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 THE THERAPEUTICS of RADIANT 
 
 LIGHT AND HEAT/ AND 
 
 CONVECTIVE HEAT 
 
 WILLIAM BENHAM SNOW, M.D. 
 
 Author of "A Manual on Electro-Static Modes of Application, 
 
 Therapeutics, Radiography, and Radiotherapy " and " Currents 
 
 of High Potential of High and Other Frequencies "; 
 
 Editor of the Journal of Advanced Therapeutics; 
 
 and late Instructor in Electro -Therapeutics in 
 
 the Nero York Post-Graduate School, etc. 
 
 NEW YORK 
 
 SCIENTIFIC AUTHORS' PUBLISHING CO. 
 1909
 
 COPYRIGHT, 1909, 
 
 BY 
 WILLIAM BENHAM SNOW, M.D.
 
 TO 
 
 MY MOTHER 
 
 The noblest thoughts my soul can claim, 
 The holiest words my tongue can frame, 
 Unworthy are to praise the name 
 More sacred than all other. 
 
 GEORGE GRIFFITH FETTER
 
 PREFACE 
 
 AT the request of students and other members of the 
 profession for a condensed manual on the employment of 
 radiant light and heat, the writer has been induced to prepare 
 the following chapters. 
 
 In considering the subject, attention has been devoted to 
 the elucidation of the physiological actions, practical indica- 
 tions, and methods of employing radiant light and heat from 
 the modern point of view. 
 
 It will be found by investigators that there is much to be 
 derived from the scientific employment of these measures in 
 therapeutics; and that the field of indication is much greater 
 than the rank and file of the profession are aware of. 
 
 A chapter has been included on the relative action of radiant 
 light and heat and the Roentgen ray, a subject of great 
 importance in radiotherapy. 
 
 Four chapters have been added on the employment of con- 
 vective heat, as showing the contrast and similarity of action 
 from the employment of the two forms of heat radiant and 
 convective. 
 
 It has been the writer's purpose in the preparation of this 
 little volume, as far as possible, to make it a practical aid to 
 beginners in an important department of physical therapeutics, 
 in which, if he has succeeded, he will be rewarded for his 
 efforts. 
 
 WILLIAM BENHAM SNOW.
 
 CONTENTS 
 
 SECTION I 
 
 RADIANT LIGHT AND HEAT 
 CHAPTER I 
 
 INTRODUCTION 15-24 
 
 General Consideration of Radiant Energy and Its Properties 
 Radiant Light and Heat and Variations as Regards Wave 
 Length Physical Characteristics of Radiant Energy Refrac- 
 tion of Radiant Energy Reflection of Radiant Energy Polar- 
 ization of Light Fluorescence of Various Substances The 
 Manifestations of Color Physical Properties of Light Effects 
 of Light Upon the Chemical Processes of the Body Tanning 
 of the Skin Hyperemia as Induced by Radiant Energy. 
 
 CHAPTER II 
 
 SOURCES OF RADIANT ENERGY 25-39 
 
 Natural Sources Artificial Sources The Electric Arc The 
 Incandescent Light The Mercury Vapor Lamp The Actino- 
 lite The Solar Arc Lamp The Finsen Apparatus Electric 
 Incandescent Lamps The Minin Light Small Lamp Light 
 Bath Cabinets Construction of Light Bath Cabinets In- 
 candescent Bath Cabinets Arc Light Cabinets Special Types 
 of Light Bath Cabinets. 
 
 CHAPTER III 
 
 PHYSIOLOGICAL EFFECTS OF RADIANT LIGHT AND HEAT . . . 40-43 
 Comparison of Forms of Radiant Energy Local Influences of 
 Radiant Light and Heat Hyperemia as Induced by Radiant 
 Light and Heat Effects Upon Metabolism Effects Upon Sim- 
 ple Inflammation Effects in Acute and Subacute Infectious 
 Conditions Derivative Effects of Radiant Light and Heat. 
 
 CHAPTER IV 
 
 PRACTICAL METHODS OF APPLICATION OF RADIANT LIGHT AND HEAT 44-^ 
 Local Administrations of Light The Induction of Hyperemia 
 by Ultra-Violet Radiations The Choice of Lamps Applica- 
 tions to Circumscribed Areas General or Constitutional Treat- 
 ment Method of Local Administration Duration of Appli- 
 cation Finsen Method of Application General Treatment 
 with High Candle Power Incandescent Lamp The Light Bath, 
 Duration, and After Treatment Mechanical Vibration after 
 Treatment Light Baths by High Candle Power Incandescent 
 Lamps.
 
 8 CONTENTS 
 
 CHAPTER V 
 
 TREATMENT OF SIMPLE INFLAMMATION 49-52 
 
 General Consideration Relief of Pain by Radiant Light and 
 Heat Post-Operative Use of Radiant Light and Heat 
 Method of Treatment of Simple Inflammation Treatment of 
 Myalgias Treatment of Muscular Soreness Treatment of 
 Lumbago. 
 
 CHAPTER VI 
 
 RADIANT ENERGY IN THE TREATMENT OF INFECTION .... 53-63 
 Bier's Method Specialized Employment 'of Radiant Energy 
 Action of the Roentgen Ray on Germ Life Actions of Radiant 
 Light and Heat on Germ Processes High Frequency Currents 
 in the Treatment of Infectious Conditions Treatment of Cys- 
 titis Treatment of Otitis Media Treatment of Chronic Otitis 
 Media Treatment of Mastoiditis Treatment of Tubercular 
 Arthritis Treatment of Tubercular Adenitis Treatment of 
 Phlebitis Treatment of Pelvic Congestion Treatment of 
 Ozena Treatment of Post-Operative Iritis. 
 
 CHAPTER VII 
 
 RADIANT ENERGY IN DERMATOLOGY 64-73 
 
 Atonic Conditions Varicose Ulcers Supportive Treatment of 
 Varicose Ulcers Treatment of Suppurating Ulcers Reports 
 by Various Authorities on Dermatology Treatment of Eczema 
 Treatment of Moist Eczema The Use of the Iron Electrode 
 Arc Lamp in Various Conditions. 
 
 CHAPTER VIII 
 
 RADIANT LIGHT AND HEAT IN CONDITIONS ASSOCIATED WITH 
 
 FAULTY METABOLISM 74-79 
 
 Actions on the Blood Action on the Superficial End Organs 
 Action on the Deep Spinal Centers Effects of General Dif- 
 fusion of Heat The Actinic and Thermic Action of Radiant 
 Light The Induction of Superficial Hyperemia The Stimu- 
 lation of Increased .Elimination Radiant Light and Heat in 
 Nephritis Radiant Light and Heat in Infectious Arthritis 
 Radiant Light and Heat in Arteriosclerosis Effects of the Ra- 
 diant Light Bath Treatment of Arteriosclerosis. 
 
 CHAPTER IX 
 
 OPPOSITE EFFECTS OF RADIANT LIGHT AND HEAT AND THE ROENTGEN 
 
 RAY 80-90 
 
 General Observations Physical Characteristics of the Roent- 
 gen Ray Stimulating or Tonic Effects of the Roentgen Ray 
 Effects of the Roentgen Ray on Animal Tissue Experiments 
 of Dr. Edward C. Titus with Light and the X-ray Conclu- 
 sions on the Relative Actions of the X-ray and Radiant Light 
 and Heat.
 
 CONTENTS 9 
 
 SECTION II 
 
 CONVECTIVE HEAT 
 
 CHAPTER I 
 
 COMPARISON OF CONVECTIVE HEAT AND RADIANT HEAT . . . 93-95 
 Application of Dry Heat Means of Applying Moist Heat 
 The Method of Using Moist Heat. 
 
 CHAPTER II 
 
 PSYSIOLOGICAL ACTIONS OF CONVECTIVE HEAT 95"99 
 
 Local Applications of Convective Heat Observations on the 
 Investigations of Dr. T. Addis Emmett The Actions of Local 
 Dry Heat. 
 
 CHAPTER III 
 
 THE ADMINISTRATION OF DRY AND MOIST HEAT .... 100-103 
 The Poultice The Hot Water Bag The Russian Bath The 
 Hot Water Bath The Hot Douche The Employment of the 
 Local and Body Hot-Air Apparatus The Hot Box The 
 Turkish Bath. 
 
 CHAPTER IV 
 
 THERAPEUTICS OF CONVECTIVE HEAT 104-110 
 
 Treatment of Early Quinsy and Suppurating Tonsilitis Treat- 
 ment of Felons and Whitlows Early Stage of Mastoiditis 
 Treatment of Mastoiditis Treatment of Otitis Media Treat- 
 ment of Inflammatory Conditions of the Pleural and Abdominal 
 Cavities Treatment of Pleurisy Treatment of Peritonitis 
 Treatment of Appendicitis Employment of Local Hot-Air 
 Apparatus in Pleural and Abdominal Cavities Method of 
 Jointly Employing Convective Heat and Cold Applications 
 In Reverse Peristalsis and Other Conditions Use of Hot 
 Douches for Rectal and Colonic Flushings Use of Dry Heat 
 in General and Local Septic Infection Trea'tment of Localized 
 Septicemia Treatment of Deep-Seated Congestions Treat- 
 ment of Non-Infectious Inflammatory Conditions Treatment 
 of Conditions of Defective Metabolism.
 
 LIST OF ILLUSTRATIONS 
 SECTION I 
 
 FIG. PAGE 
 
 i. ILLUSTRATING REFRACTION . 19 
 
 2. REFRACTION OF A BEAM OF LIGHT THROUGH A PRISM ... 19 
 
 3. THE ANGLES OF INCIDENCE AND REFLECTION 20 
 
 4. SHOWING REFLECTIONS IN PARALLEL 20 
 
 5. INDICATING THE CROSSING OF CONVERGENT RAYS .... 20 
 
 6. MARINE SEARCH LIGHT 27 
 
 7. SOLAR ARC LAMP 28 
 
 8. LEUCODESCENT LAMP 30 
 
 9. LEUOCODESCENT SCREENS 31 
 
 10. SMALL LAMPS 31 
 
 ii. VICTOR SMALL LAMP AND SCREEN 31 
 
 12. UVIOL LAMP 33 
 
 13. AUTHOR'S BATH CABINET 36 
 
 14. BETZ RECLINING BATH CABINET 37 
 
 15. KNY-SCHEERER LIGHT BATH CABINET 38 
 
 ii
 
 LIST OF PLATES 
 
 OPPOSITE PAGE 
 
 PLATE I. AUTHOR'S AND ASSOCIATE'S LARGEST OPERATING ROOM 
 
 WITH SCREENS AND CURTAINS REMOVED . . . Frontispiece 
 PLATE II. TREATMENT WITH SMALL BATH CABINET AND 500 
 
 CANDLE POWER LAMP 39 
 
 PLATE III. METHOD OF TREATMENT WITH 500 CANDLE POWER 
 
 LEUCODESCENT LAMP 44 
 
 PLATE IV. METHOD OF TREATMENT WITH 1000 CANDLE POWER 
 
 MARINE SEARCH LIGHT ARC LIGHT ..:.... 46 
 PLATE V. METHOD OF TREATMENT WITH THE LONDON HOSPITAL 
 
 LAMP 67 
 
 PLATE VI. RECLINING LIGHT BATH AS USED BY THE AUTHOR AND 
 
 ASSOCIATE 76 
 
 PLATE VII. LOCAL BETZ KNEE JOINT APPARATUS AS APPLIED . 102 
 PLATE VIII. TREATMENT OF LEG AND THIGH WITH LOCAL BETZ 
 
 DRY HOT AIR APPARATUS 108
 
 SECTION I 
 
 RADIANT LIGHT AND HEAT
 
 RADIANT LIGHT AND HEAT 
 
 CHAPTER I 
 RADIANT LIGHT AND HEAT 
 
 The application of radiant energy to the treatment of dis- 
 ease, has received no little attention from therapeutists during 
 the last decade. More earnest study and investigation of the 
 agents which have always been recognized as essential to life, 
 have resulted in the introduction of therapeutic methods which 
 bid fair to give the various forms of radiant energy rank 
 with the most valuable curative agents. Their skillful employ- 
 ment is fraught with little danger. To effect the best results 
 however in the large class of cases for which they are indicated, 
 a thorough knowledge of the requirements and limitations 
 of technique is indispensable. 
 
 Radiant energy as emitted from the usual sources includes 
 the transmission of light, heat, the Roentgen ray and the 
 emanations from radium and other radio-active substances 
 through the medium of the ether and air which are capable of 
 setting up responsive vibrations in animal tissue. The effect 
 of the various rates of frequency is normally to induce re- 
 sponses of the organs of special sense; each sense having 
 perception of a wide range of vibration frequencies during 
 health. The pressure sense and sense of hearing respond only 
 to vibrations of substantial bodies in the form of gases or 
 solids; while radiant light and heat are transmitted through 
 the ether and are of higher frequency and shorter wave length, 
 inducing responses relative to their intensity of heat, in the 
 terms of degrees, and of light, in terms of color. 
 
 The higher invisible frequencies are manifested only by the 
 effects on living tissue, and by fluorescence of substances in 
 which they are capable of setting up in other bodies thus ex- 
 posed secondary vibrations corresponding with the visible light 
 frequencies. Platino-barium-cyanide and tungstate of calcium 
 respond to the ultra-violet and Roentgen ray frequencies with 
 
 15
 
 1 6 RADIANT LIGHT AND HEAT 
 
 a clear, nearly white fluorescence and willemite with green. 
 The higher frequencies, to which the senses do not perceptibly 
 respond, are ether vibrations emanating in Nature from the 
 sun or radio-active substances or are produced from high volt 
 electrical sources as the electric arc, and the Crookes tube, 
 evolving from the former all of the frequencies of light, and 
 also the invisible frequencies at either end of the spectrum 
 the ultra violet and infra-red or heat frequencies, and from 
 the latter the various frequencies of the Roentgen ray, increas- 
 ing as they do in frequency with shortening of wave length 
 as the vacuum of the tube becomes higher. 
 
 It is readily appreciated that these various frequencies of 
 ether vibration, affecting as they manifestly do human tissue, 
 induce effects relative to their wave lengths and frequency. 
 
 When it is recognized that "heat is an energy of molecular 
 motion with sudden changes of direction and velocity, when 
 the molecules come near enough to one another" it is self- 
 evident that the human body at 98 2-5 F. is a mass of matter 
 in active molecular motion responding to heat, and coincidently 
 responding to the influences of the other frequencies. Made 
 up of active organic parts each fulfilling a rhythm of its own, 
 particularly the thrill of the cardiac contractions transmitted 
 through the coats of the arterial walls and the complexity of 
 the vibrations of the nervous mechanism, it is manifest that 
 when those functions are recognized to depend more or less 
 upon external sources for their maintenance, that a loss of 
 normal rhythm, or lost balance, would naturally be restored by 
 re-establishment of the normal rate of vibration from such 
 sources. 
 
 In accord with the law of harmonic vibration, it is prob- 
 able that the tissues attune themselves from a source of mixed 
 vibrations, as of the combined spectral vibrations of radiant 
 light and heat, deriving therefrom by selection the kind of 
 energy which sets up and restores functional activity. While 
 this is true of the light and heat frequencies which are a part 
 of normal living environment, the higher frequencies, which 
 are not essential to health under normal conditions, as the 
 radiations of the Roentgen ray and radium emanations, have 
 a tendency to overwhelm the tissues exerting abnormal in- 
 hibitory influences. It is also true that the ether vibrations 
 which constitute a normal environment do under extreme con-
 
 RADIANT LIGHT AND HEAT 17 
 
 ditions, as of prolonged exposures to the light and heat radia- 
 tions of the sun, become inhibitory or depressing in their influ- 
 ence upon human life. Under varying conditions it will then be 
 readily appreciated that the judicious employment of the wide 
 range of vibratory radiant energy will be in a large measure 
 capable either of restoring or inhibiting the vibratory energies 
 or activities of the animal organism. 
 
 These higher frequencies of radiant energy conserve the 
 chemical actions and the more gross and energetic mechanical 
 agencies, as certain electrical modalities, mechanical vibration 
 and exercise conserve the mechanical demands for relieving 
 stasis and infiltration, and also increasing the activity of the 
 grosser functions of the organism. 
 
 From the point of view suggested by the above premises, it 
 will be recognized that the study of the application of these 
 vibratory agents to therapeutics suggests the investigation of 
 the principles of adaptation of external vibratory energy to the 
 restoration of the body, properly sustained, to its normal vibra- 
 tion in all its parts, as evidenced by the revival of health with 
 the restoration of functional activities. 
 
 It must always be recognized that while external agents 
 exert temporarily the energy of motion vibration a sustain- 
 ing pabulum or tissue food is essential to its maintenance. 
 These two imparted activity and nutrition constitute a vis-a- 
 tergo leading to the restoration and preservation of the func- 
 tional activities. 
 
 Radiant light and radiant heat from the same general char- 
 acteristics, render the actions of the spectral and infra-red 
 or heat rays, similar in their effects upon living tissue, and 
 as they are emitted together, and neither is contraindicated, in- 
 most cases it is customary to treat of them in unison as 
 radiant light and heat radiations. It should be borne in mind 
 that the incandescent or mercury vapor lamps or arc lamps, 
 employed with intervening glass screens or glass lenses, cut out 
 or absorb most, if not all, of the ultra-violet frequencies. 
 This, however, is generally desirable because during courses of 
 light treatment with the ultra-violet frequencies included, as 
 when employing direct sunlight or the electric arc, the skin 
 soon becomes tanned ; afterwards largely impeding the penetra- 
 tion and consequent beneficial action of all of the light fre- 
 quencies. The irritating and tanning ultra-violet frequencies
 
 1 8 RADIANT LIGHT AND HEAT 
 
 seem therefore to be a provision of Nature for protection 
 against overstimulation of the deeper tissues of those who are 
 much exposed to the sun's rays, in the tropics and during the 
 summer in the temperate zones. 
 
 Radiant light and heat are usually derived from the same 
 sources and constitute "a form of wave motion projected by 
 the wave motion of the luminiferous ether," and differ only in 
 kind, being capable of conversion one into the other, as light 
 passed through an object which absorbs a part of the frequen- 
 cies is converted into heat units, as demonstrated in the pass- 
 age of light through blue glass. The fact that they are radiated 
 from the same sources and differ only in frequency of vibra- 
 tion and wave lengths with the objectionable higher frequen- 
 cies cut out indicates their general employment in unison. 
 
 The physical characteristics and the differences in those 
 characteristics as exerted by the various frequencies, may be 
 considered with reference to frequency or rate of vibration and 
 wave length as affecting (i) penetration, (2) refraction, (3) 
 polarization, (4) fluorescence, (5) color, and (6) heat produc- 
 tion; and as affecting human tissue, (i) inducing hyperemia, 
 (2) producing tanning, (3) superficial and deeper effects upon 
 metabolism, (4) actinic actions affecting oxidation and germ 
 life, and (5) reflex effects upon functions remote from the 
 surface through the end neurons and nerve connections. 
 
 The frequency and wave length of the radiations of light 
 vary from 45o,ooo,ooo,cxx) per second of red to 850,000,000,- 
 ooo of violet, between which range the rates of the other fre- 
 quencies. The wave length shortens relatively as the frequency 
 increases; and it has been also practically demonstrated that 
 the penetration diminishes with the wave length. In other 
 words, the infra-red or heat radiations, of the lower frequen- 
 cies of light, have relatively greater power of penetration than 
 the ultra-violet and higher light frequencies, blue, indigo and 
 violet. This rule of decrease in penetration applies with in- 
 crease of the angle of refraction as the frequency increases 
 until, as Lodge has said, "the wave lengths are found that are 
 smaller than the atoms, when they go straight on," as do the 
 x-rays. 
 
 Refraction. When a ray or beam of light passes between 
 media of varying densities, it is bent out of its direction, 
 both at the entrance to the denser and the exit into the rarer
 
 RADIANT LIGHT AND HEAT 
 
 media, being bent at an angle towards the perpendicular let 
 fall to the plane of the surface in the first instance, and from it 
 in the second, Fig. i. It is by refraction through a prism that 
 white light is resolved into the prismatic colors. A beam of 
 white light allowed to fall upon a transparent prism is divided 
 
 Fig. i. Illustrating Refraction. 
 
 into its component parts. Beginning with the more refrangible, 
 the order in which the colors occur are as shown in Fig. 2; 
 passing from the violet to red, with the varying degrees of 
 refraction, and the varying colors as may be shown by throwing 
 
 Fig. 2. Showing Refraction of a Beam of Light Passed through a Prism, and 
 the Order of the Spectral Colors. 
 
 the refracted rays upon a screen in a darkened room or as seen 
 in the rainbow. 
 
 Reflection is the property of light, whereby a pencil or beam 
 of light thrown against certain surfaces is caused to be re- 
 flected backward or at an angle according to the obliquity at 
 which the rays strike the reflecting surface, the angle of in- 
 cidence being equal to the angle of reflection; i. e., if a per-
 
 20 
 
 RADIANT LIGHT AND HEAT 
 
 pendicular be drawn or let fall to a reflecting surface, the angle 
 formed between the line of light and the perpendicular will be 
 equal to the angle between the opposite side of the perpen- 
 dicular, and the line of the reflected radiation, Fig. 3. 
 
 Fig. 3. Showing Angle of Incidence and Angle of Reflection. 
 
 The laws of reflection obtain also with the reflections from 
 concave mirrors, the proximity of the luminous body to the 
 reflecting surface varying the focal points of the radiation, 
 
 
 Fig. 4. Showing Reflections in Parallel and Convergent from Concave Mirror. 
 
 Fig. 4 ; or when placed at the requisite angle, producing parallel 
 radiations as illustrated in the accompanying drawing. An- 
 other matter for particular consideration to the therapeutist is 
 
 Fig. 5. Indicating Crossing of Convergent Rays and Dark Spot beyond, 
 within Which Shimmer Appears. 
 
 the fact that beyond the focal point where the rays cross, a 
 ring of light is produced surrounding a dark center, Fig. 5.
 
 RADIANT LIGHT AND HEAT 21 
 
 Within this light ring a violet shimmer appears which will mis- 
 lead the unsophisticated, and may be made use of to lead phy- 
 sicians unsuspectingly to believe that this shimmer is the violet 
 or ultra-violet radiation, which is quite false. It should always 
 be considered, in investigating an apparatus, where the focal 
 point will fall, and with the understanding that, except imme- 
 diately beyond the focal point, where the invisible ultra-violet is 
 present, the rays are dispersed in such a manner as to be of 
 little use for therapeutic purposes. From the incandescent 
 light, with parabolic reflector, the point of greatest intensity 
 of heat would be at about the focal point, the degree of inten- 
 sity diminishing as the object is placed nearer to the reflecting 
 surface. 
 
 Polarisation, as of interest in the consideration of light, con- 
 sists of a double refraction that occurs when light passes 
 through certain substances as Iceland spar, and is not of sig- 
 nificance as pertaining to therapeutics. 
 
 Fluorescence, as induced in certain substances, is a second- 
 ary effect arising from the projection of radiant energy. Some 
 substances, as sulphide of calcium, continue to fluoresce for 
 hours after prolonged exposures to radiant light. Certain sub- 
 stances also fluoresce under the radiations of the higher invis- 
 ible frequencies of radiant energy only, as the fluorescence of 
 willemite, tungstate of calcium, and platino-barium-cyanide un- 
 der exposures of ultra-violet and x-ray radiations. It is by 
 this property of light and matter that we are able to discern 
 the presence of the invisible frequencies. 
 
 Color is the manifestation of the various degrees of refran- 
 gibility of the spectral rays of light, the radiations that con- 
 stitute light. Some writers of recent date have erred in the 
 use of the term light, applying "x-light" to the x-ray, and 
 "ultra-violet light" to the frequencies above the violet ; where- 
 as, only the visible frequencies constitute light. The ultra-vio- 
 let, x-ray, and infra-red are the invisible frequencies of the 
 spectrum, and are discerned only through the means of fluores- 
 cence, and the effects upon sensitized plates, with the higher 
 frequencies, and by the thermopile as registering the radia- 
 tions of heat with the lower frequencies. It will be seen that 
 radiant light and radiant heat are very closely allied ; the lower 
 frequencies of light, the red and orange, containing heat radia- 
 tions, as evidenced by the thermopile. The infra-red or heat
 
 22 RADIANT LIGHT AND HEAT 
 
 rays have their maximum heat intensity at a short distance from 
 the red ; but are present to a less degree at a distance from the 
 red about equal to the range of the visible spectrum from red 
 to violet. The higher frequencies of the ultra-violet and the 
 x-ray are devoid of heat radiations. This fact readily explains 
 the difference of the temperature of incandescent bulbs trans- 
 mitting the red, orange and white light, as compared with the 
 blue or violet bulbs in which the lower frequencies are ab- 
 sorbed ; the heat of the latter becoming markedly more intense 
 under radiations employing the same candle power than the 
 transparent red or orange incandescent bulbs. In other 
 words, a secondary radiation is induced from the glass of the 
 violet bulb plus the infra-red, radiations from the conversion of 
 the lower frequencies into heat by absorption, which renders 
 the heat radiated of greater intensity from the bulbs of blue or 
 violet. 
 
 The physical properties of light above described are of in- 
 terest only in therapeutics, as defining the properties of the 
 agents employed, the principles of which are significant and 
 suggestive as to the effects produced upon the human organism. 
 
 The effects of radiant light and heat upon human tissue are 
 complex from the nature of things, and not always easy of 
 determination ; as the processes of metabolism are so difficult of 
 demonstration the building processes of anabolism, and the 
 taking down and removal of effete materials of katabolism. 
 These metabolic processes, dealing with the appropriation of the 
 nutrient circulating fluids, and combining both physical and 
 chemical qualities, indicate the necessity of incessant activity, 
 with the supply of the necessary pabulum for repair relative 
 to the activities of the organism as a whole, or the part of the 
 organism in question. 
 
 If light and heat energy are necessary to the carrying out of 
 the body's normal processes, most living creatures requiring 
 light and heat for the maintenance of health, the effects are 
 prerequisites. 
 
 The chemical processes of the human body in a state of 
 health, without exercise, are capable of supplying the requisite 
 amount of heat to resist only moderate degrees of cold, requir- 
 ing an increased chemical action and tissue combustion for the 
 maintenance of the normal body temperature unless a sur- 
 rounding temperature approaching 60 to 80 F. is maintained,
 
 RADIANT LIGHT AND HEAT 23 
 
 otherwise the escape of body heat must be prevented by cloth- 
 ing of non-conducting material to prevent cooling by convec- 
 tion. 
 
 The chemical actions of light, as inducing oxidation and ac- 
 tinic effects, are irritating and destructive, unfavorably affect- 
 ing certain forms of germ life, and for this reason notably of 
 value in therapeutics. 
 
 Tanning of the skin, by the effects of radiant energy, is in- 
 duced by the higher frequencies, particularly by the invisible 
 ultra-violet radiations. This is demonstrated in the experience 
 of those who have used the high candle power incandescent 
 lamps and light baths, when numerous prolonged exposures, 
 made from these sources, invariably have not produced tan- 
 ning; whereas, by the employment of the arc light, or the arc 
 light bath, or by the localized treatment by high candle power 
 arc lamps, rich in the higher frequencies, tanning invariably 
 results. The writer has verified this from his own experience, 
 and from this fact has abandoned the use of the arc light and 
 ultra-violet frequencies, except with the employment of inter- 
 vening glass screens, in the treatment of conditions in which 
 stimulating and metabolic influences of the penetrating rays are 
 indicated. 
 
