Frederick R.Klenner 使用维生素C的临床观察 (1939~1983)

 

Observations On the Dose and Administration of

Ascorbic Acid When Employed Beyond the Range

Of A Vitamin In Human Pathology

 

 

简介:

Frederick.R.Klenner医生出生于宾夕法尼亚,就读于St. Vincent and St. Francis学院并在此获得生物学学士和硕士学位。他后来毕业于magna cum laude并在此获得一个教学研究员职位。他亦曾被授予学院经院哲学奖章。后来,在Catholic大学获得另一个化学教学研究员职位。在这里,他攻读生理学博士学位。

然后,Klenner医生移居至北卡来纳州,在Duke大学继续他的研究。他及时赶到,运用他的生理学和化学的知识,通过把青蛙浸在10%的硝酸溶液,迅速恢复一个在研讨会的使用的青蛙的神经系统功能。他被系主任Pearse医生说服,进入了医学学校。他在Duke大学完成了他的研究,并在1936年获得了他的医学学位。

在开始私人执业以前,他在研究生医院实习了三年。虽然专门研究胸腔疾病,他坚持进行全科诊疗,因为这能提供丰富的医学观察机会。在运用天竺鼠以研究抗坏血酸的作用方面,他的病人和他一样热情。第一次巨大量的抗坏血酸他给了他自己。每次出现新问题他都服用相同数量的抗坏血酸以观察其效果。

Klenner医生获得的荣誉和专业协会职务是众多的。他被列入各种各样的名人名录里。他在他的科学生涯中,出版了28篇论文。

1949, Klenner首先报告用大剂量(每日每公斤体重350~700毫克)抗坏血酸钠静脉滴注治愈所有收治的60例流行性脊髓灰质炎 患者。在严重病毒性感染性疾病、蛇虫叮咬中毒素、一氧化碳中毒、精神类药物中毒、农药中毒等多种疾病治疗方面,他的成功案例是惊人的。。。

 

 

当以超过一种维生素的正常用量在人类病理中使用时,对抗坏血酸的剂量和使用的各种观察

Observations On the Dose and Administration of

Ascorbic Acid When Employed Beyond the Range

Of A Vitamin In Human Pathology

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

来源:WWW.DOCTORYOURSELF.COM

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

翻译: 蓝山

 

文章内容

总结

附录—更多的医案

参考书目

Klenner传记

 

古代史和简单的维生素C治疗

古文明传说,每一种侵袭人的疾病都有使它愈合的草药或对等物。在波多尼各,这个故事已流传很久,“把健康树Acerola(一种美州的小灌木,果实像樱桃),种在后院里会把感冒拒于门外。这种樱桃样的水果的抗坏血酸含量是橙汁的30倍。在美国的宾夕法尼亚,过去称它,现在很多人仍称它为驳骨草(BONESET,一种雏菊科植物),科学上,它叫做:Eupatorium perfoliatum[2]. 虽然它现在很少被医生作为处方药使用,驳骨草是美国东部最常用的药用植物。大多数农民都有一把干的放在阁楼或驳骨草柴房里,并用它做出最苦的药茶给那些感冒或发烧的人饮用。由于在那些地区居住过,我们曾有许多机会服用这种特别的饮料。1918年的流行性感冒传染性很强,Klenners家族经历并生存下来,但看到周围很多人死于这次大感冒。虽然它苦,它是有药效的,而在大多数情况下,痊愈在一夜之间。几年前,我的好奇驱使我去分析这种草药,而令我惊奇和兴奋的是,我们过去一直每次数服用10~30克的维生素C。即使在那时,它也是依体重而决定服用剂量的,儿童一杯,成人2~3杯。那时的一杯约8安士。二十世纪的人似乎已忘记,他们的祖先从各种植物和树根制造未提炼的药物,这些煎剂,浸渍剂,果汁,粉末,药丸和搽剂,可满足他们所需。高贵的制药业,只是使这些药物的形式和形状更合意。

 

早期的使用说明,作用和用量

 

要理解抗坏血酸在人体里的化学行为,你一定要走出它现在的学术性身份—或者作为生存的必需因子或作为一种预防坏血病的物质。这种知识是基本的。看看出现在1939年的食物和生命年报(Food and Life Yearbook 1939)的,美国农业部[3]这样说:事实上,即使当无任何外在症状时,亦可能处在维生素C缺乏症的状态,比坏血病本身更危险。如果这样一个状况未被发现,并持续不予纠正,牙齿和骨骼将会被损害,而可能更严重的是,血液循环会脆弱至这样的程度,它不再能抵抗或者说战胜感染,不像坏血病这么容易治疗的感染。这是真实的,没有这微不足道的物质,绝大多数身体代谢可能会恶化,甚至,发生致命性的停止。

 

抗坏血酸有许多重要的功能。它是一种强力的氧化剂,而且当给予巨大量时,也就是,50~150克,静脉内给药,对某些病理情况,以20号针头允许的速度注入血管,它可作为快速氧化剂,常常在几分钟内纠正病理状况。抗坏血酸也是一种强力的还原剂。它对毒素,外毒素,病毒感染,内毒素和组织胺的中和作用,直接比例于涉及的致命因素的数量,以及给予的抗坏血酸的数量。有时,需要使用肌肉注射。它应经常给予口服,如有可能,和注射一起使用。

 

历史上,它的目标是坏血病,现在,高血液水平是为应对自我放荡以及生理性创伤 。

如果聪明地使用抗坏血酸,某些需要抗坏血酸的指标,一定要满足。不幸的是,现在有一种叫“最少每日需要量”的“告示”。这个“私生子”一直由国家科学院和国家研究委员会共同抚养,代表了一个判断上的错误。有许多因素增加身体对抗坏血酸的需求。而除非这些需求得到满足,至少被医生,将不能有实质性的改善。认识到身体对抗坏血酸的需求远大于预防坏血病的水平是很重要的。这些需求可以被概括为:

1  个体的年龄;

2  个人生活习惯如吸烟、喝酒、娱乐;

3  睡眠、特别是人工诱导的睡眠;

4  创伤:被病原引起的创伤、工作的创伤、外科创伤、偶然或有意识的创伤;

5  肾域;

6  环境因素;

7  生理性应激;

8  不同的季节;

9  大便的丢失;

10   个人吸收率的差异;

11   身体化学;

12   商业性片剂的接合剂的差异;

13   药物;

14   杀虫剂;

15   体重;

16   不足够的储存。

 

弹性剂量标准解释为最小标准

因为以上知识,再没有必要去接受一个以术语“最小每日需要量”来表示的固定不变的数量。这是正确的,因为这样一个事实,人是不同的,而同样的人在不同的时候经历不同的环境。对抗坏血酸而言,今天的足够供应对明天的需要无任何或仅有很少的意义。让我们开始考虑最大需要量。长期以来,因为接受消极的忽视和顺从所谓的标准,我们不为我们的孩子和我们自己提供足够的抗坏血酸。依据零碎的,从可得到的大鼠获得的,哺乳动物合成数据,一个70公斤体重的个体,在无应激情况下,每日可生产1.8[5]~4[6]克的抗坏血酸。而在应激情况下,每日可生产15.2[7]抗坏血酸。对比这个和无应激情况下的70毫克日需要量,和产科病人经历的简朴压力下的200毫克日需要量,而你会认识到这种差异,从而理解为什么我们在华盛顿为此对这个当权派作了23年的孤身战争。

 

抗坏血酸不能被人合成

 

对哺乳动物抗坏血酸的生物合成的研究提示,大众接受的维生素理论是对可得到的证据[8,9,10]的过度简单化。这常常导致误解和虚假的印象。已有建议,令人类产生对外源性抗坏血酸的需求的生化损伤,是其肝脏的一种活性酶—L-古洛糖酸内酯氧化酶的缺乏。在人类, 控制这种酶合成的基因的一次缺陷或丢失,阻断了一系列转化血中葡萄糖为抗坏血酸过程的最后步骤。病毒可以突变细胞,X线可以突变细胞,而偶然亦可以引起基因突变。这样一个突变很可能会发生,制约了他的所有后代合成抗坏血酸的能力。生存需要从外界获得抗坏血酸,这并非很少见。其他公认的遗传性疾病,由一种缺失的酶引起的病理性综合症,在人类是,苯丙酮酸尿(症),半乳糖血症,尿黑酸尿。

值得注意的是,Sealock and Goodland认为抗坏血酸在酪氨酸的氧化代谢过程中,有作为辅酶的能力。这个反应的氧化速度依赖于维生素C的浓度。在分解蛋白质为可用的氨基酸的过程中,酪氨酸是必需的。患坏血病的天竺鼠的肝脏不能氧化酪氨酸,除非抗坏血酸存在。这为人类尿黑酸尿的代谢异常的研究提示了一个线索。使用抗坏血酸将纠正患坏血病的天竺鼠的尿黑酸尿。抗坏血酸对人类尿黑酸尿的效果一直是前后矛盾的。原因是:抗坏血酸使用的不足量。

 

生物化学家Irwin Stones的概念有实际应用价值

 

由于遗传错误,人类制造他自身的抗坏血酸的无能,已被Irwin Stone.[12]称为抗坏血酸缺乏症“HYPOASCORBEMIA”)。这是废除现在的每日最少需要量概念的另一个原因。 人类的生理需求和其他可以合成抗坏血酸的哺乳动物无任何区别。

 

各种测量抗坏血酸水平的操作以及身体对抗坏血酸的需求

 

各种检测已用于决定身体维生C的饱和程度,但当中的大部分,都一直误导我们。用26二氯苯酚靛酚做的血和尿样本分析将得到比用二硝基苯酚联氨得到的值小大约7% Gothlin主张毛细血管脆性检测。 它和 Hesstourniquet 检测取得类似结果。 两者可用作估计用于维持毛细血管致密性的维生素C的剂量。由Rotter发明,并被Slobody[13]修改的内皮试测,现在再获得认同。原则上,它和RingdorfCheraskin[14]lingual 检测(lingual test)相同,因为两者都依据促使染料褪色需要的时间。lingual 检测快速且操作简单,但它需要一个25号针头的注射器和持续不断的监视。因为染料方法依赖试剂被维生素C的还原,任何比染料的还原电位低的物质都可能是干扰的来源。二十年前, 我们决定测量,作为一种治疗参照,借鉴维生素C还原量化性的Benedict氏溶液的能力,测量尿中维生素C的含量。一种在已知无糖的尿液中的二个加号(﹢﹢)的Benedict氏反应作为一个标准。这个检测对测量简单的应激环境下的维生素C需要量是有帮助的,但当用作注射用治疗参照时,不够准确。15年前,我们发明了硝酸银尿检测,这个检测用105%的硝酸银和10滴尿液,置于Wasserman试管中。二分钟后读取它的结果,它将给出一个颜色相,显示白色,米黄,烟灰或碳黑或任何两种颜色的组合,取决于其在尿液中的饱和度。我们发现这种颜色指数检测是所有医生都需要的,以确定正确的抗坏血酸使用量.不管抗坏血酸是作为特异性用药,或者作为配合其他抗生素治疗的辅助,或者作为中和性化学物,通过口服,肌肉,静脉途径处理各种类型的人类病理情况。在严重的病理情况下,这个尿样本,每4小时采一次,如果要确立阳性临床结果,必须要显示一个很细的碳样沉淀,并伴有上层清液。药物在尿中溢出并非鲜闻,Abraham Keefer已展示过,静脉注射青霉素后,从尿中排出的青霉素达使用量的60%

