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Journal of Applied Nutrition Vol. 23, No's 3 & 4, Winter 1971

Observations On the Dose and Administration of Ascorbic Acid When Employed

Beyond the Range Of A Vitamin In Human Pathology

Frederick R. Klenner, M.D., F.C.C.P.

 

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Comment by RFC: This paper repeatedly refers to intravenous ascorbic acid.

My personal experience, my talking with Klenner, and with his wife, Annie

Klenner, who served as his nurse, would indicate that he means sodium

ascorbate. See my article on how to make intravenous C solutions. I am

especially indebted to Annie Klenner for her descriptions of how Fred made

the intravenous solutions of sodium ascorbate.

 

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Editor's Note:

 

Because of the unusually high amounts of ascorbic acid used in Dr. Klenner's

treatment as reported in his paper, we asked him to verify amounts

mentioned. Following is his answer:

 

" To the Editor of the ICAN Journal: This will confirm that all 'quantity'

factors given in my paper are correct and can be confirmed from hospital and

medical office records. The notation relative to 150 grams represents the

amount used for reversing pathology in a given case and was the amount given

over a period of 24 hours. (The I.V. was continuous.) This was given in

three bottles of 5D water, decanting only enough from 1000 c.c. to be

replaced by the 'C' ampoules.

 

" Recently the FDA has published a 'warning' that too much soda-ascorbate

might be harmful, referring to the sodium ion. In reply to this I can state

that for many years I have taken 10 to 20 grams of sodium ascorbate by mouth

daily, and my blood sodium remains normal. These levels are checked by an

approved laboratory. 20 grams each day and my urine remains at or just above

pH 6. "

 

Signed:

 

Fred R. Klenner, M.D.

 

 

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Body of paper

 

Summary

 

Appendix - more case histories

 

Bibliography

 

Klenner Biography

 

 

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Ancient History and Homespun Vitamin C Therapies

Folklore of past civilizations report that for every disease afflicting man

there is an herb or its equivalent that will effect a cure. In Puerto Rico

the story has long been told " that to have the health tree Acerola in one's

back yard would keep colds out of the front door. " [1] The ascorbic acid

content of this cherry-like fruit is thirty times that found in oranges. In

Pennsylvania, U.S.A., it was, and for many still is, Boneset, scientifically

called Eupatorium perfoliatum[2]. Although it is now rarely prescribed by

physicians, Boneset was the most commonly used medicinal plant of eastern

United States. Most farmsteads had a bundle of dried Boneset in the attic or

woodshed from which a most bitter tea would be meted out to the unfortunate

victim of a cold or fever. Having lived in that section of the country we

qualified many times for this particular drink. The Flu of 1918 stands out

very forcefully in that the Klenners survived when scores about us were

dying. Although bitter it was curative and most of the time the cure was

overnight. Several years ago my curiosity led me to assay this " herbal

medicine " and to my surprise and delight I found that we had been taking

from ten to thirty grams of natural vitamin C at one time. Even then it was

given by body weight. Children one cupful; adults two to three cupfuls. Cups

those days held eight ounces. Twentieth century man seemingly forgets that

his ancestors made crude. drugs from various plants and roots, and that

these decoctions, infusions, juices, powders, pills and ointments served his

purpose. Elegant pharmacy has only made the forms and shapes more

acceptable.

 

Early specifications, action and dosages for administrations.

To understand the chemical behavior of ascorbic acid in human pathology, one

must go beyond its present academic status either as a factor essential for

life or as a substance necessary to prevent scurvy. This knowledge is

elementary. Listen to what appeared in Food and Life Yearbook 1939, U.S.

Department of Agriculture[3]: " In fact even when there is not a single

outward symptom of trouble, a person may be in a state of vitamin C

deficiency more dangerous than scurvy itself. When such a condition is not

detected, and continues uncorrected, the teeth and bones will be damaged,

and what may be even more serious, the blood stream is weakened to the point

where it can no longer resist or fight infections not so easily cured as

scurvy. " It is true that without these infinitesimal amounts myriads of body

processes would deteriorate and even come to a fatal halt.

 

Ascorbic acid has many important functions. It is a powerful oxidizer and

when given in massive amounts; that is, 50 grams to 150 grams,

intravenously, for certain pathological conditions, and " run in " as fast as

20 Gauge needle will allow, it acts as a " Flash Oxidizer, " [4] often

correcting the pathology within minutes. Ascorbic acid is also a powerful

reducing agent. Its neutralizing action on certain toxins, exotoxins, virus

infections, endotoxins and histamine is in direct proportion to the amount

of the lethal factor involved and the amount of ascorbic acid given. At

times it is necessary to use ascorbic acid intramuscularly. It should always

be used orally, when possible, along with the needle.

 

Scurvy historically the target; today's goal of high blood levels to cope

with self-induced abuses and physiological traumas.

If one is to employ ascorbic acid intelligently, some index for requirements

must be realized. Unfortunately there exists today a sort of " brand " called

" minimum daily requirements. " This illegitimate " child " has been co-fathered

by the National Academy of Science and The National Research Council and

represents a tragic error in judgment. There are many factors which increase

the demand by the body for ascorbic acid, and unless these are appreciated,

at least by physicians, there can be no real progress. It is vitally

important that cognizance be taken of the demand by the body for ascorbic

acid far beyond so-called scorbutic levels. Briefly these demands can be

summarized:

 

The age of the individual;

Habits -- such as smoking, the use of alcohol, playing habits;

Sleep, especially when induced artificially;

Trauma.-- trauma caused by a pathogen, the trauma of work, the trauma of

surgery, the trauma to the body produced accidentally or intentionally;

Kidney threshold;

Environment;

Physiological stress;

Season of the year;

Loss in the stool;

Variations in individual absorption;

Variations in " binders " in commercial tablets;

Body chemistry;

Drugs;

Pesticides;

Body weight;

Inadequate storage.

Flexible dosage standards explained as minimal standards.

With such knowledge it is no longer possible to accept a set numerical unit

in terms of minimal daily requirements. This is true because of the simple

fact that people are different and these same people experience different

situations at various times. With ascorbic acid, today's adequate supply

means little or nothing in terms of the needs for tomorrow. Let us start

thinking in terms of maximum requirements. For too long a time we have under

supplied our children and ourselves by accepting through negative ignorance

and acquiescence so-called standards. Based on scant data on mammalian

synthesis, available for the rat, a 70-Kg. individual would produce 1.8

grams[5] to 4.0 grams[6] of ascorbic acid per day in the unstressed

condition. Under stress, up to 15.2 grams.[7] Compare this to the 70 mg

recommended for daily requirements without stress and 200 mg for the simple

stress of the obstetrical patient, and you will recognize the disparity and

understand why we have been waging a one man war against the establishment

in Washington for 23 years.

