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DURING the 1955 epidemic in Massachusetts more than 400 patients with poliomyelitis were hospitalized at the Massachusetts General Hospital. There were 74 adults requiring respirator management, with 17 fatal cases. Death in acute poliomyelitis that is not the result of obvious airway obstruction, ventilatory insufficiency or some other specific complication has been attributed to "circulatory collapse" secondary to involvement of the medullary vasomotor center1 , 2 and, less frequently, to "circulatory collapse" from myocarditis.3 The observations reported below appear to amend these concepts and suggest other possibilities and empirical methods of management. Presentation of the Clinical Material An analysis of these 17 . . .