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Title: Ascorbic acid therapy in certain zymotic diseases : a study of five hundred and eight cases, with a critical review of the literature
Author: MacQueen, Ian Alexis Gordon
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1949
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In cerebrospinal meningitis the value of intramuscular injections of ascorbic acid is proved beyond shadow of doubt. While it is not for a moment suggested that treatment with vitamin C should replace sulphapyridine or sulphathiazole therapy, the vitamin is a most useful adjuvant: injection of 1500 mg. during the first three days of illness causes a dramatic drop both in the percentage of deaths and in the incidence of complications and sequelae. Owing to gastro - intestinal upset, oral administration of ascorbic acid is often impracticable in cases of cerebro- - spinal meningitis; and, even in cases which can tolerate drugs given by mouth, it is doubtful whether any real benefit is conferred by oral administration of moderate doses of the vitamin. In severe faucial or nasopharyngeal diphtheria treatment with adequate amounts of the vitamin significantly reduces the mortality rate. An adequate dose for a severe case of diphtheria is, - 500 mg. intravenously, with ( or immediately after) the antitoxin, followed. by 600 mg. orally during the next three days. Since the dosage just mentioned gives satisfactory results in toxic diphtheria, the use of -the parenteral route after the first day of treatment appears to be unnecessary and - in view of the relative costs of tablets and sterile ampoules - undesirable. In mild diphtheria, streptococcal tonsillitis, and scarlet fever oral administration of the vitamin does not produce very marked results: such effects as are occasioned by ascorbic acid therapy are certainly in the direction of shortening the period of illness and the duration of faucial inflammation, but the benefits are so trivial that it is doubtful whether the giving of synthetic ascorbic acid in these diseases is a justifiable expense. It seems probable that, under the conditions of normal times, all that is necessary is the provision of sufficient fruit drinks during the acute stage and of ample fresh fruit and green vegetables during convalescence. In cases of influenza a study of the urinary excretion of ascorbic acid proves that 400 mg. of the vitamin ( or Falke's suggested dosage of 100 mg. for each day of pyrexia ) is insufficient to remedy the state of hypovitaminosis C. Since treatment with even this inadequate dosage has been found, in a comparison of only fifty -four treated and fifty-four untreated cases, to cause a diminution in the incidence of complications and relapses sufficiently marked to approach the level of statistical significance, it is suggested that - until some subsequent investigator definitely proves or disproves the value of ascorbic acid in influenza - cases of that disease should be given about 200 mg. of the vitamin daily for the first three days of illness. In brief, then, parenteral administration of vitamin C should form part of the treatment of cerebrospinal meningitis, the drug should be given orally and intravenously in severe diphtheria, and it is probably desirable to give the vitamin orally to cases of influenza; but in mild diphtheria, scarlet fever and tonsillitis the provision of synthetic ascorbic acid appears to be an unjustifiable expense.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available