T HE pediatrician's responsibilities in the diagnosis and early care of poliomyelitis are extensive, varied, and manifold. In this paper an attempt will be made to discuss some of the more important. Many of the diagnoses arc easily made by any doctor. Although no symptom, sign, or test proves the diagnosis~ there is usually enough circumstantial evidence in headache, fever, vomiting, stiffness in neck, back, hamstrings, and other muscles, and also apparent muscular disability, to lead a physician at least to suspect the disease. The diagnosis is strengthened, in fact pretty much confirmed, by the finding in the spinal fluid of a slight or moderate increase in cells. Since the proportion of cases is increasing in young adults who are first seen by internists or general practitioners, the pediatrician is not always called upon to make the diagnosis. But these adult patients are apt to be admitted along with children to poliomyelitis services where a pediatrician is usually in charge and thus has the opportunity and responsibility to confirm the diagnosis and initiate treatment. For each such new case, the responsibility at once arises for checking over the rest of the patient's family to seek out other possible illnesses that might be overlooked instances of infantile paralysis. Where there are small children it will be usual to find such cases, most commonly in the nonparalytie form. Multiple family cases are more and more being recognized, and it is now a wellknown fact that the case of poliomyelitis with recognizable loss of strength is the infrequent case--the so-called medical accident. When poliomyelitis has been identified and the patient usually hospitalized, the pediatrician becomes the coordinator and often the initiator of all types of care: pediatric, nursing, physical therapy, occupational therapy, morale building and social rehabilitation, and finally orthopedic support and reconstruction. There are few if any illnesses in the treatment of which so much must be done by so many different specialists. It is obvious that one person must be responsible for the proper coordination of all these efforts being made in the patient's behalf. In the average spinal case with involvement of a leg or an arm, the coordination of care becomes a matter of routine. A schedule of rest and relaxation, of proper nursing care, and of measures to combat increased muscle tension can be quickly and adequately instituted by any doctor at all familiar with the infection. But there are special manifestations of the disease the management of which requires experience, judgment, and skill. In general these are associated with bulbar cases and those with respiratory difficulties. Here the proper