that is involved. If this bill were to be enacted, the Federal Government would be telling States and local communities that they could not add fluorine to their local water supplies. In my judgment, the question of fluoridation of local water supplies is not a Federal question and I would therefore recommend that your committee decide adversely to H. R. 2341.

On the other hand, gentlemen, as a licensed dentist who engaged in private practice for a good many years, 2 years in the Armed Forces and 12 years in private practice I have a strong professional belief in the benefits to be brought to the public by the adjustment of the fluorine content of public water supplies. I have carefully studied the scientific literature on this subject and have concluded that the procedure is both safe and beneficial.

And, I should like to say, Mr. Chairman, that this was not a problem before the country at the time that I was practicing dentistry. The research work was just starting on this a few years after I graduated from the university.

In my own State of Wyoming, the capital city of Cheyenne has naturally in its water supply a fluoride ion content of about one part per million, the same as is recommended to be added to water-deficient supplies. The people of Cheyenne are justly proud of their healthy teeth, caused in large part by nature's munificence in providing this element of nutrition.

Mr. Chairman, fluoridation of public water supplies has been approved by every scientific society of recognized standing in the field of health. These include the American Dental Association, the dental societies of all 48 States, the District of Columbia, the Commonwealth of Puerto Rico, the Territories of Alaska and Hawaii, and the Canal Zone.

Mr. Chairman, the American Medical Association looks with great favor upon fluoridation of water and I am sure that the recommendation of that great organization carries a lot of weight with reference to health matters before the Congress of the United States.

Also included is the Public Health Service, the American Academy of Pediatrics, the Association of State and Territorial Health Officers, the American Public Health Association, the American Public Welfare Association, the Commission on Chronic Illness, the National Research Council, the American Hospital Association, the American Nurses Association, the Inter Association Committee on Health, the American Waterworks Association, the State and Territorial Dental Directors, the American Society of Dentistry for Children, the American College of Dentists, the dental section of the American Association for the Advancement of Science, and numerous State and county medical societies.

I should like to interpolate, Mr. Chairman, by saying that surely these great scientific organizations with tremendous research facilities at their command would not recommend anything having to do with the health of the people of the United States if they did not believe wholeheartedly in what they were recommending.

On these grounds, therefore, (a) That this is a local problem which should be determined locally; (b) as a dentist familiar with the prevalence of dental caries who would like to see its incidence diminished by the use of community water fluoridation; and (c) because its safety and efficacy has been endorsed by so many eminent scientific associations, I urge you to vote against H. R. 2341.

I am not going, Mr. Chairman, to attempt to overwhelm you with statistics on the prevalence of dental caries nor attempt to say what will be said more effectively and factually, of course, by the scientists who will testify before you. But, I do want to assure you that, as a practicing dentist, I have seen and treated a good many thousands of cavities in teeth.

I have never known a tooth in which decay had begun to get better by itself, or for that matter for the decay process to stop until it was treated by a dentist.

Fluorine added to the water supply will not stop decay which has already begun but it will prevent in future generations the widespread prevalence of dental decay that we know today. It will save eventually, might I say to the committee, literally millions of dollars to those who would in the future need dental care, if the water is not properly fluoridated; but over and above what I have said to the committee, it will prevent suffering; it will prevent malformed bone structure of the oral cavity, due to early loss of permanent teeth, and we will prement many facial distortions. We will be able in so many, many cases to make for a more pleasant appearance of the face, if we do not have the distortion of the oral cavity of the bone structure.

In closing, Mr. Chairman, and gentlemen of the committee, as I walked over here this morning, I passed that wonderful statue placed by the State of Georgia for Dr. Crawford Long who in 1842 first successfully demonstrated the use of sulfuric ether in general anesthesia. My point is this, Mr. Chairman, at that time certain publications, and from the pulpit, the use of general anesthesia was rather generally condemned.

Prior to that, a few years, Dr. Horace Wells, a dentist, first successfully used nitrous oxide, and then the same hue and cry went up from certain people in the country.

I also definitely remember reading when we first started in our public schools, especially, and even before that, when we were combatting the most, perhaps the most prevalent disease at that time, the disease of smallpox, the vaccination for the prevention of that disease was frowned upon widely and generally and, Mr. Chairman, even down to today there is some opposition to vaccinating our children. for smallpox.

