http://www.seanet.com/~alexs/ascorbate/197x/klenner-fr-j_appl_nutr-1971-v23-n3&4-p61.htm
[J.A.N.] 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 SD 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.
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 he 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.
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
myriad[s 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,” 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.
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 judgement. 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:
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.
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-gulono-lactone
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 tile
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.
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 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 15 test. This test employs 10
drops of 5 percent silver nitrate and 10 drops urine which is placed in a
Wasserman tube. 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.
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), Echo and polioviruses
— they all contain only ribonucleic acid and protein. There exist minor
variations. Adenoviruses contain desoxyribonucleic acid (DNA) and protein.
Other viruses such as that causing influenza contain added lipid and
polysaccharides. Desoxyribonucleic 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:
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,
enzymic 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 purines
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.
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. 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. A:
B: This stage, which is always sudden, will present itself in at least seven
forms:
Other findings of this dramatic second stage are:
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.
In 1960 we decided to research the literature before writing our paper, “Virus
Encephalities As A Sequel Of The Pneumonias.” 22 Rosenfield
in 1903 described a similar syndrome under the caption “Brain Purpura or
Haemorrhagic Encephalitis.” Comby, in 1907, was the first to call attention to
the interesting “metastic” sequela of the pneumonias. Baker and Noran in
1945 [23] enumerated five groups, each showing certain
definite clinical characteristics which may be of both diagnostic and
prognostic significance in relation to this virus syndrome.
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.
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:
Arriving in the brain the virus goes through the blood cerebro spinal fluid
barrier and/or the blood brain barrier by one of three ways: a) Electrical
charge; b) Chemical lysis of tissue; c) 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.
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.
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 29 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.
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:
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.
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 + H20 = 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.
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.
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 given 65 mg orally 2 to 3 times a day. (Dr. M. J. Vernon Smith: Med.
World News, Dec. 4, 1970)
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:
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:
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.
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. 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 1½ 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.
Merton Lamden, a bio-chemist, 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 Patterson 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.
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 re-instate 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.
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 ¼ 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 ¾ lower than the original samples.
Baylor University research team reported similar findings in 1965. Bartlett,
Jones 46 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 pre-operative 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.
After studying hundreds of college students, Yale researchers have evidence
that strengthens the link between mononucleosis and EB 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.
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 [50]
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 tryptophane 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?
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 SD 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.
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.
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 were 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.
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.
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 dose 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 and 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 and intravenous injections will
quickly relieve the pain and erythema [sic: erathema], 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. Forty grams ascorbic acid by vein
and 1000 mg to 2000 mg vitamin B-1 intramuscularly will neutralize the person
intoxicated by alcohol and will save the life if one drinks after using
Antabuse [sic: 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 epitheliomas 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.
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.
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 breakdown 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 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 SD water to each gram of “C”. In small children, 2 and 3 grams can
be given intramuscularly, every 2 hours. An ice can 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 re-appear 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 pull 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
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.
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.
The “scare” factor of large doses of ascorbic vs. kidney stones has been
laid to rest. Since the urine is usually pH-6, 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.
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 pH 6 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.
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 bio-chemist,
instigated these fears by misinterpretation of the results reported by
Patterson using the Ketone formula intravenously in rats.
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.
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.
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.
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
the day and every three hours during the night.
Ascorbic acid is the drug of choice in viral hepatitis. The dose used ranges
from 400 mg to 600 mg per Kg body weight, depending on the severity of the
disease. It should be given every 8 to 12 hours. Ten grams ascorbic acid daily
in divided doses is also given by mouth. Those under 10 years the usual
schedule of at least one gram for each year of life.
We have reviewed many other pathological conditions in which ascorbic acid
plays an important part in recovery. To these might be added Cardiovascular Diseases,
Hypermenorrhea, Peptic and Duodenal Ulcers, Post-operative and Radiation
Sickness, Rheumatic Fever, Scarlet Fever, Poliomyelitis, Acute and Chronic
Pancreatitis, Tularemia, Whooping Cough and Tuberculosis. In one case of
scarlet fever in which Penicillin and the Sulfa drugs were showing no
improvement, fifty grams ascorbic acid given intravenously resulted in a
dramatic drop in the fever curve to normal. Here the action of ascorbic acid
was not only direct but also as a synergist. A similar situation was observed
in a case of lobar pneumonia. In another case of puerperal sepsis following a
criminal abortion the initial dose of ascorbic acid was 1200 mg per Kg body
weight and two subsequent injections were at the 600 mg level. Along with
Penicillin and Sulfadiazine an admission temperature of 105.4ºF was normal in
nine hours. The patient made an uneventful recovery. In one spectacular case of
Black
Widow 69 spider bite in a 3% year old child, in coma, one
gram calcium gluconate and 4 grams of ascorbic acid was administered
intravenously when first seen in the office. Four grams ascorbic acid was then
given every six hours using a 20 c.c. syringe. She was awake and well in 24 hours.
