Experiments on the Nasal Route of Infection in Poliomyelitis

1. The experiments given in this paper, notwithstanding their seeming diversity, relate to the conditions underlying the states of susceptibility and refractoriness to infection with the virus of poliomyelitis applied to the nasal mucosa. 2. Certain monkeys are highly refractory to inoculation via the nares with the virus of poliomyelitis, apparently in virtue of a power possessed by the nasal mucous membrane to destroy or otherwise render ineffective the virus applied to it. 3. This property of the nasal mucosa appears to be distinct from any specific protective substance active upon the virus which may occur in the blood. 4. An effective nasal mucous membrane prevents the passage of the energetically applied virus to the brain and spinal cord. 5. The virus of poliomyelitis energetically applied to the nasal mucosa will survive for an undetermined period of time upon an ineffective, but for a relatively brief period of time upon an effective membrane. 6. The protective power possessed by the nasal mucosa is not in itself adequate to prevent infection with the virus introduced upon it, since slight injury to such independent structures as the meningeal-choroid plexus complex favors the passage of the virus from the nose to the central nervous organs. 7. The normal nasal mucosa is, therefore, an invaluable defense against infection with the virus of poliomyelitis; and the number of healthy and chronic carriers of the virus is probably determined and kept down through the protective activities of this membrane. 8. Antiseptic chemicals applied to the nasal mucosa upon which the virus has been deposited exhibit no great protective action and are of doubtful value. Indeed, it is not impossible that to the extent to which they may affect unfavorably the destructive properties of the nasal mucosa, they may be even objectionable. 9. Infection with the virus of poliomyelitis applied to the nasal mucosa under conditions favorable to the extension to the central nervous organs and multiplication there may be blocked or prevented by the injection of poliomyelitic immune serum into the blood. While the exact manner and site of attack of the immune serum upon the virus is somewhat conjectural, when all the available data are considered it seems probable that the meeting place of the virus and immune serum is in the subarachnoid space.