1. EXPERIMENTS WITH DIBASOL IN PLOVDIV 2. RESULTS OF DIBASOL TREATMENTS ON INFANTILE PARALYSIS PATIENTS
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CENTRAL INTELLIGENCE AGENCY
INFORMATION REPORT
This Document contains information affecting the Na-
tional Defense of the United States, within the mean-
ing of Title 18, Sections 793 and 794, of the U.S. Code, as
amended. Its transmission or revelation of its contents
to or receipt by an unauthorized person is prohibited
by law. The reproduction of this form is prohibited.
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COUNTRY Bulgaria
SUBJECT l4 b, Experiments with Dibasol in Plovdiv
Results of Dibasol Treatments on
Infantile Paralysis Patients
DATE OF INFO.
PLACE ACQUIRED
REPORT
DATE DISTR.
NO. OF PAGES
REQUIREMENT
REFERENCES
13 May 1953
32
THE SOURCE EVALUATIONS IN THIS REPORT ARE DEFINITIVE.
THE APPRAISAL OF CONTENT IS TENTATIVE.
(FOR KEY SEE REVERSE)
E,cperiments wi? h Dibasol in Plovdiv
1. Supplies of Dibasol9 presumably of Soviet origins have reached the Hospital for
Infectious Diseases in Plovdiv., but only-in quantities sufficient for experimental
purposes and not for general hospital use.
L Experiments with DibasoI have been- strictly eonffnied. to Plovdiv. No hospitals or
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ed w
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preparationo
Tests have been carried out on patients in the Plovdiv Hospital with the limited
-supply of Dibasol which is available. Issue of the drug is strictly controlled.,
and doctors entrusted with it have to sign for it and no doubt are obliged to keep
accurate records of h it- is used.
ba The amount of Dibasol'supplied by the Soviets to the Hospital at Infectious Diseases
at Plovdiv in 1951 was sufficient for the treatment of only 15 cases. No further
supplies have been forthcomings, and none are expected. (Date of i:nfbrmationp 1951-
1953D)
Results of Dibasol Treatments on Infantile Paralysis Patients
Dibasol is an odprlessp tastelessp water-soluble., light yellow powder, the chemical
composition of which has not been made public. The method of preparation and first
tests carried out with this compounds as well as the results of these testsp have
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been submitted by Professor ~ar?ov and Candidate of Medical Sciences Rozin. Rozin
reveals the singular peculiarity of Dibasol compound in its effect on the nervous
system.
The compound has been obtained by an artificial (synthetic) method by Professors
R. A. Porai -Koshietz., L. S. Efrosov., and 0. Fo G?inzburg.
7. Initial trials with rabid oats shoved that Dibasol increases the reflex activity
of these animals and at the same time produces a certain lowering.of blood pressure
and short excitation of breathing. A subsequent analysis of trials with various
laboratory animals showed that this increase of reflex activity in case of rabid
cats is not connected with the effect of the compound on the peripheral motive re-
gion of the reflective tract (path?).
89 Experiments with beheaded animals showed that Dibasol is a substance which acts
on the nervous system.
9 The spinal cord of animals is the part most sensitive to the Dibasol compound., but
at the same time., Dibasol has no visible effect on the centers of medulla oblonga-
ta and intermediate train controlling the regulation-and formation of motive
activity. The compound has a weak toxic effect., and, when taken internal. r,, grad-
ually decreases in effect since it does not possess a tendency to accumulate.
10. All this information served as a basis for investigating the effects of the com-
pound on humans.
11. Ergographic examinations of nine persons who took Dibasol internally shoved thato
compared with control experiments, the muscular activity increases one hour after
administration of one Dibasol powder (reliability factor of 3.27)-
12. Repeated experiments determined the effect of Dibasol on activity connected with
maximum pace of motive effort. Nine persons undergoing investigation had to tap
a telegraph key with the index finger during 15 seconds in an attempt tea make the
maximum possible number of taps.
13. Experiments with telegraph keys were carried out twice--before taking Dibasol
powder and one hour after taking it. During control experiments (glucose ooS).,
the work was equal to 319 percent (average of 11 experiments)., one hour after
taking,90 during experiments with Dibasol. (o 000 ?) s the work was equal to 102 *9
percent (average of nine experiments),, while during experiments with prosamine.,
the work was equal to 106.9 percent (average of nine experiments).