 

在细胞间的反应,中和毒素以及可能控制病毒复制中抗坏血酸发挥的作用

1935年,Stanley分离出一种拥有烟镶嵌型病毒的特征的晶体状蛋白。它含有二种物质,核糖核酸(RNA)和蛋白质。这种烟镶嵌型病毒的简单结构特征很快发现是许多人类病毒如柯萨奇病毒(我认为是多发性硬化症的发病原因)、埃可病毒、脊髓灰质火炎病毒的基本特征,他们都含有RNA和蛋白质,其他病毒如引起流感的病毒,含有增加的类脂和多糖。脱氧核糖核酸(DNA)用于编控大病毒,如流行性腮腺炎病毒,核糖核酸用于编控小病毒,如麻疹病毒。蛋白膜用于保护寄生物,但当它流经血管高速路淋巴系统时,蛋白膜分解核酸,以进入特定的细胞。没有它的蛋白膜,单一核酸可以被血液成分灭活。有几种关于病毒进入细胞后发生什么的情况的理论:

 

A.一旦进入特定细胞内,病毒的核酸分离它的蛋白膜并进一步改变宿主细胞或产生突变,或直接代替它的核酸;

 

B. 传染性核酸,进入人体细胞后,保留它的蛋白膜并开始生产本身的蛋白膜[16]和病毒核酸,因此,新病毒或者离开进入其他细胞或通过破坏宿主细胞,因而,使感染更加严重;

 

C.由Starr假设的在细胞病毒相互作用方式中,外来核酸碎片的引 入。在Starr[17]的理论里,可以存在由染色体装配而成的部分细胞以及由多个细胞核组成的细胞。Hiliary Kropowski坚持,这些部分细胞是假病毒'pseudo-virons'[18]并在某些肿瘤-病毒感染中被发现。在Starr-Kropowski构思中的一个关键因素是,尽管异常的形态和遗传缺陷,这个细胞维持它的生物完整性以支持病毒发育。如果这些被侵袭的细胞被消灭或侵入者被中和,病变将会突然中止。抗坏血酸有进入所有细胞的能力。正常情况下,它的存在对细胞是有益的,然而,当细胞被外来物侵犯,像核酸病毒,抗坏血酸的酶性作用有助核酸病毒降解为腺苷脱氨酶,后者再转化肌苷。总体效果是导致嘌呤的产生,并进一步被彻底分解。而不是被用于核酸合成的嘌呤。抗坏血酸也和其他病毒蛋白一起制造一个大分子,充当一个阻遏物因子。已经显示,当和阻遏物结合时,这个操纵基因—核酸病毒,不能和其他物质发生反应,以及在结构性基因诱导活动。因此,抑制新病毒的繁殖。这个大分子产生的破裂和破坏作用亦超过细胞膜的拉伸强度。另一个假说是维生素C产生新的无活力的“L”病毒。还有一个假说,认为绑定本身已足够破坏这种病毒。

 

大剂量抗坏血酸在避免和头项强直和支气管炎有关的致死性脑炎的快速效果

 

1953[19],我们呈送了一个患病毒性肺炎病人的医案和记录片。病人处于昏迷状态,体温106.8F(腋探),以140克抗坏血酸在72小时内分次静脉给药。之后,她苏醒过来,坐在床上,进食流质食物,体温正常。自这以后,我们发现更多的致死性综合征和病毒有关。这是其中一个常常袭击上呼吸道的腺病毒,产生发热、喉痛、流眼泪、而在儿童,可引起致死性肺炎。更多的死亡是由可在30分钟导致死亡的原发性脑炎引起。这些就是死在床上,认为死因是窒息的婴儿和儿童(SIDS,突发婴儿死亡综合征)。它的确是窒息,但由一种我们在1957[20]观察到和报告的综合征引起的窒息。这种综合征和在脑破伤风-毒血症的高峰期出现的膈肌痉挛,伴有呼吸困难,最终出现窒息[21]的情况相似。到1958[22],我们已从我们的诊所和医院的病人收集到足够的资料,把这种致死性综合征分成重要的二期:

*第一期:

。通常都经历一种“流感”,持续48~96小时,并有极其严重的身体和精神痛苦;或者

。一种普通感冒像过敏性鼻炎,延绵几个星期,但没有令病人失去能力。

*第二期:

。惊厥性痉挛;

。极度兴奋,手足震颤;

。重度恶寒;

。常在吃或喝过程中窒息(球茎型)

。昏倒;

。昏呆(应答性降低);

。偏瘫型。

 

此触目惊心的第二期的其他症状:

。脉博加速;

。体温可以正常、低烧或高烧;

。呼吸急促,是正常时的2~3倍,某些时候提示缺氧;

。瞳孔轻度打开,某些情况下(偏瘫)显著散大;

。白细胞计数:6,000~25,000,有差异的多形核细胞增多

。以惊厥开始的年青病人,不但有正常的肠蠕动史,而且,在第一次检查时进行的灌肠排出正常的大便;

。在我们的病例中有惊厥或处于昏迷的病人,膀胱括约肌功能异常。

神经系统变化

很明显,第二期综合征是由血脑屏障的突破而触发。神经系统的改变变得明显所需要的时间和严重脑外伤之后产生同样症状所需的时间相近。两种情况都存在大脑积水。在我的经验中,我立即给予大剂量抗坏血酸。我看过儿童在30分钟至2个小时内死亡,因为主诊医生在他们进医院后没有注意到他们的病情实质。这些死者当中的一个,显示双侧性肺炎,足以引起致死性脑炎。为表明这种综合症提示它自己如何经常出现,我引述一份报纸对一位15岁姑娘的叙述,她得轻度,持续性感冒已有几个星期,一天晚上,她参加了一个聚会,除了曾诉说极度疲劳之外,她上床时显然是正常的。次日早上,她被发现死于床上。尸体解剖发现,双侧肺炎。你曾读过多少这样的报道?这是为什么每个人都应该服用足够量的抗坏血酸,以保护自己免受这类灾难性事故的侵害原因。

 

文献研究

1960年,在写我们的论文:病毒性脑炎是肺炎的一个后遗症” [22]之前,我们决定研究有关文献。Rosenfield1903年,以标题:紫癜或出血性脑炎描述过一个类似的综合症,Comby1907年,是第一个呼吁关注令人感兴趣的转移性肺炎后遗症。Baker Noran1945年列举了5组临床症状,每组都表现出一些对本病毒综合征[23]有诊断和预后意义的特定的临床特征。

。没有特异性本质的症状:头痛,呕吐,烦躁不安;

。谵妄,发狂;

。惊厥型;

。嗜睡型;

。偏瘫型。

 

这几组加上二类,就是:

。恶寒—血液发病型;

。昏倒。

 

是正如我们报告的,独立地出现在195810月的三州医学杂志 Tri-State Medical Journal)相关报道。他们的结果:部分死亡,部分康复,而部分以植物人意识残废者方式生存。而我们的病人均完全康复,包括从Baker-Noran的报告到我们的报告的13年,以及从我们的报告到现在的,又一个13年。这个结果使这个出版变得很紧迫。医生必须认识到持续性头痛或支气管炎的内在危险并赏识早期大剂量抗坏血酸治疗的重要性。

 

大脑怎样变成脑炎—一些推测

像这几组出现的临床问题,引导你推测病毒进入大脑的途径。我们总结如下:

。通过嗅神经;

。通过食物,从胃的入口,或肺,或上呼吸道的引流液。

。从中耳炎的直接漫延或乳头细胞;

。通过血流。病毒以下面三种方式通过脑脊液屏障,和,或者,血脑屏障,进入大脑:

* 电荷;

* 组织的化学溶解;

* 渗透作用。

 

Bakay [24]报告,血脑屏障的通透性可被进入血液循环的各种毒性物改变。在调节中枢神经系统的血管通透性方面,Chambers Zweifach [25]强调细胞间质的重要性。在这种综合征里,毒性物就是腺病毒。抗坏血酸修复并维护毛细血管壁的完整性。

 

烧伤程度解释和一些治疗依据

 

在烧伤的治疗中,足够数量的抗坏血酸,反映它本身是一种真正的奇迹性物质。在40年代早期,当我使用肌注抗坏血酸,治疗志贺氏杆菌引起的杆菌性痢疾,取得极好效果时,LundLam和其他许多人,使用他们声称的大剂量抗坏血酸治疗烧伤。每日1~2克,以液体形式,是认可的剂量。烧伤是在开始的第一度,有些还只是红斑。许多时候,一度烧伤很快发展至第二度阶段并持续呈水泡状态。还有其他继续发展至第三度,在烧伤的三日后更为突出。还有因为缺乏治疗知识而导致的第四阶段,最终需要植皮和整形手术。我们认为,抗坏血酸可以消除第四阶段以及第三阶段,如果按我们后面将设计的方法使用。

 

烧伤—继续描述和相关治疗

从事故的那一刻起,烧伤的病理生理一直是在一种动态的变化中,直至愈合或者病人死亡。烧伤中首先要考虑的血液瘀积现象,最初由Knisely1945[26,27]认识到。最初是红细胞在血管内的凝集,逐渐变成看得见的、平滑的、硬的、强直的基本物质。Lofstrom1959年展示了,因为瘀积并进而减少了血流,组织的氧摄取量大大减少。Berkeley[28]1960年推论,这种瘀血现象或血凝集,导致烧伤部位的毛细血管栓塞形成,并波及远端的小动脉和小静脉,因此,产生比最初的烧伤所致的更大的组织破坏。缺氧产生更多的组织破坏。Lund Levenson[28]发现,严重烧伤后,抗坏血酸的代谢有很大的改变,表现在,在禁食或饱和试验后的低抗坏血酸血浆浓度,或在禁食或注射试验量抗坏血酸之后的低水平的尿排出量。异常的程度和烧伤程度密切相关。Bergman[30]报告,在烧伤中,尤其当上皮形成和肉芽组织形成的时候,身体对抗坏血酸的需求增加。Lam[31]1941年亦报告,在严重烧伤病人,其抗坏血酸血浆浓度有明显的下降。Klasson[32]虽然限制抗坏血酸的剂量在每日300毫克~2000毫克的范围,分次使用,但发现抗坏血酸通过产生健康的肉芽组织,并减轻水肿,加速伤口愈合。他使抗坏血酸局部使用合理化,认为2%敷料有收敛特性,和过氧化氢相似。他亦报告,抗生素治疗几乎是不需要的。

 

严重烧伤和相关治疗

 

Harlen Stone[33]建议在严重的烧伤治疗中,使用庆大霉素以降低由假单胞菌属引起的脓毒症。从已感染的烧伤伤口的外毒素的吸收抑制网状内皮系统的细菌防御机制。死亡可由毒血症或一种并发的败血症而引起。我们已发现,在烧伤治疗中的秘诀可归纳为五个步骤:

