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    Lightbulb Kaj Eli Roholm. Fluorine Intoxication. Copenhagen 1937


    To date, probably the best, most comprehensive documentation of fluoride interactions with living organisms.


    FLUORINE INTOXICATION
    A Clinical-Hygienic Study
    With A Review Of The Litterature And Some Experimental Investigations.
    By Dr. Kaj Eli Roholm



    Published by NYT NORDISK FORLAG, Arnold Busck, Copenhagen 1937
    Published by H.K. LEWIS & CO. LTD. 136 Gower Street, London 1937

    Read Online Web.Archive.org
    Download from Canadians Opposed to Fluoridation (COF-COF) (Large File - 413 Pages - 51 MB)
    Download from Web.Archive.org (Large File - 413 Pages - 16 MB)

    (Read below a quotation from a "White Paper: The Anti-Fluoridationist Threat to Public Health" which is the official response to public concern about fluoride's role in everyday life, from the medical profession, published by Institute for Science in Medicine (ISM) April 2012)

    • Table of Content: see below
    • Illustrations: see below
    • Tables: see below
    • Preface: read below
    • Introduction: coming soon

    • Sammenfatning (in Danish): read below

  2. #2
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    Lightbulb Table of Contents


    FLUORINE INTOXICATION

    A Clinical-Hygienic Study
    With A Review Of The Litterature And Some Experimental Investigations.
    By Dr. Kaj Eli Roholm




    Published by NYT NORDISK FORLAG, Arnold Busck, Copenhagen 1937
    Published by H.K. LEWIS & CO. LTD. 136 Gower Street, London 1937

    Table of Contents
    TABLE OF CONTENTS

    Preface
    (see below)
    V-VII
    Introduction (coming soon) - 1
    • The Chemistry of Fluorine Compounds
    • History
    • Own Investigations


    PART I
    A Review of the role played by fluorine in biology

    Chapter I - IX (see: 1 - 9)


    1. Fluorine intoxication in man - 9
    1. Local Effect
    2. Acute Poisoning
      a. Frequency and Form
      b. Clinical Symptoms
      c. Morbis Anatomy
      d. Toxic and Lethal Dose
    3. Chronic Poisoning
      a. Sporadic Cases
      b. Poisoning with Cryolite
      c. Mottled Enamel


    2. Intoxication of plants and animals - 36
    1. Injuries to Plants
    2. Acute Poisoning of Animals
    3. Chronic Poisoning of Animals
      a. Enzootics round Factories
      b. Darmous
      c. Domestic Animal Disease in Iceland after Volcanic Eruption
      d. Feeding on Fluoric Forage


    3. Occurrence of fluorine in inanimate nature - 46
    1. Minerals and Rocks
    2. Soil
    3. Water
    4. Volcanoes


    4. Distribution of fluorine in animate nature - 52
    1. Plants
    2. Bones and Teeth
      a. Presence of Fluorine
      b. Quantity
      c. Origin
      d. Form
    3. Other Animal Tissues


    5. Effects of fluorine on protoplasm and enzymes - 60
    1. Protoplasm. Lower Organisms
    2. Effect on Blood in vitro
    3. Effect on Various Enzymatic Processes


    6. Experimental investigations into the effects of gascous fluorine compounds - 64
    1. Effects on Plants
    2. Effects on Animals


    7. Experimental acute and subacute fluorine intoxication - 67
    1. Experiments on Man
    2. Intoxication Symptoms in Animals
    3. Morbid Anatomy
    4. Effects on Various Tissues or Functions
      - The Blood
      - The Circulatory System
      - Musculature
      - The Central Nervous System
      - Glands
      - Renal Functions. N-Metabolism
      - Sugar Metabolism
      - Mineral Metabolism
      - Total Metabolism
      - Dental Tissue


    8. Chronic experimental fluorine intoxication - 76
    1. Growth. General Condition. Reproduction
    2. Gastro-Intestinal Tract
    3. Urinary System
    4. Blood and Bone Marrow. Spleen
    5. Nervous System and Musculature
    6. Endocrine Glands
      a. Thyroid Gland
      b. Parathyroid Gland
      c. Other Glands
    7. Various Functions
      a. Inorganic Components of the Blood
      b. Calcium and Phosphorus Metabolism
      c. Other Functions
    8. Dental Tissue
      a. Gross Changes
      b. Treshold Values for rats
      c. Other Animals
      d. Histopathology
      e. Chemical Compositions
    9. Bone Tissue
      a. Gross Changes
      b. X-Ray Picture
      c. Histopathology
      d. Strength and Chemical Composition


    9. Absorption, storage and excretion - 103
    1. Absorption
    2. Storage
    3. Excretion
    4. Maternal Transfer


    PART II
    Techniques employed in own investigations

    Chapter X (see: 10)


    10. Technique - 111
    1. Determining the Dust Quantity
    2. Analytical Technique
      a. Preparation of Organic Material
      b. Qualitative Test for Fluorine
      c. Quantitative Determination of Fluorine
    3. Histological Technique
    4. Haematological Technique
    5. Fluorine Compounds Used


    PART III
    Investigations into spontaneous cryolite poisoning

    Chapter XI - XX (see: 11 - 20)


    11. Cryolite and its manufacture - 121
    1. Occurence and Mining
    2. The Properties of Cryolite
    3. Processes in Cryolite Manufacturing


    12. Number and employment-period of workers - 130
    1. Lenght of Employment-Period
    2. Extent of Investigation
      - Medical History
      - Physical Examination


    13. Complaints of workers - 136
    1. Acute or Subacute Gastric Symptoms
    2. Intestinal Symptoms
    3. Symptoms from Circulation and Respiration
    4. Symptoms from Bones, Joints and Muscles
    5. Symptoms of Nervous Character
    6. Skin Symptoms
    7. Other Symptoms


    14. Examination of osseous system - 141
    1. Röntgen Examination
      - 1st Phase
      - 2nd Phase
      - 3rd Phase
    2. Clinical Examination


    15. Other results of physical examination - 148
    1. General Condition
    2. Teeth
    3. Respiratory System
    4. Circulatory System
    5. The Blood
    6. Nervous System
    7. Endocrine Glands
    8. The Skin
    9. Urine
    10. Sundry Examination


