!6o 



NA TURE 



[July i i, 1901 



rendered parallel, to a focus on tlie skin of the patient. 

 The lower part of the apparatus is filled with distilled 

 water and is surrounded with a jacket through which 

 cold water circulates. The compression apparatus used 



.u by 



for the sun treatment is placed, as before, at the focus 

 of the light to render the skin bloodless and to kee|) it 

 cool. The length of the sitting is one hour. There is 

 no blue solution m the electric light afjparatus as now 

 made, as it has been found in prac- 

 tice that the tube of distilled water 

 and the circulating water in the 

 pressure glass are sufficient to ab- 

 sorb the comparatively small amount 

 of heat-rays given off by the arc 

 light. Rock crystal lenses are used 

 because ordinary crown glass pre- 

 \ents a great part of the chemical 

 ravs from passing through. 



As a result of an hour's applica- 

 tion of the light the skin may be a 

 little red, but there is no proper 

 reaction for from six to twelve hours, 

 when there is definite redness and 

 swelling and sometimes slight blis- 

 tering. In from three to seven days 

 all trace of reaction has usually dis- 

 appeared, and the skin, though still 

 hypersmic, can be treated again if 

 necessary. The process is repeated 

 over the whole of the diseased area 

 and especially at its inargins, the 

 most active parts, until every sign 

 of lupus tissue has disappeared. If 

 the disease is extensive, the treat- 

 ment lasts many months. It must 

 be noted that in many of the bad 

 cases not only is the skin aftected. 

 but also the mucous membranes 

 lining the mouth and nose, and these 

 parts can very rarely be influenced 

 by the light. 



In Copenhagen there is a Light Institute under the 

 direction of Prof. Finsen, and a very large number of 

 patients,more than 500, have passed through the institu- 

 tion. It was in Copenhagen that the Queen saw the 



NO. 1654, VOL. 64] 



treatment, and Her Majesty was so impressed with the 

 good results attained there that she graciously 'presented 

 a set of the apparatus to the London Hospital a little 

 moie than a year ago. The demands upon that institution 

 became so great that a second and a third lamp had to be 

 put up, and even with these it is impossible to cope with 

 the influx of patients from all parts of the British Isles, 

 iiid even from such distant colonies as Newfoundland 

 md New Zealand. 



The drawbacks to the treatment are, first, the length 

 of time which a severe case takes, and, secondly, the 

 I ost. Not only is there the cost of the electric light 

 ind the necessary maintenance, but every patient has to 

 lie attended by a nurse. At the London Hospital it has 

 licen found that it costs about 400/. or more a year to run 

 "lie lamp, so that the light department there necessi- 

 i.ites an expenditure of 1200/. a year. It is, therefore, ■ 

 -: ratifying to find that Mr. Alfred Harmsworth has come 

 liirward and endowed one lamp by a munificent gift of 

 1 0,000/. 



It must be noted also that public spirit in Manchester 

 and Liverpool will shortly provide for the installation of 

 the light treatment in these cities. 



The results in cases of ordinary lupus are excellent, 

 jirovided that the patients can remain continuously under 

 treatment for a sufficient length of time. The average 

 of a large number of cases is three months. Certain other 

 diseases, lupus erythematosus, rodent ulcer and alo- 

 pecia areata, are influenced favourably by the light treat- 

 ment. In the first mentioned disease the results are not 

 nearly so striking as in the common form of lupus, but 

 about one-third of the cases do well. 



The light treatment has been too recently tried in 

 London for any definite statement to be made as to the 

 permanence of the results. In Copenhagen it has been 

 in use for five years, and some of the earliest cases are 

 quite free from recurrence to date. 



2. — Treatment by e! 



The important advantages of this method of treatment 

 o\er every other which has been used for lupus are that 

 there is no destruction of tissue, there is no operation, 

 and therefore no anesthesia, for the treatment is pain- 



