408 ANNUAL EEPOET SMITHSONIAN INSTITUTION, 19 3 2 



ment, and to use it to the exclusion of rest and the hygienic-dietetic 

 regimen in the open, eliminating orthopedic measures or the occa- 

 sional necessary surgical intervention, will bring discredit to a really 

 desirable form of treatment. 



If one employs light as an aid only, the most favorable response to 

 solar exposures has been shown in the so-called pretuberculosis of 

 children and tuberculosis of the lymph nodes (including hilus), 

 pleura, bones and joints, peritoneum, and intestine. 



Less favorable results (yet often good) are obtained in genito- 

 urinary, laryngeal, ocular, aural, and cutaneous tuberculosis. Pul- 

 monary tuberculosis I do not consider an indication for light therapy. 

 With joint tuberculosis, Rollier claims the fibrous form of ankylosis 

 has been overcome and the joint function has been restored, but how 

 permanent these favorable results will prove to be can not be stated. 

 Restoration of function may occur in the synovial form of joint 

 tuberculosis even after large effusions have been absorbed; but one 

 is still entitled to doubt a functional return of motion in a joint 

 when the bony parts have been destroyed to any degree. Ortho- 

 pedic measures still play the major role in bone and joint tubercu- 

 losis; and intervention by surgical fusion should always be con- 

 sidered in cases of advanced bony destruction. With lymph node 

 disease, massive tuberculosis glands have been extruded from their 

 capsules during healing by light. Fistulas are most resistant to 

 treatment. 



With plain or cored carbon arcs of high amperage (from 55 to 75 

 amperes) or with arcs of lower amperage (from 20 to 29 amperes), 

 the best results have been reported with cutaneous and ocular (cor- 

 neal and i^hlyctenular) tuberculosis and that of the bones and joints, 

 lymph nodes, larynx, peritoneum, and intestines ; less favorable have 

 been the reports on pulmonary and genito-urinary tuberculosis. 



In my own experience with the use of the quartz mercury-vapor 

 light as an adjuvant, the most favorable response has been encoun- 

 tered in intestinal tuberculosis. The diagnosis is established by a 

 history of all varied digestive complaints, sucli as alternating consti- 

 pation and diarrhea, nausea, vomiting, abdominal pain, soft or watery 

 stools, or merely b}^ persistent loss of weight or slight elevation of 

 temperature otherwise unexplained — by any or all of these symptoms 

 combined with roentgen demonstration of spasm or filling defect in 

 the cecum or ascending colon in a patient known to have pulmonary 

 tuberculosis. Plate 1 shows roentgenographically the intestine 

 with a filling defect before treatment, and an almost complete 

 disappearance of this defect after eight months of quartz mercury- 

 vapor exposures; this improvement was accompanied by a cessation 

 of the digestive complaints. After the study of a large series of such 



