Abscesses.

    Marked success is obtained in aborting the pathological process. If the case be treated before pus has formed, one local erythema reaction will usually be sufficient. When pus is forming, luminous heat therapy (Sollux Lamp) may effect resolution and save incision.
    Technique.Incipient abscess). 3rd degree erythema with Kromayer Lamp and suitable applicator (e.g., No. 529) in contact with centre of lesion, followed immediately by distant irradiation through Kromayer window, 2-3 inches away, on area about 2 inches diameter, to sterilize follicles. Repeat only on subsidence, if required.
    (Established Abscess). Produce brisk hyperaemia with Sollux Lamp, using localizer, to point of tolerance (e.g., 30 minutes at 6 inches distance). Repeat daily, or even more often, until resolution occurs.
    (Chronic Abscess). Establish drainage and administer local 2nd degree erythema through Kromayer Lamp window. Repeat on subsidence until healed.
    Concomitant therapy. Tonic measures, including sub-erythema light baths with Alpine Sun Lamp: especially in chronic (tubercular) abscess cases.
    (Literature references are given in full once only in this book and are numbered consecutively for easy consultation.)
    (It is not sufficient to refer only to the special books and papers quoted under each condition. The additional references contain much valuable information and should always be consulted.)
 

Acidosis.

    This condition is very favourably influenced by actinotherapy, which produces a shift in the p.H value of the blood, rendering it more alkaline. A basic diet must be prescribed; Dr. W. K. Russell uses a fat-free diet containing large amounts of glucose.
    Technique.Alpine Sun Lamp, general irradiation, 1st degree erythema; continue as Tonic Course (page 36).
    References: 790 797
 

Acne Rosacea.

    Results from actinotherapy are usually brilliant. Treat also the underlying cause (digestive disorders, alcoholism, genital disease), or relapses may occur.
    Technique must be suited to the stage which the condition has reached.
    Hyperoemic Type. 2nd degree erythema with the Kromayer Lamp, repeated after exfoliation until lesions are cleared up.
    Hypertrophic and Telangiectatic Types. 3rd degree erythema through Kromayer window with firm compression; and repeat on subsidence until cleared. Kromayer (159a) recommends the blue filter.
    References:
    179 Stein, R. O. -- Arztl. Praxis, 15th November, 1928.
        Also No. 159a 793 795 885
 

Acne Vulgaris.

    Actinotherapy gives excellent results in all forms of acne, although relapses sometimes occur, and certain forms require concomitant measures.
    Treat the patient for any underlying disorders, particularly constipation or anaemia, and prescribe an alkaline diet. Caution the patient that a sunburn reaction will be produced, to obviate anxiety.
    Technique. 2nd degree erythema reaction with Alpine Sun Lamp to produce desquamation on all affected areas. On face, treat each profile separately, and see that whole forehead to roots of hair is exposed. Eyes to be closed but not covered by goggles; protect the ears if necessary. Repeat the 2nd degree reaction (increasing exposure as required) on subsidence, until the skin is thoroughly clear. Resistant infiltrations may need local third degree reactions with the Kromayer Lamp and applicator in contact, repeated as needed. For best cosmetic * results, produce a local hyperaemia (Sollux Lamp; red filter if practicable) on the irradiated area each time immediately after treatment.
    In Pustular Acne it is well to evacuate pustules before irradiation, and cleanse with alcohol. Some authorities (Thedering, Sibley, Donnelly) recommend X-rays, in combination with actinotherapy, for resistant nodules.
    References:
    180 Donnelly, L. C. -- Amer. Jnl. Phys. Therapy, February, 1926.
        Also Nos. 786 792 793 795 837 838 844 855 885 888 894 898 907 909
 

Acrodynia ("pink disease").

    Actinotherapy gives "the best and most dependable results in this condition" (182). The infants become quieter, perspiration decreases, appetite is regained, and a normal condition slowly established.
    Technique. Alpine Sun Lamp, general light baths on lines of Tonic Course (page 36). Sollux Lamp for auxiliary warmth before each Alpine Sun bath.
    References:
    181 Sweet, G. B.  -- Archives Ped., August, 1925 (Quartz Lamp, October, 1925).
    182. Woringer, P. -- Fortschritte d. Med. 30th September, 1927.
 

Adenitis, Tubercular.

    (See also Tuberculosis, Surgical.)
    In a large proportion of cases of primary adenitis the glands decrease in size under actinotherapy without other treatment. Irradiation is the "treatment of choice" in these conditions and the glands are usually reduced to a size that does not cause any noticeable deformity. Ulcerated and deep-seated glands with sinuses may call for intense and protracted radiation; possibly X-ray or surgical treatment in addition.
    First Stage. Enlarged hard nodes and
    Second Stage. Glands approaching caseation.
    Technique. General tonic light baths (Alpine Sun Lamp), sub to 1st degree erythema dose, repeated every 2 or 3 days, combined with general luminous heat (Sollux Lamp).
    Sollux Lamp locally on glands to produce hyperaemia and assist resorption, followed by application of the Kromayer Lamp to glands under compression, 3rd degree erythema, repeated on subsidence.
    Third Stage. Glands caseated or suppurating. Incise and aspirate, following by light treatment as above. If sinus is already present, treat by special sinus procedure (Kromayer with applicator) detailed on page 48.
    References:
    183. Brooke, C. R., American Jnl. Electrotherapeutics, November, 1924 (Abst., Quartz Lamp, February, 1925).
    184. Gerstenberger, H. J. and Wahl., S. A. -- Jnl. American Med. Asscn., November 22nd, 1924.
    185. Bonsdorg, A. -- Tubercle, October, 1926.
    186. Holzman, J. L. -- Med. Sentinel, Sept., 1929 (Quartz Lamp, October, 1929.
    187. Pattison, C. L. -- Brit. Jnl. Actinotherapy, October, 1930.
    188. Moszdien. -- Strahlentherapie, January 331st, 1931, and Brit. Jnl. Actinotherapy, November, 1931.
        Also Nos. 253 267 656 658 661 667 668 673 676 680 682 684 686 688 690 743 745 788 796 803 806a 812 824 835 843 851 853 912

Adenitis, Venereal (see Chancroid).

Alopecia (areata and totalis).

    The aim in treatment is to stimulate the follicles to regrowth. Prognosis is best in recent cases, but age and long-standing disease are not contra-indications. The scalp must abe scrupulously cleansed before treatment.
    Technique. (Alopecia totalis). 2nd to 3rd degree erythema reaction on the affected areas. Nagelschmidt (195) uses Alpine Sun, 12 inches distance, 10 minutes exposure. Screen other parts (ears, forehead, neck, etc.) from the rays (cotton wool is recommended, to prevent sharp demarcation). See that the rays fall at right angles on the area; two or three exposures may be required.
    Allay pain or oedema by suitable compresses (see p. 40).
    Repeat this reaction every 2-3 weeks, increasing first exposures. Continue course for two to three treatments after re-growth is thoroughly established, or until it becomes evident that the follicles are dead.
    (Alopecia areata). 2nd to 3rd degree erythema with Kromayer (or Alpine Sun) on each bald spot, treated separately, including a margin up to 1/2 in. The healthy hair should be cut short (males) or carefully combed away (females) before treatment. Repeat the intense reaction every 2-3 weeks.
    References:
    189. Fox, H. -- Proc. N. Y. Derm. Soc., 1921.
    190. Meyer, F. M. -- Klin. therap. Ws.,May 15th, 1922.
    191. Breiger, S. -- 1st die Glatze Heilbar ? (19265).
    192. Sampson, C. M. -- Quartz Lamp, May, 1925.
    193. Marceron, L. -- Revue d'Actinologie, January-March, 1926.
    194. De Aja. -- Quartz Lamp, May, 1925.
    195. Nagelschmidt, F. -- "Loss of hair and its tretment by light" (1926. Price 6s.).
    196. Leiter, L. -- Wiener Med. Ws., 1928, No. 9.
    197. Laird, A. H. -- Brit. Jnl. Actinotherapy, January, 1929.
    198. Eichholz, E. -- Derm. Ws., February, 1929.
    199. Eidinow, A. -- Brit. Med. Jnl., November 29th, 1930.
    200. Roxburgh, A. C. -- Brit. Jnl. Derm., January, 1931.
            Also Nos. 786 789 888 894 896 898
 
 
Amenorrhoea.

    Provided that the condition is not organic, or the result of X-ray therapy, it usually responds to actinotherapy.
    It has been noted that actinotherapy often stimulates the menses, causing earlier incidence (795).
    Technique. Alpine Sun Lamp, general body tonic dose; on abdomen and lumbar region, 1st degree erythema dose, combined with luminous heat from Sollux Lamp (and/or pelvic diathermy) to stimulate local blood supply. Repeat once weekly during 3 three months until menses established.
    (Some authorities also recommend intra-vaginal irradiation with Kromayer Lamp, speculum, and applicator).

References:

    201. Donnelly, L. C. -- Am. Jnl. Electrotherapeutics, April, 1924.
    202. Lobligeois. -- Journ. de Med. de Paris, No. 44, 1925.
        Also Nos. 390 790 793 795 797 837 853
 

Anaemia.

    For anaemia in adults actinotherapy is "almost specific." Considerable increase of red corpuscles and of haemoglobin occurs after a short course of treatment. Diagnosis should be based on a blood cell count to differentiate leukaemic conditions.
    Infantile anaemia (particularly under 18 months old) if severe, may be caused by a toxaemia. Do not expect results from actinotherapy alone in such cases unless the underlying cause is diagnosed and dealt with.
    Technique. Alpine Sun, general light baths. The more severe the condition, the milder should be the irradiation; e.g., a bad case should be given sub-erythema doses ('Sedative Course'); as improvement sets in, these may be increased to 1st degree reactions. The general light baths should be administered daily or every second day.

References:

    203. Mathieu, R. & Feldzer. -- Soc. de Pediatrics, Paris, January 20th, 1925.
    204. Jongewaard, J. -- Archives Phys. Therapy, November, 1928 (Extract, Quartz Lamp, January 1929).
        Also Nos. 257 260 264 267 796
 

Anaemia, Pernicious.

    Good results have been obtained in treating this condition, even with cases which were not receiving liver diet.
    Technique. General irradiation with Alpine Sun on the lines stated for 'Tonic Course,' for a period of 2-12 weeks.
    Concurrent sensitization with eosin administered 1/2 hour before irradiation (40 m.gm. by mouth, or 2 ccm. 2 per cent. solution intravenously) is stated to promote the systemic reaction.

Refereances:

    205. Langmead, F. S. & Wilson, C. M. -- Lancet, April 28th, 1928.
    206. Macht, D. I. & Anderson, W. T. -- Jnl. Pharmacology and experimental Therapeutics, December, 1928.
    207. Minnit, R. J. -- Brit. Jnl. Actinotherapy, April, 1929.
    208. Macht, D. I. -- Brit. Jnl. Actiotherapy, February, 1931.
        Also No. 848
 

Angina Pectoris.

    Irradiations give a considrable and lasting degree of relief. Patients are freed from pain, enabled to walk, and to dispense with nitro-glycerine. Hasselbalch reports on 44 cases; Freund 80.
    Technique. Alpine Sun. Produce 3rd degree erythema on left side of thorax. Expose limited area only, e.g., 1st exposure on chest, 2nd on side, 3rd on back. Start with 10-12 minutes at 30 inches, or more if skin is already pigmented. 2nd exposure 5-8 days later. Intervals 5-8 days at first; 10-14 days after 5th exposure. Course of 5-8 treatments, repeated after an interval of several weeks.

References:

    209. Hasselbalch & Jacobaeus. -- Berliner Klin. Ws., 1907.
    210. Freund, E. -- Wiener Klin, Ws., June 21st, 1928.
    211. Freund, E. -- Brit. Jnl. Actinotherapy, November, 1930.
        Also No. 790
 

Angioma (See Telangiectases).

Arteriosclerosis.

    In the initial stages, actinotherapy improves the circulation, the head noises and dizziness disappear. Abnormal blood pressure is reduced; appetite, sleep, and general fitness improve.
    Contra-indications include long-standing cases with hardened arteries, serious heart trouble, and high blood pressure.
    Technique.Alpine Sun Lamp, general body radiation, 1st degree erythema, repeated every second day on the lines of the 'Tonic Course.' Combine with usual dietic measures (Sansum's basic diet, etc.)
    Sollux Lamp, on the areas of peripheral circulatory disturbance, to alleviate pain and assist normal circulation. 20-30 minutes on affected area, to easy tolerance; repeat daily.

References: 791 796 828
 

Arthritis, Rheumatoid.

