Vitamin C in tuberculosis: its metabolism and therapeutic value

Abstract

(1) A review of the Literature on the claims of Vitamin C as a detoxicant and bactericidal agent is given.

(2) The findings in 101 cases of the plasma ascorbic acid level are given. Ascorbic acid is used up in severe tuberculosis, the reserves are depleted, and it is difficult to saturate the toxic case. For normal health the level must not go below 0.5 mgm. percent. There appears to be a threshold level at 1.325 mgm. per cent. when the urinary excretion rises rapidly.

On cessation of ascorbic acid given by mouth excretion falls rapidly. The normal range appears to be between 0.6 mgm. to 1.3 mgm. per cent.

(3) Urinary excretion of ascorbic acid. On a normal diet and in health a man of 10 stone weight excreted 13 mgm. per 24. hours. This figure falls in tuberculosis and most rapidly in the toxic case. The saturation test showed that unusually large doses of ascorbic acid were necessary to saturate in severe tuberculosis.

(4) There is no satisfactory proof that lack of Vitamin C leads to progressive tuberculosis.

(5) Vitamin C as a therapeutic agent: The peak value of plasma ascorbic acid seems to be 1.325 imp. per 100 ccs. after which elimination by the kidneys is increased.

(6) Vitamin C acts as a tonic agent: It has no direct action on the tuberculous process. It is necessary for health, and it seems to promote suprarenal efficiency by raising the serum sodium level. It has an action on healing tissue, and is necessary therefor. It has no action as a detoxicant, and does not alter the sedimentation rate.

(7) There appears to be such a loss of Vitamin C reserves in fatal cases of tuberculosis that the terminal features are those of scurvy. These can be overcome by the free use of ascorbic acid.

(8) A case of scurvy from depletion of Vitamin C reserves is described.