 

Ascorbic acid not synthesized by man

Work on mammalian biosynthesis of ascorbic acid indicates that the vitamin C

story as is generally accepted represents an oversimplification of available

evidence.[8,9,10] This often leads to misinterpretations and false

impressions. It has been proposed that the biochemical lesion which produces

the human need for exogenous sources of ascorbic acid, is the absence of the

active enzyme, l-gulonolactone oxidase from the human liver[11]. A defect or

loss of the gene controlling the synthesis of this enzyme in man, blocks the

final phase in the series for converting glucose to ascorbic acid. Virus can

mutate cells, X-Rays can do it and it can occur by chance. Such a mutation

could have happened, denying all progenies of this mutated animal the

ability to produce ascorbic acid. Survival demanded ascorbic acid from an

exogenous source. This is not remarkable. Other recognized genetic diseases

in which a missing enzyme causes a pathological syndrome, in man, are

phenylketonuria, galactosemia and alkaptonuria.

 

It is worthy to note that Sealock and Goodland have ascribed to ascorbic

acid the faculty of being the necessary co-enzyme in the metabolic oxidation

of tyrosine. The velocity of the oxidation in this reaction is dependent

upon the concentration of vitamin C. Tyrosine is essential in breaking down

protein to usable amino acid. The scorbutic guinea-pig's liver is unable to

oxidize tyrosine except in the presence of ascorbic acid. This suggests a

lead in the study of the metabolic abnormality Alkaptonuria in humans.

Ascorbic acid administration will correct the alkaptonuria of the scorbutic

guinea pig. Its effect on human alkaptonuria has been inconsistent. The

reason: Inadequate use of ascorbic acid.

 

Biochemist Irwin Stones' concept has practical value

The inability of man to manufacture his own ascorbic acid, due to genetic

fault, has been called " hypoascorbemia " by Irwin Stone.[12] This is another

reason for abolishing the present concept of daily minimal requirements. The

physiological requirements in man are no different from other mammals

capable of carrying out this synthesis.

 

Various procedures testing for the vitamin C levels and Requirements of the

body.

Various tests have been employed to determine the degree of body saturation

of vitamin C, but for the most part they have been misleading. Blood and

urine samples analyzed with 2:6 dichlorophenol indophenol will give values

roughly 7 percent less than when testing with dinitrophenol hydrazine.

Gothlin advocates the capillary fragility test which is similar to the

tourniquet test of Hess in results. Both can be used to estimate the

quantity of vitamin C necessary to maintain capillary integrity. The

intradermal test of Rotter as modified by Slobody[13] is again gaining new

recruits. In principle it is the same as the lingual test of Ringdorf and

Cheraskin[14] since both are based on the time required to decolorize dye.

The lingual test is rapid and simple to perform but it requires a syringe

with a 25 gauge needle and a stop watch. Since the dye methods depend on the

reduction of the reagent by vitamin C, any substance having a reducing

potential lower than the dye is a possible source of interference. Twenty

years ago we elected to measure, as a therapeutic gauge, the amount of

vitamin C in urine by borrowing on its ability to reduce qualitative

Benedict's solution. A 2 plus Benedict's reaction in a known dextrose free

urine was accepted as a standard. This test was helpful in gauging

requirements for simple stress, but not accurate enough when using needle

therapy. Fifteen years ago we developed the Silver Nitrate-Urine test[15].

This test employs 10 drops of 5 percent silver nitrate and 10 drops urine

which is placed in a Wasserman tube. When read in two minutes it will give a

color pattern showing white, beige, smoke gray or charcoal or various

combinations of any two depending upon the degree of saturation. We have

found this color index test is all one will need for establishing the

correct amount of ascorbic acid to use by mouth, by muscle, by vein in the

handling of all types of human pathology either as the specific drug or as

an adjuvant with other antibiotics or neutralizing chemicals. In severe

pathological conditions the urine sample, taken every four hours, must show

a fine charcoal-like precipitation with a clear supernatant liquid if

positive clinical results are to be realized. Spilling in the urine is not

new. Abraham and Keefer have demonstrated that when penicillin is injected

intravenously, excretions in the urine account for 60 percent of the

administered dose.

 

Role played by ascorbic acid in intercellular reactions, neutralizing,

possibly controlling virus production.

In 1935 Stanley isolated a crystalline protein possessing the properties of

tobacco mosaic virus. It contained two substances, ribonucleic acid (RNA)

and protein. The simple structure characteristic of tobacco mosaic virus was

soon found to be a basic property of many human viruses such as coxsackie

virus (which I believe to be the cause of Multiple Sclerosis), Echoviruses

and polioviruses - they all contain only ribonucleic acid and protein. There

exist minor variations. Adenoviruses contain deoxyribonucleic acid (DNA) and

protein. Other viruses such as that causing influenza contain added lipid

and polysaccharides. Deoxyribonucleic acid is used to program the large

viruses, like mumps, ribonucleic acid is used to program the small viruses,

like measles. The role of the protein coat is to protect the parasitic but

unstable nucleic acid as it rides the " blood highway " or " lymphatic system "

to gain specific cell entry. Pure viral nucleic acid without its protein

coat can be inactivated by constituents of normal blood. There are several

theories as to what happens after cell entry:

 

Once inside a given cell. the virus nucleic acid sheds its protein coat and

proceeds to modify the host cell by either creating mutations or by directly

substituting its own nucleic acid;

The infectious nucleic acid, after entering a human cell, retains its

protein coat and starts to produce its own type protein coat[16] and viral

nucleic acid, so that new units can either depart to enter other cells or by

destruction of the cell, thus making the infection more severe;

The introduction of a foreign fragment of nucleic acid in the cell-virus

interaction approach as postulated by Starr[17]. In the Starr theory there

can exist cells with partial chromosome make-up and cells with multi-nuclei.

Hiliary Kropowski holds that these partial cells are 'pseudo-virons'[18] and

are found in some tumor-virus infections. A key factor in the

Starr-Kropowski thinking is that the cell maintains its biological integrity

to support virus development despite the abnormal morphology and genetic

deficiency. If these invaded cells could be destroyed or the invader

neutralized the illness would suddenly terminate. Ascorbic acid has the

capability of entering all cells. Under normal circumstances its presence is

beneficial to the cell, however, when the cell has been invaded by a foreign

substance, like virus nucleic acid, enzymatic action by ascorbic acid

contributes to the breakdown of virus nucleic acid to adenosine deaminase

which converts adenosine to inosine. The net result is to lead to purines

which are extensively catabolized and not to p+urines which are utilized for

further nucleic acid. Ascorbic acid also joins with the available virus

protein, making a new macromolecule which acts as the repressor factor. It

has been demonstrated that when combined with the repressor, the operator

gene, virus nucleic acid, cannot react with any other substance and cannot

induce activity in the structural gene, therefore inhibiting the

multiplication of new virus bodies. The tensile strength of the cell

membrane is exceeded by these macromolecules with rupture and destruction.

Another hypothesis is that vitamin C acts to create new " L " viruses which

are impotent. Still another, that the " binding " alone is sufficient to

destroy the virus.

Promptness of massive ascorbic acid in avoiding fatal encephalitis related

to stubborn head and chest colds.

In 1953[19] we presented a case history and films of a patient with virus

pneumonia. This patient was unconscious, with a fever of 106.8°F (A.

corrected) when admitted to the hospital. 140 grams ascorbic acid was given

intravenously over a period of 72 hours at which time she was awake, sitting

up in bed and taking fluids freely by mouth. The temperature was normal.