 The hyperemia induced by the action of these frequencies 
 which is associated with tanning, is very superficial but painful 
 in its effects, in many cases inducing vesication of the skin, 
 and therefore except when such effects are desirable, is con- 
 tra-indicated. It would seem that the main object in nature, so 
 far as the human race is concerned, of the ultra-violet and 
 higher visible frequencies, is to effect tanning in order that 
 white races living in the tropics or during the summer seasons 
 in temperate zones, who are much exposed to the sunlight, may 
 not be overstimulated by the penetrating action of the stimula- 
 ting rays of light and heat of the lower frequencies. It is an 
 undoubted fact that in the course of centuries, peoples who live 
 constantly in these climates have become dark-skinned races, 
 as is notable in the Spaniards, Italians, and others living in the 
 tropics or southern portion of the north temperate zone. 
 
 The induction of hyperemia by the actinic effects of the 
 higher frequencies, and from the combined action of all the 
 frequencies of light, together with the radiant heat, are demon- 
 strated to be capable of increasing positive chemotaxis, hasten-
 
 24 RADIANT LIGHT AND HEAT 
 
 ing the destruction and release of the tissues from deleterious 
 substances, or forms of germ life present in them. The degrees 
 to which this may be effected will vary with the character of the 
 radiations as to volume and intensity. 
 
 The effect of light and heat radiations upon metabolism is to 
 quicken the functional activities of the cells thus stimulated, 
 promoting elimination through activity of the sweat glands, 
 and inducing an increased influx of blood associated with the 
 hyperemia produced, thereby favoring local nutrition and 
 elimination. The application of intense heat and light to the 
 peripheral neurons undoubtedly also stimulates reflexly greater 
 activities in parts and organs remote from the site of stimula- 
 tion. This is clinically demonstrated in the beneficial influence 
 of light upon tissue building, and increased body weight, prob- 
 ably by influences both anabolic and katabolic. These effects, 
 in a general way, indicate the therapeutic employment of light, 
 and place it in the field as one of the valuable physical the- 
 rapeutic measures.
 
 CHAPTER II 
 SOURCES OF RADIANT ENERGY 
 
 The sources of radiant energy are both natural and artificial. 
 
 The natural sources are the sun, radium, uranium and other 
 radio-active bodies ; the sun alone in connection with this chap- 
 ter calling for consideration. 
 
 The artificial sources are the electric arc, incandescent, and 
 mercury vapor lamps, and the Crookes tube, all electrical 
 sources; and others not practical for therapeutic purposes, in- 
 cluding all flaming or burning materials, which emit radiant 
 light and heat. 
 
 /. The sun, the natural source of light, furnishes all that 
 could be desired when employed in conjunction with surround- 
 ing conditions and the necessary means for facilitating conden- 
 sation, direct radiation, and in connection with various ar- 
 rangements for filtration when desirable. 
 
 The variations in weather conditions in most climates, how- 
 ever, render it as a source of radiant energy rather too capri- 
 cious for a practical means in therapeutics. 
 
 II. The electrical arc, as an artificial source of radiant energy, 
 has been employed since the first introduction of artificial light 
 in therapeutics. It possesses the advantage, especially when 
 generated in connection with iron cored electrodes, of evolving 
 rays particularly rich in the chemical or ultra-violet end of the 
 spectrum. There are disadvantages in the administration how- 
 ever, when it is to be employed for the general or constitutional 
 effects in that it cannot be applied directly over a patient, as 
 when resting in a recumbent position, because of hot flying 
 particles from the consuming carbon electrodes. Another dis- 
 advantage is that the relative amount of current consumed in 
 the production of a given amount of radiant light and heat is 
 much greater than with the high power incandescent lamp. 
 In the enclosed light bath employing sufficient candle power to 
 produce the desired radiant light and heat effects, it is impos- 
 sible for some patients, and all patients under extreme condi- 
 tions of time and intensity, to inhale and withstand the gases 
 
 25
 
 26 RADIANT LIGHT AND HEAT 
 
 thrown off from the arc lamps. These gases are composed 
 largely of nitrous acid and ozone, evolved by the electric arc. 
 Furthermore, when it is desired to produce profound, combined 
 light and heat effects, for a long period of time, the ultra-violet 
 rays, as stated in the previous chapter, induce too great a de- 
 gree of hyperemia of the skin, which is followed by marked 
 tanning, due to the peculiar action of the higher frequencies. 
 However, in certain cases, the induction of intense hyper- 
 emia may be desirable, but the tanning interferes largely with 
 subsequent beneficial effects when it is desirable to continue 
 administrations of radiant energy to the deeper tissues. For 
 the treatment of local infectious processes, as in lupus vulgaris, 
 with the employment of intense focused light, rich in ultra-vio- 
 let, the arc light is indicated in some cases. 
 
 ///. The incandescent light properly fills the widest field of 
 therapeutic indication. This type of lamp combines a large 
 percentage of radiant heat which, when focused or from lamps 
 of high candle power, is rich in luminous rays rays which 
 penetrate deeper into the tissues than the radiations of the 
 higher frequencies in which they are deficient. A light of this 
 sort is always most convenient of application, as it can be ap- 
 plied directly over the patient while reclining ; with the advan- 
 tage that a maximum surface is receiving the radiations while 
 the opposite surface is not exposed during the administration. 
 Another advantage is that the light may be moved back and 
 forth over the surface with the greatest convenience and by the 
 patient himself during applications to the front of the body. 
 Another advantage of the incandescent light is that it jsjdepleted 
 of the ultra-violet radiations and may therefore be applied, if 
 desirable, for a longer time without danger of producing a dis- 
 agreeable hyperemia or eventually tanning the surface of the 
 skin, thereby interfering with the maximum degree of thera- 
 peutic efficiency. 
 
 IV. The mercury vapor lamps have been employed by some 
 for general applications but to the present time have little 
 recognized therapeutic value. The radiations produced by 
 these lamps are rich in the higher frequencies, but the red and 
 infra-red are absent ; and as the ultra-violet frequencies are fil- 
 tered out by the glass in passing, they possess no advan- 
 tage over the incandescent lamps, but a decided disadvantage in 
 that the red and heat rays, which are most penetrating and
 
 SOURCES OF RADIANT ENERGY 27 
 
 effective, are to a very large degree absent from this type of 
 light. 
 
 There have been several types of arc lamp manufactured and 
 used for therapeutic purposes. 
 
 The marine search light, manufactured by Bogue & Co., of 
 New York, is provided with a parabolic reflector and movable 
 carriage, and self-adjusting device for maintaining the carbon 
 
 Fig. 6. Marine Search Light. 
 
 electrodes in contact (see Fig. 6). The movable or adjustable 
 platform may be so regulated as to vary the divergence or con- 
 vergence of the rays whereby either parallel rays or focused 
 rays may be projected upon the patient. The author's appara- 
 tus has also been provided by him with a hood and water cool- 
 ing device, whereby the rays from the arc may be focused and 
 emitted through plain rock crystal lenses for use for the treat- 
 ment of one patient instead of four as by the arrangement of 
 Niels Finsen, as employed for the treatment of lupus or other 
 conditions in which this method of treatment may be indicated. 
 A blue glass screen is also provided with this lamp.
 
 28 
 
 RADIANT LIGHT AND HEAT 
 
 The actinolite, one of the older types of arc lights, focuses 
 or renders the radiations parallel or divergent by means of 
 a movable glass lens. This lamp was manufactured by Kliegl 
 Bros., also of New York, and is of varying capacity. It pos- 
 sesses the same disadvantages as the other arc lamps except 
 that the light being passed through glass lenses the ultra-violet 
 radiations are cut out or absorbed. 
 
 Another arc recently put upon the market by Frank S. Betz, 
 of Chicago, (Fig. 7) is practically after the same idea as the 
 
 marine search light; but 
 uses less amperage, pro- 
 ducing less light, and in- 
 cludes colored screens for 
 cutting out the ultra-violet 
 and various colors of the 
 spectrum. The lamp is a 
 very practical one of its 
 kind and will be welcomed 
 by those who are seeking a 
 low-priced arc lamp of fair 
 intensity for the application 
 of the ultra-violet and vari- 
 ous other radiations at the 
 discretion of the operator. 
 The solar arc lamp is of cheaper and simpler construction and 
 provided with an adjustable arc and parabolic reflector, but 
 employs less amperage and consequently produces less 
 radiations. It must be observed in connection with this lamp 
 and other arc lamps provided with parabolic reflectors, that as 
 the arc is drawn from the reflecting surface, where at the focal 
 point the radiations cross, a shimmer which the uninitiated are 
 sometimes led to believe are violet radiations appears within the 
 center of the light ring. As a matter of fact, this is the dark 
 field beyond the point where the focused rays cross. (See 
 
 Fig. 7.
 
 SOURCES OF RADIANT ENERGY 29 
 
 Fig. 5.) The same is true beyond the focal point of the incan- 
 descent lamp, provided with a parabolic reflector. 
 
 The elaborate apparatus of Neils Finsen consisted of a 90- 
 ampere arc placed in the center, the radiations being projected 
 through four tubes, and condensed through rock crystal lenses 
 and the heat rays filtered out through ice or cooled water placed 
 in the tube. Four patients placed at the four angles were 
 treated at one time with the involved surfaces pressed against 
 the outer lens of rock crystal, to render the tissues anemic, a 
 necessity demonstrated by the experiments of Finsen. This 
 apparatus has been but little used in this country, though sev- 
 eral of the apparatus have been installed, because the ultra- 
 violet rays are indicated in such a limited number of cases, par- 
 ticularly the types of lupus which are very rare in this country ; 
 and because, immediately following the introduction of the 
 methods of Finsen, it was demonstrated that the x-ray was 
 more effective in the treatment of these conditions. A much 
 less expensive and equally practical apparatus is the London 
 Hospital lamp first designed by Lortet and Genoud, many mod- 
 ifications of which have been produced, notably the one shown 
 in the accompanying plate manufactured by the Victor 
 Electric Co., of Chicago, New York and Boston. This type of 
 lamp largely supplanted the more elaborate lamp of Finsen. 
 It will prove of value in a limited number of cases which may 
 not respond properly to the Roentgen ray, or in which the 
 x-ray would sacrifice the part, as the lobe of an ear involved 
 in a lupus process. 
 
 The electric incandescent lamps. A large number of thera- 
 peutic lamps of the incandescent type have been put upon the 
 market, all of which possess certain degrees of merit. A lamp 
 of small candle power is valuable for applications to circum- 
 scribed areas, even for intense local treatment, but for their 
 effects upon general metabolism and other purposes of adminis- 
 tration to large areas are not practical, as they consume too 
 much of the time, both of the patient and physician. Of the 
 high candle power incandescent lamps, the most practical 
 type is the so called Leucodescent lamp manufactured by 
 Spear-Marshall & Co., of Chicago, (Fig. 8). One feature of 
 this particular lamp is the character of the reflection, which 
 instead of being by a parabolic reflector with one focal point, is 
 constructed with a corrugated reflector and conical side reflec-
 
 RADIANT LIGHT AND HEAT 
 
 tors which project lines in parallel and crossing lines of radia- 
 tion having two parallel fields of greatest brilliancy and inten- 
 sity, which permit the operator to move the lamp about in such 
 
 a manner that these two 
 fairly large fields of in- 
 tense radiation can be 
 tolerated, as they cannot 
 be when held in one 
 position directly over 
 the regions of tender- 
 ness or inflammatory 
 involvement. At the 
 same time the whole 
 surface receives a liberal 
 radiation of light and 
 heat. In the writer's 
 experience this type of 
 lamp meets most accept- 
 ably the demands of the 
 localizing incandescent 
 lamp for general thera- 
 peutic administration. 
 The Minin light, devised first by Professor Minin of St. 
 Petersburg, consists of a 50 to 100 c. p. incandescent lamp with 
 a bulb of "natural-blue" glass, and provided with a reflector 
 for projecting the radiations. While various claims have been 
 made as to the anesthetic effects of this lamp, in the writer's 
 experience the only advantage he has discerned, if it be an 
 advantage, is the additional heat radiation from the conversion 
 of the luminous and other frequencies absorbed by the glass 
 into heat radiation. In other words, the Minin lamp becomes 
 a radiator of heat, but in this respect does not seem to have any 
 advantage over a high candle power lamp which may be raised 
 and lowered over the surface of the patient, and the tempera- 
 ture regulated to the point of toleration without cutting out the 
 generally beneficial light radiations. This statement is made 
 from the author's observations, in view of the fact that Pro- 
 fessor Minin and others have reported favorably of blue light. 
 The manufacturers of the Leucodescent lamp, Spear- 
 Marshall & Co. have manufactured screens (Fig. 9) con- 
 structed of narrow strips of colored glass in three colors 
 
 Fig. 8. Leucodescent Lamp.
 
 SOURCES OF RADIANT ENERGY 31 
 
 blue, orange and red. When fastened to the lower rim of the 
 shield, only the rays of the particular color are permitted to 
 pass to be administered together with the heat rays. They 
 also make a small hand lamp (Fig. 10), the "midget," pro- 
 
 Fig. 9. Fig. 10. 
 
 Leucodescent Screen and Small Lamp. 
 
 vided with 50 candle power bulbs of white and the other 
 colors, instead of screens as used with the large lamps. 
 
 An incandescent lamp manufactured by the Victor Electric 
 Co. is constructed with sockets for four lamps and provided 
 with individual reflectors, so placed as to throw the light in 
 practically parallel beams of light. The lamps that are em- 
 
 Fig, ii. Small Victor Lamp and Screen. 
 
 ployed are of various candle power aggregating from 200 to 
 400 candle power for the four. One of the lamps from this 
 group is provided with a handle and may be removed for the 
 purpose of use as a hand lamp, similar to Fig n, for 
 local applications. These lamps are also provided with small
 
 32 RADIANT LIGHT AND HEAT 
 
 glass screens of orange, blue, and red which may be adjusted 
 over the front of the small shield, whereby local administra- 
 tions may be made of these various colors if desirable. 
 
 There are numerous other incandescent lamps manufactured 
 of practically the same design as the small "midget" and hand 
 lamps of the Victor and Spear-Marshall, and Frank S. Betz 
 Companies, which are convenient for the treatment of local 
 lesions in which only small areas are to be treated. When 
 body or general treatment is required, however, too much 
 time is necessary for the administration to make the small 
 lamps practicable. 
 
 Another type of lamp, the Goerl lamp, in which the radia- 
 tions are produced by sparking between balls placed in circuit, 
 usually in the form of a triangle, so that sparks will pass 
 steadily between the balls during the flow of the current, has 
 been modified by the Victor Electric Company; and also in 
 the Piffard lamp, manufactured by Waite & Bartlett. A 
 type of this lamp for use with the static machine is also manu- 
 factured by the Van Houten & Ten Broeck Company. These 
 lamps, by passing a considerable current through the circuit, 
 produce a radiation that is fairly rich in ultra-violet frequencies, 
 and may be used in lieu of the more expensive lamps for mak- 
 ing application to certain superficial lupus patches, etc. As 
 has been said before, these lamps furnishing the ultra-violet 
 discharges are generally less efficient in their action than the 
 Roentgen ray, hence their therapeutic value is not of so great 
 importance. 
 
 The mercury vapor lamp, invented by Cooper Hewitt, and 
 one of the most recent sources of artificial light, is peculiarly 
 rich in the ultra-violet end of the spectrum. The fact, how- 
 ever, that the light produced is within a cylindrical glass tube, 
 does not permit the radiation of the higher frequencies the 
 ultra-violet and is deficient in heat radiations. 
 
 The Uviol lamp, Fig. 12, manufactured in Germany, is a 
 mercury vapor lamp, a modification of the Cooper Hewitt lamp. 
 The manufacturers have laid claim to the fact that the quality 
 of the glass employed permits the emanation of radiations rich 
 in ultra-violet, and some of the therapeutic results would seem 
 to justify the claims. However, careful test made by the 
 writer, in which it was endeavored to pass the ultra-violet rays 
 through the glass tube, failed to produce the characteristic
 
 SOURCES OF RADIANT ENERGY 
 
 33 
 
 green fluorescence of willemite or the characteristic fluores- 
 cence upon a platino-barium-cyanide screen in a darkened 
 room. 
 Light bath cabinets are properly of six types; the first two 
 
 Fig. 12, The Uviol Lamp. 
 
 with reference to the position of the patient during the light 
 bath whether (i) sitting, or (2) reclining (upright or horizon- 
 tal), and two with reference to the character of light em- 
 ployed, (3) arc or mixed baths, and (4) the distinctly incan-
 
 34 RADIANT LIGHT AND HEAT 
 
 descent bath cabinet, (5) a local cluster of lamps for treating 
 joints or localized inflammatory areas, and (6) another type 
 in which a high power incandescent lamp is applied over a long 
 narrow box cabinet with a glass window. These may be still 
 further varied by the employment of varying colors in the 
 baths; for which, however, there seems to be very little indi- 
 cation ; because, on general principles, the employment of white 
 light is in most cases to be preferred to any one of the prismatic 
 colors. 
 
 The types of construction of light bath cabinets are 
 based upon two principles; (i), the position of the lights and 
 reflectors in such a manner that the radiant energy will be di- 
 rected towards the body of the patient ; and (2), that the capac- 
 ity of the cabinet shall be relative to the number of lamps 
 in the space, or the degree of accumulated heat that it is de- 
 sirable to administer to the patient; for as will be readily 
 appreciated from the first lighting of the bath cabinet when 
 closed, the temperature within the cabinet increases. The ques- 
 tion, therefore, for consideration is, shall the cabinet be large 
 enough to permit radiant light and heat to produce the effects 
 of radiant energy upon the patient, or be constructed smaller 
 in proportion to the number of lights installed in order that the 
 heat accumulation in the smaller air space shall raise the tem- 
 perature of the bath, that the mixed effects of radiant light 
 and heat and accumulated convective heat shall permit the 
 employment of a high temperature within the cabinet. As 
 a matter of fact, the general-purpose bath could not com- 
 bine these two qualities except some additional means be pro- 
 vided for increasing the heat within the bath cabinet, which 
 may be readily accomplished by making provision within the 
 larger cabinet for placing a number of large sized blue glass 
 bulbs, which radiate a larger percentage of heat than the plain 
 glass bulb of equal candle power, when owing to the fact that 
 the luminous rays are converted into heat by their absorption 
 in the glass walls of the colored bulb, convective heat is evolved, 
 which effect will be readily appreciated by placing a finger 
 against a colorless glass bulb and then against a blue one both 
 radiating. 
 
 In the construction of a light bath cabinet, several features are 
 to be considered, (i) The cabinet construction should be of 
 good workmanship if not to be lined with metal sheeting, which
 
 SOURCES OF RADIANT ENERGY 35 
 
 latter plan is generally objected to by the fire-underwriters, 
 owing to the possibility of short circuits through the metal 
 lining of the cabinet. This, however, may be obviated by the 
 employment of wood pulp sheeting or smooth surfaced as- 
 bestos sheets, placed in position and coated with white enamel 
 paint. (2) The interior shape of the cabinet should be such 
 as to throw the light generally towards the center of the 
 cabinet the space to be occupied by the patient. The 
 shape of the cabinet in the interior should therefore, par- 
 ticularly the upright type, be in the form of a hexagon or an 
 octagon. The character of the reflecting surfaces should be 
 preferably of white enamel paint or white porcelain, reflecting 
 mirrors adding very little of the real utility to the cabinet. 
 Parabolic reflectors of polished metal in position back of each 
 of the incandescent or arc lamps, if properly focused will 
 aid in directing the radiations towards the position of the pa- 
 tient in the cabinet. (3) The size of the cabinet should be 
 such that the individual lamps will be located at about 14 to 
 1 8 inches from the space to be occupied by the patient, in order 
 that the patient may not be apt to come against the sharp 
 points of the incandescent lamps, which may, however, be 
 placed at varying angles, preferably at an angle of 45, as 
 the greater luminosity is projected from this angle with the 
 ordinary incandescent bulbs ; whereas with specially constructed 
 bulbs, such as are used with the smaller hand-treatment lamps, 
 provided with parabolic reflectors, a larger amount of light is 
 projected in the line of the long axis of the lamp. 
 
 In hospitals and offices where invalids of all types are to 
 be treated a reclining bath possesses an advantage if high 
 temperatures are required, particularly in patients having im- 
 paired cardiac force, because with the patient reclining there 
 will be no danger of syncope during the administration ; where- 
 as in the upright cabinet the dangers of this sort will preclude 
 the use of the light bath with a large class of patients for which 
 its use is indicated. For the family light bath cabinet, how- 
 ever, in most instances, the upright cabinet would fulfill the 
 purpose. 
 
 The incandescent bath possesses the same advantage for thera- 
 peutic administration over the arc light that the large incan- 
 descent lamp does over the high candle power arc light, as pre- 
 viously stated ; because while it is rich in the penetrating lumi-
 
 36 RADIANT LIGHT AND HEAT 
 
 nous rays and heat radiations, it is devoid of the irritating 
 effects of the higher frequencies of the arc light, particularly 
 the ultra-violet, and also from emanations from the arc of 
 nitrous acid, the fumes of which are very irritating as they 
 
 Fig- 13- Author's Bath Cabinet. 
 
 escape from the cabinet or when the cabinet is opened 
 producing disagreeable irritation to the lungs and fauces of 
 the patient when the fumes are inhaled. 
 
 If the arc light is possessed of any advantage in therapeutics 
 over the incandescent for the treatment of any class of cases, 
 it resides in the fact that the reflex effect from the irritation
 
 SOURCES OF RADIANT ENERGY 
 
 37 
 
 of the skin by the ultra-violet radiations, or other action of 
 these radiations upon the skin, possess some particular advan- 
 tage in certain skin conditions. For the administration of 
 radiant light and heat for general tonic and metabolic effects, 
 
 Fig. 14. Betz Reclining Bath Cabinet. 
 
 the radiations having the higher frequencies filtered out are in 
 all instances to be preferred. 
 
 Special types of light bath cabinets have been constructed by 
 various manufacturers to meet the indications for the treat- 
 ment of most conditions. 
 
 The writer's bath cabinet shown in Fig. 13, was constructed 
 by E. B. Meyrowitz of New York and was designed to treat 
 patients in a recumbent position. The bath is provided with
 
 38 RADIANT LIGHT AND HEAT 
 
 60 sixteen candle power incandescent lamps, and with an open 
 work chair upon which the patient reclines. A door is placed 
 at the one end, and folding doors over the top, with an opening 
 for the protrusion of the patient's head at the opposite end. 
 
 The bath cabinet shown in Fig. 14 is manufactured by Frank 
 S. Betz of Chicago and has the advantage of a sliding table 
 
 Fig. 15. Kny-Scheerer Upright Bath Cabinet. 
 
 which permits the patient to be pushed into the bath and 
 withdrawn at the end of the treatment. The lights in this 
 bath are arranged on all sides and beneath, the patient reclining 
 upon the slatted sliding framework. 
 
 The upright bath cabinet shown in Fig. 15, is manufactured 
 by the Kny-Scheerer Co. of New York, and is constructed 
 for giving the treatment in an upright position. The bath is 
 provided with mirrors and a variety of colored bulbs, and is 
 exquisite in its details of construction.
 
 Plate II. Treatment with Small Bath Cabinet and 500 Candle Power 
 
 Lamp.
 
 SOURCES OF RADIANT ENERGY 39 
 
 Another type of bath cabinet has been manufactured by 
 Spear-Marshall Co. for the writer and consists of a portable 
 collapsible box, the sides of which are made of three thick- 
 nesses of veneer, and finished within with white enamel. One 
 end is notched out for the head of the patient. Over the cab- 
 inet is fitted, when the patient is in position, a glass window. 
 The object of this cabinet is to place it over a patient, who is 
 reclining for treatment upon a long operating table. It is very 
 convenient for use when space is an element to be considered, 
 and effective in administering a combined radiant light and 
 heat and convective heat bath by swinging the five hundred 
 candle power lamp over the window of the cabinet (see 
 Plate II).
 
 CHAPTER III 
 
 PHYSIOLOGICAL EFFECTS OF RADIANT LIGHT 
 AND HEAT 
 
 In the consideration of the indications for radiant energy 
 in therapeutics, a rational basis for its employment calls in 
 each class of conditions, for a consideration of the relation of 
 the physical properties of the agents to their physiological 
 effects upon the tissues. 
 
 The forms of radiant energy penetrate the tissues to vary- 
 ing depths producing direct physical effects, vibratory in 
 character, and secondary chemical, nutritional and reflex 
 nervous influences upon metabolism and the nervous mechan- 
 ism. When radiant energy impinges upon the tissues without 
 passing through, heat is evolved in the tissues so influenced, in 
 contrast to the Roentgen ray, which passes through the tissues 
 as light passes through the window pane, without the evolu- 
 tion of heat. 
 
 When heat is evolved at the periphery from the impinging 
 of radiant light and heat radiations, the effect is not only local 
 but general. A glow of warmth is transmitted throughout 
 the body by the heated blood stream, which also, when long 
 continued or extreme, awakens the activity of the excretory 
 channels through the sweat glands, and maintains the body 
 temperature at normal, through the cooling influence of 
 absorption by the latent heat of evaporation, thereby setting 
 up a complex influence upon metabolism, far-reaching in its 
 influences, especially so, when these processes so essential to 
 healthy existence are dormant. 
 
 It is not heat alone that influences metabolism, but the pene- 
 trating luminous rays, undoubtedly, act directly upon the blood 
 cells in the circulating streams, and this influence becomes 
 marked as the irradiated tissues become hyperemic under pro- 
 longed exposures, and in a short period of time the blood of 
 the whole body has been exposed to the oxidizing and steriliz- 
 
 40
 
 EFFECTS OF RADIANT LIGHT AND HEAT 41 
 
 ing influences of light. No prolonged local administration of 
 radiant light and heat can therefore be considered local, only; 
 for the effect is coincidently general and beneficial in all con- 
 ditions of impaired or perverted nutrition and poor metabolism. 
 
 The local influences of radiant light and heat from the usual 
 sources are undoubtedly due chiefly to the heat effects, very 
 similar effects being induced by convective heat as shown in 
 another chapter. 
 
 The hyperemia induced with the vasodilatation is undoubt- 
 edly the effect which exerts the greatest local influence 
 upon the two types of inflammation ; in the simple type relax- 
 jing_the. tissues, relieving tissue tension and pain; while in 
 infectious inflammation vascularization with relaxation and 
 softening permits a greater supply of fresh arterial blood to 
 invade the infected area carrying Nature's scavengers, the 
 phagocytes, under favorable influence of oxidation where 
 their presence is demanded. Where infection is present there 
 is the additional advantage from these radiations derived from 
 the destructive or, at least, inhibitive action of radiant light 
 and heat upon the germs walled in, in the field of infection. 
 
 Clinical experience, in this connection, justifies the assump- 
 tion that radiant and convective heat and radiant light, to 
 which the higher, less penetrating frequencies are not essential, 
 increase most favorably local phagocytosis and coincidently 
 render the germs inert; a combination of circumstances al- 
 ways effective when employed with energy in the first days of 
 superficial infectious processes, and advancing recovery at any 
 stage. 
 