    16. Examination of former cryolite workers - 162
    1. Questionnaire on Discomfort of Work
    2. Result of Röntgen Examination
    3. Workers from the Cryolite Mine at Ivigtut


    17. Morbidity and mortality - 169
    1. Morbidity
    2. The Various Affections
    3. Mortality and Causes of Death


    18. Post-mortem examination of two cryolite workers - 180
    1. Cryolite Worker No. 55
      - Medical History
      - Clinical Examination
      - X-Ray Examination
      - Necropsy
      - Macroscopic Examination of Bones
      - Microscopic Examination of Bones
    2. Cryolite Worker No. 200
      - Medical History
      - Clinical Examination
      - Bones
    3. Analyses


    19. Examination of children of female cryolite workers - 195
    1. The mother is a former worker No. 100
    2. The mother is a former worker No. 98 at the factory
    3. The mother is a former worker born 1870


    20. Survey of spontaneous cryolite intoxication - 200
    1. Agent and Dose
    2. Subjective Symptoms
    3. Physical Findings
    4. Pathological Anatomy
    5. Biochemistry
    6. Pathogenesis
    7. Diagnosis
    8. Prognosis


    PART IV
    Own experimental investigations

    Chapter XXI - XXIV (see: 21 - 24)


    21. Experiments on rats - 213
    1. Technique
    2. Subchronic Intoxication
    3. Chronic Intoxication
      - Growth and Mortality
      - Attitude and Gait
      - Symptoms from Alimentary Canal
      - Skin and Eye Symptoms
      - Teeth
      - Form and position anomalies
      - Organs
      - Bones
      - Microscopic Examination
    4. Summary


    22. Experiments on pigs - 225
    1. Technique
    2. Course of Experiment. Symptoms
    3. Organs
    4. Bones
    5. Teeth
    6. Analyses
    7. Summary


    23. Experiments on calves - 234
    1. Technique
    2. Course and Experiment. Symptoms
    3. Blood and Organs
    4. Bones
    5. Teeth
    6. Analyses
    7. Summary


    24. Experiments on dogs - 244
    1. Technique
    2. Course of Experiment. Symptoms
    3. Blood and Organs
    4. Bones
    5. Teeth
    6. Analyses
    7. Summary


    PART V
    Discussion and general conklusions

    Chapter XXV - XXX (see: 25 - 30)


    25. The normal fluorine content of organic material - 257
    1. The Analytical Problem
    2. Vegetable Tissue
    3. Bones
    4. Teeth
    5. Other Animal Tissues


    26. Acute fluorine intoxication - 262
    1. Clinical Symptoms
    2. Morbid Anatomy
    3. The Dose
    4. Pathogenesis
    5. Diagnosis
    6. Prognosis and Therapy


    27. Chronic fluorine intoxication - 269
    1. Clinical Symptoms
    2. Morbid Anatomy
      - Gastro-Intestinal Tract
      - The Kidney
      - The Teeth
      - Bone Marrow. Spleen
      - Other Organs
    3. Biochemistry
      - Absorption and Excrection
      - Composition of the Blood
      - The Organs
      - The Bones
      - Metabolism
    4. The Question of the Dose
    5. Pathogenesis
    6. Diagnosis
      - The Dental Anomaly
      - Osteosclerosis
      - The Osteomalacic Condition
    7. Prognosis and Therapy
      - Dental Anomaly
      - Osteosclerosis
      - Osteomalacia


    28. Posibilities of intoxication - 292
    1. Occurrence of Fluorine
      - Drinking Water
      - Food
      - Volcanoes
    2. Extraction of Fluoric Minerals
    3. Industrial Use of Fluorine Materials
    4. Various Uses of Fluorine Compounds in Technical Processes
    5. Use of Superphosphate
    6. Fluorine Compounds as a Poison for Noxious Animals and Plants
    7. Employment of Fluorine Compounds in the Food Industry
      - Wine
      - Fruit Juice
      - Other Food
    8. Use of Fluorine in Therapy
      - Pulmonary Tuberculosis
      - Bones. Teeth.
      - Hyperthyroidism
      - Disinfection
      - Other Uses


    29. Prophylactic problems - 307
    1. Trade in Fluorine Compounds
    2. Use as Preservative in Food
    3. Use as Insecticide
    4. Undustrial Problems
    5. Other Prophylactic Problems


    30. The physiological role of fluorine - 312
    1. The Necessity of Fluorine
    2. Stimulating Effect of Small Quantities of Fluorine
    3. The Action of Fluorine in Physiological Doses


    PART VI

    Summary - 316
    - Occurrence of Fluorine in Nature
    - Effect of Enzymatic Processes and Protoplasm
    - Fluorine Compounds
    - Acute Intoxication
    - Chronic Intoxication
    - Mode of Action of Fluorine
    - Possibilities of Intoxication
    - Prophylaxis

    Sammenfatning (in Danish read below) - 322
    - Fluors forekomst i naturen
    - Virkning paa enzymatiske processer og protoplasma
    - Fluorforbindelser
    - Akut forgiftning
    - Kronisk forgiftning
    - Fluors virkemaade
    - Forgiftningsmuligheder
    - Profylakse

    Bibliography - 328
    - 36 Pages
    - 893 References

    ILLUSTRATIONS (see below)

    TABLES (see below)

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    Lightbulb Illustrations


    FLUORINE INTOXICATION

    A Clinical-Hygienic Study
    With A Review Of The Litterature And Some Experimental Investigations.
    By Dr. Kaj Eli Roholm




    Published by NYT NORDISK FORLAG, Arnold Busck, Copenhagen 1937
    Published by H.K. LEWIS & CO. LTD. 136 Gower Street, London 1937

    Illustrations
    ILLUSTRATIONS
    (Placed on or opposite page)