Since that time we have observed a more deadly syndrome associated with a

virus causing head and chest colds. This is one of the adenovirus striking

in the area of the upper respiratory tract with resulting fever, sore throat

and eyes, and when in children can cause fatal pneumonia. More often death

is indirect by way of incipient encephalitis where the child can be dead in

30 minutes. These are the babies and children found dead in bed and

attributed to suffocation [sIDS, Sudden Infant Death Syndrome]. It is

suffocation but by way of a syndrome we observed and reported in 1957[20]

which is similar to that found in cephalic tetanus-toxemia culminating in

diaphragmatic spasm, with dyspnea and finally asphyxia.[21] By 1958[22] we

had collected sufficient information from our office and hospital patients

to catalog this deadly syndrome Into two important stages.

 

Stage 1

There is always a history of having had the " Flu " which lasted 48 to 96

hours complicated with extreme physical or mental distress; or

A mild cold, similar to an allergic rhinitis, which lingered on for several

weeks but did not incapacitate the individual.

Stage 2, which is always sudden, will present itself in at least seven

forms:

Convulsive seizures;

Extreme excitability resembling delirium tremens if an adult and with

dancing of the eyeballs if a child;

Severe chill;

Strangling in the course of eating or drinking (bulbar type);

Collapse;

Stupor;

Hemiplegic type.

Other findings of this dramatic second stage are:

 

Rapid pulse;

Temperature can be normal, moderately elevated or high;

Respirations twice to three times normal and in some cases will be

suggestive of air hunger;

Pupils will be moderately open and in some instances (hemiplegic) one will

be markedly dilated;

Urine negative;

The white blood count running from 6,000 to 25,000 with a high poly count in

the differential;

Young patients starting the second phase with a convulsion there has been

not only a history of normal bowel movements but also an enema given at the

time of first examination has produced a normal stool;

Bladder sphincter control was abnormal in our cases who convulsed or who

were in coma.

Neurological Changes

It is apparent that the second stage of this syndrome is triggered by a

breakthrough at the site of the blood-brain barrier. The time required for

neurological changes to become evident is roughly comparable to the time

necessary for similar neuropathology to be demonstrated following a severe

head injury. Cerebral edema exists in both conditions. In my practice I

start massive ascorbic acid therapy immediately. I have seen children dead

in from 30 minutes to 2 hours because their attending physician was not

impressed with their illness upon hospital admission. An autopsy on one of

these patients showed bilateral pneumonitis - all one needs to spark a

deadly encephalitis. To indicate just how common this syndrome presents

itself, I relate here a newspaper account of a 15 year old girl who had a

mild, lingering cold for several weeks. She attended a dance party one

evening and except for a complaint of feeling extremely tired, she went to

bed apparently well. She was found dead in bed the following morning. An

autopsy showed bilateral pneumonia. How many times have you read such an

account? This is why it is necessary for everybody to take adequate

supplemental vitamin C to guard against such disasters.

 

Literature Research

In 1960 we decided to research the literature before writing our paper.

" Virus Encephalitis As A Sequel Of The Pneumonias. " [22] Rosenfield in 1903

described a similar syndrome under the caption " Brain Purpura or Hemorrhagic

Encephalitis. " Comby, in 1907, was the first to call attention to the

interesting " metastic " sequela of the pneumonias. Baker and Noran in 1945

enumerated five groups, each showing certain definite clinical

characteristics which may be of both diagnostic and prognostic significance

in relation to this virus syndrome. [23]

 

Symptoms of a nonspecific nature - headache, vomiting, irritability;

Delirious type;

Convulsive type;

Lethargic type;

Hemiplegic type.

These groups plus two additional types, namely:

 

Chill - blood invasion type;

Collapse,

were as we reported them, independently, in the Tri-State Medical Journal,

October 1958. Their results: Some recovered, some died and still others

lived as " vegetation " mental cripples. All of our patients recovered.

Thirteen years from the time of the Baker-Noran report to the time of our

report and 13 years from the time of our report to the present time. This

makes the issue urgent. Physicians must recognize the inherent danger of the

lingering head or chest cold and appreciate the importance of early massive

vitamin C therapy.

 

How does the brain become involved in encephalitis?--some speculations.

Clinical problems such as these groups present, leads one to speculate on

the pathways in which the virus gains entrance into the brain. We can

summarize:

 

Through the olfactory nerves;

Through the portals of the stomach from material swallowed, either pulmonary

or upper respiratory drainage;

Direct extension from otitis media or from mastoid cells;

The blood stream. Arriving in the brain the virus goes through the blood

cerebrospinal fluid barrier and/or the blood brain barrier by one of three

ways:

Electrical charge;

Chemical lysis of tissue;

Osmosis.

Bakay[24] reported that the permeability of the blood-brain barrier can be

changed by introducing various toxic agents into the blood circulation.

Chambers and Zweifach[25] emphasized the importance of the intercellular

cement of the capillary wall in regulating permeability of the blood vessels

of the central nervous system. In this syndrome the toxic substance is an

adenovirus. Ascorbic acid will repair and maintain the integrity of the

capillary wall.

 

Burns - degrees explained and some therapy rational.

In the treatment of burns ascorbic acid, in sufficient amounts, reflects

itself as a truly miracle substance. In the early forties, when I was using

ascorbic acid, intramuscularly, in treating bacillary dysentery, shiga type,

with excellent results, Lund, Lam and many others were using, what they

called, massive doses of ascorbic acid in the treatment of burns. One or two

grams each day, in fluids, was the recognized dose. Burns are at the

beginning first degree and some remain as just an erythema. Many times the

first degree burn progresses rapidly to the second degree stage and remains

as " blisters " . Still others go on to third degree which usually is more

pronounced on the third-plus post-burn day. There is a fourth stage which

results from lack of knowledge in treatment. It terminates with skin

grafting and plastic surgery. We believe that ascorbic acid will eliminate

the fourth stage and the third stage if used as we will later program.

 

Burns - continued descriptive and related therapies.

The pathologic physiology of a burn wound from the moment of the accident is

in a state of dynamic change until the wound heals or the patient dies. The

primary consideration is the phenomenon of blood sludging originally

recognized by Knisely in 1945.[26,27] Initially there is intravascular

agglutination of red blood cells into distinctly visible, smooth, hard,

rigid, basic masses. Lofstrom in 1959 demonstrated that the oxygen uptake by

the tissues is greatly reduced because of the sludging and therefore reduced

rate of flow. Berkeley[28] in 1960 concluded that this phenomenon of

sludging or agglutination results in capillary thrombosis in the area of the

burn, extending proximally to involve the large arterioles and venules and

thereby creating tissue destruction greater than that originally produced by

the burn. Anoxia produces added tissue destruction. Lund and Levenson[28]

found that after severe burns there is considerable alteration in the

metabolism of ascorbic acid as shown by a low concentration of ascorbic acid

in the plasma either with the patient fasting or after saturation tests and

also low urinary excretion of vitamin C either with the patient fasting or

after the injection of test doses. The extent of the abnormality closely

paralleled the severity of the burn. Bergman[30] reported an increase demand

for ascorbic acid in burns especially when epithelization and formation of

granulation tissue are taking place. Lam[31] also reported in 1941 a marked

decrease in the plasma ascorbic acid concentration in patients with severe

burns. Klasson[32] although limiting the amount of ascorbic acid to a dose

range of 300 mg to 2000 mg daily, in divided doses, found that it hastened

the healing of wounds by producing healthy granulation tissue and also that

it reduced local edema. He rationalized that ascorbic acid used locally as a

2% dressing possessed astringent properties similar to hydrogen peroxide. He

also reported that antibiotic therapy was rarely necessary.

