NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
September 1955] A. MARIAKULANDAI AND P. VENKATAR
TABLE V
Blood analysis of affected cattle in Kurnool district
Serial
No.
1.
2.
3.
4.
5.
Place
Ramachandrapuram, Kurnool taluk,
Kurnool district.
Veepanaguntla, Nandikotkur taluk,
Kurnool district.
Brahmanakotkur,
„
do.
Chinnabodaram, Sirvel taluk
Animal
Bullocks
„
„
Cow
Bullocks
Range in age
4-8 years
3-7 „
4-10 „
12 „
3-10 „
Number of
animals
analysed
5
6
8
1
6
Blood
inorganic
phosphorus
(mg. 100
cc. blood)
(average)
1.52
1.28
1.91
1.50
1.01
Serum
calcium
(mg. 100
cc. serum)
(average)
11.5
9.3
9.0
9.0
12.08
Becker et al., [1933] had shown that cattle reared on phosphorus deficient area
exhibit after a period of five to seven months, a condition known as 'stiffs' or 'Stiefkita
or 'Sweeny', which was a stiff sickness characterised by abnormal skeletal develop-
ment, thickening of the epiphysis of the long bones and a stiff gait. Thus the phos-
phorus deficiency by affecting the same bones and joints as the excess of fluorine
was reported to attack, was without doubt the chief factor in enhancing fluorine
intoxication in cattle. Work done elsewhere in India [Majumdar, Roy and Sen
1946] have since corroborated this conclusion.
'AFFECTED' AND 'CURATIVE' VILLAGES
In the villages where the cattle were not affected and in somewhere they were
said to be cured of the disease, herein called as 'curative villages', the fluorine content
of their water sources as revealed by the analysis presented in Table I, was generally
less than 0.5 parts per million. The affected villages in general had one or more
parts per million of fluorine in their natural waters (vide Table I). A few exceptions
in which the affected villages had a fluorine content of less than one part per million
was due to the rains received previous to the collection of the water sample, which
had temporarily brought the fluorine content below the toxic level of one part per
million. That such fluctuations exist in the fluorine content of natural waters
due to rain was clearly seen from the seasonal study made on six samples of water
from Amdagunta and Veepanaguntla villages of the Kurnool district given in
Table VI.
From this seasonal study, it was evident that July to August would give a fairly
average value in the fluorine content of the water sources, when it would neither
be too concentrated as in the summer months (March to June) nor too diluted as
in heavy rainfall season (October to December). The water samples, analysis
of which is presented in Table I, were collected in August and from the results
obtained it is seen that fluorine in the water, as a concentration of nearly one part
per million characterizes the affected zone.
27 AR/55
2
174 FULORINE INTOXICATION—I
[Vol. XXV, Part III,
TABLE VI
Seasonal variation of the fluorine content of natural waters in Kurnool district
Serial
No.
1
2
3
4
5
6
Water source
Kurnam
well,
Veppangguntla,
Nandikotkur
taluk,
Kurnool
district.
Bommanna well,
do.
Hawdry River,
do.
Pond,
Amadaguntla,
Kurnool,
taluk, Kurnool district,
Peudabhavi,
do.
Chinnabhavi,
do.
Fluorine parts per million
Season
Summer
Feb-
ruary
2.48
. .
. .
. .
1.34
. .
May
2.10
3.34
0.86
1.91
0.86
1.15
June
2.20
3.05
1.24
1.24
0.96
0.76
Rainy
August
2.39
2.86
1.43
1.24
0.48
1.15
Novem-
ber
2.86
2.86
0.48
0.48
0.48
0.48
Total solids at 105°C
Season
Summer
Feb-
ruary
760
. .
. .
. .
2232
. .
May
608
588
212
216
2324
1816
June
772
768
488
196
2588
2060
Rainy
August
544
756
420
240
2512
16040
Novem-
ber
800
840
212
160
2696
1948
pH
Season
Summer
Feb-
ruary
. .
. .
. .
. .
. .
. .