 It has to all intents been demonstrated by Neils Finsen that 
 when the tissues are rendered anemic during exposure to 
 ultra-violet radiations, their action is destructive superficially 
 to germ life. It was the object of Finsen and his cotem- 
 poraries, however, to carry the exposure to the extent of 
 reaction ; in other words, to the extent of profound hyperemia 
 which, in the light of effects produced in the treatment of 
 infection under conditions of hyperemia, would indicate an im- 
 portant part as played by such tissue engorgement. On 
 the other hand, the best results were obtained when the tissues 
 were rendered anemic during treatment, manifestly due to 
 the antigermicidal action of the ultra-violet radiations. The 
 final result is undoubtedly due to a combination of the two
 
 42 RADIANT LIGHT AND HEAT 
 
 effects, germicidal and the induction of the increased local 
 phagocytosis of hyperemia. 
 
 It will be observed, therefore, in the treatment of all local or 
 constitutional conditions by radiant light and heat radiations, 
 that the effects are due to the same physiological effects, which 
 may be summarized as follows : 
 
 /. The effects upon metabolism, local and general, are due 
 to (i) the induction of increased local activity of elimination 
 and tissue building; (2) diffusion of heat throughout the body 
 by the channels of circulation; (3) the increased general 
 perspiration induced by general diffusion of heat, when ex- 
 posures are extensive and prolonged; (4) incr eased.- oxidation 
 from heat induced, and the local action of radiant light upon 
 the blood in the dilated capillaries; and (5) the effects upon 
 the remote spinal centers due to peripheral stimulation of the 
 end neurons by heat and light radiations. 
 
 II. The effects upon simple inflammation, unaccompanied by 
 infection, is (i) to induce general tissue relaxations with 
 relief of pressure and pain; (2) by increasing local metabolism 
 and elimination to relieve the tissues of the irritating products 
 of defective metabolism as present in conditions associated 
 with myalgias, infectious arthritis, eczema, and similar con- 
 ditions; and (3) in conditions of mild traumatic injury, 
 treated promptly after injury, to remove early stasis and cure 
 the condition, but is ineffective after stasis with induration is 
 established. 
 
 ///. In acute and subacute infectious conditions alone, or in 
 connection with other measures which inhibit germ processes 
 or increase local hyperemia or both, (i) it increases local 
 hyperemia in the region of infection with a relative increase 
 of leucocytes the phagocytes; (2) it inhibits the activity of 
 the germs through the intensity of the radiant light and heat 
 radiations, and (3) it stimulates the elimination of toxic 
 materials, local and diffused, by the induction of perspiration 
 and increase of tissue oxidation. 
 
 By these means local phagocytosis is stimulated, the germs 
 inhibited and devoured and the toxic material eliminated. 
 
 IV. Derivative effects are induced when extensive exposures 
 are made, rendering the surface hyperemic by prolonged ap- 
 plications of high candle power incandescent lamps over front, 
 back, and sides, or by the arc or incandescent light bath and
 
 EFFECTS OF RADIANT LIGHT AND HEAT 43 
 
 by the coincident profuse perspiration induced; (i) lessening 
 the quantity of blood in congested regions and the larger ar- 
 teries and veins; (2) lowering arterial tension; (3) relieving 
 an overworked heart; and (4) coincidently promoting ex- 
 tensive elimination of the locked up products of poor 
 metabolism.
 
 CHAPTER IV 
 
 OF 
 
 Success or failure in the employment of radiant energy, de- 
 pends upon the attention to proper technic as to method, fre- 
 quency, and duration of treatment. To succeed with any 
 physical agent in therapeutics depends invariably upon the 
 principles of treatment employed, comparisons of results de- 
 pending as much upon the men employing them and the 
 methods employed as upon the diagnosis of the condition. No 
 physician who will not pay strict attention to the requirements 
 of every case, with intelligent recognition of the requirements 
 of each case, can expect to succeed with the application of 
 radiant energy, or any other physical or other agent. Success 
 here as in most things will depend upon the judgment as to 
 choice of modality, and the knowledge and conscience of the 
 physician in charge. No negligent nor heedless person can 
 obtain creditable results from physical measures. The self- 
 indulgent physician may succeed in some cases with placebos 
 and suggestion, but in the cases that can be cured by physical 
 agents only, an anatomical knowledge and the mechanical 
 sense of the surgeon, together with a willingness to devote the 
 requisite time, technique, and energy to every case, are 
 prerequisites. 
 
 Local administrations of light should be employed with the 
 primary idea of inducing local hyperemia, the degree, extent, 
 and frequency of application to depend upon the requirements 
 of the condition under treatment; acute inflammatory affec- 
 tions demanding frequent energetic localized applications, par- 
 ticularly in infectious cases two to four treatments daily be- 
 ing essential, as in acute otitis media. 
 
 For the local employment with a view to relieving local 
 inflammation the effects of the radiations from the incandescent 
 lamps are generally to be preferred to the electric arc; (i) 
 because the intense very superficial hyperemia induced by the 
 higher frequencies of the arc light which are filtered out by 
 
 44
 
 Plate III. Method of Treatment with 500 Candle Power Leucodescent 
 
 Lamp.
 
 PRACTICAL METHODS OF APPLICATION 45 
 
 the glass of the incandescent bulb, induce tanning, interfering 
 with the efficiency of subsequent applications, and, (2) be- 
 cause the risk of injury to the superficies from the higher fre- 
 quencies, does not permit of prolonged application of the pene- 
 trating luminous rays and infra-red or heat radiations, from 
 which the greater benefit is derived. 
 
 The hyperemia of the ultra-violet radiations is superficial 
 and intensely irritating, while the hyperemia of the other fre- 
 quencies is diffused and not irritating, with an added greater 
 and unquestioned beneficial effect upon local and general 
 metabolism. 
 
 The choice of lamps as to candle power will depend upon 
 the extent of the local lesion and the indication for general as 
 well as local treatment. 
 
 To circumscribed areas, as about the head and face, or 
 furuncles or carbuncles, the small lamps with parabolic re- 
 flector (see Figs, n and 12) answer every purpose. When, 
 however, larger areas are to be treated, or when general as 
 well as local treatment is indicated, lamps of high candle 
 power, preferably those which do not focus all of the rays, are 
 to be employed. 
 
 For general or constitutional treatment, the lamps of high 
 candle power which project practically parallel rays or rays 
 crossing in various directions are only to be considered, for 
 otherwise either time .or thoroughness are compromised, or 
 both. 
 
 The method of local administration in all cases as stated 
 elsewhere is best effected with the suspended or swinging 
 lamp, which can be brought close to the bared surface of the 
 body and moved rapidly to and fro, until the surface is 
 actively hyperemic. During the application the disengaged 
 hand of the operator or the hands of the patient may be moved 
 occasionally, in close contact, over the surface, thereby pro- 
 ducing a remarkable cooling effect to the surface, and per- 
 mitting more intense administrations. 
 
 The hand of the operator who constantly employs high 
 candle power lamps, which is passed over the body of the 
 patient, should be covered with a glove or towel. 
 
 The duration of the application: Either local or general 
 treatment should be continued for some time after the first 
 flush of hyperemia appears. In general treatment of the
 
 46 RADIANT LIGHT AND HEAT 
 
 trunk this is important, because a necessary degree of in- 
 fluence is not induced upon the circulating blood until a fair 
 measure of hyperemia is present. In local inflammation of 
 either type, it is important to carry the induction of local 
 hyperemia to a greater degree of intensity than for general or 
 constitutional effects. 
 
 Dermatitis or blistering is rarely effected by the radiant 
 light and heat radiations from the incandescent light, nor from 
 the incandescent light or the arc radiations passed through 
 glass screens. When they do occur, however, as they may 
 occur in very susceptible individuals (cases which are rare), 
 the effect is transitory and should be treated as an ordinary 
 burn; whereas, for the treatment of Roentgen ray dermatitis, 
 no agency is so generally efficient as applications of radiant 
 light and heat the two conditions arising from opposite 
 causes one from excess of stimulation and the other from 
 excess of inhibition. 
 
 The local Fins en method for local treatment of lupus and 
 epithelioma, consists of the application of the ultra-violet 
 radiation passed through focusing rock crystal lenses or rays 
 focused by a parabolic reflector and then passed through plane 
 lenses of rock crystal, with the lens or an outer compression 
 lens pressing against the surface of the tissues irradiated, the 
 pressure being employed for the purpose of rendering the 
 tissues anemic. 
 
 Adrenalin applied to ulcerated surfaces to which it is impos- 
 sible to exert pressure, as in the nose, has proved a valuable 
 accessory. 
 
 The method of Finsen has been generally superceded, par- 
 ticularly in America, by the more satisfactory employment of 
 the x-ray combined with static and high frequency applications, 
 or the more recent employment of EMuvation as instituted by 
 Riviere of Paris and later reported by Keating Hart under the 
 term Fulguration. 
 
 General or constitutional treatment for effects upon 
 metabolism may be administered either with the high power 
 incandescent lamp, the patient reclining or in the light bath. 
 
 General treatment with the high candle power incandescent 
 lamp is administered to the trunk, by application first to 
 one part of the surface and then to another, swinging the 
 lamp back and forth lengthwise over the body until the sur-
 
 a 
 
 3 
 
 c 
 a 

 
 PRACTICAL METHODS OF APPLICATION 47 
 
 face is more or less hyperemic, after which the patient is 
 thoroughly wiped off, dried, and dressed for vibration, which 
 should follow, being administered in a systematic manner on 
 the same table, to be followed in a well-regulated institution 
 with an administration of the wave current with a large metal 
 electrode over the abdomen or some other place indicated. 
 Each of these procedures favorably influences general and 
 local metabolism, acting as congeners in impaired constitu- 
 tional states, and coincidently in trained hands meeting local 
 indications as well. 
 
 The light bath administered to the patient, seated or lying 
 in the cabinet, is employed for its effects upon general 
 metabolism, and if it possesses any advantage over the method 
 described by use of the high c. p. lamps, it is due to the fact 
 that a greater degree of perspiration is induced owing to the 
 accumulation of a high temperature within the cabinet, and 
 that the limbs as well as the trunk are exposed to the radia- 
 tions. In administering light baths it is usually customary for 
 the head to protrude from the top or one side of the cabinet. 
 (See Plate VI, page 76.) 
 
 The duration and after treatment will vary with patients 
 and conditions. When profuse elimination is sought, thorough 
 stimulation of the sweat glands is indicated. The exposure 
 should be prolonged to 30 or 40 minutes after which the 
 patient may remain in the cabinet for a longer period or 
 be removed to a couch and rolled in blankets and allowed to 
 perspire for half an hour longer, after which he may be given 
 a tepid shower bath gradually lowered to 60 R, and followed 
 by a rub and mechanical vibration (general), and a static 
 wave current treatment during rest. Instead of the shower 
 an alcohol rub, vibration and static may be administered. 
 
 The treatment by vibration when scientifically administered 
 is for many reasons superior to manual massage. The addition 
 of the static treatment with a metal electrode applied over an 
 enlarged or congested part as indicated is beneficial in all cases 
 and should replace the period devoted to rest, exhilarating as it 
 does the patient with its tonic influence. 
 
 With feeble patients or atonic conditions, the time devoted 
 to the bath should not be prolonged beyond twenty minutes, 
 and always followed when possible by vibration and static 
 or auto-condensation treatment. When the static is not at
 
 48 RADIANT LIGHT AND HEAT 
 
 hand, and the auto-condensation high frequency current can 
 be administered, it is indicated except in failing heart con- 
 ditions and parenchymatous nephritis, in which high tension 
 which is compensatory would be lowered by auto-condensa- 
 tion. 
 
 In conditions of plethora or otherwise abnormally high 
 tension, associated with auto-intoxication, auto-condensation 
 should constitute a routine part of the treatment. 
 
 Light baths or local high c.p. incandescent light treatments 
 may be administered daily or on alternate days according to 
 indications. 
 
 During administrations the pulse and temperature should 
 be watched and treatment should be discontinued when tem- 
 perature reaches ioo^ F., or the pulse becomes weak, rapid 
 or irregular. Water may be given ad libitum throughout and 
 after treatment, except in conditions of edema, where it is de- 
 sirable to induce absorption of the serous effusion. It is cus- 
 tomary and agreeable to the patient to cover the head with a 
 moist towel, kept cool by frequently wringing it from a vessel 
 of cool water.
 
 CHAPTER V 
 TREATMENT OF SIMPLE INFLAMMATION 
 
 A classification of inflammatory conditions not characterized 
 by the presence of some germ, either as a causative or conse- 
 quent element, is often difficult. Conditions, however, arising 
 from trauma or other accidents, as thrombosis or embolism, or 
 as a result of faulty metabolism, or chemical or climatic 
 causes, may be properly included in that category. So also 
 may be considered some post-operative surgical conditions. 
 
 To consider the therapeutics of various conditions from the 
 point of view of employment of one modality, as of light, 
 would be misleading; it will therefore be considered proper to 
 incidentally refer to other measures when treating of the ap- 
 plications of light to special conditions. 
 
 Conditions arising from defective or perverted metabolism 
 as the myalgias, inactive secretions, and secondarily of arterio- 
 sclerosis, and perverted conditions associated with a vicious 
 circle as with the reflex o_r functional neuroses are remarkably 
 benefited by either local or general administrations of light. 
 
 With simple inflammation in contradistinction to infection, 
 the curative effects of radiant energy will depend upon the ex- 
 tent and site of the lesion, as well as upon its chronicity. In- 
 juries arising from superficial trauma, as wounds or sprains, 
 of small joints, when treated early, may be largely relieved by 
 the energetic application of radiant light and heat ; whereas, in 
 the treatment under similar conditions of large joints or deep- 
 seated injuries, it will be quite inadequate in any event; as 
 also in the treatment of inflammation in which stasis is fairly 
 extensive and well established. It is absolutely useless to ex- 
 pect to relieve established stasis by treatment with this form 
 of energy. For the relief of regions of local stasis, those who 
 are familiar with their action and use, turn, naturally, to the 
 static currents, which by throwing the involved tissues into 
 activity, by the induction in them of rapid contraction and 
 vibration, alternating with intervals of rest, which force out 
 the infiltration, induce active metabolism and restore the lym- 
 
 49
 
 50 RADIANT LIGHT AND HEAT 
 
 phatic and blood circulation by pressing open the venous and 
 lymphatic channels. 
 
 Pain is relieved by the application of radiant light and heat 
 energy in regions of local inflammation on account of the in- 
 duced relaxation of the tissues, the increased elasticity induced, 
 relieving the pressure upon the nerve filaments, which is un- 
 doubtedly due largely to the effect of the radiant heat, as the 
 same effects are derived to a less degree by applications of 
 convective heat. This relief of pain should not delude any one 
 into expecting to effect the cure of an inflammatory process in 
 which stasis is once established for the effect is transitory, not 
 curative. So in the treatment of sciatica, brachial neuritis, or 
 severe sprains, excepting in the earlier stage of the affection, 
 it is useless to expect to afford more than temporary relief from 
 the administrations of radiant energy, whereas the employment 
 of the static electrical currents insures prompt relief and the 
 ultimate cure of these conditions, when accessible; i. e., when 
 not within the chest or pelvis. Radiant light and heat, how- 
 ever, in connection with the static currents, are useful in the 
 treatment of the forms of neuritis and joint inflammations, but 
 must be employed in all cases, if at all, before the static cur- 
 rent is applied, for the purpose of improving impaired local 
 metabolism and nutrition in the tissues involved on account of 
 the lowered function of the local nervous mechanism. Ap- 
 plied in these conditions it affords temporary relief from pain, 
 but is not instrumental in removing the bete noire of simple in- 
 flammation inflammatory stasis; its only function being to 
 prevent inflammation at the outset ; but when once established, 
 radiant light and heat are absolutely impotent. When applied 
 after static treatment, radiant light and heat relax again the 
 tissues rendered tonic at the site of the lesion where accumu- 
 lated infiltration, which is causing pain by pressure, has been 
 forced out by the contraction induced in the tissues by the 
 current. 
 
 Post-operative use of radiant light and heat employed im- 
 mediately over the site of the operation is valuable from three 
 points of view: (i) relief of pain; (2) the prevention of scar 
 tissue in the line of sutures; and (3) the induction of active 
 hyperemia which promotes nutrition, and, by the local 
 increased presence of phagocytes in the region involved, les- 
 sens the possibility of local infection.
 
 TREATMENT OF SIMPLE INFLAMMATION 51 
 
 The same principle applies to the treatment of sites of local 
 operation as well as of recent wounds and injuries, and for the 
 same reasons. In myalgias, muscular sprains, and local areas 
 of pelvic tenderness and pain, the beneficial effects of light and 
 heat radiations will depend mostly upon relief of disturbances 
 of metabolism or its effects upon the presence of local infection. 
 
 The method of treatment of simple inflammation, as well as 
 of the infectious type of inflammation, consists in the localized 
 application of light either from a small hand lamp of 50 to 100 
 candle power when the affection is slight, or the employment of 
 a lamp of higher candle power for constitutional treatment or 
 over large areas. In the treatment with light under these 
 conditions, the application should be made at a distance that 
 will give as high a temperature as the patient can withstand. 
 The disengaged hand of the operator or the hand of the patient, 
 when frequently passed over in contact with the surface dur- 
 ing the administration of radiant light and heat, affords tempo- 
 rary relief, making it possible to keep up the treatment more 
 energetically than otherwise. In applying radiant light and 
 heat, the application should not be made with the lamp in a 
 fixed position, but by_ constantly moving it about or swinging it 
 to and fro over the involved area. The light should be em- 
 ployed in this manner for two reasons, (i) As great a degree 
 of temperature cannot be applied persistently as interruptedly, 
 and (2) because administered interruptedly, waves of contrac- 
 tion are induced in the tissues in response to the stimulating 
 effect of the intense heat, and in the interval before the sub- 
 sequent application there is a relative relaxation. The stimu- 
 lation to contraction and intervening release, operates to a de- 
 gree in the same manner with the alternate contraction and re- 
 laxation, occurring with the application of the static wave cur- 
 rent, and so effects to a less degree the relief of local inflam- 
 mation and stasis by tissue drainage. 
 
 The myalgias arise undoubtedly from the effects of defec- 
 tive metabolism under conditions of exposure to cold, draughts 
 or wetting of the clothing; and are liable to arise after 
 fatigue in those of inactive pursuits, particularly in the debil- 
 itated. Under the drug regime they are prone to become 
 chronic, the soreness and stiffness often persisting with ex- 
 acerbations for years. The affection is confined to no set or 
 group of muscles, but is probably most common in the regions
 
 52 RADIANT LIGHT AND HEAT 
 
 of moderate, not of greatest activity, as the back and neck 
 lumbago and torticollis. 
 
 Muscular soreness in the limbs of the active soon disappears, 
 due to the effect of such activity upon metabolism, and for 
 the same reason they are less apt to be affected, whereas 
 the dense less active muscles of the back are most apt to be 
 involved the regions of lesser activity. Lumbago and torti- 
 collis are the most common of the myalgias. 
 
 Lumbago, the type under consideration, should not be con- 
 fused with a type of lumbar arthritis arising from sprain or 
 traumatic injury of the spine. 
 
 While in acute myalgias radiant light and heat energetically 
 applied are remarkably efficacious, in the chronic or more severe 
 forms they do not compare with twenty-minute applications of 
 the static wave current with an energy just short of inducing 
 muscular contraction, followed by a few well-directed static 
 sparks. Everyone who has become familiar with the use of 
 static electricity has had success from the employment of the 
 static methods. When used in association with static applica- 
 tions, as in other inflammatory conditions, the light should 
 always precede the static treatment for reasons elsewhere 
 given. 
 
 Various writers have reported results from the employment 
 of light in lumbago. 
 
 Delvers reports a case of lumbago of two weeks' standing 
 cured by the daily treatment of fifteen minutes each with a 
 high c.p. incandescent lamp. 
 
 Russels of Chicago reports a case in a patient sixty years 
 of age, of ten years' standing, as cured by sixteen fifteen- 
 minute treatments. The treatments were given daily for six 
 days and afterwards twice weekly. The radiant light and 
 heat was administered with a high c. p. incandescent lamp, held 
 as close as it could be borne. Four months later there had 
 been no relapse. This patient also observed that without 
 other treatment his bowels, which had been constipated, became 
 regular after the sixth treatment.
 
 CHAPTER VI 
 
 RADIANT ENERGY IN THE TREATMENT OF IN- 
 FECTIOUS PROCESSES 
 
 The greater field of usefulness of radiant light and heat 
 energy is found in its remarkable potency when associated with 
 its congeners the x-ray, high frequency currents, and con- 
 vective heat in the treatment of infectious inflammation. 
 
 The attention being paid at this time to the subject of 
 hyperemia, as influencing inflammatory conditions, has until 
 recently ignored the important fact that local phagocytosis is 
 the important effect, to which the writer called attention edi- 
 torially in THE JOURNAL OF ADVANCED THERAPEUTICS for 
 March, 1907. 
 
 Probably no investigation of recent days has been so full of 
 significance and so fruitful of a revolutionary procedure as the 
 treatment of local and general infections. The work of 
 Wright in the discussion of opsonic indices of resistance, has 
 opened up a new point of view in connection with the all but es- 
 tablished theories of Metchnikoff of phagocytosis. 
 
 The fact that a region is rendered intensely hyperemic by 
 the application of an agency which brings into the field of in- 
 fection an increased influx of fresh arterial blood, rich in 
 phagocytes, favoring a positive chemotaxis, as previously sug- 
 gested by the writer, establishes rationally the indication of 
 such measures as accomplish that effect for the treatment of all 
 types of local infection. If an increased influx of blood were 
 associated with a coincident relief of the induration which 
 walled in an advanced infection, the employment of measures 
 which induce local hyperemia would be involved in an ele- 
 ment of danger, lest the infection might thereby be dissemi- 
 nated. In the relaxation of tissue which does occur, however, 
 there is sufficient influx of fresh blood to the seat of the in- 
 fection, carrying with it fresh phagocytes, to destroy the germs 
 in an infectious process without the danger of extending the 
 infection. 
 
 The means at present in vogue by the votaries of the meth- 
 
 53
 
 54 RADIANT LIGHT AND HEAT 
 
 ods of Bier, are fraught with elements of defect not found in 
 the relief of local infection by the x-ray, light and the high 
 frequency currents. Their errors reside in the facts, that (i) 
 powerful suction produces a degree of mechanical injury to the 
 local area, and (2) because the method by bandaging, cutting 
 off the return venous circulation and preventing a normal in- 
 flux of arterial blood, creating a deficiency of oxygen in the 
 tissues, does not favor positive chemotaxis; because of the 
 venous stasis induced. Whereas in the employment of radi- 
 ant light and heat, two effects are produced unfavorable to 
 the germs in the localized area, the tendency of which is op- 
 sonic : ( i ) the actinic action of light is adverse to the activity 
 and energies of many types of bacteria, and (2) that the germs 
 which exist upon the human body develop most favorably at 
 the body temperature of 98.4, and are inhibited by the energetic 
 application of radiant light and heat, while the blood stream, 
 which is passing in and out of the area, is cooled at the peri- 
 phery, returning constantly in a fresh stream to the site of 
 involvement, thereby giving advantage to the phagocytes with 
 adverse conditions exerted upon the elements of infection in 
 effect opsonic. It is furthermore probable that under the ap- 
 plications of radiant light and heat the phagocytes are more 
 active in their war upon the bacteria. 
 
 It is already a well-demonstrated fact now that these 
 theories as to the action of radiant light and heat upon the 
 germs and phagocytes are correct; or that if not for the 
 reasons given, they are for some other reasons; for clinically 
 the effect upon local infection of these applications is that 
 such processes do yield to the combined application of radiant 
 light and heat, convective heat and the high frequency cur- 
 rents, all of which induce intense local hyperemia, and that the 
 promptness and energy with which the effects are obtained are 
 accentuated by the previous applications of the Roentgen ray, 
 which probably is due to the fact that the ray sterilizes or in- 
 hibits the activity of the germs localized in the area of infec- 
 tion, while the elements of the blood which are shielded, ex- 
 cept as they pass rapidly across the field of irradiation, are 
 not adversely affected by the Roentgen ray. 
 
 It is the writer's practice in the treatment of infectious con- 
 ditions, to make a prolonged twenty to thirty minute ex- 
 posure to the Roentgen ray, making use of the energy usually
 
 TREATMENT OF INFECTIOUS PROCESSES 55 
 
 employed in the treatment of skin diseases for the purpose of 
 inhibiting the activity of the germs and then permitting an in- 
 terval of twelve to eighteen hours before the administration of 
 the radiant light and heat, or high frequency current or both. 
 The germs thus brought into a state of complete inhibition, in- 
 creased by the delay, are so affected that the phagocytes 
 brought fresh into the area, and in larger numbers, with the 
 hyperemia induced by the radiant energy, devour them with 
 a greater certainty. By this method it is possible to abort any 
 accessible pus process prior to fluctuation. 
 
 Specialised employment of radiant energy offers a means 
 in therapeutics especially valuable in the treatment of infectious 
 processes, tubercular, gonorrheal, streptococcic, or staphylo- 
 coccic; in fact, in all germ processes in which a local activity 
 of the phagocytes is capable of destroying the infection. The 
 possibilities of success or number or frequency of exposures 
 will vary with the relative opsonic index of the individual un- 
 der treatment. An important principle in the treatment by 
 hyperemia resides in the internal resistance of the subject or 
 patient the capacity of the leucocyte to seize upon more or less 
 of the germs in the field of infection. It is an important ques- 
 tion whether a greater number of leucocytes caused to enter the 
 field of infection, while each consuming a smaller number of 
 germs, may not accomplish the same ultimate result as a smaller 
 number of leucocytes under a higher index, or whether agents 
 which inhibit the activity of the germs, as the x-ray, radiant 
 light and heat, and the high frequency currents, by increasing 
 hyperemia, do not coincidently inhibit or lower the activity or 
 resistance of the germs whereby their destruction is facilitated 
 under any condition. 
 
 Clinically the writer has demonstrated the truth of each of 
 these propositions, to the extent that it can be confidently as- 
 serted: That in all infectious conditions susceptible to the 
 leucocytic influence, at the proper stage, and in regions acces- 
 sible to measures which induce intense local hyperemia, under 
 conditions of positive chemotaxis, it is possible under favor- 
 able conditions to abort such processes by destruction of the 
 cause. 
 
 No agent of equal intensity is more powerful in contributing 
 the three most important elements favorable to the induction 
 and natural effects of local phagocytosis than radiant light and
 
 $6 RADIANT LIGHT AND HEAT 
 
 heat ; and for such favorable action the ultra violet frequencies 
 are not important; viz., (i) the inhibition of germ life, (2) 
 the induction of local hyperemia, and (3) increased presence 
 of oxygen favoring a positive chemotaxis. The high fre- 
 quency current produces a deeper, more intense, and more 
 persistent hyperemia, and an inhibitory influence of different 
 character and capacity, but probably farther reaching under 
 favorable conditions, as when the d r Arsonval current is passed 
 through the tissues between two electrodes, but is deficient in 
 the important heat radiations. 
 
 The action and uses of the three forms of radiant energy 
 included, may be summarized as follows : 
 
 I. The action of the Roentgen ray upon germ life is inhibi- 
 tory; probably not directly destructive, but by rendering the 
 microbes inert and checking their propagation, they become an 
 easy prey to the phagocytes. To derive the maximum effect 
 from the x-ray in conjunction with other agents an interval 
 of 12 to 24 hours should intervene, following a massive dose 
 of 10 to 25 minutes according to the volume of radiations. 
 With the ordinary static machine of twelve revolving plates 
 making 400 to 500 revolutions per minute, the exposure for a 
 massive dose should be of 25 minutes duration. Employed in 
 this manner the x-ray adds to the efficiency of the means which 
 induce local hyperemia, in the treatment of infectious con- 
 ditions. 
 
