Fitness

Each of the 252,000 known cases of muscular dystrophy and atrophy in the United States should have been prevented.

The Muscular Dystrophy Association believes this figure to be only a fraction of the cases which actually exist. The incidence of this disease has apparently doubled in the last 10 years, running parallel to the numbers of fats which have been hydrogenated. The disease is little known because you rarely see these crippled people; most are too weak to leave their homes or to move wheelchairs. You do see a few but assume they are suffering from arthritis or the aftermath of polio.

The most depressing week end I have ever spent was last year when I was sent as a delegate to a muscular dystrophy conference in Atlantic City. Here were dozens of victims of this horrible living death; some were skeleton-thin; others appeared fat, bulky fibrous material having replaced normal muscle tissue. Many were pulled out of shape by muscles which had stopped growing long before the bones to which they were attached had ceased developing. It is almost unbelievable that weak muscles can pull the shoulder blades so close to the buttocks or can so disfigure the human form. One of their members, an eight-year-old boy, died that week end. Death occurred, as usual, from a slight cold; mucus cannot be coughed from the throat when muscles have given away. As this death was announced at the conference, one could see a look of dread and horror pass over the face of every parent in the room; you understood why each lived in deadly fear of colds.

All week end I talked with these people, admiring their spirit and marveling at their courage. I asked them about their food. Were any of them taking vitamin E in the hope of stopping the progression of the disease? Yes, a few. It has been known for years that muscular dystrophy runs in families. One Chicago family has six boys afflicted with it; a New York family, four boys. Were these people giving vitamin E to the other members of their families in the hope of preventing the onset of this disease? Not that I could find. Was one word said during the conference about preventing this disease? Not that I heard. These people want a cure, and may God answer their prayers!

It was not the contorted shapes, the emaciated forms or the useless limbs of these wonderful people facing the slow death they were all too keenly aware of which depressed me that week end. It was the mental picture of thousands upon thousands of similar children and adults who were yet to develop the disease and to suffer for seemingly endless years. As far as I know, not one step is being taken to prevent the onset of this horrible disease. Do you know of one obstetrician who routinely asks his patients to take vitamin E during pregnancy? I do not. Breast milk averages 40 times more vitamin E than does cow’s milk, but few babies are lucky enough these days to get breast milk. Do you know of one pediatrician who routinely gives vitamin E to the babies who must live on formulas? I do not.

Nothing is being done because there is no proof. In the name of heaven, how much proof is wanted? There is proof that pregnant women get little vitamin E. There is proof that children are undersupplied with this vitamin. There is proof that oils are refined and bread is white. Muscular dystrophy is produced in a dozen species of animals when the diets of both mother and offspring are undersupplied in vitamin E. Is there any proof that the muscles of these animals differ much from those of people? Since that week end I have been far more afraid of muscular dystrophy than of cancer or of polio.

Physicians have used vitamin E in attempting to treat many diseases. The most encouraging reports on its therapeutic use have come from a group of physicians in Canada led by Dr. Evan Shute (pp. 354-408 of ref. 1, p. 160). He and his co-workers have studied the effect of vitamin E on women who have had repeated miscarriages and on hundreds of persons suffering from heart disease, high blood pressure, peripheral atherosclerosis, Buerger’s disease, diabetes, diabetic gangrene, and gangrenous ulcers. Their results have been dramatic. It is proved that vitamin E fortunately decreases the body’s need for oxygen; presumably death from heart disease is caused by lack of oxygen. Gangrene, gangrenous ulcers, Buerger’ sdisease, and peripheral atherosclerosis are also conditions in which too little oxygen reaches the cells.

The work of these physicians has been confirmed in Canada, but in the United States it has met with bitter medical criticism. Several doctors have warned me that if I want physicians to respect my writing, I must not mention Dr. Shute’s name. Dr. Shute answers his critics by pointing out that if, in the early days of insulin, every physician had had all the insulin he wished and had given each patient the same amount, no two batches standardized, experimental studies could not have produced identical results. My feeling is that Dr. Shute’s work should be viewed with an open mind.

