Niels Ryberg Finsen
Dennis P. Valenzeno
Associate Dean for Medical Sciences
Chair and Professor of the Department of Medical Sciences
The University of Kansas Medical Center - Wichita
1010 N. Kansas St., Wichita, KS 67214-3199
(Reprinted from a two-part article in the ASP Newsletter
(No. 117, Oct/Nov 1988 and No. 118,
Of Tadpoles and Red Rooms
What do you do with a boy
who is dismissed from prep school for "small ability and total lack of
energy?" Of what utility to society is a man whose health begins to fail
at 23 and who is almost completely incapacitated by the age of 30?......You
have the makings of a Nobel Prize recipient who is generally regarded as the
founder of modern phototherapy, Niels Ryberg Finsen. In his brief 44 years,
Finsen employed his knowledge of light to relieve countless people from terrible
disfigurement from smallpox and lupus vulgaris. All of this was accomplished
despite rejection by the established research community and failing health.
Finsen was relegated to a wheel chair as he accepted the 1903 Nobel Prize in
physiology and medicine. His death occurred the following year.
Figure 1. Niels Ryberg Finsen. [Courtesy of the Clendening History of Medicine Library, University of Kansas Medical Center.]
A descendant of Viking Icelanders
and the son of the governor of the Faeroe Islands, Finsen was educated in Reykjavik,
Iceland, and subsequently obtained his M.D. at the University of Copenhagen
in 1891. Though tempted by a career in surgery, he chose instead to pursue his
interest in sunlight as a therapeutic force. His earliest experiments were performed
with the simplest of devices. His own skin, the earlobes of his young wife,
and assorted tadpoles convinced Finsen that sunlight could produce inflammation,
similar to that known to be produced by microbes. This, he reasoned, could be
the cause of inflammation in sun-exposed smallpox blisters. Infection and blood
poisoning might be avoided if the inflammatory response to light could be prevented.
Finsen demonstrated that it was the violet end of the spectrum that produced
the inflammation and that the red end had a healing effect. His exposition of
this proposal to the chief physician of the Blegdam Hospital in Copenhagen was
rejected with such little respect that it prompted Finsen to retort, "You
might at least try not to laugh at me!" It remained for two doctors in
Bergen, Norway to sequester newly diagnosed smallpox patients for two weeks
in "red rooms" to validate Finsen's hypothesis. Every patient emerged
with no fever, free of blood poisoning and scarless! A similar report of success
from Gothenburg, Sweden gained Finsen an international reputation and launched
his career and the field of phototherapy.
Electric Lights & Broken Needles
By 1894, Finsen had earned
a reputation with his "red room" treatment for smallpox. Still he
remained a struggling young physician with no job and no recorded means of support.
But he was convinced that light could cure as well as harm. Building on the
demonstrations of Duclaux, which showed that sunlight could kill bacteria, Finsen
reasoned that tubercle bacilli, the bacteria responsible for the disfiguring
lesions of lupus vulgaris, might succumb to sunlight. But how could the theory
be tested? Where does one find sunlight in Copenhagen in winter? Again the Copenhagen
medical establishment turned him away. How could light which could kill smallpox
patients, cure lupus patients, they asked? Finsen persisted and arranged with
the chief engineer of the electric light works for the use of a 25 amp D.C.
carbon arc lamp. There, in the electric light plant, Finsen treated the lupus
vulgaris of a Danish engineer named Mogensen who had been given up by countless
doctors as untreatable. For two hours every day over the course of 4 months
the treatment persisted. But at the end of that time, Mogensen emerged a cured
man, causing an uproar in the medical community.
Finsen's fortunes changed
dramatically. In 1896 the Medical Light Institute (now the Finsen Institute)
was founded and placed under his direction providing him with a modest annual
salary. During the next few years he refined his treatment to obtain more consistent
success, but his health continued to fail. Despite a self-imposed diet of desiccated
food and almost no water, he continued to accumulate fluid as a result of constrictive
pericarditis. In the winter of 1902 as a physician began yet another drainage
of fluid from Finsen's abdomen, there was a snap. The needle used to perforate
the abdomen had broken from its handle and had slid down the trocar into Finsen's
abdomen. Both Finsen and his physician knew that an operation to remove it was
hopeless given Finsen's condition. Keeping his composure, Finsen directed the
physician to get the strongest magnet available in the engineering college.
If the end of the needle was still in the trocar, perhaps it could be removed.
Thus, in the summer of 1904 Niels Finsen, a man whose intellect and composure
had saved his own life, as well as the lives of countless others, sat in his
wheel chair and received the Nobel Prize in physiology and medicine. Later the
same year, still planning whole body sun bath treatments, he died with his wife
at his side.
4 years the Association Internationale de Photobiology presents the Finsen Medal
on behalf of the Niels Finsen Foundation of Denmark for outstanding contributions
to the science of photobiology. For a list of awardees, see A CENTURY OF PHOTOBIOLOGY, Table 2 under Historical Vignettes on Photobiology.