14. E. I. Lyabina (a woman),, studying the effect of Dibasol on some peculiarities of
knee reflex of a healthy-human beings, tested Dibasol in eight cask and proved
that, in a dose of 0.005, Dibasol, in comparison with control experiments (glucose
00!0)., produces an increase of speed of muscular tension to a definite degree by
19.7 percent. This information is of a statistical nature (reliability factory
equal to 3.16). A peculiar feature was the presence of a distinct stimulating
effect on a number of regions of the central nervous system, and in particular on
pia mater of large semispheres of brain, with an absence of analogous effect on
formations of medulla oblongata and intermediate brain. A peculiar feature was
also the Increased working capacity In healthy human beings during some of the
experentss with a complete absence of any emotional excitation--insomnia., etc.
In this, cases Dibasol has been found to be a peculiar stimulant,, the effect of
which differs distinctly from the well-known effects of such stimulants as phena-
.ne or caffeine.
15. Therefore,., the idea appeared to be quite natural, to test whether the substance
under 1mrestigation might be able to increase the capacity for work under patho-
logical conditions, when this capacity has been disturbed as a result of disease
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of the nervous system. The effect of Dibasol on the spinal cord., established by
experiments on healthy aninals, has led to the tests of Dibasol in the first in-
stance in affections causing disruption of the nervous periphery. Such pharmaco-
therapeutic experiments were carried out on guinea pigs poisoned by tricresyl-
phosphate (tests were carried out by l y V Tsomaaiya) o As a result of poisoning, 9-
27 animals developed flabby paralysis of the hind extremities and, in sane cases.,
all four extremities. Eleven guinea pigs with the most serious clinical syanpt .
were subjected to treatment by Dibasol (dose 10 mg. per 1 kg, of weight., administer-
ed internally)., and 16 guinea pigs were left without treatment for control purposes.
of the 16 guinea pigs left for controls 15 died and the ft motions cif the remaiihi g
pigr,*hich had been damaged by poiscnn,were not restored. Of the 11 g nee pigs
subjected to Dibasol treatments nine 'remained alive and two died the functions
affected by poisoning became almost completely restored in tests, ?inea pigs. The
data of this expeklment'was confirmed by a detailed,electro-p siological investi-
gationg which also con d fully the repeated experiments of analogous nature.
16. Employment of the cordpound at the Clinic in cases of nervous system affections had
as its object to ascertain whether a single administration of Dibasol has an effect
an temporary increase of working capacitys, as was observed during experiments on
healthy. human beings0 On certain days patients received several Dibasol powders
in doses of 09005. Dyanamometric or _,' ergometric examination of the 'working capacity
of patients was carried out. For control tests., patients were given powders con-
taining 0.5O of glucose.
17. It was- observed that even a single administration of Dibasol powder increased the
temporary working capacity to a considerable degree. Greater and more progressive
effect was observed at pepeated administrations of Dibasolo This was observed
particularly clearly in case of patients in a stage of recovery after infantile
paralysis. Identical effect was observed in case of all patients of this group.
Results of i.nvestigationns on 29 patients nerved as a basis for the organization of
amide cl.ical tests of Dibasol at first at the neurological clinic in Leningrad
and later in other tco
18. By April 1944., the 'number of patients who had passed a course of Dibasol treatment
was 721, of whom 636 had poli yelitis The clearest effect was observed during
the recovery stage after poliamayelitise Observations made at first by Vo Mo-
Bykhovffi , in the nervous disease clinic of the Leningrad Pediatric Institutes)
under the guidance of Professor G. A. Aronovichg. showed that in a number of cases
the compound has a considerable clinical improvement effect on the condition of the
patient.. The effect of Dibasol on a patient in a residual period of pol .omyel.itie
was studied at the Leningrad Scientific Research Institute WGo G. Io, Tuurnaerr (con-
sualting neuro-pathologist" Professor No A. Krishov). The work was also under the
general guidance of the late Director of the Institute., N. Io Shirman. Several
teams of collaborators of this Institutes, including neuro-pathologists and ortho-
pedists;;, completed a careful study of effects of the compound. In a number of
oasesp new active movements reappeared and previously weakened movements were
etreagthened. These changes were accompanied (NOTE. from this place., the hnannd
writinng of ruse original, Bulgarian., text changes) by distinct changes in the motive
6hr6pn3:c (motor timing) 9 and likewises) in nuttnber of cases in which no visible
changes in the movements had previously-been observed, movements have now. been
recorded ergographically.. Information was obtained that in strength of its
effect., Dibasol surpasses proserine and prolamine (mixture of proserine with
phenamine). At presents Dibasol is employed with definite success in many neuro-
logical' clinics of the USSR. According to the conclusions of the Commission for
Combatting Poli.c elAtiss) attached to the Scientific Medical Council of the
Ministry of Health of the USSR,, the Dibasol compound gives in a considerable
percentage of cases (up to 4040 percent), a positive therapeutic effect to a
greater or lesser degree. Many of the patients dsiazd even greater improvemennt
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m4
Clinical improvement of patients as a result of administration of Dibasol was of
a permanent nature, and in some cases, after repeated courses of Dibasol therapy.,
still-greater improvement was observed. The adopted dosage (0.005) of Dibasol
had no toxic effect whatever. Considerably increased dosage may., in certain
cases, produce headache, dizziness, indisposition (or inclination to vomit), and
lowering of blood pressure.