.   用从前介绍的旧式覆盖车箱型的,带有三个25瓦灯泡的活动床。病人通过控制第一个灯泡的开关来控制温度以保暖。不允许穿衣和敷料。

    . 使用3%的抗坏血酸溶液,作为喷雾剂。喷雾可使用一个Devilbis喷雾器,以一个便携式活动压力泵来进行。旧式飞枪亦可使用,或以一个50CC的注射器,插

20号针头使用。3%的抗坏血酸溶液,每2~4小时使用一次,持续大约5天。

.   烧伤部位使用维生素A,维生素D搽剂,这个现已改为用3%的抗坏血酸溶液,

4小时一次。

.   过口服和静脉方式,使用大剂量的抗坏血酸。以每公斤体重500毫克,每克至少稀释至18CC5%葡萄糖溶液,生理盐水或Ringers溶液中,作为第一次的用量,以20号针头或导管的最大流量输入。减量通常是必要的。建议选择足踝部的静脉。头几天每8小时给予抗坏血酸溶液一次,之后改为每12小时一次。同时,给予抗坏血酸口服,至耐受极限,大便溏泄希烂通常是一个指标。使用大剂量抗坏血酸静脉点滴,有必要每日至少使用1克的葡萄糖酸钙,以补充在化学分解抗坏血酸为脱氢抗坏血酸,之后酮基古洛糖酸,然后,以草酸钙形式的草酸过程损失的钙离子。

    . 支持治疗。就是全血和维持电解质。

如果烧伤过后早期治疗,将没有任何感染和焦痂形成。这样排除了积液的形成。由于焦痂不存在,将没有任何远端的水肿。因为静脉和淋巴系统保持开放,将没有任何动脉阻塞和神经压迫。因为抗坏血酸在局部和全身系统性地破坏了这些外毒素,假单胞菌属将不会是一个问题。即使烧伤迟了处理,假单胞菌属这个格兰氏阴性菌将在几天内被消灭,留下一个清洁的健康表面。我看过2英寸宽,1/2英寸厚的焦痂,感染是如此严重,以至要用除臭剂喷雾以控制恶臭,这个焦痂用这里概述的方法溶解掉。抗坏血酸亦消除疼痛,因此不再需要阿片或等效药。在涉及前后躯体的广泛烧伤病人,应考虑英国人使用的“气垫床”。它使用气垫船升起一件物体同样的原理。在烧伤处理中一直被忽视的是,在烧伤部位有许多活的内皮细胞,粗心看似“生肉”,因抗坏血酸的使用,这些细胞得以保存活性,将会分化繁殖,不久将和增生的组织在新皮的形成中会合。

 

关于个人和环境污染—一氧化碳

我们都受不同程度的慢性一氧化碳中毒的折磨。这是我们为公路形成的“双轨铁路”,吸烟和赖于步行所负出的代价。少量的一氧化碳,如果持续停留在肺的小泡,可以产生严重的后果。吸进的空气中存在的一氧化碳可导致组织缺氧,产生极度的疲乏。一氧化碳和血红蛋白的亲和力是氧和血红蛋白的亲和力的300倍。除了快速代替血红蛋白,一些比例的羧基氧血红蛋白的存在减少了这种氧-血红蛋白的分离而保持原样。如果病人吸入由93%氧,7%二氧化碳组成的高压氧,一氧化碳可从血红蛋白中分离出来。而这不是可轻易得到的。抗坏血酸在血液中不停地失去分子水。完全干燥的一氧化碳和氧不能结合成二氧化碳,但在完全缺氧的情况下,一氧化碳和水,可产生二氧化碳。发生的反应是:COH2OHCOOH CO2H2Wright)伴随氢气的释放。谷胱甘肽通过作为氢的接受者(Hopkins)可能促进这个细胞内氧化。临床经验提示,如果抗坏血酸被突然加到血流—12~50克,通过闪电式氧化,一个足够高的氧浓度可把一氧化碳从血红蛋白中出来。这个快速形成的二氧化碳和这个高压氧发挥和面罩同样的作用,进一步增加这个化学作用的发生。抗坏血酸也将预防后遗症如:瘫痪,失明,感觉干扰,肌肉痉挛或在某些病例中可能是永久性的颤搐的发生。

 

在妊娠中的基本和持续性作用

通过对超过300例使用口服补充性抗坏血酸的连续的产科病例做的观察,令我确信,在孕妇中不使用这种物质至足够数量,近乎不良行为。使用的抗坏血酸,最低为每日4克,最多为15克。(记住,在鼠中,等同体重的鼠在无应激的情况下产生4克的“C”,而在应激情况下,达15.2克)。我们的孕妇,头三个月需要每日4克,第二个三个月每日6克,而在最后的三个月大约每日10克,大约20%的病人在最后的三个月,每日需要15克。80%的这组病人在入院时,接受10克的加强型静脉注射。血红蛋白水平更容易维持。小腿疼痛性痉挛的发生率少于3%,且通常和得不到抗坏血酸片剂有关。妊娠纹很少见,当出现时,常和过量进食和太少行走有关。皮肤抵御扩张的子宫的压力的能力和个体有关。产程更短,痛苦更轻。没有产后大出血出现。会阴被发现弹性很好,外阴切开术可选择施行。愈合总是第一期愈合。即使在生完最后一个孩子的15年和20年,会阴部的稳固,发现和那些连续每日服用补充性的抗坏血酸的初产妇的会阴相似。没有任何人需要导管插入。在这组病人中无任何人有妊娠中毒表现。虽然其中有22人有风湿性心脏病,没有任何人有心血管应激反应。其中一个,妊娠两次都没有合并症发生。她曾被她的产科医生警告,若再次怀孕,可能会死于妊娠。她怀第一胎没有服用任何抗坏血酸。这外女士返回教师岗位已有10年,她仍然每天服用10克抗坏血酸。所有在大剂量抗坏血酸环境下孕育的婴儿都很有活力。没有一个需要心肺复苏术。我们没有碰到任何喂养问题。Fultz的四胞胎也在这组婴儿当中,他们在第二天接受牛奶喂养。这些婴儿第一天服用50毫克抗坏血酸,当然,随着时间的推移,这个量要增加。我们的护理设备只是一张医院床,一个旧的,使用过的单一发热板,和10个旧的10夸兑的水壶。湿度和抗坏血酸告知这个故事。他们是美国南方唯一存活的四胞胎。另一个很自豪的是,我们为一对夫妇接生了10婴儿。全部健康好看。没有一次流产。全部存活和健康。他们常被喻为维生素C小孩。事实上,所有这个系列的婴儿都被护理员称为维生素C 婴儿他们鲜明地不同。

 

我们应怎样关心草酸和肾结石?一个技术性的解释

 

在每日大剂量抗坏血酸问题上,批评者使用的其中一个“吓人”的武器是草酸-肾结石假说。Meakins[36]强调在肾结石形成中的一个主要原因是代谢过程的倒错、感染和泌尿系统积液。在结石形成的成因上,有二个流派:1)。先有一个胶体核心,然后,类晶体沉淀在其上。 2)。在盐和氢离子是重要成分的高浓度的溶液中的类晶体从尿中沉积。在所有情况中,积液和尿浓缩看来都是重要的生理因素。抗坏血酸可以产生草酸的唯一方式,是通过内酯环的裂解。这在PH值高于5时发生。而当每日服用10克抗坏血酸时,尿液的反应结果是PH值为6。草酸沉淀只会在中性或PH值为7~10的碱性溶液中才会出现。Kelli and Zilva[37]报告营养实验显示,脱氢抗坏血酸在动物实验中被保护以阻止其进一步形成无抗坏血病作用的二酮古洛糖酸,草酸是从二酮古洛糖酸衍生。” Values在文献中指出正常情况下,人类24小时草酸盐排出量的幅度为14~56毫克。Lamden et al [38]发现,一组志愿者,每日服用9克的抗坏血酸,结果其尿液中的草酸盐排出量高至68毫克,而在没有附加抗坏血酸的对照组,最高的排出量为64毫克。

这些批评者忽视了患糖尿病的个体。这些糖尿病人的草酸排出量和每日服用10克抗坏血酸的正常人的草酸排出量几乎相同。在这些糖尿病人,我们发现了一个奇异现象。每日给予10克抗坏血酸口服,其尿液中的草酸盐排出量保持相对不变。糖尿病患者以多尿而闻名。每日服用10克或更多的人会发现这种有机化合物是一种很好的利尿剂。没有任何积液;没有任何尿液浓缩。

抗坏血酸肾结石故事是一个虚构的故事。二氯甲烷,65毫克,每日2~3次,会溶解草酸钙结石。(Dr. M. J. Vernon Smith: Med. World News, Dec. 4, 1970)

 

为什么死于昆虫和蛇咬?

 

估计在美国每年有6500人死于毒蛇咬伤。更多的死于飞虫,蜘蛛,某些植物和某些毛虫。这些是不必要的死亡。几种因素在这些病理中发生作用:

 

某些蛇伤,如铜头蛇或响尾蛇的毒性血清蛋白

甲酸加上一种以蛋白包裹的毒素,被Arthus[39]称为蛋白毒素proteotoxin)。比如在

蜜蜂和黄蜂发现的。

从黑寡妇(Black Widow)、 Fiddle 蜘蛛,毒蛇如眼镜蛇以及珊瑚中发现的神经毒素

组织胺的产生,特别是更严重的叮和咬后产生的组织胺。

Wells 1925[40]称某些蜘蛛和蛇的毒物为动物毒素zootoxins),而称毒性植物的毒为植物毒素(phytotoxins)。Ford[41]1911年报告在植物和真菌的三类毒素:

 

神经毒—蕈毒碱;

那些导致脂肪退化继而引起内脏结构改变的毒物

胃肠道剌激剂

 

用抗坏血酸抢救休克病人

这是一个经过验证的原理,在细胞受伤时,从脱氨基细胞蛋白质释放的组织胺和其他终极产物是休克的一个原因。当我们认识到,从受伤细胞产生的脱胺基酶被维生素C[42]抑制时,抗坏血酸在抗休克中的价值就清楚了。Chambers Pollock[43] 已显示,一个细胞的物理损伤会导致PH值的改变,这个改变会逆转细胞酶的活性,从建设性变为破坏性。这些PH值改变会扩散至其他细胞。这些破坏活性释放组织胺一种主要的产生休克的物质。抗坏血酸的存在,抑制这种酶转变成破坏相。Clark Rossiter[43]报告休克状态和应激反应导致血浆内含物的抗坏血酸的耗竭。对病毒体,抗坏血酸也和这些毒素的蛋白因子结合,产生快速的破坏。

 

这些紧急问题的解决答案非常简单,大剂量的抗坏血酸,每公斤体重350~700毫克,静脉内注射。在年纪小的病人,静脉仍小,抗坏血酸可很容易肌注,每部位可注射大至2克。每次用量可分在几个部位注射。以冰帽敷臀肌至发红,几乎消除疼痛。在注射后,我们经常给予冰敷。抗坏血酸亦给予口服,作为后续治疗。每个急诊室应该储备足够强力的维生素C安瓿,使得在抢救生命时随手可得。420CC的安瓿和1050CC的安瓿必须为医生准备好。

 

一个病案,成功是因为12克抗坏血酸注射的速效性

 

作为某些叮咬的致死作用的一个例子,我简单叙述一个医案。一个成年男性,来到我的诊所,诉说严重的胸痛和不能进行深呼吸。他说他在10分钟前被。想到这个是黑寡妇Black Widow)蜘蛛所致,因而不急于去看牙齿痕。因为情势紧急,我给予1克葡萄糖酸钙静脉内注射。这处理没有产生任何改善。他恳求帮忙,说他就快死去。他出现紫绀(因缺氧而出现蓝色或青紫色的皮肤)。12克的抗坏血酸加到50CC注射器,以20号针头最快的速度静脉内注射。甚至在推注尚未完成,他就惊叫,感激上帝。毒物就这么快速被中和了。他被送回家以寻找那个“凶手”。他很快回来,带来一个像老鼠的物体。它长11/2英寸,毛发棕色。整个背部有一个黑色的隆起物。它有七对推动足以及一条很像老鼠的尾巴。次日,我把这东西带到Duke大学,在那里,它被证实是一条毛虫(Puss Caterpillar)。这个不同寻常的毛虫在受害者的背部留下了44个红色的突出的齿痕。如果不是维生素C,这个人可能已死于休克和窒息。

