The Danish scientist Niels Finsen won the Nobel Prize in Physiology in 1903 for his pioneering work on a new form of therapy: that of light. Around the same time, an invention by one William Röntgen used radium rays to penetrate tissue and produce “X-ray” images. This NS piece from 1921 considers these still relatively new and increasingly widespread treatments, both of which were in use, with varying popularity. Our correspondent writes that witnessing Finsen’s light treatment for lupus was “the most simple and mysterious, the most beautiful and admirable demonstration of therapeutics that I have ever seen in my life or that is anywhere to be seen in the world”. And if X-rays and “radio-therapeutics” were scientifically sound, shouldn’t medicine now be “entitled to proceed to the plain everyday use of the light of the sun”?
Omitting a few names worthy of mention, we must proclaim a young Dane, Dr Niels R Finsen, a pioneer in the practice of modern sun-worship. He was working at the subject in the last decade of the 19th century, asking such questions as whether, if the actinic or chemical rays of the spectrum be favourable to chemical changes, the victim of small-pox may not be benefited by protection from such rays, in the hope that, exposed only to red light, the pustules may not be so grave in their development. It is probably of only historical interest to recall those experiments. But later, not forgetful of the demonstration by Koch and others that light is antiseptic to the tubercle bacillus, Finsen began to attempt the cure of lupus, a form of cutaneous tuberculosis, by means of light, and obtained results much superior to those of the knife or any other surgical instrument. It was, and still widely is, believed that the ultra-violet rays are the most useful, and hence various steps have been taken in order either to filter sunlight, or to use artificial light which is rich in the rays of shorter wave-length. The red rays and heat rays are hot and burning, and perhaps not therapeutic, and, in any case, they would burn so severely that the patient must be protected from them. Thus, in the earlier forms of photo-therapeutics, not yet really natural in the sense in which that word may be applied to the greatest work now being done today, we recall that the patients were exposed in one instance and on one theory to red light only, and in another instance and on another theory to light from the other end of the spectrum. But we shall see whether the whole of the sunlight through and in which our species has been evolved is not generally better for us, in disease and in health, than any of its parts.
Where sunlight is not available artificial light must be used, and we may choose our light in accordance with any theory we may hold as to the relative value of various parts of the spectrum. Hence, in Finsen’s work, which earned for him, shortly before his premature death, the Nobel Prize in Medicine, the local use of concentrated sunlight was replaced by that of artificial light rich in the higher-pitched rays to which special virtue is supposed to be attached.
London owes much to Queen Alexandra for her interest in the work of her young fellow countryman, whereby the Finsen treatment for lupus was early installed at the London Hospital, where many cases of this disease were and still are to be found. After several years of observation of surgery in the treatment of local tuberculosis, a profound impression was made upon me, by nature a modern Zoroastrian, when I visited the “London” some 19 years ago and saw the Finsen light in action. Very intense radiations are focussed on the patch of disease, for a certain period daily, passing through a double lens of quartz, between the parts of which cold water circulates, absorbing the heat rays. The results are admirable. By light and light alone, the patient is usually cured, with a minimum of scarring, deformation or destruction of healthy tissues. We note that the light does not penetrate far, and that the shortest rays are those which are most quickly absorbed. When we look at the tip of the ear, beyond which a bright white light shines, and see it red, we realise that, whilst red light may come through the blood, the rays of higher pitch are absorbed. If, therefore, we desire to obtain the healing action of those rays at any appreciable depth, we must press the skin very firmly, so as to keep out of it the blood which would otherwise absorb the rays and prevent them from doing their work except at the very shallowest levels.
Influenced, no doubt, by the valuable demonstrations of Koch, Finsen believed that the light with which he cured lupus acted as a parasiticide, an antiseptic which killed the tubercle bacilli and allowed the patient’s tissues to heal accordingly. Then the question arises whether, in fact, the light may not work rather as a stimulant to the defending tissues than as lethal to the invaders. Until this very day, I have thought that this question, whilst of high scientific interest, was essentially academic and irrelevant to practise, but I am sitting down to write after seeing the most simple and mysterious, the most beautiful and admirable demonstration of therapeutics that I have ever seen in my life or that is anywhere to be seen in the world, and tonight my belief is that our answer to the question how light cures is of high practical importance. The answer, I believe, is that the Finsen light cures – in part, at least – by helping the tissues to help themselves, and hence we may guess that light may cure even when it cannot possibly reach the tubercle bacilli in order to exercise any antiseptic action upon them; and thereupon we may begin to use light upon the body generally, for the cure of local conditions, not only superficial such as lupus, but however deeply seated. And when we do so, we modern sun-worshippers are rewarded beyond our most sanguine dreams, as by a deity who answers prayer beyond all that we can ask or think.
