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10 May 2022

From the NS archive: Heliotherapy arrives

28 April 1923: Of all flowers the human flower is that which has most need of the sun.

By Lens

This article from the regular New Statesman contributor who wrote as “Lens” discusses the use of heliotherapy as a treatment for a wide range of diseases. Despite heliotherapy’s significance in classical history, it wasn’t until the beginning of the 20th century that physicians such as the Nobel winner Niels Ryberg Finsen recognised it as a treatment for tuberculosis. For Lens, it is a matter of logic: if all other life on Earth requires sunlight to thrive, why would humans differ? “We are all children of light, that when we are planted out in gardens, so to say, or restored to the sunlight, we react as growing plants do.” Lens’ optimism is well placed: today heliotherapy is recognised for the treatment of various skin conditions, mood and sleep disorders and some cancer therapies.

The oldest of new things has reached our shores at last. According to the Egyptologists, it was Akhenaten, in the 14th century BC, who first taught the worship of the sun. He ante-dated Zoroaster, therefore, and Hippocrates, the father of medicine and heliotherapy. We find some references among the Roman physicians also, but there follows a long age of darkness, during which all forms of Nature-worship were counted Pagan and anti-Christian; and medicine, which had made a noble beginning with the Greeks, was replaced by a compost of the vilest, most degraded and imbecile superstitions. When, at long last, the idea of heliotherapy returned, it did so not on fundamental biological or physiological grounds at all, but solely as an application of the principle of disinfection, antisepsis or bactericidal action, to which the mighty work of Pasteur led us. On a very tiny scale, in a very restricted and unimportant field, this led to good results, in the local treatment of a form of cutaneous tuberculosis by sunlight, applied according to the method initiated by Finsen of Copenhagen; and, to this hour, with scarcely any exceptions (and those only exceptional in part) that is all we have grasped of the therapeutics of sunlight in this country.

Medical students are caused to learn a little botany at the beginning of their curriculum. Being eager to use the stethoscope and write prescriptions, I asked Sir Isaac Bayley Balfour, Professor of Botany in Edinburgh, in the mid-Nineties of the last century, why we should be delayed in our work by questions so entirely remote from those which were our proper concern. I vividly remember his answer, upon a hillside in Arran, during a Saturday “botany excursion”. He said that, for one reason, we should know something of plants as materia medica; but the chief reason for beginning with botany was that thus we might gain an understanding of the ways and nature of living things under the simplest conditions. It was a wise answer. The laws of life are the laws of all life. If we understood the flower in the crannied wall, we should “know what God and man is”.

The fundamentals of biology and medicine are set in biochemistry, and the vegetable world gives us these problems in their primary, most accessible and least complicated form. But consider Harley Street, without a tree or a blade of grass, the air laden with the effluent of motorcars, the dark rooms; the patients, creatures of custom and artifice; the practitioner, diving down through their clothes to an inch or two of anaemic and flaccid skin, and prescribing something out of a bottle, which is called “medicine” – a noble word that means “healing ” – or proposing one or another of the hideous operations which the surgeons successively introduce, exploit and abandon. When I am ill, I go to Harley Street, like everyone else; I believe in good drugs and have immensely benefited by good surgery. All honour to these things; but how immeasurably remote is the whole system from any natural order of things, and especially from the truth that man is a living being, part of the order of living nature, who must conform to certain universal laws of life, or pay the penalty; who, in Bacon’s profound words, can “command Nature only by obeying her”.

Consider the lilies of the field, how they grow. By a process, the first steps of which we are just beginning to be able to imitate in the laboratory, the leaf utilises the carbon from the carbon dioxide in the atmosphere, and builds it up into a series of proteins, on the one hand, and carbohydrates on the other. This it does by the light and the ultra-violet rays, but not by the heat of the sun; and upon this act the whole of the living world depends. We recognise the green plant, therefore, as anabolic, up-building or constructive in its chemistry, and photosynthesis as the beginning of all our lives. With the plant, however, we have hitherto much too sharply contrasted the animal, which we have regarded as katabolic or down-breaking, using up the products of vegetable photosynthesis; and it has been left to non-scientific persons, more or less regarded as sentimentalists or cranks, to look upon children as we look upon plants, and to introduce the idea of the “kindergarten”.

But now, also, from the lovely land of Froebel comes the discovery that we are all children of light, that when we are planted out in gardens, so to say, or restored to the sunlight, we react as growing plants do, and that, as Michelet said: “Of all flowers the human flower is that which has most need of the sun.” No priority in this matter rests with Dr A Rollier, of Leysin, nor with any other modern; for that we must go back to Hippocrates; but in 1908 Rollier began the treatment of so-called surgical tuberculosis by general exposure to sunlight, as distinct from the local antiseptic method used by Finsen against merely superficial lesions.

Ever since I became acquainted with his work, I have recognised and declared it to be the best thing, incomparably: in contemporary medicine anywhere and since reading his La Cure de Soleil, published in 1914, I have never rested until a translation of it should appear in English for those practitioners, on both sides of the Atlantic, who, in any case, seldom find time to break the wrappers of their own medical journals. There is now before us a more useful volume than the original, for it has been revised, rewritten, extended, and the record of cases and statistics has been brought up to date, with most conclusive results. I have steadily described La Cure de Soleil as the most valuable book on tuberculosis ever published, and Heliotherapy is more so. With its appearance heliotherapy itself arrives upon our shores, never to leave them, and a new epoch in medicine and hygiene dawns.

