Observations On the
Dose and Administration of Ascorbic Acid When Employed Beyond the Range Of A
Vitamin In Human Pathology
Frederick R. Klenner,
M.D., Journal of Applied Nutrition 23:61-88, (1971).
Editor's Note:
Because of the unusually high amounts of ascorbic acid used in Dr. Klenner's treatment as reported in his paper, we asked him
to verify amounts mentioned. Following is his answer:
"To the Editor of the ICAN Journal: This will confirm that all
'quantity' factors given in my paper are correct and can be confirmed from
hospital and medical office records. The notation relative to 150 grams
represents the amount used for reversing pathology in a given case and was the
amount given over a period of 24 hours. (The I.V. was continuous.) This was
given in three bottles of 5D water, decanting only enough from 1000 c.c. to be
replaced by the 'C' ampules.
"Recently the FDA has published a 'warning' that too much soda-ascorbate might be harmful, referring to the sodium ion. In
reply to this I can state that for many years I have taken 10 to 20 grams of
sodium ascorbate by mouth daily, and my blood sodium
remains normal. These levels are checked by an approved laboratory. 20 grams
each day and my urine remains at or just above pH
6."
Signed:
Fred R. Klenner, M.D.
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
Early Specifications, Action And Dos
To understand the chemical behavior of ascorbic acid in human pathology,
one must go beyond its present academic status either as a factor essential for
life or as a substance necessary to prevent scurvy. This knowledge is elementary.
Listen to what appeared in Food and Life Yearbook 1939,
U.S. Department of Agriculture[3]: "In fact even when
there is not a single outward symptom of trouble, a person may be in a state of
vitamin C deficiency more dangerous than scurvy itself. When such a
condition is not detected, and continues uncorrected, the teeth and bones will
be dam
Ascorbic acid has many important functions. It is
a powerful oxidizer and when
given in massive amounts; that is, 50 grams to 150 grams, intravenously, for certain
pathological conditions, and "run in" as fast as 20 Gauge needle will
allow, it acts as a "Flash Oxidizer,"[4] often correcting the
pathology within minutes. Ascorbic acid is also a powerful reducing
Scurvy Historically The Target; Todays Goal Of
High Blood Levels To Cope With Self-Induced Abuses And Physiological Traumas.
If one is to employ ascorbic acid intelligently, some index for
requirements must be realized. Unfortunately there exists today a sort of
"brand" called "minimum
daily requirements." This illegitimate "child" has been
co-fathered by the National Academy of
Science and The National
Research Council and represents a tr
The
Habits -- such as smoking, the use of
alcohol, playing habits;
Sleep, especially when induced
artificially;
Trauma.--
trauma caused by a pathogen, the trauma of work, the trauma of surgery, the
trauma to the body produced accidentally or intentionally;
Kidney threshold;
Environment;
Physiological stress;
Season of the year;
Loss in the stool;
Variations in individual absorption;
Variations in "binders" in
commercial tablets;
Body chemistry;
Drugs;
Pesticides;
Body weight;
Inadequate stor
Flexible Dos
With such knowledge it is no longer possible to accept a set numerical
unit in terms of minimal daily
requirements. This is true because of the simple fact that people are
different and these same people experience different situations at various
times. With ascorbic acid, today's adequate supply means little or nothing in
terms of the needs for tomorrow. Let us start thinking in terms of maximum requirements. For too long a
time we have under supplied our children and ourselves by accepting through
negative ignorance and acquiescence so-called standards. Based
on scant data on mammalian synthesis,
available for the rat, a 70-Kg. individual would produce 1.8 grams[5] to 4.0 grams[6] of ascorbic acid per day
in the unstressed condition. Under stress, up to 15.2 grams.[7] Compare this to the 70 mg
recommended for daily requirements without stress and 200 mg for the simple
stress of the obstetrical patient, and you will recognize the disparity and
understand why we have been w
Ascorbic Acid Not Synthesized By Man
Work on mammalian biosynthesis of ascorbic acid indicates that the vitamin
C story as is generally accepted represents an oversimplification of available
evidence.[8,9,10] This often leads to
misinterpretations and false impressions. It has been
proposed that the biochemical lesion which produces the human need for
exogenous sources of ascorbic acid, is the absence of the active enzyme, l-gulonolactone oxidase from the
human liver[11]. A defect or loss of the
gene controlling the synthesis of this enzyme in man, blocks the final phase in
the series for converting glucose to ascorbic acid. Virus can mutate cells,
X-Rays can do it and it can occur by chance. Such a mutation could have
happened, denying all progenies of this mutated animal the ability to produce
ascorbic acid. Survival demanded ascorbic acid from an exogenous source. This
is not remarkable. Other recognized genetic diseases in which a missing enzyme
causes a pathological syndrome, in man, are phenylketonuria,
galactosemia and alkaptonuria.
It is worthy to note that Sealock and Goodland
have ascribed to ascorbic acid the faculty of being the necessary co-enzyme in
the metabolic oxidation of tyrosine.
The velocity of the oxidation in this reaction is dependent upon the
concentration of vitamin C. Tyrosine is essential in breaking down protein to
usable amino acid. The scorbutic guinea-pig's
liver is unable to oxidize tyrosine except in the presence of ascorbic acid.
This suggests a lead in the study of the metabolic abnormality Alkaptonuria in humans. Ascorbic acid administration
will correct the alkaptonuria of the scorbutic guinea
pig. Its effect on human alkaptonuria has been
inconsistent. The reason: Inadequate use of ascorbic acid.
Biochemist Irwin Stones' Concept Has Practical Value
The inability of man to manufacture his own ascorbic acid, due to genetic
fault, has been called "hypoascorbemia" by Irwin Stone.[12] This is another reason
for abolishing the present concept of daily minimal requirements. The
physiological requirements in man are no different from other mammals capable
of carrying out this synthesis.