    Dr. Percy Hall (215) states his opinion, based on hundreds of cases, that ultra-violet radiation alone, correctly administered, will afford benefit to the majority of sufferers, and effect lasting cure in a large proportion of cases.
    Prognosis is best in early cases, but many joints given up as hopeless have been "restored to a degree of usefulness." Dr. Deck (576).
    Technique. Acute Stage. Rest inflamed joints.
    Local luminous heat (Sollux Lamp with localizer) applied to joint, close as tolerable, for 30 minutes minimum, to produce deep hyperaemia round entire joint, or as far round as possible. Repeat at least once daily during the acute stage.
    General light baths with the Alpine Sun Lamp, sub-erythema reactions only. Sedative Course.
    Chronic Arthritis. General luminous heat baths (large Sollux Lamp) on entire body or whole affected limb, to promote circulation, assist elimination, and relieve pain. 10-15 minutes each side, increasing as indicated.
    Concurrent ultra-violet radiation (Alpine Sun Lamp) 1st degree erythema.
    The combined light bath to be repeated 2-3 times each week for course of 10-12 treatments. After intermission, repeat entire course if indicated.
    Ankylosed Joints. Kromayer Lamp (use blue filter for deep penetration) applied with firm compression all round joint, 4th degree erythema dose (6-8 minutes with blue filter). Produce and maintain bullous dermatitis and internal deep reaction all round joint by 4-5 inch doses within 2-3 days. Subsequent loosening enables passive and active mobilizing measures to be begun (831).
    Concomitant Therapy. Elimination of focal sepsis; diathermy and other physical measures as indicated.

References:

    212. Charbonnier. -- Jnl. Med. Paris, No. 4, 1926.
    213. McFee, W. D. -- Phys. Therapeutics, September, 1926.
    214. Roberts, A. -- Brit. Med. Jnl., January 29th, 1927.
    215. Hall, P. -- Brit. Jnl. Actinotherapy, Jan.-April, 1927.
    216. Snow, M. L. H. -- Phys. Therapeutics, May 1928.
    217. Pringle, G. L. K. -- Brit. Jnl. Actinotherapy, April, 1929.
        Also Nos. 576 581 786 796 831 854 855
 

Asthma.

    In a majority of cases, actinotherapy gives a very decided improvement or a relief. In a disease with such diverse responses to treatment, it is not surprising that different procedures are adopted by actinotherapists. Dr. Auld (225) uses, in combination with desensitizing measures (serum peptone injections) sub-erythema doses with the Alpine Sun, sometimes combined with intra-nasal local actinotherapy. Hollender and Cottle (857) adopt similar measures.
    In France, Duhem (218) and others have cured infantile asthma with larger doses. The Drs. Biancani (223) have observed that relief commences only after an erythema has been produced. Wellisch (230) applies regional 2nd degree erythema doses on chest and back, divided into four areas treated in rotation.
    Whilst due attention should be given to desensitizing therapy, calcium and thyroid administration, septic foci, etc., some patients respond to actinotherapy alone.
    Technique.Alpine Sun Lamp, general body baths, sub-erythema doses (e.g., 40 inches, 2 minutes, increased by one minute each time up to 15 maximum). Repeat every 3 days; course of 6 weeks; 1 month break, then repeat course.

References:

    218. Duhem, P. -- Paris Medical, February 20th, 1926.
    219. Saidman, J. -- Jnl. Med. Paris., June 30th, 1926.
    220. Tixier, L. & Mathieu, R. -- Brit. Jnl. Children's Dis., July-September 1926.
    221. Bryce, A. -- Brit. Med. Jnl., March 19th, 1927.
    222. Woodbury, F. T. -- Phys. Therapeutics, August, 1927.
    223. Biancani, E. & H. -- Brit. Jnl. Actinotherapy, September-October, 1927.
    224. Wilmer, H.B. -- Archives Phys. Therapy, January, 1928.
    225. Auld, A. G. -- Brit. Med. Jnl., June 1st, 1929.
    226. Lautman, R. -- ler Congres Internat. Actinologie, July, 1929.
    227. Hall, P. -- "Asthma and its treatment" (1930).
    228. Ledingham, U. -- In Report of Asthma Research Council, 1930.
    229. Auld, A. G. -- Lancet, April 11th, 1931.
    230. Wellisch, E. -- Med. Klin., No. 7, 1931.
        Also Nos. 402 405 799 807 814a 857
 

Bed Sores (see Gangrene, cutaneous).
 

Blepharitis (see Ophthalmology).
 

Blood Pressure.

    "Both diastolic and systolic arterial pressures are lowered by biological doses sufficient to produce slight erythema, and I regard this method as one of the best at our disposal for reduction of arterial pressures which are too high, and the raising of those which are too low." Dr. J. F. Halls Dally (834).
    Contra-indications. Advanced cardiac disease with failure of compensation; advanced arterio-sclerosis.

References:

    231 Gunther, B. -- Med. Klinik, March 4th, 1928.
    232. Marx, H. -- Klin. Ws., April 22nd, 1928.
        Also Nos. 789 790 792 793 796 834 847 854
 

Boils, Carbuncles, Furunculosis.

    "Heavy doses of the rays cause healing at a very much more rapid rate than by any other known method"(894). If the case is seen in the early stage, one third-degree erythema treatment will usually abort the pathological process. If pus has formed, incise and evacuate, following this with the erythema reaction. The result is speedy resolution, and relief of pain takes place within a few hours, with practical cessation within two days. Also irradiation of the surrounding skin destroys any staphylococci which have found lodgment in adjacent follicles.
    Technique. Kromayer Lamp. Irradiate area 3-4 inches diameter with lesion in centre. Produce heavy 3rd degree reaction. Do not cover up the surrounding skin. Repeat in 2-3 days only if needed.
    Alpine Sun Lamp. General irradiation and other measures to increase lowered general resistance.
    Sollux Lamp after incision, using localizer and red filter for deep penetration. 15-30 minutes' irradiation on lesion to alleviate pain and effect thorough drainage. Follow this by mild irradiation locally with the Alpine Sun to accelerate healing.

References:

    233. Hustead, C. L. -- Archives Phys. Therapy, January, 1928.
    234. Blatt, M. L. -- Archives Phys. Therapy, October, 1928.
        Also Nos. 178 793 822 853 894 903 908 914
 

Bronchitis: Bronchial Asthma.

    The good results of light therapy in these conditions are due to the efficacy of deep hyperaemia produced by luminous heat in all forms of inflammation, coupled with the effects of actinic rays on the sympathetic nervous system. Septic tonsils (q.v.) or obstructive throat conditions should be remedied.
    Technique. Sollux Lamp on front and back of chest, 20-30 minutes each. (The more acute the condition, the more powerful these luminous heat applications should be). Follow up with Alpine Sun Lamp: (a) 1st degree erythema reaction on chest; (b) whole body radiation, sub-erythema dose. Repeat every two days, but as condition improves increase intervals up to seven days. 4-8 weeks course of treatment; a repeat course (after 2-3 weeks interval) is sometimes required.

References: 178 267 807 819 831 853
 

Bruises and Haematomata.

    Valuable results are obtained in local or general bruising from applying luminous heat for its immediate decongesting effects, followed by ultra-violet radiation as restorative treatment.
    Technique. Sollux Lamp, with localizer if necessary, applied to produce hyperaemia. If area affected is small, 20-30 minutes at short distance using localizer. If area large, use with open reflector at sufficient distance for uniform irradiation, giving 30-45 minutes and repeating on back of body if affected Follow with Alpine Sun (or Kromayer locally) 2nd degree erythema on affected area. Repeat at 2-3 day intervals.

References: 825 913 915
 

Bubo (see Chancroid).
 

Burns and Scalds.

    Actinotherapy relieves pain more rapidly than any other method; healing is more rapid and the resultant scar is finer (239). The technique is necessarily varied according to the extent of the lesion, and the patient's condition.
    Localized Lesions. Kromayer Lamp. Wash the lesion clean with liquid paraffin; remove any adherent fragments of dead tissue. Then cover the burn with a thin, even layer of liquid paraffin. This can be done by soaking a double layer of gauze in the oil, squeezing out excess, and laying it carefully over the burn and a margin of undamaged skin. When ready to irradiate, peel off the gauze by two adjacent corners, and make sure that the surface is fully and evenly covered with oil.
    Irradiate with the Kromayer Lamp at a distance sufficient to cover the lesions and margins. Give mild dose (e.g., 30 seconds at 6 inches). Dress the lesion with a plain gauze pad soaked in paraffin. Repeat the irradiation daily, giving the same dosage. When epithelialization is well established, say, in 7 to 10 days, a slight increase may be needed if the rate of healing slows down (Technique published by Dr. J. Peake, Royal Free Hospital, London (237 239).
    Alpine Sun Lamp, General body baths, sub-erythema dose, continued as sedative course of irradiation.
    Larger Lesions (affecting less than quarter of the body surface).
    Alpine Sun Lamp. Treat the lesion as described above. When covered with the film of paraffin, irradiate with 1st degree erythema dose (e.g., 2 minutes at 30 inches). Repeat daily.
    If heavily infected when first seen, give 50 per cent. more than a 1st degree erythema dose, for the first treatment only, to promote cleansing. Continue with milder doses only, to promote cleansing. Continue with milder doses as above. Remember that newly formed epithelium is easily damaged by short bactericidal rays. The liquid paraffin acts as a filter; if this is not used, only the mildest dosage should be given during the regenerative stage of the lesion, or the blue filter used for long-wave technique.
 

Large Area Burns (over one-third of total skin area).

    The prognosis is considered hopeless. In a grave case like this, where you will have no opportunity to give a second treatment if the first fails, select two areas of normal skin--each a square foot--and give a 3rd degree erythema reaction on each. (Alpine Sun Lamp, 10 inches, 1 minute.)
    Immerse the patient, suspended on a blanket or other soft support, in a bath of tepid water. Give general irradiation (sub-erythema dose, 40 inches distance) on entire body, removing any charred fragments first, and shielding raw surface. Repeat this twice daily until the unburned skin shows a beginning reaction, in which case halve the time.
    When the time comes to take the patient out of the bath use perforated oil silk to cover the granulating areas.
    Use no grease of any kind on the lesion.
    (Condensed from "Practice of Physiotherapy," by Dr. C. M. Sampson, 786).

References:

    235. Kessler, E. B. -- Archives Phys. Therapy, June 21926.
    236. Lemariee, P. -- Rev. d'Actinologie, May, 1929.
    237. Peake, J. -- Brit. Jnl. Actinotherapy, August, 1929.
    238. Shillito, L. -- Brit. Med. Jnl., October, 1929.
    239. Heald, C. B. -- Lancet, November 9th, 1929.
    240. Peck, W. S. -- Brit. Jnl. Phys. Med., November, 1931.
        Also Nos. 763 786 848 852 915 919
 

Bursitis and Teno-synovitis.

    Symptoms are greatly relieved by production of powerful hyperaemia round the lesion. In suitable locations, this reaction can be brought to the regenerative stage by compression irradiation with the Kromayer Lamp and blue filter.
    Technique. Sollux Lamp with localizer, 20-30 minutes at close interval, followed by Kromayer Lamp with blue filter, compression 6-8 minutes (standard Kromayer) to produce bleb ovr lesion. Repeat on different (adjacent) skin area next day. "This technique allows of the most penetrating and intensive active hyperaemia which is in any way possible" (831). When the lesion is in the stage of strong inflammatory reaction, after 4-5 such doses on 2-3 days, manipulative measures can be successfully applied.
    Alpine Sun Lamp. General body baths, 1st degree erythema: Tonic Course.

References: 794 831 845 913
 

Cancer.

    Ultra-violet radiation itself has no effect on the size of existing cancerous tumours, but general resistance plays an important part in enabling the system to combat the invasion. Combined with deep x-ray therapy to the growths, actinotherapy improves the general resistance, restores loss of weight, and frequently enables the patient to return to normal life for prolonged periods.
    Technique. Alpine Sun Lamp. General body baths, sub to 1st erythema doses: Tonic Course.

References:

    241. Hernaman-Johnson, F. -- Brit. Med. Jnl., November 19th, 1927.
    242. Hernaman-Johnson, F. -- Brit. Jnl. Actinotherapy, May, 1929.
    243. Hernaman-Johnson, F. -- Brit. Med. Jnl., October 5th, 1929.
    244. Worth, E. H. -- Med. Press, October 1st, 1930.
        Also Nos. 792 913
 

Carbon Monoxide Poisoning.

    Coupled with the usual measures (oxygen respiration, cardiac stimulants), actinotherapy accelerates desaturation of the blood and assists the heart's action.
    Technique. Alpine Sun Lamp. General Body irradiation, 2nd degree erythema dose. Continue with tonic dose during convalescence.

Reference:

    245. Koza, F. -- Med. Klin., No. 12, 1930 (Abstract Brit. Jnl. Actinotherapy, September, 1930, April, 1931.).
 

Cabuncles (see Boils).
 

Catarrh, Nasal (Rhinitis, Coryza).
(See also Ozoena.)