    • Mottled teeth in man - figure 1 - page 32
    • Spontaneus intoxication in sheep - figure 2-9 - page 42
    • Apparatus for determination of dust - figure 10 - page 111
    • Processes in cryolite manufacturing - figure 11-15 - page 124
    • Radiographs of cryolite workers - figure 16-31 - page 144
    • Diagram illustrating occurence of osteoscrelosis - figure 32 - page 145
    • Picture of cryolite worker - figure 33 - page 145
    • Necropsy findings in cryolite workers - figure 34-46 - page 184
    • Mottled teeth in children of cryolite workers - figure 47 - page 184
    • Weight curves for rats - figure 48-51 - page 216
    • Weight curves for rats - figure 52 - page 223
    • Intoxication in rats - figure 53-60 - page 224
    • Weight curves for pigs - figure 61 - page 226
    • Intoxication in pigs - figure 62-76 - page 232
    • Weight curves for calves - figure 77 - page 336
    • Intoxication in calves - figure 78-90 - page 240
    • Intoxication in dogs - figure 91-96 - page 248


    TABLES (see below)

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    Lightbulb Tables


    FLUORINE INTOXICATION

    A Clinical-Hygienic Study
    With A Review Of The Litterature And Some Experimental Investigations.
    By Dr. Kaj Eli Roholm




    Published by NYT NORDISK FORLAG, Arnold Busck, Copenhagen 1937
    Published by H.K. LEWIS & CO. LTD. 136 Gower Street, London 1937

    Tables

    TABLES
    1. The water Solubility of Some Fluorine Compounds - Page 2
    2. Acute, Fatal Fluorine Intoxications 1873-1935 - Pages 12-23
    3. Acute, Non-fatal Fluorine Poisoning 1873-1935 - Pages 24-25
    4. Frequency of Each Symptom in 34 Cases of Acute Fatal Fluorine Poisoning - Page 27
    5. Pathologico-Anatomical Changes in 32 Cases of Acute Fluorine Intoxication - Page 28
    6. Approximate Toxic and Lethal Dose in Acute Fluorine Poisoning in Man - Page 30
    7. Fluorine Content in Natural Water - Page 48
    8. Volcanoes Emitting Fluorine - Pages 50-51
    9. Analyses of Normal Fluorine Content in Bones and Teeth - Pages 55-56
    10. Fluorine Content of Normal Organs Page 58
    11. Dosis minima letalis of various Fluorine Compounds - Page 69
    12. Experimental Fluorine Intoxication - Pages 78-83
    13. Deposition of Fluorine in a Dog which received Sodium Fluoride perorally - Page 104
    14. Storage of Ingested Fluorine in Bones and Teeth - Pages 104-105
    15. Determination of Error of Willard and Winther's Method of Fluorine Analysis - Page 114
    16. Double Analyses of Fluorine Content in Bone Ash, Willard and Winter's Method - Page 115
    17. Gravimetric Determination of Dust Content in the Air at Various Working Places - Page 128
    18. Grain Size in Dust Samples from Factory - Page 129
    19. Employment Period of Discharged Male and Female Cryolite Workers - Page 131
    20. Age Distribution of Examined Cryolite Workers - Page 132
    21. Period of Employment of Examined Cryolite Workers - Page 133
    22. Frequency of Various Complaints by Cryolite Workers - Page 137
    23. Frequency of Complaints Arranged in Groups - Page 138
    24. Frequency of Osteosclerosis and its Relations to Period of Employment, Exposure to Dust etc. - Page 144
    25. Relationship between Osteosclerosis and Restriction of Motility in Columna - Page 147
    26. Condition of Teeth in 66 Cryolite Workers - Page 149
    27. Grequency of Pulmonary Found by X-ray Examination - Page 150
    28. Relation between Period og Enployment and Occurrence of Pulmonary Fibrosis - Page 151
    29. Relation between Changes in Lungs and Bones in Cryolite Workers - Page 152
    30. Average of Blood Composition in Cryolite Workers - Page 155
    31. Relation between Osteosclerosis and Blood Picture - Page 156
    32. Serum Calcium of Cryolite Workers - Page 159
    33. Fluorine Content in Teeth of Cryolite Workers Compared with Normal Teeth - Page 160
    34. Frequency of Various Complaints of Former and Present Cryolite Workers - Page 163
    35. Relation between Lenght of Employment and Frequency of Certain Complaints among Cryolite Workers - Page 163
    36. Frequency of Osteosclerosis and Pulmonary Fobrosis among Former Cryolite Workers - Page 164
    37. Results of Röntgen Examination of 9 Male Workers from the Cryolite Mine at Ivigtut, Greenland - Page 167
    38. Morbidity of Cryolite Workers in the Period January 1st, 1923 til January 4th, 1933, recorded by the Factory - Page 169
    39. Morbidity before, during and after Employment at the Cryolite Factory, Recorded by Sick-Clubs - Page 170-171
    40. Distribution of Sick-Days over Individual Diseases or Disease-Groups - Page 174-175
    41. Cause of Death and Post-mortem Examination of Former Cryolite Workers - Page 176-177
    42. Fluorine Content in Organs of Cryolite Workers - Page 192
    43. Fluorine Content of Bones in Cryolite Workers - Page 193
    44. Fluorine Content in Costae (Rib/red.) of Normal Individuals - Page 193
    45. Data concerning Rats 1-25 - Page 214
    46. Data from Experiment on Pigs, Concerning Stabling of Animals, Fluorine Compounds Used, Weight - Page 226
    47. Change of Form of Corpus Mandibule in Pigs - Page 229
    48. Fluorine Content of Organs in Pigs - Page 231
    49. Fluorine Content of Bones and Teeth in Pigs - Page 232
    50. Intoxication Symptoms in Calves - Page 235
    51. Blood Picture in Calves - Page 238
    52. Fluorine Content of Bones and Teeth in Calves - Page 242
    53. Summary of Doses of Fluorine Compounds used in Experiments with Dogs - Page 246
    54. Blood Picture in Dogs after Fluorine Ingestion - Page 247
    55. Fluorine Content in Bones and Teeth of Dogs - Page 251
    56. Fluorine Content of Bones and Teeth of Normal Animals - Page 259
    57. Various Uses of Fluorine Compounds in Technical Processes - Page 299

  5. #5
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    Lightbulb Preface


    FLUORINE INTOXICATION

    A Clinical-Hygienic Study
    With A Review Of The Litterature And Some Experimental Investigations.
    By Dr. Kaj Eli Roholm




    Published by NYT NORDISK FORLAG, Arnold Busck, Copenhagen 1937
    Published by H.K. LEWIS & CO. LTD. 136 Gower Street, London 1937

    Preface V-VII
    PREFACE

    Cryolite intoxication, a hitherto unknown disease among the workers at the Øresund Chemical Works, Copenhagen, was found in November, 1932, as a result of a profitable collaboration between the Industrial-hygienic Researches of the Inspectorate of Factories and Workshops and the X-ray Department of the Rigshospital. Professor P. Flemming Møller, the leader of that department, interested me in the disease and suggested that I should go more deeply into the problems of fluorine intoxication.