May
7.89
7.93
7.64
7.44
7.90
7.40
June
7.78
7.70
7.74
7.44
7.65
7.79
Rainy
August
7.77
7.86
7.73
7.53
7.66
7.74
Novem-
ber
7.89
7.93
7.64
7.44
7.90
7.40
September 1955] A. MARIAKULANDAI AND P. VENKATARAMAIAH 175
The affected zone and its geological formation. As fluorine in the water must
have probably originated from the underlying rocks, a study of such rocks was made.
From the geological map of the affected area it was noted that the underlying forma-
tions were as given below :
1. The Cuddapah-Kurnool formations.
2. Unclassified crystalline granites and gneisses.
3. Granite and syenite formation.
4. Dharwar series.
Typical rock samples from each of these formations were collected and analysed for
their fluorine content and the result is given in Table VII.
TABLE VII
Analysis of rock samples
(from the geological formations underlying the affected area)
Serial
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
Source
Mantrala pass, Nallamalais,
Kurnool District.
do.
do.
Nandikotkur, Kurnool District
Somayajulupallaghat, Kurnool
District.
do.
do.
Nandyal,
do.
do.
Panyam, Nandyal taluk
do.
Karivemulla, Nandyal taluk
Kodunuru Nandyal taluk
Well rock, Amadaguntla
do.
do.
Kenchenguda,
Siruguppa,
Bellary District.
Bhattorahalli, Siruguppa Road,
Bellary District.
Bevenhalli,
do.
Name of the rock formation
Cuddapah formation
do.
do.
Kurnool formation
Cuddapah formation
do.
do.
Kurnool formation
do.
do.
do.
Unclassified crystalline and
gneisses formation.
do.
do.
do.
do.
do.
Granite and Syenite formation
Dharwar series
Name of the rock samples
Light yellowish white shale
Reddish brown shale
Grey shale
Brown limestone
Crystalline limestone
Banded limestone
Shales
Grey limestone
Light chocolate limestone
Quartzite
Sandstone
Granite
Quartzite
Tourmaline crystals
Quartz and felspar
Schistose
Mica granite
Red granite
Horablands trap
Fluorine
P.P.M.
370
450
620
700
330
960
790
780
670
390
630
490
390
655
320
495
380
45
140
176
FLUORINE
INTOXICATION-I
[Vol. XXV, Part III,
The rock formations underlying the affected area were, therefore, to a greater
or lesser extent, a permanent source of supply of fluorine to the waters which flow
through them. Similarly the soils produced by weathering from these rocks contain
large amounts of fluorine. A soil sample from Veepanaguntla, Kurnool taluk,
had a fluorine content of 310 parts per million and another sample from Chinna-
bhodanam, Sirvel taluk, contained 410 parts per million fluorine. The plants grown
on these soils too were analysed and found to contain good amounts of fluorine
ranging from 0.1 to 0.26 mg. per gram of plant ash.
Thus the fluorine originally contained in the rock and soil got into the forage
and fresh water and due to the combined action of the fluorine in the feed and
water, the animal got the toxicosis.
Summing up it may, therefore, be stated that this disease is caused by lack
of phosphorus in the soils and hence in the herbage, and also due to the presence of
fluorine in the water as well as the roughage which is made up of cereal straws and
groundnut haulms.
Symptoms. The first indication of the disease is seen in the lameness of one
or more limbs, more often the fore limbs and more acutely in the shoulders, which
appear to be thrown forward. When the hind limbs are affected, the gait is of a
swinging nature. This meta-static lameness soon spreads to all the four limbs pro-
ducing in a few months a stiff, cramped and laboured gait. Anorexia and loss of
condition ensure. Swollen joints, especially of the knee and hock joints, followed
by ankylosis mark the next stage of the disease before advanced emaciation
resulting in death.
PROPHYLACTIC AND CURATIVE MEASURES
It became clear from the field survey that the disease among cattle in the
affected area was due to both a deficiency in phosphoric acid and the presence of
fluorine in waters. Hence, it was evident that the preventive and curative measures
should include addition of mineral supplements containing phosphoric acid and
removal of fluorine from contaminated waters. Work in this direction was attempted
in 1940 : (a) by removing fluorine from potable waters, and (b) by feeding bone
meal as a phosphatic supplement.
