17 OCTOBER 1925, Page 8

O N the Simplon line, easy to reach, a few miles

above the head of the Lake of Geneva, is Aigle, whence a cogwheel railway takes one in some forty minutes to Leysin. The place is thus extremely easy to reach, and can be readily taken in when travelling to or returning from Italy. It is, perhaps, even more interesting in winter than in summer, but, indeed, its interest is consummate at all seasons of the year. Serious visitors, really concerned with the conquest of tuberculosis and much more, are welcome. These facts are here placed in the forefront of this article, for no excuse whatever exists for critics, cut-and-come-again surgeons; insular myopics or others, who during the past four years have asserted my praises of Leysin to be exaggerated without going to see it for themselves. We are entitled to rule out all such critics : and there are no others !

Dr. A. Rollier is a pupil of the world-famous surgeon,, the late Professor Kocher of Berne. Personal reasons took him to Leysin, in the Alpes Vaudoises, a tiny village some 4,500 feet above sea level. In 1903, with five patients, he opened a clinic for the treatment-of surgical tuberculosis; falsely so-called; by means of sunlight. He was not the first. The surgeon, Bonnet, had success.- fully so treated this disease in Lyons as long ago as 1845. One surmises that the glorious work of Pasteur and Lister, offering new powers to surgery, was the reason why Bonnet's work was forgotten. And Finsen, the Dane, in 1893, treated tubercle of the skin by local application of light, regarded by him, at first, as simply an antiseptic—though when I was in Copenhagen two years ago I was shown, at the superb Finsen Institute, evidence that, before his lamentably early death, Finsen had perceived that light is more—an " incitement," as he called it, to the tissues to save themselves.

Dr. Rollier had observed the habits of Alpine animals, such as the chamois : how they love the early-morning light, and shelter themselves from the midday heat of the sun. His method was the general sunbath, whereby the body should save itself. It was the method of Bonnet, but practised under very favourable conditions, where sunlight is abundant and complete all the year round, with figures for ultra-violet radiation never approached in Lyons or in London, even when, on rare occasions, the curse of coal-smoke happens to be absent. The details are simple but all-important. Hasten very slowly : expose only a small area of skin at first ; watch each case individually and measure the dose accordingly ; fear the heat and love the light ; value the early morning ; use no surgical operations whatsoever ; nor any drugs ; totally exclude alcohol in any quantity in every case ; use a " lacto-vegetarian " diet, milk and its products, eggs, cereals, fruit and vegetables, with a minimum of meat for patients who greatly desire it. The recognized principles of rest and relief for diseased parts are practised ; no massage nor Faradism is necessary in order to preserve the vigour of unused muscles, for " the sun is the best masseur." Under these conditions cases recover, as a matter of course, such as have never recovered before in the history of medical science. They recover with restored function of bones and joints. The Swiss Govern. ment maintains two clinics at Leysin for its tuberculous soldiers. They learn a trade whilst recovering ; this is the " work cure," furnishing occupation, without which no one can be healthy or happy. The children learn lessons, play games, sing and are, in short, the happiest and jolliest youngsters anywhere to be seen. The authoritative discussion of the whole subject is now to be had in English ; it is a rewriting and amplification of the great book, Le Cure de Soleil, published by Rollier in 1914, just before the War, and unfortunately over- whelmed by that event.* This is not the place for a discussion of clinical medicine. Here I need only observe that the five patients are now represented by a thousand and more, from all parts of the earth, and that, when I met Dr. Rollier a few weeks ago, at the First International Child Welfare Congress in Geneva, I learnt that, having vowed four years ago never to rest until I had closed all his clinics, I may now visit three new ones, with 120 more beds, which he has just had to open.