 

Severe burns and related therapy.

Harlen Stone[33] suggested the use of gentamicin in major burns to lower the

sepsis caused by pseudomonas. Absorption of its exotoxin from the infected

burn wound inhibits the bacterial defense mechanism of the

reticuloendothelial system. Death can result either from the toxemia alone

or from an associated septicemia. We have found that the secret in treating

burns can be summarized in five steps:

 

The use of the " old covered wagon " type cradle when indicated, with three 25

watt bulbs. The patient controls the heat by turning on and off the first

bulb as needed to keep warm. No garments or dressings are allowed;

The employment of a 3% ascorbic acid solution as a spray over the entire

area of the burn. The spray can be applied with a Devilbis unit using an

ordinary portable pressure pump. The old type " flit gun " can also be used or

even a 50 c.c. syringe with a 20 gauge needle. The 3% solution is used every

2 to 4 hours for a period of roughly five days;

The use of vitamin A and D ointment over the area of the burn and this is

now alternated, q4h with the 3% ascorbic acid solution;

The administration of massive doses of ascorbic acid by vein and by mouth.

500 mg per Kg. body weight diluted to at least 18 c.c. per gram vitamin C

using 5% dextrose in water, saline in water or Ringers solution and for the

initial injection, run in as fast as a 20 gauge needle or catheter will

carry the flow. Cut-downs are frequently necessary and the foot-ankle area

is recommended. Vitamin C solution is repeated every 8 hours for the first

several days, then at 12 hour intervals. Ascorbic acid, by mouth, is given

to tolerance. Loose stools is accepted as this index. Using large doses of

ascorbic acid I.V. will necessitate the administration of at least one gram

calcium gluconate, daily, to replace free calcium ions removed in the

breakdown chemical action as ascorbic acid goes to dehydroascorbic acid,

then to ketogulonic acid and later to oxalic acid as the calcium salt;

Supportive treatment; that is, whole blood and maintaining electrolyte

balance.

If seen early after the burn there will be no infections and no eschar

formations. This eliminates fluid formation, since the eschar traps will not

exist and there will be no distal edema because the venous and lymphatic

systems will remain open. There will be no arterial obstruction and no nerve

compression. Pseudomonas will not be a problem, since ascorbic acid destroys

the exotoxin systemically and locally. Even if the burn is seen late when

pseudomonas is a major problem the gram negative bacilli will be destroyed

in a few days leaving a clean healthy surface. I have seen eschars 2 inches

wide and 1/2 inch thick, severely infected so that stench had to be

controlled with deodorizing sprays, melt away when employing the method

outlined. Ascorbic acid also eliminates pain so that opiates or their

equivalent are not required. In extremely extensive burns that involve back

and front of the patient, the " Hoverbed " [35] employed by the British should

be considered. It uses the same principle as the hovercraft to lift a solid

object. What has been overlooked in burns is that there are many living

epithelial cells in the areas that grossly look like " raw muscle. " With the

use of ascorbic acid these cells are kept viable, will multiply and soon

meet with other proliferating units in the establishment of a new

integument.

 

Regarding personal and environmental pollution-carbon monoxide.

We are all plagued with varying degrees of chronic carbon monoxide

poisoning. This is the price we pay for putting our " railroads " on our

highways, smoking and being too lazy to walk. Small amounts of carbon

monoxide, if constantly maintained in the alveoli, can produce serious

effects. Carbon monoxide in the inspired air leads to oxygen deficiency in

the tissues causing extreme exhaustion. The affinity of carbon monoxide for

hemoglobin is roughly 300 times as great as that for oxygen. In addition to

active replacement of oxy-hemoglobin the presence of some proportion of

carboxy-hemoglobin decreases the dissociability of such oxy-hemoglobin as

remains. Carbon monoxide can be released from hemoglobin if the patient is

exposed to high pressure of oxygen, 93% along with 7% carbon dioxide. This

is not always available. Ascorbic acid in the blood is constantly losing

molecules of water. Perfectly dry carbon monoxide and oxygen cannot unite to

form carbon dioxide, but carbon monoxide and water may give rise to carbon

dioxide in the complete absence of oxygen. The reactions which take place

are CO + H2O = HCOOH CO2 + H2 (Wright). Here the oxygen of the water has

been used to oxidize carbon monoxide to carbon dioxide with the liberation

of hydrogen. Glutathione may facilitate this cellular oxidation by acting as

a hydrogen acceptor (Hopkins). Clinical experience suggests that if

sufficient ascorbic acid is suddenly placed into the blood stream - 12 grams

to 50 grams - that through " Flash Oxidation " a concentration of oxygen is

made high enough to pull carbon monoxide from hemoglobin to form carbon

dioxide. This rapidly formed carbon dioxide acts with the high oxygen

tension to serve the same purpose as when given by " mask, " further enhancing

the chemical action taking place. Ascorbic acid will also prevent residuals

such as paralysis, blindness, interference with sensations, muscle spasms or

twitchings which in some cases can be permanent.

 

Primary and lasting benefits in pregnancy.

Observations made on over 300 consecutive obstetrical cases using

supplemental ascorbic acid, by mouth, convinced me that failure to use this

agent in sufficient amounts in pregnancy borders on malpractice. The lowest

amount of ascorbic acid used was 4 grams and the highest amount 15 grams

each day. (Remember the rat-no stress manufactures equivalent " C " up to 4

grams and with stress up to 15.2 grams). Requirements were roughly 4 grams

first trimester, 6 grams second trimester and 10 grams third trimester.

Approximately 20 percent required 15 grams, each day, during last trimester.

Eighty percent of this series received a booster injection of 10 grams,

intravenously, on admission to the hospital. Hemoglobin levels were much

easier to maintain. Leg cramps were less than three percent and always was

associated with " getting out " of Vitamin C tablets. Striae gravidarum was

seldom encountered and when it was present there existed an associated

problem of too much eating and too little walking. The capacity of the skin

to resist the pressure of an expanding uterus will also vary in different

individuals. Labor was shorter and less painful. There were no postpartum

hemorrhages. The perineum was found to be remarkably elastic and episiotomy

was performed electively. Healing was always by first intention and even

after 15 and 20 years following the last child the firmness of the perineum

is found to be similar to that of a primigravida in those who have continued

their daily supplemental vitamin C. No patient required catheterization. No

toxic manifestations were demonstrated in this series. There was no cardiac

stress even though 22 patients of the series had rheumatic hearts. One

patient in particular was carried through two pregnancies without

complications. She had been warned by her previous obstetrician that a

second pregnancy would terminate with a maternal death. She received no

ascorbic acid with her first pregnancy. This lady has been back teaching

school for the past 10 years. She still takes 10 grams of ascorbic acid

daily. Infants born under massive ascorbic acid therapy were all robust. Not

a single case required resuscitation. We experienced no feeding problems.

