not arise very often, they do occur frequently enough and are important enough to demand increasing attention. In considering these difficulties we must keep in mind the following possibilities : 1. Cases of acute anterior poliomyelitis with no noticeable sensory symptoms. These are rare, at least in adults and in children old enough to express themselves. 2. Cases of acute anterior poliomyelitis with severe pain and hyperesthesia in the paralytic members in the onset and lasting for a variable

more »

... time. These cases are also rare. 3. Cases of acute anterior poliomyelitis in which the sensory disturbances fall between the extremes of numbers 1 and 2. These are the usual cases. 4. Cases of multiple neuritis with unusual sensory symptoms and distribution. 5. Cases of so-called "multiple neuritis of the motor type," with little or no sensory symptoms. 6. Cases in which multiple neuritis and poliomyelitis are associated. Such cases have been pathologically demonstrated. They are difficult to diagnosticate; and certainly are not frequent. They are caused by some widespread and intense toxic process, producing grave general symptoms. 7. Miscellaneous conditions, as acute ascending paralyses, "family periodic paralysis," myesthenia, hysteria, etc., which, in the differentiation under consideration, will hardly create confusion when carefully studied.