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prolonged inquiry is necessary to get at the truth, whichis elusive and difficult to arrive at, and that theinquiry must embrace many very carefully ascertainedfacts.

All those who have studied with an open mind therather crude observations which have been publishedwill agree that it is impossible at the present day tocome to any safe conclusion upon the problem whichthey seek to solve ; and that meanwhile we are notjustified in denying to the public a measure of probableprotection. By availing ourselves of suitable agentsand methods of disinfection it is certain that we canachieve much superior results to those which can besecured by

"

spring cleaning." That fact can admitof no doubt, for its truth can be demonstrated quiteeasily.

2’Ae Sale of Disinfectants and the Public Interests.If there were in this country a deliberate conspiracy

to discredit disinfectants as useful weapons withwhich to fight the germs of disease, that circumstancealone could explain the following facts.Any agent may be puffed as a disinfectant and false

claims may be made as to its powers. In the UnitedStates of America both the public and the producersof really good class agents are protected by the seizureof stocks and infliction of fines whenever there ismisrepresentation. The general public is voiceless insuch matters, but the best elements of the trade indisinfectants have called for such protection. It is inthe public interest that this should be afforded, anda resolution to this effect was proposed and carried atboth the Birmingham Congress of the Royal SanitaryInstitute (1920) and the Congress of the Royal Instituteof Public Health at Brussels (1921). That resolutionwas circulated to all county borough councils by theRoyal Sanitary Institute, and it was endorsed by alarge majority of these councils, not a single councilhaving anything to say in disapproval.The sale of relatively poor and inefficient agents is

fostered by the conditions imposed upon the sale ofdisinfectants. Under the Poisons and Pharmacy Act,1908, all of those disinfectants which contain over3 per cent. of carbolic acid or its homologues must belabelled " poisonous," and may only be sold bychemists. But comparatively useless agents of feebledisinfectant value, containing not more than 3 per cent.of carbolic acid or its homologues, need not be solabelled, and may be sold at oil and grocery shops andstores. Therefore the Act tends to favour the sale ofthe low class disinfectants, for the public buy far moredisinfecting material from oil and grocery shops andstores than from chemists.

HELIOTHERAPY IN THE U.S.A.

(FROM AN OCCASIONAL CORRESPONDENT.)

IT was not until the winter of 1913 that helio-

therapy was seriously undertaken in the UnitedStates, although occasional experiments with the suncure had been made, especially in the south-westernStates before that time. But in that year the lateDr. John H. Pryor came back to this country full ofenthusiasm for the excellent results which he hadseen at Leysin. His enthusiasm was needed, for theidea of heliotherapy was not readily accepted byAmerican surgeons whose technique had then justreached a height of perfection that was a remarkableadvance on the methods of a previous generation.In spite of difficulties Dr. Pryor built up at theJ. N. Adam Memorial Hospital at Perrysburg, N.Y.,a fine and successful institution. Dr. Horace LoGrasso, the present director, gave an interestingaccount of the results achieved up to the beginningof this year when he addressed the School of Hygieneof Johns Hopkins University on April 12th.The records do not include patients who failed to

remain for three months in the institution. This isa reasonable limit considering that the average

duration of illness before admission is about two anda half years. Up to Jan. 1st, 1926, 1034 patientshad been discharged who had resided for three monthsor longer. The attached table shows the results

Results of Heliotherapy at Perrysburg, N. Y.,to Jan. Ist, 1926.

* Figures in parentheses are percentages.

achieved in the various groups. Three of the17 deaths resulted from influenza during the epidemic,one was the result of a psoas abscess which rupturedinto the peritoneum and the remainder were all caseswhich had advanced pulmonary disease. Fourteenper cent. of adults and 21 per cent. of children hadmultiple lesions, while 69 per cent. of adults and16 per cent. of children had a

" diagnosable "

pulmonary lesion.Dr. Lo Grasso thinks that Rollier’s attitude towards

surgical interference is too conservative. He himselfrecommends the use of the knife for removal of

sequestra or of a kidney where there is advanceddisease in one kidney only. He hesitates, however,to resort to surgery until sunlight alone has beengiven a good trial. He is prepared to qualify alsoDr. Rollier’s dictum that those do best who tan mostreadily. Though he has found this rule to be true ingeneral, still there are those who show very littletan yet improve markedly. It would be more nearlyin consonance with his experience to say that thosedo best who most nearly approach their own limit ofpigmentability.

During the summers of 1922 and 1923, 100 cases ofuncomplicated pulmonary tuberculosis were treatedwith heliotherapy by way of experiment. Noheemoptyses were observed, although some of thecases had previously bad haemoptysis and one casehad been bleeding only a week before treatmentcommenced. Dr. Lo Grasso believes that pulmonarycases respond well to this treatment and may safelytake the sun cure if the necessary precautions areobserved. These include gradual exposure, beginningfrom the feet (an excellent chart for this purpose hasbeen printed by the institution), avoidance of the hotmidday sun in summer and of cold draughts inwinter, and no sun treatment for one hour beforeand two hours after meals. Cases with nephritis orwith much emaciation must be treated very cautiouslyto avoid chilling.

Dr. Lo Grasso has not been able to obtain equallygood results by the use of lamps. Some improvementmay be observed, but the remarkable growth ofmuscle tissue that is observed with heliotherapy isnever noticed in treatment by artificial light. Thetanning which the ultra-violet from artificial sourcesproduces is, he claims, different from that producedby sunlight. It is possible to distinguish the skintanned by sunlight with one’s eyes closed, so charac-teristic is its smoothness of texture. No doubtthe air-bath plays a large part in the success ofheliotherapy.

Baltimore, April 16th.