The Fultz quadruplets were in this series. They took milk nourishment on the

second day. These babies were started on 50 mg ascorbic acid the first day

and, of course, this was increased as time went on. Our only nursery

equipment was one hospital bed, an old, used single unit hot plate and an

equally old 10 quart kettle. Humidity and ascorbic acid tells this story.

They are the only quadruplets that have survived in southeastern United

States. Another case of which I am justly proud is one in which we delivered

10 children to one couple. All are healthy and good looking. There were no

miscarriages. All are living and well. They are frequently referred to as

the vitamin C kids, in fact all of the babies from this series were called

" Vitamin C Babies " by the nursing personnel--they were distinctly different.

 

How concerned should we be about oxalic acid and kidney stones? A technical

explanation.

One of the " scare " weapons used by the critics on high daily doses of

ascorbic acid is the oxalic acid-kidney stone hypothesis. Meakins[36] states

that the chief factors in the formation of renal calculi are perversions of

metabolic processes, infection and stasis in the urinary tract. There are

two schools of thought on stone formation: 1) That there is a central

nucleus of colloids on which the crystalloids are precipitated; 2) That the

crystalloids are deposited from the urine in which they are present in

concentrated solution, in which salt and hydrogen ion concentrations are

important factors. In all cases stasis and a concentrated urine appear to be

the chief physiological factors. The only way that oxalic acid can be

produced from ascorbic acid is through splitting of the lactone ring. This

happens above pH5. The reaction of urine when 10 grams of vitamin C is taken

daily is usually pH6. Oxalic acid precipitates out of solution only from a

neutral or alkaline solution-pH7 to pH10. Kelli and Zilva[37] reported that

" Nutrition experiments showed that dehydroascorbic acid is protected in vivo

from rapid transformation to the antiscorbutically impotent diketogulonic

acid from which oxalic acid is derived. " Values reported in the literature

for normal 24 hour urinary oxalate excretions for humans range from 14 mg to

56 mg. Lamden et al.[38] found in a group of volunteers that the ingestion

of 9 grams ascorbic acid daily resulted in oxalate spills as high as 68 mg

for 24 hours and in the controls without extra vitamin C the high was 64 mg

for a 24 hour period.

 

These critics have overlooked the individual with diabetes mellitus. The

amount of oxalic acid found in the diabetic patient approximates that found

in the urine of a normal person taking 10 grams vitamin C each day. With the

diabetic we find a paradox. Give this individual 10 grams ascorbic acid

daily, by mouth, and the urinary oxalate excretion remains relatively

unchanged. Diabetics are known for their diuresis. The individual who takes

10 or more grams of vitamin C each day will find that this organic compound

is an excellent diuretic. No urinary stasis; no urine concentration.

 

The ascorbic acid kidney stone story is a myth. Methylene blue will dissolve

calcium oxalate stones giving 65 mg orally 2 to 3 times a day. (Dr. M. J.

Vernon Smith: Med. World News, Dec. 4, 1970)

 

Why death from insect and snake bites?

It is estimated that 6500 deaths occur each year in the United States from

snake bite. Many more from various flying insects, spiders, certain plants

and some caterpillars.These are needless deaths. Several factors are at work

in these pathologies:

 

The tox-albumin of the snake bite, like the copperhead or rattler;

Formic acid plus a toxin with a protein cover, called proteotoxin by

Arthus,[39] such as found in bees and wasps;

Neurotoxin from the Black Widow, the Fiddle Spider and snakes like the Cobra

and Coral;

Production of histamine, especially in the more severe stings and bites.

Wells[40] in 1925 called the poison of certain spiders and snakes zootoxins

and of poisonous plants, phytotoxins. Ford[41] in 1911 reported three

classes of toxins in plants and fungi:

 

Nerve poisons-muscarine;

Those causing structural changes in the viscera with resulting fatty

degeneration;

Gastrointestinal irritants.

Ascorbic acid to the rescue.

It is a demonstrated principle that the production of histamine and other

end products from deaminized cell proteins released by injury to cells are a

cause of shock. The clinical value of ascorbic acid in combating shock is

explained when we realize that the deaminizing enzymes from the damaged

cells are inhibited by vitamin C.[42] It has been shown by Chambers and

Pollock[43] that mechanical damage to a cell results in pH changes which

reverse the cell enzymes from constructive to destructive activity. The pH

changes spread to other cells. This destructive activity releases histamine

a major shock producing substance. The presence of vitamin C inhibits this

enzyme transition into the destructive phase. Clark and Rossiter[44]

reported that conditions of shock and stress cause depletion of the ascorbic

acid content of the plasma. As with the virus bodies, ascorbic acid also

joins with the protein factor of these toxins effecting quick destruction.

 

The answer to these emergencies is simple. Large amounts of ascorbic acid

350 mg to 700 mg per Kg. body weight given intravenously. In small patients,

where veins are at a premium, ascorbic acid can easily be given

intramuscularly in amounts up to two grams at one site. Several areas can be

used with each dose given. Ice held to the gluteal muscles until red, almost

eliminates the pain. We always reapply the ice for a few minutes after the

injection. Ascorbic acid is also given, by mouth, as follow-up treatment.

Every emergency room should be stocked with vitamin C ampoules of sufficient

strength so that time will never be counted-as a factor in saving a life.

The 4 gram, 20 c.c, ampoule and 10 gram 50 c.c. ampoule must be made

available to the physician.

 

A case history-success due to promptness with a twelve gram injection.

As an example of the lethal effect of certain stings and bites, I briefly

relate a case history. An adult male came to my office complaining of severe

chest pain and the inability to take a deep breath. Stated that he had been

" stung " or " bitten " 10 minutes earlier. Thinking that it was a Black Widow

and not bothering to look for fang marks, due to the gravity of the

situation, I gave one gram calcium gluconate intravenously. This gave no

relief. He begged for help saying he was dying. He was becoming cyanotic

[blue or livid skin from lack of oxygen]. Twelve grams of vitamin C was

quickly pulled into a 50 c.c. syringe and with a 20 gauge needle was given

intravenously as fast as the plunger could be pushed. Even before the

injection was completed, he exclaimed, " Thank God " . The poison had been

neutralized that rapidly. He was sent home to locate the " culprit " . He soon

returned with an object that looked like a mouse. It was 1 1/2 inches long

with long brown hair. There was a dark ridge down the entire back. It had

seven pairs of propelling units and a tail much like a mouse. The following

day I took " The Thing " to Duke University where it was identified as the

Puss Caterpillar. This unusual caterpillar left 44 red raised marks on the

back of its victim. Except for vitamin C this individual would have died

from shock and asphyxiation.

 

Some concern answered regarding high dosage of ascorbic acid.

Merton Lamden, a biochemist, writing in the New England Journal of Medicine,

Feb. 11, 1971, expresses grave doubts about the safety of large doses of

ascorbic acid taken by mouth. He gives a report by Paterson[45] on the

diabetogenic effect of dehydroascorbic acid on rats. Paterson in 1950

employed only the Ketone formula of ascorbic acid, dehydroascorbic acid,

which he administered, undiluted, intravenously, in extraordinary amounts.