    Local irradiation gives good results. General irradiation is a useful adjuvant in many cases.
    Technique. Cleansing, removal of mucus and crusts, is essential before treatment. Spray or paint the nostrils with anaesthetic (20 per cent. cocaine).
    Kromayer Lamp. Have the lamp running, with socket disc affixed. Insert nasal applicator (No. 504, 505 or 508) to full extent into the nostril. Then grease nostrils ("Protectol," lanoline) to protect them from aberrant radiation. Bring up the lamp and attach burner to applicator. Irradiate for 2nd degree erythema reaction on entire length of membrane, withdrawing the applicator steadily during the treatment.
    Acute Coryza will frequently clear up under luminous heat therapy alone (857).
    Sollux Lamp with localizer, applied locally for 20-30 minutes at smallest tolerable distance, protecting the eyes.
    Chronic Nasal Catarrh may require protracted treatment. General light baths with the Alpine Sun are a valuable adjuvant in this condition.

References:

    246. Evers, A. -- Med. Klin. No. 11, 1931.
        Also Nos. 178 790 796 857 862 863 879
 

Chancroid.

    Several writers report excellent results from ultra-violet alone. Bubos sometimes subside without incision; observation should be kept and abscesses evacuated if they persist after two or three irradiations.
    Technique. Kromayer Lamp with applicator, massive doses (4th degree reaction) on ulcer surface only; then a local 3rd degree erythema dose on surrounding skin. After infection is killed, give milder local stimulus doses daily until healing is established. Most cases are cleared up in two weeks; chronic cases may require much longer.

References:

    247.  Tomasone, U. -- Riforma Medica, 1925, No. 14.
    248.  Soukhareff, V. -- Brit. Med. Jnl., January 5th, 1929.
        Also Nos. 621   786   790   827   881
 

Chilblains.

For dealing with the local lesions, the results from actinotherapy are surprisingly good.  The worse the condition the more striking the results (793).  There is usually an underlying systemic condition, for which general actinotherapy combined with calcium lactate is valuable (or with thyroid gland and iodine in the fat, phlegmatic type of female patient (249).  Under local irradiation the irritation is rapidly calmed and the fingers or toes resume their normal appearance.  The severe itching subsides at the first or second irradition; results are lasting.

References:

    249. Barber, H. W. -- Lancet, December 4-11th, 1926.
    250. Humphris, F. H. -- Practitioner, October, 1930.
    251. Jost -- Schweizer Med. Ws., 1920, No. 52.
        Also Nos. 157 790 792 793 854 885 894
 

Child Welfare.

    The application of actinotherapy in children's diseases is indexed under various sections of this book: Rickets, Tetany, Whooping Cough, etc. Refereance is here made to its use in a wider, prophylactic sense. In the words of Dr. H. Stanley Baks (261):
    "Of all the uses of ultra-violet light in the field of Public Health, that which seems to me to be easily first in importance in this country is in the prevention and cure of rickets, malnutrition and debility in infants . . . Ultra-violet light can do much to restore their unstable metabolism to one which enables them to grow strong and straight, with good powers of resistance to acute disease."
    In a carefully recorded typical series of cases, this writer observed the following effects of light treatment:
    Increase in weight (group 1-2 years old, 10.2 ozs. gain per month--41 per cent. over normal).
    Increase in haemoglobin (average 9 per cent. gain).
    Increase in muscular activity (all children over 12 months were enabled to stand or walk).
    Improvement in general health (better sleep, better appetite, decrease of nervous irritability -- constant crying, etc. -- more activity and brightness).
    Healing of specific conditions (rickets, bronchitis, enteritis, spasmophilia).
 
References: (selected):

    252. Gamgee, K. M. L. -- The Artificial Light Treatment of Children (10/6), 1927.
    253. Birk, W. & Schall, L. -- Die Behandlung der Kinderkrankheiten mit ultra-violett und Rontgenstrahlen (2nd edition), (RM.12), 12932.
    254. Weltring, B. -- Med. Klinik, 1924, No. 15.
    255. Sherry, I. S. -- Clinical Med., March, 1926 (Quartz Lamp, June, 1926).
    256. Churchill, S. -- Med. Officer, July 17th, 1926.
    257. Sherry, I. L. -- Archives Phys. Therapy, November, 1926.
    258. Cassie, E. -- Maternity and Child Welfare, September, 1927.
    259. Cassie, E. -- Lancet, November 26th, 1927.
    260. Huldschinsky, K. -- Lichtbehandlung (in Handbuch der Lichttherapie, ed. Hausmann & Volk), 1927.
    261. Banks, H. S. -- Brit. Jnl. Actinotherapy, March, 1928.
    262. Reynolds, N. R. -- Phys. Therapeutics, May, 1928.
    263. Scott, H. C. -- Actinic Practitioner, April, 1929.
    264. Wilkins, E. H. -- Med. Officer, May 4th, 1929.
    265. Cassie, E. & Cox, U. -- Lancet, April 19th, 1930.
    266. Wilkins, E. H. -- Med. Officer, January 23rd, 1932.
    267. Perlman, H. N. -- Brit. Jnl. Phys. Med., February, 1932.
        Also Nos. 472 805 807 809 812 812a 813 814a 814b 816 819
 
 
Chorea.

    Irradiation rapidly mitigates symptoms and relieves insomnia. Results are satisfactory in most cases, e.g., Derby School Clinic (810) report on 19 cases; all who completed treatment (15 cases) "much improved."
    Technique. Alpine Sun Lamp, general irradiation, 1st to 2nd degree erythema. Continue Tonic Course until results are established.

References: 790 810 819
 

Coeliac Disease.

    "Coeliac rickets can be completely cured, even when the patient is on a fat-free dietary, by ultra-violet irradiation" (270). The value of light therapy consists here in increasing calcium-assimilation. It should of course be combined with strict regulation of diet.
    Technique.Alpine Sun Lamp, general body baths, 1st degree erythema; Tonic Course.

References:

    268. Hess, J. H. -- North West Med., June, 1926.
    269. Michelmore, R. S. -- Lancet, December 18th, 1926.
    270. Parsons, L. G. -- Archives, Dis. in Childhood, August, 1927.
        Also No. 589
 

Colds, Common.

    This common infection is readily aborted by a sterilizing dose of ultra-violet rays to both nostrils, the naso-pharynx, and tonsils. In the acute stage, a single treatment usually effects this result within 12 hours.
    As a prophylactic measure, it is found that the resistance of cold-susceptible persons is markedly increased by a course of general body baths (273).
    Technique. (Acute Cold). Kromayer Lamp, with applicator 504 inserted full length into nostril (blue filter). Switch over to white light and slowly withdraw so that 3-4 minutes irradiation has been given to passage. Repeat in other nostril. Change to applicator 507 and irradiate naso-pharynx 2-3 minutes; then with No. 501, about 1 minute to back of throat. (These approximate times are stated for Standard Kromayer Lamp, and should be increased for the Model II type).
    (Prophylaxis). Alpine Sun Lamp, preferably combined with Sollux Lamp to guard against chill General body baths, sub to 1st degree erythema doses, repeated once weekly.

References:

    271. Hill, L. & Clement, M. -- "Common Colds" (1929).
    272. Maugham, G. H. & Smiley, D. F. -- Brit. Jnl. Actinotherapy, May, 1929.
    273. Maugham, G. H. & Smiley, D. F. -- Brit. Jnl. Actinotherapy, September, 1930.
    274. Webster, J. H. D. & Troup, W. A. -- Brit. Med. Jnl., March 5th, 1932 (Quartz Lamp, S. April, 1932).
 

Colitis.

    Whether the condition is due to vagotonia, infection, diverticulosis, or associated with adhesions, actinotherapy gives valuable results. Prescribe suitable diet free from roughage, with sedatives and bismuth or barium medication.
    Levy (280) analyses results of treating 600 cases by technique outlined below; about 70 per cent. of all cases remain free from symptoms, and 90 per cent. of mucous colitis patients.
    Technique. Sollux Lamp regional on abdomen, 20-30 minutes, followed by Alpine Sun, general body baths, 1st degree erythema. Continue as stated for tonic course. Repeat the Sollux Lamp treatment at each session until acute inflammatory symptoms subside.

References:

    275. Armani, L. -- Raggi Ultravioletti, April 1925.
    276. Hurst, A. F. -- Lancet, December 4th, 1926.
    277. Levy, L. H. -- Phys. Therapeutics, February, 1927.
    278. Levy, L. H. -- Phys. Therapeutics, February 1928.
    279. Levy, L. H. -- Phys. Therapeutics, February 1929.
    280. Levy, L. H. -- Phys. Therapeutics, May, 1929.
    281. Torrelli, G. -- Raggi Ultravioletti, March-April, 1930.
        Also No. 793
 

Conjunctivitis, Acute.

    Acute forms, after removal of all immediate causes, respond quickly to luminous heat treatment.
    Technique. Sollux Lamp, short and frequent sessions (10-20 minutes) two to three times each day, on closed eyelids. In specific types (gonococcal, etc.) apply luminous heat as adjuvant to medicinal procedures. (See Gonorrhoeal ophthalmia).

References: 502 504
 

Conjunctivitis, Chronic.

    Technique. Kromayer Lamp with applicator, to produce 3rd degree erythema on conjunctiva; use everting forceps if necessary. The cornea should be protected from the rays.
    General tonic baths with the Alpine Sun may be combined with advantage.

References: 504 506 513
 

Convalescence (see Debility).
 

Corneal Ulcers (seee Ophthalmology).
 

Coryza (see Catarrh, Nasal).
 

Cystitis.

    The main information available is given by Dr. Saidman and his assistants at the Institut d'Actinologie. Using combined luminous heat and ultra-violet irradiation for cases of cystitis after nephrectomy for renal tuberculosis, he states that:--
    "Cystitis is refractory to irradiation. Only about the 6th session is any amelioration of symptoms observed. The pain on micturition first diminishes; the urine becomes clearer; frequency is reduced towards normal; seminal capacity increases; hematuria becomes less frequent."
    Other authorities (Bernay 883, Meschede 884) have devised special appliances for cystic irradiation, and claim good results.

References: 749 791 883 884
 

Dacryo-Cystitis (see Ophthalmology).
 

Deafness.

    Some cases of deafness, due to various causes, show marked improvement after general light baths. In cases due to lymphadenoid hyperplasia, Denman (283), Hollender (857) and others, advise X-radiation to eliminate lymphoid foci, combined with general ultra-violet to assist recovery.
    Technique. Combined with special treatment of underlying causes according to the case-indications, give general irradiation with Alpine Sun Lamp. 1st degree erythema doses, repeated two to three times weekly.
    Perforated eardrums. Leicher (286) has effected regeneration of drum tissues in 19 cases, using combined cautery and local ultra-violet. Prognosis depends largely on patient's age; best results are obtained below 25 years, but sucess has been achieved at twice that age.
    Technique. Close the perforation with cotton wool. Apply the Kromayer Lamp with applicator round margins of drum (5 times trunk erythema dose), to produce vascular suffusion on malleum. 24 hours later, cauterize drum margins with concentrated trichloracetic acid. Repeat irradiation and cautery at 2 to 3 weeks intervals, until regeneration is satisfactory.

References:

    282. Lacy, T. B. -- Jnl Radiology, October, 1924.
    283. Denman, I. O. -- Clinical Medicine, February, 1926.
    284. Barnet, H. N. -- Jnl. Larynology, December 1927.
    285. Hunter, T. C. -- Brit. Med. Jnl., January 19th, 1929.
    286. Leicher, H. -- Zs. fur Laryngologie 1931, 20, No.4.
        Also Nos. 792 857

Debility and Convalescence.

    These conditions are "probably the most responsive of all general ailments to ultra-violet light, provided erythema doses are avoided and there is no "master" ailment inhibiting benefit"(852).
    Premature and debilitated infants make excellent progress under actinotherapy, with steady gain in weight (791).
    Debility during Convalescence after acute illness shows rapid improvement, provided that due attention is given to diet, rest, and general hygiene.
    Recovery from whooping cough has been reduced from 50 to 20 days by actinotherapy (775), and it is recommended as routine treatment for all Isolation Hospital convalescent cases (261).
    Convalescence after operation. (See also "Wounds"). The general tonic effects of actinotherapy are found valuable in post-operative cases. Patients rest better, heal more quickly, gain strength more rapidly, and qualify for earlier discharge.
    Used as a routine measure, actinotherapy and other physical treatment hae shortened patients' stay in hospital by 3 1/2 days (289).
    Technique.Alpine Sun Lamp (or Jesionek Lamp). General body baths; sub-erythema doses: Sedative Course. If patient is confined to bed at home, this course can be administered with the Portable Lamp.

References:

    287. Heald, C. B. -- Lancet, December 4th, 1926.
    288. MacIntyre, E. J -- Brit. Jnl. Phys. Med., August 1931.
    289. Miller, H. C. -- Archives Phys. Therapy, February, 1932.  (Quartz Lamp, S., April, 1932).
        Also Nos. 252 261 264 265 791 793 796 797 800 808 809 810 814a 817 819 830 852
 

Dental Surgery.