The book is well illustrated, though not on the ample scale of the original, and it is in some sense encyclopaedic, thanks to the chapters contributed by experts on various aspects of the subject. It must and necessarily will be read by all persons who, in any capacity, are concerned with the treatment or prevention of tuberculosis. This is primarily a clinical volume, by a master clinician, setting forth the methods and results of a mode of treatment which is without a remote rival, and which constitutes an inevitable and final condemnation of all other methods of treating “surgical” tuberculosis; but it contains a page or two upon what I have called helio-hygiene, and a very brief chapter upon the heliotherapy of non-tuberculous diseases-a mere introduction to what in a short time will be the theme of many volumes.

Two smaller works by the Swiss master are required in our language as complementary to this clinical volume. They are L’Ecole au Soleil and Comment Lutter Contre la Tuberculose? Admirable translations of them have been made by Mr Macleod Yearsley, FRCS, whose valuable services to the present volume are acknowledged by the author, and the sooner those translations appear the better for education and hygiene in this country, and the quicker the end of a disease which, in its so-called surgical form alone, is responsible for some nine or ten thousand deaths in this country every year, and the continued existence of which is a disgrace to our inchoate civilisation.

When the “human flower” is put in the sunlight, chemical processes begin, as in the case of the plant. Our anabolic possibilities have doubtless been underrated. Under the action of the light, pigment develops, and things as yet not understood begin to happen. On a fixed diet, the quantities of phosphorus, calcium and iron in the blood, if previously deficient, begin rapidly to rise. At one time it even seemed probable that vitamin A might be made in the skin under the action of light, thus accounting for the foreign discoveries that sunlight cures rickets, on the hypothesis that the disease is due to lack of vitamin A in the diet. The most recent evidence is to the effect that this piece of construction does not happen, but that the light makes a little vitamin go a long way.

But when I saw the work of Dr Alfred F Hess in Columbia University last December, it seemed clear that light would cure or prevent rickets with certainty, whilst the subject of the experiment was receiving a diet believed to be totally destitute of vitamin A. When last I referred to this subject here, in July of last year, I was rebuked for not explaining how sunlight cures rickets. I fear that nobody knows; we simply watch the rachitic bones by the X-rays, and after a fortnight or so the lesions begin to disappear, the total exposure to light having amounted to perhaps less than five hours. But we connect rickets with questions of the deposition of lime and phosphorus in growing bone, and therefore note that exposure to light will double the quantity of phosphorus in a baby’s blood during the fortnight that elapses before its rickety bones begin to heal. We are merely at the beginning of a vast enquiry, but we have abundance of knowledge for practice already.

The most important question of all, for practitioners, is the application of heliotherapy to pulmonary tuberculosis. I believe it will succeed in that field when its principles are understood, but I warn my readers against any attempts in this direction before the technique, as taught by Rollier, has been mastered. Doubtless the forgotten factor, hitherto, has been the temperature of the reaction. On this I understand that, in the Department of Applied Physiology of the Medical Research Council in Hampstead, the relations between the action of light and the temperature of the living body are being thoroughly worked out for the first time. Clinicians who have made disastrous experiments hitherto have doubtless failed to keep the patient cool. I strongly advocate the extension of heliotherapy to phthisis, and utterly repudiate responsibility for the accidents that will happen to clinicians who begin by exposing the chest to the midday sun for an hour or two. The profession must master this volume; and those who have responsibility for tuberculosis should visit Leysin, and attend the course of lectures and demonstrations which will be given, gratuitously, during a week in next August.

Helio-hygiene is, however, the concern of us all. The practical applications of these discoveries are many. They constitute a potent new argument against the slums, they involve the reconsideration of clothing, especially of children, and so on. The first and simplest thing they require is the abolition of the smoke above our cities, and I will ask the reader to bear with me whilst, in a single paragraph, I indicate the present situation. We have to deal with the domestic chimney. On that the point is to build aright our new houses, with smokeless equipment, as in North America. The case is clear and the Minister of Health should act in accordance with the unanimous Interim Report of Lord Newton’s Committee, the recommendations of which have hitherto been signally neglected by the Ministry itself, under whose roof that Committee sat. Also, we have to deal with the industrial chimney. A deputation representing some of the capitalistic interests involved has lately been to the Ministry protesting against any legislation. These are the men who have inherited our industries from the 19th century, and under whose direction of them we are steadily losing our place in competition with enlightened and enterprising and scientific industry in other countries.

When these men tell us that they do not know how to conduct their enterprises without making places like Sheffield and Manchester and the Potteries, we have no difficulty in believing them. But we are entitled to point to smokeless Essen and Cologne and Düsseldorf and Zurich and New York, and to require that our manufacturers should learn lest we perish. This deputation from the Federation of British Industries represented a very grave danger to the principal industry of any nation, which is the culture of life, and upon which all other industries depend, and I welcome the timely publication of Heliotherapy because it may arouse all who care for public health and happiness, the basis of all industrial efficiency, to bestir themselves against the vested interests, the apathy, the ignorance and the utter indifference to the public welfare which are largely responsible for the damnable and deadly darkness, like nothing else out of hell, above all the cities of what once was England’s green and pleasant land.

Read more from the NS archive here, and sign up to the weekly “From the archive” newsletter here. A selection of pieces spanning the New Statesman’s history has recently been published as “Statesmanship” (Weidenfeld & Nicolson).

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