RELATION OF SKIN TO NONSPECIFIC RESISTANCE 137 



use made of this effect in the therapy of internal disease is of particu- 

 lar interest in disclosing the degree to which the skin reactivity can 

 make its influence manifest on the metabolism of the internal organs 

 and pathological processes there present. When a patient is exposed 

 to light rays in the manner developed by Bernhardt, by Rollier and 

 others, certain systemic changes occur which in many ways resemble 

 very closely the reaction that we have described for the protein shock 

 reaction or the nonspecific reaction. Rollier observed an increase in 

 eosinophils as well as in hemoglobin and red cells. D'Oelsnitz ob- 

 served changes in the temperature, in the respiration and in the blood 

 cytology. The temperature and the respiration are both increased at 

 the beginning, the pulse rate may be accelerated to some extent all of 

 the reactions depend greatly on individual factors and particularly on 

 the disease from which the patient is suffering; in tuberculosis, par- 

 ticularly on the type of the tuberculous lesion, whether active or 

 latent, etc. The leukocytes that are produced are usually young forms, 

 although in the reaction mononuclears predominate; eosinophils were 

 also observed by D'Oelsnitz. 



Dual Effect of Heliotherapy. Just as in other nonspecific re- 

 actions the effect of the sunlight on the skin and the effect on patho- 

 logical conditions is a dual one. Thus it may activate an inflammatory 

 focus. In active progressive tuberculosis with hemorrhage and a septic 

 type of temperature, exposure may do decided harm. In its genera] 

 effect the reaction set up is similar in character and duration to that 

 elicited by tuberculin and the centra-indications are the same. Thus 

 a latent tuberculosis on exposure to prolonged sunlight may react with 

 a typical temperature, increase in pulse-rate and the general malaise 

 that we associate with the tuberculin reaction. And just as it is a dual 

 reaction the negative phase is followed by a positive one. That is, the 

 difference between irritation and stimulation and overstimulation is 

 a matter of very small margin and depends on the individual, as 

 Pottenger has pointed out. Sunlight has no specific effect on tuber- 

 culosis ; it is not a cure in the ordinary sense of the word. It is merely 

 a stimulant similar in character to many of the other nonspecific agents 

 which are able to cause a focal reaction and thereby influence the 

 process. Its difference from some of the other forms of therapy lies in 

 the fact that the leukocytic response that follows heliotherapy seems 

 to be rather a lymphocytic than a polymorphonuclear reaction. In 

 nontuberculous affections it has been recommended in general con- 

 valescence, where it is followed by an improvement in the anemia 

 (effect on hematopoietic system) and in the weight of the patient. 

 Aimes has found it very useful in acute articular rheumatism, in 

 tracheobronchial adenopathies and in neurasthenic patients. (Kellogg) . 

 Lovett has reported excellent results in chronic infections. 



Heliotherapy as Protein Therapy. It seems most probable that 

 instead of seeking to find the cause of the therapeutic effect of the 