 

 

对大剂量抗坏血酸的担心的回答

Merton Lamden,一个生物学家,在1971年二月的新英格兰医学杂志上表达他对口服大剂量抗坏血酸安全性的极大的不相信。他引用Paterson[45]的关于脱氢抗坏血酸在鼠上引起糖尿病的作用的报告。在1950年,Paterson只使用包含抗坏血酸和脱氢抗坏血酸的Ketone配方(Ketone Formula),不作任何希释地,极度不寻常大量地静脉注射。他的结果建立在受试动物鼠,体重100~120克,脱氢抗坏血酸的量从20~50毫克。这个转换成70公斤体重的人,将代表一个3500~5000克的抗坏血酸的剂量。很显然,这个研究和人类口服抗坏血酸无任何联系。自从我18年前最后一次访问这所学院,我每日口服10~20克抗坏血酸。我无糖尿病,并且,如果我离开主题,我亦无肾结石。

 

糖尿病对口服10克抗坏血酸的反应

过去的17年,我们研究了糖尿病病人,每日口服10克抗坏血酸的效果。我们发现每个没有服用抗坏血酸补充剂的病人,可以被诊断为患有隐性坏血病。因为这个原因,病人发现伤口难以愈合。糖尿病人将使用补充性抗坏血酸以促进胰岛素的更好利用。它将在碳水化合物的代谢方面帮助肝脏并恢复他的身体像正常人一样的愈合伤口的能力。我们发现60%的病人可通过节食和每日口服10克抗坏血酸而控制。其他40%的病人将需要少得多的胰岛素注射和更少的口服治疗。和送到医生的医学新闻信的情况相反(Vol. 12 # 26, Dec. 25 1970),在检测尿样本中,Tes-Tape测验(一种尿液检测试纸)是准确的。

 

术后病人血浆抗坏血酸水平的观察.推论是术前需要补充相当数量的抗坏血酸

1960年,然后再在1966年,我在三州医学 Q2Q会发表的报告上,呼吁关注在手术后病人中发现的坏血病水平的抗坏血酸。记录的血浆抗坏血酸水平,麻醉前,吸入麻醉结束后以及手术完成后保持不变。这个结果导致许多人相信,外科手术产生很少或甚至不产生对“C”的补充性需求。然而,我们发现,取自术后6小时的血液样品,显示比开始时下降了1/4,而在手术后12小时,血浆水平下降为原来的1/2。而在术后24小时,没有补充抗坏血酸的样品,比原来下降了3/4Baylor大学的研究小组在1965年亦报告了类似的发现。Bartlett, Jones[48]和其他研究人员亦报告,尽管在做手术时血浆的抗坏血酸水平低下,正常伤口愈合能力可通过术后补充足量抗坏血酸而产生。Lanman and Ingalls[47]显示,正在愈合的伤口的伸缩性在坏血病血浆水平出现时,比正常的低。Schumacher[48]报告,术前口服少至500毫克的维生素C,在预防拨牙后出现的休克和虚脱非常成功。许多其他研究者,已经在实验室和临床研究显示,最佳的基本伤口愈合,在很大程度上,取决于组织的维生素C含量。

 

1949年,我有机会在一个腹部探查性剖腹术中担当助手。一小块内脏组织被发现粘在一起。这个部位是如此脆弱,每次试图分开它都会导致小肠的撕裂,在作了20处修补之后,外科医生在绝望的情况下缝合了伤口。在48小时内,每2小时给予2克抗坏血酸静脉注射。随后改为每天4次。病人在36小时内,就在大厅内行走,而在第7天,病人痊愈出院,并没有疼痛。她比她的外科医生估计的长寿许多年。我们建议所有病人每天口服10克抗坏血酸。没有这样做的人,当选择手术时,手术前的几个星期应给予每日10克的抗坏血酸。术后,至少每天给予30克抗坏血酸,配成溶液静脉滴注。直至可以口服并且耐受。

 

单核细胞增多症可用抗坏血酸改善

在研究了数以百计的学生后,Yale大学的研究者,找到证据,就是支持这个联系:单核细胞增多症和E-B(Epstein-Barr)病毒,一种疱疹样物有关。而这种病毒亦和Burkitt淋巴瘤[49]有关。大剂量静脉注射“C”,对单核细胞增多症的病程有显著的影响。一个正接受为她举行的最后一次教堂仪式的病人,女孩的母亲把东西塞在她手里,当主诊医生拒绝给予维生素C时,在每瓶静脉滴注的液体,她都会快速塞进”20~30克维生素C。病人取得顺利的康复。她的母亲获得护理学学士学位,而同时是长期的“C”治疗支持者。

 

抗坏血酸有抗癌特性吗?

Tulane 大学的Schlegel[50]一直使用每天1.5克抗坏血酸预防膀胱癌的复发。他和生物学家Pipkin已经可以显示,只要有抗坏血酸的存在,致癌代谢物便不能在尿液中形成。他们认为,肿瘤自发形成是由于当尿液在膀胱停留时,色氨酸代谢 失调的结果。Schlegel称抗坏血酸为一种抗癌维生素。沿着这个方向,Glick and Hosoda[51]报道Von Numers Pettersson的研究结果,天竺鼠皮肤的肥大细胞的耗竭是由于抗坏血酸的缺乏。这个可能性显示,维生素C,直接或间接地,对肥大细胞的形成以及其功能的维持,是必须的。如果每天口服20~30克,抗坏血酸可以控制骨髓细胞性白血病。

 

你只可以推测何等程度的大剂量治疗对各种类型的癌症会起什么样的作用。许多病理情况可通过在4~6星期内,静脉点滴500百万~100,000百万单位的青霉素而治愈。我们必须要等多久才会看到某位医生开始,以每天200~300克的抗坏血酸,对各种恶性病变进行连续2~3个月的静脉点滴?

 

休克的巴比妥酸盐中毒病人用抗坏血酸恢复正常

Clemmesen[52]指出,在处理巴比妥酸盐中毒症的重要原则是,抗休克,连续给氧和保持呼吸道畅通。Hadden et al[53]提出6项措施作为支持治疗。为实施这些功能,一个严密监护室是必须的。所有人都应该要做的是给予足够量的抗坏血酸治疗。一个服了2640毫克的Lotusate(talbutal,塔耳布妥)的病人正在急诊室被处理,血压为60/0。用50CC注射器给予12克维生素C静脉注射,然后把针头插到含有50克抗坏血酸的5%葡萄糖溶液中。在10分钟内,血压回升到100/60,显示抗坏血酸对休克的效果。第二瓶含有1Ethamivan (Emivan)(香草乙二胺,以前作为呼吸兴奋剂使用,但现在已不推荐使用,因为有效量接近中毒量)的5%的葡萄糖溶液在另一手臂开始静脉点滴。病人在三个小时内苏醒,服用加了“C”的果汁。她在12个小时内通过静脉接受了125克的抗坏血酸。抗坏血酸不但帮助肝脏的代谢,而且亦是一个强力的利尿剂,通过肾脏冲洗那些复合物。同时亦给予每分钟6升的输氧。另一个病人,吸了2400毫克的速可眠和仲乙醛,经以20号针头最快的速度静脉注射了42克的抗坏血酸后苏醒过来,她在24小时内通过静脉接受了75克,同时口服了30克抗坏血酸。

 

当每天抗坏血酸摄入量高时,胆固醇不是一个问题

抗坏血酸发挥作为体内胆固醇形成速度的调节剂的作用[54]应受关注;这种维生素的缺乏加速这种物质的形成。在实验性的研究显示,进食不含抗坏血酸饮食的天竺鼠,其肾上腺胆固醇形成的速度显示增加了600%。每天10克或更多,然后吃你想吃的鸡蛋。这就是我的程序表,而我的胆固醇始终保持正常,俄国已经出版了许多文章,显示这些同样的益处。

 

缓解牙关紧闭

在许多病变的治疗中,把抗坏血酸作为辅助,配合其他药物使用,没有更好的替代物。和mephenesin(商品名,Tolserol)配合,对牙关紧闭有治疗作用。两种药物都必须使用适当的剂量。在我们的病例,一个体重20公斤的男孩,使用1000毫克的Tolserol静注,产生最佳的效果。在48小时内,他被给予90克的抗坏血酸和3000毫克的Tolserol,都是静脉注射。Jungeblut[56]报告,在动物实验中,当把维生素C加到破伤风毒素中,令毒素灭活。

2例旋毛虫病被处理,并使用维生素C和对氨基苯甲酸[57]治愈。虽然体温曲线在36小时内回复正常,但发现需要9天的治疗才能彻底治愈。

 

缓解感染性肝炎

病毒性肝炎需要作简短地说说。肝炎有二种类型 :1)感染性肝炎;2)针头传播性肝炎。体力性活动一直认为会加重疾病的严重程度和延长其病程[58]

在越南,Freebern Repsher发现,199例保持卧床休息[59]的病人对比,进行体力活动对199例对照组的病人没有任何影响。有一样是肯定的,给予大剂量抗坏血酸静脉治疗,病人会在3~7天内恢复正常和重返工作。在这些病例,这种维生素亦给予口服作为后续治疗。在瑞士的贝塞尔大学诊所的Bauer医生报告,只需每天10克的抗坏血酸静脉注射,证明是可实施的最好的治疗。

 

抗坏血酸治疗用于各种疾病

我们可以连续不断地赞美抗坏血酸的功迹。

Boyd and Campbell[60]报告在角膜溃疡的愈合中的极好效果,即使他们的巨大剂量只是每天1.5克。在一个被老式火柴的磷而引起的角膜烧伤病例,其疼痛马上被12克的抗坏血酸,以50CC注射器静脉注射缓解。另外,处以每小时1克,口服,连服50克。角膜在不到24小时内恢复正常。

 

只需注射一次抗坏血酸,以每公斤体重500毫克计算用量,将治愈中暑。

 

注射1~3次这种维生素,以每公斤体重400毫克的范围计算用量,将对病毒性全心脏

产生显著的治愈效果。

 

1~2小时口服1克的抗坏血酸将预防太阳灼伤

 

静脉注射将快速缓解疼痛和太阳灼伤, 即使当未采取预防措施而至的第二度烧伤

 

以每公斤体重400毫克,每8小时一次静脉注射1~3次,将会令水痘24小时内

沽”。

 

如果有恶心,它消除恶心。

 

这些注射通常以每1克希释至5CC液体,以注射器注射。这个浓度会产生立即的口渴。这可以通过让病人在注射前喝一杯果汁而避免。

 

40克抗坏血酸静脉注射加上2000毫克维生素B1肌肉注射,将中和酒精中毒病人的中毒,如果他在使用了戒酒硫(商品名,Antibuse)后喝酒,将挽救他的生命。

 

如果每天使用10次或更多,5%的水溶液搽剂将治愈急性热病性疱疹,并且,使用30%的搽剂我们已去除了上皮瘤的几个基础细胞。

 

意大利罗马大学眼科诊所的Virno[61]医生,报告了用每公斤体重100毫克,在饭后和睡前服用,对青光眼有令人鼓舞的结果。他亦报告这些剂量是安全的。

 