His results were based on giving rats, weighing 100 grams to 120 grams,

dehydroascorbic acid in doses from 20 to 50 mg. This transposed to a man

weighing 70 kilograms would represent a dose of 3,500 grams-roughly 5,000

grams ascorbic acid. Obviously the work has no relationship with the

ingestion of ascorbic acid by humans. I have taken from 10 to 20 grams of

ascorbic acid daily since my last visit to this college - 18 years ago. I do

not have diabetes mellitus and if I might digress a moment, neither have I

had a kidney stone.

 

Diabetes mellitus response to 10 grams ascorbic acid by mouth.

Over the past 17 years we have studied the effect of 10 grams by mouth, in

patients with diabetes mellitus. We found that every diabetic not taking

supplemental vitamin C could be classified as having sub-clinical scurvy.

For this reason they find it difficult to heal wounds. The diabetic patient

will use the supplemental vitamin C for better utilization of his insulin.

It will assist the liver in the metabolism of carbohydrates and to reinstate

his body to heal wounds like normal individuals. We found that 60% of all

diabetics could be controlled with diet and 10 grams ascorbic acid daily.

The other 40% will need much less needle insulin and less oral medication.

Contrary to what Medical News Letter, (Vol. 12 # 26, Dec. 25 1970) carried

to the physicians the Tes-Tape is accurate in testing urine samples.

 

Observations following post-surgery cases on blood plasma levels of ascorbic

acid. Deduction is evident of the need for substantial amounts of ascorbic

acid prior to surgery.

In 1960 and again in 1966, in papers delivered before the Tri-State Medical

Society, I called attention to the " scurvy " levels of ascorbic acid found in

postoperative patients. Plasma levels recorded before starting anesthesia

and after cessation of such inhalants and completion of surgery remained

unchanged. This has lead many to believe that surgery created little or no

demand for supplemental " C " . We found, however, that samples of blood taken

six hours after surgery showed drops of approximately 1/4 the starting

amount and at 12 hours the levels were down to one-half. Samples taken 24

hours later, without added ascorbic acid to fluids, showed levels 3/4 lower

than the original samples. Baylor University research team reported similar

findings in 1965. Bartlett, Jones[48] and others reported that in spite of

low levels of plasma ascorbic acid at time of surgery, normal wound healing

may be produced by adequate vitamin C therapy during the post-operative

period. Lanman and Ingalls[47] showed that the tensile strength of healing

wounds is lowered in the presence of " scurvy plasma levels " . Schumacher[48]

reported that the preoperative use of as little as 500 mg of vitamin C given

orally " was remarkably successful in preventing shock and weakness "

following dental extractions. Many other investigators have shown in both

laboratory and clinical studies, that optimal primary wound healing is

dependent to a large extent upon the vitamin C content of the tissues.

 

In 1949, it was my privilege to assist at an abdominal exploratory

laparotomy. A mass of small viscera was found " glued together " . The area was

so friable that every attempt at separation produced a torn intestine. After

repairing some 20 tears the surgeon closed the cavity as a hopeless

situation. Two grams ascorbic acid was given by syringe every two hours for

48 hours and then 4 times each day. In 36 hours the patient was walking the

halls and in seven days was discharged with normal elimination and no pain.

She has outlived her surgeon by many years. We recommend that all patients

take 10 grams ascorbic acid each day. Where this is not done and the surgery

is elective, then 10 grams by mouth should be given for several weeks prior

to surgery. At least 30 grams should be given, daily, in solutions,

post-operatively, until oral medication is allowed and tolerated.

 

Mononucleosis aided by ascorbic acid.

After studying hundreds of college students, Yale researchers have evidence

that strengthens the link between mononucleosis and Epstein-Barr virus, a

herpes-like agent also associated with Burkitt lymphoma.[49] Large doses of

intravenous " C " has a striking influence on the course of mononucleosis. In

one patient who was given the last rites of her church, the girls mother

took things into her own hands when the attending physician refused to give

ascorbic acid. In each bottle of intravenous fluids she would quickly " tap

in " 20 to 30 grams vitamin C. The patient made an uneventful recovery. Her

mother has her B.S. in Nursing and has been a long time advocate of massive

" C " therapy.

 

Could ascorbic acid have anti-cancer features?

Schlegel[50] from Tulane University has been using 1.5 grams ascorbic acid

daily to prevent recurrences of cancer of the bladder. He and biochemist

Pipkin have been able to demonstrate that in the presence of ascorbic acid,

carcinogenic metabolites will not develop in the urine. They suggest that

spontaneous tumor formation is the result of faulty tryptophan metabolism

while urine is retained in the bladder. Schlegel termed ascorbic acid " An

Anticancer Vitamin " . Along this line Glick and Hosoda[51] reported on work

by Von Numers and Pettersson that the depletion of mast cells from guinea

pigs skin was due to ascorbic acid deficiency. The possibilities indicated

are that vitamin C is necessary either directly or indirectly for formation

of mast cells, or for their maintenance once formed or both. Ascorbic acid

will control myelocytic leukemia provided 25 to 30 grams are taken orally

each day.

 

One can only speculate on what massive therapy would do in all forms of

cancer. Many pathologic conditions are cured by giving 5 million to 100,000

million units of penicillin as an intravenous drip over a period of 4 to 6

weeks. How long must we wait for someone to start continuous ascorbic acid

drip for 2 to 3 months, giving 100 to 300 grams each day, for various

malignant conditions?

 

Barbiturate patients in shock normalized with ascorbic acid.

Clemmesen[52] states that the important principles in management of

barbiturate poisoning are anti-shock therapy, continuous oxygen and patent

airways. Hadden et al.[53] suggest six measures as supportive treatment. An

intensive care unit would be necessary to carry out these functions. All one

really need do is give adequate ascorbic acid therapy. One patient who had

taken 2640 mg Lotusate (talbutal) was seen in the emergency room with a

blood pressure of 60/0. Twelve grams vitamin C was given intravenously with

a 50 c.c. syringe and then the needle attached to a bottle of 5D water

containing 50 grams ascorbic acid. Within 10 minutes the blood pressure was

100/60 demonstrating the effect of vitamin C on shock. A second bottle of

250 c.c. 5D water containing one gram emivan was started in the other arm.

The patient was awake in 3 hours, taking juice with " C " added. She received

125 grams ascorbic acid by vein in 12 hours. Ascorbic acid not only assists

with hepatic metabolism but also as a major diuretic flushes these compounds

out by way of the kidneys. Nasal oxygen running 6 liters per minute was also

employed. Another patient who had masked 2400 mg seconal with paraldehyde

was awake after 42 grams of ascorbic acid had been given by vein as fast as

a 20 gauge needle could carry the flow. She received 75 grams vitamin C by

vein and 30 grams by mouth in a 24 hour period.

 

Cholesterol not a problem, when daily intake of ascorbic acid is high.

Mention should be made of the role[54] played by vitamin C as a regulator of

the rate at which cholesterol is formed in the body; deficiency of the

vitamin speeding the formation of this substance. In experimental work,

guinea pigs fed a diet free of ascorbic acid showed a 600 percent

acceleration in cholesterol formation in the adrenal glands. Ten grams or

more each day and then eat all the eggs you want. That is my schedule and my

cholesterol remains normal, Russia has published many articles demonstrating

these same benefits.

 

Lockjaw relieved.