    Actinotherapy has an established place in Dental Surgery. Much can be accomplished by local application as a conservative measure in septic conditions of the mouth and teeth.*  (*Special handbooks on dental conditions are obtainable on request from the Hanovia Co. or its agents.)
    Research work indicates that there is a still greater field for the application of general irradiation as a prophylactic measure to ensure proper development and resistance to caries; and general light baths are always a most valiable adjuvant to the focal irradiation.
    The oral conditions in which actinotherapy has found greatest use are:

    Post-extractive pain.
    Bleaching of discoloured teeth.
    Dental Abscess.
    Alveolectomy (after-treatment).
    Maxillary Fractures.
    Pyorrhoea (q.v.).
    Gingivitis (q.v.).
    Vincent's Angina (q.v.).

    Post Operative Pain. (See also Neuralgia, facial). This procedure is based on the marked analgesic effects of ultra-violet rays on the nerve endings. The local reaction results in a suffusion of the tissues with lymph and leucocytes, producing a rapid formation of granulation tissue. Bleeding wounds dry up in a few hours, and due to the antiseptic effects of the irradiation, the risks of secondary infection are greatly reduced. Irradiation is a great help to rapid healing of the wound.
    Technique. Dry out the wound thoroughly. Use the Kromayer Lamp fitted with applicator 558, applied to socket of extracted tooth in contact for 1st degree reaction (use applicator 552 or 553 if access is difficult). Then same exposure to gums facially (use applicator No. 554) and linqually (applicator No. 555 or 506). Repetition is seldom required.

Reference:

    290. Winter, L. -- Internat. Jnl. Orthodontia, May, 1932. (Quartz Lamp, S., October, 1932).

    Bleaching Discoloured Teeth. Rosenthal, Betancourt and other users of this procedure state that time for final result depends on whether the tooth is dead or alive, its original colour, etc. Excellent cosmetic results are obtained in very many cases.
    Technique. Open tooth; clean pulp cavity and canals, and seal. Isolate tooth with rubber dam. Moisten tooth with fresh neutral H2O2, and insert peroxide tampon inside. Renew peroxide every few minutes during prolonged irradiation (20-30 minutes each session, using the Kromayer Lamp with suitable applicator). Repeat till result is satisfactory; it is advisable slightly to overbleach if possible.

References:

    291. Rosenthal, P. -- Le Laboratoire et la Progres Dentaire, September 2nd, 1910.
    292. Betancourt, J. -- The Dental Surgeon, March 21st, 1925.
    293. Bischoff, A. -- Schweizerischer monats, f. Zahnheilkunde, April, 1926.
 

    Dental Abscesses. Folstein (295) (310), whose technique is summarized below, obtains regeneration after about five sessions.
    Technique. Take X-ray to establish status of tooth. Procedure is then as follows, visits being at two days intervals: Irradiation is given each time on both facial and lingual aspects of tooth in apical region, using Kromayer Lamp with suitable applicators. First degree reaction, except as otherwise indicated.
    1st Visit. Open tooth and establish drainage of pus. Irradiate.
    2nd Visit. Remove contents of pulp chamger, and seal cavity with mild dressing. Irradiate.
    3rd Visit. Sterilize root canals; seal with mild dressing. Irradiate.
    4th Visit. Adjust coffer dam, open canals and flush with alcohol. Fill canals with chloro- resin solution (50/50) followed by gutta-percha inserted in the form of small needles. Seal cavity. Irradiate with compression for 3rd degree reaction.
    5th Visit. X-ray to check regeneration. If incomplete continue successive irradiations (2nd degree reactons) until final result.
    Where a fistula exists, continue irradiation after sealing root canals; 2 to3 treatments, until it heals.

References:

    294. Bovie, W. T. -- The Quartz Lamp, April 15th, 1925.
    295. Folstein, I. L. -- The Dental Cosmos, November, 1925.

    Alveolectomy (use after). Technique. Retract the gum tissue-flap; protect tissue with gauze or cotton, and give a 3rd degree reaction on the exposed bone over each extraction, placing the applicator on a level with the root of the tooth. If the incised gum is to be sutured, this should be done first and a second degree reaction given over that area. If the frenum has been incised, it should be sutured before irradiation.
    Maxillary Fractures. "The treatment of fractures of the superior and inferior maxillae presents difficulties not found in fractures of any other bones of the body. The necessity for the restoration of perfect occlusion and the position of the oral cavity as the portal of the alimentary tract furnish complications which necessitate rapid and accurate therapeutic measures. The ultra-violet ray through its inherent properties, is an invaluable adjunct to the recognized methods of treatments" (312).
    Technique. First dehaematize the area by local irradiation with the Sollux Lamp, using localizer and blue filter for 30 minutes minimum.
    Irradiate with the Kromayer Lamp in contact with tissue directly above line of fracture; 1st-2nd degree reation. Repeat daily.

References on Dental Surgery (selected):

    296. Lippmann, L. B. -- Amer. Jnl. Electrotherapeutics, October, 1921.
    297. Bode, A. -- Zahntechnische Reform, January 13th, 1925.
    298. Lake, F. W. -- Dental Cosmos, February, 1925.
    299.Rowlett, A. E. & Spain, I.S. -- Brit. Dental Jnl., August 15th, 1925.
    300. Talbot, F. -- Brit. Dental Jnl., November 16th, 1925.
    301. Read, C. -- Brit. Dental Jnl. Autust 2nd, 1926.
    302. Rowlett, A. E. -- Brit. Jnl. Actinotherapy, June, 1926.
    303. Evans, W. H., Riding, D. & Glynn, E. E. -- Lancet, September 17th, 1927.
    304. Hall, P. -- Brit. Dental Jnl., April 15th, 1927.
    305. Kieffer, J. -- Dental Mag., June, 1927.
    306. Lake, F. W. -- Archives Phys. Therapy, May, 1927.
    307. Miller, N. -- Brit. Jnl. Actinotherapy, January, 1927.
    308. Rowlett, A. E. -- Dental Surgeon, October 8th, 1927.
    309. Bramer, M. L. -- Jnl. Amer. Dental Assn., October, 1928.
    310. Folstein, I. L. -- Amer. Jnl. Phys. Therapy, August, 1928.
    311. Talbot, F. -- Actinotherapy for Dental Diseases (5/-). 1928.
    312. Winter, L. & Hayes, L. V. -- Dental Cosmos, November, 1928.
    313. Hlavac, C. W. -- Amer. Dental Surgeon, April 1929. (Quartz Lamp, June, 1929).
    314. Murphy, J. F. X. -- Internat. Jnl. Orthodontia, July, 1929.
    315 Reade, R. J. -- Canadian Dental Research Foundation, 1929, Bulletin No. 13.
    316. Dufestel, L. G. & Chambenoit, R. -- Les Applications locales des rayons Ultra-violets: Odonto-Stomatologie (18 frcs.) 1930.
    317. Folstein, I.L. -- Amer. Jnl. Phys.Therapy, August, 1930.
    318. Rasmussen, A. T. -- Archives Phys. Therapy, May, 1930.
    319. Furniss, A. -- Med. Officer, January 10th, 1931.
    320. Furniss, A. -- Ultra-violet Therapy (12/6), 1931.
    321. Holman, C. B. -- Brit. Jnl. Phys. Med., June, 1931.
    322. Nivard, E. -- 8th International Dental Congress, Paris, 1931.
    323. Sampe, A. A. -- Dental Survey, November, 1931 (Quartz Lamp, S., April, 1932).
    324. Talbot, F. -- Brit. Dental Jnl., February, 2nd, 1931.
        (See also Special References Nos. 567-572 767)
 
 
Dermatitis.

    Whether a dermatitis be due to infection (staphylococcus, seborrhoea, etc.) or to an irritant (fur, dyes, vegetation, etc.) some supersensitiveness of the skin is probably a causal factor. Combined with avoidance of further irritation, and due alleviatives for the irritation (salicylic alcohol 1 per cent., etc.), actinotherapy is valuable for re-establishing a healthy skin condition.
    Technique. During "weeping" stage, Sollux Lamp, at tolerable distance, with red filter for drying effect, as advised under "Eczema."
    When lesions are dry, Alpine Sun Lamp, sub-erythema doses (distance 40 inches). Increase cautiously if obvious improvement results.
    (For Roentgen dermatitis, see "X-Ray Burns.")

References:

    325. Dowling, G. B. -- (Staphylococcal eruptions), Jnl. Clin. Research, April, 1926.
    326. Ullmann, K. -- (Fur dermatitis), Ars Medici, April, 1926.
    327. Goldstein, M. -- Dermatitis venenata due to chrysanthemum leaves, Jnl. A.M.A., May 16th, 1931.
        Also Nos. 855 901
 

Dermatomycoses.

    Powerful local sterilizing doses of ultra-violet rays give good results in fungus infections of the skin.
    Technique is as detailed under "Tinea (treatment)." Other forms mentioned in available reports include Saccaromycosis (329), Actinomycosis (914), and Favus (328). In the last condition Dr. Cipriani used the Sollux Lamp for deeper penetration.
    In many of these conditions, the characteristic fluorescence of the fungus is a useful aid to diagnosis (see pages 23, 142).

References:

    328. Cipriani, M. -- Raggi Ultravioletti, January, 1929.
        Also No. 329 651 652 914
 

Diabetes.

    Good results are obtained in cases of glycosuria. Irradiation stimulates pancreatic activity and insulin formation. In some cases glucose will disappear under irradiation; where insulin is being administered, the dose can often be reduced. A patient of Nicory's (854), after 48 irradiations, reduced insulin intake from 245 to 174 units, was able to resume exercise, and gained 9 lbs. in weight.
    Rothmann (329) and others report good results in associated skin disorders, diabetic xanthoma, pruritis, furunculosis, and intertriginous mycosis.
    Caution. High insulin-intake may sensitize the subject (see page 41). Erythema-reaction should be determined before giving the first irradiation.
    Techniqe. Alpine Sun Lamp. General body baths, 1st degree erythema doses. Continue as Tonic Course, keeping check of sugar in the urine.

References:

    329. Rothmann, S. -- Strahlentherapie, 1927, 24, p. 465.
        Also Nos. 114 152a(discussion) 791 797 848 854
 

Diphtheria Carriers.

    Local actinotherapy administered to the tonsils and naso-pharynx sterilizes diphtheria carriers. 50 per cent. of cases are sterilized at the first irradiation; in a test series none were swab-positive after three treatments.
    The valuable effects of general actinotherapy for diphtheria convalescents should also be remembered (see "Debility").
    Technique. Kromayer Lamp, with applicator No. 510, contact on tonsils, giving powerful reaction. Treat one tonsil at each session.
    Kromayer Lamp with applicator No. 508 in nose, after contracting the mucous membrane (adrenalin chloride solution). Insert applicator to full length before attaching lamp. Ten minutes application in each nostril, slowly withdrawing the rod during treatment.

References:

    330. Donnelly, L. C. -- Jnl. Mich. State. Med. Soc., September, 1921.
    331. Langenfelter, G. P. -- Colorado Med., March, 1928. (Quartz Lamp, May, 1928).
    332. Petit, O. A. -- Brit. Jnl. Actinotherapy, September, 1930.
    333. Herve, F. -- Jnl. de Med. Bordeaux, May 20th, 1930.
 

Duodenal Ulcers (see Gastric Ulcers).
 

Dysmenorrhoea (see under Amenorrhoea).
 

Dysmenorrhoea, Membranous.

    Kustner (324) describes this condition as due to lack of the trypsin ferments necessary in elimination of the uterine membrane. Experiments having indicated that red light gave the required hormone stimulus, he applied these in a series of cases, with outstanding success.
    Technique.Sollux Lamp with red filber. First exposure, local over abdomen, 1 hour at 20 inches distance; repeat daily. After about 15 exposures, every 2nd day; after 30 exposures, 1-2 times weekly.

References:

    334. Kustner, H. -- Zentralbl. f. Gynak, September 24th, 1932.
 

Eclampsia.

    The value of actinotherapy in reducing abnormal blood pressure (q.v.) has led to its effective use in pre-eclamptic states. Mayer's 25 cases (all primaparae) showed reductions of blood pressure from 160 to 110 mm., disappearance of headache, oedema and albumen; convulsions were averted and spontaneous delivery obtained after irradiation 2-3 times weekly.
    Technique. Alpine Sun Lamp. General body baths, 2nd degree erythema doses on half the body area. Take observation of blood pressure and albumen in urine. Repeat irradiation (on other half body area) in 2-3 days.

References:

    335. Hochenbichler, A. -- Monatss. f. Geburtshilfe, 1922, 62, p. 269.
    336. Mayer, A. -- Wiener Klin, Ws., 1926, No. 52. Abs. Brit. Jnl. Actinotherapy, October, 1927.
    337. Hochenbichler, A. -- Med, Press, April 25th, 1928.
 

Eczema.