19. Dibasol has a number of advantages over proserineo As one of these advantages,
it is necessary to mention first the absence of toxic effects. At present, it
may be regarded as confirmed that Dibasol surpasses proserine byr its greater
therapeutic effect. A resolution of the Pharmaceutical Committee attached to the
Scientific Medical Council of the Ministry of Health of the USSR of 29 October 1949
allows a wide employment of Dibasol which is manufactured on an industrial scale
and issued by pharmacies on doctorst prescriptions.
20. Ivashentsov considers that favorable results have been obtained with Dibasol, and
that these results give a basis for recommendation of a method of treatment indi-
cated by Lazarev?s experiments. He considers that the curative effect of Dibasol
on poliomyelitis patients (in residual and recovery stages) is shown by the
appearance and restoration of motive functions which had been absent or weakened
as a result of disease. At first, the appearance of curative effect depends upon
the nature, periods and intensity of pathological process. Sometimes the curative
effect of the compound begins to be felt as soon as one or two hours after ad-
ministration of a powder. In his opinion, the course of treatment with Dibasol
consists of five to 10 administrations of the compound, one powder a day or every
other day.
21a Dosages are as follows,
ao For Children of less than one year of age,, 0.001;
b. For children between one and three years of age, 0,002;
c. For children between three and eight years of age, 0.0030
do For children between eight and 12 years of age, 0.0049
e. For children over 12 years of age, 0.00,5 and
f. For adults, 00005.
22. It is'recommended that the compound be administered during the interval between
meals, A repetition of the course of treatment three or five months after the
first course may yield additional curative effect.
Clinical Cases in which the Soviet Dibasol Compound was Used
23.. Case No. 1, M. P. (initials of name)., a child 10 months old from Brezovo village
(N 42-21, E 25-04), Plovdiv Okoliya, Hospital List No. 12749, vek1.eu No. 1071
(probably B9clinic No. l071JB), admitted to the Clinic on 9 October 1951, dis-
charged on 29 October 1951.
a. (Extract) from anamiesis (case history)s During 20 days., the child was rest-
leas, and suffered from diarrhea. During the last seven or eight days., the
right leg began to hang, and the child was unable to stand on it. After an
examination at a Cbildret Clinic, the child- was sent to the Clinic and
admitted with a diagnosis of infantile paralysis.
b. General status8 b. o. (probably means normal).
ca Specific status.- The tone of muscles of the right leg., mainly of the
quadricep k muscle, was lowered considerably. Patellar and Achill.6s reflexes
of the same leg were absent. The leg was hanging completely, and passive
movements were possible in all joints. Active movements existed only in the
toes.
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d. Paraclinical investigations&
(1) Urines. albumen /?/., sediment m urates.
(2) Blood.- erythrocites m 31O0O0o. Haemoglobin 85 percent. Leucocytes
11400. "shtab" (rod nuclei) a 4. 1Qseg" (segmented nuclei) a 6o.
lymph ? 36.
(3) Lumbar punctures spinal fluid m rapid and flows out at pressure.
"Pandyql (test for protein in spinal fluid) -/,$/s I?Pavl" (see Washington
Comment) -/+/,, Riv m/?/, kl. (possibly. ?D kletka" s i. e. s cell) - nil
albumen - L.2 mg.%., sugar - 55 mg. % chloridgs m 840 mg,, %.
e 4 Treatments Galvanic treatment of the right leg for 10 minutes daily during.
a period of 21 days. (Extract) from "dekursus" (clinical record) s On the
fifth day after admittance to the Clinic, the tone of muscles of the right
legs particularly of the quadriceps muscle of the legs imps; ved. Reflexes were
absentp active movements only iin the toes. On the thirteenth day, the tone of
muscles and reflexes remained the samep but the child became able to bend the
leg in the knee Joint by about 30 degrees. A neurologist summcn ds.f?or,; a; ,,,
sultation made the following statements. "setivnost" (possibly sensitiveness)
b.o.3 ability to move m limited in the right leg. Tone of muscles - consider-
ably? lowered. Tendon reflexes in the right leg absent. Conclusions - refers
to monoplegia of the right leg.
f. Dia osis& "Polomyelitis acuta anterior."