Various Procedures Testing For The Vitamin C
Levels And Requirements Of The Body.
Various tests have been employed to determine the degree of body
saturation of vitamin C, but for the most part they have been misleading. Blood and urine samples analyzed with
2:6 dichlorophenol indophenol will give values roughly 7 percent less
than when testing with dinitrophenol hydrazine. Gothlin advocates the capillary fr
Role Played By Ascorbic Acid In Intercellular
Reactions, Neutralizing, Possibly Controlling Virus Production.
In 1935
Once inside a given cell. the virus
nucleic acid sheds its protein coat and proceeds to modify the host cell by
either creating mutations or by directly substituting its own nucleic acid;
The infectious nucleic acid, after entering a human cell, retains its
protein coat and starts to produce its own type protein coat[16] and viral nucleic acid,
so that new units can either depart to enter other cells or by destruction of
the cell, thus making the infection more severe;
The introduction of a foreign fr
Promptness Of Massive Ascorbic Acid In Avoiding Fatal Encephalitis Related
To Stubborn Head And Chest Colds.
In 1953[19] we presented a case
history and films of a patient with virus
pneumonia.
This patient was unconscious, with a fever of 106.8∞F (A. corrected) when
admitted to the hospital. 140 grams ascorbic acid was given intravenously over
a period of 72 hours at which time she was awake, sitting up in bed and taking
fluids freely by mouth. The temperature was normal. Since that time we have
observed a more deadly syndrome associated with a virus causing head and chest
colds. This is one of the adenovirus striking in the area of the upper
respiratory tract with resulting fever, sore throat and eyes, and when in
children can cause fatal pneumonia. More often death is indirect by way of
incipient encephalitis where the
child can be dead in 30 minutes. These are the babies and children found dead
in bed and attributed to suffocation [SIDS,
Sudden Infant Death Syndrome]. It is
suffocation but by way of a syndrome we observed and reported in 1957[20] which is similar to that
found in cephalic tetanus-toxemia culminating in diaphr
St
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.
St
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
st
Rapid pulse;
Temperature can be normal, moderately
elevated or high;
Respirations twice to three times
normal and in some cases will be suggestive of air hunger;
Pupils will be moderately open and in
some instances (hemiplegic) one will be markedly
dilated;
Urine negative;
The white blood count running from
6,000 to 25,000 with a high poly count in the differential;
Young patients starting the second phase with a
convulsion there has been not only a history of normal bowel movements but also
an enema given at the time of first examination has produced a normal stool;
Bladder sphincter control was abnormal
in our cases who convulsed or who were in coma.
Neurological Changes
It is apparent that the second st
Literature Research
In 1960 we decided to research the literature before writing our paper.
"Virus Encephalitis As A Sequel Of The Pneumonias."[22] Rosenfield
in 1903 described a similar syndrome under the caption "Brain Purpura or Hemorrh
Symptoms of a nonspecific nature - headache, vomiting, irritability;
Delirious type;
Convulsive type;
Lethargic type;
Hemiplegic type.
These groups plus two additional types,
namely:
Chill - blood invasion type;
Collapse,
were as we reported them, independently, in the
Tri-State Medical Journal, October 1958. Their results: Some recovered, some died and still others lived as
"vegetation" mental cripples. All of our patients recovered.
Thirteen years from the time of the Baker-Noran
report to the time of our report and 13 years from the time of our report to
the present time. This makes the issue urgent. Physicians must recognize the inherent danger of the lingering head or
chest cold and appreciate the importance of early massive vitamin C
therapy.
How does the brain become involved in
encephalitis?--some speculations.
Clinical problems such as these groups present, leads one to speculate on
the pathways in which the virus gains entrance into the brain. We can
summarize:
Through the olfactory nerves;
Through the portals of the stomach from
material swallowed, either pulmonary or upper respiratory drain
Direct extension from otitis media or from mastoid cells;
The blood stream. Arriving in the brain the virus goes
through the blood cerebrospinal fluid barrier and/or the blood brain barrier by
one of three ways:
Electrical charge;
Chemical lysis
of tissue;
Osmosis.
Bakay[24] reported that the permeability of the blood-brain barrier
can be changed by introducing various toxic
Burns- degrees explained and some therapy rational.
In the treatment of burns
ascorbic acid, in sufficient amounts, reflects itself as a truly miracle
substance. In the early forties, when I was using ascorbic acid, intramuscularly,
in treating bacillary dysentery,
shiga type, with excellent results,
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
Severe burns and related therapy.
Harlen Stone[33] suggested the use of gentamicin in major burns to lower the sepsis caused by
pseudomonas. Absorption of its exotoxin from the
infected burn wound inhibits the bacterial defense mechanism of the reticuloendothelial system. Death can result either from
the toxemia alone or from an associated septicemia. We have found that the
secret in treating burns can be summarized in five steps:
The use of the "old covered w
The employment of a 3% ascorbic acid solution as a
spray over the entire area of the burn. The spray can be applied with a Devilbis unit using an ordinary portable pressure pump. The
old type "flit gun" can also be used or even a 50 c.c. syringe with a
20 gauge needle. The 3% solution is used every 2 to 4 hours for a period of
roughly five days;
The use of vitamin A and D ointment over the area of the burn and this is
now alternated, q4h with the 3% ascorbic acid solution;
The administration of massive doses of ascorbic
acid by vein and by mouth. 500 mg per Kg. body weight diluted to at least 18 c.c.
per gram vitamin C using 5% dextrose in water, saline in water or Ringers
solution and for the initial injection, run in as fast as a 20 gauge
needle or catheter will carry the flow. Cut-downs are frequently necessary and
the foot-ankle area is recommended. Vitamin C solution is repeated every 8
hours for the first several days, then at 12 hour intervals. Ascorbic acid, by
mouth, is given to tolerance. Loose stools is accepted
as this index. Using large doses of ascorbic acid I.V. will necessitate the
administration of at least one gram calcium gluconate,
daily, to replace free calcium ions removed in the breakdown chemical action as
ascorbic acid goes to dehydroascorbic acid, then to ketogulonic acid and later to oxalic acid as the calcium
salt;
Supportive treatment; that is, whole blood and maintaining electrolyte
balance.
