines has a lot of good reference work and logic -not to mention results-to back up his choice of treatment. We can't imagine an excuse for a doctor's following any other. We think that the preventive measures for polio could well be based on Dr. Boines' theories. We hope that the authorities will seriously consider adopting them. You don't have to wait for a national movement, however. You can begin protecting your children right now. See that they get plenty of the protein that forms antibodies to fight infections such as polio. Stuff them with vitamin C-bioflavonoid-rich fresh fruits and vegetables and C supplements. Skip the sweets and sodas. You won't need to depend upon vaccines to protect them. Good health fortified with good nutrition will do the job.
Remember, too, the Sandler diet for preventing polio, which is a diet high in protein in which starches, especially refined starches, are completely eliminated, and even natural foods that are high in starch are restricted.
Polio in Primitive Countries Wrote an Associated Press reporter on September 11, 1954, "Polio was pictured Friday as the great leveler, attacking the highest and sparing the lowest of the world's civilizations. Its incidence rises with the standard of living. It seems to thrive where other diseases fail. Where infant mortality is highest, it is lowest. It probably will continue to advance along with civilization, until some dramatic new vaccine brings it to a halt. "This phase of one of the world's problem diseases was presented Friday to the final session of the Third International Poliomyelitis Congress."
At the same congress, Dr. Rivers, Director of the Rockerfeller Institute for Medical Research in New York, said, It is now well known among medical researchers that in primitive countries and in communities where the economic and social levels are low, antibodies against polio appear sooner than they do among the "privileged" children of the higher civilizations and communities. Said Dr. A. M. M. Payne of the World Health Organization, "Until the infant mortality rate falls to about 100 per 1000 live births, the incidence of poliomyelitis is generally below 2 per 100,000. As the infant mortality rate falls from about 50 to 20, there appears to be a tendency for the incidence of polio to increase alarmingly."
In our file on polio, we have some of the most astounding theories you can imagine-for instance, an observation that the paralytic aspects of polio may be much worse after the child has been transported in an ambulance to the hospital. We have theories on whether polio is hereditary, whether it attacks only certain racial groups and other equally nonsensical observations. And now we have the theory that, so long as children are living under the worst possible conditions of bad sanitation and squalor, they will somehow manufacture antibodies to combat polio when they are quite young, and so, will never get the disease when they are exposed it later on. If there is indeed anything to this theory, then we see even less need for the programs of spraying with DDT, which are carried out regularly in many parts of the country as a precaution against polio. We have never heard of any polio epidemic being stopped by spraying with DDT and we have heard of localities where the polio incidence rose after the DDT spraying.
But, to return to Dr. Rivers and Dr. Payne. You see where this line of thinking leads us-if we're just dirty enough and disregard even the basic laws of sanitation; our children will be safe from any threat of polio. Isn't that exactly what they imply in statements such as they made?
Polio Is a "Civilized" Disease. Disregarding the theory about antibodies being formed in the blood only of children who live in filth, let's consider for a moment the well known facts (for they are well known by now) that children and adults in primitive countries simply don't get polio. And the more civilization they have, the more polio they have. The lower their infant mortality, as a result of wonder drugs and all the marvels of civilized medicine, the higher their rate of polio.
For instance, a letter from a Turkish correspondent in the Journal of the American Medical Association for August 6, 1950, assures us that polio is practically unknown in Turkey. Monthly reports submitted to the Ministry of Health and Social Assistance indicate that there are two or three cases of polio a year in the whole country. There is no evidence that an epidemic has ever occurred there. Medical students never observe the disease in its acute stage and seldom see a patient with recent paralysis. We are told that, in the summer of 1947, the child of a prominent physician, returning from a summer resort in Istanbul was the first patient admitted to the Ankara General Hospital with polio. Remember those conditions-the boy had been away to a summer resort on a vacation.
In Science News Letter for October 4, 1947, we read of a group of university scientists visiting the orient to take blood specimens in an effort to discover why American troops in Japan, India, and North Africa suffered from an increased incidence of polio, while the native populations had no polio at all.