Ascorbic acid has no equal as a adjuvant with other drugs in many

conditions. With Tolserol it is curative in the treatment of Lockjaw. Both

drugs must be used in proper amounts. In our case 1000 mg Tolserol given

intravenously to a boy weighing 20 Kg. was the optimal amount to use. In 48

hours he was given 90 grams ascorbic acid and 3000 mg Tolserol, all

intravenously.[55] Jungeblut[56] reported that vitamin C, when added to

tetanus toxin " in vitro " , brings about inactivation of the toxin.

 

Two cases of Trichinosis was treated and cured using Vitamin C: and

Para-Aminobenzoic acid.[57] Although the temperature curve was returned to

normal in 36 hours it was found that nine days of treatment was necessary

for permanent cures.

 

Infectious hepatitis relieved.

Viral hepatitis needs brief mentioning. There are two types: 1) Infectious

hepatitis; 2) Needle hepatitis. Physical activity has always been considered

to increase the severity and prolong the course of the disease.[58] In

Vietnam, Freebern and Repsher showed that pick-and-shovel details had no

effects on the 199 controls as against 199 kept at bed rest.[59] One thing

is certain. Given massive intravenous ascorbic acid therapy and patients are

well and back to work in from 3 to 7 days. In these cases the vitamin is

also employed by mouth as follow-up therapy. Dr. Bauer at the University

Clinic, Basel, Switzerland, reported that just 10 grams daily,

intravenously, proved the best treatment available.

 

Ascorbic acid therapy applied to various maladies.

We could continue indefinitely extolling the merits of ascorbic acid.

 

Boyd and Campbell[60] reported excellent results in the healing of corneal

ulcers even though their massive doses was 1.5 grams daily. In one case of a

corneal burn from the phosphorus off an old time match, the pain was

relieved immediately with the intravenous injection of 12 grams vitamin C

with a 50 c.c syringe. One gram was prescribed each hour for 50 grams. The

cornea was normal in less than 24 hours.

One single injection of ascorbic acid calculated at 500 mg per Kg. body

weight will reverse heat stroke.

One to three injections of the vitamin in a dose range of 400 mg Kg. body

weight will effect a dramatic cure in Virus Pancarditis.

One gram taken every one to two hours during exposure will prevent sunburn.

Intravenous injections will quickly relieve the pain and erythema, even the

second degree burns when precautions are not taken.

One to three injections of 400 mg per Kg. given every eight hours will " dry

up " chicken-pox in 24 hours.

If nausea is present it will stop the nausea.

These injections are usually given with a syringe in a dilution of one gram

to 5 c.c fluid. This concentration will produce immediate thirst. This is

prevented by having the patient drink a glass of juice just before giving

the injection.

 

40 grams ascorbic acid by vein and 1000 mg to 2000 mg vitamin B1

intramuscularly will neutralize the person intoxicated by alcohol and will

save the life if one drinks after using Antibuse.

5 per cent ointment using a water soluble base will cure acute fever

blisters if applied 10 or more times a day and we have removed several small

basal cell epithelioma has with a 30 percent ointment.

Dr. Virno[61] at the eye clinic, University of Rome, Italy, reported very

promising results in glaucoma with a dose schedule of 100 mg per Kg. body

weight taken after meals and bed hour. He also reported that these large

doses have proved to be safe.

In arthritis at least 10 grams daily and those taking 15 to 25 grams daily

will experience commensurate benefit. Supportive treatment must also be

given. Repair of collagenous tissue is dependent of adequate ascorbic acid.

Complications of smallpox vaccination are usually handled by adequate oral

ascorbic acid. Several times we found it necessary to give the " C "

intravenously along with Adenosine. Twenty percent ichthammol used locally

with vaccinia necrosum is good psychology.

In herpes zoster two grams vitamin C intramuscularly and 50 mg Adenosine

5-Monophosphoric acid, aqueous solution, also intramuscularly every 12

hours. Compound tincture benzoin locally is helpful.

In massive " shingles " ascorbic acid should also be given by vein. Always as

much by mouth as can be tolerated. Heavy metal intoxication is also resolved

with adequate vitamin C therapy.

General all around benefits of one to ten grams ascorbic acid per day.

It has been suggested that ascorbic acid metabolism may be an index of total

metabolism and thus serve as a general diagnostic guide. Adults taking at

least 10 grams of ascorbic acid daily, and children under ten at least one

gram for each year of life will find that the brain will be clearer, the

mind more active, the body less wearied and the memory more retentive.

 

Summary

The types of pathology treated with massive doses of ascorbic acid run the

entire gamut of medical knowledge. Body needs are so great that so called

minimal daily requirements must be ignored. A genetic error is the probable

cause for our inability to manufacture ascorbic acid, thus requiring

exogenous sources of vitamin C. Simple dye or chemical test are available

for checking individual needs. Ascorbic acid destroys virus bodies by taking

up the protein coat so that new units cannot be made, by contributing to the

break-down of virus nucleic acid with the result of controlled purine

metabolism. Its action in dealing with virus pneumonia and virus

encephalitis has been outlined. The clinical use of vitamin C in pneumonia

has a very sound foundation. In experimental tests monkeys kept on a vitamin

C free diet all died of pneumonia while those with adequate diets remained

healthy.[62] Many investigators have shown an increased need for ascorbic

acid in this condition.[63,64] Brody in 1953 after studying vitamin C and

colds in college students advised that ascorbic acid be given early and

often in sufficient amounts. Regnier[65] reporting in review of Allergy

found that the larger the dose of ascorbic acid the better were the results.

Our findings resulted in a schedule of one gram each hour for 48 hours and

then 10 grams each day by mouth. Those under ten at least one gram for each

year of life.

 

Virus Encephalitis.

Virus encephalitis is a deadly syndrome and must be treated heroically with

intravenous and/or intramuscular injections of ascorbic acid. We recommend a

dose schedule of from 350 mg to 700 mg per Kg. body weight diluted to at

least 18 c.c. of 5D water to each gram of " C " . In small children, 2 and 3

grams can be given intramuscularly, every 2 hours. An ice cap to the buttock

will prevent soreness and induration. Ascorbic acid in amounts under 400 mg

per Kg. body weight can be administered intravenously with a syringe in

dilutions of 5 c.c. to each one gram provided the ampoule is buffered with

sodium bicarbonate with sodium Bisulfite added. As much as 12 grams can be

given in this manner with a 50 c.c. syringe. Larger amounts must be diluted

with " bottle " dextrose or " saline " solutions and run in by needle drip. This

is true because amounts like 20 to 25 grams which can be given with a 100

c.c. syringe can suddenly dehydrate the cerebral cortex so as to produce

convulsive movements of the legs. This represents a peculiar syndrome,

symptomatic epilepsy, in which the patient is mentally clear and experiences

no discomfiture except that the lower extremities are in mild convulsion.

