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 ascorbate 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.

Burns – degrees explained and some therapy rational

In the treatment of burns ascorbate, in sufficient amounts, reflects itself as a truly miracle substance. In the early forties, when I was using ascorbate, intramuscularly, in treating bacillary dysentery, shiga type, with excellent results, Lund, Lam and many others were using, what they called, massive doses of ascorbate 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 ascorbate will eliminate the fourth stage and the third stage if used as we will later program.

Burns – continued descriptive and related therapies

The pathologic physiology of a burn wound from the moment of the accident is in a state of dynamic change until the wound heals or the patient dies. The primary consideration is the phenomenon of blood sludging originally recognized by Knisely in 1945.[26,27] Initially there is intravascular agglutination of red blood cells into distinctly visible, smooth, hard, rigid, basic masses. Lofstrom in 1959 demonstrated that the oxygen uptake by the tissues is greatly reduced because of the sludging and therefore reduced rate of flow. Berkeley[28] in 1960 concluded that this phenomenon of sludging or agglutination results in capillary thrombosis in the area of the burn, extending proximally to involve the large arterioles and venules and thereby creating tissue destruction greater than that originally produced by the burn. Anoxia produces added tissue destruction. Lund and Levenson[28] found that after severe burns there is considerable alteration in the metabolism of ascorbate as shown by a low concentration of ascorbate 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 ascorbate 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 ascorbate concentration in patients with severe burns. Klasson[32] although limiting the amount of ascorbate 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 ascorbate 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:

1. 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;
2. The employment of a 3% ascorbate 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;
3. The use of vitamin A and D ointment over the area of the burn and this is now alternated, q4h with the 3% ascorbate solution;
4. The administration of massive doses of ascorbate by vein and by mouth. 500 mg per Kg. body weight diluted to at least 18 c.c. per gram vitamin C [sodium ascorbate] 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 [sodium ascorbate] solution is repeated every 8 hours for the first several days, then at 12 hour intervals. Ascorbate, by mouth, is given to tolerance. Loose stools is accepted as this index. Using large doses of ascorbate 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 ascorbate goes to dehydroascorbate, then to ketogulonic acid and later to oxalic acid as the calcium salt;
5. 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 ascorbate 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. Ascorbate 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 ascorbate these cells are kept viable, will multiply and soon meet with other proliferating units in the establishment of a new integument.

Primary and lasting benefits in pregnancy

Observations made on over 300 consecutive obstetrical cases using supplemental ascorbate, by mouth, convinced me that failure to use this agent in sufficient amounts in pregnancy borders on malpractice. The lowest amount of ascorbate 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 [stretch marks] 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 ascorbate with her first pregnancy. This lady has been back teaching school for the past 10 years. She still takes 10 grams of ascorbate daily. Infants born under massive ascorbate 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 ascorbate 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 ascorbate 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.

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.

Ascorbate 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 ascorbate 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 ascorbate content of the plasma. As with the virus bodies, ascorbate also joins with the protein factor of these toxins effecting quick destruction.

The answer to these emergencies is simple. Large amounts of ascorbate 350 mg to 700 mg per Kg. body weight given intravenously. In small patients, where veins are at a premium, ascorbate 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. Ascorbate 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.

Summary

The types of pathology treated with massive doses of ascorbate 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 ascorbate, thus requiring exogenous sources of vitamin C. Simple dye or chemical tests are available for checking individual needs. Ascorbate 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 ascorbate in this condition.[63,64] Brody in 1953 after studying vitamin C and colds in college students advised that ascorbate be given early and often in sufficient amounts. Regnier[65] reporting in Review of Allergy found that the larger the dose of ascorbate the better were the results. Our findings resulted in a schedule of one gram each hour for 48 hours and then 10 grams each day by mouth. Those under ten at least one gram for each year of life.

Virus Encephalitis.

Virus encephalitis is a deadly syndrome and must be treated heroically with intravenous and/or intramuscular injections of ascorbate. 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. Ascorbate 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 ascorbate, 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 ascorbate pulls free calcium ions from the vicinity of the platelets or from the calcium-prothrombin complex as the lactone ring of dehydroascorbate 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 ascorbate 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 ascorbate to appreciate its importance. If ascorbate can destroy the exotoxin of tetanus, as Jungeblut demonstrated, it can also destroy the exotoxin of Pseudomonas. Ascorbate plays an important role in maintaining fluid balance in the body. Ruskin pointed out that the vitamin activates the 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 test 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 ascorbate 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 ascorbate 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 ascorbate 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 ascorbate 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 ascorbate 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 ascorbate 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 ascorbate is being prepared. In their absence a second “syringe” dose of ascorbate will suffice. Fluids by mouth should be given to prevent or correct thirst which all patients seem to experience.

Diabetes

Large doses of ascorbate 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. [That is 100x the largest amount of ascorbate Klenner gave to humans, and a different form (see above).]

In Surgery

In surgery the use of ascorbate 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 ascorbate given intravenously over a prolonged period offers a medical challenge. From cabbage and tomatoes grown in the carbon-14 chambers radioactive ascorbate 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 ascorbate 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. Ascorbate 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 ascorbate 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

Ascorbate 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 ascorbate 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 ascorbate 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
• Tuberculosis

In one case of scarlet fever in which Penicillin and the Sulfa drugs were showing no improvement, fifty grams ascorbate given intravenously resulted in a dramatic drop in the fever curve to normal. Here the action of ascorbate 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 ascorbate 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 ascorbate was administered intravenously when first seen in the office. Four grams ascorbate 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 ascorbate, daily, by mouth. Before age 10 the amount given was on a sliding scale.[71]

Intravenous Application

Ascorbate 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 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 ascorbate that experiments on man are the only experiments which can give positive evidence of therapeutic action in man. Likewise, the use of ascorbate 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.

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 ascorbate with a 50 c.c. syringe every 8 hours. The concentration was one gram for each 5 c.c. diluent. He was returned home on the second hospital day. The third boy received supportive treatment but did not receive ascorbate. 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 ascorbate, 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 ascorbate every two hours by mouth. She lived and is now a graduate nurse. The other children did not receive ascorbate 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 ascorbate, 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 ascorbate, 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 ascorbate. 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 100.8°F pulse 140, respirations 32. She was extremely restless. Twenty-four grams ascorbate 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 ascorbate in the blood stream, patient was awake and rational but completely paralyzed, right arm and leg. Five grams ascorbate was given in fruit juice every 6 hours by mouth and 6 grams ascorbate 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 ascorbate 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 ascorbate 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 102.6°F.  At this point all oral medication was discontinued. I immediately gave six grams of ascorbate intravenously with a 30 c.c. syringe. He was awake and asking, “what happened” in 5 minutes. Six grams ascorbate 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. Ascorbate 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 ascorbate 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 1/2 degree fever. She was given a second dose of 4 grams of ascorbate 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 ascorbate 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.

Compare 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 98.6°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 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 98.4°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 ascorbate, 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 99.0°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 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 ascorbate 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 ascorbate 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 ascorbate 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 105°F. Ascorbate 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 ascorbate 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 ascorbate 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 ascorbate. Although 50 grams (25 ampoules) of ascorbate 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. Nausea and vomiting were present. Serum amylase studies showed a concentration of 345. This was the 4th such attack experienced by this patient. Sixty grams ascorbate 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 ascorbate 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.”

Bibliography