Removing fluorine from potable waters
The problem of removing fluorine from potable waters has been the subject of
some study in the U. S. A. and elsewhere, but the methods suggested are mostly
expensive and are more suited for application in large municipalities and corpora-
tions with a protected system of water distribution from reservoirs. For conditions
which prevail in Kurnool district, where wells provide water for all the needs of
men and animals and that too to a very limited extent, no method involving ex-
pensive procedure or elaborate equipment can be recommended. Laboratory
trials were made on the use of a number of reagents on a solution of sodium
fluoride containing 10 parts per million fluorine. Table VIII gives details of treat-
ment and fluorine content before and after treatment.
September 1955] A. MARIAKULANDAI AND P. VENKATARAMAIAH 177
TABLE VIII
Reagents tried for fluorine removal
Serial
No.
1
2
3
4
5
6
7
8
9
10
Reagents
Boric acid
Potash alum
Tricalcium phosphate
Commercial superphosphate
Borax
Alumina cream
Calcium carbonate
Lime (CaO)
Lime and superphosphate
Lime and potash alum
Fluorine P.P.M.
In original
solution
10
10
10
10
10
10
10
10
10
10
In treated
solution
8.59
8.59
7.64
9.55
9.55
3.34
8.59
0.95
0.95
0.76
Fluorine
removed
p.p.m.
1.41
1.41
2.36
0.45
0.45
6.66
1.41
9.05
9.05
9.24
In this trial it was seen that lime alone and lime with alum were the most effec
tive, having removed 9 parts of fluorine out of 10 per million. The effect of lime
at varying concentrations ranging from 100 to 4,000 parts per million was tried
next on a similar synthetic solution of fluorine. Results are given in Table IX.
TABLE IX
Effect of different concentrations of lime
Serial
No.
1
2
3
4
5
6
7
8
9
Treatment
4000 p.p.m. i.e. 4 gm. of CaO
per litre of F. water.
3000 p.p.m. i.e. 3.0 gm. of CaO
per litre of F water.
2500 p.p.m. i.e. 2.5 of gm.CaO
per litre of F water.
2000 p.p.m. i.e. 2.0 of CaO
per litre of F water.
1500 p.p.m. i.e. 1.5 gm. of
CaO pet litre of F water.
1000 p.p.m. i.e. 1.0 gm. of
CaO per litre of F water.
500 p.p.m. i.e. 0.5 gm. of
CaO per litre of F water.
200 p.p.m. i.e. 0.2 gm. of
CaO per litre of F water.
100 p.p.m. i.e. 0.1 gm. of
CaO per litre of F water.
Fluorine concentration P.P.M.
Original
water
10.0
10.0
10.0
10.0
10.0
10.0
10.0
10.0
10.0
After
one
day
2.86
2.86
2.86
2.86
3.34
3.34
3.34
8.11
8.11
After
two
days
0.95
0.95
1.91
1.43
2.39
2.39
2.39
7.16
7.16
After
three
days
0.95
0.95
0.95
0.95
1.43
1.43
1.43
7.16
7.16
After
four
days
0.95
0.95
0.95
0.95
1.43
1.43
1.43
7.16
7.16
After
six
days
0.95
0.95
0.95
0.95
0.95
1.43
1.43
7.16
7.16
pH.
Original
water
6.44
6.44
6.44
6.44
6.44
6.44
6.44
6.44
6.44
After
six
days
9.6
9.6
9.6
9.6
9.6
9.6
9.6
8.1
7.8
178
FLUORINE
INTOXICATION-I
[Vol. XXV, Part III,
It was seen that lime alone at 1,500 parts per million brought down the fluorine
content from 10 parts per million to 0.95 parts per million in six days. The fluorine
in the form of calcium fluoride settles down and is easily removed. The same treat-
ment was then applied to natural well waters of Kurnool and Coimbatore districts.