If seen early after the burn there will be no infections and no eschar formations. This eliminates fluid formation, since
the eschar traps will not exist and there will be no
distal edema because the venous and lymphatic systems will remain open. There
will be no arterial obstruction and no nerve compression. Pseudomonas will not
be a problem, since ascorbic acid destroys the exotoxin
systemically and locally. Even if the burn is seen late when pseudomonas is a
major problem the gram negative bacilli will be destroyed in a few days leaving
a clean healthy surface. I have seen eschars 2 inches wide and 1/2 inch thick, severely infected
so that stench had to be controlled with deodorizing sprays, melt away when employing the method
outlined. Ascorbic acid also eliminates pain so that opiates or their equivalent are not required. In
extremely extensive burns that involve back and front of the patient, the
"Hoverbed"[35] employed by the British
should be considered. It uses the same principle as the hovercraft to lift a solid
object. What has been overlooked in burns is that there are many living
epithelial cells in the areas that grossly look like "raw muscle."
With the use of ascorbic acid these cells are kept viable, will multiply and
soon meet with other proliferating units in the establishment of a new
integument.
Regarding personal and environmental
pollution-carbon monoxide.
We are all pl
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
How concerned should we be about oxalic acid and kidney stones? A technical explanation.
One of the "scare" weapons used by the critics on high daily
doses of ascorbic acid is the oxalic acid-kidney stone hypothesis. Meakins[36] states that the chief
factors in the formation of renal calculi are perversions of metabolic
processes, infection and stasis in the urinary tract. There are two schools of
thought on stone formation: 1) That there is a central nucleus of colloids on
which the crystalloids are precipitated; 2) That the crystalloids are deposited
from the urine in which they are present in concentrated solution, in which
salt and hydrogen ion concentrations are important factors. In all cases stasis
and a concentrated urine appear to be the chief
physiological factors. The only way that oxalic acid can be produced from
ascorbic acid is through splitting of the lactone
ring. This happens above pH5. The reaction of urine when 10 grams of vitamin C
is taken daily is usually pH6. Oxalic acid precipitates out of solution only
from a neutral or alkaline solution-pH7 to pH10. Kelli and Zilva[37] reported that
"Nutrition experiments showed that dehydroascorbic
acid is protected in vivo from rapid transformation to the antiscorbutically
impotent diketogulonic acid from which oxalic acid is
derived." Values reported in the literature for normal 24 hour urinary
oxalate excretions for humans range from 14 mg to 56 mg. Lamden et al.[38] found in a group of
volunteers that the ingestion of 9 grams ascorbic acid daily resulted in
oxalate spills as high as 68 mg for 24 hours and in the controls without extra
vitamin C the high was 64 mg for a 24 hour period.
These critics have overlooked the individual with diabetes mellitus. The amount of oxalic acid found in the diabetic
patient approximates that found in the urine of a normal person taking 10 grams
vitamin C each day. With the diabetic we find a paradox. Give this individual
10 grams ascorbic acid daily, by mouth, and the urinary oxalate excretion
remains relatively unchanged. Diabetics are known for their diuresis.
The individual who takes 10 or more grams of vitamin C each day will find that
this organic compound is an excellent diuretic. No urinary stasis; no urine
concentration.
The ascorbic acid kidney stone story is a myth. Methylene
blue will dissolve calcium oxalate stones giving 65 mg orally 2 to 3 times a
day. (Dr. M. J. Vernon Smith: Med. World News, Dec. 4, 1970)
Why death from insect and snake bites?
It is estimated that 6500 deaths occur each year in the
The tox-albumin
of the snake bite, like the copperhead or rattler;
Formic acid plus a toxin with a protein
cover, called proteotoxin by Arthus,[39] such as found in bees and
wasps;
Neurotoxin from the Black Widow, the
Fiddle Spider and snakes like the Cobra and Coral;
Production of
histamine, especially in the more severe stings and bites.
Wells[40] in 1925 called the poison
of certain spiders and snakes zootoxins
and of poisonous plants, phytotoxins. Ford[41] in 1911 reported three
classes of toxins in plants and fungi:
Nerve poisons-muscarine;
Those causing structural changes in the
viscera with resulting fatty degeneration;
Gastrointestinal
irritants.
Ascorbic acid to the rescue.
It is a demonstrated principle that the production of histamine and other end products from deaminized cell proteins released by injury to cells are a
cause of shock. The clinical value of ascorbic acid in combating shock is
explained when we realize that the deaminizing
enzymes from the dam
The answer to these emergencies is simple. Large amounts of ascorbic acid
350 mg to 700 mg per Kg. body weight given intravenously. In small patients,
where veins are at a premium, ascorbic acid can easily be given intramuscularly
in amounts up to two grams at one site. Several areas can be used with each
dose given. Ice held to the gluteal muscles until
red, almost eliminates the pain. We always reapply the ice for a few minutes
after the injection. Ascorbic acid is also given, by mouth, as follow-up
treatment. Every emergency room should be stocked with vitamin C ampules of sufficient strength so that time will never be
counted-as a factor in saving a life. The 4 gram, 20 c.c,
ampuIe and 10 gram 50 c.c. ampule 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
Some concern answered regarding high dos
Merton Lamden, a biochemist, writing in the New
England Journal of Medicine,
Diabetes mellitus response to 10 grams ascorbic
acid by mouth.
