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Some heliotherapists will not permit sun-baths during menstruation, claiming that the reduced bactericidal power of the blood at this time is further reduced by sunlight. Others have given them under these conditions, often at the request of the patients themselves, with no unfavorable results. Many women feel the bracing influence of sunlight more keenly at this period than at other times. If the treatment is given with judgment, nothing but good should result from it.
Tuberculosis of both kidneys, with impending uremia, is a contraindication. This is a comparatively rare condition, however, and as the patient is certain to be under the care of a physician, it need not be considered in mapping out a pro¬gram for self-use.
While sun-baths are of great value in skin eruptions, the after-treatment must be carefully adapted to suit the ease. Friction is to be avoided, of course, and the finishing tonic ap¬plication should be mild, say a prolonged shower-bath at a temperature of from 85 to 78 degrees or a tepid bath at 90 to 85 degrees, for from two to five minutes. To bring about reaction after the bath, exercise is much better in these cases than friction.
Advanced circulatory diseases, especially uncompensated valvular disease or myocarditis, are said to respond poorly to or to be affected unfavorably by sun-baths. However, if very short exposures are given at first and the “creeping” sun-cure employed with caution, also if the tonic applications follow¬ing be very moderate, benefit may result. A cold-towel or wet-sheet rub lasting for from ten to twenty seconds, with water at 60 degrees, or above, will not be detrimental.
Some authorities believe that, since sun-baths raise the calcium content of the blood and since this condition already exists in gout, gout is a contraindication to the use of sunlight as a therapeutic agent. This opinion is not unanimous, and too few cases of genuine gout are met with these days for physicians to know definitely what the influence of sunlight would be. If the baths were given with much caution but persistently, they would, no doubt, be very helpful; but in such conditions considerable care must be taken not to give very cold or very prolonged cool applications after the bath. The water at first should be between 75 and 85 degrees, and should be applied for only twenty to sixty seconds; then from day to day the temperature should be gradually lowered until it is from 65 to 60 degrees. If the cold or cool water is applied directly to the affected joints, the pain will be in- creased; hence this should be avoided. The tepid sponge, shower, fan douche, or broken horizontal jet will be the most suitable form of application in these cases.
Cases of insomnia require much care in the application of the sun-bath, because of the danger of overheating the head and over-stimulating the nervous system. In these cases the duration of the bath should be very gradually increased, and, as a rule, the head should be very well protected; also, the cold application following should be very moderate at first, but may terminate with a ten or fifteen-minute douche, spray, or affusion to the legs and feet at a lower temperature than that used for the general application. The temperature of the latter may be gradually reduced from day to day, If these precautions are observed, sun-baths will be beneficial in such cases.
Authorities claim that diabetes is a contraindication, that not only manifest diabetes and excess sugar in the blood, but latent conditions of a similar nature make the sun-bath unde¬sirable. Others consider properly conducted sun-bathing, with corrected dietary, very beneficial in these cases. It is largely a matter of individual peculiarities, and, since helio¬therapy is of decided value in some of these cases, and since it cannot be foretold what cases will respond favorably, it is best to try it before any real damage is done. Indications will arise to show whether or not the bath is suited to the pa¬tient, and it is worth while running the slight risk of mildly undesirable developments for the greater benefit that may result from the treatment.
During the mild fever that occasionally develops in chronic tuberculosis of the lungs, it is best to avoid sun-baths alto¬gether. In cases of fever the temperature-regulating mecha¬nism of the body is disturbed and it is easy to induce an in¬crease in temperature. Pulmonary tuberculosis in its acute form, with even a ver}- slight febrile condition, is a positive contraindication to the sun-bath; and in those cases in which no fever develops, it must be used with extreme caution, even though practically all should receive it. The cases of pul¬monary tuberculosis most benefited are those in which the dis¬ease is localized—in which there is a single “focus.” Progress is less satisfactory when there are “multiple foci,” and with more or less regular or decided increase or fall in temperature, and in hemorrhages.
Dr. Rollier and others have proved the tremendous value and importance of sunlight in the treatment of tuberculosis anywhere in the body. Successfully responding to this treat¬ment are not only tuberculosis of the lungs, but of the spine, hip, knee, foot, shoulder, elbow, hand, pelvis structures, lym¬phatic glands, skin and mucous membrane, kidney and epididymis, together with tuberculous sinuses and peritonitis. Among other conditions for which sunlight should be employed are varicose ulcers, burns, and septic abscesses, including felons; while in convalescence from practically any disease, a return to normal or usual health is greatly hastened by sun-baths.
Naturally the sun-bath cannot be employed in all these cases in the same manner nor in the same dosage. Very great care and technical skill are necessary in many of them; others are more easily handled. In some, such as wounds, ulcers, and bone diseases, local irradiation alone may be sufficient to effect a cure; but even in these cases, more rapid progress will be made if the local treatment is supplemented by exposure of the entire body to the sun’s rays.
What are the contraindications to the use of the sun-bath? It would seem from the above enumeration of disorders fa¬vorably influenced by sunlight that there can be few contra¬indications, and such is the case.
Numerous skin affections are corrected or greatly improved by the sun-cure. Among these may be mentioned acne of all kinds, alopecia, especially alopecia areata, boils, furunculosis and carbuncles, chilblains, most forms of dermatitis, including x-ray dermatitis, scars, acute and chronic eczema, herpes of any part of the body, hives, impetigo, lupus, psoriasis, pruritis, ulcers of any kind, and wounds. All traumatic injuries, in¬cluding lacerations, fractures, gun-shot wounds and all infected wounds heal more rapidly under the influence of sunlight than with any other treatment.
Respiratory affections, including tuberculosis and pleurisy, are very favorably influenced by sunlight. Surgical adhesions are often lessened in number, .sometimes almost disappearing, and pelvic disorders of men and women improve. Sunlight is one of the greatest rejuvenants known, having a favorable influence upon the glands of sex as well as upon all other tissues affected by the aging process—which, of course, means every tissue in the body. Muscular affections, including lumbago and strains, quickly yield to sunlight. Without any exercise at all the patients of Dr. llollier show wonderful improvement in muscular tone and volume, de¬veloping muscles of surprising size and firmness.
In fact, the contraindications are very few, as will be seen later. In all metabolic disorders, especially when there is re¬duced or defective oxidation, the sun-bath is particularly beneficial. In this class of disorders are obesity, rheumatism, and the uric-acid diathesis. All anemias, including primary and secondary, promise a good field for sun-bathing, since it improves the quality of the blood and aids in the elimina¬tion of toxins. It helps to correct the tendency to spasm of the cutaneous vessels, with resulting internal congestion. Hemophilia is said to respond favorably to it, and circulatory defects are also benefited. Nervous disorders, including vari¬ous forms and degrees of neurasthenia, headache, sciatica, and some forms of paralysis are corrected or improved. Defective alimentation or nutrition is greatly benefited, espe¬cially in children, but also in the malnourished adult. The bony systems seems particularly responsive to sun-baths, as has been shown by the successful treatment of a wide range gt bone affections, chief among them being rickets, osteomalacia, and tuberculosis. The end of rickets seems in sight now, since it has been proved to be one of the “diseases of darkness,” and hygiene.
The indications for the sun-bath cover a wide range of general and local disorders, in addition to its usefulness as a general hygienic or prophylactic factor of first importance.
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