Franklin Delano Roosevelt: The Diagnosis of Poliomyelitis Revisited

Abstract

Revisiting the ailments of famous historical persons in light of contemporary medical understanding has become a common academic hobby. Public discussion of Franklin Delano Roosevelt's (FDR) diagnosis of poliomyelitis after his sudden onset of paralysis in 1921 has received just such a revisitation. Recently, this 2003 historical analysis has been referenced widely on the Internet and in biographies, raising speculation that his actual diagnosis should have been Guillain-Barré Syndrome, a noncontagious disease of the peripheral nervous system rather than poliomyelitis. The authors of that 2003 analysis used a statistical analysis of his case by selectively choosing some of his reported symptoms. FDR's diagnosis of poliomyelitis, however, was fully supported by the findings of leading expert physicians of that time, who were very knowledgeable in the then-common disease and who periodically examined him during the period of 1921-1924. The most significant diagnostic features of polio are the absence of objective sensory findings in the presence of flaccid motor paralysis. These features are consistent with diagnostic criteria extant during the periods of major poliomyelitis epidemics as well as those of the Center for Disease Control 90 years later. Additional findings of fever, prodromal hyperesthesia, more severe residual proximal muscle weakness, and extensive lower extremity impairment requiring mobility with long leg braces or a wheelchair give further evidence for the diagnosis in FDR's case. Nonbulbar Guillain-Barré Syndrome, which shares the features of a flaccid paralysis and thus mimicking the initial presentation of poliomyelitis, has more than an 80% complete recovery with no reported cases of eventual wheelchair use. The most severe cases of Guillain-Barré Syndrome often have persistent objective sensory loss, associated with greater weakness in the feet and hands, which show no resemblance to FDR's impairment and disability. In light of the expert initial assessments by physicians completely familiar with the signs and symptoms of the then-common disease, review of his initial and subsequent disease course, and residual symptoms in comparison with those of Guillain-Barré syndrome, we find no reason to question the diagnostic accuracy of poliomyelitis and wish to put this debate to rest.

Growing Academic Physiatry: The Comparative Impact of Baruch Grants to Harvard Medical School and Columbia College of Physicians and Surgeons. Part I

“…His study of the organization of British reconstruction (rehabilitation) hospital with Dr. Joel Goldwaith, head of orthopedic surgery for the Army at the invitation of the U.S. Surgeon General is cited in the literature . Granger advocated improving the educational credentials of physical therapy technicians (reconstruction aides during the war) and partnered with Marguerite Sanderson at Walter Reed, one of the founders of the American Physical Therapy Association (APTA).…”

“…He demonstrated his clinical diagnostic skills by differentiating the paralysis and sensory findings of poliomyelitis from Guillain‐Barre Syndrome (GBS) . This differentiation of polio vs GBS recently had become a topic of controversy in Franklin Delano Roosevelt's diagnosis . Watkins' comprehensive 1946 review of physical medicine treatments of neurological disorders documented the use of electrical testing to aid in both diagnosis and management .…”

Sister Elizabeth Kenny and Polio in America: Doyenne or Demagogue in Her Role in Rehabilitation Medicine?

“…Poliomyelitis awareness in America had escalated dramatically, in part because of Franklin D. Roosevelt's diagnosis in 1926. His election to the Presidency in 1932 created increased momentum for the fight against polio, despite the White House's efforts to hide the depiction of his residual disabilities [7,8]. Roosevelt and his former law partner, Basil O'Connor, worked to create the NFIP in 1938, and this led to the March of Dimes campaign, the greatest money‐making philanthropic effort in our nation's history [1,2].…”

“…Roosevelt and his former law partner, Basil O'Connor, worked to create the NFIP in 1938, and this led to the March of Dimes campaign, the greatest money‐making philanthropic effort in our nation's history [1,2]. O'Connor became its director [7].…”

Aquatic Therapy in Contemporary Neurorehabilitation: An Update

“…The use of aquatic therapy in the management of neurologic disease in United States has a long history, reaching its peak in the era of poliomyelitis, when it was aggressively supported by Franklin Roosevelt following his contracting the virus in 1921, during that year's epidemic. 1 The use of aquatic therapy definitely diminished following that epidemic but has remained in use for the treatment of stroke, spinal cord injury, multiple sclerosis, and Parkinson disease. In 2009, a review article was published in this journal describing the underlying physiology and rehabilitative applications of aquatic therapy and the scientific support for its use.…”