Over the past 17 years we have studied the effect of 10 grams by mouth, in
patients with diabetes mellitus. We found that every diabetic not taking
supplemental vitamin C could be classified as having sub-clinical scurvy. For this reason they find it difficult to heal wounds. The diabetic
patient will use the supplemental vitamin C for better utilization of his
insulin. It will assist the liver in the metabolism of carbohydrates and to
reinstate his body to heal wounds like normal individuals. We found that 60% of
all diabetics could be controlled with diet and 10 grams ascorbic acid daily.
The other 40% will need much less
needle insulin and less oral medication. Contrary to what Medical News
Letter, (Vol. 12 # 26, Dec. 25 1970) carried to the physicians the Tes-Tape is accurate in testing urine samples.
Observations following post-surgery cases on blood
plasma levels of ascorbic acid. Deduction is evident of the need for substantial
amounts of ascorbic acid prior to surgery.
In 1960 and
In 1949, it was my privilege to assist at an abdominal exploratory laparotomy. A mass of small viscera was found "glued
together". The area was so friable that every attempt at separation
produced a torn intestine. After repairing some 20 tears the surgeon closed the
cavity as a hopeless situation.
Two grams ascorbic acid was given by syringe every two hours for 48 hours and
then 4 times each day. In 36 hours the patient was walking the halls and in
seven days was discharged with normal elimination and no pain. She has outlived
her surgeon by many years. We recommend that all patients take 10 grams
ascorbic acid each day. Where this is not done and the surgery is elective,
then 10 grams by mouth should be given for several weeks prior to surgery. At least
30 grams should be given, daily, in solutions, post-operatively, until oral
medication is allowed and tolerated.
Mononucleosis aided by ascorbic acid.
After studying hundreds of college students, Yale researchers have
evidence that strengthens the link between mononucleosis and Epstein-Barr virus, a herpes-like
Could ascorbic acid have anti-cancer features?
Schlegel[50] from
One can only speculate on what massive therapy would do in all forms of
cancer. Many pathologic conditions are cured by giving 5 million to 100,000
million units of penicillin as an intravenous drip over a period of 4 to 6
weeks. How long must we wait for someone to start continuous ascorbic acid drip
for 2 to 3 months, giving 100 to 300 grams each day, for various malignant
conditions?
Barbiturate patients in shock normalized with ascorbic acid.
Clemmesen[52] states that the important
principles in man
Cholesterol not a problem, when daily intake of
ascorbic acid is high.
Mention should be made of the role[54] played by vitamin C as a
regulator of the rate at which cholesterol is formed in the body; deficiency of
the vitamin speeding the formation of this substance. In experimental work,
guinea pigs fed a diet free of ascorbic acid showed a 600
percent acceleration in cholesterol formation in the adrenal glands. Ten grams
or more each day and then eat all the eggs you want. That is my schedule and my
cholesterol remains normal,
Lockjaw relieved.
Ascorbic acid has no equal as a adjuvant with
other drugs in many conditions. With Tolserol it is curative in the treatment of Lockjaw. Both
drugs must be used in proper amounts. In our case 1000 mg Tolserol
given intravenously to a boy weighing 20 Kg. was the optimal amount to use. In 48 hours he was given 90 grams ascorbic acid and 3000
mg Tolserol, all intravenously.[55] Jungeblut[56] reported that vitamin C,
when added to tetanus toxin "in vitro", brings about inactivation of
the toxin.
Two cases of Trichinosis
was treated and cured using Vitamin C: and Para-Aminobenzoic
acid.[57] Although the temperature curve
was returned to normal in 36 hours it was found that nine days of treatment was
necessary for permanent cures.
Infectious hepatitis relieved.
Viral hepatitis needs brief mentioning. There are two types: 1) Infectious
hepatitis; 2) Needle hepatitis. Physical activity has
always been considered to increase the severity and prolong the course of the
disease.[58] In
Vietnam, Freebern and Repsher
showed that pick-and-shovel details had no effects on the 199 controls as
Ascorbic acid therapy applied to various maladies.
We could continue indefinitely extolling the merits of ascorbic acid.
Boyd and Campbell[60] reported excellent
results in the healing of corneal ulcers
even though their massive doses was 1.5 grams daily. In one case of a corneal
burn from the phosphorus off an old time match, the pain was relieved
immediately with the intravenous injection of 12 grams vitamin C with a 50 c.c syringe. One gram was prescribed each hour for 50
grams. The cornea was normal in less than 24 hours.
One single injection of ascorbic acid calculated at 500 mg per Kg. body
weight will reverse heat stroke.
One to three injections of the vitamin in a dose range of 400 mg Kg. body
weight will effect a dramatic cure in Virus Pancarditis.
One gram taken every one to two hours during exposure will prevent sunburn.
Intravenous injections will quickly relieve the pain and erathema,
even the second degree burns when precautions are not taken.
One to three injections of 400 mg per Kg. given every eight hours will
"dry up" chicken-pox
in 24 hours.
If nausea is present it
will stop the nausea.
These injections are usually given with a syringe in a dilution of one
gram to 5 c.c fluid. This concentration will produce
immediate thirst. This is prevented by having the patient drink a glass of
juice just before giving the injection.
40 grams ascorbic acid by vein and 1000 mg to 2000
mg vitamin B1 intramuscularly will neutralize the person intoxicated by alcohol and will save the life if one drinks after
using Antibuse.
