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161
The total number of treatments given was 13,581, being
made up of 9,575 carbon-arc, 2,789 mercury-vapour, and
1,217 radiant heat.
The following clinical notes by Dr. Lynham will be
read with interest in view of the wide-spread attention given
to this form of treatment at the present time.
" It was considered advisable to begin treatment on
conservative lines, and, as the number of attendances was
large in proportion to the staff, a definite procedure was
arranged for all cases when first admitted to the clinic,
variations in time and distance being made in special
cases after their reactions to the routine treatment had
been observed. With the times and distances chosen,
there was no discolouration of the skin other than a
faint bronzing which persisted for months. By reducing
the distance to 30 inches with the carbon-arc, pronounced
pigmentation was easily produced. The criterion
for the full dose in any child was the appearance of an
erythema which persisted over-night.
Debility, etc. In the early days of the Clinic, the
great majority of the children seen were fair complexioned
and appeared to suffer from want of tone and general
listlessness, rather than from any definite disease. They
were pale, with poor appetites, fretful by day, and
restless at night. These children responded quickly,
the first evidence of improvement being more restful
sleep. In the first weeks almost all of them lost weight,
but if they kept up their attendances this was steadily
regained. They presented an obvious change in appearance,
their pale flabby aspect being replaced by one of
firmness, with pink cheeks. After three months' attendance
many of these were given a month's intermission,
when they resumed treatment if desired. Where further