Table X gives details of treatment and fluorine content before and after
treatment.
TABLE X
Lime treatment in natural waters
Serial
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Lab.
No.
39—40
1675
1676
1677
1678
1679
1680
1681
1682
1683
1684
1685
1686
1687
1688
Water-source
Kunnam well, Veppanaguntla,
Nandikotkur,
Kurnool district
Bommanna well Veppanaguntla, Nandikotkur,
Kurnool district
Step well, Veeragimangalam, Dharapuram, Coim-
batore district
„
Suryanallur, Dharapuram, Coimbatore
district
„
Nanjampalayam, Dharapuram, Coim-
batore district
„
Padiyur,
Dharapuram, Coimbareto
district
„
Kandadam, Dharapuram, Coimbatore
district
„
Mudalipalayam, Dharapuram, Coim-
batore district
„
Kangayam, Dharapuram, Coimbatore
district
„
Kannapuram, Dharapuram, Coimbatore
district
„
Vellakoil, Dharapuram, Coimbatore
district
„
Kadiyur, Dharapuram, Coimbatore
district
„
Mulanur, Dharapuram,
Coimbatore
district
Channel Dharapuram, Dharapuram, Coimbatore
district
Lime
dosage
p.p.m.
1000
1000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
Fluorine in
Original
water
P.P.M.
2.86
2.86
2.40
3.72
1.43
1.34
2.40
0.76
1.15
1.53
0.76
1.15
0.95
0.57
Treated
water
p.p.m.
0.95
0.95
0.48
0.48
0.48
0.48
0.48
0.48
0.48
0.48
0.48
0.48
0.48
0.48
pH
Original
water
8.63
8.57
7.72
7.71
7.54
7.63
7.71
7.82
7.61
7.58
7.44
7.51
7.54
7.43
Treated
water
9.4
9.4
9.6
8.2
9.6
9.6
9.6
9.6
9.6
9.6
9.6
9.6
9.6
9.6
The treatment was seen to be effective in bringing down the fluorine content
from about 2.86 to 0.95 with 1,000 parts of lime per million parts of water and from
3.72 to 0.48 parts of F per million with 2,000 parts of lime per million parts of
water. As higher dosages of lime increase the pH and as the well waters on an
average contain one to three parts per million fluorine in the affected area and
from subsequent trials not reported herein, 500 parts of lime per million of water
can be taken as a workable dosage for practical purposes. Lime is cheap and
locally available anywhere in the country and there should be no difficulty in the
practical application of this reagent for fluorine removal.
September 1955] A. MARIAKULANDAI AND P. VENKATARAMAIAH 179
Fluorine removal directly from wells
To ascertain whether this method of lime treatment to remove fluorine is suitable
for application to the water in the well itself, a step well was chosen for treatment
at Gospad, an affected village in the Kurnool district. This well which was mainly
used by animals, was treated with lime for removal of fluorine. The diameter of
the well was 22 feet and the depth of water 24 feet. Slaked lime at roughly 500
parts per million was added straight into the well and six men were made to swim,
dive and churn with poles to ensure complete mixing of the lime added. Samples
of water were taken for analysis before adding lime and after adding lime. The
lime settled down completely in 36 hours. Samples of water were taken for analysis
of fluorine, total solids, CaO and pH on three succeeding days after treatment and
after 18 days from the date of treatment.
The results of analysis are given in Table XI.
TABLE XI
Removal of fluorine in wells.
Heads of analysis
Fluorine (P. P. M.)
Total solids „
Lime
„
pH
16-12-1942
Before
lime
treatment
4.750
956
63.01
7.3
After
lime
treatment
3.325
1036
85.41
7.4
Well water sample collected on
17-12-42
3.325
..
..
..