关节炎,至少每天10克,而那些每天服用15~20克的病人,将取得相等的效果。支持治疗必须要给予。胶原组织的修复依赖于足量的抗坏血酸。

 

天花接种引起的合并症可用口服足量抗坏血酸处理。有几次,我们发现有必要“C”和腺甙一起静脉注射。20%的鱼石脂局部应用于牛痘坏死是不错的心理治疗。

 

带状疱疹2克维生素C肌注和50毫克腺苷酸水溶液,也是肌注,每12小时一次。安息香复合酊剂局部应用有帮助。

。大范围的带状疱疹,抗坏血酸应静脉给药。同时总是口服至耐受极限量。重金属中毒亦可用足量的维生毒C治疗解决。

 

每天1~10克抗坏血酸产生的广泛的无处不在的好处

现在认为,抗坏血酸代谢可能是整体代谢的一个指标,因而作为一个基本的诊断指引。成人每天至少10克,10岁以下儿童每周岁服1克,会发现大脑更清醒,思维更活跃,身体更少忧虑以及记忆力更好。

 

小结

 

以大剂量抗坏血酸治疗的病变类型涵盖整个医学知识范围。身体的需要是如此大,以至称为最少每日需要量的概念必须要被漠视。一个遗传缺陷可能是我们不能制造抗坏血酸的原因,因而需要外部来源的维生素C。为检测个体对抗坏血酸的需要,可利用简单的染色或化学检验。通过占据膜蛋白至使新病毒不能制造;通过控制嘌呤代谢而导致促使核酸病毒的降解,抗坏血酸破坏病毒体。它对病毒性肺炎和病毒性脑炎的作用概要已被列出。维生素C在肺炎的临床使用有扎实的依据。在实验性试验中,连续进食不含抗坏血酸的猴子都死于肺炎,而那些进食足够抗坏血酸的猴子则保持健康。许多研究者已发现这种情况下对抗坏血酸增加的需要。在研究了维生素C和感冒的关系后,Brody建议抗坏血酸应在早期并常给予足够的量。Regnier报告,在评估了过敏症之后,发现量越大效果越好。我们的发现导致每小时1克,连服48克,之后,每日口服10克的程序表。那些10岁以下的,每周岁每日至少1克。

 

病毒性脑炎

病毒性脑炎是一个致死综合征,必须要果断地用静脉注射或肌注抗坏血酸治疗。我们建议一个剂量表,每公斤体重350~700毫克,每1克的“C”希释至至少18CC5%葡萄糖溶液中。在小童,可每2小时肌注2~3克的抗坏血酸。一个冰帽放于臀上将预防疼痛和硬结。如果注射液已经加进碳酸氢钠和亚硫酸氢钠以缓冲其安瓿,每公斤体重400毫克以下的用量可用注射器,以每克希释至5CC溶液静脉内注射。多达12克的抗坏血酸可以这种方式用50CC注射器给予。更大的数量应以瓶装葡萄糖或盐水溶液希释,并以静脉点滴方式给予。这是正确的,因为,像20~25克,可以100CC注射器给予的数量,可以突然令大脑皮层脱水,产生腿部的惊厥性活动。这代表一个奇特的综合征一个症状性癫痫,病人意识清醒,没有经历任何模糊意识,除了下肢有轻微的抽搐外。这种癫痫型发作将持续20分钟以上,然后突然停止。轻微的压力按在膝上会停止它,只要保持这种压力,它就不会复发。如果仍在发作的期限内,只要松开压力发作便会再出现。我曾在两个,第二次接受用100CC注射器,静脉内注射26克抗坏血酸的病人发现这种综合征。一个有脊髓灰质炎,另一个是恶性麻疹。两个都是成年人。肌注通常是500毫克加到1CC溶液。如果连续静脉内注射大剂量抗坏血酸,每天必须至少加1克葡萄糖酸钙到静脉点滴的溶液中。这样做是因为,我们发现,当脱氢抗坏血酸的内酯环被打开时,大剂量的抗坏血酸会吸引血小板或钙-凝血酶原附近的游离钙离子。失去钙离子的第一征象是鼻出血。这和有时在水痘和麻疹出现的鼻出血不同。后者代表抗坏血酸缺乏引起的显性坏血病。其病理是毛细血管的脆弱性[66]

 

烧伤

一种治疗烧伤的新方法的大纲已经指出,如果依此治疗,将排除皮肤移植和整形外科手术。这种方法可能因为过于简单而难在短期内接受。医学文献提示抗坏血酸对烧伤治疗的价值已有许多年。但合适的局部应用和系统性使用方法一直都是误导的。一个人只需看一例恰当使用抗坏血酸治疗的烧伤,就会赏识它的重要性。如果抗坏血病能够破坏破伤风的外毒素,就如Jungeblut展示的,它也能够破坏假单胞菌属的外毒素。抗坏血酸在维持身体体液平衡中发挥重要的作用。Ruskin指出,这种维生素激活精氨酸酶,后者分解精氨酸,导致其中一种对组织液平衡起关键作用的尿素的产生。

 

妊娠

妊娠的简朴压力需要补充性维生素C。这个量因人而异。硝酸银尿检测将简化这个操作过程。维生素C看来特别亲和间质组织。当你考虑胎儿和婴儿,尤其是早产儿的需要,很明显,妊娠期间大剂量维生素C的摄取是必要的,因为这个寄生物会从母体内抽取可利用的“C”Greenblatt[67]报告采用口服维生素C治疗习惯性流产有极佳的效果。在我的实践中,我使用维生素C,能够让有5次流产而没有一次成功妊娠的妇女,顺利地怀孕2~3胎。德国媒介有成堆的文章,建议在妊娠期间口服大量的维生素C,因为他们相信这种物质对孕妇的健康和预防感染有极大的好处。抗坏血酸对身体组织的关键贡献可归纳为细胞间的物质,尤其是连接性组织、骨骼、牙齿和血管的形成和维护。如果准母亲每天服用10克或更多的抗坏血酸,遗传缺陷有可能被有效预防。我们发现,孕妇在妊娠这个正常的生理过程的简朴压力下,和大鼠在应激情况下有相等的需求,这个是很有意义的。King et al的实验已显示,对维生素C的需要从胚胎开始。

 

肾结石

大剂量抗坏血酸对肾结石的哧唬人的”因素由来已久。由于尿液的PH值通常是6。你会明白内酯环的打开是缓慢的过程。这个反应通常在组织发生并可能由存在的谷胱甘肽调节。重要的考虑因素是,要产生相当数量的类晶体沉淀,你一定要有浓缩的尿液`,积液必定是一个因素,尿液必须要是碱性的。这种情况在大剂量抗坏血酸治疗中绝对不会出现。而且,在一个对照性的实验中,对照组几乎排出和每天服用9克的抗坏血酸的志愿者同样多的草酸。

 

昆仑、毒蛇咬伤

在毒蛇咬伤和蜘蛛咬伤,大黄蜂叮咬以及旋毛虫反应的结果的快速性展示了其在抢救中的有用性。最好用注射器静脉内给予因为瓶装准备时间太长。一个预防措施必须做足。有一种2克的抗坏血酸安瓿,而讽刺的是,它是我所知的唯一被FDA批准的抗坏血酸安瓿,这个安瓿会杀人,如果不作希释便用注射器直接使用的话。每安瓿含2克抗坏血酸钠。安瓿内含:硫代甘油0.4%,甲醛合次硫酸轻钠0.05%,尼泊金甲酯0.13%,尼泊金丙酯0.015%,以碳酸轻钠缓冲至PH6;注射用水。这个安瓿只有在每1克至少希释至25CC才能静脉内注射。有时可能会出现极不寻常的过敏和休克症状伴随急性呼吸道梗阻。在这种情况下,一定要使用苯海拉明,静脉内和或肌肉注射,以及肾上腺可的松激素如地塞米松(Decardron)。这些可在准备抗坏血酸时由护士给予。如果没有这些,第二注射器的抗坏血酸亦可满足治疗所需。应给予口服液体以预防或纠正所有病人看来都会感觉的口渴。

 

糖尿病

大剂量抗坏血酸不会如认为的那样,引起糖尿病。相反,每天10克,口服,已经证明是有益的。10克会让这些病人像常人一样愈合伤口的事实在将来将保全许多完整的腿。Lamden,一个生物化学家,由于误译了Patterson在鼠实验使用Ketone配方(Ketone Formula)静脉内注射导致的结果,煽动这些忧虑。

 

在外科手术中

 

在外科手术中,抗坏血酸的使用成为一个“必须的”状况。 这个术后24小时测出的显性抗坏血病水平应是足够有力的证据,鼓励所有外科医生在他们的液体中放心使用维生素C。维生素C被外科医生的适当使用将消除所有术后死亡。

 

在恶性肿瘤

一个延长时期的,很大量的抗坏血酸静脉内给药提供了一个医学挑战。从一个装置碳-14辐射的房里生长的卷心菜和番茄,可提取放射性抗坏血酸,然后用于微量研究。至少一个研究小组已显示,在癌症中,所有可利用的“C”都动员至恶性肿瘤的部位。Lauber and Rosenfeld报告“C”从身体组织动员并选择性集中到受到创伤的部位。在一个绝望的病例,我们每天使用17克,连续用了92天,但始终不能改变和坏血病相关的血液和尿液的抗坏血酸水平。这是我们相信一个每天100~300克的剂量范围,通过连续静脉点滴几个月,可能会有意想不到益处的原因。伴随这样的研究,应每天跟综血液的化学变化。Schlegel发现,即使每天1.5克的剂量,口服,将预防膀胱癌。

 

巴比妥酸盐中毒

我们在不少于15例的巴比妥酸盐的中毒的发现提示,任何死亡都不应该因判断错误而产生。我们也观察到,静脉内注射12克对休克的血压的影响。中暑出现的休克在注射完后已经被纠正。使用的剂量是每公斤体重500毫克。

 

破伤风—旋毛虫病

在破伤风的治疗,抗坏血酸和美芬新(mephenesin(商品名,Tolserol)的配合使用,应被接受为普遍的治疗。这里,再次强调,剂量必须要适当。在决定这些剂量时,我们这里报告的病例,应作为一个指引。抗坏血酸配合对氨基苯甲酸对旋毛虫病有治疗作用。两种药物都通过口服使用。据估计在美国,至少有500万例慢性旋毛虫病患者。只需9天就可能这些病者回复正常。在我们的病例,每天给予10克抗坏血酸口服,同时使用大剂量的对氨基苯甲酸。开始4~6克,然后,每2小时3克,连服8次。余下时间,程序表是白天每2小时3克,而在晚上则是每3小时3克。

 

 

病毒性肝炎

抗坏血酸是病毒性肝炎应选择的药物。使用的剂量范围是每公斤体重400~600毫克,依病情的严重性而定。应该每8~12小时给药一次。每天亦应分次给予共10克的抗坏血酸口服。那些低于10岁的儿童,通常的剂量表是每周岁至少1克。

 

