72 SMITHSONIAN MISCELLANEOUS COLLECTIONS VOL. 63 



the patient to the sun is the essential feature and after three to ten 

 days of accHmatization indoors he begins with five minute exposures 

 of the feet, five times a day. This is steadily increased as pigmenta- 

 tion appears until finally the entire surface of the body is exposed 

 from sunrise to sunset. The head is, however, protected with white 

 caps and shaded glasses. With the development of the pigmentation 

 the cure progresses until recovery is complete. Dr. Rollier has sent 

 us photographs of a boy who had 32 foci of tuberculosis, even the 

 lungs being involved. This boy was considered cured after fifteen 

 months of treatment. See plate 26. 



In another case there were multiple lesions, including a badly dis- 

 organized and anchylosed elbow with seven sinuses and a history 

 of three resections of the joint and forearm. This boy also made 

 a good recovery with complete return of function, full flexion and 

 full extension. See plate 27. Dr. Brannan adds that he has seen 

 many such cures at " See Breeze " and has kindly furnished photo- 

 graphs of some of these patients. See plate 16. 



According to Rollier the pigmentation is the important element 

 in the cure, inasmuch as it affords to the skin a remarkable resist- 

 ance, favors the cicatrization of wounds and confers a local immunity 

 to microbic infections. On days when there is no sunshine recourse is 

 had to radiotherapy for the adults and the Bier treatment (local 

 lowering of atmospheric pressure) for the children ; at all times, 

 whether the sun shines or not, the skin has its bath of air and light. 



Two hundred beds in Rollier's sanatoria are reserved for children. 



Dr. Rollier presented to the XVII International Medical Congress 

 at London in 19 13, a resume of his method of heliotherapy and 

 refers to eighteen separate communications to medical literature, in 

 which he and his associates have described the method. Among other 

 things we notice that he reports the number of adults having external 

 tuberculosis treated by him as greater than that of children, 522 to 

 477. The prognosis for the former is as favorable as for the latter 

 and the duration of treatment is never much longer. In Rollier's 

 paper, referred to, all his cases for the past eleven years are tabu- 

 lated and out of 1,129 patients, 951 are reported cured. Of the total 

 number only three underwent the operation of resection. These 

 were cases of gonorrheal arthritis ; one was adult of over fifty years. 

 Two cases of tuberculosis of the foot were treated by amputation ; 

 both were adults of over sixty years. 



Rollier uses fixation by means of plaster, especially in Pott's Dis- 

 ease, but in all cases insists strenuously that the tuberculous joint 