    Through the medium of an appointment at private expense as Assistant Physician under the Inspectorate of Factories and Workshops, I was enabled to complete the principal part of the investigations which form the foundation of the present work. The material from the first investigation was placed at my disposal, including the blocks for the illustrations Figg. 16, 19—26, 28 and 29.

    I wish to thank Professor Flemming Møller for inducing me to embark on the subject, for kind permission to examine my material by X-ray at the Rigshospital, for passing judgment on the radiographs of cryolite workers’ lungs, and for unflagging interest in my efforts.

    To the Director of the Inspectorate of Factories and Workshops, Mr. E. Dreyer, and its Chief Physician, Dr. Sk. V. Gudjonsson, I tender my best thanks for their confiding the task to me and allowing me a free hand to complete it as well as for their interest and support. By his energetic labours for industrial hygiene in Denmark Dr. Gudjonsson laid the foundation on which this work was started.

    A great deal of the work was done at the Copenhagen University Institute of Hygiene and the Budde Laboratory, to whose Director, Professor L. S. Fridericia, I am greatly indebted for hospitality, the best of facilities, and friendly interest. I am obliged to the staff of workers at the Institute for help and encouragement in the daily work. Miss Kirsten Becker and Miss Lotte Holm assisted me in tending the experimental animals and with the preparation of microscopic slides. Preparations were photographed in collaboration with Mr. Henrik Jensen and Mr. E. D. Lange. Some of the microphotographs are the work of Miss Margrete Falck, of the Copenhagen University Institute of Pathological Anatomy.

    It would not have been possible to carry on the work without help and kindness from many quarters. Dr. O. Brinch discussed problems of bone pathology with me and gave me valuable guidance. Dr. J. Engelbreth-Holm assisted me in judging the microscopic organ changes. Mr. R. Bogvad, M. Sc, examined bone slides in the polarization microscope. Mr. H. Buchwald, the Chief Chemist, analyzed fluorine preparations for me and helped with the analytical part. Mr. C. J. Howitz, of Viborggaard Farm, Herlufmagle, and Mr. S. Hjortlund, the Veterinary Surgeon, Copenhagen, assisted me to tend and slaughter the large experimental animals.

    Materials of many kinds, comprising case-records, radiographs, autopsy material and statistics, were entrusted to me by Professors H. M. Hou-Jensen, Poul Møller, K. Sand, Erik Warburg, and J. Collin, all in the Copenhagen University; Professor J. J. Hoist, School of Dental Surgery; Dr. M. Degerbal, Zoological Museum; the Chief Chemist H. H. Stevenius-Nielsen, of the Danish Fertilizer Company, Ltd.; Chief Physician G. Biering, Kommunehospitalet; Chief Physician Chr. I. Baastrup, Bispebjerg Hospital, and the Cryolite Mining and Trading Co. Ltd., Copenhagen.

    The sending out of an international questionnaire was made possible through the kind assistance of Dr. Johs. Frandsen, Director of the Danish National Health Service, and the Ministry of Foreign Affairs.

    With financial assistance from the Dano-Icelandic Union-Foundation I was able to undertake a journey to Iceland in the autumn of 1935 to investigate conditions connected with the sheep disease gaddur. When collecting literature I was given excellent help by many Danish and foreign libraries, but especially by the University Library in Copenhagen, where the officials were indefatigable in their readiness to assist. By means of a grant from the Budde Foundation I was able to make library studies in Berlin in the summer of 1934.

    A number of investigators abroad very kindly placed materials of various descriptions at my disposal: Professor E. W. Baader, Berlin; Dr. M. Bonjean, Rabat; Professor J. Casares Gil, Madrid; Dr. Juan Chaneles, Buenos Aires; Air. H. T. Dean, D. S., Washington; Professor Niels Dungal, Reykjavik; Dr. Leon Goldemberg, Buenos Aires; Dr. F. S. McKay, New York; Professor L. Slagsvold, Oslo; Dr. Margaret C. Smith, Tucson, Arizona; Dr. H. Velu, Casablanca.

    It was possible to accomplish the work in its present form through considerable financial support from the Øresund Chemical Works, Copenhagen. Mr. H. Tuxen, the Manager, Dr. A. Westergaard, the Secretary, as well as the employees and officials have displayed great interest in it and helped me in the course of my daily collaboration with them. So did Mr. C. F. Jarl, C. B. E., the Proprietor of the Works, who induced me to extend my investigations as far as possible in order to find out available prophylactic measures. The translation of the book is the work of Mr. W. E. Calvert, Copenhagen.

    I tender my most cordial thanks to all who in any way have aided me in my work.

    Kaj Roholm

    Blegdamshospitalet, Copenhagen N.

    February 1937

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    Lightbulb Indroduction


    FLUORINE INTOXICATION

    A Clinical-Hygienic Study
    With A Review Of The Litterature And Some Experimental Investigations.
    By Dr. Kaj Eli Roholm




    Published by NYT NORDISK FORLAG, Arnold Busck, Copenhagen 1937
    Published by H.K. LEWIS & CO. LTD. 136 Gower Street, London 1937

    Introduction
    INTRODUCTION (coming soon)

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    Lightbulb Sammenfatning (in Danish)


    FLUORINE INTOXICATION

    A Clinical-Hygienic Study
    With A Review Of The Litterature And Some Experimental Investigations.
    By Dr. Kaj Eli Roholm




    Published by NYT NORDISK FORLAG, Arnold Busck, Copenhagen 1937
    Published by H.K. LEWIS & CO. LTD. 136 Gower Street, London 1937

    Sammenfatning (in Danish)
    • Written off and words as well as medical terminology explained by Anisa.
    • Avskrevet (med forbehold) og ord, så vel som medisinsk terminologi forklart av Anisa.