In accordance with the required
qua,ran Mnoe of 4) days$ the child was discharged from the ClirxLc on the twenty-
first day after admittance. The condition of the child was as follows tone of
muscles of the right leg loweredp particularly of the quadriceps muscle. Pa-
tellar and Acillis reflexes ? absent? Active movements observed only in the
toes of the logs which the child was able to bend in the knee Joint by about
30 degrees. The child maintained a sitting position. Was able to stand., but
became tired quickly and bent the right leg in the knee joint.
g. Check-uu examination, No. 4046 at the ?Q ambulatoriya,," on 30 November 1951s
s h ed the same neur~Aogical results as at the time of discharge from the
Cl,ign,:La. In form of clinical treatment., the patient was given 10 powders of
Dibasol of 0.001. After taking the powders., the child was returned for a
chebk-up on 12 December 1951, when the following was. established (statement
of mothers the child began to stand for longer periods., bending the right
leg less frequently. The child attera. ted 1
to get up unaided, supported it- self e its army. Moved see 25X1
( Comments) more ditens as the passing
of water was more frequent.:-.than before taking the ponders. Neurological
statuss The tone of muscles of the right leg, including quadriceps better, the cchi.ld could stand upright for longer periods without bending right leg. Was able to bend the right leg in the knee joint by about, ding the
degrees. In a standing 90
g position attempted to take steps., but was unable
to do so. Reflexes were absent.
2I. Case No. 20 P. G V s a child of 21 months from the village of Krumevo (N L2-O5;
E 24-48)., Asenovgrad Okoliyas Hospital List No. 99889 "kl." No. 827. Admitted
to the Clinic on 9 August 1951 and discharged on 13 September 1951.
a. From anamcnesis& Four days befc9 the chil&s temperature rose. Three days
t aa1& s left leg became lame. On the fourth days lameness of the
left leg increaseds and during the night the child lost the ability to move
it., and became unable to turn around in bed. On the fifth day., brought in
for an examination at the Childr%-nsf Clinic., the child was sent to the Clinic
with a diagnosis of infantile paralysis.
b. From the general statues it is characteristic that the child occupied a
pass ,ve pos ? oar g on its back in bed.
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c. S ecific ;statuss The tone of lumbar muscles and quadriceps muscle of the
left leg considerably lowered. Gluteal creases completely smoothed out.
Active movements in the pelvic and. thigh joint and knee joint completely
absent, .There was a clearly defined hyperesthesia and painfulness of the
left leg. The child was unable to maintain an upright position even when
sitting.
d. Paraclinical investigations:
(1) Urines albumen--j; sediment -;sodium orates; 8-9 erythrocytes in the field
cxf vision., one leucocyte in the field of vision
(2) Bloods erythrocytes - 320000 (3)-s leucocytes - 8200, "yung" (see
Washington Comments) - 10; rod-shaped nucleoli - 10;. segs - b8;.. lympho-
cytes 32.
(33) Lumbar punctures: spina1ifluid - speedy and flows out at pressure.
"Pandy" -/l/ traces. "Pavl" -/-/. '"Riv".-/?/, albumen.- 38 mg. %, sugar -
60 mg. %, chlorides - 1078 mg, %;, "kl." 180, mostly lymphocytes.
e. Treatment: During eight successive days, the child received one cubic c ti-
meters of cylotropine (sic) every day. Heterohaemotherapy (sic) - five days
in succession. 30 cubic centimeters each day from mother. Warm poultices
during four days. On sixtheenth day after commencement of illness, the child
received hot pack treatment ("nagre'ka")d
f. From "dekursus"s On the seventh day after admittance to the Clinic., the tone
of muscles o the left leg was unchanged. The leg could be actively bent in
the knee joint by about 10 degrees. Passive movements were free in all joints,
but painful. Actii a movement of toes existed, The child was able to sit in
bed. Reflexes of the left leg were absent. On the ninth day, the child w s
able to bend the left leg in the knee joint by about 20 degrees. On the
nineteenth day, the tone of the left leg was a little better, Reflexes of
the leg were absent0 There were active movements of the toes, The child was-
able-to stand upright on both legs and even move the left leg forward, during
which, the leg described an .r6hl3ke movement outwards. On the thirty-first
days, the tone of the left leg was better. Reflexes were absent, The child was
able to bend the leg in the knee joint by about 30 degrees. On the thirty-
sixth day at the C:liaaic, the fortieth day after commencement of illness. the
child was discharged from the Clinic with the following statuss tone of the
left leg, better; Patellar and Achillis reflexes absent; active movements of
toes of the leg in existence. The child was able to bend the left leg
actively bj odbout 40 degrees-,. The left leg was colder than the right leg.