5 per cent ointment using a water soluble base will cure acute fever blisters if applied 10 or more
times a day and we have removed several small basal cell epithelioma
has with a 30 percent ointment.
Dr. Virno[61] at the eye clinic,
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 coll
Complications of smallpox
vaccination are usually handled by adequate oral ascorbic acid. Several
times we found it necessary to give the "C" intravenously along with
Adenosine. Twenty percent ichthammol used locally
with vaccinia necrosum is
good psychology.
In herpes
zoster two grams vitamin C intramuscularly and 50 mg Adenosine
5-Monophosphoric acid, aqueous solution, also intramuscularly every 12 hours. Compound tincture benzoin
locally is helpful.
In massive "shingles"
ascorbic acid should also be given by vein. Always as much by
mouth as can be tolerated. Heavy metal intoxication is also resolved
with adequate vitamin C therapy.
General all around benefits of one to ten grams
ascorbic acid per day.
It has been suggested that ascorbic acid metabolism may be an index of
total metabolism and thus serve as a general di
Summary
The types of pathology treated with massive doses of ascorbic acid run the
entire gamut of medical knowledge. Body needs are so great that so called
minimal daily requirements must be ignored. A genetic error is the probable
cause for our inability to manufacture ascorbic acid, thus requiring exogenous
sources of vitamin C. Simple dye or chemical test are available for checking
individual needs. Ascorbic acid destroys virus bodies by taking up the protein
coat so that new units cannot be made, by contributing to the break-down of
virus nucleic acid with the result of controlled purine
metabolism. Its action in dealing with virus pneumonia and virus encephalitis
has been outlined. The clinical use of vitamin C in pneumonia has a very sound
foundation. In experimental tests monkeys kept on a
vitamin C free diet all died of pneumonia while those with adequate diets
remained healthy.[62] Many
investigators have shown an increased need for ascorbic acid in this condition.[63,64] Brody in 1953 after
studying vitamin C and colds in college students advised that ascorbic acid be
given early and often in sufficient amounts. Regnier[65] reporting in review of
Allergy found that the larger the dose of ascorbic acid the better were the
results. Our findings resulted in a schedule of one gram each hour for 48 hours
and then 10 grams each day by mouth. Those under ten at least
one gram for each year of life.
Virus Encephalitis.
Virus encephalitis is a deadly syndrome and must be treated heroically
with intravenous and/or intramuscular injections of ascorbic acid. We recommend
a dose schedule of from 350 mg to 700 mg per Kg. body weight diluted to at
least 18 c.c. of 5D water to each gram of "C". In small children, 2
and 3 grams can be given intramuscularly, every 2 hours. An ice cap to the
buttock will prevent soreness and induration.
Ascorbic acid in amounts under 400 mg per Kg. body
weight can be administered intravenously with a syringe in dilutions of 5 c.c.
to each one gram provided the ampule is buffered with
sodium bicarbonate with sodium Bisulfite added. As
much as 12 grams can be given in this manner with a 50 c.c. syringe. Larger
amounts must be diluted with "bottle" dextrose or "saline"
solutions and run in by needle drip. This is true because amounts like 20 to 25
grams which can be given with a 100 c.c. syringe can suddenly dehydrate the
cerebral cortex so as to produce convulsive movements of the legs. This
represents a peculiar syndrome, symptomatic epilepsy, in which the patient is
mentally clear and experiences no discomfiture except that the lower
extremities are in mild convulsion. This epileptiform
type seizure will continue for 20 plus minutes and then abruptly stop. Mild
pressure on the knees will stop the seizure so long as pressure is maintained.
If still within the time limit of the seizure the spasm will reappear by simply
withdrawing the hand pressure. I have seen this in two patients receiving 26
grams intravenously with a 100 c.c. syringe on the second injection. One
patient had poliomyelitis, the other malignant measles. Both were adults. I
have duplicated this on myself to prove no after effects. Intramuscular
injections are always 500 mg to 1 c.c. solution. With continuous intravenous
injections of large amounts of ascorbic acid, at least one gram of calcium gluconate must be added to the fluids each day. This is
done because we have found that massive doses of ascorbic acid pulls free
calcium ions from the vicinity of the platelets or from the calcium-prothrombin complex as the lactone
ring of dehydroascorbic acid is opened. The first
sign of calcium ion loss is "nose bleeding". This differs from the
nosebleed found, at times, in cases of chicken pox or measles. Here it
represents frank scurvy from vitamin C deficiency. The
pathology being "Capillary fr
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
us
Pregnancy.
The simple stress of pregnancy demands supplemental vitamin C. This amount
will vary with the individual. The silver nitrate-urine text will simplify these
findings. Vitamin C seems especially concerned with mesenchymal
tissue. When one considers the demands of the fetus and infant, especially
premature babies, it is obvious that high vitamin C intakes are required during
pregnancy because this "parasite" will drain available "C"
from the mother. Greenblatt[67] reports excellent results
following the oral administration of vitamin C in the therapy of habitual
abortion. In my own practice I was able to take women who had had as many as
five abortions without a successful pregnancy and carry them through two and
three uneventful pregnancies with the use of supplemental vitamin C. The German
literature is "stacked" with articles recommending high doses of
vitamin C during gestation because they believe that this substance is of great
benefit in influencing the health of the mother and in preventing infections.
The vital contribution of ascorbic acid to the body tissues can be summed up in
the formation and maintenance of normal intercellular material, especially in
the connective tissue, bones, teeth, and blood vessels. Genetic errors might be
prevented if prospective mothers were advised to take 10 or more grams of
ascorbic acid daily. It is significant that we found in the simple stress of
pregnancy, a normal physiological process, that
equivalent requirements paralleled those found in the rat when under stress. Experiments by King et al.[68] have shown that the need
for supplemental vitamin C begins with the embryo.