 //. The action of radiant light and heat as previously stated 
 is (i) to induce active hyperemia; (2) to increase local oxida- 
 tion with the induction of positive chemotaxis, and (3) to 
 inhibit or exhaust walled-in germ processes, while the constant 
 influx of cooled blood into the field through the relaxed walls 
 brings leucocytes fresh for the fray. 
 
 ///. High frequency currents (i) produce profound local 
 hyperemia; and (2) undoubted actinic and other antiseptic 
 effects adverse to germ life. 
 
 In cystitis, and the deeper-seated pus processes, the em- 
 ploymenTof the x-ray should be persisted in with 10 minute ex- 
 posures on alternate days until the pus has entirely disappeared 
 from the urine. These observations are based upon a series of 
 clinical results by the writer in the treatment of carbuncles, 
 felons, furuncles, cystitis, and other septic infections, without 
 an unsatisfactory result during a period of five years.
 
 TREATMENT OF INFECTIOUS PROCESSES 57 
 
 It can be truly said that in the applications of radiant light 
 and heat, the x-ray, and high frequency currents we possess 
 the greatest means for coping with a large class of infectious 
 conditions, particularly the streptococcic and staphylococcic 
 infections. We have reason to believe that the same rule ap- 
 plies equally to tuberculosis and gonorrhea, and to a greater 
 or less degree in all other types of inflammation arising from 
 infectious causes. It is a subject fraught with the greatest 
 possibilities and deserving immediate serious investigation, and 
 general adoption. 
 
 The three agents may be considered congeners in infections, 
 and while each when used alone may succeed in selected cases, 
 their combined use in the treatment of most infected conditions, 
 when skillfully managed, is most effective. 
 
 It is impossible to consider the treatment of any class of 
 conditions intelligently with the use of one modality, for though 
 in selected cases it may prove efficient, in others another 
 modality or combination may be required. So in a treatise on 
 radiant energy, or any other subject, when the therapeutics is 
 considered, the indication and use of congeners and antagonists 
 of the agent under consideration should be included. 
 
 Otitis media, either the acute or chronic form, is a condition 
 which under the ancien- regime and even in the hands of many 
 modern otologists has too often been left with the possible 
 paracentesis to the further working of the vis medicatrix 
 natures. 
 
 No greater mistake can be made than to fall into this error, 
 when in the light of known possibilities the condition can always 
 be aborted in the early stage and cut short in any stage. 
 
 The indication is to inhibit the pyogenic bacteria and destroy 
 them by the induction of an intense local hyperemia in the field 
 of infection. 
 
 Treatment. Radiant light and heat and to a less degree con- 
 vective heat are eminently successful in meeting both indica- 
 tions. Applications of radiant energy from either the smaller 
 lamps of 50 c. p. are made as near the surface as can be borne, 
 or with lamps of higher c. p. for 15 to 20 minutes or longer if 
 pain is not relieved, every 3 to 12 hours according to severity, 
 the recurrence of pain being the indication for repetition of 
 treatment. When convective heat is employed the heat should 
 be maintained at as high a temperature as can be borne, for
 
 58 RADIANT LIGHT AND HEAT 
 
 from three to five hours consecutively, and repeated for a like 
 period if there is any recurrence of the pain. Radiant light 
 and heat application is the method to elect, convective heat 
 being only permissible in lieu of the preferred method not being 
 at hand. 
 
 In chronic otitis media, frequent short exposures of the 
 x-ray may be made on every second day for ten minutes, alter- 
 nated with radiant light and heat for half an hour to an hour, 
 or a more approved plan is to make one exposure of the x-ray 
 for 20 minutes, followed after 18 to 24 hours by prolonged in- 
 tense daily treatments with radiant light and heat until the dis- 
 charge of pus ceases. Except there are necrotic ossicles this plan 
 of treatment will effect a cure in most chronic cases within three 
 weeks. The additional application of high frequency currents 
 over the mastoid and in front of the tragus will hasten the 
 recovery in severe cases. 
 
 Mastoiditis. The same plan of treatment, including the 
 application of the x-ray as described above, will in the early 
 stage abort this distressing condition, as has been demonstrated 
 in the writer's experience and that of others, as the following 
 cases attest. 
 
 Dr. T., dentist, came under observation after having had an 
 otitis media for three months with no sign of abatement. She 
 came under treatment with the consent of the aurist under 
 whose care she had been on account of her desire to go abroad 
 in five weeks, and having no assurance that other treatment 
 would relieve the condition. On the day that she applied for 
 treatment she had forcibly injected water into the middle ear 
 and came the following day with a developed mastoiditis, with 
 pain and marked tenderness over the mastoid, and the outer ear 
 standing out in the characteristic manner. Having employed 
 the x-ray for 20 minutes on the first day, on the next day, when 
 she came with the mastoid involvement, light from a high candle 
 power incandescent lamp was administered for about 30 
 minutes, until an intense general hyperemia was induced over 
 the region, followed by a 15 minute application of the high fre- 
 quency current with a glass vacuum tube. This application 
 was made twice daily for three days when the mastoid com- 
 plication had entirely subsided, improving from the first applica- 
 tion. Treatment was continued daily for three weeks in the 
 same manner when the discharge of pus had ceased and she was
 
 TREATMENT OF INFECTIOUS PROCESSES 59 
 
 pronounced cured by her previous attendant, who by letter com- 
 mended the method and result, acknowledging that both a mas- 
 toiditis and the otitis media had been cured. 
 
 The following cases were reported by Dr. Herbert F. Pitcher 
 of Haverhill, Mass.* 
 
 " A case of mastoiditis was cured in five treatments. This 
 case, a woman, thirty-six years of age, had been treated a week 
 by the usual remedies before I saw her. She complained of 
 very severe pain in and around the ear and mastoid, with 
 tenderness on pressure and pain on percussion over the mastoid 
 bone. The membrana tympani was red and inflamed, and 
 temperature 100.2 F., without chill. 
 
 " Application of strong light was made over the mastoid, in 
 and around ear, side of the face, head, and neck of affected side 
 for fifteen minutes. She returned next day with a report of a 
 good night's rest, but some pain yet. Another application, the 
 same as before, was made. The patient said there was abso- 
 lutely no pain when she left the office, and there was no pain 
 whatever after that. She received three more applications with 
 complete subsidence of the inflammation, and there has been no 
 trouble since. 
 
 " A man, sixty-three years of age, weighing 240 pounds, had 
 the grippe, followed by severe pain in right side of his head and 
 ear for three weeks. The last week the pain was so severe he 
 could neither sleep nor eat. When I saw him he was a wreck. 
 There was a profuse purulent discharge from the ear, the 
 membrana tympani was ruptured, and the typical conditions 
 with the symptoms of acute purulent otitis media. After 
 thorough cleansing of the canal I applied the light for fifteen 
 minutes to the painful side of the head and neck, and into the 
 orifice of the external meatus. 
 
 " The patient returned next day saying that he had had the 
 first good night's rest for three weeks. He received six treat- 
 ments with the result that pain and inflammation have entirely 
 subsided, discharge ceased, and the patient was feeling as well 
 as usual. There has been no return of ear trouble. 
 
 " I could enumerate many cases of like conditions and re- 
 sults. It is a source of great satisfaction to me to be able to 
 
 * Phototherapy in General Practice, ADVANCED THERAPEUTICS, June, 
 1906.
 
 60 RADIANT LIGHT AND HEAT 
 
 relieve and even cure poor suffering humanity of a disease at 
 once so painful and possibly dangerous to the loss of hearing 
 and even life itself. 
 
 " I do not contend that it will cure all cases of severe in- 
 flammation of the middle ear or where the mastoid has become 
 affected, needing operative relief. But if the light could be 
 used in the early stages it would abort the inflammatory condi- 
 tions in most cases." 
 
 Carbuncles, furuncles, felons, suppurative tonsilitis, and all 
 abscess processes in the early stages are promptly aborted by 
 essentially the same procedures as that employed in the treat-' 
 ment of otitis media, and after evacuation when the presence 
 of fluctuation indicates it, or after evacuation by the natural 
 method, no means is so effective in restoring the conditions to 
 normal and removing all latent infection which might otherwise 
 terminate by extension of infection in a series of abscesses or 
 furuncles, as radiant energy, light, heat, the Roentgen ray and 
 high frequency current systematically employed. 
 
 Another method, however, may be indicated in the first 36 
 hours of pyogenic infections, i. e., to follow a prolonged applica- 
 tion of radiant energy with a ten minute administration of 
 direct static vacuum tube current (employing the same connec- 
 tions with the vacuum tube as with the metal electrode with 
 the wave current) directly to the indurated area. By the 
 effect of this method the induration is dissipated and the 
 phagocytes get at the germs and destroy them when the extent of 
 infection is small. The danger of this method is in letting out 
 the infection when the local resistance or phagocytosis is not 
 sufficient to overpower the vicious element, which is small 
 indeed in the early stage. 
 
 The results are so uniformly successful by these methods, 
 that in but rare instances, and under exceptional conditions, 
 is failure possible, where the technique is properly carried 
 out. 
 
 Tubercular arthritis, treated with the x-ray and high 
 frequency currents in accord with the rationale enunciated, is 
 remarkably relieved. When actual destruction of parts of 
 the joint structure has not taken place, the prognosis from 
 energetic treatment along the lines described, together with 
 liberal judicious diet and approved general regime is good, 
 and the chance of benefit in all cases is assured.
 
 TREATMENT OF INFECTIOUS PROCESSES 61 
 
 In tubercular adenitis the same regime and general prognosis 
 obtains. The writer's method of treating this affection is to 
 make one massive x-ray exposure to be followed after 24 
 hours by light and the high-frequency vacuum tube applications. 
 The applications, except the x-ray, should be continued daily 
 until all evidence of infection has disappeared. 
 
 Phlebitis. There is probably no condition in which greater 
 and more prompt relief can be obtained than in early phlebitis by 
 the combined applications of radiant light and heat, followed in 
 each instance by application of the static brush discharge. 
 The writer has cured six cases by this combined method; two 
 in cases of over two weeks' standing, and the others of shorter 
 duration. In each case the veins became patent and the re- 
 covery was complete after from three days to two weeks daily 
 treatment. The light from a high c. p. lamp was applied for 
 from 15 to 20 minutes, followed by a thorough application of 
 the brush discharge over the indurated veins. 
 
 Pelvic Congestions. Over various regions of tenderness in 
 the lower abdomen, intense local light and heat radiations 
 afford marked relief and eventually seemingly relieve some 
 internal conditions. This observation is pertinent because it 
 is the experience of many observers that radiant light and heat 
 increase peristalsis, the bowels being frequently stimulated to 
 movement after an energetic administration of light. 
 
 Cleaves has also employed light with a specially devised lamp 
 per vaginam from which she has reported favorably.* 
 
 Orloff of Russia and Makarejev have also reported favor- 
 able results from the employment of white light to the pelvic 
 tissues. These observations, while important as showing the 
 possibilities of light therapy, do not equal in point of efficiency 
 the applications of the high frequency and static currents. 
 
 Desloges of Montreal reports a case of highly congested left 
 ovary in a neurasthenic treated by 20 minute daily applications 
 of light from a high c. p. incandescent lamp, applied every other 
 day for two weeks when the condition was cured and three 
 months later there had been no relapse. 
 
 Curatulo " recommends phototherapeutics as a new thera- 
 peutical agent in obstetrics and the diseases of women. He 
 describes a speculum which he has constructed in order to em- 
 
 * Cleaves, " Light Energy,'' p. 55.
 
 62 RADIANT LIGHT AND HEAT 
 
 ploy the different rays separately and combined. Therapeutic 
 results may be expected in cases of metritis and hypertrophy 
 of the cervix, in cases of badly developed uterus and peri- and 
 para-metritic exudates." * 
 
 Ozena is a condition difficult of treatment by light and 
 readily and effectively treated by the direct static and high 
 frequency currents with vacuum tube electrodes, but some 
 writers have reported favorable results from the use of light 
 reflected into the throat and nasal cavities. 
 
 Diosurio f reports 16 cases of ozena under treatment with in- 
 candescent light reflected into the nose and by introducing a 
 water- jacketed lamp in the nose or a larger lamp in the mouth. 
 In every case he reports a noteworthy " decrease of the waste 
 and secretion, and a disappearance of the characteristic fetor." 
 
 Cleaves suggests $ the use of the arc light " in treating the 
 nasal, anal, and buccal cavities ; with it a profounder influence 
 is obtained, involving greater tissue reaction, when topically 
 applied, by reaction of the complex chemical frequencies." 
 
 Post-Operative employment of incandescent light is one of the 
 niceties of modern surgery. Radiant light and heat applied a 
 few hours after an operation for from 10 to 20 minutes will 
 remove to a large extent the diffuse soreness of the tissues, 
 affording the patient great relief. Applied in the same man- 
 ner over the dressings or better directly to the bared surface, 
 it will promote union and prevent scarring and delayed union. 
 So valuable is this employment of radiant energy, that it should 
 occupy a place as a routine practice in every well ordered 
 hospital, where there is no reason that patients should not have 
 everything conducive to their comfort, and a recovery in the 
 shortest period of time. 
 
 Post-Operative Iritis. A specialist reports following removal 
 of a lens ; five days after the operation a severe iritis occurred. 
 " An exudate filled the entire pupillary space, and organized 
 secondary membrane formed; and vision, which was good on 
 the fourth day, was reduced to the barest perception of strong 
 electric light. At first atropin, donin, and local heat were 
 used night and day with little improvement, when an incan- 
 
 * Brit. Med. Jour., October n, 1902. 
 f Gag. Med. Ital., February 6, 1902. 
 \ Cleaves, " Light Energy," pp. 547-550.
 
 TREATMENT OF INFECTIOUS PROCESSES 63 
 
 descent lamp of high candle power was installed with which 
 the patient was treated every four hours for ten minutes. The 
 relief from pain was prompt, the swelling and discoloration 
 of the iris changed at once, improvement setting in promptly. 
 At the end of two weeks the iris had recovered, and the exudate 
 and secondary membrane had been reduced to the extent that 
 a secondary operation, usually necessary after several weeks, 
 especially following iritis, was undertaken. The operation was 
 successful in opening a beautiful black pupil. As a precau- 
 tionary measure the lamp was used a few days following the 
 secondary operation, when the patient was discharged with no 
 signs of iritis, secondary cataract, or other untoward result."
 
 CHAPTER VII 
 RADIANT ENERGY IN DERMATOLOGY 
 
 Radiant energy plays an important role in the treatment of 
 diseases of the skin, for upon this superficial organ the energy 
 of radiant light and heat are largely expended. 
 
 Atonic conditions associated with infiltration or impaired 
 metabolism, or infectious processes are all favorably affected 
 by the employment of radiant light and heat either alone or in 
 conjunction with high potential efHeuves, static brush-dis- 
 charge or vacuum tube applications of high-frequency cur- 
 rents. These measures act by increasing local hyperemia and 
 tissue activity with restoration or increase of elimination, af- 
 fording trie tissues increased nutrition and general functional 
 metabolism and removal of edema or infiltration. 
 
 The Roentgen ray in certain infectious processes, followed 
 by radiant light and heat after the requisite degree of inhibition 
 rfas been effected, is more effective in infectious and malignant 
 conditions of the skin, than the administration of radiant light 
 and heat alone. In some infectious processes, particularly 
 superficial streptococcic or staphylococcic processes, the early 
 employment of radiant light and heat and high-frequency cur- 
 rents will be effective. 
 
 The following report of cases and methods will give the best 
 idea for the indication of methods and treatment of various 
 skin diseases. 
 
 Varicose ulcers. The pathological condition resulting in 
 varicose ulcer is one of induration and edema in the skin and 
 subcutaneous tissue in which the parts most remote from the 
 sources of nutrition break down leaving an ulcerated area, 
 which is prone to increase in size as the region of induration 
 widens and becomes more impervious to the circulation. 
 
 The indication is plainly (i) to get rid of the induration; 
 
 (2) to stimulate active local metabolism with hyperemia, and 
 
 (3) to support the tissues and prevent recurrence. 
 Treatment No agent known to the writer is so energetic 
 
 in removing the local induration and tissue infiltration as the 
 
 64
 
 RADIANT ENERGY IN DERMATOLOGY 65 
 
 static brush-discharge applied daily, following a prolonged 
 application of radiant light and heat. The brush-discharge 
 should be applied each "day until the involved tissues are well 
 softened. By this method it is surprising how promptly the 
 process in early cases is healed and with perseverance nearly 
 all cases are ultimately healed. 
 
 The supportive treatment consists in the firm application of 
 an elastic bandage over a splint of veneer or stiff paste- 
 board or a perforated metal shield; the surface having been 
 dusted with bismuth subnitrate and covered with a thin layer of 
 gauze over which is placed one thickness of absorbent cotton. 
 After the surface is healed, a firm elastic bandage such as the 
 crepe velpeau, an English production, should be constantly 
 worn and the area daily massaged to prevent recurrence. 
 
 Case i. Miss B., set. thirty, came under observation, referred 
 by a physician in a neighboring city, with a varicose ulcer 
 which had been increasing in size for more than a year. It 
 was circular in form and about one inch in diameter, sur- 
 rounded by an indurated area about six inches in diameter, and 
 surrounded by a general edema below the knee. Twenty-min- 
 ute applications of intense radiant light and heat, followed by a 
 daily energetic application of the static brush-discharge and 
 the employment of a crepe velpeau bandage applied from the 
 toes to above the knee, were made daily. 
 
 When treatment was instituted, surrounding the ulcer was 
 a margin about one inch in width of livid degenerated skin on 
 the verge of breaking down, which rendered healing of the 
 ulcer relatively slow. The improvement was prompt and in 
 six weeks the surface had entirely healed, being covered with 
 a normal skin. This patient was then discharged with direc- 
 tions to continue to wear the bandage, and give the limb a 
 daily massage, removing any commencing infiltration or hard- 
 ening. 
 
 Case 2. Mr. McD., set. 63, came under observation in Janu- 
 ary, 1908, with an extensive ulceration of practically nine years' 
 duration on the left leg, about midway between the knee and 
 foot. 
 
 The open areas were one large ulcer about two inches in 
 diameter and three smaller ones around it, with a tissue area 
 fully four inches in diameter about to break down. The ex- 
 tremity below the area was livid and cold, resembling Raynaud's
 
 66 RADIANT LIGHT AND HEAT 
 
 disease and the leg from four inches below the knee was infil- 
 trated, cold, and edematous. The second toe was about black, 
 and the nail separating. The extensors of the toes were con- 
 tracted to the extent that the end of the great toe and the 
 smaller ones, when the patient stood upon them, did not come 
 to within three-quarters of an inch to one inch of the floor. On 
 the left foot one inch forward of the external malleolus was an 
 ulcer about three-quarters of an inch in diameter, and though 
 not so generally edematous, the foot was livid and cold, with 
 the extensors of the toes contracted as on the right leg. 
 
 The treatment of this case consisted of the prolonged daily 
 application of radiant light which was manipulated by the 
 patient for from one-half to three-quarters of an hour daily, 
 followed by thorough application of the static brush-discharge 
 which removed the induration daily. The surface of the ulcer, 
 which was inactive and of a venous hue, became active and of 
 an arterial hue after the first treatment, indicating the opening 
 up of the arterial channels to the influx of blood to the margins 
 of the ulcer. The surface was dressed each time, at first with 
 vaseline and later with subnitrate of bismuth, a layer of gauze, 
 a layer of absorbent cotton, a flexible board splint large enough 
 to protect the affected surface, and over all a crepe velpeau 
 bandage extending from toes to knee. The small ulcer on the 
 reft foot was healed in two weeks and the improvement in the 
 large one was marked and progressive though slow. Treat- 
 ment was given daily except Sundays for three months and on 
 alternate days for the following two months, when the ulcera- 
 tion was entirely healed. The second toe and feet resumed 
 normal color within two months. A healthy, normally vigor- 
 ous nail grew upon the second toe of the right foot, and con- 
 tractures of the extensor muscles of the feet became relaxed so 
 that within two months the great toe came normally to the 
 level of the foot. 
 
 When treatment was begun the patient, who for months had 
 been seated in his room with his foot elevated, came once in a 
 cab and afterwards by the street car, being rendered com- 
 fortable and relatively free from pain at once on the institu- 
 tion of treatment. This patient had been in the best hands 
 on two continents for five years, during which time all previ- 
 ously recognized methods had failed, marking it as one of un- 
 usual severity.
 
 Plate V. Method of Treatment with the London Hospital Lamp.
 
 RADIANT ENERGY IN DERMATOLOGY 67 
 
 Suppurating Ulcer. Dr. J. A. Mohnson reports the follow- 
 ing case: Male, aet. forty-five, who in November, 1904, ran a 
 barbed wire into his elbow, which was neglected, resulting in 
 a chronic infection. In September, 1905, there were seven 
 suppurating ulcers with thickened edges, covering a surface 
 six inches long by four broad. The whole surface was tender 
 and indurated and of a bluish color. The condition was 
 treated with a 500 c.p. incandescent lamp, exposures twenty to 
 thirty minutes each, the lamp brought down as close as it could 
 be borne, with an occasional " hot one " within a few inches of 
 the affected surface. In all seventeen treatments were given. 
 All of the ulcers were healed though considerable induration 
 remained. 
 
 Lupus and Allied Conditions. " Rieder of Munich says that 
 in order to utilize electric arc light for therapeutic purposes in 
 skin affections, it must be more concentrated, than from a re- 
 flector. This was first overcome by Finsen (1893). Strong 
 currents and concentration of the light by quartz lenses as well 
 as elimination of the heat rays are necessary for an intense ef- 
 fect of the arc light. 
 
 " There has always been a tendency to create new light 
 sources, apt to produce more chemical rays than the old sources 
 do. But only the so-called iron lamps have been of any ac- 
 count. The rays of the iron light have a strong irritating and 
 bactericidal effect, combined with moderate heat-radiation, but 
 they possess very little of the quality of penetration. There- 
 fore deep-seated affections of the skin for instance, lupus are 
 not affected by this light. On superficial diseases it is very 
 effective. 
 
 " The question, whether the heat rays are of use in curing 
 skin diseases, is nowadays generally answered in the affirma- 
 tive, but Rieder is skeptical and points to the Finsen method 
 which is of cold light; for behind the water-cooled compres- 
 sion-lenses, there is nevertheless heat produced. This light 
 seems to be a lucky combination of light and heat rays. 
 
 " It is absolutely necessary to produce a slight reaction in 
 the skin before beneficial results may be expected. There are 
 four stages of reaction ; hyperemia of the skin, painful blister- 
 ing, superficial ulceration, necrosis with the formation of 
 ulcers." * 
 
 * Wiener med. Presse, 44, 1903, pp. 2074, 79.
 
 68 RADIANT LIGHT AND HEAT 
 
 " Morris and Dove compare their results in the light treat- 
 ment in lupus and other diseases of the skin with those of Fin- 
 sen. Finsen gives in lupus 94 per cent, and in epithelioma 
 50 per cent, cures. The results of Morris and Dove are not 
 so f ai orable. From 65 cases of lupus in treatment 1 1 re- 
 mained for two years without recurrence. Improvement took 
 place even in the worst cases. They used for the skin the 
 Finsen lamp and for mucous membrane Roentgen rays. In 1 1 
 cases of. lupus erythematosus 7 remarkable improvements were 
 recorded. In 27 cases they improved very well. Two cases 
 of alopecia did not improve. Patients should be kept under 
 observation for at least three years." * 
 
 " Moller of Stockholm reports results of phototherapeutic 
 treatments at the St. Goran Hospital. Up to April, 1904, were 
 treated 113 cases; 79 cases of lupus vulgaris, 17 lupus ery- 
 thematosus, 12 carcinoma cutis, 3 alopecia areata, i nevus vas- 
 culosus, i acne rosacea. In the lupus cases light treatment 
 proved to excel all other methods. Of the 32 completed 
 treatments 17 cases were cured, 10 almost cured, 4 improved, 
 i hardly influenced. The treatment was either pure light treat- 
 ment or it was assisted by the application of salves or galvano- 
 caustic puncture, removal of tuberculous glands, etc. In cases 
 of lupus erythematosus the infiltrated forms reacted well, while 
 the superficial ones showed no results. Of 12 cases of skin 
 carcinoma, 7 were cured. Two cases of alopecia areata were 
 cured." f 
 
 " Schaltz of Berlin contends that in treating lupus vulgaris 
 with chemical rays the heat rays play a conspicuous part. If, 
 for instance, on an agar-layer is placed a Finsen cooler and 
 through this is illuminated with a concentrated electric arc 
 lamp, the agar-layer will melt on the back-side, but not on 
 the side exposed to the light source. From this and other ex- 
 periments the author concludes, that the cooling of the skin is 
 only superficial and that the heat is in action in the deeper 
 layers." $ 
 
 " Lesser of Berlin reports on the light treatment of skin dis- 
 eases after the Finsen method and says that two qualities of the 
 light are to be considered, i. e., the tissue-destroying and hereby 
 
 * Practitioner, 1903, April. 
 
 fNorcisk medicinsk Arkiv., 1904, No. 10. 
 
 i Berl. Win. Woch., 1904, No. 18.
 
 RADIANT ENERGY IN DERMATOLOGY 69 
 
 inflammation-causing quality and, secondly, the bactericidal 
 quality of light. In fact, those two qualities are combined in 
 one and the same process when certain light rays destroy a cell 
 in the human body or when they kill bacteria, as each micro- 
 organism is nothing else than a living cell. The more a method 
 is destroying the affected without attacking the healthy c ^11 the 
 more it is nearing the ideal requirement. At the University 
 of Berlin are used Finsen apparatus of 30-40,000 candle power 
 (48-50 volts, 70-80 amperes) mostly in the treatment of lupus 
 cases, and although the exact results are not yet available, the 
 superiority of this method over others is established." * 
 
 " Teredde reports the results from phototherapy in 1 1 re- 
 bellious cases of lupus erythematosus of the face. Of these 3 
 were cured, 2 were benefited to a marked degree and passed 
 from under treatment. Of the 6 patients remaining 4 were 
 being cured and 2 showed no improvement. He regards this 
 method of treatment the best for grave forms of the disease." f 
 
 " Schamberg of Philadelphia gives his results in treatment 
 of various diseases by Finsen light and Roentgen rays. 
 
 " i. Finsen light is beneficial in the treatment of lupus vul- 
 garis ; but large lamps are required. 
 
 " 2. In lupus erythematosus Finsen light effected some im- 
 provement but no cures. 
 
 " 3. In certain cases of lupus vulgaris (ulcerated nodules, 
 when mucous membrane of nose, lips, or mouth is affected) 
 the Roentgen rays are preferable. 
 
 " 4. The Roentgen rays have certain distinct limitations in 
 the treatment of cancer of the skin, when not deep-seated. 
 
 " 5. Roentgen rays are very valuable in acne. 
 
 " 6. Roentgen rays are valuable in eczema. 
 
 " 7. Roentgen rays have proved beneficial in sycosis, lichen, 
 planus, hypertrichosis, ringworm, and favus of hairy regions, 
 tuberculosis of the skin, mycosis fungoides, etc." $ 
 
 " Pick and Asahi of Prague have treated after the method 
 of Tappeiner and Jesionek 12 cases of lupus, 2 cases of tuber- 
 culosis cutis verrucosa and ulcus rodens, 5 cases of trichophy- 
 tosis and 3 cases of scrofuloderma. The affected parts were 
 in the morning brushed with one per cent, solution of eosin in a 
 
 *Zeit. f. Diat. & Phys. Then, Vol. 5, 1902, pp. 449-457- 
 f Bui. Gen. de Therap., January 23, 1901. 
 $ American Medicine, December 19. 1903.
 