The child stood upright and walked., but during walking threw the left' leg
outwards. The condition of the left leg leas not changed until (possibly
as of) 18 December 1951, and on 19 December 1951, the child was prescribed
ib ibas bl - powders ' of ' 0.002 each in form of polyolinical treatment, by the
Area'?hysician. On 29 December 1951p during a dispensary check-up,, the
following was established (statement of mother) & After taking five powders,
the child showed a desire to walk, During walking, the child was less tired
and threw out the left leg to a lesser degree. The child urinated 'more often,
g. Neurological status: After 10 days, the hyper-reflex action of the right leg
was restored and sight. reflexes of the'left leg appeared. During walking,
the left leg was thrown outwards. less and was bent better in the knee and
ac he joints. The patient was able to walk independently. The tone of
muscles of the left leg was betters including the quadriceps muscle.
25 Case No, 3, IL. I. K.;, achild three years and three months old., resident of
the Rakovski area (N 4Z-03p. E 25-35) of Dimitrovgrad, Hospital list No, 13659,
"ki " No. 1179. Admitted t? the Clinic on 29 October 1951 and discharged on
1 December 1951.
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-7-
a. From anamnesiss Seven days before, the child had a high temperature and
refused to eab. After three days, the temperature came down and the child
calmed downs On the fourth dayT, wishing to get up from bed, the child fell
down and it was discovered that it was unable to stand on its left leg, or
to move the left leg. The district hospital at Khaskovo (N 41??55, E 25-32);
sent the child with a diagnosis of infantile paralysis to the Clinic which
admitted the child.
b. From them status, it is important to note that the child was taking
up a fully relaxed pce ition., lying on its back in bed.
c. Specific status- The child was unable to maintain,a standing or sitting posi-
tiohe head remained dropping back and the child could not straighten up.
The tone of the left quadr?icepte, lumbar and occipital muscles considerably
lowered gluteal creases of the left leg which was in a fully relaxed lying
position were smoothed out. Patellar and Achillis releases of the left leg
were absent, Active movements existed only in the toes of that leg.
d. Paraclinical investigations
(1 'Urines albumen m/m/a sediment - "b.o."'.
(2) Blood& er hrocy-tes m 3800000- leucocytes 10600; "mladi" (see
Comments) 4 69 seg - 543, lymph m 40. 25X1
(3) Lumbar punctures spinal fluid m speedy., flows out at increased pressure.
"Pandy" "Pat]." -/*/- traces, 9URiv.1e. -/-/ 38 mg-
; albumen -%;
sugar 66 mg. %; chlorides m 740 mg. %; cells m 160, mostly lymphocytes.
e. Treatment & Heterohaemotherapy from mother during four days 30 dubic centi-
meters daily. Warming (hot) poultices during eight days in succession. Vitamin
B1 during eight days. Fifteen days after commencement of illness, galvanic
treatment of left leg for 17 minutes during 19 days and massage during 18 days.
Dibasol was prescribed on the.thirty seventh day after commencement of illness
in doses of 0Q002 daily after meals, about 2-3 hours after dinner, during 10
days in succession.
f. From "dekursus"a on the eighth day after admittance to the Clinic, the child
started to keep its head upright (straight) but was unable to stay in a sitting
position. The condition of left leg showed no change. On the twelfth day
after commencement of illness, the child was able to keep the head upright
and to maintain sitting position. The child was able to bend the left leg in
the knee Joint by about 30 degrees`. The reflexes of the left leg were absent.
The tone of the quadriceps muscle was lowered. The consulting neurologist
made the following statements the child was crying and resisted examination
and this made it impossible to establish detailed neurological status. An
impression was created that the active movements of the left leg were re-
stricted (limited) and the tone lowered. The tendon reflexes were absent.
Conclusions "poliomyelitis acuta anterior."
g. On the sixteenth day from the beginning of illness., the child was able to
bend left leg in the knee joint by about 60 degrees and in the pelvic and hip
joint by about I9.0.degrees. The reflexes were absent. The tone of the
quadriceps muscle was lowered., but the gluteal creases became slightly de-
fined. On the thirtieth day from the beginning of illness and twenty-eighth
day after admittance to the Clinic., treatment with Dibasol started with doses
of O,o002 per day, three hours after dinner. At the beginning of Dibasol
treatment; the neurological status was as follows- reflexes in the left leg
were absents the tone of quadriceps muscle m lowered, the left leg could be
bent in the knee joint by about 60 degrees and in the pelvic and hip joint
by about 70 degrees,- the child was unable to walk.