Kidney Stones.
The "scare" factor of large doses of ascorbic vs. kidney stones
has been laid to rest. Since the urine is usually pH6, one can see that the
opening of the lactone ring is a slow process. This
reaction takes place in tissues and is probably regulated by the amount of
glutathione present. The important considerations are that one must have a
concentrated urine, that stasis must be a factor and that the urine must be
alkaline for any appreciable amounts of the crystalloids to precipitate out.
This will never occur with massive ascorbic acid therapy. Furthermore, it has
been shown that the controls in a given experiment had almost as much oxalic
acid spill as did those volunteers taking 9 grams of ascorbic acid daily.
Insect - Snake Bites.
The quickness of results in snake bite, spider bite, hornet stings and
caterpillar reactions demonstrates the usefulness in saving lives. It is best
to give the vitamin intravenously with a syringe since bottle preparations are
too time consuming. One precaution must be given.
There exist a 2 gram ascorbic acid ampule, 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 ampule
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 ampule can be used
intravenously ONLY when diluted to at least 25 c.c. to one
gram. One sometimes will be confronted with extraordinary allergic and
shock symptoms along with acute respiratory obstruction. In these situation one
must employ Benadryl intravenously and/or intramuscularly and an adrenocortical hormone such as Decadron.
These can be given by a nurse while the ascorbic acid is being prepared. In
their absence a second "syringe" dose of ascorbic acid will suffice.
Fluids by mouth should be given to prevent or correct thirst which all patients
seem to experience.
Diabetes
Large doses of ascorbic acid do not cause diabetes mellitus in humans as
has been suggested. On the contrary 10 grams daily, by mouth, has proved to be
beneficial. The fact that 10 grams will allow them to heal wounds like normal
individuals will save many legs in. the future. Lamden,
a biochemist, instigated these fears by misinterpretation of the results
reported by Patterson using the Ketone formula
intravenously in rats.
In Surgery.
In surgery the use of ascorbic acid resolves itself into a
"must" situation. The 24 hour frank scurvy levels should be
sufficient evidence to encour
In Malignancy.
The part very large doses of ascorbic acid given
intravenously over a prolonged period offers a medical challenge. From
cabb
Barbiturate Poisoning.
Our findings in no less than 15 cases of barbiturate poisoning suggested
that no death should occur from this error in judgment. We also observed the
dramatic effect of 12 grams intravenously on blood pressure associated with
shock. The shock seen in heat stroke had been corrected by the time the
injection was completed. The dose range used was 500 mg per Kg body weight.
Tetanus - Trichinosis
The use of ascorbic acid with Tolserol in the
treatment of Tetanus should be accepted as universal treatment. Here
Viral Hepatitis.
Ascorbic acid is the drug of choice in viral hepatitis. The dose used
ranges from 400 mg to 600 mg per Kg body weight, depending on the severity of
the disease. It should be given every 8 to 12 hours. Ten grams ascorbic acid
daily in divided doses is also given by mouth. Those under 10 years the usual
schedule of at least one gram for each year of life.
Multiple Uses.
We have reviewed many other pathological conditions in which ascorbic acid
plays an important part in recovery. To these might be added Cardiovascular
Diseases, Hypermenorrhea, Peptic and Duodenal Ulcers,
Post-operative and Radiation Sickness, Rheumatic Fever, Scarlet Fever, Poliomyelitis,
Acute and Chronic Pancreatitis, Tularemia, Whooping
Cough and Tuberculosis. In one case of scarlet fever in which Penicillin and
the Sulfa drugs were showing no improvement, fifty grams ascorbic acid given
intravenously resulted in a dramatic drop in the fever curve to normal. Here
the action of ascorbic acid was not only direct but also as a synergist. A
similar situation was observed in a case of lobar pneumonia. In another case of
purperal sepsis following a criminal abortion the
initial dose of ascorbic acid was 1200 mg per Kg body weight and two subsequent
injections were at the 600 mg level. Along with Penicillin and Sulfadiazine an
admission temperature of 105.4∞F. was normal in nine hours. The patient made an
uneventful recovery. In one spectacular case of Black Widow[69] spider bite in a 3 1/2
year old child, in coma, one gram calcium gluconate
and 4 grams of ascorbic acid was administered intravenously when first seen in
the office. Four grams ascorbic acid was then given every six hours using a 20
c.c. syringe. She was awake and well in 24 hours. Physical examination showed a
comatose child with a rigid abdomen. The area about the umbilicus was red and indurated, suggesting a strangulated hernia. With a 4 power
lens, fang marks were in evidence. Thirty hours after starting the vitamin C
therapy the child expelled a large amount of dark clotted blood. There was no
other residual. A review of the literature confirmed that this individual has
been the only one to survive with such findings; the others were reported at
autopsy. Ten grams vitamin C and 200 mg to 400 mg vitamin B-6, by mouth, daily
will "shield" one from mosquito bites. Twenty percent will also require
100 mg vitamin B-6 intramuscularly each week.
General Nutrition.
Vitamin C plays a very important role in general nutrition. Deficiency of
this substance in sufficient amounts can be a factor in loss of appetite, loss
of weight or failure to grow, muscular weakness, anemia and various skin
lesions. The relationship between vitamin C and the health of the gums and
teeth has long been recognized. Laboratory studies on
gum-teeth connective tissue have reaffirmed this relationship.[70] Our son who will be 19 in
July has never developed a tooth cavity. Since
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 c.c. of 5 per cent dextrose in water,
saline in water or Ringer's solution. Many times Adenosine
5-Monophosphate, 25 mg in children and 50 to 100 mg in adults, given
intramuscularly, is necessary to achieve results. The aqueous solution is more
effective for quick results, although Adenosine in Gel can be employed. In
debilitated individuals or when the pathology is serious, Desoxycorticosterone
Acetate (DCA), aqueous solution, must also be added to the schedule. Usually
2.5 mg for children and 5 mg for adults is the daily intramuscular dose
required. Sudden swelling of the feet indicates abnormal sensitivity and the
drug must be discontinued.