各种各样的使用

我们评估了抗坏血酸在康复中起重要作用的其他病理情况。这些病况可能包括心血管疾病、月经过多、胃及十二指肠溃疡、各种手术后情况和辐射疾病、风湿热、猩红热、脊髓灰质炎、急性和慢性胰腺炎、免热病、百日咳和肺结核。在一例青霉素和磺胺药不能改善的猩红热病例,50克抗坏血酸静脉内注射产生显著的发烧曲线下降到正常。在这里,抗坏血酸的作用不仅是直接的,而且还是协同作用者。一种类似的情况也在大叶性肺炎中观察到。在另一个在非法人流后出现的产后脓毒血症的例子,初始的抗坏血酸剂量是每公斤体重1200毫克,接着2次的注射剂量是每公斤体重600毫克水平,配合青霉素和磺胺嘧啶,入院时的体温105.4∞F9小时内回复正常。病人获得顺利康复。在一例非常严重的黑寡妇毒蜘蛛咬伤案例,毒蜘蛛咬了一个3 1/2的小孩,小孩处于昏迷状态,一到诊所就给她1克的葡萄糖酸钙和4克抗坏血酸静脉内注射,之后,每6小时以20CC注射器静脉内注射4克抗坏血酸。她在24小时内苏醒和好转。体格检查发现一个昏迷的小孩,腹部板硬。脐周围发红和呈现硬结,提示一个绞窄性脐疝。以一个4倍的放大镜,牙齿痕看得很清楚。维生素C治疗30小时后,小孩吐出大量的黑色瘀血。没有任何后遗症,对文献的评估证实,这个小孩是这种病例的唯一幸存者。其他报告的都经尸体解剖。10克维生素C200~400毫克维生素B6,每日口服,将保护你不受蚊子叮咬。20%的人还需要每周注射100毫克维生素B6

 

基本营养

维生素C 在基本营养方面发挥重要作用。这种物质的不足够可以是食欲减退,体重减轻或发育不良,肌肉无力,贫血和各种皮肤损害的一个因素。维生素C和牙龈和牙齿的关系长久以来都被认可。实验室关于牙龈-牙齿连接组织的研究再次证实了这种关系。我们的孩子这个七月将满19岁,他从未长过牙洞。从10岁开始,他每日至少口服10克的抗坏血酸。10岁以前,剂量相应减少。

 

静脉应用

一定要以注射方式给予抗坏血酸以快速逆转各种对人体的“侵害”。我们已发现用量一定要在每公斤体重350~1200毫克之间。每公斤400毫克以下的注射,如果已含碳酸氢钠和亚硫酸氢钠缓冲,可用注射器直接静脉内注射。每公斤体重超过400毫克的剂量,尤其是这里讨论的安瓿,这种维生素必须要希释至每克18CC5%的葡萄糖溶液,生理盐水或Ringer氏溶液中使用。许多时候,要达到疗效,腺苷酸,儿童25毫克,成人50~100毫克,肌注,是必要的。虽然腺甙可以凝胶形式使用,但水溶液更快起效。在丧失功能或病情严重者,醋酸去氧可的松(DCA)水溶液一定要加到医嘱中。通常儿童每天2.5毫克,成人每天5毫克是需要的量。足部突然肿胀提示异常的敏感性,这种药必须停用。

应记住,当使用抗坏血酸时,在人类的实验是唯一能获得治疗作用的肯定性依据的实验。

同样,抗坏血酸在人类疾病的使用必须遵守质量作用定律:“在可逆性反应中,化学变化的程度和正在发生反应的活性质量成正比。”

FRED R. KLENNER, M.D.

Reidsville, N.C.

 

附录

 

医案:杀虫剂中毒

 

三个年龄在7~12岁的男孩,在N.C公路上被喷洒农药的飞机击倒。最小的被其他二个以身体保护,因此,只有很少的部位暴露在农药之下,他在附近医院的急诊室治疗后被送回家。其中二个由不同的医生诊治。一个年龄12岁的,由我们负责,给予10克抗坏血酸,以50CC注射器静脉内注射,每8小时一次。浓度为每克希释至5CC希释剂中。他在住院的第二天被送回家。第三个只接受支持治疗,但不含抗坏血酸。他的身体明显不一样。这些喷雾已产生过敏性皮炎和化学性灼伤。他在住院第5天死亡。

 

医案:鼻白喉

 

三个邻近的小孩,感染了鼻白喉。三个小孩由三个不同的医生诊治。由我们负责的小女孩,开始的24小时,每8小时以50CC注射器给予10克的抗坏血酸静脉注射。之后改为每12小时一次。然后,每2小时口服1克抗坏血酸。她存活而且现在是一个毕业护士。另二个孩子没有接受抗坏血酸治疗,二个都死亡。我们的年青病人亦接受了40,000单位的抗白喉毒素皮下注射治疗。其他二个亦接受了这种抗毒素治疗。

 

医案:脊髓灰质炎

 

虽然我们可以用抗坏血酸治愈许多脊髓灰质炎,但一个例子展示了抗坏血酸的价值。有二兄弟患脊髓灰质炎。依体重不同而给予10克和12克,以50CC注射器静脉注射,每8小时一次,连续4次。之后,每12小时一次,连续4次。他们亦全天24小时,每2小时口服1克的抗坏血酸。他们完全康复,二人都是中学和大学的运动员。第三个孩子,一个邻居,接受另一个医生的治疗,没有用任何抗坏血酸。这个孩子亦生存,这位年青女士仍在,不过要靠支撑物行走。

 

 

医案:急性病毒感染代表致死性病毒性综合征

 

出现瘫痪的病例极度有趣,同时它们挑战诊断的勇敢亦同样有趣。其中一个病例,一位58的女士,表现出三种类型,她因为惊厥抽搐而入院。她感冒延绵不断达10天。入院后,她经历了另外三次惊厥抽搐。体温100.8F,脉搏每分钟140次,呼吸每分32次。她极度烦躁不安。24克抗坏血酸,溶于360CC的注射液中静脉点滴。每8小时一次,连续3次。分别在第一次和第三次加上1克的葡萄糖酸钙于点滴液中。入院后24小时,以及有72克抗坏血酸在血液循环中,病人清醒和有理智,但右手和右腿完全瘫痪。此后8天,每6小时把5克抗坏血酸放入果汁中口服,以及6克抗坏血酸加上复方维生素B注射液静脉点滴,每天一次。右手和右腿在入院后48小时恢复正常。而原有的粗皮病在这次住院期间亦痊愈了。

 

医案:反复发作的病毒感染

 

这个例子证明足够量的抗坏血酸治疗必须持续不断,以杀灭病原体。否则,感染会复发。1960年,我治疗一个7岁的患流感样症状的男孩,断断续续,达6周。药物包括从霉提取的磺胺嘧啶和5~10克的抗坏血酸口服。在三个不同的场合,这个方案都非常有效。当孩子第四次发病,上述抗生素和口服维生素C的使用没有任何逆转的效果。在发病后的第三日,孩子突然变得嗜睡及明显的木呆,体温从一直的很低烧升高至102.6F,此时,所有口服治疗中断。我马上给予6克抗坏血酸,以30CC注射器静脉注射。他苏醒并问:5分钟内发生了事?” 4小时内再次给予6克抗坏血酸静脉注射。之后,隔6小时给予6克静脉注射。他在24小时内完全康复并且保持如此。之后,再次给予5克抗坏血酸于果汁中口服,每8小时一次。一星期后,这个量减少至每天7。我有充足的机会去观察这个病例这个孩子是我们的小孩。

 

医案:毒蛇效伤

 

一个四岁的小孩,傍晚7点,在后院玩耍时被高原噬鱼蛇(moccasin,一种主要生活在水中的毒性美洲水蛇)咬伤小腿,我在730在当地医院的急诊室看到小孩正在呕吐,大哭,因为伤口疼痛,双手按在牙齿痕上。发烧99.0F。在735,以20CC注射器给予4克抗坏血酸静脉注射。接着的25分钟用于试验抗毒液血清。在这段时间,以及给予抗毒液血清治疗前,孩子停止了呕吐。她已停止大哭,坐在急诊大厅的台上,笑着喝着一瓶橙汁。她提出,爸爸,过来,我现在没事了,我们回去吧。她被准许回家,但基于这样的前提,她的父亲当晚要每小时用电话报告一次病情。这个要求他做到了,他的报告,每一次,都是孩子和平常一样正在熟睡,除了她的小腿稍微肿胀及有1/2度发烧。次日早上10点,在诊所看见她,小腿仍有轻度肿胀有1/2度发烧。她被给予第二次4克的抗坏血酸静脉注射。下午5点看见她,已无发烧,但肿胀依旧,没有任何疼痛。接着一日,咬伤后38小时,她完全正常了。由于这是第一次以维生素C治疗毒蛇咬伤,在这次复诊,我们选择给予一次额外的4克抗坏血酸。没有给予任何其他抗生素,亦无任何需要。由于她最近接受了一次加强型破伤风抗毒素注射。这次治疗没有给予任何破伤风抗毒素。

 

 

比较早前一个16岁女孩的毒蛇咬伤,在牵拉烟叶时被同样大小的噬鱼蛇(moccasin)咬伤。正如量度牙齿痕大小所发现的。她被送医院住了三个星期。他接受了3次抗毒液血清治疗。手臂连续用硫酸镁溶液捆扎。肿胀程度是另一手臂的四倍,而整个手臂都出现了条纹。除了医院常规饮食中含有的维生素C,没有接受任何其他的维生素C。她需要吗啡以控制疼痛。(我们不再使用任何抗毒液血清)。

 

医案:隐匿性病毒

 

这是一个18个月的小孩。晚上7点,在她去我家的路上碰见她。发病史很短,孩子在吃晚餐时出现窒息。在汽车前座位上的简单检查,发现她极度烦躁不安,哭嚷,体温98.6F(腋探),呼吸道无任何梗阻。我们详细查出了有关信息,这个孩子感冒已有几天。我们亦了解到,她的母亲头一天带她走了很长的路,可能是或可能不是一个潮湿和寒冷的地方。很明显,把她带回家的冲动是很大的。

 

记住,我曾见过孩子在入院后但还没有接受治疗以前,在30分钟~2小时内死亡。我决定争取一些时间。 我建议孩子的父亲送孩子到当地医院的急诊室。值班护士依医嘱进行肛探体温。之后进行快速灌肠。如果结果不理想,在30分钟内使用盐水溶液重复这个操作。离开我家约45分钟,值班的内科医生通过电话报告,孩子昏迷到这样的程度,仅对疼痛剌激有反应。灌肠仍未给予。我立即赶到医院,情况就如描述的一样。使用一条合适的肠管,我给她灌肠,效果很好。大便证明是正常的。肛探体温在医院为98.4F,脉搏每分钟152次,呼吸每分钟32次。不能看到咽喉,因为口“锁上”了,正如你剌激牙关紧闭者后可看到的。我们的印象是病毒现在已进入了大脑。

 

30克抗坏血酸,分成多次,在36小时内静脉注射。青霉素粉针从第二天开始给予,总共300,000单位,分成多次在3日内注射。这是为预防继发感染。入院后12小时,我们用一块4*4的纱布,以水湿润,放在病儿的嘴唇上,吸吮的反应仍然完整。但孩子立即窒息。变换为头低位,少量的水从鼻孔流出。现在已清楚,当孩子在吃晚餐时,是这种球茎现象在起作用。入院后1个半小时,护理记录显示体温是99.0F。又过了1个半小时,体温是100.0 F,护理记录这时这样写没有任何意识征象。入院后4小时,体温是101.2F。而入院后6小时,体温是102.4F,现在的护理记录,婴儿可饮水,没有吞咽困难。从这里开始,体温曲线开始下降,而到下午7点(入院后11个小时),孩子的反应很敏感,灵活地用茶匙喝水。第一次注射抗坏血酸后的28小时,体温正常。使用瓶喝水、牛奶、橙汁。口服液体维生素C。在第5个住院日出院。开始时,体温记录提示病儿正走向死亡,抗坏血酸治疗后,她开始对此做出反应。因而发烧,随后,病毒被杀灭。体温恢复正常。

