Artificial Light Treatment
THE severe criticism of certain uses of the ultra- violet rays which has appeared in a Report of the Medical Research Council has caused conster- nation among people who thought that they were safe in regarding applications of these rays as a proved cure for several diseases and, at the least, a tonic which introduced the desirable Vitamin D into the human body. One's judgment on the Report depends upon how one reads it. A reader who takes the passages on light treatment as a cavalier dismissal of a mass of evidence favourable to this treatment would feel justi- fied in saying that the Report was unfair and almost cynically depressing. A reader, on the other hand, who is oppressed by the widespread quackery which is being conducted by unregistered practitioners of the treatment, or by the offers of fool-proof lamps for installation in bath-rooms, might well look upon the Report as merely a wholesome warning against excess and exaggeration.
In the long run the Report is not likely to do any harm. Public discussion always brings the truth into the open. What is true about the treatment—which is still, of course, in its experimental stage—will certainly survive.
The strictures on ultra-violet ray treatment in the Report are based on the researches of Dr. Dora Colebrook in the winter of 1927-28. She conducted various tests of the value of the rays as stimulants of growth in school children, and as agents for increasing the bactericidal power of their blood. Her conclusions were that the treatment caused no increase in weight or height and no raising of spirits, and that the "common cold" was actually more common among those who received the treatment than among those who did not. It is there- fore suggested in the Report that hospitals and other institutions which are spending much money upon artificial light should divert part of the money to dis- covering whether they are justified in spending more, If it should be ascertained that the results are unsatis- factory it would undoubtedly be true that the money could be better spent on suitable diet ; for it is obvious that ray treatment is much more expensive than cod liver oil or some other food which contains Vitamin D.
It must not be supposed, however, that the Report rashly condemns all ray treatment as the result of Dr. Colebrook's tests. The value of ultra-violet rays in the treatment of surgical tuberculosis, for instance, is not questioned. What the Report does suggest is that in several diseases there may be alternative treatments of equal value, and that in these circumstances it is foolish to spend money on the more expensive.
The layman is not supposed to have any right to an opinion on such subjects as this, yet treatment by artificial light is one of the most popular subjects of general conversation to-day, and the layman who has studied the effects of treatment upon himself and his friends must have collected evidence of some sort. The usual lay opinion, for what it is worth, seems to be that ray treatment, or a special food containing one of the vitamins in a high degree, is traceably beneficial if the patient is in that physical condition which signifies a lack of any required vitamin or vitamins. Although imagination always plays a considerable part, a large number of people, on recovering from an illness or being otherwise " run down," cannot have been wholly mistaken in believing that they were braced by artificial light, or by one of the new forms of food into which a vitamin has been scientifically introduced. On the other hand, many normal or ordinarily healthy persons who have submitted themselves to the rays, or consumed the appointed foods, must have felt neither a penny the better nor, for that matter, a penny the worse—except in their pockets. Is it not a reasonable conclusion that the human body, though it perishes for want of the proper vitamins, does not need more than the necessary amount of them ? Presumably in a healthy person the necessary amount is always present in a varied and wholesome diet. The addition of specially procured vitamins is, in that case, useless.
The answer of the enthusiasts of light therapy to the present criticisms—we are thinking of qualified practi- tioners, not quacks—is that condemnation of the treat- ment is often based on undiscriminating or partial experiments. Dr. W. J. O'Donovan, physician in charge of the skin and light treatment departments of the London Hospital, said to a representative of the Daily Telegraph that it was " impertinence " for anyone to say that hospitals should be called upon to justify their expenditure. " Cures," he said, " have been effected in types of cases previously uncured "—as, for example, the tubercular form of blindness, lupus, tubercular disease of the larynx, chronic arthritis, and extreme anaemia. The Medical Research Council had remarked that for increasing the bactericidal power of children's blood a mustard plaster would do as well as arti- ficial light. But a mustard plaster would not cure lupus.
Another doctor disputed what the Report had said about rickets. " While it may be argued," he said, " that Vitamin D can be administered by the mouth in cases of rickets, it does not represent the whole value of light treatment." Certainly anybody can imagine circumstances in which weak children may be helped by light therapy before they are strong enough to move about in the sunshine out of doors, and the same thing must be true of grown persons. The doctors would not have treated the King with ultra-violet rays unless they had had very good reason for believing in them in that stage of the illness. Now they prefer Bognor. Dr. G. Murray Levick has said, in the Times, that some treatments by artificial light are not varied enough, and naturally fail. " The use of the mercury vapour lamp without auxiliary apparatus to produce the solar rays other than ultra-violet is a crude and incomplete method."
We wait for the doctors to settle this dispute. In the meantime the unscientific public will do well to act upon only one conclusion—that the uncontrolled practice of light therapy should be suspect.
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