In an art gallery
ARTIFICIAL DAYLIGHT
There is a vast amount of testimony which proves the bactericidal action of light. Bacteria on the surface of the body are destroyed by ultra-violet rays. Typhus and tubercle bacilli are destroyed equally well by the direct rays from the sun and from the electric arcs. Cultures of diphtheria develop in diffused daylight but are destroyed by direct sunlight. Lower organisms in water are readily killed by the radiation from any light-source emitting ultra-violet rays comparable with those in direct sunlight. From the great amount of data available it appears reasonable to conclude that radiant energy is a powerful bactericidal agency but that the action is due chiefly to ultra-violet rays. It appears also that no bacteria can resist these rays if they are intense enough and are permitted to play upon the bacteria long enough. The destruction of these organisms appears to be a phenomenon of oxidation, for the presence of oxygen appears to be necessary.
The foregoing remarks about the bactericidal action of radiant energy apply only to bacteria in water, in cultures, and on the surface of the body. There is much uncertainty as to the ability of radiant energy to destroy bacteria within living tissue. The active rays cannot penetrate appreciably into such tissue and many authorities are convinced that no direct destruction takes place. In fact, it has been stated that the so-called chemical rays are more destructive to the tissue cells than to bacteria. Finsen, a pioneer in the use of radiant energy in the treatment of disease, effected many wonderful cures and believed that the bacteria were directly destroyed by the ultra-violet rays. However, many have since come to the conclusion that the beneficent action of the rays is due to the irritation which causes an outflow of serum, thus bringing more antibodies in contact with the bacilli, and causing the destruction of the latter. Hot applications appear to work in the same manner.
Primitive beings of the tropics are known to treat open wounds by exposing them to the direct rays of the sun without dressings of any kind. These wounds are usually infected and the sun's rays render them aseptic and they heal readily. Many cases of sores and surgical wounds have been quickly healed by exposure to sunlight. Even red light has been effective, so it has been concluded by some that rays of almost any wave-length, if intense enough, will effect a cure of this character by causing an effusion of serum. It has also been stated that the chemical rays have anæsthetic powers and have been used in this rôle for many minor operations.
It is said that the Chinese have used red light for centuries in the treatment of smallpox and throughout the Middle Ages this practice was not uncommon. In the oldest book on medicine written in English there is an account of a successful treatment of the son of Edward I for smallpox by means of red light. It is also stated that this treatment was administered throughout the reigns of Elizabeth and of Charles II. Another account states that a few soldiers confined in dark dungeons recovered from smallpox without pitting. Finsen also obtained excellent results in the treatment of this disease by means of red light. However, in this case it appears that the exclusion of the so-called chemical rays favors healing of the postules of smallpox and that the use of red light is therefore a negative application of light-therapy. In other words, the red light plays no part except in furnishing a light which does not inhibit healing.
Although the so-called actinic rays have curative value in certain cases, there are some instances where light-baths are claimed to be harmful. It is said that sun-baths to the naked body are not so popular as they were formerly, except for obesity, gout, rheumatism, and sluggish metabolism, because it is felt that the shorter ultra-violet rays may be harmful. These rays are said to increase the pulse, respiration, temperature, and blood-pressure and may even start hemorrhages and in excessive amounts cause headache, palpitation, insomnia, and anemia. These same authorities condemn sun-baths to the naked body of the tuberculous, claiming that any cures effected are consummated despite the injury done by the energy of short wave-length. There is no doubt that these rays are beneficial in local lesions, but it is believed that the cure is due to the irritation caused by the rays and the consequent bactericidal action of the increased flow of serum, and not to any direct beneficial result on the tissue-cells. Others claim to cure tuberculosis by means of powerful quartz mercury-arcs equipped with a glass which absorbs the ultra-violet rays of shorter wave-lengths. These conclusions by a few authorities are submitted for what they are worth and to show that this phase of light-therapy is also unsettled.
Any one who has been in touch with light-therapy in a scientific rôle is bound to note that much ignorance is displayed in the use of light in this manner. In fact, it appears safe to state that light-therapy often smacks of quackery. Very mysterious effects are sometimes attributed to radiant energy, which occasionally border upon superstition. Nevertheless, this kind of energy has value, and notwithstanding the chaos which still exists, it is of interest to note some of the equipment which has been used. Some practitioners have great confidence in the electric bath, and elaborate light-baths have been devised. In the earlier years of this kind of treatment the electric arc was conspicuous. Electrodes of carbon, carbon and iron, and iron have been used when intense ultra-violet rays were desired. The quartz mercury-arc of later years supplies this need admirably. Dr. Cleaves, after many years of experience with the electric-arc bath, has stated:
From the administration of an electric-arc bath there is obtained an action upon the skin, the patient experiences a pleasant and slightly prickly sensation. There is produced, even from a short exposure, upon the skin of some patients a slight erythema, while with others there is but little such effect even from long exposures. The face assumes a normal rosy coloring and an appearance of refreshment and repose on emerging from the bath is always observed. From the administration of the electric-arc bath there is also noted the establishment of circulatory changes with a uniform regulation of the heart's action, as evidenced by improved volume and slower pulse rate, the augmentation of the temperature, increased activity of the skin, fuller and slower respiration, gradually increased respiratory capacity, and diminished irritability of the mucous membrane in tubercular, bronchitic, or asthmatic patients. There is also lessened discharge in those patients suffering from catarrhal conditions of the nasal passages. In diseases of the respiratory system, a soothing effect upon the mucous membranes is always experienced, while cough and expectoration are diminished.
The cabinet used by Dr. Cleaves was large enough to contain a cot upon which the patient reclined. An arc-lamp was suspended at each of the two ends of the cabinet and a flood of light was obtained directly and by reflection from the white inside surfaces of the cabinet. By means of mirrors the light from the arcs could be concentrated upon any desired part of the patient.