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On the twenty-seventh day (?) (on fourth-day after commencement of Dibasol
treatment) the child became able to. walk, although able to move the left leg
only slowly.,, bending and unbending it in the knee and pelvic-and hip joints
not more than the above-mentioned extend (60 and 70 degrees)., but doing this
without aid frcm other peoples The tone of the quadriceps muscle was some-
what better. Slight reflexes in the left leg appeared. On the thifty-first
day from admittance to the Clinic and the thirty-seventh day from the commence-
ment of illness (NOTEs the count -of' date--ie a 1'iii--O'ng) - and the eighth day
after the start of Dibasol treatment.,. the condition-was as follows s The child
got up from bed independently and wa]:freely bending and straightening the
left leg. The tone of quadriceps muscle was still better and the gluteal
creases were very well. outlined. The child did not get tired walking. The
Patellar and. Achillis reflexes in the left leg were slight. When the child
was discharged from the Clinic on the fortieth day from the commencement of
illness and eleventh day from. the commencement of Dibasol treatment., the state
of wealth was as follows TheAe of muscles of the left leg., mainly that of
the quadriceps muscle was a little lowered. The reflexes of the right leg
were higher and of the left leg ? were normal. The child got up from bed un-
aided and moved about freely. The check-up lumbar function showeds "Pandi"{
m/t/ traces; "Riv" /m/ "Pawl." -/+/; albumen - 16.5 mg. %; chlorides - 750
mg. %; "kletka" (cells?., 0.
26. Case No. 4 N. R. Q..9; a. child of four.years-of age from the village of Krumovo9
Asenovgrad Okoliya9 Hospital list No. 12593,,, "kl.P'No. 1051. Admitted on 5 October
1951. Discharged on U November 1951.
a. From anamnesisg Three days before, the chiMMd cried from pains in the stomach.
On the nex?ay,, the pain spread to the left leg$ but the child still walked
about unaided, When it was.decided to show the child to the doctor., it was
found that the child had become very weak and was unable to stand.
b. From the general status;, it should be noted that the child took up a passive
and fully relaxed po ion- on its back in bed.
c. Specific status& The tone of quadriceps muscle of the left leg$ of the lumbar
and cc pmuscles greatly lowered, The left leg was completely powerless;
and took yap any position given to it. Active movements; existed only in the
toes of the leg. Patellar and Ach llis reflexes were absent. The child was
unable to maintain a, sitting position and fell to the sides. The tonsils were
enlarged, full and reddish and clear.
d. Paraclinical investigationss
(1) Urines Albumen sediment" "b..o."
(2') Bloods erythrocytes ? 1.230000; leucocytes 27000; seg - 56; rod-
shaped nucleoli * 6;', lymphocytes - 323 monocytes - 6.
(3) Lumbar punctures spinal fluid:'- speedy and flows out at pressure.
"Paned" "Pavl." -/-/.I "Riv" m/-/~ "'kletka" (cells) - 1209 mcs tly
lymphocytesa
Treatmento Heterohaemotherapy from mother$ 20 cubic entimeters per day during
five days in succession. Vitamin C.during 20 days. five cubic centimeters per
day. Massage starting on fifteenth day after commencement of illness to the
day of discharge from the Clinic., during 26 days.
From the "dekurszs"a On the thirteenth day after admittance to the Clinic
(sixteenth day from the commencement. of illness)$ the neurological status was
as foil owes the tone--oaf muscles of the left leg greatly lowered. Patellar
and Achillis reflexes absents The tone of lumbar muscles also greatly lowered
and the child was unable to maintain sitting position. The tone of occipital
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musalee' better and 'thirv fiild'fae- able. to keep iu- iiiel upright. On the
twentieth day after admittance to the Clinic (twentythird day of il2neis),-
the tone of quadriceps muscle was greatly lowered. The' reflexes in this leg
were'absent, The glute-al creases were smoothed outs Active movements were
observed only in the toes. The child was unable-to maintain sitting position.
The neck would be kept in upright -position, On the twenty-eighth day of the
ilinee:s,. the summoned consulting neurologist -made the following statement:
"setivnost" - "boo*";ability to moves in neck, lumbar region and left leg,
active movements limitedo. Muscular tone in same regions lowered. The knee
and Aohillis re exe~a absent. ors tie ' f_ t. leg.' The remainder "boo." Con-
clusions "poliomyelitis acutna anterior." On the thirty-third day of the
illness, the tone of-lumbar muscles and left leg was betters The child was
able-to sit and with aid' was able to get up from bed and to make attempts to
walksin whit the left leg was.thrown outwards. 11 Nov teh the
fortieth day of the illfiess the child was dischar ed from the her C19n1 th liric o the
following neurological statusa the tone of occipital and lumbar muscles was
good.' The tone of-quadrioeps muscle was better, but still remained lowered.
