The German medical journal Therapiewoche (publisher Verlag G. Braun, Karlsruhe), one which lays claim to credibility, published an editorial in its issue No. 39, 49 (1989) under a heading which read: `Low-power lasers: Humbug or therapeutic light?' The contents of this article were meant to be an epitaph to LLLT medicine. There was someone who would have that laser light biostimulation does not exist, The intention was to ridicule laser therapy, Various assumptions, presumptions and speculations were said to constitute the true and proper science. Graduate engineer Claus Schwing of Frankfurt, West Germany. is the author of this compendium on laser therapy. The scientific problem appears simple, summarized by him as: Laser therapy is humbug! From a question mark in the heading. the text of the article advances to a statement of fact!
In the following the major passages of Mr Schwing's article are summarized (in translation by the author DK) together with my reply. which unfortunately was not printed in Therapiewoche. I have it to the reader of Laser Therapy to draw their own conclusions.

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A murine mammary adenocarcinome was treated with intraperitoneal photofrin II and Lascr (10 mW, 632 nm. He-Ne laser), Photofrin II was given intraperitoneally 4 h before 30-min laser treatment. A total of six photofrin II/laser treatments. given at 3-4 day intervals. rwsultwd in 52.6% complete response, the cure rate was 26.3%; BCG or PD60 were given in association with PDT to CBA mice with mammary carcinoma. Addition of nonspecific immunostimulants significantly increased the antitumour effects of PDT, and the combination of PDT + PD60 resulted in the highest incidence of complete tumour regression (8.1%).
Enhanced activity of phytohemagglutinin-M response T-lymphocytes and natural killer cells capable of killing K562 tumour cells was noted.
These experimental observations i.e. marked inhibition of the mammary adenocarcinoma developed due the 'combined' PDT-immunothcrapy, suggest the possible use of this new methodology as an adjuvant in clinical practice.

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Hyperpigmentation may occur after trauma. operation. cryotherapy or laser cosmetic surgery of skin.Dermabrasion often exacerbated such condition. and depigmenting ointment could only make temporary effect and require repeated application. Since 19S7. we devised Quen-zhi cosmetic cream, extracting and refining from plants. without adding any synthetics. It is capable of moisturizing skin. making whitish. elastec, tender, and natural reddish appearance on face and lips. The fine furrows and wrinkles faded.hair orifices lessened and the skin senile degeneration delayed, It has remarkable effect in conjunction with low level He-Ne or CO₂ laser therapy after cosmetic surgery. After following up of 3000 cases, the total effective rates were 92.5%. The detailed procedure of application and its mechanism were discusseed.

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With the gradual increase in standard of Living and environmental factors conducive To life, world life expectancy is increasing. adding a large percentage to the population over the age of 60. The incidence of shingles and its painful aftermath, postherpetic neuralgia. or PHN, is also showing a steep rise. The present study set eut to cva:uate the application of low reactive-level laser therapy. or LLLT. for a small patient population who had received other conventional therapies but with no success. The LLLT system used was a gallium aluminium arsenide (GaAlAs) diode laser LLLT system. with an output power of 60 mW in continuous wave at 830nm. It is designed for contact application. The study population consisted of 20 patients, with a mean age of 68.3 (male) and 57.5 (female). The mean duration of PHN was 11.8 months, Twelve of the 20 patients respended to the LLLT, 60%. Further studies are needed. with emphasis on methodology. as these figures are not as high as those from other workers in this field, The success rate was high enough however to make the authors consider a larger programme in the future, including double-blind and crossover components. The GaAlAs diode laser in contaet LLLT certainly provides a new noninvasive and easily applied therapy for PHN.

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Lasers emitting comparatively low-powered beamns, giving low incident power densities in target tissue, are being used in many specialities, under the acronym LLLT, standing for Low reactive-Level Laser Therapy, The authors prcsent in this study data from the specialty of neurosurgery concerning clinical application of a GaAlAs diode Laser (830 mm. 60 mW. continuous wave) used in the contact technique for a number of pain types, The effectiveness was evaluated as a percentage in four grades: the first two (excellcnt and good) were then added to give the overall effective rate in 32 casses of occipital neuralgia. the effective rate was 81%: in shoulder/arm/neek syndrome pain. 78.9%: for lower back pain, 49.6%. Treatment parameters may need to be changed in order to increase the effective rate for lumhar pain. A secondary experiment centred on the applications of LLLT in hypo- and hypertensive patients. Two case reports are presented, The effects of LLLT need to be examined in more experimental detail. In order to pinpoint the mechanisms und p31hways or LLLT's analgesic action in pain therapy of different types,

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Low reactive-Level Laser Therapy (LLLT) has been reported in the literature as enhancing bone generation and bone fusion in experimental animal models. This paper presents the application of LLLT for treatment of a fracture in an older patient with the added complication of chronic osteomyelitis of more than 20 years' ,standing, While further experimental work is necessary to pinpoint the mechanisms and pathways by which LLLT works on the production of bone callus of a more mineralized quality and stronger matrix, the author feels that LLLT immediately offers the orthopaedic surgeon a non-invasive and effective tool to enhance bone fusion for the treatment of fractures, especially with added complications such as osteomyclitis.

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Scald injuries are particularly seen in children and can be serious. if not treated promptly. The present study summarizes the work by the author on a group of 100 scald injury patients. treated using HeNe laser acupuncture on the points Tausanli, Tachii, Hoku, Chichik, Waikuan, Waichung, Hsuekhai, and Yanglingchuan, and scanning noncontact LLLT over the scald area, The success rates were as follows: recovercd-87%; improvcd-9%; no change-4%, Acupuncture was carried out for 3-4 min : and scanning for 5-10 min per treatment, once per day, 5 days per course. Fresh scalds healed quickly after one course, with two courses sufficient for the remainder. Most injuries healed well with no scar. Minor scarring occurred in three patients only. HeNe lascr acupuncture and LLLT offer the physician a noninvasive and effective way to deal with scald injuries.

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