It must be remembered when using ascorbic acid that experiments on man are
the only experiments which can give positive evidence of therapeutic action in
man. Likewise, the use of ascorbic acid in human pathology must follow the Law
of Mass Action: "In reversible reactions, the extent of chemical change is
proportional to the active masses of the interacting substance."
FRED R. KLENNER, M.D.
1 Correspondence with
colle
2 Jennings & Avinoff:
Wild Flowers of
3 Food and Life: P. 236, 1939 Yearbook,
U.S. Dept. Agriculture, U.S. Printing Office, Washington, D.C. ref
4 Klenner, F.
R.;: Correspondence with Dr. Bauer, University of
5 J. J. Burns, et al.: J. Biol. Chem.
207: 679, 1954. ref
6 Salomon, L. L, et al.: N.Y. Acad.
Science 93: 115, 1961. ref
7 Conney, A.
H., et al.: N.Y. Acad. Science 92: 115, 1961. ref
8 Grollman,
A. P. & Lehninger, A. L.: Arch. Biochem., 69:458, 1957. ref
9 Chattejee,
10 Isherwood,
F. A. & Mapson, L. W.: N.Y. Acad. Science 92:6,
1961. ref
11 Burns, J. J. Am. J. Med. 26: 740,
1959 ref
12 Stone,
13 Slobody,
L. B.: J. Lab & Clinical Med. 29 #5, 464-472, 1944. ref
14 Ringsdore,
W. M., Cheraskin, E. Sec., Oral Med., U. of Ala. Med.
Center, Birmingham, Ala. ref
15 Klenner,
F. R.: Tri-State Med. J., Feb. 1956. ref
16 Larson, C.: Ordnance, PP. 359-360,
Jan.-Feb. 1967. ref
17 Starr, T. J.: Hospital Practice, p.
52, November 1968. ref
18 Kropowski,
H.: Med. World News, p. 24,
19 Klenner,
F. R.: J. Applied Nutrition, 1953. ref
20 Klenner,
F. R.: Tri-State Med. Journal, June 1957. ref
21 Klenner,
F. R.: Tri-State Med. J., Oct. 1958. ref
22 Klenner,
F. R.: Tri-State Med. J., Feb. 1960. ref
23 Baker, A. B. & Noran, H. H.: Archives Int. Med. Vol. 76, 146-153, 1945. ref
24 Bakay, L:
The Blood-Brain Barrier, C. Thomas, 1956. ref
25 Chambers, R. et al: Physiol. Rev., Vol. 27, 436-463, 1947. ref
26 Knisely,
M. H. et al: Archives Surgery, 51-220, 1945. ref
27 Knisely,
M. H. Science 106: 431, 1947. ref
28 Berkeley, W. T., Jr.: Southern Med.
J., Vol. 58, pp. 1182-1184. 29 Lund & Levenson:
Arch. Surg., Vol. 55: 557, 1947. ref, ref
30 Bergman, H. C. et al: Am. Heart J.,
Vol. 29, 506-512, 1945. ref
31 Lam, C. R.: Col. Rev. Surg. Gyn. & Obst.,
Vol. 72, 390-400. 1941. ref
32 Klasson,D. H.: N.Y. J. Med., 51, 2388-2392, Oct. 1951. ref
33 Stone, H. H.: Med. J., Aug. 1: 6-10,
1970. ref
34 Borsook,
H. et al: J. Biol. Chem, 117:237, 1937.
35 Hoverbed: Med. World News,
36 Meakins,
J. C.: The Practice of Med., C. V. Mosby, 1938. ref
37 Kelli
& Zilva; J. Biochemistry, 29: 1028. 1935. ref
38 Lambden,
M. P. et al: Proc. Sec. Exp. Biol. Med., 85: 190-192, 1954. ref
39 Arthus: J.
Pharm. Chemi.,
40 Wells, H. C.: Chem. Pathology,
Saunders, 3rd Ed., 1925. ref
41 Ford: J. Pharmacy, 2, 285; 1911. ref
42 Editorial:
J.A.M.A. (117) 11: 937-938, 1941. ref
43 Chambers, R., & Pollock, H.: J.
Gen. Physiology, 10: 739, 1927. ref
44 Clark & Rassiter:
Q. J. Exp. Physiology, V32, 279, 1944. ref
45 Patterson, J. W.: J. Biological
Chemistry, 81-88, 1950. ref
46 Bartlett, M. K., et al.: New
47 Lanman, T.
H., Ingalls, T. H.: Am. Surgery, Vol. 105, 616, 1937.
ref
48 Schumacher:
49 Mono-Epstein-Barr
virus-Burkitt Lymphoma: Med. World News,
50 Schlegal,
G. E., et al.: Trans. Am. Ass. Genito Urinary
Surgery, Vol. 61, 1989, ref
51 Click and Hosoda: Proc. Sec. Exp. Biology and Med., 119, 1965. ref
52 Clemmesen,
C.:
53 Hadden,
J., et al.: J. Am. Med. Assoc., 209: 893-900, 1989. ref
54 Becker, R. R., et al.: J. Am. Chem.
Sec. 75: 2020, 1953. ref
55 Klenner,
F. R.: Tri-State Med. J., July, 1954. ref
56 Jungeblut,
C. U.: J. Immunology, Vol. 33 #3, Sept. 1939 ref
57 Klenner,
F. R.: Tri-State Med. J., April 1954. ref
58 Capps, R. B.: Modern Med.,
59 Freeben,
R. K., Repsher, L. R.: Mod. World News,
60 Boyd,T. A. Campbell, F. W.: B. Med. J., 2: 1145, Nov.
1950. ref
61 Virno, M.:
Eye, Ear, Nose & Throat Monthly, Vol. 46, p. 1502. ref
62 Sabin: J.
Exp. Med., 89: 507-515, 1939. ref
63 Wright: Ann. Int. Med., 12, 4:
518-528, Oct. 1938. ref
64 Brody, H. D.: J. Am. Diet. Assoc.,
29: 588, 1953. ref
65 Regnier,
E.: Review of Allergy, 22: 948, Oct. 1968. ref
66 Pollock, H. & Halpen:
67 Greenblatt,
R. B.: Obstet. & Gynec.,
2: 530, 1953. ref
68 King, C. C., et al.: New York Times,
69 Klenner,
F. R.: Tri-State Med. T., Dec. 1957 ref
70 Baume, L.
J.: Science News Letter, 64: 103, 1953. ref
71 Klenner,
F. R.: Tri-State Med. J. Nov. 1955. ref
Appendix
Case History: Pesticide Poisoning
Three boys ranging in years from
Case History: Nasal Diphtheria
Three children, living in the same neighborhood, developed nasal
diphtheria. All three children had different physicians. A little girl under
our care was given 10 grams ascorbic acid, intravenously, with a 50 c.c.
syringe every 8 hours for the first 24 hours and then every 12 hours for two
times. She was then put on one gram ascorbic acid every two hours by mouth. She
lived and is now a graduate nurse. The other children did not receive ascorbic
acid and both died. Our young patient also received 40,000 units diphtheria
antitoxin which was given intraperitoneal. The other
children also were administered the antitoxin.
Case History: Poliomyelitis
Although we were able to cure many cases of polio with massive doses of
ascorbic acid, one single instance demonstrates the value of vitamin C. Two
brothers were sick with poliomyelitis. These two boys were given 10 and 12
grams of ascorbic acid, according to weight, intravenously with a 50 c.c.
syringe, every eight hours for 4 times and then every 12 hours for 4 times.
They also were given one gram every two hours by mouth around the clock. They
made complete recovery and both were athletic stars in high school and college.
A third child, a neighbor, under the care of another physician received no
ascorbic acid. This child also lived. The young lady is still wearing braces.
Case History: Acute Virus Infection representing Deadly Virus Syndrome
Cases with paralysis are
extremely interesting in as much as they challenge di
Case History: Repeating virus infection
This case proved that adequate ascorbic acid therapy must be continued long enough to destroy all virus bodies,
otherwise the infection will recur. In 1960, I treated a seven year old boy,
off and on, over a period of six weeks, for influenza like symptoms. Therapy included
one of the mold derived drugs, sulfadiazine and 5 to 10 grams ascorbic acid by
mouth. On three different occasions this treatment schedule was dramatically
effective. When the child became ill for the fourth time, the administration of
the above antibiotics and oral vitamin C had no reversing effect. On the third
day of this illness the child suddenly became lethargic and just as suddenly to
frank stupor. The temperature which had been running low grade was now
102.6∞F. At this paint all oral medication was discontinued. I
immediately gave six grams of ascorbic acid intravenously with a 30 c.c.
syringe. He was awake and asking, "what happened" in 5 minutes. Six
grams ascorbic acid was given in 4 hours and then at 6 hour intervals for two
additional doses. The recovery was complete in 24 hours and remained so.
Ascorbic acid was
Case History: Snake bite
Child of 4 years was struck on the lower leg by a large highland moccasin
at
Comparing this to an earlier case of snake bite in a 16 year old girl,
struck by a moccasin of about the same size, as gauged from the fang marks, on
the hand while pulling tobacco plants, and who was hospitalized for three
weeks. She was given 3 doses of anti-venom. The arm was compressed continuously
with m
Case History: An Insidious virus
This was a child of 18 months. She was seen in the driveway to my home at
about
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 ascorbic acid, in divided doses, was given intramuscularly
over a period of 36 hours. Crystalline penicillin was started on the second day
and 300,000 units were administered in divided doses over the next three days.
This was added to block secondary invaders. One hour following admission we
applied a 4 x 4 gauze, saturated with tap water, to
the child's lips. The sucking reflex was still intact, but the child
immediately strangled. Turning the child head down, the small amount of water
ran from its nostrils. Now it was clear. It was this "bulbar phenomenon" that was at
play when the child was eating supper. The nursing log showed the temperature
to be 99.0∞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
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 di
Case History #1: Acute Virus qancarditis
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..
Ascorbic acid calculated at 400 mg per Kg body weight was given intravenously
with a syringe. Within two hours the picture had almost reverted to normal.
Injection of Vitamin C was repeated in 6 hours and
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
Case History: Acute Pancreatitis
Adult Male seen in the emergency room of local hospital complaining of
severe,
End
I am in full
Frederick R. Klenner,
M.D., F.C.C.P.
A native of
Dr. Klenner then 'migrated' to
Dr. Klenner served three years in post graduate
hospital training before embarking on a private practice in medicine. Although
specializing in diseases of the chest, he continued to do general practice
because of the opportunities it afforded for observations in medicine. His
patients were as enthusiastic as he in playing guinea pigs to study the action
of ascorbic acid. The first massive doses of ascorbic acid he gave to himself.
Each time something new appeared on the horizon he took the same amount of
ascorbic acid to study its effects so as to come up with the answers.
Dr. Klenner's list of honors and professional
society affiliations is tremendous. He is listed in a flock of various
"Who's Who" registers. He has published many scientific papers
throughout his scientific career.