    Actinotherapy is a valuable adjuvant in healing all forms of eczema. Being usually due to underlying metabolic disorders, the condition calls for general irradiation applied for systemic reactions. The diverse skin manifestations necessitate a very varied technique of irradiation which must be suited to each case, combined with other therapeutic measures, following the lines indicated.
    Acute Weeping Eczema (eczema rubrum). Erythema will exacerbate the condition. Irradiation with Alpine Sun Lamp, minimal doses (e.g., 1 minute at 40 inches) followed by 2 per cent. boric lotion or 1 per cent. resorcin fomentations. Thedering (795) and other authorities advise Sollux Lamp with red filter, applied from a distance of 30 to 40 inches, to dry the acute weeping surfaces thoroughly before ultra-violet treatment is commenced.
    Sub-Acute Eczema. Alpine Sun Lamp. General body baths, sub-erythema doses (e.g., 2 minutes at 40 inches). If the condition has reached a chronic stage it may be necessary to stir it to an acute stage by one 2nd degree erythema dose, followed by mild irradiations (Sedative Course).
    Pustular Eczema. Alpine Sun Lamp. General body baths. 1st degree erythema dose, repeated once weekly.
    Squamous Eczema, with crusting. All crusts must be removed (e.g., H2O2) before irradiation. Then Alpine Sun Lamp, 2nd degree erythema dose. If this produces a weeping reaction, alleviate as indicated above, and repeat after 4-5 days interval with the same or smaller dose. When reaction is moderate, continue on lines of Intensive Course.
    Hyperkeratotic Eczema: Chronic indurated Eczema. Here the aim of light therapy is to produce desquamation of the stratum corneum. The Alpine Sun Lamp is applied to the affected areas with a 3rd degree erythema dose; obdurate cases may require contact irradiation with the Kromayer Lamp and blue filter. Repeat on subsidence and increase according to previous reaction. Three or four such applications should be sufficient.
    Special Technique. Huldschinsky (340) has obtained excellent results by wetting the eczema surfaces with 5 per cent. silver nitrate solution and irradiating locally until the solution blackens. Repeat every 1-2 days until healed.

References:

    338. Mosse, K. -- Deuts. Med. Ws., 1924, No. 51.
    339. Falkner, H. G. -- Actinic Practitioner, February, 1929.
    340. Huldschinsky, K. -- Brit. Jnl. Actinotherapy, February, 1929.
    341. Kirschmann, K. -- Deuts. Med. Ws., July 5th, 1929.
    342. Savill, A. -- Lancet, April 6th, 1929.
    343. Savill, A. -- Brit. Jnl. Actinotherapy, December, 1930.
    344. O'Donovan, W. J. -- Lancet, October 31st, 1931.
        Also Nos. 159a 793 795 848 853 885 887 889 891 892 893 896 907
 

Emphysema, Pulmonary.

    Actinic irradiation produces good results on the symptoms, functional disturbance, and general condition.
    Technique. Alpine Sun Lamp, locally on chest and back. Second degree erythema, repeated on subsidence (or irradiate chest and thorax at alternate sessions).

References: 724 791
 

Empyema.

    Following antrum or sinus operation, appendictectomy, pneumonia, etc., discharging empyema can be effectually cleared up under actinotherapy.
    Technique. Clean opening. Produce hyperaemia by Sollux Lamp (or H.F. effluvation in cavity).
    Kromayer Lamp with suitable applicator in cavity to produce moderate reaction (e.g., standard Kromayer, four minutes).
    With this, combine a general light bath from the Alpine Sun Lamp, giving 1st to 2nd degree erythema according to patient's general condition.
    Repeat every other day until discharge is cleared up.

References:

    345. Bierman, W. -- Phys. Therapeutics, June, 1928.
    346. McKenzie, T. Clyde & Rowatt, J. -- Brit. Jnl. Actinotherapy, December, 1929.
        Also Nos. 168 296 307
 

Encephalitis Lethargica.

    The few available reports on this condition indicate good results; Jaffe (348) obtained improvement in 35 out of 40 cases. In several instances patients were enabled to resume full occupation.
    Technique. Alpine Sun Lamp. General body bath, full 2nd degree erythema, continued as Therapeutic Course (intervals of 3 days). Repeat the course after 30 days break.
    Also, Kromayer Lamp with applicators, to nasal and tonsillar mucous membranes, following usual technique.

References:

    347. Fawcitt, R. -- Brit. Med. Jnl., March 5th, 1927.
    348. Jaffe, H. N. -- Brit. Med. Jnl., December 31st, 1927.
        Also No. 442
 

Epicondylitis ("Tennis elbow," etc.)

    There are two methods of light treatment in these conditions: (a) the palliative (using luminous heat), and (b) the regenerative, using actinic rays.
    (a) Bryce (350) obtained speedy relief from "sickening pain," and a complete clear-up within two months, by luminous heat.
    Technique. Sollux Lamp, with localizer, applied as close as tolerable to injury. Irradiate 30 minutes minimum: repeat daily.
    (b) Frey (349) cured a series of cases by ultra-violet after heat treatment had failed. His patients were enabled to resume the activities which caused their condition (tennis, carpentry, ironing, etc.) without relapse.
    Technique. Kromayer Lamp, in contact over the epicondyle, 2nd degree erythema dose. Repeat 3-4 times in all.

References:

    349. Frey, E. -- Wiener, med. Ws., April 21st, 1928.
    350. Bryce, A. -- Brit. Jnl. Actinotherapy, June, 1930.
        Also No. 168
 

Epididymitis (Gonorrheal, Traumatic, Tubercular); Orchitis.

    Acute Forms. These necessitate such usual measures as rest in bed, purgation, etc. Light treatment will consist in local luminous heat radiation for its analgesic and decongestive effect.
    Technique. Sollux Lamp with localizer, to affected testicles, at least 30 minutes irradiation, which may be repeated as frequently as required until pain and swelling subside.
    Chronic Forms. These react favourably to actinic irradiation. Reduction in size is usually observed after 4-6 exposures, but treatment should be continued after parts have become normal, to obviate relapse.
    Technique. Alpine Sun Lamp, local irradiation for 3rd degree reaction on all sides of affected scrotum, covering healthy skin. Taparelli (357) gives 10 minutes at 16 inches. Stone (351) uses Kromayer Lamp in contact for 3 minutes.

References:

    351. Stone, C. T. -- Jnl. Phys. Therapy, April, 1924.
    352. Auge, A. & Alpinat, P. -- Amer. Jnl. Phys. Therapy, September, 1924.
    353. Cipriani, M. -- Raggi Ultravioletti, 1927.
    354. Petrucci, A. -- Raggi Ultravioletti, January, 1927.
    355. Cipriani, M. -- Raggi Ultravioletti, September, 1928.
    356. Dal Pino, C. -- Raggi Ultravioletti, 1928.
    357. Taparelli, A. -- Raggi Ultravioletti, 1928.
    358. Cipriani, M. -- Raggi Ultravioletti, January, 1929.
        Also Nos. 168 622 740 785 796 822 880 881
 

Episcleritis (see Ophthalmology).
 

Erysipelas.

    The effects of actinotherapy in erysipelas are specific. Previously noted by Continental and American Workers, they have been recently re-stated by Dr. J. M. Davidson (369) after recording 52 cases. A critical fall in temperature sets in within 24-48 hours, and the condition clears up quickly. Relapses are rare, and clear up equally readily on subsequent irradiation.
    Technique. Kromayer Lamp. Remove any greasy soothing preparation. At 2 inches distance, irradiate the whole of area affected, including 1 1/2 inches of healthy skin at margins, to produce heavy 3rd degree reaction. Protect only the eyeballs in head cases The Kromayer Lamp is best for small areas.
    For larger lesions, use the Alpine Sun Lamp, covering healthy skin almost to margins of area.
    One treatment usually suffices, unless part of the area has been under-irradiated. Leave the area uncovered after irradiation.

References:

    359. Petenyi. -- Monatsh. f. Kinderheilk, 1921, 21, p. 269.
    360. Czepa, A. -- Wiener Klin. Ws., 1922, No. 25.
    36l. Brunauer, S. -- Med. Klin., 1924, No. 29. (Abstract, Amer. Jnl. Phys. Therapy, November, 1924).
    362. Becker, J. -- Munch. Med. Ws., March 25th, 1927.
    363. Becker, J. -- Strahlentherapie, 1929, 34, p. 205.
    364. Bohmer, L. -- Strahlentherapie, 1930, 35, p. 133. (Abstract, Quartz Lamp, S. October, 1931).
    365. Brown, R. K. -- Brit. Jnl. Actinotherapy, September, 1930.
    366. Ude, W. H. -- Brit. Jnl. Actinotherapy, January, 1930.
    367. Ude, W. H. & Platou, E. S. -- Jnl. Amer. Med. Asscn., July 5th, 1930. (Quartz Lamp, August, 1930).
    368. Ude, W. H. -- Archives Phys. Therapy, January, 1931. (Quartz Lamp, February, 1931).
    369. Davidson, J. M. -- Brit. Jnl. Phys. Med., December, 1932. (Abstract, Quartz Lamp, S. July, 1932).
    370. Troup, W. A. -- Brit. Jnl. Phys. Med., December, 1932. (Abstract, Quartz Lamp, S., January, 1932).
        Also Nos. 253 786 790 796 863 885 887
 

Erysipeloid.

    One single intensive irradiation clears up most cases. Certain forms relapse and may require up to 5 to 6 repetitions; no instances of failure are recorded.
    Technique. Alpine Sun Lamp or Kromayer Lamp. Intense irradiation locally on affected area (e.g., Alpine Sun Lamp, 15 minutes at 8 inches). Repeat on second or third day only if necessary.

References:

    371. Muhlpfordt, H. -- Munxh mws. Qa., 1924, 20, 649.
    372. Klauder, Richter and Harkins. -- Arch. of Derm. and Syph., 1926, 14, 6.
    373. Muhlpfordt, H. -- Derm. Zts., 1931, 60, 445. (Abstract in Brit. Jnl. Phys. Med., August 1932).
        Also No. 846
 

Erythema Induratum (Bazin's).

    The results reported refer to cases in the tuberculous type of erythema indure (Bazin), which occurs in young women, usually on the leg. Oliver (374) reports five cases, all successfully treated.
    Technique. Kromayer Lamp, applied with firm compression to indurated areas, 4th degree erythema dose. Treat two or three areas at each session. One application to each area is usually effective.

References:

    374. Oliver, E. L. -- Archives Derm. and Syph, November, 1922. (Abstract, Quartz Lamp, September 1924).
        Also Nos. 892 898
 

Fibrositis (see Rheumatism).
 

Fistulae.

    Chronic discharging fistulae following appendicectomy, empyema, etc., usually do well. A typical case reported by Dr. Punch (837), which had persisted for three years, cleared up within two months under local and general irradiation.
    Technique. Alpine Sun Lamp, General body baths, 1st degree erythema, continued as Tonic or Sedative Course according to patient's general condition.
    Also Kromayer Lamp, with suitable applicator, to penetrate the fistula deeply. Expose for intense local reaction; repeat on subsidence until healed. The special sinus technique (page 48) may be used in these cases.

References:

    375. Menard & Foubert. -- C. rendus A.d. Sciences, April 7th, 1924.
    376. Bruer, M. -- Amer. Jnl. Phys. Therapy, April, 1926.
        Also Nos. 314 740 753 805 837 895
 

Fractures.

    Light therapy is a useful adjuvant in treatment.
    Luminous heat rays dilate the vessels and increase circulation where applied. This indicates local application of the Sollux Lamp to fractures in or about the joints (Colles' fracture, Potts' fracture, etc.) accompanied by swelling.
    Actinic rays increase the calcium and phosphate content of the blood serum. During the process of repair, light baths with the Alpine Sun Lamp will accelerate callus formation. Combined calcium administration and ultra-violet therapy is stated to be more effective than either alone.
    Cases are reported of spontaneous rachitic fractures (377) cleared up by actinotherapy.
    Technique. Alpine Sun Lamp, local around site of fracture. 1st degree erythema, repeated daily or alternate days.
    (General light baths for tonic effect according to patient's condition). Concomitant calcium medication.
    For fractures accompanied by pain and swelling (particularly swelling of the hand or foot), allow primary inflammatory reaction to subside. When sub-acute or chronic stage is reached, apply Sollux Lamp daily to tolerance. Follow this by irradiation with the Alpine Sun as above, and with other measures (elevation, passive and active movements, massage) to prevent fibrous ankylosis.

References:

    377. Ribadeau-Dumas, Debray & Saidman. -- Soc. de Pediatrie, June 16th, 1925.
    378. Ponzio. -- Radiology, October, 1931. (Abstract, Quartz Lamp, September 15th, 1932).
        Also Nos. 166 839 841 913
 

Furunculosis (see under Boils).
 

Gangrene, Cutaneous.

    The few available case reports indicate that this condition in cases of senility, arteriosclerosis, diabetes, etc., can be successfully cleared up by actinotherapy.
    Technique. Alpine Sun Lamp (1) general body baths, 1st degree erythema, followed by (2) local 3rd degree erythema dose on ulcers, after removing sloughs. Repeat every 2-3 days.