 70 RADIANT LIGHT AND HEAT 
 
 physiological salt solution. During the day these parts were 
 repeatedly moistened with a salt solution in order to avoid 
 drying in, and as much as possible exposed to the sun; over 
 night the parts were covered with an indifferent salve bandage. 
 The results were in 11 cases very encouraging. In cases of 
 lupus the inflammatory infiltrations receded and the process 
 of cicatrization made fast progress ; the cases of trichophytosis 
 healed in a few days." * 
 
 Eczema treated by radiant energy is generally effective and 
 in other cases it adds greatly to the efficiency of local applica- 
 tions. No agent is so efficient in the writer's experience as the 
 local application of the static brush-discharge for removing 
 the local induration or infiltration of eczema either alone or 
 following local applications of radiant light and heat ; and when 
 persisted in, it is generally effective. Excellent results have 
 been effected by numerous observers from the use of radiant 
 light and heat. 
 
 " Winternitz of Vienna claims to have proved conclusively 
 that the effects of sun and electric light are not simply of ther- 
 mal character. For example, the elimination of the chemical 
 rays with a transparent red material is sufficient to make the 
 high temperature in an electric bath endurable. This phenom- 
 enon induced Winternitz when applying sun baths to cover tfie 
 part of the body which was exposed to the sun, or the whole 
 body, with red cloth. The results of this measure were diminu- 
 tion of chronic skin hyperemia, anemization of hyperemic por- 
 tions of the skin, improvement and cure of eczema." f 
 
 Desloges reports a case of eczema of eight years' standing 
 covering much of the body to which for several weeks high- 
 frequency currents were applied to the hands with success. To 
 the eruption still remaining on the legs and surface of the body 
 generally the high candle power incandescent lamp was applied. 
 The redness gradually disappeared and the scars separated, 
 leaving the skin clear and in a normal condition after three 
 weeks. The applications were made for twenty minutes morn- 
 ing and evening. Two years later there had been no recur- 
 rence. 
 
 Eczema, moist, of hands. Dr. Walter of Kramer, Ind.,. 
 
 * Centr. f. d. med. Wissensch., 43, 1905, p. 158. 
 f Bericht. u. d. 22 off. Versaml dr. Balneol. Gessellsch. Zu Berlin,. 
 7-21 Murz, 1901.
 
 RADIANT ENERGY IN DERMATOLOGY 71 
 
 reports a case in a man of fifty years. First attack involving 
 hands and wrists with severe itching and exudation of serum 
 from cracks and fissures made no improvement from wearing 
 gloves and using various ointments, not washing during six 
 weeks' treatment. After two weeks' treatment with the 
 leucodescent lamp every night he made a complete recovery. 
 Improvement was noted from the seventh treatment. This 
 case had had treatment from able dermatologists. 
 
 Psoriasis. Dr. Walter of Kramer, Ind., reports over thirty 
 cases of psoriasis cleared up during two years with the high 
 candle power incandescent lamp. He states that results begin 
 to show in from ten to twenty daily treatments, and that thirty 
 to forty treatments extended over a period of six weeks should 
 be given, taking an hour for each treatment when the entire 
 body requires treatment. Under this plan he states that spots 
 clear up in the center and become more pink and then fade 
 away. Subsequent treatments when small spots return will 
 keep it from reappearing. 
 
 He emphasizes the statement that if cases are treated for 
 from six to eight weeks making exposures of from fifteen to 
 thirty minutes to each part, cases of psoriasis will completely 
 respond. These statements are made from an experience with 
 from thirty to fifty cases during three years in an institution 
 where such cases congregate. 
 
 Steiner of Leipzig reports results in electric light treatment. 
 He used concentrated arc light in cases of furunculosis and 
 sycosis barbae, no benefit. In cases of psoriasis, the results 
 were doubtful. Cases of scabies were cured with three appli- 
 cations. Pityriasis versicolor disappeared after five applica- 
 tions. Prurigo ceased after two baths. Grave cases of 
 impetigo were cured with eight baths. Very grave cases of 
 chronic dermatitis were cured after seventeen applications. 
 Cases of seborrheic eczema were cured after four baths. 
 Chronic eczema was cured. Steiner gives the clinical history 
 of thirty-two cases confirming his claims.* 
 
 Dr. Charles R. Dickson f refers to the use of the iron arc 
 ultra-violet lamp in the treatment of a number of conditions, 
 
 * Munich med. Woch., 52, 1905, pp. 748-51. 
 
 f " Some Aspects of Phototherapy," Journal of Advanced Thera- 
 peutics, January, 19x15.
 
 72 RADIANT LIGHT AND HEAT 
 
 maintaining that while the penetration is slight, it fills a place 
 of its own in the therapeutics of certain skin conditions. 
 
 " The ultra-violet rays," he states, " have a marked analgesic 
 action. This was very clearly manifested in an extensive, in- 
 operable epithelioma of the lower lip recurrent after excision, 
 in a man aged 57 years. The case was really too far gone for 
 any raying, but it was rayed in the hope of retarding somewhat 
 the progress of the disease. In spite of all that was done, the 
 tissues were breaking down extensively and there was much 
 pain in the lip. Ultra-violet rays being used as an alternative, 
 relieved this pain so that the patient dropped off to sleep a few 
 minutes after the first time they were employed, and there 
 never was severe pain thereafter. 
 
 " Superficial neuralgias are often speedily relieved by ultra- 
 violet rays, as is also the itching of epithelial neoplasms, benign 
 as well as malignant. 
 
 " The atonic action of the iron arc rays may be observed 
 readily when they are employed to promote rapid healing of 
 superficial abrasions, for instance, on the hands or fingers of 
 surgeons where dressings are very inconvenient, and an 
 abraded epidermis is a constant menace to safety. In such 
 cases it is rarely necessary to repeat an exposure of ten min- 
 utes. All signs of inflammation, if present, will usually have 
 passed away by the following morning, or in the course of a 
 few hours after raying." 
 
 He also treats of the employment of the ultra-violet rays 
 in the treatment of seborrheic eczema, in which after prolonged 
 treatment no permanent result was obtained. In lupus' ery- 
 thematosus some benefit was obtained. A case of acne rosacea 
 on the nose of a young lady, was practically cured after 29 
 treatments. He also reported its employment in acne vulgaris, 
 chronic eczema, and varicose ulcers, with variable results. 
 Dickson further states that the bactericidal action of the iron 
 arc rays is well marked in sycosis, in the treatment of which 
 adrenalin chloride is used in connection with the employment 
 of the rays from the iron arc lamp, the lamp being held about 
 an inch away from the hairs. Five treatments of ten minutes 
 each effectually removed the condition in ten days. 
 
 Another evidence of the bactericidal action of the rays re- 
 ported by Dickson, was in the treatment of a furuncle on the 
 neck of a boy 12 years of age. The treatment was made fol-
 
 RADIANT ENERGY IN DERMATOLOGY 73 
 
 lowing adrenalin chloride applied to render the tissues anemic. 
 The swelling was remarkably diminished and after the second 
 raying of ten minutes, one day intervening, the furuncle had 
 disappeared. 
 
 Excellent results were also quoted in the early treatment of 
 carbuncles and also in the ulcerated surfaces following the 
 opening of the abscess. The effects of these rays, the writer 
 states, are efficacious in superficial lupus.
 
 CHAPTER VIII 
 
 RADIANT LIGHT AND HEAT IN THE TREATMENT 
 OF CONDITIONS ASSOCIATED WITH FAULTY 
 METABOLISM 
 
 The stimulating and tonic effects of radiant light and heat 
 upon general metabolism are due to several specific actions or 
 effects induced on the tissues in the circulating fluids of the 
 body. 
 
 /. The actions on the blood, (i) The oxidizing influences 
 of radiant light and heat favor to a remarkable degree active 
 tissue metabolism. (2) The oxygen carrying function of the 
 blood is enriched by an increased percentage of hemoglobin 
 due to the direct action of light rays, and (3), the lymphatics 
 are rendered more active in eliminating waste products and 
 toxins by the sweat glands and other emunctories of the body. 
 
 II. The superficial end organs are stimulated to a greater 
 activity with an increased tissue change, both anabolic and 
 catabolic. 
 
 ///. The deep spinal centers are reflexly stimulated to 
 greater reflex activity by the intense effects of the applications 
 of radiant light and heat to the peripheral neurons, thereby 
 arousing greater general activity of the vital centers, particu- 
 larly the perspiratory, cardiac, and excretory centers. 
 
 IV. The general diffusion of heat which takes place by 
 convection from the blood heated at the periphery, promotes 
 general tissue oxidation and elimination throughout the 
 organism. 
 
 V. The actinic and thermic action of the radiant light and 
 heat upon the germs in local areas of infection, causes inhibition 
 of activity and destruction of the germs by the phagocytes, 
 thereby relieving the tissues generally from the toxic materials 
 otherwise thrown out. 
 
 VI. The induction of superficial hyperemia, local or gen- 
 eral, promotes nutrition in the tissues by an increase of nutri- 
 tious pabulum distributed through the tissues, as well as an 
 increase in the number of nature's scavengers, the phagocytes, 
 
 74
 
 IN TREATMENT OF FAULTY METABOLISM 75 
 
 where hyperemia exists, thereby increasing the general tissue 
 resistance, as well as awakening a greater metabolic activity. 
 
 VII. The stimulation of increased elimination through the 
 sweat glands and other emunctories, induces the removal from 
 the system of the poisonous toxins which vitiate the general 
 system and cause general impairment of metabolism. 
 
 The actions thus instituted by the systematic employment of 
 radiant light and heat, it will be readily seen, are most valuable ; 
 because, when administered in a technically scientific manner 
 with the requisite attention to details of administration, they 
 favor the elimination of waste materials, and the increased 
 activity of general and local metabolism with marked increase 
 of oxidation and tissue combustion, generally favorable to the 
 establishment of the normal functions of the body. The in- 
 crease of superficial hyperemia not only influences the insti- 
 tution of increased local tissue resistance, but in conditions of 
 impaired kidney functions and arteriosclerosis, relieves arter- 
 ial tension and facilitates the elimination of the waste products 
 through the skin, which the impaired kidneys are unable to 
 eliminate. 
 
 In all forms of nephritis, radiant light and heat are indicated, 
 and offer probably greater aid in relieving the system 
 loaded with nitrogenous waste products than other therapeutic 
 measures. In parenchymatous nephritis, particularly, radiant 
 light and heat afford a remarkable means of relief. Cases 
 which have failed to yield to medicinal or other physical treat- 
 ment, when placed under the systematic employment of radiant 
 light and heat, have been effectually relieved and cured. The 
 treatment of parenchymatous nephritis by radiant light and 
 heat should be carried out under a thorough regime. The 
 full light baths should be given daily for periods of 20 to 30 
 minutes, preferably with the patient reclining in the bath cab- 
 inet. A greater degree of diaphoresis is induced in the cabinet 
 owing to the accumulation of convective heat. Diaphoresis is 
 not the chief indication conserved, but favors the elimination 
 of a larger quantity of nitrogenous products through the skin. 
 The reflex effect of the heated blood upon the spinal centers 
 favors the relief of general tension and engorgement, and pro- 
 motes the restoration of the normal function of the kidneys. 
 The added employment of the static wave current over the kid- 
 neys further favors the relief of local engorgement.
 
 76 RADIANT LIGHT AND HEAT 
 
 The elimination of toxins, often the active cause of paren- 
 chymatous nephritis, as present following diphtheria, nephri- 
 tis, and other infectious conditions, favors the restoration of 
 the kidney function, and also relieves other parts of the organ- 
 ism, unfavorably affected by the presence of toxic material 
 in the fluids and sluggish recesses of the body as often occurs 
 following attacks of local infection, when it would seem that 
 the phagocytes engorged with the pyogenic bacteria, had be- 
 come lodged in the regions of imperfect circulation as in the 
 joints, setting up a local inflammatory process as present in 
 various types of infectious arthritis. 
 
 Infectious arthritis or so-called rheumatism, and conditions 
 which have been considered as allied to rheumatism, are un- 
 doubtedly due to the influences of toxic infection arising from 
 some active site of germ proliferation either present in the 
 alimentary canal, or elsewhere in the tissues, as in the seminal 
 vesicles in cases of gonorrheal arthritis. The older notion that 
 germs themselves were locally present and affecting the local 
 inflammatory processes, seems to have been generally dis- 
 proved. 
 
 With the above premises accepted, it is evident that the first 
 indication is to stop the pyogenic or other bactericidal process 
 either by the induction of local hyperemia, by means of an 
 increase of local phagocytosis, or by the employment of intes- 
 tinal or other local antiseptic measures to destroy the germ 
 in situ. Another indication is to promote as rapidly as possible 
 the elimination of the toxins from every part of the body, 
 which is best effected either by the use of a general light bath 
 with as high a temperature as can be borne, or the employ- 
 ment of the body dry hot air bath. That the light bath pos- 
 sesses a greater energy than dry heat in the treatment of gen- 
 eral infection, is probably due to the fact that the actinic action 
 of light upon the blood is added to the thermic effects. Fur- 
 thermore, the light radiated upon the surface of the body, as 
 explained elsewhere in this volume, penetrates to stimulate 
 tissues to greater depth than with the application of convective 
 heat alone; whereas, with the radiant light and heat bath cab- 
 inet both radiant light and heat, and convective heat, influence 
 by stimulation of the emunctories the elimination of waste 
 products. The only advantage that can be demonstrated of 
 convective heat applications, is from the fact that the body
 
 IN TREATMENT OF FAULTY METABOLISM 77 
 
 wrapped in Turkish toweling which takes up the moisture 
 which congeals upon the surface, will stand a degree of tem- 
 perature above the boiling point without blistering the surface 
 of the body, as is certain to occur if too high temperatures are 
 otherwise employed. 
 
 The general indications are practically the same where a 
 general toxemia exists with a tendency to an involvement of 
 joint or other structures in remote parts of the body ; whereas, 
 in cases of local septic infection, as stated elsewhere, the local 
 employment of convective heat seems the most practical means 
 of effecting the destruction of the infection (see convective 
 heat in septic infection on page 98). 
 
 In arteriosclerosis two important points for consideration 
 are present: (i) the correction of those conditions or habits of 
 life and diet which lead to toxemia ; conditions which seem 
 to superinduce arterial hypertension, and (2) the elimination 
 of toxic materials which are retained in the system. 
 
 Dr. T. D. Crothers called attention to the importance of 
 radiant light and heat in the treatment of arteriosclerosis in 
 a paper published in 1905,* in which he stated that " frequently 
 the use of drink and drugs are symptoms as well as causes of 
 those pathological conditions. Always associated with it are 
 toxic states with defective elimination, local congestion, and 
 palsies of the vaso-motor nerve, and with defective nutrition 
 and elimination, there is starvation and poisoning. 
 
 " The radiant light bath by this specific sudorific action, 
 appears to have a marvelous effect on the elimination of the 
 toxins, and the stimulation of the vaso-motor centers also 
 influences metabolism." 
 
 He quotes cases in which he has demonstrated beyond ques- 
 tion the efficacy of the radiant light bath in the treatment of 
 arteriosclerosis. In another paper published in the Journal of 
 Advanced Therapeutics for December, 1906, " in control ex- 
 periments with healthy patients, the tension is generally low- 
 ered. ... In a person with high arterial tension and a 
 regular heart action, together with the static breeze, radiant 
 light and the shower after, there is a falling of the tension and 
 an improvement of the action of the heart." 
 
 Experiments made by the writer in conditions of high arte- 
 
 * Radiant Light Bath in Arteriosclerosis, Advanced Therapeutics, August, 
 1905.
 
 78 RADIANT LIGHT AND HEAT 
 
 rial tension, have demonstrated a uniform fall of from 5 to 10 
 mm. with the modified Riva Rocci sphygmomanometer, from 
 a prolonged application of radiant light and heat from a 500 
 c.p. incandescent lamp, which effect is undoubtedly due to two 
 influences to capillary dilatation of the smaller superficial 
 arterioles and capillaries, and the relief of the system from a 
 certain amount of toxic materials with perspiration. 
 
 The treatment of arteriosclerosis should not be confined to 
 the employment of light, as the regulation of diet, and the 
 use also of high frequency auto-condensation, the last of 
 which promotes a large degree of tissue combustion and elim- 
 ination, play an important role in the treatment of this condi- 
 tion. If taken early in hand by careful attention to habit and 
 regime, arteriosclerosis can be effectually controlled and pre- 
 vented in most cases. The employment of light in these cases, 
 however, should always constitute a part of a well regulated 
 regime in the treatment of arteriosclerosis. All conditions 
 associated with impaired nutrition, as anemia, leukemia, per- 
 nicious anemia, leucocythemia, rheumatoid arthritis, peripheral 
 defects of metabolism associated with spinal cord affections, 
 and the functional neuroses, in all of which conditions there is 
 a lessening of the local resistance of the tissues with a relative 
 degree of defective local or general metabolism, are 
 always benefited by any agency which will stimulate an in- 
 creased blood supply co-incident with increase or stimulation 
 of end-organ metabolism. It is therefore a matter of much 
 importance in the general recognition of the advantages of 
 these important therapeutic agencies, that they should be ap- 
 preciated in the treatment of all conditions associated with 
 impaired metabolism, local or general. This systematic em- 
 ployment, in conjunction with other physical methods and 
 dietetic regulation, is indicated in all such cases. So important 
 is the employment of radiant light and heat as a daily regime 
 in the management of these cases, that its employment is cer- 
 tain to become a general routine practice as important as the 
 shower bath in the home under the direction of the family 
 physician. The light bath must become in the well regulated 
 household of all those who can afford it, a part of the daily life 
 regime for those who are suffering from impaired metabolism 
 or would employ it as a prophylactic against the inroads of 
 disease.
 
 IN TREATMENT OF FAULTY METABOLISM 79 
 
 It is an undoubted fact that the business man or woman and 
 the housewife who are confined within a home or office during 
 the larger part of the day, and who when in the open are 
 clothed in thick garments opaque to light, fail to receive the 
 requisite amount of sunlight to properly maintain a normal 
 physical status. For this reason the general use for a short 
 time daily of the electric light bath in the home, should be 
 encouraged. It should be adopted as a prophylactic measure, 
 or for the relief of conditions of impaired metabolism, but 
 should not preclude the necessity of the regulation of other 
 hygienic measures, particularly, careful attention to the diet 
 of the individual. 
 
 Until such time as the community shall be educated to the 
 importance of these things, the profession must employ radiant 
 light and heat in the treatment of many of their cases; for it 
 will not be possible, in the face of the importance of these 
 measures, to conscientiously manage the treatment of diseased 
 conditions in which the indication for the employment of 
 radiant light and heat is so apparent without either the institu- 
 tion of the means in the practitioners' office, or their direction 
 to their patients to go elsewhere.
 
 CHAPTER IX 
 
 OPPOSITE EFFECTS OF RADIANT LIGHT AND 
 HEAT AND THE ROENTGEN RAY 
 
 The study of the different forms of radiant energy reveals a 
 variety of action and effect which indicates a diversity of appli- 
 cation to therapeutics. The relation of the frequency of vibra- 
 tion to penetration, the degree of penetration, diminishing as 
 the frequencies increase, until the higher frequencies of the 
 Roentgen ray are reached, regulates the therapeutic indications. 
 
 " It was predicted by Helmholtz, the great mathematician," 
 says Sir Oliver Lodge, " that if waves could exist still smaller, 
 you would ultimately get waves smaller than the atoms, and that 
 then, instead of being bent more, would be bent less ; and in that 
 way we should have the upper part of the spectrum with dis- 
 persion reversed the spectrum at last folding back upon itself, 
 until, you come to the ultimately small waves, they would not 
 be bent at all, but would go straight on. The prediction was 
 fulfilled in the x-ray, which is not refracted, but goes straight 
 on, and is constituted of the shortest wave-lengths, excessively 
 rapid, and waves smaller than anything conceived before. Ful- 
 filling the theory of Helmholtz these rays go straight on." 
 
 It was observed by the writer in a paper published by him,* 
 that a remarkable contrast exists between the ultra-violet and 
 the x-ray. The latter, of varying wave-lengths, are not sorted 
 out from one another are not refracted, but go straight on 
 without any deviation whatever. 
 
 Sir Oliver Lodge describes the x-ray as follows : " It is 
 simply a solitary wave, a solitary pulse, up and down almost 
 instantaneously, and no more; nothing continuous, not a suc- 
 cession of waves a solitary pulse, one splash like a whip- 
 crack, just again and again. With every blow of an electron 
 the derived x-rays proceed from the target in very rapid suc- 
 cession, in all these flashes or cracks, because the electrons or 
 cathode rays are bombarding the target in very large numbers." 
 
 * " Comparison of Forms of Radiant Energy," Archives of the 
 Roentgen Ray for December, 1906. 
 
 80
 
 OPPOSITE EFFECTS OF ROENTGEN RAY 81 
 
 It will be readily seen, therefore, that the characteris- 
 tics of the Roentgen ray differ materially from those of radi- 
 ant light and heat radiations, both as to wave-length and 
 the method of discharge or irradiation, which from a physical 
 point of view accounts for their different action upon the tis- 
 sues. The effect must be looked at also from another point 
 of view with reference to their impingement or absorption by 
 the tissues. In the matter of radiant light and heat rays, they 
 do not pass through dense and deep tissues, their energy being 
 spent, when they have each passed to depths relative to their 
 wave lengths. While the penetrations, particularly the lower 
 frequencies, are considerable, they are generally absorbed before 
 passing through the body upon which they impinge, while the 
 x-rays pass through. It must also be taken into consideration 
 that the density, or volume, of these radiations from the 
 usual sources of radiant light and heat is very much greater 
 than from the usual sources of the x-ray. The heat effect, 
 therefore, of the forms of radiant light and heat, is pronounced 
 whereas a large percentage of the radiations from a modified 
 Crookes tube pass directly through the tissues producing rela- 
 tively little, if any heat from the effects of absorption, or spent 
 energy. Another factor must be taken into account with refer- 
 ence to these radiations the effect of passing through the tis- 
 sues in the interspaces between the cells, as suggested by Helm- 
 holtz, and confirmed by Sir Oliver Lodge, would be liable to 
 produce an effect upon the cell bodies ; because the other ethereal 
 vibrations, as evidenced by the effects of radiant light and heat, 
 possess an energy within themselves, capable of affecting cell 
 protoplasm. It is probable, on account of the intense rapid 
 vibration of the penetrating Roentgen rays, that they pro- 
 foundly affect cell protoplasm, as first observed in a previous 
 work of the writer * in which the Physiological Effects of the 
 Roentgen ray were considered as follows : 
 
 " The study of the actions of the x-ray is the study of the 
 effects of a form of vibration agitation of the ether of the 
 highest recognized intensity. It is an invisible force, and, like 
 other invisible forms of vibration, can only be comprehended 
 by the effects arising from its actions. 
 
 " The physical characteristics are as follows : 
 
 * " Static Electricity and the Uses of the Roentgen Ray," p. 220.
 
 82 RADIANT LIGHT AND HEAT 
 
 " I. They penetrate many substances which absorb the visible 
 rays of the spectrum. 
 
 " II. They are refracted * when passing from one medium to 
 another of different density, but very slightly. 
 
 " III. They are but slightly reflected, and are absorbed by 
 substances which they do not penetrate, and cause others to 
 fluoresce. 
 
 " IV. What the peculiar effects of the rays may be upon the 
 protoplasmic structures of the body as they pass through the 
 tissues can only be determined from the conditions arising, 
 which are as follows : 
 
 " ( i ) As one stands before the radiating tube with the rays 
 penetrating the body, there is little perceptible sensation. It 
 may have been noticed, however, if the hand be held before the 
 tube for several minutes that a sensation of gentle contraction 
 of the skin is perceptible. The statement of this fact is not 
 uncommonly made by patients under treatment by the x-ray, 
 and it is so from the writer's personal observation. 
 
 " (2) It is also observed that the surface of an ulcerating 
 cancerous growth appears as if glazed or as covered with a 
 thin coating of collodion after an exposure of several minutes. 
 
 " (3) The substance of a growth, when standing promi- 
 nently above the surrounding surfaces, is also perceptibly con- 
 tracted. 
 
 " (4) Following a series of exposures it has been observed 
 by all familiar with the subject that the skin becomes atrophied, 
 and the hair follicles and sweat glands become inactive hair 
 falling out and secretion of sweat ceasing. 
 
 " (5) Pain is in most cases relieved to a remarkable extent 
 after a few exposures in various inflammatory and malignant 
 conditions. 
 
 " (6) Congestion is evidently diminished, as is indicated by 
 the relief of conditions which could be explained under no other 
 hypothesis, occurring, as it does, when inflammatory conditions 
 are exposed to the influence of the rays. 
 
 " (7) Long or repeated short exposures produce dermatitis 
 and necrosis, deep or superficial, according to the length of 
 exposure. 
 
 " The above propositions, jointly and severally, point strongly 
 
 * Recent convincing reports affirm that the x-rays are slightly re- 
 fracted, contrary to Roentgen's first statement.
 
 OPPOSITE EFFECTS OF ROENTGEN RAY 83 
 
 to one effect in particular, which accounts for all the con- 
 traction of cell protoplasm. The sense of contraction of the 
 normal skin, the glazing and contraction of an ulcerated sur- 
 face, the atrophy of the skin, and the relief of pain and conges- 
 tion are all indicative of tissue contraction. Indeed, it is the 
 most plausible explanation of the impaired nutrition, for necro- 
 tic and sloughing tissue, normal or diseased, betokens a dimin- 
 ished blood supply local anemia ; due as a consequence of the 
 contraction of the muscular coats of the vascular system. 
 Whether the action is the influence upon the end plate of the 
 neurons or upon the individual cells it would be difficult to 
 assert; but the latter is most probable." 
 
 The writer in a former contribution * presented a statement 
 of the results of the action based upon clinical observation: 
 " That the effects of the x-ray upon the normal tissue are (i) 
 to induce normal activities, due to the vibratory effect of the 
 rays, or of the ether in the presence of the rays. (2) That 
 these effects with short exposures at proper distances with high 
 vacuum tubes induce activity of normal tissue cells, which, in 
 some cases, supplant abnormal tissue elements without evi- 
 dences of disintegration. (3) That exposures destroy only the 
 abnormal tissues unless they be too prolonged. (4) That ab- 
 normal tissue thus exposed breaks down and disappears through 
 the natural channels of absorption or by sloughing." It has 
 been shown in the writer's experience that tissues of low 
 vitality are always the first to break down. 
 
 " It is probable that the vitality of all tissue is lowered by 
 cutting off the blood supply as well as by inhibition induced in 
 the cells. Naturally, under such circumstances, tissues of low 
 vitality are the first to break down. It is also well established 
 that the tissues of debilitated patients do not resist the destruc- 
 tive action of the rays as do those of normal individuals, which 
 confirms the theory. 
 
 " It has also been demonstrated that malignant tumors in the 
 aged or infirm are more likely to soften and break down than 
 in normal individuals, which confirms the view that when, for 
 any reason, the tissue resistance is lowered the tissues break 
 down. The violent toxemia occurring under such conditions is 
 
 * " The Uses of the X-ray and Accessory Measures in the Treatment 
 of Diseases of the Skin," JOURNAL OF ADVANCED THERAPEUTICS, June, 
 1903.
 
 84 RADIANT LIGHT AND HEAT 
 
 not due to extension of the malignant process, but to the auto- 
 infection arising from absorption of toxins present in the 
 broken-down structures. 
 
