LIGHT THERAPY MAYER 405 



It is highly probable that, in most forms of progressive acute 

 tuberculosis, light therapy is not indicated. It is well known that 

 roentgen therapy is not indicated in such cases. In my experience, 

 intestinal tuberculosis is an exception. In this complication at times, 

 even when progressively active, mercury-vapor quartz light has 

 seemingly been of great value. 



With any form of tuberculosis, light is used merely as an adjuvant 

 and should be combined with every other possible aid. The main- 

 stays of treatment still exist in rest, good food, and hygienic outdoor 

 life. 



With bone and joint tuberculosis, orthopedic treatment with 

 immobilization and traction is absolutely essential while light 

 exposure is being employed. Surgical intervention is occasionally 

 needed, especially for the aspiration of abscesses or for hastening 

 the expulsion of sequestrums. Joint resection and surgical fusion 

 are necessary less often with heliotherapy, but there may even yet 

 be certain social, economic, and other factors, as well as the stage 

 of the disease, that occasionally force this intervention. The plaster 

 cast is less often needed. As pointed out earlier, one always com- 

 bines general and local light exposures, regardless of the location 

 of the lesion. 



TECHNIC OF EXPOSURES 



With sunlight, the patients are graduated to increasing periods 

 of exposures over increasingly large areas of the body according to 

 Rollier's technic. Sunlight of the lowlands and highlands can both 

 be employed clinically, but the heat of the day should be avoided.^* 

 Diffuse daylight and air exposures on cloudy days are used to great 

 advantage. Chilling winds should be avoided. Overexposures may 

 incite latent foci of disease to activity. It is important that patients 

 during and after solar exposures feel as well as or better than they 

 do before taking them. Headaches, restlessness, nervousness, or 

 irritability, elevation of body temperature or pulse rate are all indi- 

 cations of undue reactions that call for some change in the program 

 of solar exposures. 



With plain carbon arcs, as used at the Finsen Institute, one begins 

 with a 15-minute irradiation, front and back, and then increases 

 daily 15 minutes front and back until exposures of 2 hours daily 

 are reached. The lamps are placed at a distance from the patient, so 

 that the heat emitted from this source of light is tolerable. Fre- 

 quently, sweating occurs during the exposures. The treatment is 

 then terminated with a sponge bath. General body exposures are 



5* RoUier, Auguste, Heliotherapy, New York, Oxford University Press, 1923 ; Strahlenth^ 

 rapie, vol. 28, p. 259, 1928. 