 

医案:一氧化碳中毒

 

一个处于昏迷状态的州路政工被送到我的诊所。他是一个糖尿病患者。他的呼吸并不是Kussmaul型,并且皮肤温暖和干燥。我们了解到他被发现在他的驾驶室里,车窗关闭,发动机正开着。这是一个严寒的冬天。想到一氧化碳中毒的诊断,我们立即给予12克抗坏血酸,以50CC注射器,20号针头,静脉注射。(我用50CC注射器配合20号针头,30CC配合21号针头,20CC配合,22号针头,10CC配合23号针头,这帮助控制注射速度,这是重要的,尤其是对儿童)。10分钟内,病人清醒,坐在床边,擦着眼睛说,我怎么会来到您的诊所?” 他在45分钟内回到他的工作单位。

 

医案#1:急性病毒性全心炎

 

一个15岁男孩被送到医院随同一个麻疹愈后复发的病史。体检发现,脉搏细而无力。听诊有明显的摩擦音。心电图显示,RS-T波偏移。体温是105F。抗坏血酸,以每公斤体重400毫克,以注射器静脉注射。2个小时内,心电图已几乎恢复正常。6小时后重复维生素C的注射。在12小时后再次注射。第4次注射在24小时后给予,虽然病人已临床治愈。孩子在第4个住院日回家。

 

医案#2:严重感冒后的急性病毒性全心脏炎

 

表现大概和医案#1相似,孩子的父母被建议把孩子送到Duke医学中心。起行前往60英里的医学中心之前,给孩子注射了6克的抗坏血酸。到达医学中心时,孩子对抗坏血酸的单一注射产生如此惊人的反应,以致病人的父母想回家。接诊医生质疑病儿的病情和我在电话介绍的不一致,她的父母保证,病儿曾经病得很严重,但她的改变是在注射了抗坏血酸之后。虽然50(25 安瓿)抗坏血酸和其父母一同带去,但丝毫未用。因为主诊医生声称,他不敢给这个小儿注射那个份量的抗坏血酸。事实上,我们使用的6克抗坏血酸,代表每公斤体重400毫克,对血浆的抗坏血酸水平,没有任何影响。实验室检查,证实了我们的印象。这个小孩住院2个星期。另加2次抗坏血酸注射可能已在24小时内治愈了这个小孩。

 

医案:急性胰腺炎

 

一个成年男子,在当地医院的急诊室,主诉,上腹部剧烈疼痛,并放射至背部,同时,伴有恶心和呕吐。血清淀粉酶检查显示浓度为345。这是病人的第4次类似的发作。60克抗坏血酸,溶于700CC葡萄糖水溶液静脉点滴。不需要任何另加的阿片。病人取得顺利的康复。他被安排每天口服10克抗坏血酸,已有5年没有复发。但,他患上一种轻微的糖尿病,现在以饮食和维生素C控制。

 

结束语

 

我完全同意Lancelot Hogben所说的:一个科学的理念必定是危险地活着,或死于无能。科学繁荣于勇敢的归纳。没有特别科学的东西是过度谨慎的。过度小心的探险者不能横渡真理的大西洋。

 

 

Introduction: 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. Boneset, scientifically called Eupatorium perfoliatum,2 is now rarely prescribed by physicians, but was once 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. A later assay of this herbal medicine showed, to my delight, that we had been taking from ten to thirty grams of natural vitamin C at one time. Twentieth century man seemingly forgets that his ancestors made crude drugs from various plants and roots, and that these decoctions served his purpose.

Early Specifications, Action and Dosages

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. This appeared in Food and Life Yearbook 1939, U.S. Department of Agriculture3: “In fact even when there is not a single outward symptom of trouble, a person may be in a state of vitamin C deficiency more dangerous than scurvy itself. When such a condition is not detected, and continues uncorrected, the teeth and bones will be damaged, and what may be even more serious, the blood-stream is weakened to the point where it can no longer resist or fight infections not so easily cured as scurvy. It is true that without these infinitesimal amounts, myriad 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, i.e. 50 grams to 150 grams, intravenously, for certain pathological conditions, and run in as fast as a 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, however, it should be given orally at the same time as well.

If one is to employ ascorbic acid intelligently, some index for requirements must be realized. Unfortunately there exists today “minimum daily requirements.” This illegitimate child has been co-fathered by the National Academy of Science and The National Research Council and represents a tragic error in judgement. There are many factors which increase the demand by the body for ascorbic acid beyond so-called scorbutic levels including: age of the individual; habits such as smoking, the use of alcohol, playing habits; sleep, especially when induced artificially; trauma caused by a pathogen, work, surgery or accident; kidney threshold; physiological stress, season of the year; loss in the stool; variations in individual absorption; variations in binders of commercial tablets; body chemistry; drugs; body weight; inadequate storage.

Flexible Dosage Standards Explained as Minimal Standards

With ascorbic acid, today’s adequate supply means little or nothing in terms of the needs for tomorrow. Based on scant data on mammalian synthesis, available for the rat, a 70 kg individual would produce 1.8 grams5 to 4.0 grams6 of ascorbic acid per day in the unstressed condition. Under stress, up to 15.2 grams.7 Compare this to the the the 70 mg recommended for daily requirements without stress and the 200 mg for the simple stress of the obstretical 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.6,7,8 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.9 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. Such a mutation could have happened by a virus, radiation or simply chance, thus denying all progenies of this mutated animal the ability to produce ascorbic acid. Survival demanded ascorbic acid from an exogenous source. The inability of man to manufacture his own ascorbic acid, due to genetic fault, has been called hypoascorbemia by Irwin Stone.10

Various Procedures for 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 seven 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 Slobody11 is again gaining new recruits. In principle it is the same as the lingual test of Ringdorf and Cheraskin12 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.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.13 This test employs ten drops of 5% silver nitrate and ten 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

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 coat14 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 Starr15 suggests that there can exist cells with partial chromosome makeup and cells with multinuclei. Hiliary Kropowski holds that these partial cells are pseudo-virons16 and are found in some tumor-virus infections. A key factor in the Starr-Kropowski thinking is that the cell maintains its biological integrity to support virus development despite the abnormal morphology and genetic deficiency. If these invaded cells could be destroyed or the invader neutralized the illness would suddenly terminate. Ascorbic acid has the capability of entering all cells. Under normal circumstances its presence is beneficial to the cell, however, when the cell has been invaded by a foreign substance, like virus nucleic acid, enzymic action by ascorbic acid contributes to the breakdown of virus nucleic acid to adenosine deaminase which converts adenosine to inosine. The net result is to lead to purines which are extensively catabolized and not to 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

Promptness of Massive Ascorbic Acid in Avoiding Fatal Encephalitis Related to Stubborn Head and Chest Colds

In 195317 we presented a case history and films of a patient with virus pneumonia. This patient was unconscious, with a fever of 106.8ºF when admitted to the hospital. 140 grams ascorbic acid was given IV 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 Sudden Infant Death Syndrome. It is suffocation but by way of a syndrome we observed and reported in 195718 which is similar to that found in cephalic tetanus toxemia culminating in diaphragmatic spasm, with dyspnea and finally asphyxia.19 By 195820 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; respiration twice to three times normal and in some cases will be suggestive of air hunger; moderately dilated pupils and in some instances hemiplegic; White blood count running from 6,000 to 25,000 with a high poly count in the differential.

Neurological Changes

It is apparent that the second stage of this syndrome is triggered by a break-through 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. Physicians must recognize the inherent danger of the lingering head or chest cold and appreciate the importance of early massive vitamin C therapy. 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.

How does the brain become involved in encephalitis? Some speculate on the pathways in which the virus gains entrance into the brain, summarized as follows:

a) 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

b) 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.

c) Bakay21 reported that the permeability of the blood-brain barrier can be changed by introducing various toxic agents into the blood circulation. Chambers and Zweifach22 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.

Burn Degrees Explained and some Therapy Rational

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 1945.23,24 Initially there is intravascular agglutination of red blood cells into distinctly visible, smooth, hard, rigid, basic masses. Oxygen uptake by the tissues is greatly reduced because of the sludging and therefore reduced rate of flow. Berkeley25 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 Levenson26 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. Bergman27 reported an increase demand for ascorbic acid in burns especially when epithelization and formation of granulation tissue are taking place. Lam28 also reported in 1941 a marked decrease in the plasma ascorbic acid concentration in patients with severe burns. Klasson29 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 Stone30 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% ascorbic acid solution as a spray over the entire area of the burn. 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% ascorbic acid solution

     

  4. 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

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 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. Ascorbic acid also eliminates pain so that opiates or their equivalent are not required. 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.

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 four grams and the highest amount 15 grams each day. Requirements were roughly four grams first trimester, six grams second trimester and ten grams third trimester. Approximately 20 percent required 15 grams, each day, during last trimester. Eighty percent of this series received a booster injection of ten grams, intravenously, on admission to the hospital. Infants born under massive ascorbic acid therapy were all robust.

How Concerned Should we be About Oxalic Acid and Kidney Stones?

One of the scare weapons used by the critics on high daily doses of ascorbic acid is the oxalic acid-kidney stone hypothesis. In all cases stasis and a concentrated urine appear to be the chief physiological factors. Meakins31 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. 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 Zilva32 reported that dehydroascorbic acid is protected in vivo from rapid transformation to the anti-scorbutically 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.33 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.

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 Paterson34 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.

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 ten grams ascorbic acid daily. The other 40% will need much less needle insulin and less oral medication.

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. Plasma levels, recorded before starting anesthesia and after cessation of such inhalants and completion of surgery, remained unchanged. We found, however, that samples of blood taken six hours after surgery showed drops of approximately one-quarter 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 three-quarters lower than the original samples. Baylor University research team reported similar findings in 1965. Bartlett, Jones35 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 Ingalls36 showed that the tensile strength of healing wounds is lowered in the presence of scurvy plasma levels. Schumacher37 reported that the pre-operative use of as little as 500 mg of vitamin C given orally was remarkably successful in preventing shock and weakness following dental extractions. Many other investigators have shown in both laboratory and clinical studies, that optimal primary wound healing is dependent to a large extent upon the vitamin C content of the tissues.

In 1949, it was my privilege to assist at an abdominal exploratory laparotomy. A mass of small viscera was found glued together. The area was so friable that every attempt at separation produced a torn intestine. After repairing some 20 tears the surgeon closed the cavity as a hopeless situation. Two grams ascorbic acid was given by syringe every two hours for 48 hours and then four 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 ten grams ascorbic acid each day. At least 30 grams should be given, daily, in solutions, post-operatively, until oral medication is allowed and tolerated.

Could Ascorbic Acid have Anti-cancer Features?

Schlegel38 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 Hosoda39 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.

Cholesterol not a Problem when Daily Intake of Ascorbic Acid is High

Mention should be made of the role40 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. Take 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.

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.41 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.42 One thing is certain. Given massive intravenous ascorbic acid therapy and patients are well and back to work in from three to seven days. In these cases the vitamin is also employed by mouth as followup 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 Campbell43 reported excellent results in the healing of corneal ulcers even though their massive dose was 1.5 grams daily. 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 chickenpox 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 five cc fluid. This concentration will produce immediate thirst. This is prevented by having the patient drink a glass of juice just before giving the injection.