Physical examination showed a comatose child with a rigid abdomen. The area
about the umbilicus was red and indurated, suggesting a strangulated hernia.
With a 4 power lens, fang marks were in evidence. Thirty hours after starting
the vitamin C therapy the child expelled a large amount of dark clotted blood.
There was no other residual. A review of the literature confirmed that this
individual has been the only one to survive with such findings; the others were
reported at autopsy. Ten grams vitamin C and 200 mg to 400 mg vitamin B-6, by
mouth, daily will “shield” one from mosquito bites. Twenty percent will also
require 100 mg vitamin B-6 intramuscularly each week.
Vitamin C plays a very important role in general nutrition. Deficiency of
this substance in sufficient amounts can be a factor in loss of appetite, loss
of weight or failure to grow, muscular weakness, anemia and various skin
lesions. The relationship between vitamin C and the health of the gums and
teeth has long been recognized. Laboratory studies
on gum-teeth connective tissue have reaffirmed this relationship. 70
Our son who will be 19 in July has never developed a tooth cavity. Since age 10
he has received at least 10 grams ascorbic acid, daily, by mouth. Before age 10
the amount given was on a sliding scale.
Ascorbic acid must be given by needle to bring about quick reversal of
various “insults” to the human body. We have
found [71] that doses must range from 350 mg to 1200 mg per
Kg body weight. Under 400 mg per Kg of body weight the injection can be made
with a syringe provided the vitamin is buffered with sodium bicarbonate with
Sodium Bisulfite added. Above 400 mg doses per Kg body weight, and a particular
ampoule described in this summary, the vitamin must be diluted to at least 18
c.c. of 5 per cent dextrose in water, saline in water or Ringer’s solution.
Many times Adenosine 5-Monophosphate, 25 mg in children and 50 to 100 mg in
adults, given intramuscularly, is necessary to achieve results. The aqueous
solution is more effective for quick results, although Adenosine in Gel can be
employed. In debilitated individuals or when the pathology is serious,
Desoxycorticosterone Acetate (DCA), aqueous solution, must also be added to the
schedule. Usually 2.5 mg for children and 5 mg for adults is the daily
intramuscular dose required. Sudden swelling of the feet indicates abnormal
sensitivity and the drug must be discontinued.
It must be remembered when using ascorbic acid that experiments on man are
the only experiments which can give positive evidence of therapeutic action in
man. Likewise, the use of ascorbic acid in human pathology must follow the Law
of Mass Action: “In reversible reactions, the extent of chemical change is
proportional to the active masses of the interacting substance.”
FRED R. KLENNER, M.D.
Reidsville, N.C.
BIBLIOGRAPHY
APPENDIX
[Case History: Caterpillar Sting—(Jump to Case
History in Article Body)]
[Case History: Barbiturate Poisoning—(Jump to Case
History in Article Body)]
Case History: Pesticide Poisoning—Three boys ranging in
years from age seven to age 12 were walking along a North Carolina Highway.
They were caught in the “spray” of a dusting airplane. The youngest boy had
been covered by the other two and so received little exposure. He was seen in
the emergency room of the local hospital and sent home. The other two boys had
different physicians. One lad age 12, under our care, was given 10 grams of
ascorbic acid with a 50 c.c. syringe every 8 hours. The concentration was one
gram for each 5 c.c. dilutent. He was returned home on the second hospital day.
The third boy received supportive treatment but did not receive ascorbic acid.
His body was something to see. The spray had produced an allergic dermatitis as
well as a chemical burn. He died on the 5th hospital day.
Case History: Nasal Diphtheria—Three children, living in
the same neighborhood, developed nasal diphtheria. All three children had
different physicians. A little girl under our care was given 10 grams ascorbic
acid, intravenously, with a 50 c.c. syringe every 8 hours for the first 24
hours and then every 12 hours for two times. She was then put on one gram
ascorbic acid every two hours by mouth. She lived and is now a graduate nurse.
The other children did not receive ascorbic acid and both died. Our young
patient also received 40,000 units diphtheria antitoxin which was given
intraperitoneal. The other children also were administered the antitoxin.
Case History: Poliomyelitis—Although we were able to cure
many cases of polio with massive doses of ascorbic acid, one single instance
demonstrates the value of vitamin C. Two brothers were sick with poliomyelitis.