18-12-42
2.850
852
26.62
7.5
19-12-42
2.850
868
26.62
7.4
3-1-43
4.75
1060
39.21
7.3
The same well had a fluorine content of 2.10 parts per million in August 1940
but at the time of this experiment for fluorine removal, viz. December 1942, it had
risen up to 4.75 parts per million due to the failure of the north-east monsoon in
1942. From the data in Table XI, it will be seen that the addition of lime in situ
to the well, effected a temporary removal of fluorine up to 40 per cent, but the final
value did not go below the threshold value of one part per million and in the course
of 18 days the fluorine once again came up to the original value of 4.75 parts per
million due to fresh supplies from well springs. Immediately after the treatment
the total solids and lime content went up but the next day after setting down, it
was found to be reduced even below the original values. The pH was not materially
affected by the treatment.
Thus, though the direct treatment of the well would have very much simplified
fluorine removal from waters, yet from the results obtained at Gospad, this was
ruled out as impracticable. The only inexpensive alternative, therefore, is to treat
the water in pots overnight before using it the next day.
180
FLUORINE
INTOXICATION—I
[Vol. XXV, Part III,
Curative method
As pointed out earlier, there is aphosphorosis in the tract. To correct this
phosphorus deficiency and thus remove one of the contributory causes of the disease,
bone meal feeding was tried as a phosphatic supplement. Four naturally affected
fluorosis bullocks were obtained from the farmers of Gospad in Kurnool district.
These four animals were stationed on the Government Farm, Nandyal, which is a
curative place with a fluorine content of less than one part per million in the drinking
water. All the four animals were badly affected with fluorosis and the most per-
ceptible symptoms, viz. lameness, was present in all the four cases. The animals
were divided into two groups, one group (group A: Bullocks 1 and 2) received the
basic ration with change of water and rest, while the other group (Group B: Bullocks
3 and 4) received in addition to the basic ration 3 ounces of bonemeal per day.
The charged water fed to the animals during the experiment contained only 085
parts per million fluorine while they were previously drinking water containing 4.75
parts per million fluorine. In keeping with the farmer's ration of the area, the
following basic ration was supplied per diem per head: 15 lb. of cholam straw;
5 lb. of green fodder; 1 lb. of cotton seed, 1 lb. of groundnut cake and 1 oz. of salt.
The animals were weighed daily and the average weight worked out weekly.
The weekly liveweight averages of the four animals are presented in Table XII.
It will be seen that all the four animals increased in weight, the bone meal group
increasing more than the other group. It was observed that the lameness disappeared
in about 40 days in all the four animals, the cure being quicker in the bone meal
group.
TABLE XII
Improvement of cattle affected with fluorosis
Period of experimentation
1st week 20-12-1942 to 26-12-1942
2nd week 27-12-1942 to 2-1-1943
3rd week 3-1-1943 to 9-1-1943
4th week 10-1-1943 to 16-1-1943
5th week 17-1-1943 to 23-1-1943
6th week 21-1-1943 to 30-1-1943
7th week 31-1-1943 to 6-2-1943
8th week 7-2-1943 to 13-2-1943
9th week 14-2-1943 to 20-2-1943
10th week 21-2-1943 to 27-2-1943
Total increase in live-
weight.
Liveweight increase per
week.
Weekly liveweight averages in pounds
No bonemeal group
Bullock
No. I
760
788
797
811
823
831
830
859
860
858
+ 98
+9.8
Bullock
No. II
703
721
703
713
718
727
721
733
732
738
+ 35
+3.5
Bonemeal group
Bullock
No. III
628
644
665
682
692
609
706
727
731
737
+ 109
+10.9
Bullock
No. IV
760
791
802
828
840
846
856
870
876
877
+ 117
+11.7
September 1955] A. MARIAKULANDAI AND P. VENKATARAMAIAH 181
SUMMARY
Fluorine intoxication was noted in Kurnool and parts of Nellore districts of
Madras State (now Andhra State). The etiology of the disease was locally attri-
buted to the greater incorporation of groundnut haulms in the feed of the animal
due to increased cultivation of groundnut after the introduction of the short
duration 'bunch' variety of groundnuts in the tract. But no evidence to support
the belief of the locality could be adduced from this study. However, it was noted
that the phosphorus deficiency of the tract might have been a contributing cause
in the more severe manifestation of the affection initially due to fluorine ingestion
through potable water, and this explained also the lesser affection in the cattle
of Nellore district as against those in Kurnool. The primary cause of the disease
was definitely correlated to excess of fluorine in the drinking water, which was
shown to be derived from the underlying soil and rocks of the area.