Five 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. Virno44 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 at 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. In herpes zoster use two grams vitamin C intramuscularly and 50 mg adenosine-5 monophosphoric acid, aqueous solution, also intramuscularly every 12 hours. In massive shingles ascorbic acid should also be given by vein and always as much by mouth as can be tolerated. Heavy metal intoxication is also resolved with adequate vitamin C therapy.

General all around benefits, that the brain will be clearer, the mind more active, the body less wearied and the memory more retentive, will accrue with a daily dosage of one to ten grams ascorbic acid per day for adults and one gram for each year of life for children under ten.

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 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.45 Many investigators have shown an increased need for ascorbic acid in this condition.46,47 Brody in 1953 after studying vitamin C and colds in college students advised that ascorbic acid be given early and often in sufficient amounts. Regnier48 reporting in review of Allergy found that the larger the dose of ascorbic acid the better were the results. Our findings resulted in a schedule of one gram each hour for 48 hours and then 10 grams each day by mouth. Those under ten at least one gram for each year of life.

Virus Encephalitis

Virus encephalitis is a deadly syndrome and must be treated heroically with intravenous and/or intramuscular injections of ascorbic acid. We recommend a dose schedule of from 350 mg to 700 mg per kg body weight diluted to at least 18 cc of 5% dextrose water to each gram of C. In small children, two or three grams can be given intramuscularly, every two 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 cc to each one gram provided the ampule is buffered with sodium bicarbonate with sodium Bisulfite added. As much as 12 grams can be given in this manner with a 50 cc 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 cc 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 cc 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 one 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.49

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. Greenblatt50 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.51 have shown that the need for supplemental vitamin C begins with the embryo.

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.

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 ºF was normal in nine hours. The patient made an uneventful recovery. In one spectacular case of Black Widow52 spider bite in a 3H year old child, in coma, one gram calcium gluconate and four 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 4X 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 B6, by mouth, daily will shield one from mosquito bites. Twenty percent will also require 100 mg vitamin B6 intra-muscularly 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.53 Our son who will be 19 in July has never developed a tooth cavity. Since age 10 he has received at least 10 grams ascorbic acid, daily, by mouth. Before age 10 the amount given was on a sliding scale.54

Intravenous 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 ampule described in this summary, the vitamin must be diluted to at least 18 cc of 5% dextrose in water, saline in water or Ringers solution. Many times Adenosine 5-Monophosphate, 25 mg in children and 50 to 100 mg in adults, given intramuscularly, is necessary to achieve results. The aqueous solution is more effective for quick results, although Adenosine in Gel can be employed. In debilitated individuals or when the pathology is serious, Desoxycorticosterone Acetate (DCA), aqueous solution, must also be added to the schedule. Usually 2.5 mg for children and 5 mg for adults is the daily intramuscular dose required. Sudden swelling of the feet indicates abnormal sensitivity and the drug must be discontinued.

It must be remembered when using ascorbic acid that experiments on man are the only experiments which can give positive evidence of therapeutic action in man. Likewise, the use of ascorbic acid in human pathology must follow the Law of Mass Action: In reversible reactions, the extent of chemical change is proportional to the active masses of the interacting substance.

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.”

References

  1. Correspondence with colleague from Puerto Rico.

     

  2. Jennings & Avinoff: Wild Flowers of Western Penna. & Upper Ohio Basin, University of Pittsburgh Press, Vol. 2, Plate 156.

     

    1. Food and Life: P. 236, 1939 Yearbook, U.S. Dept. Agriculture, U.S. Printing Office, Washington,

       

    2. D.C.
  3. Klenner, F. R.;: Correspondence with Dr. Bauer, University of Switzerland.

 

 

 

 

 

Klenner传记

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

Reidsville, North Carolina

 

Klenner医生出生于宾夕法尼亚,就读于St. Vincent and St. Francis学院并在此获得生物学学士和硕士学位。他后来毕业于magna cum laude并在此获得一个教学研究员职位。他亦曾被授予学院经院哲学奖章。后来,在Catholic大学获得另一个化学教学研究员职位。在这里,他攻读生理学博士学位。

 

然后,Klenner医生移居至北卡来纳州,在Duke大学继续他的研究。他及时赶到,运用他的生理学和化学的知识,通过把青蛙浸在10%的硝酸溶液,迅速恢复一个在研讨会的使用的青蛙的神经系统功能。他被系主任Pearse医生说服,进入了医学学校。他在Duke大学完成了他的研究,并在1936年获得了他的医学学位。

 

在开始私人执业以前,他在研究生医院实习了三年。虽然专门研究胸腔疾病,他坚持进行全科诊疗,因为这能提供丰富的医学观察机会。在运用天竺鼠以研究抗坏血酸的作用方面,他的病人和他一样热情。第一次巨大量的抗坏血酸他给了他自己。每次出现新问题他都服用相同数量的抗坏血酸以观察其效果。

 

Klenner医生获得的荣誉和专业协会职务是众多的。他被列入各种各样的名人名录里。他在他的科学生涯中,出版了28篇论文。

 

 

 

 http://www.nutriforce.cn/Frederick.R.Klenner.files/image001.gif

参考书目

1 Correspondence with colleague from Puerto Rico.

2 Jennings & Avinoff: Wild Flowers of Western Penna. & Upper Ohio Basin, University of Pittsburgh Press, Vol. 2, Plate 156.

3 Food and Life: P. 236, 1939 Yearbook, U.S. Dept. Agriculture, U.S. Printing Office, Washington, D.C.

4 Klenner, F. R.;: Correspondence with Dr. Bauer, University of Switzerland.

5 J. J. Burns, et al.: J. Biol. Chem. 207: 679, 1954.

6 Salomon, L. L, et al.: N.Y. Acad. Science 93: 115, 1961.

7 Conney, A. H., et al.: N.Y. Acad. Science 92: 115, 1961.

8 Grollman, A. P. & Lehninger, A. L.: Arch. Biochem., 69:458, 1957.

9 Chattejee, I. B., Kar, N. C., Guha, B. C.: N.Y. Acad. Science 92:36, 1961.

10 Isherwood, F. A. & Mapson, L. W.: N.Y. Acad. Science 92:6, 1961.

11 Burns, J. J. Am. J. Med. 26: 740, 1959

12 Stone, I.: Brief Proposal Per. Biology & Medicine, Autumn 1966.

13 Slobody, L. B.: J. Lab & Clinical Med. 29 #5, 464-472, 1944.

14 Ringsdore, W. M., Cheraskin, E. Sec., Oral Med., U. of Ala. Med. Center, Birmingham, Ala.

15 Klenner, F. R.: Tri-State Med. J., Feb. 1956.

16 Larson, C.: Ordnance, PP. 359-360, Jan.-Feb. 1967.

17 Starr, T. J.: Hospital Practice, p. 52, November 1968.

18 Kropowski, H.: Med. World News, p. 24, June 19, 1970.

19 Klenner, F. R.: J. Applied Nutrition, 1953.

20 Klenner, F. R.: Tri-State Med. Journal, June 1957.

21 Klenner, F. R.: Tri-State Med. J., Oct. 1958.

22 Klenner, F. R.: Tri-State Med. J., Feb. 1960.

23 Baker, A. B. & Noran, H. H.: Archives Int. Med. Vol. 76, 146-153, 1945.

24 Bakay, L: The Blood-Brain Barrier, C. Thomas, 1956.

25 Chambers, R. et al: Physiol. Rev., Vol. 27, 436-463, 1947.

26 Knisely, M. H. et al: Archives Surgery, 51-220, 1945.

27 Knisely, M. H. Science 106: 431, 1947.

28 Berkeley, W. T., Jr.: Southern Med. J., Vol. 58, pp. 1182-1184. 29 Lund & Levenson: Arch. Surg., Vol. 55: 557, 1947.

30 Bergman, H. C. et al: Am. Heart J., Vol. 29, 506-512, 1945.

31 Lam, C. R.: Col. Rev. Surg. Gyn. & Obst., Vol. 72, 390-400. 1941.

32 Klasson,D. H.: N.Y. J. Med., 51, 2388-2392, Oct. 1951.

33 Stone, H. H.: Med. J., Aug. 1: 6-10, 1970.

34 Borsook, H. et al: J. Biol. Chem, 117:237, 1937.

35 Hoverbed: Med. World News, Oct. 13, 1967;

36 Meakins, J. C.: The Practice of Med., C. V. Mosby, 1938.

37 Kelli & Zilva; J. Biochemistry, 29: 1028. 1935.

38 Lambden, M. P. et al: Proc. Sec. Exp. Biol. Med., 85: 190-192, 1954.

39 Arthus: J. Pharm. Chemi., 20: 41, 1919.

40 Wells, H. C.: Chem. Pathology, Saunders, 3rd Ed., 1925.

41 Ford: J. Pharmacy, 2, 285; 1911.

42 Editorial: J.A.M.A. (117) 11: 937-938, 1941.

43 Chambers, R., & Pollock, H.: J. Gen. Physiology, 10: 739, 1927.

44 Clark & Rassiter: Q. J. Exp. Physiology, V32, 279, 1944.

45 Patterson, J. W.: J. Biological Chemistry, 81-88, 1950.

46 Bartlett, M. K., et al.: New Eng. J. of Med., Vol. 226, 474, 1942.

47 Lanman, T. H., Ingalls, T. H.: Am. Surgery, Vol. 105, 616, 1937.

48 Schumacher: Ohio State Med. J., 42: 1248, 1946.

49 Mono-Epstein-Barr virus-Burkitt Lymphoma: Med. World News, Dec. 13, 1968.

50 Schlegal, G. E., et al.: Trans. Am. Ass. Genito Urinary Surgery, Vol. 61, 1989,

51 Click and Hosoda: Proc. Sec. Exp. Biology and Med., 119, 1965.

52 Clemmesen, C.: Bisperbjerg Hospital, Copenhagen, Mod. Med., 123-124, July, 1954.

53 Hadden, J., et al.: J. Am. Med. Assoc., 209: 893-900, 1989.

54 Becker, R. R., et al.: J. Am. Chem. Sec. 75: 2020, 1953.

55 Klenner, F. R.: Tri-State Med. J., July, 1954.

56 Jungeblut, C. U.: J. Immunology, Vol. 33 #3, Sept. 1939

57 Klenner, F. R.: Tri-State Med. J., April 1954.

58 Capps, R. B.: Modern Med., Jan. 11, 1971.

59 Freeben, R. K., Repsher, L. R.: Mod. World News, Jan. 23, 1970.

60 Boyd,T. A. Campbell, F. W.: B. Med. J., 2: 1145, Nov. 1950.

61 Virno, M.: Eye, Ear, Nose & Throat Monthly, Vol. 46, p. 1502.

62 Sabin: J. Exp. Med., 89: 507-515, 1939.

63 Wright: Ann. Int. Med., 12, 4: 518-528, Oct. 1938.

64 Brody, H. D.: J. Am. Diet. Assoc., 29: 588, 1953.

65 Regnier, E.: Review of Allergy, 22: 948, Oct. 1968.

66 Pollock, H. & Halpen: Washington Nat. Research Council Publication, 234, 1942.

67 Greenblatt, R. B.: Obstet. & Gynec., 2: 530, 1953.

68 King, C. C., et al.: New York Times, Nov. 2, 1952.

69 Klenner, F. R.: Tri-State Med. T., Dec. 1957

70 Baume, L. J.: Science News Letter, 64: 103, 1953.

71 Klenner, F. R.: Tri-State Med. J. Nov. 1955.