These two boys were given 10 and 12 grams of ascorbic acid, according to
weight, intravenously with a 50 c.c. syringe, every eight hours for 4 times and
then every 12 hours for 4 times. They also were given one gram every two hours
by mouth around the clock. They made— complete recovery and both were athletic
stars in high school and college. A third child, a neighbor, under the care of
another physician received no ascorbic acid. This child also lived. The young
lady is still wearing braces.
Case History: Acute Virus Infection representing Deadly Virus
Syndrome—Cases with paralysis are extremely interesting in as much as
they challenge diagnostic prowess. One of our cases, a female age 58,
demonstrated three different types. She entered the hospital because of a
convulsive seizure. She had had a lingering cold for ten days. She experienced
three additional convulsive seizures after hospital admission. The temperature
was 100.8ºF, pulse 140, respiration 32. She was extremely restless. Twenty-four
grams ascorbic acid in 360 c.c. SD water was given intravenously for three
times at 8 hour intervals. One gram calcium gluconate was added to the first
and third bottle. Twenty four hours following admission and 72 grams ascorbic
acid in the blood stream, patient was awake and rational but completely
paralyzed, right arm and leg. Five grams ascorbic acid was given in fruit juice
every 6 hours by mouth and 6 grams ascorbic acid along with a B complex
preparation was given intravenously, daily for eight additional days. The right
arm and leg returned to normal 48 hours after admission. Classical pellagra was
also corrected during this hospital stay.
Case History: Repeating virus infection—This case proved
that adequate ascorbic acid therapy must be continued long enough to destroy
all virus bodies, otherwise the infection will recur. In 1960, I treated a
seven year old boy, off and on, over a period of six weeks, for influenza like
symptoms. Therapy included one of the mold derived drugs, sulfadiazine and 5 to
10 grams ascorbic acid by mouth. On three different occasions this treatment
schedule was dramatically effective. When the child became ill for the fourth
time, the administration of the above antibiotics and oral vitamin C had no
reversing effect. On the third day of this illness the child suddenly became
lethargic and just as suddenly to frank stupor. The temperature which had been
running low grade was now 102.6ºF. At this point all oral medication was
discontinued. I immediately gave six grams of ascorbic acid intravenously with
a 30 c.c. syringe. He was awake and asking. “what happened” in 5 minutes Six
grams ascorbic acid was given in 4 hours and then at 6 hour intervals for two
additional doses. The recovery was complete in 24 hours and remained so.
Ascorbic acid was again started by mouth giving 5 grams in juice every 8 hours.
After one week, this was reduced to the usual daily “take” of seven grams. I
had ample opportunity to observe this case—the child was our son.
Case History: Snake bite—Child of 4 years was struck on the
lower leg by a large highland moccasin at 7:00 P.M., while at play in the yard
of her country home. Seen in the emergency room of the local hospital at 7:30
P.M., the child was vomiting, was crying because of severe pain in her leg,
which she held with both hands above the “fang marks”. Fever was 99.0ºF, Four
grams of ascorbic acid was given intravenously at 7:35 P.M. with a 20 c.c.
syringe. The following 25 minutes were taken to follow a skin test on
anti-venom. At this time and before the anti-venom was administered the child
had stopped vomiting, she had stopped crying and was sitting on the emergency
room table, laughing and drinking a glass of orange juice. She commented: “Come
on, Daddy, I’m all right now, let’s go home.” She was allowed to return home
with the understanding that her father would give me a report, by phone, each
hour during the night. This he did. His report, each time, was that the child
was sleeping as usual and that except for moderate swelling to the “calf of the
leg” appeared normal. Seen in the office at 10:00 A.M. the following morning
she still demonstrated the small amount of swelling of her leg and had ½ degree
fever. She was given a second dose of 4 grams of ascorbic acid intravenously.
Seen at 5 P.M. she had no fever but the swelling remained constant. There was
no pain. The following day, 38 hours after being bitten, she was completely
normal. Since this was our first case of snake bite treated with vitamin C, we
elected to give an additional 4 grams of ascorbic acid on this visit. No other
antibiotics were given and none was required. Since she had had a booster
injection of tetanus toxoid in recent months, none was given at this time.
Comparing this to an earlier case of snake bite in a 16 year old girl, struck
by a moccasin of about the same size, as gauged from the fang marks, on the
hand while pulling tobacco plants, and who was hospitalized for three weeks.
She was given 3 doses of anti-venom. The arm was compressed continuously with
magnesium sulfate solution. Swelling was four times that of the opposite arm
and striae developed over the entire surface. This patient received no vitamin
C other than that found in a regular hospital diet. Morphine was required to
control pain. (We no longer use anti-venom.)