This epileptiform type seizure will continue for 20 plus minutes and then

abruptly stop. Mild pressure on the knees will stop the seizure so long as

pressure is maintained. If still within the time limit of the seizure the

spasm will reappear by simply withdrawing the hand pressure. I have seen

this in two patients receiving 26 grams intravenously with a 100 c.c.

syringe on the second injection. One patient had poliomyelitis, the other

malignant measles. Both were adults. I have duplicated this on myself to

prove no after effects. Intramuscular injections are always 500 mg to 1 c.c.

solution. With continuous intravenous injections of large amounts of

ascorbic acid, at least one gram of calcium gluconate must be added to the

fluids each day. This is done because we have found that massive doses of

ascorbic acid pulls free calcium ions from the vicinity of the platelets or

from the calcium-prothrombin complex as the lactone ring of dehydroascorbic

acid is opened. The first sign of calcium ion loss is " nose bleeding " . This

differs from the nosebleed found, at times, in cases of chicken pox or

measles. Here it represents frank scurvy from vitamin C deficiency. The

pathology being " Capillary fragility " .[66]

 

Burns.

A new treatment for burns has been outlined, which if followed will

eliminate skin grafting and plastic surgery. It is probably too simple to

gain early acceptance. The literature has been suggesting the value of

ascorbic acid in burns for many years. Proper local application and the

amount for systemic usage has been misleading. One only need see one case

properly treated with ascorbic acid to appreciate its importance. If

ascorbic acid can destroy the exotoxin of tetanus, as Jungeblut

demonstrated, it can also destroy the exotoxin of Pseudomonas. Ascorbic acid

plays an important role in maintaining fluid balance in the body. Ruskin

pointed out that the vitamin activates an enzyme arginase, which breaks down

the amino acid arginine, resulting in production of urea which is one key to

tissue fluid balance.

 

Pregnancy.

The simple stress of pregnancy demands supplemental vitamin C. This amount

will vary with the individual. The silver nitrate-urine text will simplify

these findings. Vitamin C seems especially concerned with mesenchymal

tissue. When one considers the demands of the fetus and infant, especially

premature babies, it is obvious that high vitamin C intakes are required

during pregnancy because this " parasite " will drain available " C " from the

mother. Greenblatt[67] reports excellent results following the oral

administration of vitamin C in the therapy of habitual abortion. In my own

practice I was able to take women who had had as many as five abortions

without a successful pregnancy and carry them through two and three

uneventful pregnancies with the use of supplemental vitamin C. The German

literature is " stacked " with articles recommending high doses of vitamin C

during gestation because they believe that this substance is of great

benefit in influencing the health of the mother and in preventing

infections. The vital contribution of ascorbic acid to the body tissues can

be summed up in the formation and maintenance of normal intercellular

material, especially in the connective tissue, bones, teeth, and blood

vessels. Genetic errors might be prevented if prospective mothers were

advised to take 10 or more grams of ascorbic acid daily. It is significant

that we found in the simple stress of pregnancy, a normal physiological

process, that equivalent requirements paralleled those found in the rat when

under stress. Experiments by King et al.[68] have shown that the need for

supplemental vitamin C begins with the embryo.

 

Kidney Stones.

The " scare " factor of large doses of ascorbic vs. kidney stones has been

laid to rest. Since the urine is usually pH6, one can see that the opening

of the lactone ring is a slow process. This reaction takes place in tissues

and is probably regulated by the amount of glutathione present. The

important considerations are that one must have a concentrated urine, that

stasis must be a factor and that the urine must be alkaline for any

appreciable amounts of the crystalloids to precipitate out. This will never

occur with massive ascorbic acid therapy. Furthermore, it has been shown

that the controls in a given experiment had almost as much oxalic acid spill

as did those volunteers taking 9 grams of ascorbic acid daily.

 

Insect - Snake Bites.

The quickness of results in snake bite, spider bite, hornet stings and

caterpillar reactions demonstrates the usefulness in saving lives. It is

best to give the vitamin intravenously with a syringe since bottle

preparations are too time consuming. One precaution must be given. There

exist a 2 gram ascorbic acid ampoule, and ironically it is the only one to

my knowledge approved by the Food and Drug Administration, which might

" kill " if used undiluted in a syringe. This lethal factor is due to the

preservatives added. Each ampoule contains 2 grams sodium ascorbate. Vehicle

contains: Monothioglycerol 0.14%; Sodium Formaldehyde Sulfoxylate 0.05%;

Methyl Paraben 0.13%; Propyl Paraben 0.015%. Neutralized to pH6 with Sodium

Bicarbonate; Water for injection q.s. This ampoule can be used intravenously

ONLY when diluted to at least 25 c.c. to one gram. One sometimes will be

confronted with extraordinary allergic and shock symptoms along with acute

respiratory obstruction. In these situation one must employ Benadryl

intravenously and/or intramuscularly and an adrenocortical hormone such as

Decadron. These can be given by a nurse while the ascorbic acid is being

prepared. In their absence a second " syringe " dose of ascorbic acid will

suffice. Fluids by mouth should be given to prevent or correct thirst which

all patients seem to experience.

 

Diabetes

Large doses of ascorbic acid do not cause diabetes mellitus in humans as has

been suggested. On the contrary 10 grams daily, by mouth, has proved to be

beneficial. The fact that 10 grams will allow them to heal wounds like

normal individuals will save many legs in. the future. Lamden, a biochemist,

instigated these fears by misinterpretation of the results reported by

Patterson using the Ketone formula intravenously in rats.

 

In Surgery.

In surgery the use of ascorbic acid resolves itself into a " must " situation.

The 24 hour frank scurvy levels should be sufficient evidence to encourage

all surgeons to use vitamin C freely in their fluids. Proper employment of

vitamin C by the surgeons will all but eliminate the post-surgery deaths.

 

In Malignancy.

The part very large doses of ascorbic acid given intravenously over a

prolonged period offers a medical challenge. From cabbage and tomatoes grown

in the carbon-14 chambers radioactive ascorbic acid can be extracted, which

can be used in tracer studies. At least one research team has demonstrated

that in cancer all available " C " is mobilized at the site of the malignancy.

Lauber and Rosenfeld reported that " C " is mobilized from the tissues of the

body and selectively concentrated in traumatized areas. In one hopeless case

we administered 17 grams daily for 92 consecutive days without changing the

blood or urine levels from that associated with scurvy. This is the reason

we believe a dose range of 100 grams to 300 grams daily by continuous

intravenous drip for a period of several months might prove surprisingly

profitable. Blood chemistry should be followed daily with such an

investigation. Schlegel found that even a dose of 1.5 grams a day, by mouth,

would prevent bladder cancer.

 

Barbiturate Poisoning.

Our findings in no less than 15 cases of barbiturate poisoning suggested

that no death should occur from this error in judgment. We also observed the

dramatic effect of 12 grams intravenously on blood pressure associated with

shock. The shock seen in heat stroke had been corrected by the time the

injection was completed. The dose range used was 500 mg per Kg body weight.

 

Tetanus - Trichinosis

The use of ascorbic acid with Tolserol in the treatment of Tetanus should be

accepted as universal treatment. Here again the dose must be proper. Our

case as reported will serve as a guide in making these calculations.

Ascorbic acid along with Para-Aminobenzoic acid is curative in Trichinosis.

Both drugs are administered by mouth. It is estimated that at least 5

million cases of chronic Trichinosis exists in the United States. Just nine

days of treatment would return these individuals to normal. In our cases 10

grams ascorbic acid was given daily and Para-Aminobenzoic acid was employed

in high range. Four to six grams to start then three grams every 2 hours for

eight times. For the remainder of the nine day schedule it was given 3 grams

every two hours during th

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