Sunlight treatment – effective or not?
The benefits of sunlight treatment at Manor Gardens Centre are well documented by many success stories of the time. Medical staff reported on the progress made by the children in rather enthusiastic terms, speaking of ‘improvement in their appetites, vitality and contentedness’ as well as their general look of wellbeing.
Ailing mothers (suffering from depression) seem also to have benefited from the ‘Light’ and the happy atmosphere of the ‘Sun clinic’ at the Centre is reported to have been a contributing factor to their better health.
Although enthusiastically adopted by medical practitioners at the time and widely recognised as effective, ‘Light’ therapy was criticised for being expensive. Also, its beneficial results appeared at times questionable on scientific investigation.
Dora Colebrook takes on the medical establishment
Indeed, in winter 1927-28 Dora Colebrook, a former doctor at the Centre who had later moved into medical research, conducted some experimental studies on the effects of artificial light therapy on a group of school children.
The experiment involved studying 3 different groups: one with exposure to artificial sunlight from a lamp, another with exposure to a similar lamp but with a filter to remove ultraviolet rays, and a third group with no exposure at all. The findings concluded unequivocally that there was no evidence of beneficial results from exposure. More specifically, no improvement was demonstrated in height, weight, incidence and duration of colds and other minor infections.
The report written by Dora Colebrook was published in 1929 by the Medical Research Council in their Special Reports Series. The publication caused a furore among the established medical profession and provoked harsh criticism against Colebrook, sparking a debate on the effectiveness of sunlight treatment.
The debate that followed is brilliantly captured by the following extracts taken from the Spectator in 1929.
THE severe criticism of certain uses of the ultra- violet rays which has appeared in a Report of the Medical Research Council has caused consternation among people who thought that they were safe in regarding applications of these rays as a proved cure for several diseases and, at the least, a tonic which introduced the desirable Vitamin D into the human body…
The strictures on ultra-violet ray treatment in the Report are based on the researches of Dr. Dora Colebrook in the winter of 1927-28. She conducted various tests of the value of the rays as stimulants of growth in school children, and as agents for increasing the bactericidal power of their blood. Her conclusions were that the treatment caused no increase in weight or height and no raising of spirits, and that the “common cold” was actually more common among those who received the treatment than among those who did not…
It is therefore suggested in the Report that hospitals and other institutions which are spending much money upon artificial light should divert part of the money to discovering whether they are justified in spending more. If it should be ascertained that the results are unsatisfactory it would undoubtedly be true that the money could be better spent on suitable diet ; for it is obvious that ray treatment is much more expensive than cod liver oil or some other food which contains Vitamin D.
It must not be supposed, however, that the Report rashly condemns all ray treatment as the result of Dr. Colebrook’s tests… What the Report does suggest is that in several diseases there may be alternative treatments of equal value, and that in these circumstances it is foolish to spend money on the more expensive…
The answer of the enthusiasts of light therapy to the present criticisms…is that condemnation of the treatment is often based on undiscriminating or partial experiments. Dr. W. J. O’Donovan, physician in charge of the skin and light treatment departments of the London Hospital, said… it was “impertinence” for anyone to say that hospitals should be called upon to justify their expenditure. ” Cures,” he said,” have been effected in types of cases previously uncured “—as, for example, the tubercular form of blindness, lupus, tubercular disease of the larynx, chronic arthritis, and extreme anaemia..
Another doctor disputed what the Report had said about rickets. “While it may be argued,” he said, “that Vitamin D can be administered by the mouth in cases of rickets, it does not represent the whole value of light treatment.”
Medical Research Council report
The Issues raised by the debate about the potential merits of sunlight treatment are clearly evident in the Preface to Dora Colebrook’s report. Here, however, the MRC seems to avoid taking a definite position on the subject and while on the one hand it endorses Colebrook’s efforts, on the other it refers to the limitations and the contingent nature of Colebrook’s study, warning against using the findings to condemn other types of sunlight therapy:
“ It would be no more legitimate to generalize the application of Dr. Colebrook’s negative results, obtained under particular conditions, than it would be to suggest that, because ultraviolet radiation will cure rickets by a known proves, it will probably have a beneficial effect on almost any condition of defective health. Each claim for a particular remedial effect of a particular form of light treatment ought to be considered on its own merits”.
Much of the debate taking place at the time (when studies on light therapy and vitamins were both at an experimental stage) revolved around Sunlight treatment and vitamin D and vitamin D and diet. In other words, sunshine versus diet and their effectiveness in treating diseases.
The 2 following quotes well illustrate these 2 contrasting views – one in favour of sunlight, both natural and artificial; the other in favour of the delivery of vitamin D through Diet :
‘Sunshine, whether natural or produced artificially by electric arc lamps, had a most profound effect on health. Rickets in children could be cured by it, even if a bad diet were not changed during the treatment’. (Leonard Hill reported in The Times 1925c)
“With all the good in the world, even if we were prepared to go about naked we would find it difficult in England to procure from sun enough ultra-violet radiations to keep our bones straight…It cannot be too much emphasised that rickets can be completely prevented…if sufficient vitamin D is included in the diet from birth and pre-natally…
Finally, all those interested in public health…would probably begin to realize…that in vitamin D they have one of the greatest dietetic weapons at present known…for preventing widespread bodily defect and hill health.”(Edward Mellanby 1930)
Modern echo of the debate
Echo of the debate of the 1920s about the benefits of sunlight still seems to resonate nowadays and medical studies seem to show the ultra-violet light is (still) an effective treatment for many health issues
Back in 1925 Professor Leonard Hill had recognised the importance of light on the human body and its effect on the immune system:
“The ultra violet rays act by producing inflammatory reaction with determination of more blood and lymph and lymphocytes to the part and by altering the immunizing power of the body”(Leonard Hill 1925)
The following article published in the Herald Scotland in 2012 contains some extracts that show how Artificial Light – its beneficial effects and therapeutic use – are still discussed today in connection with Vitamin D and Diet – in a way that remind us of the debate that animated the 1920s and 1930s.
Aberdeen scientists have found that ARTIFICIAL SUNLIGHT can have a “striking effect” in helping treat sufferers of diseases such as Multiple Sclerosis.
Researchers from AberdeenUniversity studied patients in the north of Scotland (an area with very low level of winter sun which has the highest rate of MS in the UK) treated during winter with artificial UV-B light therapy for skin diseases caused by their immune systems acting inappropriately.
The research – published in the Journal of Allergy and Clinical Immunology – shows how UV-B light boosts vitamin D as well as cells in our body that are responsible for regulating or balancing the immune system. (Vitamin D is made in our bodies by UV-B light from the sun)
Dr Anthony Ormerod, clinical reader in dermatology at the university, said: “Our study shows that UV-B light, which mimics sunshine, can have a striking effect on the immune system of patients.
“Our findings have important implications for future interventions including the recommendations for healthy lifestyle and a possible role for phototherapy and/or vitamin D supplementation in the prevention or treatment of autoimmune and inflammatory diseases”.
Dr Helen Macdonald, senior lecturer in nutrition and translational musculoskeletal research at the university and chair of the National Osteoporosis Society Nutrition and Lifestyle forum, said: “There are risks associated with high levels of both therapies, so it is important that we get the balance right.
“We would also want to stress that we are not advocating sun bed use since this is not the same type of radiation produced by sun beds which already have well-documented health risks.
Professor Mark Vickers, chair in applied medicine at the university, added: “Ours is the first study to demonstrate in patients a cause and effect between UV light, vitamin D and systemic immune function in people.”
The section on Sunlight Treatment was written by Giuseppina Mancini, a volunteer at the Centre.