Dr. A. B. Sabin, writing in the Journal of the American Medical Association for June 28, 1947, discusses the same puzzling aspect of polio. Why, asks Dr. Sabin, in the same year, when polio epidemics are raging in cities like New York, Chicago, Los Angeles and Denver, do Chinese cities occupying the same latitude report only rare, rare cases of the disease?
Dr. Sabin tells how polio occurred among American troops in China, Japan and in the Philippines, in spite of the fact that there were no outbreaks of polio at the time among the native children and adults. In 1954, there were 246 cases of polio with 52 deaths among American troops in the Philippines. There have never been any outbreaks of polio among the native Philippines. For many years, medical magazines have been commenting and marveling on the scarcity of reports of polio among the races living in North China.
What Civilization Contributes to Polio Isn't it discouraging how our experts will examine every aspect of the problem except the obvious one that is staring them in the face? They study the climate of Chicago compared to the climate of Shanghai. They study the blood of the children of China and compare it with that of American children. They note with care the number of flies in homes in Shanghai and on the South Side of Chicago. These and countless other angles have been investigated. Why have they never studied the food eaten by the people of these countries and compared it with the food eaten by Americans and Europeans, whether they are at home or abroad?
It's pretty obvious that American troops in all the fighting theatres of the last war ate, in general, the same foods they eat at home-including white bread, refined cereals, white sugar, soft drinks, ice cream, candy, canned vegetables, and all the degerminated, devitalized, refined foods that "civilized" people eat. And the American troops went right ahead consuming their annual 100 pounds of sugar per person. Consumption of sugar in China is 3.2 pounds per person, annually. Why is it that no writers except the "faddists" have pointed out this fact?
What kind of food did the Turkish physician's son have at the summer resort that was different from the food he ate at home? Does it seem far-fetched to believe that, because he was a physician's son, his family could afford to buy him refined and processed food such as the other Turkish children could not afford to eat? What would a survey reveal about the food habits of this boy and those of the other Turkish children who apparently are not susceptible to polio?
We do not believe that the per capita consumption of 100 pounds of sugar annually is solely responsible for the high incidence of polio among Americans abroad and the low incidence of polio among the native peoples in the same countries. But when the Third International Poliomyelitis Congress announces to the world that the higher the scale of civilization, the higher the rate of polio, we believe that the time has come to investigate the part played in such a circumstance by "civilized" food as opposed to the more or less natural foods eaten by people who have not as yet attained our level of civilization.
We suggest that one of the best guarantees against polio is to keep yourself and your family as nearly as possible on a diet, which is not "civilized"-that is, avoid the foods that have been put through the mill of civilized processing. Avoid foods made from white sugar and white flour, canned foods, prepared "mixes," ice cream, bakery products, cold cereals or any cereals that are not completely whole grain. Stick to the natural foods-fresh fruits and vegetables, as many raw as possible, for cooking is actually a form of processing, remember. Eat fresh meats, nuts, eggs, fresh or frozen fish. Even though you live in a civilized country, you do not have to suffer the penalties for that, if you will take just a little trouble to avoid the foods that civilization has turned into health menaces.
Vitamin A vs. Polio A very strong case for the addition of vitamin A to the list of elements of health known to be necessary to build up resistance to polio, is presented by Dr. Jose Guadalupe Reyes of New York City in his article in the New York State Journal of Medicine for August 1, 1945. Of 84 children suffering from polio who were admitted to St. Francis Hospital during the epidemic of that year, 98 per cent showed skin symptoms of vitamin A deficiency; and of these, all but two recovered under the proper care and with a well-balanced diet amply provisioned with vitamin A.
Dr. Reyes was especially interested in the skin manifestations of polio because physicians can very often determine what is taking place inside the body as evidenced by skin changes. A science of the various skin conditions would open the way to easier recognition of diseased conditions of internal organs. Addison's disease, for example, in which one or both of the glands located above the kidney is destroyed, produces brown pigmentation on the skin, especially near mucous membrane areas and over the bony prominences. A disease called hemochromatosis, in which metabolism is disordered, produces a bronze shade of pigmentation of the skin occurring at the same time as an enlargement of the liver and changes in the pancreas, a gland producing digestive juices and insulin.