References:

    379. Kriser, A. -- Munch. med. Ws., 1914.
    380. Barth, K. -- Munch. med. Ws., September 12th, 1924.
    381. Bousfield, P. -- Lancet, May 14th, 1927.
        Also Nos. 784 791
 

Gastric and Duodenal Ulcer.

    Actinotherapy is used as an adjuvant in these conditions, in combination with customary dietic measures, administration of HC1, etc.
    Technique. For speedy relief of pain, the aim is to produce a deep reaction over the epigastric area. This may be done by the Alpine Sun Lamp alone, but quicker results are obtained by preliminary luminous heat therapy as below:--
    Sollux Lamp on chest and abdomen for 10-15 minutes, to produce mild hyperaemia; followed by Alpine Sun Lamp, locally, 3rd degree erythema on area from nipples to navel.
    One or two days later, give the same reaction on the back. Continue until acute symptoms subside, then give Tonic Course of general light baths for constitutional effects.

References:

    382. Plank. H. T. -- Amer. Jnl. Electrotherapeutics, November, 1924. (Quartz Lamp, February, 1925).
    383. Pope, C. -- Amer. Jnl. Phys. Therapy, June, 1927.
    384. Levy, L. H. -- Phys. Therapeutics, February, 1928.
    385. Plaschkes, S. -- Zts. f.d. ges. Phys. Therapie, 1930, 38, No. 4.
        Also Nos. 786 789 799 828
 

Gingivitis.

    Technique. The teeth should be thoroughly cleaned. Examine for the most infected areas. Using the Kromayer Lamp, with applicator 532 and 555, give a 2nd degree reaction both on the facial and lingual surfaces, on the inter-dental papillae. Not more than three posterior teeth should be irradiated at one time. An open mouth irradiation for all the teeth should follow. Further technique follows that stated under "Stomatitis."
 
References: 296 801 303 308
 

Glossitis.

    If the condition is due to sepsis, relief is obtained by combined local and general irradiation.
    Technique. Kromayer Lamp with suitable applicator, applied with gentle stroking to affected areas. First exposure, 30 seconds (Standard Kromayer). Repeat every 3 to 4 days, increasing by 10-15 seconds to maximum of 2 minutes.
    Also Alpine Sun Lamp, general body baths, to assist local action.

Reference:

    386. Cutner, M. -- Brit. Med. Jnl., Octoaber 10th, 1931 (Quartz Lamp, S, January, 1932).
 

Goitre and Exophthalmic Goitre.

    In early cases benefit frequently follows on the use of actinotherapy. Ultra-violet rays have stimulating effects on the endocrine glands, and also assist in overcoming any underlying toxaemia or sympathetic disturbance. Plotinkow (388) reports 24 cases cured out of 27 treated. Other writers have failed to obtain comparable results, and regard actinotherapy as an adjuvant only. Saidman gives a caution that patients may be hypersensitive, and prescribes minimal doses. Irradiation is a valuable complement to iodine therapy.
    If thyroid gland is being administered it should be given in half doses only during irradiation.
    Technique. Local irradiation over the thyroid gland area with the Kromayer Lamp or Alpine Sun to produce 3rd degree reaction. Combine with this a general light bath with the Alpine Sun Lamp, sub- or 1st degree erythema dose only.
    Repeat the combined light treatment at intervals or 2-3 days.

References:

    387. Langemak. -- Deuts. Zts. f. Chirugie, 1922, 177, 343.
    388. Plotinkow, L. M. -- (2nd Russian Contress of Psycho-Neurology, 1924).
        Also Nos. 791 792 796 834
        Book Nos. 386-388
 

Gonorrhoea (Male).

    Acute gonorrhoea in the male is not an indication for local actinotherapy. General body baths with the Alpine Sun and Sollux Lamp combined are valuable to build up resistance to the infection. These should follow the normal lines of the Tonic Course.
    In sub-acute and chronic cases, results have been obtained by local combined with general actinotherapy, although ionization or diathermy are stated to be more effective forms of physical therapy.
    Technique. After urethral irrigation, introduce urethral rod (No. 571) lubricated with glycerine, not more than 11-12 centimetres. Attach Kromayer Lamp running at full intensity, and irradiate for 1 minute only along the entire urethra (i.e., not more than a few seconds at any point). Repeat on subsidence, and increase dosage according to first reaction.
    Alpine Sun Lamp, general body baths, 2nd degree erythema, following Therapeutic Course.
 

Gonnorrhoea (Female).

    The female mucosa is less sensitive to ultra-violet rays than the male urethra, and will usually tolerate 30 seconds irradiation with a new Standard Kromayer burner to give 2nd-3rd degree reaction (796). Actinotherapy is valuable in both acute and chronic forms.
    Technique. Before irradiation it is desirable to produce hyperaemia of the membranes; diathermy or luminous heat (Sollux Lamp) should be used.
    Introduce quartz speculum of suitable size to smooth out the walls. Irradiate with Kromayer Lamp and suitable applicator (e.g., No. 501) through the quartz walls to the membrane. Give heavy 3rd degree erythema on each gland and duct. (If quartz speculum is not available, use an ordinary metal duckbill fully inserted and fully stretched. Irradiate the end, then withdraw the speculum an inch or two till the treated area folds together; repeat irradiation and withdrawal until the labia are reached).
    Give separate irradiation to cervix, using applicator 571 or 508 inserted to the internal os, and giving a 3rd degree reaction throughout its length.
    Alpine Sun Lamp, general body baths, 2nd degree erythema continued as Therapeutic Course.

References: 390 394 399 621 622 786 791 794
 

Gonorrhoeal Ophthalmia.

    Dr. J. J. P. Armstrong (389) has successfully treated seventy cases by luminous heat. The active hyperaemia which is thus produced opens the channels of drainage, and relieves stasis, whilst the temperature applied locally is over the survival limit for the gonococcus.
    Technique. With patient on couch, wash the eyes with boric acid solution until pus is removed. Cover face and forehead with towels, leaving eyes exposed. Then irradiate with large Sollux Lamp bulb vertically over eyes at 16-24 inches distance according to tolerance, for 1 hour. Wipe off pus and tears as they gather. Wash with boric acid and instill a few drops of argyrol. Repeat twice daily.

References:

    389. Armstrong, J. J. P. -- Phys. Therapeutics, April, 1928.
        Also No. 165
 

Gout.

    The action of ultra-violet rays in stimulating skin function and mobilizing enzyme accounts for their pronounced benefit in this condition. Light treatment should be used as an adjuvant to the usual diet and medicinal measures.
    Technique. Alpine Sun Lamp, general body baths, commence with sub-erythema doses, but build up dosage until 2nd degree erythema is obtained.
    Kromayer Lamp, to affected joints, 2nd to 4th degree reaction depending on condition. Fibrosed and ankylosed joints will demand the heavier reaction (see Arthritis).

References: 168 789 791 797 831
 

Gynaecological Conditions.

    "If you will use these rays in treating your gynaecological cases suffering from acute or chronic infections, giving sufficient time for the rays to act and of sufficient frequency to get a continued effect, you will agree that they are the best single method of treatment you possess. But do not attempt to remove pus en masse or a fibroid tumour with them (390)."
    The conditions in which actinotherapy is successfully applied include:
        Pelvic inflammation.
        Cervicitis and cervical erosions.
        Endometritis.
        Vaginitis.
        Vulvitis.
        Metrorrhagia.
        Gonorrhoea (q.v.)
        Amenorrhoea and Dysmenorrhoea (q.v.)
        Eclampsia (q.v.)
        Leucorrhoea (q.v.)
        Pruritis vulvae (q.v.)
    Technique. Best results are obtained from the combination of local (vaginal) irradiation with the Kromayer Lamp, using suitable applicator to reach the affected area, and general irradiation with the Alpine Sun Lamp. Bear in mind that the vaginal membrane normally tolerates a dose about 50 per cent. greater than corresponding skin dose; and that the more inflamed the part is, the larger the dose indicated.
    Where the local condition is associated with systemic toxaemia, general light baths are indicated in addition.
    These general light baths are a valuable adjuvant in many forms of gynaecological treatment. Intensive pelvic diathermy, for example, will often produce extreme fatigue in a patient; general irradition is of great value in overcoming this.
    Local Treatment (Kromayer Lamp). Use quartz speculum if necessary to smooth out membrane folds. Affix suitable applicator to reach the lesion. Produce 2nd-3rd degree erythema reaction. Repeat on subsidence, and continue according to results.
    General Treatment (Alpine Sun Lamp), general irradiation (abdomen and sacrum to be fully exposed), 1st degree erythema. Repeat every second day or twice weekly.

References:

    390. Plank, T. H. -- Detroit Surgical and Gynaecological Soc., June 19th, 1918.
    391. Donnelly, L. C. -- Jnl. Michigan State Med. Soc., January, 1922.
    392. Willmoth, A. D. -- Med. Herald and Physiotherapist, November, 1925 (Quartz Lamp, November, 1925).
    393. Lang, E. -- Die Lichttherapie in der Gynakologie (Handbuch der Lichttherapie, ed. Hausmann & Volk), 1927.
    394. Flaskamp, W. -- Proc. 2nd International Conf. on Light, London, 1928.
    395. Rocchi & Boschis, O. -- Raggi Ultravioletti, November, 1928.
    396. Willmoth, A. D. -- Phys. Therapeutics, December, 1928.
    397. Franco, C. D. -- Proc. 1st Philippine Tb, Congress, 1926 (Quartz Lamp, April, 1929).
    398. Ballico, I. -- Raggi Ultravioletti, March-April, 1930.
    399. Wilson, J. -- Brit. Jnl. Actinotherapy, January, 1931.
    400. The use of ultra-violet therapy in obstetrics and gynaecology (Hanovia Chem. Soc., Bulletin No. 311).
        Also Nos. 796 848 914
        Book Nos. 390-400
 

Hay Fever.

    Results are excellent; although the immunity given may last only for one season, patients are enabled to continue occupation and reasonable outdoor activity. The combined therapy outlined utilizes the power of general irradiation to raise and fix the blood-calcium, with local irradiation to reduce hypersensitivity in the affected membranes.
    Technique. Alpine Sun. General body baths, sub-to 1st degree erythema dose, continued as Sedative Course. This course should be commenced about a month before the onset of the seasonal attacks. Combine with calcium and thyroid medication to establish normal blood-calcium values.
    Kromayer Lamp. Technique will vary according to the patient's condition. If seen before violent hyperaesthesia has set in, the procedure given by Sampson (786), Hollender (857) and others may be followed:--Produce hyperaemia of nasal membranes by local high frequency. Follow with Kromayer Lamp and nasal applicator (No. 504, 505 or 508) inserted full length, and withdraw by stages so as to give 30 seconds exposure every half-inch along the nostril. Repeat both sides.
    Remove nasal applicator and attach No. 507. Insert flat into mouth past uvula, then turn end upwards to irradiate posterior nares. Give diffused irradiation over entire area, avoiding any local overdose. Remove lamp and applicator, attach No. 510, and give final irradiation to throat and tonsils.
    Avoid any blistering, but aim at definite erythema reaction on entire nasal mucosa. Repeat every second day. The number of treatments to ensure immunity may vary from 1 to 14; about 7 constitute an average. The treatment should be repeated every year or two.
    If the membrane is hypersensitive, the modified technique used by Cemach (408) may be used. Desensitize with 20 per cent. cocaine, and give mild intra-nasal irradiation as indicated above, using the blue filter and giving at most 2 minutes to each nostril (Standard Kromayer Lamp). In this way, ascertain the dose which will stimulate the membrane without producing increased rhinitis; this dose is then increased cautiously. (Cemach omits the posterior nares irradiation).

References:

    401. Hollender, A. R. & Cottle, M. H. -- Eye, Ear, Nose and Throat Monthly, 1924.
    402. Hollender, A. R. & Cottle, M. & H. -- Jnl. of Otology, etc., August, 1924.
    403. Hollender, A. R. -- Amer. Jnl. Clin. Med., April, 1924.
    404. Davison, H. M. -- Jnl. Med. Assn. Georgia, January, 1925.
    405. Hollender, A. R. & Cottle, M. H. -- Med. Herald, July, 1925.
    406. Myers, J. L. -- Am. Jnl. Electro. and Rad., December, 1925.
    407. Ramirez, M. A. -- Amer. Jnl. Med. Sc., December, 1928.
    408. Cemach, A. J. -- Brit. Jnl. Phys. Med., June, 1931.
    409. Schmidt, ). -- Med. Klinik, No. 22, May, 1931 (Quartz Lamp, S, July, 1932).
        Also Nos. 786 796 857 870 873 876 879
 
 
 Heart Diseases.
(See also Angina Pectoris: Blood Pressure.)