I think, Mr. Chairman and gentlemen, that the opposition to the fluoridation of our water supplies today falls to some extent within the same category that I have just mentioned with reference to smallpox and anesthesia.

I thank you, Mr. Chairman and members of the committee for the time you have so generously given me.

The CHAIRMAN. Are there any questions?

Mr. HESELTON. Mr. Chairman.

The CHAIRMAN. Mr. Heselton.

Mr. HESELTON. Senator, you mentioned the fact that Cheyenne's water supply had a natural supply of fluorine. Is it in quantities similar to the quantity that is advocated be placed in waters which are without fluorine?

Senator HUNT. It happens in this particular case to be almost identical; I think exactly the same as is recommended in the fluoridation of water, which is about one part per million.

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Mr. HESELTON. Has there been any effort to try to deluoridate, i that is the proper term, to try to get the fluorine out of the water? Senator HUNT. I have never heard of it, sir.

Mr. HESELTON. Is the existence of natural fluorine rather wide spread in Wyoming?

Senator HUNT. Yes; and some situation, I would say to the gentle man, that, of course, you can have ill effects from too much fluorine in the water. I happen to have practiced in one of those areas, a mountain community, where many of the teeth of the patients I took care of, or treated their teeth, there was overfluoridation of water. which is not beneficial to the teeth. But, of course, the amount of fluorine that is put in our waters today is naturally very carefully and scientifically handled, so that there is no danger from that angle. The CHAIRMAN. Any further questions, gentlemen? If not, we thank you, Senator, for your appearance before our committee this morning and, by way of confirming the statement that you have made as to the viewpoint of the American Dental Society and the American Medical Society, in the several State organizations, I would say that we have received many statements confirming what you have said from those different organizations, and the American Dental Society has witnesses here today to testify in opposition to the bill. Senator HUNT. Thank you.

Mr. PRIEST. Mr. Chairman.
The CHAIRMAN. Mr. Priest.

Mr. PRIEST. Senator, I appreciate your statement this morning. I know you have been greatly interested in public-health matters of all types since you have been a Member of the Senate.

I simply want to make a very, very brief observation, because I feel it is appropriate at this place.

You stated that millions of dollars might be saved to the people of the country insofar as dental bills are concerned if fluoridation of water is permitted, provided, of course, that the people want it in the local communities.

The dental societies that have opposed this bill-and I think most of them have, including the national association— have been enthusiastic in their approval of the practice of fluoridation of water.

if

I think that they deserve a great deal of credit for a very unselfish attitude in that respect, because the millions of dollars, of course, you look at it from that viewpoint, the millions of dollars that the public might save, on the estimates that have been made, are millions of dollars that otherwise might be fees for dental services.

I feel that the American Dental Association deserves a pat on the back, if I might put it that way, for what appears to me at least to be a most unselfish attitude; an attitude that is in the public interest; and I wanted to make that point a matter of record while you, as a representative of the profession and a Member of the Senate, are present before the committee.

in

Senator HUNT. Might I just add to the statement that you have made, by saying that the most widely spread, the most prevalent of all diseases are dental diseases, and as you gentlemen well know, World War II especially, the greatest number of men who were found ineligible for the draft were found to be so due to dental conditions. Thank you, Mr. Chairman.

The CHAIRMAN. Thank you, Senator.

STATEMENT OF DR. CHARLES A. BRUSCH, B. S., M. D., DIRECTOR, CAMBRIDGE MEDICAL CENTER, BOSTON, MASS.

The CHAIRMAN. Our next witness will be Dr. Brusch. Dr. Brusch, I note from a copy of your statement which has been presented to me that it is a very worthwhile statement; but would take considerable time to give in its entirety. For that reason I call to your attention the limitation of 15 minutes for witnesses, so that you may utilize that time to the best advantage in whatever way you see fit. You may proceed.

Dr. BRUSCH. Mr. Chairman and gentlemen of the committee, those who engage in the controversy that exists today on the fluoridation of communal water supplies must take into consideration the fact that fluorides are divided into two classes-natural, and inorganic or artificial.