Case History: An Insidious virus—This was a child of 18
months. She was seen in the driveway to my home at about 7:00 P.M. The history
was brief. The child had strangled on food while eating supper. A cursory
examination given in the front seat of an automobile revealed an extremely
restless, whining child. The temperature was 98.6ºF (axillary 10
minutes-corrected). There was no obstruction to the airways. We did elicit the
information that the child had had a cold for several days. We also learned
that the child’s mother had taken her for a long stroller ride the previous
day—which in this area was damp and cold. Frankly the impulse to send the child
home was great.
Remembering that I had seen children dead within 30 minutes to two hours
after hospital admission without treatment, I decided to buy some time. The
Uncle was asked to take the child to the emergency room of the local hospital.
The nurse on duty was given an order to take a rectal temperature and then give
a fleets enema. If the results proved unsatisfactory, she was to repeat the
procedure in 30 minutes using a normal saline solution. Approximately 45
minutes after leaving my home, the intern on duty reported by phone, that the
child was unconscious to a point where she responded only to pain stimuli. The
enema had not been given. Going at once to the hospital, conditions were found
as described. The little patient was lying motionless on the examining table.
Using a suitable size rectal tube I gave the enema with good results. The stool
was normal. Rectal temperature taken at the hospital was 98.4ºF (corrected).
The pulse rate was 152 per minute and respiration was 32 per minute. It was
impossible to visualize the throat because the mouth was “locked” as one finds
after stimulation in lockjaw. Our impression was that the virus had now entered
the brain. Thirty grams of ascorbic acid, in divided doses, was given
intramuscularly over a period of 36 hours. Crystalline penicillin was started
on the second day and 300,000 units were administered in divided doses over the
next three days. This was added to block secondary invaders. One hour following
admission we applied a 4 x 4 gauze, saturated with tap water, to the child’s
lips. The sucking reflex was still intact, but the child immediately strangled.
Turning the child head down, the small amount of water ran from its nostrils.
Now it was clear. It was this “bulbar phenomenon” that was at play when the
child was eating supper. The nursing log showed the temperature to be 99.0ºF
(corrected) 1½ hours after admission and 1½ hours later it was recorded at
100.0ºF (corrected). The nursing log at this time read: “Shows no sign of
consciousness.” Temperature was 101.2ºF four hours after admission and was
102.4ºF (corrected) after six hours. Now the nursing log read: “Baby swallowed
water without difficulty.” At this point the temperature curve started back
down and by 7:00 A.M. (11 hours following admission) the child was alert and
taking water freely from a spoon. Twenty eight hours after the first injection
of ascorbic acid the temperature was normal. Water, milk and orange juice were
now taken from a bottle. Cecon (liquid vitamin C) was given by mouth. Discharge
was on the 5th hospital day. The initial low fever recording indicated that the
child was dying; after ascorbic acid therapy she began to respond, thus the
fever. After the virus was killed, the temperature returned to normal.
Case History: Monoxide Poisoning—State highway employee
carried into my office in unconscious condition. He was a known diabetic. The
breathing was not Kussmaul type and his skin was warm and dry. We elicited the
information that he had been found in the cab of his truck with the windows
closed and the engine running. It was a cold Winter day. Entertaining a
diagnosis of Monoxide intoxication we immediately gave 12 grams ascorbic acid
with a 50 c.c. syringe using a 20 gauge needle. (We employ a 20 G needle when
using a 50 c.c. syringe; 21 G needle for a 30 c.c. syringe; 22 G needle for a
20 c.c. syringe and a 23 G needle for a 10 c.c. syringe. This assists in
controlling the rate of flow which is important, especially, in young
children). Within 10 minutes the patient was awake, sitting up on the edge of
the examining table, rubbing his eyes and saying: “Doc, what in the world am I
doing up here in your office.” He returned to his place of employment within 45
minutes.
Case History #1: Acute Virus Pancarditis—A five year old
boy was admitted to the local hospital with history of having a “relapse” after
recovery from measles. The physical findings showed a thready and feeble pulse.
A distinct rub was in evidence by auscultation. The EKG showed RS-T deviations.
The temperature was 105ºF. Ascorbic acid calculated at 400 mg per Kg body
weight was given intravenously with a syringe. Within two hours the picture had
almost reverted to normal. Injection of Vitamin C was repeated in 6 hours and
again at 12 hours. A fourth injection was given after 24 hours although the
patient was clinically well. The child returned home on the 4th hospital day.
Case History #2: Acute Virus Pancarditis following a deep cold—The findings approximated those of case #1. The parents ele