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later became chairmann o f the Hygiene Committee o f Helath Department.
Cosmus Bræstrup, the commissioner o f the Copenhagen Police. Bræstrup was fa
mous for his energy, and he got the notification-offices etc. organized quickly.
Sofus Engelsted, M.D., during the epidemic appointed registrar in Almindelig Hos
pital, having the unenviable job o f being in charge o f Almindelig Hospital during the
epidemic. Later on he became a member o f the Health Department and chief physi
cian o f the venerological ward o f the Municipal Hospital. Engelsted was a character,
and he often went hos own way. Hen was notorious for his sharp remarks.
Poliomyelitis.
Polio has been known occurring endemically since Underwood described the first
cases in 1789 .
The first poliomyelitis epidemics were recognized at the beginning o f the 19 th cen
tury, but it was the two research workers Heine and Medin, who finally distinguished
polio from other diseases with paresis involvement. Medin also discovered that it was
an infection.
A fter the discovery o f vims at the beginning o f the 20th century it was contrived
to disclose poliomyelitis as a viral disease. A t first it was assumed to be transmitted
primarily by droplet infection, but during the large American epidemics in the nine-
teenforties a great many polioviruses were discovered in faeces. Only when it was made
possible to cultivate poliovirus in tissue a vaccine was finally invented.
The first poliovaccine used for large-scale vaccination in 19 5 3 consisted o f killed
vaccine (Jonas Salk). In 1960 Bruce Sabin produced the first vaccine o f live attenuated
vims.
Poliomyelitis is caused by a vims o f the enteric group. Man is the natural host. The
entrance gate being the mouth. After about a week the infection is located in the in
testinal tract. Here the disease will either stop or become general. When, after a stage
o f viraemia, the vims has entered the central nervous system the characteristic para
lysis will occur.
The illness will probably leave life-long immunity. The fact that after 19 4 0 it has
appeared more epidemically, and with increasing maximum o f age, is probably due to
the progress o f hygiene, which is a protection against asymptomal infections in the
early childhood. This can also explain, why the disease during the years after the
Second World War became epidemic in industrialized poor countries. Thanks to the
vaccination the disease is now rare in Europe and the United States.
Up to 19 5 2 Denmark had had several minor epidemics. Therefore the disease was
known and a new outbreak expected, although not such a violent one.
The patients in Copenhagen could be admitted to Blegdamshospitalet, the capacity
o f this hospital being flexible.
At Statens Seruminstitut experiments with semm treatment were carried out, and
they were interested in vaccine against polio at an early stage.
The epidemic broke out in Ju ly 19 5 2 , and the last cases occured in January 19 5 3 .
During this period nearly 3.000 cases were reported in Copenhagen, out o f which num
ber, though, 1600 were nonparalytic.
The medical officers at Blegdamshospitalet distributed the patients. The minor ca
ses had to be transferred to emergency wards established in other hospitals o f the
town.
The 35 0 patients with respiratory paresis represented a special problem. The mor
tality o f this kind o f patients had been nearly 100% in previous epidemics. In 19 5 2 ,
by a fruitful teamwork o f medical officers, anaesthesiologists, laryngoologists and
technicians, it was contrived to develop a new technique o f permanent artificial ven
tilation. The treatment included tracheostomia, physiotherapy, control o f O
2
- and
CO
2
-tension in the blood and primarily manuel balloon ventilation, - later on mechani
cal ventilation in respirator.
The polio patients often needed a long rehabilitation period after the acute stage.
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