Recent Posts

ARTHRITIS AND RHEUMATISM: ASCORBIC ACID (PURE VITAMIN C)

From the Book: Healing Factor Vitamin C Against Disease – by Irwin Stone, Linus Pauling, Albert Szent-Gyorgyi 1972.

Source on-line: https://vitamincfoundation.org/stone/

Source download book: https://welib.org/md5/35609ae8abf6e1dcb1cc701374943358

Approximately 13 million Americans suffer from arthritis, making it the nation's number-one crippler. Over 10 million have seen a doctor seeking relief and more than 3 million report limitation of their usual activity because of the disease. An estimated 1.3 billion dollars is the yearly toll on the economy (1).

Arthritis is not a killing disease, so the prevalence rises with age, the victims becoming disabled and wracked with pain -- but they continue to live and suffer. Arthritis gradually withdraws from productive activity large numbers of otherwise capable people.

Arthritis, rheumatism, and other related conditions are often referred to as the collagen diseases because of the definite involvement of this protein in their genesis and cause. Anyone having read the previous chapter on heart disease will recall the relation of ascorbic acid to collagen production and the absolute necessity for the presence of high levels of ascorbic acid in the body for the proper syntheses and maintenance of high-quality collagen protein. Briefly, collagen makes up about a third of our body's protein content. It is deprivation of ascorbic acid, with the consequent synthesis of poor quality collagen or no synthesis at all, which brings on the most distressing bone an joint effects of clinical scurvy. There can be no doubt about the intimate association of ascorbic acid and the collagen diseases.

Rivers (2), in 1965, in a review article on the tissue derangements caused by a lack of ascorbic acid states "Abnormalities" in this protein (collagen) are baic to the crippling deformities associated with rheumatic diseases and with a number of congenital connective tissue defects." Robertson (3), in studies on induced granuloma tissue of prescorbutic and normal guinea pigs, showed that guinea pigs deprived of ascorbic acid for only 14 days produced tissue containing only 2 to 3 percent collagen, while the tissues in normal guinea pigs contain 14 to 16 percent. Udenriend (4) Stone and Meister (5), and many others have shown that the dependence of high-quality collagen protein on ascorbic acid is due to its chemical action on one or two of the amino acid building blocks used in the manufacture of collagen.

As in many other diseases, the discovery of ascorbic acid inspired much research on the collagen diseases in the 1930s. A classic series of papers by Reinhart and coworkers (6) appeared in the period from 1933 to 1938 relating deficiencies of ascorbic acid and infection to the development of the rheumatoid process. They developed a theory intimately linking ascorbic acid with the genesis of rheumatic fever from the evidence of its social, urban, and familial incidence, the role of malnutrition, the age of incidence, seasonal incidence, geographic distribution, the symptomatic similarities of latent scurvy with the early rheumatic state, the role of infection, the problems of hemorrhage, and the existence of latent scurvy in rheumatics. Their logic was impeccable and everything fitted together like a jigsaw puzzle.

As might be expected, the publication of Rinehart's series of papers evoked much discussion and further tests. The papers resulting from this additional work may be divided into those that agreed with and more or less checked Rhinehart's work (7) and those that disagreed (8). Reviewing these discussions in detail now would serve no useful purpose and would occupy too much space. If anyone is interested, they can refer to the original papers. Of vital importance is the clinical work conducted, in these early days to test Rinehart's hypotheses; and we shall see with the advantage of hindsight how this clinical work was inadequate. We will first review the clinical work on dosages at the "vitamin" levels and observe their general ineffectiveness. After this we will take up the scant clinical data where tests were conducted using ascorbic acid at the lower fringes of megascorbic therapy with good clinical results.

M.P. Schultz (9) in 1936, reported on tests conducted at the hospital for the Rockefeller Institute in which ambulatory patients received from 100 to 250 milligrams of ascorbic acid daily either orally or intravenously for periods of months (the average was 2-1/2 months). The conclusion was that the incidence of rheumatic fever or the clinical manifestations of the disease were not favorably or demonstrably affected by this medication. F.H. Mosse (10), in 1938, described a single case, the dramatic improvement of a farmer with acute multiple arthritis, in the midst of a scurvy epidemic in China, by the ingestion of 800 to 1200 cubic centimeters of "fresh red fruit juice." He also discussed the etiology of rheumatic fever in northern China in those days. M.G. Hall and coworkers (11) a the P.B. Brigham Hospital in Boston reported, in 1939, that all of the patients with rheumatoid arthritis were placed on an intake of 200 milligrams of ascorbic acid per day for eight months with no improvement that could be attributed to this treatment.