The child was able to wales leading on both arms and throwing out the left
leg. On 18 December 19511 during bhec ;uplcexaminations the state of health.
of the child_ was recognized to be the same as at the time of discharge from
the Ciiriic. The area physioi'an agave the child 10 Dibasol powders of 0.003
in form of polyclinical treatment. : After 1:0 days on 29 December 1951s the
following was aseert fined (statement of m?ther)s Four days after starting
to take the medicines, the child was able to walk longer periods-with light
outside aid, supporting itself on one arm, The child urinated more often.
Neurological statuss the child was able to walk b3r slightly supporting itself
with fingers'of its right hands and tircwitig its left _leg outwards. The tone-,
of quadriceps muscle. of the, left -lag was better,, The r eflexes of the left leg,
Pante].lar and Achillisa were absent. During a.second check-up examination on
9 January 1952? no change in state of health' was observed, apart from the
statement of mother tit child was walking forlonger periods and did not get
tired.
27. Case No.,!, A. M. A., 3 tear.old child, from Ivaylovgrad (N Iil-33, E 26=07), Hospi-
tal list too W73, "kl. No'. 12.58. Admitted to the Clinic on 15 November 1951.
Discharged on 20 December, 1951,1
a. From anamnesiss Three days before,. the'ohild was unwell.. There were indica
one of tonsillitis ("angina") q with high temperature. On the following days,
the temperature dropped. OA the third daypwhtle +I ase cIthesc? :ldsin;;;t er
Abrsutn'g#a. a mother saw that the child.could not stand upright, and step on
the right leg. The child was taken to the District Hospital at Khaskovo and
from there to the Clinic
be bent in the knee joint only to the extent of about 30 degrees. The child
was unable to maintain sitting position. The Patellar,and Achil.lis reflexes
on the right leg were absent and of;the left leg were weake,
d. Paraclinical investigations$
(1) Urinez albumen -/-/g sediment b.c.'
(2) Bloods erythrocytes - .1t17O000 ,Teucocy-tes? 7600, rod-shaped nucleoli -
6, seg - 56, lymphocytes - 36,'monocytes 2.
~,i);b.Lumbar punctures spinal fluid -epee, , flows out at increased pressure.
"Pandy" /4/, "Riv." ..!, "Pave." -// traces t, "kletka" - 170, mostly
lymphocytes; albumen - 28 mg.. %, chlorides 860 mg. %, sugar - 62 mg.%.
From the general. status. "boo,"
.S ecific.sts the tone of quadriceps muscle of the right leg lowered.
Gluteal creases smoothed out., Active movements of. the right leg remained
only in the toes. The : tone of'-quadriceps muscle of. the left leg lowered. Sn
the left legs active movements remained only in the toes. The left leg could
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Treatment- Heterohaemotherapy 30 cubic centimeters per day during five days
from father. Vitamin B. Vitamin C. tSKorticherPsyrup made up of dylotropine
during eight days and Dibasol, the employment of which will be described in
details
treatments the child was able to sit ("stand' was probably meant in this case)
properly on its legs. With the aid of otherss the child was able to move the
leg slowly forward., but was easily tired. The tone of quadriceps muscle of_
the right leg was better. The reflexes showed no change. Gluteal creases on
both legs were more clearly defineds, particularly on the left leg. On the
seventeenth day of illness and seventh-from the start of Dibasol treatment,
t13 child was able to move legs freely, but the right leg more slowly. The tone
of muscles of both legs,; particularly of the lefts, was better. The reflexes of
the left leg were present., and those of the right leg were defined weakly. On
the twenty-ninth-day 'of illness, the tone of muscles of the left leg was goody
but that of the right leg w4s still lowered.. The gluteal creases had normal
aspects The child was able to walk freely, only slightly supporting itself
with fingers of the left hand? The reflexes were without changes On the twenty-
seventh day after admittance to the Clinic' (thirty first day of illness) aiid-
ninth day after start of Dibasol treatment., repeat treatment with Dibasol was
started - daily one powder of 0.001, during 10 days. On 20 December 1951, the
fortieth day of illness, the chid was discharged in the following state of
health,; tone of muscles of the left legs as well as the reflexes., normal.
Tone of muscles of the right leg, particularly that of the quadriceps muscle.,
lowered. The child was able to sit freely and to walk wells but bent its
right leg in the "knee joint more energetically (with more force or effort)
than the left leg$ and required slight support when walking. Reflexes of the
right leg were absent.