Prophylactic measure comprised removal of fluorine from the drinking
waters by treatment with freshly slaked lime and through correction of the phos-
phorus deficiency by bone meal feeding. Lime at 500 parts per million was found
to be effective in reduction of the fluorine contents of natural waters below the toxic
level, while three ounces of bone meal per diem per animal was suitable to amel-
iorate the fluorine intoxication which was enhanced through aphosphorosis.
REFERENCES
Becker, R. B., Neal, W. M. and Shealy, A. L. (1933). Florida Univ. Agri. Exp. Sta. Bull., 2644
Majumdar, B. N., Ray, S. N. and Sen, K. C. (1946). Indian J. vet. Sci. XII, 95
Palmer, L. S. and Eckles, G. H. (1927). Proc. Soc. Exp. Biol. and Med., 24, 307, 1927, Chem. Absh.
21, 2492
Pandit, C. G., Raghavachari, T. N. S., Rao, D. S. and Krishnamurthi, V. (1940). Indian J. med. Res.,
28, 533
and Rao, D. S. (1940). Indian J. med. Res., 28, 559
Raghavachari, T. N. S. and Venkataraman, K. (1940). Indian J. med. Res., 28, 517
Ramiah, P. V. (1939-40) (1940-41) Report of the Animal Nutrition Work, Coimbatore, Imperial Council
of Agricultural Research, New Delhi
Roholm, K. (1937). 'Fluorine intoxication', Published by Lewis & Co., London
Smith, M. C., Lanz, E. M. and Smith, H. V. (1931). Univ. Arizona Tech. Bull. No. 32
27 AR/55
3
BIOCHEMICAL STUDY OF FLUORINE INTOXICATION*
II. METABOLISM OF FLUORINE
By A. MARIAKULANDAI, Ph.D., and P. VENKATARAMAIAH, M.A., Chemistry Section,
Agricultural Research Institute, Coimbatore
(Received for publication on 24th March 1954)
(With three text figures)
I NVESTIGATIONS done into the etiology of fluorine intoxication by the authors
(1939-1941) indicated that insufficiency of phosphorus in the ration and the
presence of fluorine in waters in toxic amounts are two main factors that cause the
affection in the cattle of Kurnool and adjoining tracts. To confirm this by controlled
study, an experiment was conducted in 1940-41 to induce fluorine intoxication arti-
ficially in calves, by feeding sodium fluoride solution, while noting side by side the
protective effect of bone meal in preventing the onset of the disease. Metabolism
studies were conducted on the animals both indirectly through balance experiments
and directly by slaughter technique. The gross symptoms of the intoxication were
also noted. These are presented in this paper.
MATERIALS AND METHODS
Urine and faeces were collected in the metabolism experiment. Bones, tissues
and organs were sampled for analysis at the time of the post-mortem examination
of the experimental calves. Blood was drawn from the jugular vein for analysis.
Fluorine was estimated by the Willard and Winter method [1933]. Blood
phosphate was assayed by Kay's method [1930]. The modified method of Larson
and Greenberg [1938] was used for estimation of serum calcium and the micro-
colorimetric method of Kuttner and Lichstenstein [1932] adopted for blood inorganic
phosphorus.
PROCEDURE
Six calves of nearly the same age and size were procured and divided into
three groups of two each as follows:
Group I—Controls
Group II—Bone meal plus fluorine
Group III—Fluorine
Calf No. 1
Calf No. 2
Calf No. 3
Calf No. 4
Calf No. 5
Calf No. 6
* Work done from 1939 to 1942 under the financial aid of the Imperial Council of Agricultural
Research, New Delhi.
183
27 AR/55
4