 " This effect upon circulation and nutrition when employed 
 to the extent of destroying malignant growths is at best a dan- 
 gerous one, and demands careful attention to the management 
 of details and a knowledge of their consequences. 
 
 " The cumulative action is a striking feature of the effects of 
 the rays and demonstrates the more or less persistent condition 
 of contraction which follows a series of exposures and explains 
 the diminished metabolism after long exposures or series of 
 exposures. 
 
 " It would seem, therefore, that the logical explanation of 
 the action of the x-ray when nearby, prolonged, or frequent 
 administrations are given is, that the exposed structures con- 
 tract at the expense of nutrition and produce, when carried to 
 a certain degree, necrosis of the part. This theory accords with 
 the therapeutic results obtained from nearby and prolonged ex- 
 posures. 
 
 " The stimulating or tonic effect of the Roentgen ray, in- 
 duced by short exposures or with a high-vacuum tube at dis- 
 tances of sixteen to twenty inches from the anti-cathode, is 
 probably due to the disposition of the vibratory influences of 
 the rays both to overcome local stasis, restoring tone to the 
 muscular coats of the arterioles, and at the same time to induce 
 a more active local metabolism. 
 
 " A knowledge of the action of all stimulants teaches that 
 their employment must be judicious or the opposite effects will 
 result. So with the x-ray, to obtain the tonic action, exposures 
 must be infrequent (not oftener than twice weekly), with pene- 
 trating rays emanating from a tube usually at a distance of 
 from twelve to twenty inches. The length of exposures under 
 these circumstances may be for the usual period of ten minutes." 
 
 The inhibitory actions from prolonged exposures are effects, 
 which we are considering as antagonistic to the stimulating 
 effects of radiant light and heat from short or prolonged ex- 
 posures. The stimulating effects of the Roentgen ray as re- 
 ferred to are not generally employed for the reason that the 
 other forms of radiant energy best conserve that purpose. 
 These views expressed by the writer in 1904 have been in the 
 experience of many observers verified ; and while to the present
 
 OPPOSITE EFFECTS OF ROENTGEN RAY 85 
 
 time no other definite physiological effects have been published, 
 the general consensus of opinion is drawing to the recognition 
 of the part contraction of protoplasm plays. 
 
 Since these observations were made, it has been further 
 demonstrated that the tissue inertia induced from the inhibitory 
 action of the Roentgen ray, points to another very significant 
 effect, which is likewise best explained by the condition of 
 tissue inertia following the profound effects upon protoplasm, 
 in response to trie intense vibratory influence of the penetrating 
 rays ; that is, the effect upon the procreative functions in mam- 
 mals as well as in the lower forms of germ life. This fact was 
 referred to by the writer in an editorial * on " The Actions of 
 the X-ray upon Animal Tissues," as follows : 
 
 " The physical characteristics of the x-ray, as generally ac- 
 cepted by physicists, precludes the acceptation of the idea of 
 ionization or that the rays possess any electrical qualities, except 
 peculiar characteristics which can be derived from no other 
 source. They are lines of longitudinal ether vibration (not 
 Hertzian waves) transmitted in straight lines from a source of 
 great energy, possessing qualities whereby they penetrate solid 
 bodies indicating an expenditure of the energy derived, which 
 may be either entirely spent upon bodies of too great density or 
 absorbed in varying degrees in their passage through objects of 
 different densities. Under the laws of conservation of energy 
 when projected against animal tissue this force is spent upon 
 the tissues, exerting characteristic influences the effects of the 
 x-ray. 
 
 " There are three hypotheses upon which the results of these 
 exposures which are so little appreciated by the profession 
 to-day, might be explained, (i) It is probable that cell pro- 
 toplasm is affected by the stimulating action of these energetic 
 lines of vibration to a state of contraction that suspends activity 
 in varying degrees depending upon the duration, frequency, or 
 intensity of the exposures. Under this hypothesis nutritive 
 processes would be suspended by lessening or discontinuance 
 of the metabolic processes and at the same time by diminishing 
 or cutting off the local blood supply owing to the contraction 
 of the cells which comprise the muscular coats of the arteries. 
 In this connection it is a well authenticated fact that the action 
 
 * ADVANCED THERAPEUTICS, March, 1905.
 
 86 RADIANT LIGHT AND HEAT 
 
 of the ray is cumulative, that the extreme degree of physio- 
 logical effect is not reached except the exposure is prolonged or 
 of great volume or intensity, or at the termination of a series 
 of exposures. 
 
 " (2) It is possible that only the neurons are stimulated re- 
 sulting in the effects upon metabolism and the circulation as 
 above described. It is doubtful, however, if such stimuli 
 would only affect the vasomotors. 
 
 " (3) It would be tenable and account for most of the results 
 that the effects are induced by the contraction of muscular 
 cells. 
 
 " The former hypothesis is the most probable because it bet- 
 ter explains the various actions of this remarkable agent. It 
 is the induction of cell contraction with the effects of suspen- 
 sion of animation, of activity, of function, of metabolism. 
 These results would obtain from the effect upon protoplasm 
 above suggested, and seem to explain every consequent action 
 of the rays upon animal tissue. 
 
 " It will be observed by those familiar with the x-ray that the 
 bulk of a superficial tumor exposed to the x-ray will be appre- 
 ciably contracted after an exposure; that a surface moist and 
 discharging will be covered as by a glazing or coating as of 
 collodion after a ten minutes' exposure ; that the skin becomes 
 thinned and atrophied after a series of exposures, that a so- 
 called dermatitis occurs. An x-ray dermatitis is not analogous 
 to an inflammatory process but to the commencing stage of 
 necrosis, to be followed, if persisted in, by a type of necrosis 
 occurring from no other source. When exposures are made 
 to an unprotected surface, with sufficient energy to produce 
 tissue necrosis a striking evidence is presented of the varying 
 degree of intensity relative to the distance from the central 
 point of exposure over the convex surface nearest the source, 
 and of greatest intensity the part closest to the rays will be 
 necrotic, and between the center of the exposed field and the 
 margin where normal skin is present all shades of vitality will 
 be induced from without inward. This fact explains the tedious 
 process toward recovery after one of these serious mishaps. 
 
 " The effects upon the various organic structures of the body 
 are in full accord with the first hypothesis. The effects of the 
 ray in leukemia while they seem to be beneficent, by diminish- 
 ing the enlargement of the glandular structures, have been
 
 OPPOSITE EFFECTS OF ROENTGEN RAY 87 
 
 shown from a long series of cases to produce only temporary 
 alteration in the character of blood, while in the end, the patient 
 dies. It would seem in this instance that the ray was inter- 
 fering with a beneficent provision of nature. 
 
 " In hyperidrosis pedis by a few x-ray exposures, the activity 
 of secretion is abated. It has been shown by many observers 
 that enlarged thyroids may be reduced in size by a series of ex- 
 posures, but no evidence of complete suspension of function has 
 been presented. The effect upon the absorbents, as is demon- 
 strated by prolonged exposures over the abdomen, is to lessen 
 the functional activity with marked decrease of body weight. 
 The effect upon all tissues the habitat of germ processes is to 
 destroy or diminish the activity of the germ by rendering the 
 abode unsuitable. The effect upon glandular structures is to 
 produce inactivity, as stated previously. The processes of ovu- 
 lation, fetal development and the function of the seminal 
 vesicles may be seriously impaired or suspended, the degree 
 of interference depending upon the extent of the exposure. 
 These functions, except a possible termination of pregnancy, 
 will resume normal conditions in a few months after the cessa- 
 tion of exposure. In all cases these results are evidences of sus- 
 pension of nutrition or activity arising from contraction of the 
 cell." 
 
 The experiments of Dr. Edward C. Titus, as published * fur- 
 ther demonstrate the inhibitory action of the Roentgen ray upon 
 germ processes, as well as upon the germinal spot in eggs and 
 seeds. 
 
 " Being greatly interested in these investigations, I made a 
 series of experiments to which I will now briefly refer. 
 
 " I took a definite quantity of various seeds, such as bird 
 seed, lentils, peas, beans, and oats, and planted one portion of 
 them in soil and another portion in wet cotton in order to deter- 
 mine whether they would grow. 
 
 " Having convinced myself of this I then subjected another 
 portion of the seeds from the same supply to the action of the 
 x-rays, then sowed them under the same conditions, and now 
 found that no growth took place. When, however, some of 
 
 * " Relative Action of the Roentgen Ray and Light upon the En- 
 zymes, and Their Therapeutic Significance," JOURNAL OF ADVANCED 
 THERAPEUTICS, November, 1905.
 
 88 RADIANT LIGHT AND HEAT . 
 
 these rayed seeds were exposed to the parallel rays of a marine 
 searchlight and afterwards planted, they began to sprout, but 
 not as vigorously as in the control experiment. My next ex- 
 periment was made with fresh hen's eggs procured from a re- 
 liable dealer ; these were divided into three lots. Of these one 
 dozen were placed in an incubator and after three weeks nine 
 were found to have been hatched. The next two lots of one 
 dozen each were subjected to prolonged exposure to the x-rays 
 and of these one dozen were placed at once in the incubator and 
 the remainder first submitted to the action of the searchlight 
 before doing so. The two dozen which had been rayed were 
 left in the incubator for four weeks, and when removed it was 
 found that those which had not been exposed to the light had 
 undergone no evolution whatever, while those which had, 
 showed different stages of embryonic development." 
 
 These results, together with experiments by the writer during 
 the summer of 1904, led to the conclusion that from these two 
 forms of radiant energy radiant light and heat and the Roent- 
 gen ray there were distinctly opposite effects ; the stimulating 
 effects of the former, and the inhibitory effects of the latter, 
 each diametrically opposed to the other. In an editorial in that 
 year, the writer had called attention to the fact as follows: 
 
 " One year's experience in the employment of a thirty-five 
 ampere arc light, projecting parallel rays from a parabolic mir- 
 ror, as provided in a marine searchlight, has demonstrated its 
 great value in preventing x-ray dermatitis. Whereas, formerly 
 this condition appeared in from three to five weeks, varying 
 with the resistance of the individual case, it is now possible to 
 keep up the x-ray exposures indefinitely in most cases. The 
 x-ray diminishes the resistance of the skin, and light increases 
 it. If, therefore, it is desirable to produce a profound effect 
 of the x-rays upon tissues beneath the integument, the employ- 
 ment of the arc light of sufficient intensity, projected against 
 the surface, will restore the resistance of the skin, without 
 diminishing the effects of the ray upon parts beneath. 
 
 " It is customary to employ an arc of sufficient intensity to 
 produce heat which can be just tolerated over a circle fifteen 
 to twenty inches in diameter, when the patient is placed ten 
 feet from the apparatus, i.e., with parallel rays thrown against 
 the surface. The use of the arc light is usually begun after 
 exposures to the x-ray have been made on alternate days for
 
 OPPOSITE EFFECTS OF ROENTGEN RAY 89 
 
 about two weeks, and persisted in during the course of treat- 
 ment to be administered for ten to fifteen minutes following 
 each application. Under this regime it is possible to keep up 
 practically continuous application of the x-ray without the in- 
 duction of dermatitis ; or, if dermatitis occurs, the skin may be 
 restored to a normal condition in the shortest possible time by 
 this method of treatment. For obvious reasons, the arc light 
 is not employed over superficial or open processes. It is hardly 
 necessary to add that whenever a dermatitis does occur, even as 
 it may occasionally, during its employment combined with the 
 light, x-ray exposures should be discontinued, and the use of 
 the light persisted in. 
 
 " The employment of the arc light in the above manner adds 
 to the possibility of success in the treatment of deep-seated 
 conditions.* 
 
 It will be "observed therefore from the foregoing observations 
 and experiments that the effects of radiant light and heat are 
 diametrically opposite to each other. In other words, one is 
 the exact antithesis to the other the former producing direct 
 stimulation and increased metabolism and nutrition, while the 
 other, carried to the physiological degree, induces distinct in- 
 hibition and diminished metabolism, terminating in a degree 
 of tissue inertia which will result in the death of the tissues 
 irradiated if carried too far. 
 
 The high-frequency currents, static-brush discharge and 
 other stimulating electrical discharges, are analogous in other 
 effects to radiant light and heat, and offset in a similar manner 
 the inhibitive effects of the Roentgen ray. Failure to recog- 
 nize this fact has led to incorrect observations with reference 
 to the Roentgen ray as applied with the tube in contact with 
 the tissues; one writer having misconstrued the fact that with 
 the x-rays administered in this way, a mixed effect is derived 
 from the high-frequency discharges from the surface to the 
 tube when so applied ; for which reason much longer exposures 
 are required to produce the peculiar effects of the x-ray result- 
 ing in a final dermatitis. A dermatitis will occur, however, 
 from x-rays applied in this manner, as has been demonstrated 
 in the experience of several observers, indicating that the 
 
 * " The Employment of the Arc Light as a Prevention to X-ray 
 Dermatitis in the Treatment of Deep-seated Conditions," JOURNAL OF 
 ADVANCED THERAPEUTICS, December, 1904.
 
 90 RADIANT LIGHT AND HEAT 
 
 Roentgen ray administered for the same length of time with 
 the mixed high-frequency discharges, has a dominant effect. 
 From this fact it will be generally acknowledged that it is bet- 
 ter to employ an agent strong enough to induce an inhibition 
 first, and when signs of dermatitis appear, to then institute 
 the use of light or the high-frequency currents to offset or 
 restore a degree of tone to the tissues, which will prevent an 
 unpleasant degree of x-ray dermatitis. The writer has used the 
 x-ray and the other forms of radiant energy in this manner and 
 has demonstrated all these relative effects for the past five years. 
 Without exception, the dermatitis produced by the Roentgen 
 ray has been readily counteracted by the subsequent applica- 
 tion of radiant light, or the static brush-discharge or the high- 
 frequency currents to a surface so affected.
 
 SECTION II 
 
 CONVECTIVE HEAT
 
 CHAPTER I 
 
 COMPARISON OF CONVECTIVE HEAT AND RADI- 
 ANT HEAT 
 
 Connective heat, in contradistinction to radiant heat, pos- 
 sesses the advantage of being a convenient means for domes- 
 tic and professional administration under conditions in which 
 the combined heat and light radiations from the sun, or the 
 electrical incandescent or arc light, are not accessible nor con- 
 venient, and may be preferred in certain cases. The physical 
 difference between these two methods of heat administration 
 for therapeutic purposes is at once suggested by the distinc- 
 tion between radiation and convection. 
 
 Radiant energy projected against the tissues, penetrates to 
 considerable depth as the radiant heat energy moving with 
 great rapidity impinges upon the tissues of the body. Ad- 
 ministered from radiant sources, the action is not to the same 
 extent limited to the circulating fluids of the body, but acts 
 upon all other structures upon which the radiations impinge 
 and to a greater depth; including all cells of the muscular, 
 nervous, and connective tissue structures; thereby carrying 
 into the tissues degrees of heat, which are not rapidly dis- 
 persed by convection, and raising and maintaining the 
 temperature of the tissues to a higher degree than with the 
 convective methods of administration; the influence of which, 
 applied to the surface of the body, does not permit the penetra- 
 tion of the heat to any considerable depth as has been well 
 shown by Oilman Thompson and others. By the convective 
 methods, the blood becoming heated is rapidly conveyed on- 
 ward, raising the temperature of the body, but resulting under 
 normal conditions, in the induction of intense hyperemia and 
 perspiration, followed by evaporation with the secondary 
 cooling effect of latent heat absorption, thereby maintaining 
 normal blood temperature throughout the body. Another ad- 
 vantage is also conserved the elimination of effete material 
 through the activity of the sweat glands. The areas imme- 
 diately contiguous to the application of convective heat, be- 
 come at first hyperemic through the stimulating effect of 
 the application, thereby permitting a larger volume of the blood 
 
 93
 
 94 CONVECTIVE HEAT 
 
 stream to become heated and coincidently other actions take 
 place within the tissues in the vicinity, the importance of which 
 will be subsequently considered. 
 
 In the application of convective heat, moist and dry, the fol- 
 lowing methods are employed : 
 
 The application of dry heat to the surface of the body may 
 be made with temperatures ranging from 150 to 200 F., 
 tolerated without covering. It is readily apparent that dry 
 heat possesses certain distinct advantages in cases demanding 
 a marked degree of general peripheral stimulation, and coin- 
 cidently in a dry air a rapid absorption of heat by the prompt 
 evaporation of perspiration takes place, thereby facilitating 
 profuse elimination of effete and toxic materials and inducing 
 a marked degree of end nerve stimulation followed by prompt 
 responses of the vascular and respiratory centers. Moist heat 
 applications do not permit of local evaporation, though the 
 heating of the blood does induce perspiration to a degree from 
 the surface of the body not exposed to the direct application 
 of the moist heat. These distinctions render the two forms 
 of convective heat application of distinct advantage or dis- 
 advantage according to the condition for which it is employed. 
 
 The means of applying moist heat have been long in vogue 
 and comprise the employment of poultices, a combination of 
 kaolin and glycerine, or the familiar antiphlogistine adminis- 
 trations, as well as the use of douches, and the general ap- 
 plication of steam or Russian baths. Moist applications may 
 also be applied by placing a damp flannel cloth over the surface 
 treated, over which dry heat should be applied from hot flannel 
 pads, hot water bags, or other heated material. 
 
 The method of using moist heat may be by application of 
 local poultices, hot water bags, pads or other heated mate- 
 rials placed over moistened flannels, or the employment of 
 kaolin cataplasms, or antiphlogistine, heated as hot as can be 
 borne, the heat being maintained in all cases by frequent 
 changes of the poultice or overlying material which gives up 
 its heat least rapidly, as water in bags, or heated flannels, or 
 heated objects wrapped in flannel. Another well recognized 
 method of applying heat to the cavities of the body is by means 
 of hot water douches or enemas. For general applications of 
 moist heat, the hot bath or Turkish or steam baths are the 
 means usually employed.
 
 CHAPTER II 
 PHYSIOLOGICAL EFFECTS OF CONVECTIVE HEAT 
 
 The physiological effects of convective heat give it rank 
 among the most valuable of the therapeutic agents. It occu- 
 pies a well recognized place of great utility in the sanitariums, 
 at the bedside, and in the office of the practitioner. The effects 
 may be divided into local and general. 
 
 The local applications of convective heat as applied to in- 
 flammatory conditions, from the point of view of a local con- 
 stringent, was ably described by Dr. Thomas Addis Emmett in 
 the third edition of his work on "Principles and Practice of 
 Gynecology," page HI, in the following language: 
 
 "Cold is a prompt exciter of reflex action by which the ves- 
 sels are made to contract, but on reaction taking place, the 
 parts will become more congested than before, both the arteries 
 and the veins being distended. 
 
 "Heat, unless at a temperature that would destroy the parts, 
 does not act so promptly in causing this contraction as either 
 electricity or cold. In fact, its immediate effect is to cause 
 relaxation, and to increase the congestion of the parts; but, 
 if its application is prolonged reaction ensues, and contraction 
 takes place; in other words, the reaction from heat is con- 
 traction. Under the increased nerve stimulus the capillaries 
 are excited to contract, this effect extending also to the coats 
 of the larger vessels, and as their caliber becomes smaller the 
 congestion is diminished. The popular belief is that heat 
 relaxes and increases the congestion of parts, and such indeed 
 is the case at first. But a hot poultice is never applied with 
 the object of increasing the congestion, but, as any 'old wife' 
 would express it, to draw the 'fire' or inflammation out; in 
 other words, it lessens the congestion by stimulating the blood- 
 vessels to contract. That such is the effect, from the pro- 
 longed use of a poultice, is familiar to everyone, and is well 
 shown by the blanched and shriveled appearance of the tissues 
 after its removal. The hands and arms of a washerwoman, 
 when in hot water, become swollen at first, from the increased 
 
 95
 
 96 CONVECTIVE HEAT 
 
 flow of blood to them, but it is a well-known fact that they 
 afterwards become markedly shriveled. 
 
 "Placing the hands in cold water at once causes the skin 
 to shrivel, as the vessels are stimulated to contract, but we 
 know that reaction promptly comes on, and a larger quantity 
 of blood returns to the parts than was driven out. But, after 
 soaking in hot water, the skin does not recover its natural ap- 
 pearance for hours, since the capillaries remain contracted. In 
 their return to the natural state the reaction does not go on 
 to a paralysis of over-distention, and hence there is no sub- 
 sequent congestion. The immediate effect of cold upon the 
 capillaries, therefore, is contraction, and with reaction comes 
 dilatation ; but the reverse is true of heat, which causes at first 
 dilatation, followed by contraction." 
 
 Acting upon the principles laid down in the above explana- 
 tion of the effects of heat and cold, the author has made use 
 of these agents for more than twenty years. At the time 
 of the publication of the third edition of Dr. Emmett's work 
 (1884), there was no published knowledge of the action of 
 the phagocytes connective tissue cells (macrophages), or 
 leucocytes (microphages) which envelop germs and devour 
 them. The significance, therefore, of the induction of intense 
 local hyperemia and the fact that such hyperemia favored de- 
 struction of microbes, could not then be appreciated. At this 
 time, however, when it is a well established fact that the body 
 in varying degrees depending upon the physical condition of 
 the individual is capable by its own defenses of destroying in- 
 fectious elements through the agency of these active cell 
 bodies, the recognition of phagocytosis is of the greatest sig- 
 nificance. 
 
 That in the early stage of superficial suppurating processes, 
 the application of heat, with the proper degree of energy, is a 
 most certain means of resolving the process, has been estab- 
 lished by the writer and many other observers by practical 
 experience. 
 
 There are several possible factors which may be active in 
 effecting the resolution and healing of septic processes as in- 
 duced by the administration of hot applications, (i) The 
 increased hyperemia occurring with tissue relaxation, which 
 is present during the early part of the heat administration, 
 brings into the involved tissues a greater number of leucocytes
 
 EFFECTS OF CONVECTIVE HEAT 97 
 
 in proportion as the volume of arterial blood is increased, to- 
 gether with an increased amount of oxygen, so essential to 
 local metabolism and prompt diapedesis of the leucocytes. 
 (2) The profuse local and general perspiration induced, alters 
 toward normal the fluids in the field of involvement and coin- 
 cidently eliminates to an extent other materials affecting the 
 constitutional condition of the patient possibly favoring a 
 general phagocytosis. (3) The action of heat, upon the super- 
 ficial tissues, may coincidently inhibit the activity of the mi- 
 crobes, or by altering the constitution of the fluids, as sug- 
 gested, produce a larger degree of positive chemotaxis. (4) 
 The production of more active metabolism in the tissues will 
 tend also to increase the natural fortifications of the involved 
 tissues, increasing the activity of the macrophages. 
 
 Clinical experience has well demonstrated the efficacy of 
 the hyperemia and stimulating effects of heat in effecting the 
 local destruction of infection a fact worthy of investigation 
 and definite determination as to whether in the workings of the 
 vis medicatrix natures the fever process is not a condition 
 created for action unfavorable to the infecting microbes, by 
 coincidently favoring a positive' chemotaxis or action tending 
 tq_ limit the disease. The remarkable effects derived from ad- 
 ministrations of dry hot air in the destruction of local and 
 general infection with the coincident falling of the body tem- 
 perature to normal, would seem to indicate that the workings 
 of nature's processes against infection are normally, by rais- 
 ing the body temperature to assist the phagocytes, to destroy 
 the microbes by the induction of such increased body tempera- 
 ture the fever. If so, it is evidently an error, except under 
 conditions of extreme hyperpyrexia, to interfere with body 
 temperature, and rather than employ cold baths, to institute the 
 use of the body dry hot air or light baths to assist nature, in 
 increasing the activity of the phagocytes. 
 
 The following observations made by the writer, with Drs. 
 Grad and Munday, would seem to fortify this hypothesis. A 
 patient in extremis from general septicemia, three weeks after 
 a difficult surgical operation, with the characteristic feeble 
 pulse, livid countenance, and a temperature of 105 F., was 
 wrapped by the usual method in Turkish toweling and placed 
 in a body hot air apparatus at a temperature of 300 to 350 
 F., and after thirty minutes removed with a full strong pulse,
 
 98 CONVECTIVE HEAT 
 
 a marked hyperemia of the skin, and a mouth temperature of 
 103 F. Eight hours later the temperature was normal, and 
 the patient convalescent in ten days. This extraordinary re- 
 sult could only be explained by (i) the induction of an active 
 phagocytosis with a positive chemotaxis; (2) stimulation by 
 heat of the deep spinal centers, particularly the cardiac and 
 respiratory; and (3) the elimination of toxins and other 
 bodies through the agency of the profuse perspiration induced 
 by the high temperature. 
 
 The writer has invariably observed the rapid fall of tem- 
 perature following the application of heat to areas of local 
 infection as in suppurative tonsilitis, as well, also, in cases in 
 which the static current has been employed for the relief of 
 early local infection. 
 
 The action of local dry heat on localized septic infection, 
 when high temperatures are employed, as in the case above 
 described, has been uniformly successful in the writer's ex- 
 perience even in cases of extensive local infection involving 
 the hand and arm and also in cases of gangrene, all tending 
 to confirm the physiological effect of high temperature in re- 
 lieving local as well as general infection. 
 
 In conditions of poor metabolism, arising from bodily in- 
 activity, excesses in diet, and auto-intoxication, the effects of 
 convective dry heat or the combination of radiant light and 
 heat together with convective heat, as administered in in- 
 closures with the high candle-power incandescent or arc lights, 
 or better in the incandescent electric light bath, are remarkably 
 efficient in promoting the elimination of waste products through 
 the skin, and coincidently by stimulation of the deep spinal 
 centers, the effect of exposure of the surface to intense heat 
 thereby inducing greater activity of the other channels of ex- 
 cretion and elimination. This fact is clinically well demon- 
 strated by chemical analysis of the secretions and relief from 
 conditions of auto-intoxication, nephritis, and gouty and rheu- 
 matic affections. It is an undoubted fact that owing to effects 
 of profuse perspiration, the sweat glands do eliminate nitrog- 
 enous, toxic, and other effete materials from the organism, 
 which in nephritis is wonderfully effective in relieving the labor 
 of the diseased kidneys, and removing the danger from other 
 grave conditions. 
 
 The action of dry heat in the body apparatus upon the
 
 EFFECTS OF CONVECTIVE HEAT 99 
 
 7r r~ 
 periphery induces a pronounced general hyperemia of the skin, 
 
 and coincidently stimulates the activity of the heart and rep 
 spiratory centers. Together, however, with the profuse per- 
 spiration, the draft upon the general circulation to tlu 3 
 hyperemia of the skin, offers the only danger from the a3- 
 ministration by leaving too small amount of blood in the larger 
 arteries. Such danger is obviated by keeping the patient in 
 a recumbent position and administering frequent draughts 
 of water during and following the administration.
 
 "I c 
 
 ~L ^ 
 
 111 
 ^ o 
 
 11 1*1 ^ 
 
 W o 
 
 ix p- cc 
 
 CHAPTER III 
 
 ADMINISTRATION OF DRY AND MOIST HEAT 
 
 administrations of dry heat are best executed locally 
 by'me&ns of the hot water bag wrapped in dry flannel cloths 
 to prevent the too rapid escape of heat, or by means of the 
 various dry hot air apparatus manufactured for local and gen- 
 eral treatment, by the application of other heated substances to 
 the surface, or by the use of Turkish baths. The application* 
 of dry hot air by means of the hot air apparatus, the body be- 
 ing wrapped in Turkish toweling, partakes to a slight degree 
 of the character of moist applications, the perspiration con- 
 stantly escaping from the body to be absorbed by the Turkish 
 toweling, but to no extent approaching the degree of moisture 
 of the wet applications. 
 