In 1940, R.H. Jacques (12) reported that in a series of forty-eight arthritic cases, forty-seven had low levels of ascorbic acid in their blood plasma. Treatment with 100 milligrams a day of injectable ascorbic acid for one week and 300 milligrams a day of injectable ascorbic acid for one week and 300 milligrams a day of ascorbic acid orally for another few weeks brought up the blood plasma levels. The patients were followed for a period of three weeks to six months thereafter on a regime of 100 milligrams of ascorbic acid a day orally. His conclusion -- there was no marked clinical response even though the plasma levels had returned to normal. Twenty percent were moderately improved, 33 percent were slightly improved, and 47 percent showed no change or were worse. In a short report in a Russian journal, Vilyansky (13) treated thirty-nine patients with 200 to 300 milligrams of ascorbic acid intravenously per day. He reported that his tests showed his patients to be quite deficient in ascorbic acid and they responded well to the treatment. There was less pain, better mood, less swelling, and increased mobility in twenty-six of his patients. Eleven took longer to respond and two showed no effect. These two had been treated previously with salicylates. He states that in most cases three to five injections of ascorbic acid were sufficient to "liquidate" the attack of rheumatism.

Freyberg (14), in 1942, using fruit juices or ascorbic acid in amounts to maintain the blood plasma levels at "normal" levels in thirty-seven patients, found that "there was no evidence that the arthritis was better or that the course of the disease was different in any way whether or not the vitamin C deficiency was corrected." Trant and Matousek 15), in 1949, reported their experiences treating a series of eighteen arthritic patients at Chicago Presbyterian Hospital with 100 Milligrams of ascorbic acid daily. They concluded, "On the principle of good hygiene it is well to restore low levels of serum ascorbic acid to normal, but not with the anticipation that any improvement in the arthritis will result."

Rinehart (16), in 1943, in a paper entitled "Rheumatic Fever and Nutrition, " reviewed the work of the previous decade and admitted:

While it has been shown that vitamin C does not exert a specific curative effect upon rheumatic fever it is likely that the frequency and severity of the hemorrhagic manifestations have been reduced. It is not known to what extent vitamin C or related factors might further protect the patient. Maintenance of rheumatic patients on adequate amounts of ascorbic acid will evidently not prevent recurrence of the disease.

The conclusions to be drawn from these early tests are that the measurement of ascorbic acid blood levels is not a good criterion for therapeutic effects and that the approach used by all these investigators was wrong. They were trying to correct a nutritional deficiency instead of treating a serious disease. The daily dosages required to raise the blood levels of ascorbic acid to what they considered normal were greatly below the megascorbic levels actually required to obtain a definite therapeutic effect in the collagen diseases. These early clinical tests were experiments in home economics rather than the thorough pharmacological testing of a new medicament.

Massell (17), in 1950, in a preliminary report on the use of 4 grams “4,000mg”of ascorbic acid (1 gram four times per day) in seven young patients (five to eighteen years) for only eight to twenty-six days obtained rapid cessation of symptoms and stated, "Our observations suggest that ascorbic acid when administered in sufficient amounts possesses anti-rheumatic activity." He also mentions:

Previous therapeutic failure may perhaps be attributed to the fact that practically all investigators were thinking in terms of vitamin C deficiency and, hence, used doses of ascorbic acid considerably smaller than those used by us... It is possible that individual doses of more than 1 gram or total daily doses of more than 4 grams, if found harmless, may prove to be therapeutically even more effective.

The purpose of the publication of this preliminary report was to "stimulate further investigations of the therapeutic potentialities of ascorbic acid." Large-scale tests were never made to check these exciting results. The only further testings which were made are the following highly successful clinical tests reported in the 1950s by private investigators -- then we have silence.

Baufeld (18), in 1952, using individual intravenous dosages of 6 grams of ascorbic acid for acute and chronic rheumatism, observed "astonishing" results in some cases. He also noticed good response in lumbago, sciatica, and bronchial asthma. He stated that he believed he had found something which called for further testing. In 1953, Greer (19) found 8 to 12 grams of ascorbic acid, in combination with antibiotics, to be an effective anti-rheumatic fever measure in several serious cases. McCormick (20), in 1955, after offering a scholarly review of the literature dating back to the seventeenth century, showed the relationship of scurvy to the rheumatic diseases and stated that a number of his acute rheumatic fever cases were treated with 1 to 10 grams of ascorbic acid daily with a rapid and complete recovery in three to four weeks without cardiac complications. Similar results were obtained in incipient arthritis. Afanasieva (21), in a 1959 Russian paper, noted gains in 48 rheumatic fever women patients using 1.25 grams of ascorbic acid daily for twenty to twenty-five days in combination with other therapy.

If the government agencies and the publicly supported foundations interested in the arthritic diseases, had pursued these scant but provocative leads supplied by Massell and others in the 1950s, the past two decades may have seen the elimination of these collagen diseases as a major crippler of the population