FIRST PAGE OF PAPER
All animal tissues and plants contain fluorine in very small amounts. It is found in soils, rocks and water.
No convincing evidence has been as yet produced to show that it performs any useful function in animal nutrition, or that it is essential for animal metabolism. During the past 15 years, however, evidence has been accumulated to show that the prolonged ingestion of abnormal quantities produces a chronic toxic state, the earliest visible sign of which is called ‘mottled enamel’ of the teeth or chronic dental fluorosis. Its most common source is drinking water, and the level above which effects are produced is about one part of a million, equivalent to grain of fluorine to a pint of water. However, it is interesting to note that increased immunity to dental caries is supposed to be associated with an increased intake of fluorine (Wilson, 1941).
The presence of fluorosis in the Madras presidency was investigated first in 1937 by Shortt and others. In 1940, Raghavachari and Venkataramanan recorded the wide distribution of fluorides in the water in the province, and they indicated the districts of Bellary, Kurnool and Guntur as an endemic area. These districts are separated from Raichur, Mahboobnagar and Nalgonda districts of Nizam’s Dominion by the river Krishna. This led us to believe that those districts of our Dominion which were adjacent to the Madras presidency might have waters containing fluorine, and that we might find cases of chronic fluorine intoxication. Therefore, while doing nutrition and diet surveys of the districts, we took an opportunity to look for cases of fluorine intoxication and to determine the fluorine content of water used for drinking (see Map). In all these districts, well-water contained fluorine ranging from 0.25 part to 4 parts per million, and we came across children showing mottled enamel of the teeth. A good many cases of bone involvement and joint affections in elderly people were also seen clinically; unfortunately the diagnosis could not be confirmed by x-ray examination.
Table I shows the parts per million of fluoride content of water in different districts, with their geological strata. The water from…
* Paper presented before the Indian Science Congress Association, 32nd
Raghavachari, T. N. S., Indian J. Med. Res., 28, and Venkataramanan, 517. K. (1940).
Shortt, H. E., Pandit, Indian Med. Gaz., 72, 396. C. G., and Raghava- chari, T. N. S. (1937).
Wilson, D. C. (1941) .. Lancet, i, 375.