Following the experimental work of Denny, Robson, and Irwin, and the clinical investigation by Crombie and Blaisdell, an investigation of aluminium therapy was begun at Washington, Pa., which is situated In a very large industrial section of the State. Some of the men to be studied were from plants manufacturing silica brick, refractories used in steel and glass manufacturing, and semi-porcelain table-ware; others were workers in foundries, sand blasters, and men engaged in the quarrying of ganister rock.This group of workmen gave an opportunity to study the effects of aluminium on various types of silicosis which differed somewhat from that found in hard-rock miners.EXPOSUREIn their occupations, the men studied were exposed to silica dust concentrations ranging from 17 to 97 per cent free silica. In the silica brick industries, the unfired product averages 96 per cent silica in the form of quartz, whereas the fired brick contains 50 to 62 per cent. cristobalite plus 11 to 80 per cent. tridymite, forms of silica that, on account of their higher solubility, are more toxic than quartz. The operational dust counts in the plants varied from 15 to 9,500 particles per c.c., and the median particle size from the aerial samples was 1.0 micron for the green product and 2.0 microns for the fired product. The length of exposure varied with the occupation as well as with the individual plant, but disabling silicosis could be produced in less than four years in certain exposures. The average time needed to produce radiological silicosis in those susceptible to this disease was eight years. Some of the men in our series of cases have been treated as long as fifteen years after exposure had ceased, and have improved under treatment.The dust counts mentioned above had been reduced prior to the aluminium therapy studies and the presen.t exposures do not exceed '900 particles per c.c., the average being 370 particles. per c.c. This improvement in dust conditions was due to improved dust control apparatus, which was installed before aluminium therapy was instituted. Aluminium powder is not a substitute for dust control.PATHOLOGYThe pathological picture of silicosis in men engaged in the ceramic industry is somewhat different from that in hard rock miners." Due to exposure to high concentrations of dust containing high percentages of silica of varying degrees of solubility andvery small particle size, these men are subject to a relatively rapid type of silicosis, which sets up an acute...