Leading Article from "British Medical Journal," London, 4th, November, 1944.Assuming that silica exerts its injurious effect upon animal tissue through a slow transformation into silicic acid, Denny, Robson, and Irwin thought that if the solubility of siliceous material retained in the lungs could be suffciently reduced the usual fibrotic response could be diminished or prevented. They discovered that aluminum powder rendered siliceous material insoluble in vitro by coating the silica particle with a thin film of gelatinous hydrated alumina, which on drying formed crystalline alpha aluminum monohydrate. The presence of this adsorbed layer on the surface of the quartz was shown by staining it with aurin. That metallic aluminum dust produced no fibrosis in the lungs was demonstrated by dust-inhalation experiments on eight rabbits. Attempts were therefore made to prevent silicosis by mixing quartz with metallic aluminum dust.Animals exposed to quartz dust developed typical silicosis in about five months, but the addition of 1 per cent. aluminum powder prevented this even after exposure had been lengthened up to 22 months, provided the aluminum powder was of a particle size below 5. This year Crombie, Blaisdell and MacPherson have reported the treatment of 34 silicotic miners by the daily inhalation of fine aluminum powder freshly ground from small aluminum pellets in a specially constructed mill. Daily treatment began with five-minute inhalations, which were gradually increased to 30 minutes. Some of the men received 300 treatments, but the majority only 200. Out of the 34 cases thus treated clinical improvement was manifested by lessening or disappearance of shortness of breath, of cough, of pain in the chest, and of fatigue. In 15 cases the condition became stationary and remained so in spite of continuous employment in silica dust throughout the treatment. The progress of the disease was assessed by means of tests for respiratory function repeated at three-monthly intervals. Obviously this treatment cannot be regarded as a cure for silicosis, since it cannot restore lung tissue which has undergone fibrotic change; but Crombie and his colleagues believe that the inhalation of finely particulate aluminum powder offers every prospect of preventing the development of human silicosis.In view of these findings, it is surprising that repeated papers by Goralewski from Germany describe various types of lung disease attributed to aluminum dust, and press for them to be scheduled under the Workmen's Compensation Act in that country. Seven hundred workers were investigated. They were making, probably by a stamping process, aluminium powder containing about four milliards of particles of dust per grain, and are reported as complaining of dry cough with pain on breathing, shortness of breath, poor appetite, and gnawing abdominal pain. Spontaneous pneumothorax developed in four workers. No abnormal physical...