Organic fluorides, such as calcium fluoride, or calcium phosphofluorides, are found in our daily foods and in drinking water in some areas. They are not readily soluble, and they do not dissolve readily in solution. Calcium fluoride 0.0016 gram per 100 cubic centimeters of water is the solubility.

It appears that in areas where there is naturally fluoridated water the individuals develop a certain amount of immunity to this water because the calcium fluoride here is found in company with other minerals.

When drinking artificially fluoridated water, such as sodium fluoride, this immunity seems to be lost. Calcium fluoride is held together by covalent bonds which gives it a certain chemical property. On the other hand, the artificial, or inorganic, sodium fluoride is a highly toxic, protoplasmic poison, freely soluble. The amount that is soluble is 4 grams per 10 Ocubic centimeters of water. This sodium fluoride is generally a byproduct of bauxite. If we break down fluoride, we find that it contains sodium 54.76 percent and fluoride 45.24 percent. Artificial sodium fluoride is very readily ionizable and diffuses readily in solution.

The difference is apparent. The first is a natural product, calcium fluoride, which is held together by covalent bonds, and not very soluble. Artificial fluoride is inorganic, readily soluble, contains no covalent bonds; 1 part per million contains 0.25 miligram of hydrofluoric acid to the glass of water.

INDIVIDUAL VARIATION

Individual variations run as high as several hundred percent in susceptibility to medication, foods, chemicals, drugs, and so forth. Since sodium fluoride is a protoplasmic poison affecting every cell in the body depending to an extent on the cells' carbohydrate demand.

Each system is affected in a different way, for example, the skeletal, the muscular, the vascular, the nervous, the circulatory, perspiratory, gastrointestinal, genitourinary tract, and reproductive organs. Whether as air, liquid, or solid, the amount and method by which it is taken into the system is of great importance, as fluorides are used in practically every industry, such as glassmaking, tanneries, bleach

eries, rubber works, varnish making, plastics, emory wheels, flux, and so forth.

In air it is taken into the respiratory tract as dust or fumes. As a liquid it is taken in by beverages, milk, fluids and liquid; as solids, in foods, vegetables, and fruits that have been sprayed or crops raised in a highly fluoridated area or fertilizers which contain high percentages of fluorine.

In highly fluoridated areas, such as Texas and New Mexico, crops that are grown there and shipped to this area are found to contain large quantities of fluorine. When boiled and cooked in water artificially fluoridated, their fluorine content is greatly increased.

For instance, if the water is 1 part per million, it becomes in 20 minutes' boiling 2 parts per million. Such food as oatmeal, cereals, and so on, will absorb that additional concentration of artificial fluorides in addition to their own original high content of fluorine.

The concentration is of importance because the greater the amount taken in, the greater amount is absorbed to a certain level. The duration of time it stays in the system is also a factor in the amount that is absorbed by the system. The factors are in pH of the media is acid in the blood or in GI system, more of the fluoride is absorbed.

If the fluoride is taken in with slow-absorbing food or with calcium, minerals, and vitamins, such as B1, B2, or B6, less of the fluoride is absorbed. If the system, at the time the fluoride is taken in, has a low calcium or mineral content, more of it is absorbed.

AGE IS IMPORTANT

Age of the individual is important because an infant or child with growing connected tissue absorbs more than an adult or senile person. The sex of the individual is a factor. Females or individuals of a high metabolism absorb more than males or those with normal metabolism. People with a high temperature, such as those with a fever, absorb more.

People with fevers and healthy people have different reactions. Sufferers from chronic diseases, like rheumatic fever, diabetes, heart condition, kidney trouble, and blood conditions, would absorb more.

The weather, humidity, heat or cold, must be considered. The warmer the day, the greater the amount ingested. Change in weather conditions bring about a like change in the reservoir where the artificially fluoridated water is stored.

Again, the action of radioactive substances, the rays, such as cosmic rays, rays from the chemicals themselves, must be taken into consideration.

The diet and nutritional makeup of an individual is another factor. Sodium fluoride has greater effect on the poorly nourished person who lacks calcium and minerals and vitamins, for they absorb more of NaF2 (sodium fluoride).

In autopsies performed on normal and abnormal individuals there is a very minute difference.