During the check-up examination at the dispensary on 4 January 1952, the
following was established& increased reflexes on the left leg and indications
of reflexes in the right legs with still more clearly expressed tone of
muscles on the left legs The child was able to move the right leg wells but
threw it slightly outwards. When walling., was supporting itself with one hand,
f. From Bede]kursus"& On the second day after admittance to the Clinic (sixth day
affer commencement of illness)., the child was able to sit in bed. On the
eleventh days the child was able to maintain sitting position. Active movements
in knee joints& in the left leg m bending by 40 degrees and in the ri ght leg
bending by 60 degrees. Active movements in the pelvic and hip joint,6O??0
degrees. The child was unable to stand upright, The child started to receive
daily one powder of Dibasol of 0.001 three hours after dinner. On the thirteenth
day of the illness (third day after start of Dibasol' treatment), the consulting
neurologist made the following statements active movements in legs., mainly in
the right legs limited. The tone of muscles.- lowered. Tendon reflexes in the
right leg absent entirely and in the left leg hardly noticeable. Conclusions
"poliomyelitis acuta anterior."
g. On the ?ourteenth day of the illness and fourth day after start of Dibasol
28. Case No. 60 S. R. Sh,, a child of 15 months from Plovdiv, Hospital' list No. 10638,
"k1. No. 888. Admitted on 24 August 1951. Discharged on 2 October 1951.
a. With regard. to the specific status and treatments, the present case is identical
was-e N; 1a
b. On 12 December 1951, the following neurological status was established and
was identical with the status at the time of discharge from the Clinics the
tone of muscles of the left leg lowered, mainly that of the quadriceps muscle.
Patellar and Achillis reflexes expressed weakly. The child was able to bend
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the legs in pelvic and hip joint - the left- leg by about 40 degrees. When
walking, the child threw the left'leg outwards{ 'The'child was given 10
Dibasol powders of 0'0002 during 10 days in succession as' polyclinical treat-
ment. During a 'check-up examination on 31 December 1951, the following was
established- (statement of mother) t after taking the sixth powder, the
child started walking more and became less tired; when walking threw the
left leg no longer so much outwards. Urinated more and oftener. Neurological
status& the tone of quadriceps muscle of thei-left leg was better. There were
indications of Patellar and,Achillis reflexes of the left leg. The child was
walking better, bent .the leg better in the knee joint and three the leg less:
outwards (sideways)?
S
Analyzing the above oases, we come to-the following conclusion regarding the
effect of the Soviet preparation Dibasol, employed during the convalescent period
in infantile para3ysis8
a. In seas cases
Dibasol
ave ver
ood
lt
,
g
y g
resu
s, in others - Just good results#
and in some bases - weak results, depeing upon the condition (state)..o f
paralysis and on the date of the illness that treatnemt with the drug was in-
stituted) i.e. Apparently dependent on the degree of patho].ogi.cal process
setting in in the grey. matter of the spinal cord. This conclusion is analogous
with the opinion of Ivashentsov.
in all cases, the muscular force increased and muscular tiredness decreased.
c.. The existing reflexes were improved and the reflexes which had disappeared
returned.
d. In some cases reflexes of sound extremities, or of those affected by disease
only slightly, were increased.
ea Almost in all cases, frequency of urination was increased, as well as the
quantity of urine secreted, the fact which had not been noted by Soviet
authors.
f. There were no cases in which patients were unable to take Dibasol, or in
which toxic effect had appeared,
b, " sed" - sediment in urine,
C. "shtab" (stab) r immature polymorphonuclear leu-cocytes.
"b. o . t' - probably means "normal4"
Comment: The following is a brief summary of some terms which were
partially explained or identified above:
d. "seg" mature polymorphonuclear leucocytes,
e. "Pandy" m test for protein in spinal fluid,
f. "Patl" (also noted as "Pavl") and "Riv" possibly abbreviations of Polish
wordOg sugar - chlorides -.acid - base ? or blood, any of which could fit
here. Since determination of albumen is one of the results from "Parody"' test,,
if the parallel can be drawn, "patl! may refer to sugar and "riv" to chlorides.
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-12..
could logically be "kletka" (cell).
h. a*bulatoriya - central place of treatment (1) to which patients come
(ambulate) for treatment or (2) in which the paTients being treated are
ambulatory.
i. jung((could be "Yung" in Polish)* These are the most immature leucocytes. Their
presence indicates extremely- severe infection*
rod-shaped nucleoli b These are the "stabs" mentioned in "0" above,
k. "Nagrevka" - the use of "nagrevka" (burn) as here used "on the sixteenth day"
undoubt
dl
ef
s
e
y r
er
to the commencement of ht pk ttt Thi i
oacreamen.ss a good
polio treatment usually commenced on the fourteenth day and consists of placing
heated felt pads (hot packs) on muscles involved,
anamnesis (an,.amesis) - case history.
in, creases - good technical term - when modified by such words as gluteal'
ax3ll
"
ary. Correct explanation is "folds
. %ladi" (see paragraph 25 d 2)' - possibly means monooytes.
o. "dekursus" - clinical record.
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