 The methods of applying moist heat are in principle the 
 same; the object being to maintain a temperature as high as 
 can be borne on the surface of the body or in the cavities for 
 periods of time, varying with the indication for relief of the 
 affection under treatment. 
 
 The poultice, the oldest popular form of heat application, 
 derives its efficacy from the length of time which it will main- 
 tain a higher temperature than the body. The material best 
 suited for the purpose is therefore one which will hold the 
 heat for the longest time. Flax-seed has generally been the 
 material preferred. The writer recalls the old way in which 
 the poultice was used by the layman and the physician who 
 little appreciated the requirements of the poultice. A thin paste 
 applied hot, as if the virtue lay in the paste, but not changed 
 for hours, or a day, was too often the error of our ancestors 
 and their patients. By these it was little realized that the 
 object of the poultice was the application and maintenance of 
 intense heat for its therapeutic properties. 
 
 Time has practically displaced the poultice as the institu- 
 tion of the hot water bags and the later preparations of kaolin 
 cataplasms of which the proprietary preparation, antiphlogis- 
 tine, was the earliest if not the best product of the kind. It
 
 ADMINISTRATION OF DRY AND MOIST HEAT 101 
 
 possesses such advantages over the sodden poultice that the 
 latter is employed relatively little by the present generation. 
 In his own private practice the writer, before the days of 
 antiphlogistine and before the general use of the water bag, 
 recognizing the principles of heat application, instituted for 
 his own cases the employment of large, thick, woolen pads, 
 made of old material quilted together in pads of one and one- 
 half to two inches in thickness, and of sizes large and small 
 to meet varying conditions, two of them being always in requi- 
 sition. It was the custom to apply the heat in this manner 
 by placing one thickness of flannel cloth wrung from hot water 
 over the inflamed area, following, usually, the application of 
 a sinapism, alternating the application of these two pads every 
 fifteen or twenty minutes, thereby maintaining for hours an 
 intense application of moist heat, the changes being effected 
 without exposing the surface to the cool air of the room. 
 
 The hot water bag may be employed in the same manner, 
 but its weight is often objectionable. When used, if wrapped 
 in flannel, the heat is preserved for a longer time. When of 
 the proper size, if the water is frequently changed, it is a con- 
 venient and practical means of maintaining heat application. 
 
 In antiphlogistine, the proprietary preparation, or the 
 kaolin cataplasm, is added the hygroscopic glycerine which is 
 capable of abstracting considerable fluid from the tissues 
 another advantage particularly in inflammatory conditions as- 
 sociated with infiltration. When this or similar preparations 
 are used they should be applied in a thick coating and as hot 
 as can be borne directly to the bare skin. It is desirable in 
 most cases to maintain the heat in these materials by the appli- 
 cation of dry heat over all, as of the hot water bag, the addi- 
 tional application thereby maintaining the heat as long as is 
 desirable. In these applications the effect is derived from the 
 dry heat and the combined depleting effects of the glycerine 
 in combination with the heat conducting qualities of the 
 material of which they are composed. 
 
 The Russian bath is deservedly the least popular of all of 
 the moist applications ; because the patient is not only subjected 
 to intense heat in a moist atmosphere, and the necessity of 
 employing lower temperatures because the moisture does not 
 permit of ready evaporation from the surface of the body of 
 perspiration, and at the same time the patient is subjected to
 
 102 CONVECTIVE HEAT 
 
 the inhalation of the heated steam. The method is of too little 
 therapeutic value to deserve more than mention of its char- 
 acteristics. Administrations of convective dry heat in a hot 
 box or the Turkish bath in such a manner that the perspiration 
 will be rapidly evaporated, are far superior in their effects to 
 the use of the moist steam bath. 
 
 The hot water bath as a general application possesses an 
 advantage over the Russian bath and is a convenient method 
 of inducing prompt relaxation or reflex stimulation under con- 
 ditions in which it would not be convenient to administer the 
 Turkish or dry hot air bath. 
 
 The hot douche for the employment of heat by means of hot 
 water, is the recognized method of administering heat to the 
 cavities of the body. The method was first accorded urgent 
 recommendation by Dr. Thomas Addis Emmett, of New York. 
 The value of this measure is appreciated by the profession at 
 large; but too often douches have been administered in a 
 perfunctory manner, the necessity for maintaining the tempera- 
 ture at 108 to 110 F. for long enough periods of time not 
 having been generally appreciated by many who have employed 
 and prescribed it. The value of this method was ably described 
 in the work of Dr. Emmett. 
 
 The administration of dry heat may be made either by means 
 of apparatus constructed for the purpose as the local and 
 body hot air apparatus, or by means of light baths which com- 
 bine the effects of radiant and convective heat ; the accumulated 
 heat in the inclosed cabinet having the convective characteristic 
 with the radiant heat added. 
 
 Another method which is practical at the bedside is effected 
 by placing alongside of the patient, covered with one thickness 
 of Turkish toweling to prevent the bottles of hot water from 
 coming in contact with the skin, or by wrapping the receptacles 
 in moist or dry flannel cloths, as many gallons of boiling hot 
 water as is desirable, covering all with flannel blankets. In this 
 manner dry heat may be applied with pronounced effect at a 
 temperature of approximately 200 F. and maintained for as 
 long a time as desirable. 
 
 When the local or body hot air apparatus is employed, the 
 parts exposed to the heat should be wrapped in two or three 
 layers of Turkish toweling so applied as to come in contact 
 with every part of the surface so exposed, in order that the
 
 Plate VII. Local Betz Knee Joint Apparatus as Applied.
 
 ADMINISTRATION OF DRY AND MOIST HEAT 103 
 
 perspiration as it escapes from the tissues may be taken up 
 by capillary attraction from the surface by the little wicks 
 of the toweling. At any part of the surface that is not in con- 
 tact, drops of water will collect, boil, and scald the surface; 
 for with the temperatures employed, 300 to 400 F., the water 
 will be readily raised to 212 by the penetration of heat through 
 the wrappings. The rapid evaporation from the skin under 
 these conditions permits an intense application of heat to the 
 surface under the above precautions, with the induction of 
 intense hyperemia and without danger to the tissue so exposed, 
 offering one of the best facilities for the induction of pro- 
 found reflex stimulation and intense hyperemia so valuable for 
 the treatment of infectious troubles, as well as inducing pro- 
 nounced elimination through the agency of the perspiration. 
 
 The hot box, used in connection with hydrotherapeutic ap- 
 plications, is so constructed that the patient, seated upon a 
 stool, nude, with the head protruding through an opening, 
 which closes about the neck, is exposed to an influx of dry 
 heat at temperatures from 200 to 225 F. This method is so 
 employed, when it is intended to be followed by the applica- 
 tion of the hydrotherapeutic douche, spray, or plunge, the sud- 
 den changes of temperature being employed to induce extreme 
 degrees of reaction. The light bath, as employed by Winternitz 
 and his followers in connection with the hydrotherapeutic es- 
 tablishments, is rapidly replacing the hot box. 
 
 The Turkish bath administered to the patient nude in a 
 room heated to a temperature of from 150 to 170 F., is a pop- 
 ular method of applying heat for the induction of perspiration. 
 The particular objections to this method are that the patient is 
 obliged to inhale this heated air, and that with the head in 
 the same temperature, moist towels but partially relieve the dis- 
 agreeable effects of cerebral congestion. This method of treat- 
 ment is as a rule employed in connection with rubbing, knead- 
 ing, and massage, and possesses certain advantages of a pop- 
 ular sort, but is not calculated for use in the treatment of 
 localized conditions, or when there is indication for profound 
 effects upon general metabolism.
 
 CHAPTER IV 
 THERAPEUTICS OF CONVECTIVE HEAT 
 
 The indications for the employment of convective heat sug- 
 gested by the physiological effects upon the organism, com- 
 prise its application alone or in conjunction with radiant light 
 and heat, the x-ray, or the static or high frequency currents, 
 one or more of them, in the treatment of infectious inflamma- 
 tion, and in the early stage of traumatic or non-infected inflam- 
 mation, when sometimes better means are not at hand. It is also 
 a valuable factor in association with other measures applied 
 with the body hot air apparatus or light bath for the relief of 
 defective metabolism. 
 
 The therapeutics of convective moist and dry heat at the 
 bedside and in many conditions in which other measures bet- 
 ter adapted are not at hand, is very large and under these 
 conditions is one of the most valuable means at command. 
 
 The local use of convective heat is indicated in all super- 
 ficial inflammatory processes associated with the presence of 
 pus; not in a perfunctory way by the casual application of a 
 hot wet poultice, a hot water bag, or a thick layer of antiphlo- 
 gistine to be left in situ for hours without the application of 
 additional heat, but with strict observance of the temperatures 
 employed and of the time necessary to meet the indication. 
 
 The treatment of an early quinsy or suppurative tonsilitis 
 which may be readily aborted if given proper attention, would 
 go on suppurating with the indifferent use of local heat appli- 
 cations. In tonsilitis some application may be made first as a 
 sinapism for the purpose of inducing a very active local hyper- 
 emia, over and around the indurated area, to be removed be- 
 fore blistering as soon as an intense redness is effected. A 
 thin flannel cloth, large enough to cover the spot rendered 
 hyperemic by the mustard, wrung from hot water should be 
 laid over the surface, and over this a large hot water 
 bag covered with several thicknesses of flannel or a pad 
 made of several thicknesses of flannel should be placed. 
 The hot water bag or heated flannel pads used should be 
 changed as often as necessary to keep the heat at as high and 
 
 104
 
 THERAPEUTICS OF CONVECTIVE HEAT 105 
 
 uniform temperature as can be borne. These applications 
 should be maintained for four or five hours, or until every bit 
 of induration or pain has disappeared. If such applications 
 are made on the first or second day, the effect is abortive 
 and, as suggested above, is explained by the fact that the 
 hyperemia is effected with coincident relaxation of the involved 
 tissues, associated with the presence of a greater number and 
 greater activity of the phagocytes conditions favorable to the 
 destruction of the germs, followed by the later constringent 
 effect with final resolution of the induration, and removal of 
 every trace of the inflammatory process. 
 
 The same effect as in tonsilitis is readily obtained in the 
 treatment of felons or whitlows, by another method. With a 
 cup of water and a pitcher of boiling water at hand, the pa- 
 tient is directed to at first place his finger, out and in, the fluid 
 in the cup until it can be held constantly within the hot water, 
 adding from the pitcher of boiling water from time to time 
 sufficient to maintain the highest possible temperature that can 
 be borne. It is important to keep this up from three to four 
 hours, or until all pain has ceased, and the finger is in a 
 shriveled and puckered condition, repeating the procedure 
 after several hours, if necessary, until no pain returns. In 
 the early stage when the throbbing and pain are well estab- 
 lished, but before much pus is present, this method will in- 
 variably abort this painful condition. The same result can 
 be effected with the static brush discharge or the vacuum tube 
 current taken directly from the static machine in from ten 
 to fifteen minutes, and likewise in tonsilitis. (See Snow's 
 " High Potential Currents.") 
 
 In the early stage of mastoiditis, or of furuncles in the 
 aural canal, or otitis media, the surface application of heat in 
 the same manner as in the treatment of tonsilitis and for as 
 long or longer periods of time, when employed early, is very 
 effective in relieving the conditions, though not with such 
 energy and promptness as the application of radiant heat. The 
 same method is applicable to the treatment of boils, furuncles, 
 and other abscesses superficially located. 
 
 In inflammatory conditions of the pleural and abdominal 
 cavities, applications of heat on the same principle are very 
 effective, though in deep-seated conditions they will often ut- 
 terly fail of effecting the desired result.
 
 106 CONVECTIVE HEAT 
 
 In pleurisy, treatment for from three to five hours with 
 large surface applications kept as hot as can be borne, a happy 
 result is promptly effected in most cases, and it is a question 
 if many cases of pneumonia may not be aborted by these same 
 early applications of heat in conjunction with other rational 
 procedures. Probably in this case the employment of kaolin 
 cataplasms or antiphlogistine in a thick hot layer placed over 
 the affected area, over which applications of heat are made to 
 maintain the temperature, is a most convenient and effective 
 means of treatment. It is a striking fact that over some condi- 
 tions, these preparations, mixed as they are with glycerine, will 
 become dry and hardened, while in others the abstraction of 
 moisture will cause the composition to become thin and volatile 
 in consistence. This is explained from the fact that in severe 
 inflammatory conditions of congestion with impaired secretion, 
 the tissues seem to absorb the glycerine from the compound. 
 
 In peritonitis and the painful conditions associated with 
 appendicitis or other abdominal abscesses, where the weight 
 of the application is an objectionable feature, the application 
 of a sinapism, followed by the flannel cloth wrung from hot 
 water, and the subsequent frequent changing of heated flannel 
 pads, for hours, maintaining as high a temperature as can 
 be tolerated, is indicated. This method first favors a localized 
 active phagocytosis, and is later followed by a resolvent action 
 and restoration in favorable cases as a result of the destruction 
 of the germ in situ. 
 
 Applied for relief of the deeper processes, as demonstrated 
 by Oilman Thompson,* the effects of convective heat are not 
 effective. Hence the administration of convective dry heat 
 is generally ineffective, except in so far as it raises the 
 general resistance by promoting metabolism and general elim- 
 ination. In such cases, however, the body hot air bath, by em- 
 ploying very high temperatures, offers much ; but probably no 
 agent, except the x-ray, which has a potent effect upon pus 
 processes, is more efficacious in deep-seated processes than 
 radiant light and heat focused to small surfaces or applied 
 largely from sources of high candle-power. There is no doubt 
 in the mind of the writer, from his own experience, and the 
 experience of his confreres, that radiant light and heat are very 
 effective in influencing deep inflammatory processes in the 
 
 * Thermotherapy, New York Medical Record, April, 1907.
 
 THERAPEUTICS OF CONVECTIVE HEAT 107 
 
 cavities of the trunk, and are indicated in all such cases, the 
 applications being made for considerable time, and as close to 
 the source of radiation as can be borne, and frequently repeated 
 until the inflammatory process is abated. 
 
 The employment with the local hot air apparatus over in- 
 flammatory regions in the pleural and abdominal cavities, is an- 
 other efficient method of applying convective heat in these 
 cases. The patient, reclining, is placed near the edge of the 
 bed, with the side or surface involved directed towards the 
 open side of the apparatus.. The surface to be treated is then 
 wrapped with two or three layers of Turkish toweling and 
 the hood of the apparatus is brought to the surface in such 
 a manner as to convey the heat to the affected area; by this 
 means temperatures ranging from 300 to 400 F. may be 
 administered for as long a period as indicated, usually for 
 from twenty minutes to one-half hour. 
 
 Another method of employing convective dry heat in con- 
 nection zvith cold applications will prove invaluable in some 
 subacute inflammatory processes, or abdominal hyperemia, 
 as follows. In congestion of the large glands, the liver and 
 spleen, for example, associated with a low grade general 
 metabolism, the application of heat to the lower portion of the 
 trunk and limbs, by means of several gallons of boiling hot 
 water in receptacles, wrapped in flannel cloths and placed upon 
 the blankets upon which the patient reclines, and then with 
 all the lower abdomen and lower extremities enveloped in 
 blankets, cold compresses at a temperature of 60 F., and fre- 
 quently changed are applied over the involved glands. This 
 method will be found also invaluable in cases of reversed 
 peristalsis, when occurring in connection with post-operative 
 vomiting. The happiest result in a condition of this kind was 
 effected in the writer's family at the suggestion of Dr. Morris 
 W. Brinkmann, of New York, and its value, well attested by 
 the prompt relief afforded after three days of stercoraceous 
 vomiting. 
 
 The use of hot douches for rectal and colonic flushings, and 
 the treatment of pelvic cellulitis per vaginam, which is cordially 
 recommended as instituted by Dr. Thomas Addis Emmett,* is 
 a means of conveying convective heat into the cavities of the 
 body, which has proved extremely efficient in the class of cases 
 
 * Principles and Practice of Gynecology, 3d edition, page 113.
 
 io8 CONVECTIVE HEAT 
 
 in which it is indicated. The correctness of the technique em- 
 ployed in these cases is of the utmost importance. It should 
 be borne in mind (i) that the treatment is for the purpose 
 of the convective application of moist heat to inflammatory con- 
 ditions; (2) that a temperature should be maintained at as 
 high a degree as can be tolerated (from 108 to 115 F.) ; 
 (3) that it should be administered to the patient with the hips 
 elevated, with the employment of a proper douche pan; and (4) 
 that the flow should be retarded and the time of the adminis- 
 tration be made from thirty minutes to one hour, the quantity 
 of water employed being the secondary consideration, the 
 time element and temperature being the elements of greatest 
 importance. In congestion associated with infection, a hot 
 douche will prove of the greatest service at the bedside, but 
 will not compare in value with the employment of the static and 
 high frequency currents in inflammatory conditions, using 
 the static wave current or the direct vacuum tube current in 
 non-infected cases, or the high frequency currents or the x-ray 
 in infected cases. 
 
 In cases of general septic infection following a condition of 
 localized infection, the employment of the body hot air applica- 
 tions at temperatures varying from 250 to 350 F., the patient 
 properly wrapped in Turkish toweling, as previously described, 
 offers, we believe, one of the greatest possibilities of controlling 
 those generally fatal conditions of any means yet employed. 
 The light bath employing the combined effects of radiant light 
 and convective heat, from accumulation of heat, in the cabinet, 
 may serve an equal or better purpose in such cases, in accord- 
 ance with the physiological effects upon phagocytosis and ac- 
 tive elimination and stimulation of the reflex centers, all of 
 which tend to raise the opsonic index and increase of the 
 body energy. 
 
 The treatment of localised septicemia in the extremities 
 offers an efficient means ; and a greater boon to humanity, is 
 hard to find than the employment of convective dry heat in 
 these cases, with the proper local apparatus capable of em- 
 ploying temperatures of 200 to 400 F. In these cases it is 
 always necessary to open up and drain all collections of pus, 
 when the subsequent daily applications of dry heat in the man- 
 ner described will effectually terminate the infectious process 
 in all cases within a few days, three usually sufficing.
 
 Plate VIII. Treatment of Leg and Thigh with Local Betz Dry Hot Air 
 
 Apparatus.
 
 THERAPEUTICS OF CONVECTIVE HEAT 109 
 
 In cases of remote acute congestion, as in lesions of the spinal 
 cord, or liver, it may be desirable to stimulate the vasculariza- 
 tion of the skin in order to drive as much as possible of the 
 blood from the deep processes into the skin. In these cases, 
 the employment of the body hot air bath, or at the bedside 
 by placing many gallons of hot water in receptacles wrapped 
 in flannel cloths about the patient in bed and over all placing 
 several blankets, is effective. By this means a temperature of 
 200 may be maintained for the desired length of time, vary- 
 ing with the conditions under treatment. 
 
 The treatment of non-infectious inflammatory conditions, 
 by the employment of convective moist or dry heat, is of com- 
 paratively little efficiency except in the early stages of such 
 congestion. While it may relieve pain temporarily by lessen- 
 ing tissue and vascular tension, it will fail to remove the ex- 
 isting condition of stasis with the associated tissue infiltra- 
 tion and induration, and consequently fail to effect complete 
 relief of the condition. This has been amply demonstrated in 
 the treatment of synovitis, sprains, and contusions which 
 promptly yield to the administration of the static current. 
 When these means, however, are not at hand, in the early 
 stage of trauma, the judicious employment of heat, preferably 
 dry heat, in connection with strapping, is often effective, but 
 not so promptly as applications of static currents and sparks. 
 
 For defective general metabolism associated with gout, 
 rheumatism, and auto-intoxication the forerunners of arterio- 
 sclerosis, the frequent administration of convective dry heat 
 or radiant and convective light and heat administrations in 
 the light bath, are measures demanding the most urgent rec- 
 ommendation ; for by acting reflexly upon the centers govern- 
 ing the functions of excretion and elimination of the skin, 
 kidneys, and other emunctories, they exercise a most valuable 
 influence in quickening metabolism and promoting an elimina- 
 tion of waste products and toxins from the body, and together 
 with regulated exercise and diet, and avoidance of such things 
 as aggravate the conditions, influence a restoration of the nor- 
 mal physical conditions of metabolism to a degree readily 
 appreciated. Administrations are to be made during the course 
 of treatment, two or three times weekly, for two or three 
 months, or until the conditions of arterial tension and the char- 
 acter of the secretions eliminated, indicate a restoration to
 
 i io CONVECTIVE HEAT 
 
 normal of the functions generally. Convective dry heat, or 
 radiant light and heat, always administered in conjunction with 
 auto-condensation, alternated with the constitutional adminis- 
 tration of the static wave current, is remarkably efficacious 
 in lowering high arterial tension, and preventing farther de- 
 structive or calcareous changes in the muscular coats of the 
 arterioles, thereby warding off or preventing a dangerous de- 
 gree of arteriosclerosis. 
 
 The above observations are readily appreciated by those who 
 have become familiar with the employment of physical agents, 
 but as will be suggested throughout this series, it is evident to 
 the trained medical mind that the greatest results in therapeu- 
 tics are to be obtained not from the employment of any one 
 physical agent, but by the intelligent employment of each, in 
 combination with others, as indicated to best meet the con- 
 ditions presenting.
 
 INDEX 
 
 Absorption induces heat, 22 
 
 Acne rosacea, 68 
 
 Actinic effects of light, 23 
 
 of radiant light, 74 
 
 Action of Roentgen ray on germ 
 
 life, 56 
 
 Activity essential to health, 17 
 
 Adenitis, tubercular, treatment of, 
 61 
 
 Administration of light bath, 47 
 
 Alopecia areata, 68 
 
 Anal conditions treated by arc 
 light, 62 
 
 Anemia, pernicious, 78 
 
 Antiphlogistine, application of, 94- 
 101 
 
 Arc light, advantages of, 26 
 
 and incandescent lamps com- 
 pared, 26 
 
 bath, 36 
 
 , disadvantages of, 26 
 
 in nasal and throat condi- 
 tions, 62 
 
 in treatment of cavities, 62 
 
 in treatment of impetigo, 71 
 
 in treatment of pityriasis 
 
 versicolor, 71 
 
 in treatment of prurigo, 71 
 
 , objections to, 25 
 
 rich in ultra-violet, 26 
 
 Areas, circumscribed, treated with 
 
 smaller lamps, 45 
 
 Arterial tension, high, treatment 
 of, 48 
 
 Arteriosclerosis, controlled, 78 
 
 , dry heat as a preventive 
 
 measure, 109 
 
 , treatment by dry heat, 1 10 
 
 , treatment of, 77 
 
 Arthritis, gonorrhea!, observation 
 on, 76 
 
 , infectious, treatment of, 76 
 
 , tubercular, x-ray and high 
 
 frequency treatment of, 60 
 
 Artificial sources of radiant en- 
 ergy, 25 
 
 Atonic skin conditions, 64 
 
 Auto-condensation after light bath, 
 
 47 
 
 Auto-intoxication, dry hot air in 
 
 treatment of, 109 
 , light baths in, 48 
 
 Bath, hot water, application of, 
 94-102 
 
 , moist steam, 94-101 
 
 , Turkish, 94-102 
 
 Bier and advocates do not recog- 
 nize phagocytosis, 54 
 
 on treatment by hyperemia, 
 
 54 
 Blood, effects of radiant light on, 
 
 74 
 
 not affected by Roentgen ray 
 
 when localized, 54 
 
 stream heated by radiant en- 
 ergy, 40 
 
 Body hot air apparatus, action of 
 heat in, 98 
 
 temperature dependent upon 
 
 radiation, 22, 
 
 temperature, effects of dry 
 
 heat on, 97 
 
 Brinkmann, Dr. Morris Weil, 
 107 
 
 Brush discharge, static, in treat- 
 ment of phlebitis, 61 
 
 Buccal cavities treated by arc 
 light, 62 
 
 Cabinets, light bath, 33 
 Carbuncles, treatment of, 60 
 Cases of varicose ulcer treated, 
 