But, for the moment, let us pursue the truth that light, or certain kinds of light, may be directly destructive to our enemies of various kinds. Along this line much may be done, even though it be nothing to what may be done on the subtler and less comprehensible assumption. Thus, we may seek certain exceptional kinds of radiation – the more novel, exceptional and remarkable the better our patients will be pleased – and try to obtain from them results which, it goes without saying, no one would expect from ordinary daylight. And we are certainly rewarded up to a point. Certain of the Röntgen rays, for instance, called “hard,” have a high penetrative power and are directly lethal to living cells, and to different kinds of cells in different degree. The best resources of the physicists must be invoked, in order to make available for the clinician the most precise doses of rays of the most definite wave-length, and invaluable advances have very recently been made in this respect. Clinical results improve pari passu, and we cannot but believe that greater things than hitherto – and those are well worth while – will yet be achieved in the control of malignant cells by the action of this invisible light. In the same category, note the radiations from radium. The beta rays in especial have a definitely selective action upon living cells. In the least malignant and most superficial form of malignant disease, known as rodent ulcer, radium acts “like a charm”. I am not a practitioner of any branch of medicine or surgery, but it was lately my duty to take an elderly friend to a dermatologist, who sent her to the Radium Institute, where her cheek was once exposed to radium, unscreened, for an hour and a half, and was perfectly cured, without pain and with a result, from the aesthetic point of view, otherwise utterly unobtainable.
Of course, such achievements are splendid in themselves and rich in promise of much more along the same lines. The reader who wishes to learn more about radium-therapy should obtain the last report of the Radium Institute, written by its able superintendent, Captain AE Hayward Pinch, FRCS, and he will then realise how much we owe to the late King Edward for his influence in founding the Institute, and how much we shall owe to Madame Curie, now in Paris with the 100,000 dollars’ worth of radium which was lately given to her by the women of America and which she had with her on the Olympic when, as it happened, I sailed from New York in that boat in June. But I am inclined to believe that the best services rendered by Professor William Röntgen, by the late Professors Finsen and Pierre Curie and by Madame Curie to modern therapeutics consist Jess in the healing powers of the radiations from a Crookes tube, a Finsen lamp, or from radium, than in the demonstration that any radiations may have such powers. From these exceedingly rare, peculiar, artificial, “unnatural” forms of radio-therapeutics, demonstrated to be potent, we are entitled to proceed to the plain everyday use of the light of the sun, nor can anyone now say that our hopes are “high-fantastical” or contrary to anything in already recorded experience? Indeed are we not entitled to say that, if Röntgen rays and the beta rays of radium or of its emanation, are in certain conditions sanative and therapeutic, though neither of these have any natural relation to mankind, it is a priori immeasurably more probable that sunlight itself, part of the natural environment of man, will be sanative and therapeutic?
Let us state the truth as it appears today. It is that, when we have added together all the healing and healthful virtues of the Finsen light and radium and the Röntgen rays, and all the uses of heat rays in, for instance, the local treatment of rheumatism at Harrogate or elsewhere, and all the uses of electrical waves in the care of atrophied or unused muscles, or in any other respect; that is, when every particular form of radiation from one end of the ethereal gamut – if that is what it be – to the other has been tried and exploited to the uttermost, even including all and every advance that may yet be hoped for in the attack on malignant cells – the value of natural sunlight upon us children of light, whether as therapeutic in certain forms of disease, such as so-called surgical tuberculosis, or as hygienic and prophylactic during developmental years, and maturity and old age, outweighs all these other things as the Atlantic outweighs the contents of the Olympic swimming bath. Until this evening I could not have written thus, even though I have been proclaiming the value of light all my life, and particularly in the New Statesman during the past two and a half years. It is what I have seen today, in a few of the thirty and more cliniques of Dr Rollier at Leysin in Switzerland, that has really opened eyes which I had already thought to be wide open to the value of light.
The truth is that we are Naamanites one and all. Perhaps we admire Pasteur, who said that “Tout est miracle”, and Walt Whitman, who wrote superbly about natural miracles in more poems than one, and we proclaim the value of simple, daily things; but the moment that some surprising novelty is announced we forget ourselves and our philosophy – like the great crowd of doctors who had listened to a lecture on X-ray therapeutics at a medical congress a few years ago and who promptly walked out of the lecture theatre when Dr Rollier followed with a paper on mere helio-therapy. Naaman the leper wanted thaumaturgy, some marvellous recitation, or passes of the hands, or invocations of Heaven, and he was told to “wash and be clean.” What an insult! What banality! We want a buzzing X-ray tube, a good bedside manner, a superb operating theatre, a perfectly modelled plaster-of-Paris jacket, a drug with a high number, a long name and a remarkable history like 606, or anti-tuberculosis serum made at vast expense by the inoculation of animals; and when, as Elisha long ago told the leprous to strip and bathe in the water of common Jordan and be clean, Rollier now tells the tuberculous to strip and bathe in the light of common day and be well, we think his formula too simple – simpletons that we are.
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