    Through the action of ultra-violet rays on blood pressure (q.v.) blood composition, diuresis, etc., it has pronounced benefit in Tachycardia, Premature contractions, Rheumatic Endocarditis and functional disturbances.
    Contra-indications. Where compensation is deficient, actinotherapy may increase oedema and dyspnoea.
    Technique. Correct any deficiencies of nutrition (especially of calcium, sugar, iron) and treat septic foci.
    Sollux Lamp, short exposure on entire body for gentle warmth (excessive heating is not advisable). This may be followed by massage towards the heart as stimulant to peripheral circulation. Follow on with Alpine Sun Lamp, general body bath, sub- to 1st degree erythema only; after 3rd treatment increase to 2nd degree erythema. The more corpulent the patient, the heavier should be the erythema reaction. Repeat 2-3 times weekly during 3-6 months, with suitable rest intervals.

References:

    410. Schacker. -- Strahlentherrapie, 12, 1921.
    411. Echtman, J. -- Med. Jnl. and Record, December 1st, 1926.
    412. Plate, E. -- Brit. Jnl. Actinotherapy, July, 1929.
    413. Laqueur, A. -- Brit. Jnl. Phys. Med., April, 1931.
        Also No. 796
 

Herpes Zoster (Shingles).

    Much assistance can be given to the patient in all forms of herpes, and relief afforded not only from the severity of the eruption but from the accompanying pains. In fact, if seen early enough, little or no pain is experienced after the first treatment. Vigorous local irradiation (2nd degree erythema doses) not only stop the immediate discomfort but prevent scarring (417).
    Post-herpetic neuralgia is not a usual sequel in cases treated by actinotherapy. This painful condition has been successfully treated by luminous heat irradiation (Sollux Lamp), as detailed under Neuralgia.
    Technique. If the blebs are very irritable, use the Sollux Lamp, with red filter for its drying effect, before applying ultra-violet rays. Sollux Lamp 15-30 minutes, 20 inches distance.
    Alpine Sun, local irradiation on lesion, for heavy 2nd degree erythema on all vesicles. Repeat at 1-2 days intervals until irritation disappears.

References:

    414. Vajano, D. -- Giornale Italiana delle malattie veneree, 1924, No. 1
    415. Tarchini. -- Amer. Jnl. Phys. Therapy, Novembe, 1925.
    416. Jackson. -- Urologic and Cutaneous Review, June, 1926.
    417. Weingren, M. -- Lancet, October 22nd, 1927.
    418. Cipriani, M. -- Raggi Ultraviioletti, November, 1928.
    419. Devois, A. -- Revue d'Actinologie, March, 1931.
        Also Nos. 515 793 841 847 885 895 896
 

Hyperpiesis (see Blood Pressure).
 

Impetigo.

    "Three or four applications of ultra-violet light in the course of a week or ten days will usually cure an impetigo contagiosa at any stage" (420). All crusts and discharge should be removed, and a brisk reaction is required, repeated until risk of relapse is past (790). It is not necessary to let the disease take its usual three weeks course; irradiation will definitely check the infection.
    Technique. With the Alpine Sun or Kromayer Lamp produce a local 3rd degree erythema reaction after lesion is cleansed of crusts and discharge. Repeat on subsidence until results are established against relapse.
    Continue a course of general body baths with the Alpine Sun Lamp, Sedative Course.

References:

    420. Adamson, H. G. -- Med. Press, May 25th, 1927.
    421. Ellison, J. B. -- Lancet, June 25th, 1927.
    422. O'Donovan, W. J. -- Lancet, February 28th, 1931.
        Also Nos. 790 894 896 900 907
 

Infantile Paralysis (see Poliomyelitis Anterior).
 

Iridocyclitis (see Ophthalmology).
 

Iritis (see Ophthalmology).
 

Keloid.

    Successful results are reported from blister doses with the Kromayer Lamp. On account of the extensive thickening of the tissues, the blue filter is useful in this condition, as it ensures deeper penetration.
    Technique. Kromayer Lamp, with blue filter, firm compression, 4th degree erythema, repeated after sloughing has occurred.

References:

    423. Sibley, W. K. -- 17th Report London Derm. Soc., 1928, p. 61.
        Also Nos. 793 795 885 888
 

Keratitis (see Ophthalmology).
 

Leishmann"s Sore.

    Dr. F. H. Humphris has treated two cases with ultra-violet rays. Other remedies had been ineffective, but improvement was soon manifest. One case had a triangular sore in the groin of 7 inches wide; after 16 weeks treatment the entire surface was healed over except two small holes.

Reference: 793
 

Leprosy.

    Results have been obtained in a few cases only. The value of actinotherapy is proven on leprotic ulcers, but experimental as regards other lesions. Treatment has been given both by Kromayer Lamp in contact, and by the Alpine Sun Lamp, using general body baths.

References:

    424. Cruz, M. C. -- J. Philippine Islands Med. Assn., July, 1928.
    425. Dhur-Roy, J. & Rakshit, A. -- Indian Med. Gazette, April, 1930.
 

Leucoderma: Vitiligo.

    Energetic treatment is essential to ensure restoration of pigment; results are permanent.
    Technique. Kromayer Lamp, window in compression contact, 4th degree erythema. Treat each area three to four times, allowing reaction to subside between treatments, and taking care not to produce over-pigmentation. Sibley (429), Axmann (428) and others report that results are accelerated by dabbing skin with alcohol before irradiation; Louste and Juster (426) use oil of bergamot in the same way.

References:

    426. Louste & Juster. -- Bull. Soc. franc de dermat., 1918, 53, 920 (Quartz Lamp, August 1929).
    427. Toomey, N. -- Jnl. Missouri State Med. Asscn., December, 1922 (Quartz Lamp, October 1923).
    428. Sibley, W. K. -- 17th Rep. London Derm. Soc., 1928 (p. 25).
 

Leucorrhoea.

    Many cases are reported of irritating discharge cleared up by local actinotherapy. This form of treatment is found particularly valuable when the condition is a symptom of vaginitis.
    Technique. After examination, insert quartz speculum and irradiate vaginal walls with Kromayer Lamp and suitable applicator, giving special attention to any eroded areas on cervix or membranes. Produce a moderate reaction (1st degree erythema), allowing 50 per cent. more than skin-reaction time for the lamp and applicator used.

References: 390 397 793 794 825
 

Lichen Planus: Lichen Tropicus.

    The eruptions clear up rapidly under actinotherapy. Vigorous erythema is necessary. Lichen hypertrophicus necessitates prolonged compression irradiation with the Kromayer Lamp. In Bernstein's (885) case, repetition during four months effected eradication of the trouble.
    Technique. With the Alpine Sun Lamp, irradiate the area affected or whole body, for 2nd degree erythema. Repeat on subsidence; continue as Therapeutic Course.

References:
 
    430. Juster & Tchiprout. -- Bull. Soc. franc. Derm., 1928, 35, p. 15 (Quartz Lamp, July, 1928).
        Also Nos. 885 886 892 896
 
 
Lumbago.

    Acute attacks are relieved by production of deep local hyperaemia with luminous heat rays. Chronic forms benefit from erythema doses of ultra-violet rays over the lumbar region.
    Technique. Using Sollux Lamp and localizer (or demarcate the area by clothing, etc.) give a full hyperaemia dose on lumbar region (20-30 minutes at short distance) followed by Alpine Sun Lamp locally on back, 2nd degree erythema. Repeat on subsidence; continue course till results are established.

References:

    431. Girone, V. -- Raggi Ultravioletti, 1927.
    432. Hall, P. et al. -- Brit. Jnl. Actinotherapy, September, 1928.
        Also Nos. 175 491 831 851 852 856
 

Lupus Erythematosus.

    Satisfactory results are obtained in most cases from actinotherapy provided that general light baths are given chief place in treatment.
    Technique. General light baths with the Alpine Sun Lamp, sub- to 1st degree erythema reactions, repeated every second day (Sedative-Tonic Course), combined with local irradiation with Kromayer Lamp (Thedering recommends compression, using blue filter, 5-10 minutes).

References:

    433. Carter, L. J. -- Canadian Med. Jnl., February, 1925 (Quartz Lamp, October, 1930).
    434. Rowstron, N. F. -- Brit. Med. Jnl., March 10th, 1928.
    435. Montgomery, W. E. -- Phys. Therapeutics, December, 1930.
        Also Nos. 159a 795 889a
 

Lupus Vulgaris (see also Tuberculosis verrucosa).

    The best results are obtained by treating lupus as the local manifestation of a general tubercular infection; both local and general actinotherapy are indicated. At the London Hospital this procedure has increased cure from 60 per cent. to 90 per cent. of cases, and Dr. O'Donovan of this institution states (446) that "Early lupus is always curable." The granular tissue surrounding the nodules is dissolved by repeated irradiation until the modules lie in new scar tissue and are resorbed under the action of light. Treatment may necessitate many months, and patients should be examined after six months, to guard against relapse.
    Technique. Kromayer Lamp with skin lens (or window), firm compression, 4th degree erythema on each focus and 1/2 in. zone surrounding. Alleviate reaction by cold boracic compresses; repeat on complete subsidence.
    Use same procedure, with suitable applicator, for lesions in mouth, throat and nose.
    Both the immediate reactions and final results are greatly improved if local hyperaemia is produced in the diseased tissues before application of the Kromayer Lamp. The Sollux Lamp with localizer will give valuable help in this regard.
    If lesions are heavily fibrosed through previous mal-treatment, softening measures (e.g., luminous heat, electrodessication, creosote + salicylic acid plaster) may be necessary before the erythema reaction can be obtained Some authorities advise X-rays for this purpose; others regard them as likely to cause carcinoma later.
    Alpine Sun Lamp (combined with Sollux Lamp). General body baths, 1st degree erythema, repeated on subsidence. (Note.--Lupus patients may require about 50 per cent. over normal exposures.)

References:

    436. Sibley, W. K. -- 13th Rep. London Derm. Soc., 1924.
    437. O'Donovan W. J. -- Brit. Jnl. Tuberculosis, October, 1927.
    438. Sequeira, J. H. & O'Donovan,W. J. -- Lancet, November 26th, 1927.
    439. Jadassohn, W. -- Klin Ws., September 30th, 1928 (and Brit. Jnl. Actinotherapy, March, 1929).
    440. Reyn, A. -- 1er Conf. Int. Lumiere, Lausanne, 1928.
    441. Hallam, R. -- Brit. Med. Jnl., November 16th, 1929.
    442. Hunt, E. -- Brit. Jnl. Actinotherapy, May, 1929.
    443. Sibley, W. K. -- Brit. Jnl. Actinotherapy, November, 1929.
    444. Wilson, J. -- Brit. Jnl. Bio-physics, October, 1929.
    445. Frieboes, W. -- Strahlentherapie, 1930, 35.
    446. O'Donovan, W. J. -- Brit. Jnl. Actinotherapy, May, 1930.
    447. Volk, R. -- Brit. Jnl. Actinotherapy, October, 1930.
    448. Beatty, J. -- Practitioner, March, 1932.
    449. Volk, R. -- Brit. Jnl. Phys. Med., June, 1932 (Quartz Lamp, S, July, 1932).
        Also Nos. 159a 438 668 672 673 676 677 680 688 743 795 804 820 838 886 894 896 897 900 903 905
 

Mastitis.

    The few reports available indicate that actinotherapy has great possibilities in this condition. Even after gangrene and infiltration has set in, irradiation effects improvement within 24 hours, and 4 to 6 treatments suffice to save the breast and enable lactation to be resumed.
    Technique. Alpins Sun Lap, 1st degree erythema on affected breast, repeated daily.

References:

    450. Tauber, J. -- Med. Klin., May 8th, 1924.
    451. Kustner, H. -- Munchener Med. Ws., January, 1930 (Abs. Brit. Jnl. Actinotherapy, March, 1930).
 

Mastoiditis.

    Acute mastoiditis, if uncomplicated, responds to luminous heat irradiation. If no improvement is noted with 5 or 6 days, it must be assured that complications exist, and surgery is indicated. Dr. Cemach distinguishes two groups as indications:
    (1) "Incipient cases without fever, usually between the third and fifth week of a suppurative otitis, characterized by moderate discomfort, unilateral headache, slight but increasing pain. Moderate pain on pressure, contour of the mastoid process slightly indistinct. All cases in this group react promptly to Sollux Lamp radiation and are rapidly cured. The results of radiation in such cases far outstrip those from all other known conservative means."
    (2) "Cases with more pronounced discomfort, local change, and increased temperature. All cases in this group have been cured without relapse . . . . Seventeen cases were treated, six for a month, eight for three weeks, and three for two weeks. Acute mastoiditis is the outstanding indication and its cure the greatest achievement of the Sollux Lamp."
    Technique. It is essential to establish and maintain drainage.
    Sollux Lamp, with localizer, distance about 4 inches, applied for 30 minutes minimum. Repeat daily or twice daily.
    Post-operataive cases. Where a sluggish, non-healing infected wound remains after the mastoid operation, local irradiation of the cavity, using the Kromayer Lamp and penetrating applicator, combined with irradiation of infected cervical glands and with a tonic course of general body baths with the Alpine Sun, will effect freedom from pain, decrease of toxicity, and early improvement in the patient's local and general condition.

