Frederick R Klenner M.D. |
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 deive 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 +
H
2O = HCOOH CO
2 + H
2 (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 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 the day and every three
hours during the night.
Viral Hepatitis.
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.
Multiple Uses.
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 purperal 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 105.4°F. was normal in nine hours. The patient made an uneventful recovery.
In one spectacular case of Black Widow
[69]
spider bite in a 3 1/2 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.
General Nutrition.
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 siiding scale.
Intra-Venous Application.
Ascorbic acid must be given by needle to bring about quick reversal of
various "insults" to the human body. We have found 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 aquous 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), aquous 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 reversable 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
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APPENDIX
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 antitoxon 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 poliomyelities. 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
prowness. 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 100.8°F. pulse 140, respirations 32. She was extremely
restless.
Twenty-four grams ascorbic acid in 360 c.c. 5D 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 dramtically 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
102.6°F. 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 99.0°F. 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 righ 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 1/2 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 vist. No other
antibiotics were given and none was required. Since she had had a booster injection of
tetanus toroid 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 giveq 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 98.6°F.
(axillary 10 minutes-corrected). There was no obstruction to the air-ways. 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 un-satisfactory, 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 98.4°F. (corrected). The
pulse rate was 152
per minute and respirations were 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 phenonmenon" that was at play when the child was eating supper. The
nursing log showed the temperature to be 99.0°F. (corrected) 1 1/2
hours after admission
and 1 1/2 hours later it was recorded at 100.0°F. (corrected). The
nursing log at this time
read: "Shows no sign of consciousness." Temperature was
101.2°F. four hours after
admission and was 102.4°F. (corrected) after six hours. Now the
nursing log read:
"Baby swallowed water without diffculty." 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 controling 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 saving:
"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 qancarditis-A five year old boy was
admitted to the local hospital with history of having a "re-lapse" 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
105°F. 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 elected to take the child to Duke
Medical Center. Six grams of ascorbic acid was given by needle before starting the trip to
the hospital which was 60 miles away. Upon arrival at the Medical Center the child had
made such dramatic response to the single injection of ascorbic acid that the parents were
tempted to return home. The receiving physician questioned the sickness of the child as
being out of proportion to that relayed by me during our telephone conversation. The
parents assured the physician that the child had been seriously ill, but that the change
came about after receiving the ascorbic acid. Although 50 grams (25 ampoules) of ascorbic
acid was sent along with the parents, none was given because the physician in charge
stated that he would be afraid to give that size dose, intravenously, to a child. The fact
that we had administered six grams, which represented a dose of 400 mg per Kg body weight,
apparently had no influence. Laboratory findings, however, confirmed our impression and
the child was hospitalized for two weeks. Two additional injections of vitamin C would
have cured the child in 24 hours.
Case History: Acute Pancreatitis-Adult Male seen in the emergency room
of local hospital complaining of severe, agonizing pain in the epigastrium which radiated
to the back. Ngusea and vomiting were present. Serium amylase studies showed a
concentration of 345. This was the 4th such attack experienced by this patient. Sixty
grams ascorbic acid in 700 c.c. Dextrose in water was given intravenously. 20 mg Pantapon
was given in the emergency room. No additional opiates were required. The patient made an
uneventful recovery. He was placed on 10 grams ascorbic acid by mouth and has not had a
recurrence in almost 5 years. He has, however, developed mild diabetes mellitus which is
now controlled with diet and vitamin C.
END
I am in full agreement with Lancelot Hogben who said: "A
scientific idea must live dangerously or die of inanition. Science thrives on daring
generalizations. There is nothing particularly scientific about excessive caution.
Cautious explorers do not cross the Atlantic of truth.
Frederick R. Klenner, M.D., F.C.C.P.
Reidsville, North Carolina
A native of Pennsylvania, Dr. Klenner attended St. Vincent and St.
Francis College, where he received his B.S. and M.S. degrees in biology. He graduated
magna cum lauda and was awarded a teaching fellowship there. He was also awarded the
college medal for scholastic philosophy. There followed another teaching fellowship in
chemistry at Catholic University, Where he pursued studies for a doctorate in physiology.
Dr. Klenner then 'migrated' to North Carolina and Duke University
to continue his studies. He arrived in time to use his knowledge in physiology and
chemistry to free the nervous system of the frog for a symposium by immersing the animal
in 10% nitric acid. Taken in tow by Dr. Pearse, chairman of the department, he was finally
persuaded to enter the school of medicine. He completed his studies at Duke University and
received his medical degree in 1936.
Dr. Klenner served three years in post graduate hospital training
before embarking on a private practice in medicine. Although specializing in diseases of
the chest, he continued to do general practice because of the opportunities it afforded
for observations in medicine. His patients were as enthusiastic as he in playing guinea
pigs to study the action of ascorbic acid. The first massive doses of ascorbic acid he
gave to himself. Each time something new appeared on the horizon he took the same amount
of ascorbic acid to study its effects so as to come up with the answers.
"Dr. Klenner's list of honors and professional society
affiliations is tremendous. He is listed in a flock of various "Who's Who"
registers. He has published many scientific papers throughout his scientific career.
Source:
www.advancedhealthplan.com/ascorbic_acid_klenner.html