Finsen's light treatment of lupus vulgaris

Niels Ryberg Finsen was born at Thorshavn in the Faroe Islands in 1860 and qualified in medicine at Copenhagen in 1890. From 1883, or earlier, he had the illness later identified as Pick's disease, a thickening of the membranes around the liver, heart and spleen. In 1893 he gave up his post as prosector of anatomy to have more time for research on the effects of light.

His first proposal, in July 1893, concerned smallpox. Patients were to be nursed in rooms where red glass or thick red cloth shut out the chemical rays of sunlight, the ultraviolet end of the spectrum. Finsen reported that their blisters then usually did not suppurate and healed with little or no scarring. In February 1894 Dr. Benckert at Gothenburg treated 16 patients this way. Three died, only one of them from the fever of suppuration, and Benckert reported that suppuration was usually prevented.

He then put the same rays to work. Light was known to kill bacteria, as Downes and Blunt had observed in 1877. In November 1895 Finsen began treating his first patient with lupus vulgaris, a tuberculosis of the skin that could eat away the nose, lips and cheeks over decades and had resisted every treatment. Sunlight, or more often the beam of a powerful electric arc lamp, passed through lenses that removed the heat rays and was focused on a small patch of skin pressed bloodless, for an hour at a time. The patch reddened and became inflamed, then healed to a surface almost like normal skin. Each part of the lesion had to be treated in turn, so the method was slow and expensive and needed constant supervision.

Patients came from far and near. The Finsen institute for light treatment opened in Copenhagen in 1896, paid for largely by private donors with help from the state and the city, and Finsen published his treatise on concentrated chemical light rays in medicine that year. By 1903 the institute had 8 doctors and 53 nurses. Its report on the first 800 lupus cases, treated up to November 1901, recorded the skin disease cured in half and treatment failing in about 5 per cent.

The Nobel Prize in Physiology or Medicine for 1903 went to Finsen for this work. On the day of the ceremony in Stockholm he was at home in a wheelchair, and he gave 50,000 crowns of the prize to the institute. In his last years fluid had to be drained from his abdomen 18 times. He died on 24 September 1904.