References:

    452. Cemach, A. J. -- Monatschr f. Ohrenheilk, 1922, Nos. 8-9.
    453. Doyle, G. F. -- Kentucky Med. Jnl., December, 1924 (Quartz Lamp, July, 1925).
    454. Vicenzini, B. -- Raggi Ultravioletti, 1927.
 

Maternity.

    A course of actinic irradiation is highly beneficial throughout pregnancy and lactation. Extensive observations have been made at the Public Health Clinics of Cardiff (460), Bermondsey (806), and many other places. Vomiting is cured in nearly all cases; tone is increased, and nervous excitability reduced. In the words of Dr. L. C. Donnelly (832): -- "Pregnant mothers are impressed with the fact that ultra-violet treatments insure that their babe will be born with the proper development, and that they will go through pregnancy without loss of teeth, that their kidneys, thyroid and glands of internal secretions will function properly and that they will not develop high blood pressure and convulsions, that their musculature, including heart and uterus, will be developed, so that they will be in physical condition to have sufficient muscular power to give birth to their baby (the tone of their abdominal muscles will be such that they do not develop a large abdomen following child birth); the coagulation time of their blood will approach normal so they do not need to fear hemorrhage, and their resistance to infection will be so raised that there is little danger of infection. They are told that if there is an ultra-violet light deficiency that they will themselves suffer by having the calcium and phosphorus withdrawn from their blood in order to nourish the child. This is shown in the mother by increased tendency to tooth decay, breaking down the arches of her feet, tendency to fractures, etc. If there is a marked ultra-violet light deficiency the child will be malformed; great deficiency could produce a monster. If the mother has plenty of ultra-violet light the child starts life with a stored up amount of the products of light and is able to better resist disease. The mother who has had plenty of ultra-violet light will have an abundance of health nourishing milk and will have no trouble nursing her child. Any mother who does have trouble nursing her child will have much less or no trouble if both mother and child receive ultra-violet."
    Technique. General irradiation with the Alpine Sun (or Jesionek) Lamp, following the lines of the Tonic Course (page 36).

References:

    455. Gamgee, K. -- Jnl. R. Sanitary Inst., April, 1926.
    456. Brown, R. K. -- Med. Times, June, 1928.
    457. Deck, E. J. -- Nursing Mirror, 20th October, 1928.
    458. Holman, H. D. -- Brit. Jnl. Actinotherapy, February, 1930.
    459. Gibbs, N. K. -- Ann. Rept. M.O.H., Cardiff, 1931 (Quartz Lamp, S, January, 1933).
        Also Nos. 394 400 806 814 818 820

    Lactation. Observations made on a series of nursing mothers who were able to maintain attendance at the Manchester Municipal Clinic (461) showed that "all were successful in improving or maintaining milk-supply for prolonged periods." Similar observations have been made elsewhere. Irradiation of the mother also increases the anti-rachitic properties of her milk (462).
    Technique. General light baths with the Alpine Sun Lamp, following lines of Tonic Course (page 36) or alternatively local irradiation with Alpine Sun Lamp on breasts (protecting nipples), 2nd-3rd degree erythema (e.g., 5 minutes at 32 inches distance), repeated daily or every other day.

References:

    461. Chisholm, C. & McKillop, M. -- Lancet, July 30th, 1927.
    462. Hess, A. F., Weinstock, M. & Sherman. -- Jnl. A.M.A., January 1st, 1927.
    463. Smith, N. -- Med. Officer, November 3rd, 1928.
    464. Stolte, K., Wiener, C. -- Deutsche med. Ws., February 17th, 1928 (Brit. Jnl. Actinotherapy, July, 1928).
    465. Vogt, E. -- Deutsche med. Ws.,August 17th, 1928 (Quartz Lamp, June, 1929).
    466. Bunbury, D. E. -- Brit. Jnl. Actinotherapy, November 1929.
    467. Wachtel, M. -- Zentralbl. f. Gynakologie, 1929, No. 16.
 

Mental Diseases.

    The use of actinotherapy in mental treatment was debated at the Royal Society of Medicine in 1929 (470) by officers of mental hospitals which administer this form of treatment. Apart from marked increases in weight, appetite, activity and cheerfulness, it is found that with delusional cases, mild types of melancholia, and manic-depressive types, there is considerable benefit in the mental condition.
    Dr. Sugden (472) points to the improvement of the dull and backward child, "transformed into a robust, well-nourished and perfectly healthy little animal within a few weeks."
    Some cases of confusional insanity, dementia praecox and anergic stupor also yield good results. In Dr. Cormac's words, "Actinotherapy is a very necessary adjunct to the treatment of mental cases. It is employed as a routine for convalescent cases, whose recovery is thereby hastened."
    Technique. Alpine Sun (or Jesionek) Lamp, general body baths. Degree of erythema and frequency of repetition must be suited to the circumstances of the case and the underlying condition. Concomitant therapy not to be omitted.

References:

    468. Gauvain, H. & McCrae, C. R. -- Maternity & Child Welfare, July, 1925.
    469. Jackson, J. D. & Chamberlain, L. R. -- Med. Jnl. & Record, December 19th, 1928 (Quartz Lamp, January, 1929).
    470. Cormac, H. D. et al. -- Proc. R. Soc. Med., February, 1929.
    471. "Lunacy & Mental Deficiency," 16th Annual Report of the Board of Control, 1929. Part II (Several reports on light therapy).
    472. Sugden, F. -- Brit. Med. Jnl., November 29th, 1930.
    473. Rep. Med. Supt. County Mental Hospital, Whittingham, March, 1931 (Quartz Lamp, S, April, 1932).
        Also No. 844
 

Migraine.

    Excellent results are obtained from actinotherapy by combined luminous heat and ultra-violet radiation. The attacks decrease in intensity and frequency, and finally cease. Relapse may occur after some months; repetition of the course is then again effective.
    Technique. Alpine Sun and Sollux Lamps in combination, general body baths, 2nd degree erythema. Repeat on lines of Therapeutic Course.

Reference:

    474. Freund, L. -- Wiener Klin. Ws., 1923, No. 42.
 

Myalgia. (see Rheumatism).
 

Myositis.

    "There are few therapeutic measures which will yield such brilliant, dramatic results as those which physical therapy will yield when applied to inflammatory conditions of this nature" (476).
    Technique. Examine for causal focus and treat.
    Sollux Lamp to affected area, applied for at least 30 minutes, close as can be tolerated.
    Combine with static wave electrical treatment.

References:

    475. Taparelli, A. -- Raggi Ultravioletti,March 1926.
    476. Bierman, W. -- Phys. Therapeutics, May, 1929.
 
 
Naevus, Vascular (Port-wine mark).

    Intensive actinotherapy will clear up many of these birthmarks, and largely benefit even the more resistant types which do not fade under pressure. Successful results are reported in cases up to 40 years of age.
    Technique. Kromayer Lamp with lens in firm contact on skin of naevus to produce very heavy reaction (e.g., Standard Kromayer 5-20 minutes) on the entire affected area. (Clark uses blue filter and 40-minute exposures). Two to four repetitions may be required, at intervals of 3-4 weeks.

References:

    477. Clark, W. L. -- Therapeutic Gazette, May 15th, 1916.
        AlsoNos. 159a 263 793 795 885 888 890 896 898 899 906
        Book Nos. 474-481
 

Neuralgia, Facial.

    "Patients with trigeminus neuralgia have been relieved of all pain after the fifth treatment and to date there has been no return" (305).
    Technique. Sollux Lamp with localizer to affected area. Distance: shortest tolerable; time 10-20 minutes according to tolerance. Increase progressively to 30 minutes; daily irradiation.
    Alpine Sun Lamp, general body baths, 1st degree erythema; continue as Tonic Course.
    In cases of the douloureux, the general body bath should be supplemented by local irradiation (Alpine Sun) on the affected area, 2nd degree erythema dose. Supplement this by intra-oral irradiation with Kromayer Lamp, using applicator 555, along superior and inferior arches of affected side, close as possible to apices of teeth, for 1-4 minutes.

References:

    478. Lichnitzki, V. -- Paris Med., December 20th, 1924.
    479. Kirschmann, K. -- Fortschritte d. Med., 30th June, 1927.
    480. Vicenzini, B. -- Raggi Ultravioletti, 1927.
    481. Talbot, F. -- Med. World, July 29th, 1932 (Quartz Lamp, S, October, 1932).
        Also Nos. 305 308 312 314 793 796 842
 

Neuritis and Sciatica.

    Rational application of actinotherapy frequently gives brilliant results in these disabling conditions. The acute pain can be relieved by luminous heat as a palliative measure; more permanent results are assured by the production of severe erythema reactions along the course of the affected nerve and at any points which are tender to pressure. Obviously underlying causes such as septic foci or autogenous toxins must also be treated.
    Technique. Sollux Lamp, locally to affected nerve, shortest tolerable distance, 20-30 minutes to produce deep hyperaemia. Followed by:
    Kromayer Lamp, contact irradiation at a series of points over the nerve roots and along the nerve course; 3rd degree erythema at each point. For deep penetration, use the blue filter with four-fold exposure.
    Alpine Sun Lamp, general body baths, sub-erythema doses, continue as Sedative Course.
    Alternative Technique. Lepsky, Weiss and others have treated many cases successfully on the following lines:--
    Alpine Sun, local 3rd degree erythema dose on two areas each 4 inches square, (a) lumbar region; (b) back of affected thigh from lower buttock downward. Repeat (on subsidence) on fresh area, centre of thigh, next on lower third, and down leg if pain still continues.

References:

    482. Kliatschkin, G. A., Kazan Med. Jnl., October 7th, 1924.
    483. Hall, P. -- Brit. Jnl. Actinotherapy, September, 1926.
    484. Kowarshik, H. -- Wiener Klin, Ws., 1926, No. 10.
    485. Weinbren, M. -- Lancet, July 24th, 1926.
    486. Hall, P. -- Brit. Med. Jnl., June 18th, 1927.
    487. Harris, W. -- Lancet, November 5th, 1927.
    488. Marchesini. -- Raggi Ultravioletti, November, 1928.
    489. Weiss, R. F. -- Med., Klinik, 1929, No. 15 (Abstr. Brit. Jnl. Actinotherapy, January, 1930).
    490.Lepsky, J. -- Ann. Inst. Actinologie, May, 1931 (Quartz Lamp, S. January 1932).
    491. Lepsky, S. -- Ultra-violett Behandlung der Ischias (Mk. 1,60). 1932. (Extract Quartz Lamp, S. October, 1932).
        Also Nos. 167 478 581 719 786 790 793 797 826 831 839 848 856
 

Nystagmus.

    Recent reports indicate that cases of Miners' Nystagmus which come under treatment early respond very well to actinotherapy. Concomitant measures should be applied to the neurosis (iron, strychnine), to septic foci, errors in diet and habits rectified, etc.
    Technique. Alpine Sun Lamp, general body baths, 2nd degree erythema on half body area, repeated three times weekly.

References:

    492. O'Sullivan, F. -- Practitioner, January, 1932 (Quartz Lamp, S. July, 1932).
    493. O'Sullivan, F. -- Brit. Jnl. Phys. Med., May, 1932.
        Book Nos. 482-494
 

Obesity.

    Dr. A. Lorand (789), discussing the various types of obesity, states that "in addition to the prescribed diet and the administration of the glandular extracts, the simultaneous use of the Quartz Light will give the very best results with considerable loss of the body weight.
    Technique. Alpine Sun, general body baths, more intense on fattest portions (abdomen, breasts, hips, etc.). Follow procedure as Therapeutic Course (page 37).

References:

    494. Williamson, C. L. & Broomhead, C. H., Lancet, February 4th, 1928.
        Also Nos. 789 793
 

Ophthalmology.

    In the eye the diseases most amenable to treatment are chronic inflammations, for which little can be done by ordinary means of treatment. The best time to start treatment is immediately the acute stages have passed, and before the lesion is complicated by accumulation of massive deposits and restoration rendered impossible.
    Light treatment is given in the form of general irradiation only, sometimes with local actinotherapy in combination. In the acute inflammatory forms of these diseases luminous heat treatment with the Sollux Lamp gives valuable assistance.
    Indications for general irradiation alone:
    Oculart Tuberculosis, including:
        Iridocyclitis (Cases, with few exceptions, improve from
        Keratitis (the comencement, often with remarkable
        Dacryo-cystitis (rapidity.
    Phlyctenular Keratitis and Keroato-Conjunctivitis.
        After a few days most of the symptoms usually disappear, and a few weeks' treatment secures lasting improvement. The course of treatment should be repeated as a prophylactic against relapse.
 

Infective Iridocyclitis       Choroiditis       Iritis