A complex disease picture prevalent in this country has been traced (Spira, 1928) to the protracted ingestion of drinking water derived from the tap, and of food prepared in aluminium cooking utensils. No indication could at that time be given of the exact irritant, beyond stating that a mineral or metal seemed to be involved. Further observation revealed a frequent association with paraesthesiae affecting the hands and fingers, especially those supplied by the dorsal cutaneous branch of the ulnar nerve. The feet were affected to a lesser extent. Since there is, in the present state of our knowledge, only one poison which affects the ulnar nerve, namely, fluorine, Spira (1933) concluded that it may be this halogen which was one of the aetiological factors concerned. It was the wide-spread occurrence of mottled teeth in this country (Spira, 1942a, b), known to be produced by a drinking water with a content of not less than 1 part of fluorine per million parts of water (1 p.p.m.), equivalent to gr. 1/120 of fluorine to a pint of water, ingested during the period of calcification of the teeth, which helped to establish the fact that it is indeed fluorine which is the causative agent producing signs and symptoms of a hitherto obscure origin.
(Received November 16 1945)