 65 
 Centers, deep spinal, effects of 
 
 radiant light and heat on, 74 
 Chemical processes produce heat, 
 
 22 
 
 Chemotaxis, effects of dry heat 
 on, 97 
 
 , positive, demands oxygen, 54 
 
 , positive, influenced by light, 
 
 23 
 
 , radiant light and heat in, 56 
 
 Choice of incandescent lamps in 
 treatment, 45 
 
 Classification of simple inflamma- 
 tions, 49 
 
 Cleaves, Dr. Margaret A., 61-62 
 
 Colonic flushings, 107 
 
 Color defined, 21 
 
 production, 18 
 
 Confinement, effects of, 79 
 Congestion, treatment with dry 
 
 heat, 109
 
 112 
 
 INDEX 
 
 Constitutional or general treat- 
 ment, 46 
 
 treatment with lamps of high 
 
 c.p. preferred, 45 
 
 Convective equalization of heat, 
 40 
 
 heat, advantages of, 76 
 
 , Oilman Thompson's experi- 
 ments with, 93 
 
 in contradistinction to radi- 
 ant heat, 93 
 
 , indications for employment 
 
 of, 104 
 
 , induces phagocytosis, 96 
 
 , influence of elimination, 76 
 
 , local applications of, 95 
 
 , methods of applications of, 
 
 94 
 
 heat, physiological actions 
 
 of, 295 
 
 in suppurative tonsilitis, 104 
 
 vs. radiant energy in otitis 
 
 media, 59 
 
 Convergent reflections, dark spots 
 beyond focus in, 20 
 
 Crookes tube, 25 
 
 , penetration of rays from, 81 
 
 Crothers, Dr. T. D., 77 
 
 Curatulo on the uses of photo- 
 therapy in obstetrics, 61 
 
 Cystitis, treatment by high fre- 
 quency currents, 57 
 
 , treatment by radiant energy, 
 
 56 
 
 , treatment by x-rays, 57 
 
 Danger of radiant energy small, 
 15 
 
 Dark spots of parabolic lamps, 20 
 
 Delbers reports of lumbago 
 treated, 52 
 
 Derivative effects of radiant light 
 and heat, 42 
 
 Dermatitis or blistering rarely oc- 
 curs from incandescent radia- 
 tions, 46 
 
 Dermatology, radiant energy in, 
 64 
 
 Desloges, Dr., ovaritis, treatment 
 by white light, 61-70 
 
 Dickson, Dr. C. R., on use of iron 
 electrode arc, 71 
 
 Diosurio's treatment by light and 
 high frequency currents, 62 
 
 Douches, hot, 107 
 
 , vaginal, in cellulitis, 107 
 
 Dry heat, action of, on chemio- 
 taxis, 97 
 
 , action of, on localized in- 
 fection, 98 
 
 , action of, on metabolism, 97 
 
 Dry heat, application by hot water 
 bags, 94-101 
 
 , application of, 
 
 , a preventive measure in ar- 
 teriosclerosis, 109 
 
 , body, in treatment of gout, 
 
 199 
 
 , body, remarkable effects of, 
 
 97 
 
 by Turkish baths, 94-101 
 
 , comparison with light bath, 
 
 , convective, ineffective in 
 
 deep-seated conditions, 106 
 
 , convective in treatment of 
 
 localized septicemia, 108 
 
 , effects of application, 94-100 
 
 , effects of perspiration from, 
 
 97 
 
 , effects on temperature, 97 
 
 , effects on toxemia 97 
 
 , hyperemia induced by, 94 
 
 in felons or whitlows, 105 
 
 in mastoiditis, 105 
 
 in treatment of furuncles, 
 
 105 
 
 in treatment of non-infected 
 
 inflammation, 109 
 
 , methods of applying, 104 
 
 , not affecting stasis, 109 
 
 Dry hot air in treatment of auto- 
 intoxication, 109 
 
 in treatment of rheumatism, 
 
 109 
 
 Eczema, moist, of hands, treat- 
 ment of, 70 
 treated by radiant energy, 70 
 
 treated by radiant light and 
 
 heat, 70 
 
 treated by static brush dis- 
 charge, 70 
 
 Effects, extreme, of normal radi- 
 ations, 17 
 
 of absorption of colored in- 
 candescent bulbs, 22 
 
 Effleuvation instead of Finsen 
 method, 46 
 
 Effleuve high potential in atonic 
 skin conditions, 64 
 
 Elimination induced by radiant 
 light and heat, 42 
 
 through emunctories induced 
 
 by radiant light and heat, 75 
 
 Emmett, Dr. Thomas Addis, 95- 
 
 107 
 , Dr. Thomas Addis, on heat 
 
 effect, 94-102 
 Emmett's, Dr., work, 96 
 End organ, stimulation of, by 
 
 radiant light and heat, 74
 
 INDEX 
 
 Energy effects activity of func- 
 tion, 16 
 
 Errors of terminology, 21 
 Excretory channels awakened by 
 radiant energy, 40 
 
 Felons or whitlows treated by dry 
 
 heat, 105 
 
 , treatment of, 60 
 
 Fever and the vis medicatrix 
 
 naturae, 97 
 Finsen and contemporaries sought 
 
 reaction, 41 
 
 apparatus, 29 
 
 apparatus, use of, 69 
 
 method generally superseded, 
 
 46 
 
 method, local, for treat- 
 ment of lupus, 46 
 
 , Niels, 29-67 
 
 Flannel pads for application of 
 dry heat, 94-101 
 
 Fluorescence, 18 
 
 , induction of, 21 
 
 of higher frequencies, 15 
 
 Forms of radiant energy, 15 
 Frequencies, higher, how mani- 
 fested, 15 
 
 , relative effects of, 81 
 
 Frequency and relation of wave 
 length, 18 
 
 , rates of, 18 
 
 Fulguration of Keating Hart, 46 
 Furuncles treatment by dry heat, 
 
 105 
 
 , treatment of, 60 
 
 Furunculosis treated by radiant 
 
 light and heat, 71 
 
 Germ activity inhibited by Roent- 
 gen ray, 54 
 
 life, ultra-violet action on, 
 
 4i 
 
 processes, radiant light and 
 
 heat in, 56 
 
 Germs inhibited by heat, 54 
 
 inhibited by radiant light 
 
 and heat, 74 
 
 Gilman Thompson, Dr., experi- 
 ments with convective heat, 93 
 
 , observations by, 106 
 
 Glass cuts out ultra-violet fre- 
 quencies, 17 
 
 Goerl lamp, 32 
 
 Gonorrheal conditions, radiant 
 energy in, 55 
 
 Gout, use of dry heat in, 109 
 
 Grad, Dr. Herman, 97 
 
 Health, essential to maintenance 
 of, 17 
 
 Heat and cold, combined applica- 
 tion of, 107 
 
 applications, principles of in- 
 dication, 94 
 
 convective, local uses of, 104 
 
 , evolution of, by radiant en- 
 ergy, 16 
 
 induced by absorption, 22 
 
 production, 18 
 
 rays, infra-red, 22 
 
 rays, maximum intensity of, 
 
 22 
 
 Helmholtz, 80 
 
 Hewitt, Cooper, lamp, 32 
 
 High c.p. incandescent lamp for 
 
 constitutional treatment, 46 
 Higher frequencies, effects on 
 
 races, 23 
 
 frequencies, hyperemia of, 23 
 
 frequencies, unimportant, 41 
 
 High frequencies, effects upon the 
 
 tissues, 16 
 
 High frequency currents, effects 
 of, on germ life, 56 
 
 in cystitis, 57 
 
 induce hyperemia, 56 
 
 in treatment of eczema, 70 
 
 in treatment of tubercular 
 
 arthritis, 60-61 
 
 produce actinic and antisep- 
 tic effects, 56 
 
 High frequency replaces Finsen 
 
 method, 46 
 Hot air apparatus, body or local, 
 
 94 
 
 apparatus, local employment 
 
 of, 107 
 
 , body, in septic infections, 108 
 
 Hot box, 94-103 
 
 Hot douche, applications of, 94- 
 
 102 
 Hot water bag, application of, 94- 
 
 101 
 
 bags for application of dry 
 
 heat, 94-101 
 
 Human tissue, how affected by 
 radiant energy, 22 
 
 Hyperemia as influencing inflam- 
 matory conditions, 53 
 
 by high frequency currents, 
 
 55 
 
 , effects of, 41 
 
 , effects on infection, 97 
 
 favors local nutrition, 24 
 
 from higher frequencies con- 
 sidered, 23 
 
 from ultra-violet, irritating, 
 
 45 
 
 , general effects from, 74 
 
 general or local, induced by 
 
 radiant light and heat, 74
 
 INDEX 
 
 Hyperemia, important effect, 41 
 
 increased by high potential 
 
 high frequency currents, 64 
 
 induced by dry heat, 94 
 
 induced by radiant energy, 
 
 24 
 
 in the treatment of infection, 
 
 53-96 
 
 modus operandi in treatment 
 
 of infection, 53 
 
 treatment by, a principle, 55 
 
 Hyperidrosis pedis, x-ray in, 17 
 Hypertention, effects of radiant 
 
 light and heat on, 77 
 
 in arteriosclerosis, 77 
 
 Impetigo treated by arc light, 71 
 Incandescent lamp, 25 
 
 lamp and arc light compared, 
 
 26 
 
 lamp preferable in treatment 
 
 of local infections, 44 
 
 lamps, advantages of, 26 
 
 lamps, choice of, in treat- 
 ment, 45 
 
 lamps, disadvantages of, 26 
 
 lamps of high candle power, 
 
 29 
 
 lamps of high candle power 
 in auto-intoxication, 48 
 
 lamps of high candle power 
 
 in plethora, 48 
 
 lamps of high candle power 
 
 preferred for constitutional 
 treatment, 45 
 
 lamps of lower candle power, 
 
 31 
 
 lamps smaller, for treating 
 
 circumscribed areas, 45 
 
 lamps, types of, 29 
 
 light bath, 35 
 
 light in the treatment of 
 
 eczema, 69 
 
 light, post-operative uses of, 
 
 61 
 
 Indications for employing convec- 
 
 tive heat, 104 
 Infection, effects of hyperemia on, 
 
 97 
 
 general, elimination of tox- 
 
 ines in, 76 
 
 , Roentgen ray in treatment 
 
 of, 55 
 .treatment by hyperemia, 53- 
 
 96 
 Infectious inflammations, radiant 
 
 energy in, 53 
 
 processes, radiant energy 
 
 effective in, 41 
 
 Inflammation, non-infected, treat- 
 ment by dry heat, 109 
 
 Inflammations, infectious, com- 
 pared, 49 
 
 , local methods of treatment, 
 
 51 
 
 , non-infectious compared, 49 
 
 Inflammatory conditions, plural 
 and abdominal, convective dry 
 heat in, 105 
 
 Infra-red heat rays, 22 
 
 Infra-red not "light," 21 
 
 Inhibitory action of Roentgen ray, 
 56 
 
 Iritis, post-operative, treatment by 
 light, 63 
 
 Iron electrode arc in the treat- 
 ment of skin diseases, 71 
 
 Kaolin, application of, 94-101 
 Keating Hart, Dr., 46 
 
 Lamp for intestinal treatment, 61 
 
 , Goerl, 32 
 
 , leucodescent, 32 
 
 , mercury vapor, 32 
 
 , small incandescent, 32 
 
 , uviol, 32 
 
 Lartet and Genoud lamp, 29 
 Law of harmony of vibration, 16 
 Lesser of Berlin, reports of light 
 
 treatment, 68 
 Leucocythemia, 78 
 Leucodescent lamp, 29 
 Leukemia, 78 
 - , x-ray effects in, 86 
 Light, actinic action of, 54 
 
 and heat, methods of appli- 
 cation of, 44 
 
 applications always general 
 
 as well as local, 40 
 
 bath, administration of, 47 
 
 , after treatment, 47 
 
 a prophylactic measure, 79 
 
 , arc, 36 
 
 as substitute for hot box, 94 
 
 cabinets, 23 
 
 cabinets, Betz, 38 
 
 cabinets, construction of, 34 
 
 cabinets, Kny-Scheerer, 38 
 
 cabinets, special types of, 37 
 
 cabinets, types of, 33 
 
 cabinets, upright, 38 
 
 cabinets, writer's, 37 
 
 , comparison with dry heat, 76 
 
 , duration of treatment, 47 
 
 followed by auto-condensa- 
 tion, 47 
 
 followed by static treatment, 
 
 47 
 
 followed by vibration, 47 
 
 for constitutional treatment, 
 
 46
 
 INDEX 
 
 Light in auto-intoxication, 48 
 , incandescent, 35 
 
 in high arterial tension, 48 
 
 in obesity, 48 
 
 in the household, 79 
 
 , reclining, 35 
 
 , temperature with, 47 
 , water given ad libitum with, 
 
 48 
 
 Light, chemical actions of, 23 
 , counter effect to x-ray, 88 
 
 dependent upon radiant 
 
 energy, 22 
 
 not effective in relieving 
 
 local stasis, 50 
 
 treatment, reports of, 69 
 
 Local administrations, the methods 
 of, 45 
 
 applications, effects not local 
 
 only, 41 
 
 inflammation, incandescent 
 
 lamp preferable in, 44 
 
 influences of radiant light 
 
 and heat, 41 
 Localized infection, action of dry 
 
 heat in, 98 
 
 Local nutrition, favored by induc- 
 tion of hyperemia, 24 
 Lodge's conception of the x-ray, 
 
 80 
 
 Lodge, Sir Oliver, 80-81 
 London hospital lamp, 29 
 Lumbago, cases reported, 52 
 
 differentiation of types, 52 
 
 radiant light and heat in, 
 
 52 
 
 Lumbar arthritis, differentiation 
 
 from lumbago, 52 
 Lupus, and allied conditions, 
 
 treatment of, 67 
 , cases, reports, and results, 68 
 
 erythematosus, reports of 
 
 cases, 68 
 
 erythematosus, treatment of 
 
 by iron electrode arc, 72 
 Lymphatics, effects of radiant 
 light and heat on, 74 
 
 Makarejev on the uses of white 
 light in pelvic conditions, 61 
 
 Marine search light, 27 
 
 Mastoiditis, in the early stage of, 
 105 
 
 radiant energy in treatment 
 
 of, 59 
 
 x-ray in treatment of, 59 
 
 Mechanical vibration, comparison 
 
 with radiant energy, 17 
 Mercury vapor lamp, 25-32 
 vapor lamps cut out ultra- 
 violet, 17 
 
 Mercury vapor lamps, employment 
 
 of, 26 
 Metabolism, effects of light and 
 
 heat on, 24 
 , effects of radiant light and 
 
 heat on, 42 
 -, end organ, stimulated 
 
 radiant light and heat, 78 
 , faulty, treatment of, 
 
 by 
 
 by 
 
 radiant light and heat, 78 
 , general effects of dry heat 
 on, 109 
 
 increased by dry heat, 97 
 
 Metchnikoff's phagocytosis, 53 
 Minin light, 30 
 
 Prof., 30 
 
 Molecular motism induced, 16 
 Moller of Stockholm, reports of 
 
 cases, 68 
 Moist heat, methods of applying, 
 
 94-100 
 
 , principles of applying, 94 
 Morris' and Dove's reports of 
 
 cases, 68 
 
 Munday, Dr. Bert, 97 
 Muscular soreness, radiant light 
 
 and heat in, 52 
 Myalgias, radiant light and heat 
 
 in, 51 
 
 Nasal 'conditions treated by arc 
 
 light, 62 
 Natural sources of radiant energy, 
 
 25 
 Nature, object of ultra-violet in, 
 
 23 
 Nephritis, radiant light and heat 
 
 in, 75 
 Neurons, peripheral, effects of 
 
 light on, 24 
 Nevus, vasculosis, 68 
 Niels, Finsen's demonstrations 
 
 concerning ultra-violet, 41 
 
 Objection to ultra-violet frequen- 
 cies, 17 
 
 On actions of heat, 95 
 Opposite effects of radiant light 
 
 and heat and the x-ray, 80 
 Orloff of Russia, 61 
 Otitis media, abortion of, 57 
 
 , case, report of treatment, 59 
 
 , chronica, x-ray in, 59 
 
 , indications for treatment of, 
 
 , treatment by convective heat, 
 
 105 
 , treatment of, by radiant 
 
 energy, 59 
 Ovary, congested, treated by white 
 
 light, 61
 
 u6 
 
 INDEX 
 
 Oxidation by light, 23 
 
 radiant light and heat in, 56 
 
 Oxidizing influences of radiant 
 
 light, 74 
 Oxygen, demand of, for positive 
 
 chemotaxis, 54 
 Ozena treated by incandescent 
 
 light, 62 
 
 treatment by light and high 
 
 frequency currents, 62 
 
 Pain relieved by radiant light, 50 
 Parabolic reflections produce dark 
 
 spots, 20 
 Parenchymatous nephritis, radiant 
 
 light and heat in, 74 
 
 , treatment of, 75 
 
 Pelvic conditions, treatment by 
 
 white light, 61 
 
 congestions, treatment of, 61 
 
 Penetration of radiant energy, 40 
 Peritonitis, treatment by dry heat, 
 
 106 
 Perspiration, induced by dry heat, 
 
 97 
 , induced by radiant energy, 
 
 24 
 Phagocytes, locally increased by 
 
 hyperemia, 41 
 Phagocytosis, induced by convec- 
 
 tive heat, 96 
 
 Phlebitis, treatment of, 61 
 Physical characteristics of radiant 
 
 energy, 18 
 characteristics of the x-ray, 
 
 81 
 
 properties, relation to thera- 
 peutics, 22 
 
 Physiological actions of the x-ray, 
 82 
 
 effects of convective heat, 95 
 
 effects of radiant light and 
 
 heat, 40 
 
 Pick and Asahi of Prague, reports 
 of cases treated by, 69 
 
 Pitcher, Dr. Herbert R, on mas- 
 toiditis, and otitis media, 59-60 
 
 Pityriasis versicolor, treatment of, 
 by concentrated arc light, 71 
 
 Platino, barium cyanide fluoresces, 
 15 
 
 Plethora, treatment of, 48 
 
 Pleurisy, treatment of, by dry 
 heat, 106 
 
 Polarization, 18-21 
 
 Post-operative uses of incandes- 
 cent light, 62 
 
 Races, color, comparison of, 23 
 Radiant energy, affecting chemo- 
 taxis, 23 
 
 Radiant energy compared with 
 the coarser vibrations, 17 
 , comparison of forms of, 
 
 16 
 88 
 
 counter effects to x-ray, 
 
 , effects of, 40 
 
 - effects on human tissue, 18 
 
 - effects upon metabolism, 42 
 
 - , elimination induced by, 24 
 
 - essential to light, 22 
 
 - , forms of, 15 
 
 - , forms of, congeners, 57 
 
 - , frequencies variable, 15 
 
 - , importance of technic in, 15 
 
 - in cystitis, 56 
 
 - in dermatology, 64 
 
 - induces hyperemia, 18 
 
 - in germ processes, 55 
 
 - gonorrheal infection, 55 
 
 - inhibits germ activity, 54 
 
 - in infectious conditions, 53 
 
 - in otitis media, chronica, 
 
 59 
 
 - in streptocpccic and staphy- 
 lococcic infection, 55 
 
 - in treatment of eczema, 70 
 
 - in treatment of mastoiditis, 
 
 59 
 59 
 
 in treatment of otitis media, 
 
 in tubercular infection, 55 
 
 , little danger of, 15 
 
 , penetration of, 18-40 
 
 -, physical characteristics of, 
 
 18 
 
 55 
 
 projected, 93 
 -, relative effects of, 16 
 -, sources of, 16 
 -, specialized employment of, 
 
 5 
 
 -, tanning of the skin by, 23 
 
 , summarized, 56 
 
 , value of, as a curative agent, 
 
 15 
 
 vs. convective heat in otitis 
 
 media, 59 
 
 Radiant heat and radiant light 
 
 compared. 17 
 Radiant light, actinic effects of, 
 
 74 
 Radiant light and heat, action of, 
 
 56 
 
 and the Roentgen ray, oppo- 
 site effects of, 8q 
 
 , characteristics of, 81 
 
 derivative effects, 42 
 
 -, duration of applications of, 
 
 45 
 
 -, effects of, 81 
 
 - effects on hypertension, 77
 
 INDEX 
 
 117 
 
 Radiant light and heat effects on 
 deep spinal centers, 74 
 
 effects on lymphatics, 74 
 
 effects on simple inflamma- 
 tion, 42 
 
 favorable to positive chem- 
 
 otaxis, 54 
 
 for constitutional treatment, 
 
 46 
 
 from incandescent lamps no 
 
 blistering or dermatitis, 46 
 
 hyperemic effects of, 41 
 
 in atonic skin conditions, 64 
 
 in chemotaxis, 56 
 
 in conditions of poor met- 
 abolism, 78 
 
 in conjunction with the 
 
 Roentgen ray, 64 
 
 in faulty metabolism, 74 
 
 in germ processes, 56 
 
 in infectious conditions, 42 
 
 , inhibition of germ life by, 55 
 
 in myalgias, 51 
 
 in nephritis, 75 
 
 in otitis media, 57 
 
 on oxidation, 56 
 
 in parenchymatous nephritis, 
 
 75 
 
 interchangeable, 18 
 
 in traumatic injury, 42 
 
 in treatment of carbuncles, 
 
 60 
 
 in treatment of eczema, 70 
 
 in treatment of felons, 60 
 
 in treatment of furuncles, 60 
 
 in treatment of furunculosis, 
 
 in treatment of lupus and 
 
 allied conditions, 67 
 
 in treatment of phlebitis, 61 
 
 in treatment of suppurating 
 
 ulcers, 67 
 
 in treatment of suppurating 
 
 tonsilitis, 60 
 
 in treatment of tubercular 
 
 arthritis, 61 
 
 , local administration of, 44-45 
 
 , local influences of, 41 
 
 , observation on effects, 75 
 
 , physiological effects of, 40 
 
 , postoperative uses of, 50 
 
 , preferable in local infections, 
 
 55 
 
 , reflex effects of, 74 
 
 , sudorific action of, 77 
 
 , thermic effects of, 74 
 
 Radiant light and radiant heat 
 
 compared, 17 
 
 Radiant light, effects on blood, 74 
 , effects on faulty metabolism, 
 
 74 
 
 Radiant light, effects on pain, 50 
 
 , oxidizing influences of, 74 
 
 , post-operative uses of, after 
 
 eye operations, 63 
 
 Radiations, comparative rates of 
 vibration of, 18 
 
 , effects upon tissue of, 22 
 
 , extreme effects of, 17 
 
 Radium and Roentgen ray over- 
 whelm tissues, 16 
 
 Rates of vibration, varying effects 
 of, 17 
 
 Reaction from ultra-violet sought, 
 4i 
 
 Rectal flushings, 107 
 
 Reflexes of peripheral stimulation, 
 24 
 
 Reflections parallel, 20 
 
 Refraction defined, 18 
 
 illustrated, 18 
 
 of radiant energy, 18 
 
 Reports of eczema treated with 
 
 high frequency currents, 70 
 
 light treatment, 71 
 
 Rheumatism, dry hot air in treat- 
 ment of, 109 
 
 Rheumatoid arthritis, 78 
 Rieder of Munich, 67 
 Riviere, Dr. J. A., 46 
 Roentgen ray, action on germ life, 
 56 
 
 and radium overwhelm tis- 
 sues, 16 
 
 , effect upon blood, 54 
 
 , employment of, in infection, 
 
 56 . 
 
 inhibits germ activity, 54 
 
 in infected skin diseases, 64 
 
 in treating infection, 55 
 
 , sterilizing effects of, 56 
 
 Russell's reports of lumbago, 52 
 Russian baths, 94, 100, 101 
 
 Schamberg, reports of cases, 69 
 Senses, response to radiant energy, 
 
 15 
 Septicemia, localized by convec- 
 
 tive dry heat, 108 
 Septic infection, treatment of, 77 
 processes, effects of dry heat 
 
 on, 96 
 Simple inflammation, effects of 
 
 radiant light and heat on, 41 
 
 inflammations, classified, 49 
 
 Solar arc lamp, 28 
 
 Sources, artificial, of radiant 
 energy, 25 
 
 of radiant energy, 25 
 
 , natural, of radiant energy, 25 
 
 Staphylococci and streptococci 
 susceptible to x-ray, 57
 
 n8 
 
 INDEX 
 
 Staphylococcic conditions, radiant 
 
 energy in, 55 
 Stasis, local light not effective in, 
 
 50 
 
 not affected by dry heat, 109 
 
 Static brush discharge in atonic 
 
 skin conditions, 64 
 
 in treatment of eczema, 70 
 
 Static treatment after light bath, 
 
 47 
 
 Steiner of Leipzig, reports of 
 cases, 71 
 
 Streptococcic conditions, radiant 
 energy in, 55 
 
 Sudorific action of radiant light 
 and heat, 77 
 
 Summarization of use of radiant 
 energy, 56 
 
 Sun light, objections to, in thera- 
 peutics, 25 
 
 Suppurating ulcers, light treat- 
 ment of, 60 
 
 Suppurative tonsilitis, treatment 
 of, 60, 104 
 
 Surgery, modern uses of light in, 
 
 63 
 
 Sweat glands, effects of radiant 
 light and heat on, 74 
 
 Tanning by ultra-violet a natural 
 protection, 17 
 
 by ultra-violet, when objec- 
 tionable, 17 
 
 of the skin by radiant energy, 
 
 23 
 
 of the skin objectionable in 
 
 therapeutics, 23 
 
 prevents further penetration 
 
 by radiant energy, 17 
 
 Technique important in radio- 
 therapy, 15 
 
 Terrde reports on phototherapy, 
 69 
 
 The actinolite, 28 
 
 The arc lamp solar, 28 
 
 The hot poultice, principles of 
 applying, 94-100 
 
 Therapeutics depending upon 
 physical properties, 22 
 
 Thermic effects of radiant light 
 and heat, 74 
 
 The Roentgen ray and ultra-violet 
 cause fluorescence, 16 
 
 The sun the natural source of 
 light, 25 
 
 Thoroughness, importance of, in 
 physical therapeutics, 44 
 
 Titus, Dr. Edward C, experi- 
 ments of, 87 
 
 Tonsilitis, suppurative, treatment 
 of, 104 
 
 Torticollis, radiant light and heat 
 in, 52 
 
 Toxemia, effects of dry heat on, 
 98 
 
 , following x-ray, 84 
 
 , general indications for radi- 
 ant light and heat in, 76 
 
 , prevention of, 77 
 
 Toxines, elimination of, following 
 diphtheria, 76 
 
 , elimination of, following 
 
 general infection, 76 
 -, elimination of, following 
 
 nephritis, 76 
 -, elimination of, by radiant 
 
 light and heat, 74 
 
 Traumatic injury, radiant light 
 and heat in, 42 
 
 Treatment of carbuncles by radi- 
 ant light and heat, 60 
 
 by x-ray, 60 
 
 Treatment of felons by radiant 
 
 light and heat, 60 
 Treatment of furuncles by radiant 
 
 light and heat, 60 
 
 by x-ray, 60 
 
 Treatment of simple inflammation, 
 
 49 
 Treatment of suppurative tonsilitis 
 
 by radiant light and heat, 60 
 Tubercular conditions, radiant 
 
 energy in, 55 
 Tuberculosis, x-ray in, 57 
 Tungstate of calcium fluoresces, 
 
 15 
 
 Turkish baths, 94-102 
 , administration of, 94 
 
 as a means of applying dry 
 
 heat, 94-101 
 
 Turkish toweling, wrappings in 
 
 hot air treatment, 108 
 Types of light bath cabinets, 33 
 
 Ulcers, suppurating, light treat- 
 ment of, 67 
 Ultra-violet, absorbed by glass, 17 
 
 , action on germ life, 41 
 
 , advantage of elimination of, 
 
 17 
 
 , arc light rich in, 26 
 
 , fluorescence of, 21 
 
 , not "light." 21 
 
 , object in Nature, 23 
 
 , objections to, 17 
 
 radiations irritating, 45 
 
 rays produce fluorescence, 16 
 
 , tanning effects of, 17 
 
 Uviol lamp, 32 
 
 Varicose ulcers, indication for 
 treatment of, 65
 
 INDEX 
 
 119 
 
 Varicose ulcers, supportive treat- 
 ment of, 65 
 
 , treatment of, 64 
 
 Venous hyperemia, not favorable 
 
 to positive chemotaxis, 54 
 Vibration, effects on function, 16 
 
 , law of harmony of, 16 
 
 , mechanical, following light 
 
 bath, 47 
 
 Walter, Dr., 70 
 
 Water administered during light 
 bath, 48 
 
 Wave length and relation of fre- 
 quency, 1 8 
 
 White light, uses of, in pelvic con- 
 ditions, 61 
 
 Willemite fluoresces, 16 
 
 Winternitz, experiments with sun 
 light, 70 
 
 Wright's opsonic indices, 53 
 
 Writer's method of treating in- 
 fection, 54 
 
 X-ray breaks down tissue, 83 
 
 , characteristics of, 81 
 
 , cumulative action of, 84 
 
 , dermatitis cause of, 82 
 
 dermatitis not analogous to 
 
 inflammation, 86 
 
 , effect on abnormal tissue, 83 
 
 , effect on all protoplasm, 83 
 
 , effects on congestion, 83 
 
 X-ray, effects on normal tissue. 
 
 93 
 
 , effects on pain, 82 
 
 , effects upon absorption, 87 
 
 , effects upon glandular struc- 
 tures, 87 
 
 , effects upon ovulation, 87 
 
 , effects upon seeds, 87 
 
 , fluorescence of, 21 
 
 , hypothesis of action, 85 
 
 , in cystitis, 56 
 
 induces contraction of 
 
 masses, 85 
 
 induces tissue inertia, 84 
 
 , inhibitive effects of, 84 
 
 in hyperidrosis pedis, 87 
 
 in leukemia, 86 
 
 in treatment of carbuncles, 60 
 
 in treatment of furuncles, 
 
 60 
 
 in treatment of mastoiditis, 
 
 59 
 
 in treatment of tubercular 
 arthritis, 61 
 in tuberculosis, 57 
 
 , longitudinal ether vibrations, 
 
 85 
 
 , not ionization, 85 
 
 , producing toxemia, 84 
 
 , replaces Finsen method, 46 
 
 , sterilizing effects of, 87 
 
 , stimulating effects of, 84 
 
 , wave lengths of, 18
 
 Date Due 
 
 APR 17 
 
 1978 
 
 PRINTED IN U.S.*. CAT. NO. 24 161
 
 '52 
 
 * 
 
 00041698^ 
 
 WBU95 
 
 1909 fS 
 
 Snow, William Benham 
 
 The therapeutics of radiant light and O 
 
 MEDICAL SCIENCES LIBRARY 
 
 UNIVERSITY OF CALIFORNIA, IRVINE 
 
 IRVINE, CALIFORNIA 92661