    SAMMENFATNING

    Udgangspunktet for forfatterens undersøgelser er den af Flemming Møller og Gudjønsson beskrevne, hidtil ukendte, fluorforgiftning hos arbejdere i en københavnsk fabrik, hvor man under støvdannelse renser og formaler kryolit. Da fluorforgiftningen ikke tidligere har været genstand for en omfattende undersøgelse foretages i Afsnit I en systematisk, kritisk-syntetisk gennemgang af de i litteraturen foreliggende talrige og lidet kendte arbejder vedrørende fluors rolle i biologien. Hovedvægten lægges på en undersøgelse af de forskellige forgiftningsformers genese og deres kliniske og patologisk-anatomiske billede. Fluors forekomst i den livløse og levende natur behandles indgående.

    Efter omtale af teknikken ved egne undersøgelser (Afsnit II) gives i Afsnit III en detaljeret redegørelse for resultaterne af forfatterens kliniske, patologisk-anatomiske og erhvervshygiejniske studier over den humane kryolitforgiftning. En sammenfattende oversigt afslutter dette afsnit. I Afsnit IV beskrives forfatterens intoksikationsforsøg med rotter, svin, kalve og hunde, idet der er for hver dyreart gives en afsluttende oversigt over de opnåede resultater.

    I Afsnit V Diskussion og konklusioner sammenfattes resultaterne af litteraturstudierne og forfatterens undersøgelser ved en kortfattet systematisk gennemgang af den akutte og kroniske fluorforgiftning, forgiftningsmulighederne og de profylaktiske problemer. Fluors mulige fysiologiske rolle behandles i et afsluttende kapitel. Nedenfor gøres rede for de vigtigste konklusioner, der fremgår af arbejdet.

    Fluors forekomst i naturen

    Som en konstant bestanddel af eruptive bjergarter er fluor et udbredt element i den livløse natur. Fra denne kilde stammer fluor i jordbund, ferskvand og havvand. Vulkanske produkter kan indeholde fluor. Aflejringer af fluorholdige mineraler og bjergarter forekommer som flusspat, kryolit, apatit og forsforit. Planter og dyr optager normalt små mængder fluor, afhængig af lokale faktorer. Spor af fluor findes sandsynligvis i alt organisk væv.

    Da der består en affinitet (stoffers tilbøjelighed til at reagere med hinanden/red.) mellem fluor og calciumfosfat, aflejres fluor navnlig i knogler og tænder. Som regel indeholder knogleaske af landpattedyr 0,1-1‰ (promille = 1/10%/red.) og tandaske 0,1-1 ‰ fluor. Knogler og tænder af dyr, der lever i havet, indeholder omkring 10 gange så meget fluor. I tænderne aflejres fluor fortrinsvis i dentin (den del af tanden, der dækker rodhulen med pulpa, tandens nerve/red.), i ringere grad i emalje.

    Virkning på enzymatiske processer og protoplasma

    Fluorforbindelser påvirker en mængde enzymatiske processer (bl.a. vævs-respirationen, blodets koagulation, mælkesyredannelsen i musklen, gærens spaltning af stivelse). Virkningen er som regel hæmmende, men ofte har en svag koncentration en stimulerende, mens en stærkere koncentration en hæmmende effekt.

    Aktive fluorforbindelser destruerer protoplasma (samlebetegnelse for det materiale, en levende celle er sammensat af/red.) og hæmmer bakterievækst. Gærceller har tilvænningsevne overfor fluorforbindelser. Det er tvivlsomt, om den under normale forhold fluormængde har fysiologisk betydning. Eksperimentelt har fluor stimulerende virkning på vækstprocesser i mængder, der ligger under den toksiske grænse.

    Det er aldrig påvist og ikke sandsynligt, at fluor i fysiologiske doser skulle være nødvendig for eller have gavnlig virkning på tanddannelsen.

    Fluorforbindelser

    Fra et toksisk synspunkt kan fluorforbindelserne deles i fire grupper: (1) Luftformige, fluorbrinte (HF), siliciumtetrafluorid (SiF4) og visse organiske forbindelser; (2) opløsninger af flussyre (HF) og kieselflussyre (H2SiF6); (3) relativt letopløselige fluorider og silikofluorider; (4) tungtopløselige forbindelser, navnligt kryolit (Na3AlF6) og calciumfluorid (CaF2). De tre førstnævnte grupper spiller en rolle ved akutte forgiftninger, alle ved kroniske.

    Akut forgiftning

    Den akutte forgiftning viser sig ved en blanding af lokale irritations- eller ætsfænomener (ætsning/red.) og resorptive (som følge af optagelsen i vævene/red.) symptomer. Indtaget per os fremkalder fluorforbindelser hos mennesket opkastninger, ofte blodige, diffuse abdominalsmerter og universelle (generelle som/red.), svaghed, tørst, spytflod, sved, dyspnose (åndenød/red.), pulssvækkelse, evt. mors (dødsfald/red,). Flere eller færre symptomer kan mangle (i det enkelte tilfælde af fluorforgiftning/red.).

    Pattedyr viser et lignende billede, også ved parental indgift af fluor (det betyder at fluor tilført forældrene, påvirker deres børn/afkom/red.). Blodets calcium-indhold nedsættes. Ved respiration (indånding/red.) af luftformige fluorforbindelser iagttages irritationssymptomer fra øjets og luftvejenes slimhinder, og mere eller mindre udtalte resorptive (som følge af optagelsen i vævene/red.) symptomer.

    Post-mortem (under obduktion/red.) findes ved akut forgiftning hæmorrhagisk gastroenteritis (blødende forgiftning af mavetarmskanal og slimhinder/red.) med tendens til nekrosedannelse (celle-/vævsdød/red.), akut toksisk nefritis (nyrebetændelse/red.) og varierende parenkymatøs (parenkymatøs = funktionelle del af organet, i modsætning til støttevæv = passive del af organet/red.) degeneration af organerne.