Evidently, therefore, mankind has not yet seen the point. The results of surgery in our hospitals are com- pared with Rollier's, and the suggestion is made that one or more municipalities should maintain clinics in Leysin, *hither their tuberculous children should be sent ; and it can be reasonably urged that it would actually cost less in the long run to pay for the journeys and to maintain the children for many months or more, and have them strong and well and self-supporting thereafter, than it costs at present to treat these children in shadow and endure nearly nine thousand deaths from " surgical

* " Heliotherapy," by Dr. A. }Wilier and his assistants, with introductions by Sir Henry Gauvain and Dr. C. W. Saleeby. (Oxford Medical Publications, 1923. 25s. net ). See also " Sunlight and Health," by Dr. C. W. Saleeby, with introduction by Sir William Bayliss, F.R.S. (Nisbet and Co. Second edition, 1924. 5s. not.)

tuberculosis " in these islands every year, to say nothing of the vast army of the permanently disabled. Or it may be urged that we should seek to learn from Leysin by setting up solaria in our own country, where the Alpine results may be rivalled—especially if we choose the sea coast, where the water reflects an extra quantum of ultra- violet rays, not least in the south-eastern corner of England, which has most sunlight, and less moisture than the south-west.

Of course, that is an excellent proposal, and it is abundantly justified by the results of English sunlight, as seen at the Heritage Craft Schools, at Chailey in Sussex, under Mrs. C. W. Kimmins, at the Treloar Cripples' College and Hospital at Alton, in Hampshire, under Sir Henry Gauvain ; and perhaps best of all at the recently established seaside branches of those institu- tions. But it is not the real moral of Leysin.

The world-lesson of that lovely spot is learnt and taught, a mile or two down the road towards Sepey, by the " School in the sun," established at Cergnat by Dr. Rollier in 1910, whither, for fifteen years, have been sent children, doubtless on the average somewhat delicate; though not positively ill : children whose winter coughs, or subnormal weight, or lack of life, or pallor, has baffled their parents and doctors, until at length they have been sent to live in pure sunlight and the open air at Cergnat, and there to be at school. The results, of course, have been consistently superb. They constitute the true lesson of the thirty-seven or forty clinics higher up the road. For if tuberculosis can be cured (even after many years, secondary infections and numerous operations) by the return to unspoilt Nature, so much the more can it and should it be prevented.

We spend about a million pounds a year on sanatoria in this country. The results are pitiful in the extreme. About fourteen patients per thousand recover. We must find something better than that costly and almost futile plan. Nearly thirty years have passed since the late King Edward, then Prince of Wales, asked of tuberculosis : " If preventable, why not prevented ? " There is none but the most disgraceful answer to that question.

The home and the school in the sun : these are the means whereby an enlightened civilization will yet close Rollier's clinics, whilst the pioneer institution at Cergnat multiplies all over the world. The progress of the open-air school in this country has been pitifully slow. We need vastly to accelerate it, and meanwhile to enhance its powers incalculably by introducing the sunbaths which are, indeed, so potent that even artificial light in closed apartments can do wonders. We need no more of the shadow schools, built at vast expense, wherein we immure our healthy children, calling the process educa- tion, until we have to transfer them, as sick children, to shadow hospitals, calling the process medicine. Rollie" has shown us how the diseases of darkness may be wholly abolished.

The remedy, the preventive, is too simple for simpletons, no doubt : as " wash and be clean " was for Naaman, ancestor of such a mighty host in our own day. The case of typhoid may, perhaps, arouse us. That disease may to-day be prevented in large degree by the use of a vaccine, just as tuberculosis appears to have been pre- vented in cows by the comparable vaccine of M. Spahlinger. But only in time of war do we think it necessary to require the anti-typhoid vaccination of the soldiers, who will leave—what ? The protection involved in the pure and safe water supply of our cities. It was the restoration of pure water to our urban hosts that abolished the water- borne diseases under ordinary conditions. Disraeli's opponents called his proposal a " policy of sewage," and deserve to be pilloried, therefore, throughout all coming time.

To-day it is to be argued that we should restore to our cities another simple, commonplace natural boon—the light of life. Let us do so, and the diseases of darkness, far worse in sum than the water-borne diseases of yore, will vanish as they did. The arguments are manifold and various, but there is none on earth so lovely, so absolute, so final as the solaria of Leysin and the school in the sun, where such bodies are made as no tubercle bacillus can enter without committing certain suicide. No doctor, no teacher, no parent, no architect, no statesman is qualified for his task who has not learnt what Leysin has to teach. In the beginning God said, " Let there be Light." And there was Light. It is for enlightened man, now become a partaker of the Divine nature, to speak again that