In the cases of polio described in Dr. Reyes' article, the skin disorders were symmetrically located below both kneecaps, over the ankle bones, the arches and on the soles of the feet. These areas were typically horny and appeared as patches of warty elevations or scattered pimples with roughness and dryness on the skin of the legs. They varied in size from a dime to a half dollar and sometimes were covered with fine scales. Children's skin may often show irritation at places where friction is present-where tight clothes or shoes rub the skin, for instance. But these horny and scaly patches resulting from vitamin A deficiency were not to be mistaken for friction skin diseases, even though they occurred in some areas where friction might be present.
Some children even had a horny hardening of lymph sacs under the skin in certain areas such as below the kneecap, on the tops of the toes, especially the big toes, and on the fronts of the hips and the backs of the forearms. These were not of an inflammatory or acne-form type.
Since mucous membranes are also readily affected by vitamin A deficiency, Dr. Reyes expected to find evidences of equal injuries to the internal organs. He was not surprised, therefore, to observe gastrointestinal symptoms such as nausea, vomiting, diarrhea, and abdominal pain in 60 per cent of the cases. Moreover, 5 children had musical rales (a sound in the lung) all over the chest, with a cough similar to whooping cough without the whoop.
Investigations of vitamin A deficiency have revealed the course of the resultant changes in the body beginning with general disturbances and followed by structural changes affecting, primarily, the skin. There is a hardening and shrinkage of the outer layers with excessive multiplying of the basal cells. This occurs in the skin as well as in mucous membranes, such as the under surfaces of the eyelids, the tongue, mouth, nose and throat, the passages of the lungs, the urogenital system and "possibly the whole gastrointestinal tract." The hardening may also take place in the ducts of the mucus or the skin glands, with the formation of cysts or abscesses produced by the blocking of the duct passages. A description of the effects of vitamin A deficiency on the spinal cord and nervous system is given in Sollman's Manual of Pharmacology, indicating that degeneration of the myelin sheaths (or coverings) of surface nerves, especially the sciatic nerve and of scattered areas in the spinal cord, begins several days before other signs of deficiency appear in rats, and increases until the animals die, with muscular weakness, lack of coordination and final paralysis of the hind legs. The progress of this degeneration can be stopped by supplying the deficiency (of vitamin A). In its effect on the rest of the body, this deficiency makes it easy for bacteria to enter into the deeper layers of the skin and nerves, and hence lowers the body's resistance to infection, since vitamin A is essential for the normal cellular metabolism of the body.
Dr. Reyes suggested that "It may be possible that this modified skin or mucous membrane may be one of the portals of entrance for the poliomyelitis virus, since the vitamin A deficiency has diminished or impaired the normal resistance of these structures. It is now known that this virus is highly neurotropic (nerve-loving) and that it travels mainly in the nerves through the myelin sheath.... Vitamin A deficiency also produces changes in the myelin sheath of the nerves, probably facilitating in this way the destruction wrought by the virus.... The final changes in the nerves, however, may be due to the combination of both factors."
Although vitamin A deficiency may be a factor in many diseases, it seems to have a special connection with polio. Children admitted to St. Francis Hospital for other diseases showed the skin manifestations described above once for every eight polio cases in which they occurred.
Many vegetables and fruits, such as carrots, yellow squash, broccoli leaves, beet greens, escarole, apricots, etc., contain carotene, which is converted into vitamin A by the body. Fish liver oils contain large quantities, in addition to vitamin D. Since the vitamin concentration of the blood depends on the amount eaten, it is good to eat plenty of carotene-bearing vegetables in summer when they are fresh. Vitamin A is fat-soluble; hence, oils and fats favor its absorption, so put plenty of dressing on your salads. Beware, however, of mineral oil, which prevents absorption of vitamin A as well as of calcium.
As Dr. Reyes recommends: "Routinely, a diet rich in vitamin A should be administered to all children, especially during the periods of epidemics, and this diet should be supplemented by cod liver oil." Rose hips are rich in vitamin A as well as vitamin C-they contain about 25 times as much vitamin A as oranges contain. So keep rose hip powder, syrup or puree on hand.