    Luftformige [fluorforbindelser] fremkalder betændelsesforandringer i lungerne. Dosis minima letalis (den mindste dødelige dose/red.) afhænger af den hastighed, hvormed fluor resorberes (optages/red.). For de almindeligt i laboratoriet anvendte pattedyr er d. m. l. (den mindste dødelige dose/red.) 23-90 mg fluor per kg legemsvægt ved peroral (gennem munden/red.) indgift.

    Mennesket er langt mere følsomt, idet 6-9 mg per kg [legemsvægt] har fremkaldt mors (dødelig udgang/red.). Som regel ligger dødelig dosis væsentligt højere (omkring 5-15 g natriumfluorid). De dødelige forgiftninger forløber oftest i løbet af timer (han mener at det går hurtigt med at dø af fluorforgiftning/red.).

    Kronisk forgiftning

    Symptomerne afhænger af dosis, indgiftens varighed, dyrearten, individets alder, fødens sammensætning og andre, tildels ukendte, forhold. Fluors skadelige virkning er navnlig lokaliseret til knogler og tænder.

    Forgiftningen viser tre forskellige former, der kan kombineres på forskellig måde: (1) Degenerative tandforandringer; (2) diffus osteosklerose (sygelig udfyldning af knoglevævets [rette] kanaler og hulheder med [urette] væv/red.); (3) en af almensymptomer ledsaget diffus knoglelidelse, der ligner den klassiske osteomalaci (bløde, deformerede knogler/red.). Den mindste dosis, der kan fremkalde de forskellige former [af forgiftning], er endnu ret usikker, men synes at være stigende fra (1) til (3).

    Tandforandringer er iagttaget hos mennesker og mange dyrearter. Færdigforkalkede tænder påvirkes ikke eller kun ringe grad af fluorindgift. Tænder eller tandafsnit, der forkalker under fluorindgiften, viser degenerative forandringer, der synes at være patognomoniske (dvs. så karakteristiske for en sygdom, at [alene] det beviser dens tilstedeværelse/red.).

    Ved de letteste grader er emaljen uklar, kridtagtig hvid med gul, brun eller sort pigmentering af de for lyset udsatte partier af tænderne. De svære grader karakteriseres ved hypoplastisk (hypo-dannelse pga. formindsket antal celler/red.), lidet resistent (skrøbelig/red.) emalje og dentin (den del af tanden, der dækker rodhulen fyldt med pulpa som er kar- og nerveholdige bindevæv/red.).

    Det abnormt stærke slid kan forårsage betydelige funktionsforstyrrelser. Tænderne kan vise abnormiteter i størrelse, form og stilling. Histologisk (mikroskopisk/red.) iagttages degenerative forandringer af emalje-epithelet og langformet aflejring af hypoplastisk, mangelfuldt forkalket emalje og dentin. (Kort sagt, hele tanden bliver deformeret, skrøbelig inkl. emaljen/red.) Den mindste daglige dosis fluor, der hos rotter kan fremkalde netop erkendelige forandringer (under lup), er ca. 1 mg fluor per kg legemsvægt.

    Mennesket er langt følsommere [over for fluor], idet [kun] ca. 0,007 mg (0,007 mg = 7 mcg = 7 µg/red.) fluor per kg [legemsvægt] daglig kan give makroskopiske (synlige med det blotte øje, dvs. uden mikroskop/red.) forandringer. Disse doser ledsages ikke af anden kendt (i 1937/red.) skadelig påvirkning af organismen.

    Osteosklerosen (sygelig udfyldning af knoglevævets [rette] kanaler og hulheder med [urette] væv/red.) kendes hos mennesket som en systemsygdom, der angriber alle knogler, men navnlig de spongiøse (svampede/red.). På røntgenpladen iagttages forøget knogleproduktion, såvel fra periost som endost (forsnævrede marvrum [inde i knoglen], periostale aflejringer [uden på knoglen]). Spongiøse knogler fortættes og kan give diffus, strukturløs skygge.

    De ossose ligamenter (knoglernes bindevæv/red.) forkalker, navnlig i columna (rygsøjlen/red.). Klinisk iagttages uregelmæssig fortykkelse af subkutane (synlige under huden/red.) knogleflader og indskrænkning (hæmning af/red.) af bevægeligheden i columna (ryggen/red.) og thorax (brystkassen/red.).

    Knoglerne viser sig ved post-mortem undersøgelse (under obduktion/red.) plumre (ujævne/red.), indtil tre gange så tunge som normalt, og relativt skøre. Overfladen er ujævn, ligamenter og ledkapsler [er] forkalkede, men ikke brusken. Mikroskopisk undersøgelse viser et abnormt struktureret knoglevæv og en excessiv (voldsom/red.) kalkaflejring; kalken udfældes tildels som uregelmæssige klumper og korn (granulat/red.). Almentilstanden er ikke påvirket, og der iagttages ingen sikre forandringer i andre organer; tænderne viser dog tegn på forøget dannelse af cement og dentin.

    Lidelsen fremkaldes hos mennesket sandsynligvis ved en daglig optagelse af 0,20-0,35 mg (200-350 mcg/µg/red.) fluor per kg legemsvægt. Forandringerne udvikles dog først efter flere års regelmæssig fluoroptagelse. Hos rotten kan [dog] eksperimentelt fremkaldes en lignende, om ikke identisk, tilstand ved [kun] måneders indgift af fluor.

    Den osteomalaciske tilstand kendes (i 1937/red.) hos en række pattedyr, men ikke hos mennesket. Den er led i en mere eller mindre udtalt kakeksi (alvorlig afmagring eller vægttab med tydelige tegn på nedbrydning af muskelmasse og fedtvæv/red.), der viser sig ved anorexi, afmagring, anæmi, groft hår samt diverse øjenforandringer. Samtidigt iagttages som regel tegn på latent (skjult/red.) eller manifest (åbenbar/red.) tetani (stivhed/red.), nemlig stiv og besværet gang, tendens til nedsættelse af blodcalcium og tremor (rystelser/red.). Knoglesystemet viser varierende exostosedannelse (unormalt fortykkeses-lag/red.), navnlig på mandibel (forkæber, kindbakker/red.) og ekstremitetsknogler (i arme og ben/red.).

    Ved sektionen (obduktionen/red.) konstateres knoglerne lette og bløde, spongiosa og compacta atrofisk (svind i det svampede og kompakte knoglevæv/red.) , men knoglerne kan [alligevel] imponere som (om de var større og stærkere, hvilket de ikke er/red.) fortykkede ved dannelsen af et abnormt struktureret væv, med tilbøjelighed til kornet (granuleret/red.) udfældning af kalken.

    Patologisk-anatomisk (anatomi af unormale, syge eller skadede væv/red.) minder forandringerne om rakitis (Engelsk syge/red.) og klassisk osteomalaci (bløde, deformerede knogler/red.), men kan dog ikke identificeres med disse. De parenkymatøse (aktivt bio-fungerende/red.) organer, inklusive knoglemarven, viser varierende grad af degenerationsfænomener, nyren tillige en overvejende interstitiel (inde i nyrenes indre mellemrum/red.), skrumpende nefritis (skrumpenyre/red.). Nyrevirkningen er ulige hos forskellige dyrearter. Dosis varierer, men er oftest omkring 15-20 mg fluor per kg [legemsvægt] daglig (rotter, svin, hunde).

    Planteædere synes særlig følsomme [for fluor]. Tilstanden udvikles, og mors (døden/red.) kan indtræde i løbet af uger eller måneder.

    Et forøget kalkbehov (vækst, graviditet, laktation) fremskynder [fluor]forgiftningens udvikling.

    Fluor absorberes fra mave-tarmkanalen; luftformige fluorforbindelser kan absorberes gennem lungen. Det vides ikke (i 1937/red.), i hvilken form fluor absorberes, cirkulerer, aflejres eller udskilles. Den største aflejring sker i knogler og tænder, sandsynligvis som en blanding af hydroksyl- og fluorapatit (fluorforbindelser/red.). Aflejring som krystallinsk calciumfluorid finder ikke sted.

    Fluor aflejres diffust i knoglesystemet, men navnlig i de spongiøse (svampede/red.) knogler. Fluor kan sandsynligvis aflejres i færdigdannet emalje. Alle former af kronisk forgiftning viser forhøjet indhold af fluor i knogle- og tandaske (fra ca. 2 til ca. 30‰). Fluor passerer som regel ikke placenta (moderkagen/red.) i små mænder; de forskellige dyrearter forholder sig dog forskelligt.

    Hos mennesket og rotten udskilles fluor i modermælken.

    I relativt store doser fremkalder fluor en negativ calciumbalance (calcium-mangel/red.), formentlig ved at beslaglægge organismens (kroppens depoter af/red.) calcium; calciumfluorid er meget tungtopløseligt. Fluors calcioprive (calcium-berøvende/red.) virkning kan ikke forklare alle forgiftningens symptomer. Osteosklerosen (sygelig udfyldning af knoglevævets [rette] kanaler og hulheder med [urette] væv/red.) ledsages af forøget mineralaflejring, tandforandringerne fremkommer ved så små doser, at en direkte (dvs. i forvejen eksisterende/red.) kalkmangel er udelukket. Fluor må [derfor] antages at have en særlig [aktiv] vævseffekt.

    Virkningen på knogle- og tandvæv viser sig generelt ved (1) dannelsen af en abnormt struktureret organisk matrix (grundmasse/red.) og (2) en forkalkningsanomali (anomali = undtagelse fra normen, uregelmæssighed/red.) , hvorved knoglens mineralsalte udfældes uregelmæssigt og i diskrete korn (granulat/red.) og klumper.

    Relativt små doser [fluor] synes at fremkalde forøget vækst og forøget forkalkning, relativt store doser overvejende atrofiske (svind, indskrumpning/red.) processer og nedsat forkalkning. Fluors knoglevirkning beror rimeligvis på en påvirkning af de enzymatiske processer knyttet til mineralsaltenes udfældning, efter omstændighederne stimulerende eller hæmmende.

    Det er muligt, men ikke sandsynligt, at virkningen på kalkstofskiftet udøves via glandulae parathyreoideae (biskjoldbruskkirtler/red.). Fluor påvirker adskillige stofskifteprocesser, og forgiftningssymptomerne har formentlig en kompliceret patogenese (sygdomsproces/red.). Mellem vitamin C og fluor består en særlig relation.

    Forgiftningsmuligheder

    Lokale ætsfænomener (ætsning/red.) er hyppige i industrien. Den akutte forgiftning opstår navnlig ved ulykkestilfælde (forveksling); også selvmord og mord kendes. I tidsrummet 1873-1935 offentliggjordes 112 humane forgiftningstilfælde, hvoraf 60 dødelige. Adskillige forgiftninger af dyr er beskrevet.

    De spontane, kroniske forgiftninger opstår alle ved optagelse af fluor gennem mave-tarmkanalen. Luftformige fluorforbindelser kan fremkalde kronisk forgiftning ved resorption (optagelse/red.) gennem lungen.

    De kendte spontane kroniske forgiftninger omfatter (1) mottled teeth (senere navngivet som "dental fluorosis"/red.), en tandsygdom, der er endemisk hos mennesket visse steder i Europa, Amerika, Afrika og Asien; (2) osteosklerose *), erhvervssygdom hos kryolitarbejdere i København; (3) osteomalaci, endemisk hos planteædere i omegnen af diverse fabrikker i Europa; (4) darmous [som er] en tand- og kæbesygdom hos planteædere i visse egne i Nordafrika; (5) gaddur [som er] en tand- og knoglelidelse hos planteædere i Island efter vulkanudbrud.

    *) Fornylig er osteosklerosen iagttaget hos personer lidende af darmous og hos en mand, beskæftiget med fremstilling af gødning, af fluorholdig fosforit. (Fig. 78a)

    Større eller mindre mulighed for forgiftning yder: Drikkevand, der indeholder mere end 1 mg fluor per liter; planter dyrket i egne, hvor jorden er særlig rig på fluor; udvinding og anvendelse af fluorholdige produkter i industrien; fluorholdige affaldsprodukter fra fabrikker; fluorholdige vulkanske produkter.

    En række anvendelser af fluorforbindelser er at interesse, uden at de dog, såvidt vides (i 1937/red.), har forårsaget forgiftning, nemlig sprøjtebehandling af spiselige planter med fluorforbindelser mod parasitter, gødning med fluorholdig superfosfat, tilsætning af fluorforbindelser til levnedsmidler i konserverende øjemed, og terapeutisk anvendelse af fluorforbindelser.

    Profylakse (forebyggelse/red.)

    Indskrænkning af den frie handel med de fluorforbindelser, der har størst akut toksicitet.

    Forbud mod tilsætning af fluorforbindelser til levnedsmidler i konserverende øjemed.

    Maksimalgrænse for indhold af fluor i spiselige plantedele, behandlet med fluorholdige sprøjtemidler.

    Forbud mod at beskæftige kvinder og mindreårige i arbejde med fluorforbindelser, der udvikler støv eller dampe.

    Beskyttelse af og kontrol med arbejdere, der udsættes for fluorpåvirkning.

    Anerkendelse af den kroniske fluorforgiftning som erstatningspligtig erhvervssygdom.

    Krav til industrielle virksomheder om at uskadeliggøre fluorholdige affaldsprodukter.

    Ophør med terapeutisk anvendelse af fluorforbindelser til børn.

    Undersøgelse for fluor ved den rutinemæssig analyse af drikkevand, levnedsmidler og forgiftningstilfælde med uklar ætiologi (årsag/red.).

    • Written off and words as well as medical terminology explained by Anisa.
    • Avskrevet (med forbehold) og ord, så vel som medisinsk terminologi forklart av Anisa.

  8. #8
    Medlem siden
    Mar 2009
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    2,323

    Exclamation A quotation from a "White Paper: The Anti-Fluoridationist Threat to Public Health"

    To date, probably the best, most comprehensive documentation of fluoride interactions with living organisms.


    FLUORINE INTOXICATION
    A Clinical-Hygienic Study
    With A Review Of The Litterature And Some Experimental Investigations.
    By Dr. Kaj Eli Roholm




    Published by NYT NORDISK FORLAG, Arnold Busck, Copenhagen 1937
    Published by H.K. LEWIS & CO. LTD. 136 Gower Street, London 1937

    A quotation from a "White Paper: The Anti-Fluoridationist Threat to Public Health" which is the official response to public concern about fluoride's role in everyday life, from the medical profession, published by Institute for Science in Medicine (ISM) April 2012)
    A quotation from a White Paper: The Anti-Fluoridationist Threat to Public Health which is the official response to public concern about fluoride's role in everyday life from the medical profession, published by Institute for Science in Medicine (ISM) April 2012:

    "Institute for Science in Medicine (ISM) is an international, educational and public-policy organization comprised of health care professionals, scientists, and researchers who agree that the best science available should be used to determine health policy and to establish a standard of care that both protects and promotes the public health. We necessarily oppose policies which erode a science-based standard of care and thereby significantly expose the public to fraudulent, worthless, or harmful medical practices and products."

    "Declared by the Centers for Disease Control and Prevention to be one of the ten greatest public-health achievements of the Twentieth Century [1], community water fluoridation has been under attack by a small band of critics since its inception. The scientific consensus over fluoridation’s health benefits, safety, social justice, and economies has been firmly established over six decades of widespread use in the United States and elsewhere. Nevertheless, anti-science critics have never relented in their opposition — recycling previously disproven charges of harm, inventing new ones out of whole cloth, misrepresenting scientific facts and research, exaggerating risks, understating benefits, inappropriately invoking the precautionary principle, and accusing public health officials of corruption, conspiracy, and ‘mass medication’ of whole populations."

    If it is not corruption and conspiracy, then it must be a bottomless ignorance that makes modern doctors cluster to statistical algorithms, they call for evidence-based medicine, rather than they are seeking real knowledge and clinical science. And they really call themselves doctors?

    Do you still think, the Institute for Science in Medicine (ISM) and other mainstream doctors are indeed serving the "do no harm" principle ?

    We do not think so. Not after years of bad, painful, annoying and disappointing experiences with doctors, who are much more loyal to their colleagues and teachers than they are loyal to their patients.

    Primum non nocere ("First, do no harm")
    From a oath of ethical professional behavior sworn by new physicians and attributed to Hippocrates.

    The “do no harm” principle
    Humanity, Neutrality, Impartiality


    "Humanitarian principles and standards of conduct for humanitarian workers have been developed by various actors over the past several years, based largely on international humanitarian law and the work of the ICRC. The Red Cross Movement and many of the major humanitarian NGOs have adopted a 10-point Code of Conduct. The “do no harm” principle, developed by Mary B. Anderson in the 1990’s, has developed into an approach, inspiring a series of training workshops for humanitarian workers. The Sphere Humanitarian Charter includes a set of principles that constitute an operational framework for accountability for the Steering Committee on Humanitarian Response, Interaction, VOICE, ICRC, and ICVA. The UN agencies are committed to the three core humanitarian principles listed in GA Resolution 46/182 which established the present system of UN coordination in humanitarian crises, i.e. humanity, neutrality, impartiality."

    Source: 4.2 UNICEF’s (therefore also UN's/red.) Humanitarian Principles (Doc)

    Now is the time to think for yourselves: who - do you think - in fact cares more for human kind? Us - who does warn ordinary, defenseless people of any age against fluorides, or the medical profession and dentists, who in fact do the opposite by supporting the use of fluorides in everyday life. What do you think?
    Til alle norske og danske stoffskifte-pasienter, anbefaler vi boken STOP stofskiftevanviddet, skrevet av verdens ledende pasient-aktivist Janie Bowthorpe, som i 2005 grunnla nettstedet Stop The Thyroid Madness. Boken er utgitt på dansk i 2014. För alla svenska hypotyreos-patienter, rekommenderar vi samma bok, översatt till svenska med titeln Stoppa sköldkörtelskandalen (2012). Til alle gode leger, og pasienter som ønsker å lære mer av "the right stuff", anbefaler vi boken Stop The Thyroid Madness II (2014) med bidrag fra 10 leger MD. I Skandinavia, definitivt de to beste og mest nyttige bøker for hypotyreose-pasienter, for deres familier og venner, og for deres leger.

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