Although these Canadian physicians have found that they cannot obtain results with much less than 300 milligrams of natural vitamin E daily and that the need for at least adequate vitamin E is unquestioned, the diet used by physicians for high blood pressure (p. 303 of ref. 1, p. 160) contains only 7.22 milligrams per day. The reducing diet recommended by the American Medical Association (p. 303 of ref. I, P: 160), frequently given to persons suffering from heart disease or women wanting a healthy baby, supplies 4.3 to 6.6 milligrams. The diabetic diet in a textbook (p. 619 of ref. 1, p. 160) used in medical schools and by practicing physicians supplies 8.6 milligrams. A tablespoon of soybean oil, taken as salad dressing at lunch and/or dinner, could at least supply 30 to 60 milligrams of vitamin E for these patients and prevent the destruction of vitamin A in their bodies.

I have a hunch that vitamin E played a major role, together with the B vitamins and other nutrients, in the vital statistics published in Denmark after World War I; when no grains were milled, there were fewer cases of high blood pressure, diabetes, and heart disease, the very diseases Dr. Shute has found to respond to vitamin E. Another of my hunches is that these same diseases could be less common in the United States. If we applied what is already known, proof might soon be forthcoming.

My final hunch is that if people stayed on adequate diets including a generous amount of vitamin E, they, like the hundreds of animals studied at Columbia University, might retain their appearances of youth and their normal sexual functions to a late age; their life span, too, mi.ght be tremendously increased.

In female animals, the estrus cycle-menstrual cycle to us - becomes irregular when vitamin E is undersupplied. The onset of menopause is early, but if vitamin E is increased, normal estrus (menstruation) and fertility are restored. When large amounts of vitamin E are given, menopause is delayed to an advanced age, although eventually all females become sterile. If middle-aged or older males low in vitamin E are given testosterone, they develop enlargement of the prostate, and their testicles atrophy, or shrivel.

At the College of Physicians and Surgeons of Columbia University a four-year study was made of hundreds of animals past their menopause to see whether vitamin E was involved in the aging process. It was found that the less vitamin E given, the higher the percentage of sick animals. The testicles of males receiving less than optimum amounts of vitamin E atrophied, or became smaller, and both males and females lost sex interest and would not mate. Although animals showed no abnormalities when fed “normal” quantities of the vitamin, added vitamin E had a striking effect in prolonging youth and increasing the life span; the conclusion was that aging may be a consequence of multiple deficiency states rather than the result of “natural” processes.

Such research would indicate that vitamin E plays some role in the production of normal sex hormones. Although the relation of this vitamin, if any, to secondary sex characteristics has not been studied, my hunch is that it is important. A number of physicians have pointed out that young people these days seem to be losing their secondary sex characteristics. The hips of boys and men are often too large, whereas girls and women frequently have flat chests and slender hips. “Falsies” for women and corsets for men, semantically known as “surgical belts,” have both become major industries. I am horrified at the frequency with which I find little boys, whose diets appear to be adequate except for vitamin E, with round-cheeked hips or girls with narrow masculine hips. It has been my experience that when the diet is made completely adequate and vitamin E is increased temporarily to perhaps 100 units after each meal, these children develop normal sex characteristics quite rapidly. In my opinion, a boy’s chest should be at least two inches wider than his hips, and a girl’s hips should be as wide or wider than her shoulders. I have seen a few cases where normal breasts have developed after flat-chested women from twenty to thirtyfive years old have conscientiously followed an excellent nutrition program.

Another problem, possibly the result of multiple deficiencies of the nutrients including vitamin E, needed for normal hormone production, is that of children growing excessively large. The rooster becomes a huge capon when the testicles are removed; the slender-hipped bull becomes a steak-producing steer. Any animal supplied with too little sex hormones grows to a larger-than-normal size, Similarly many girls these days grow so large that their mothers, not realizing that poor nutrition may lead to glandular abnormalities which can result in overgrowth, are afraid, for example, to allow them to take vitamin supplements; the mothers fear that their daughters cannot find boys large enough to date with them or eager to marry them. Although there is no proof, I for one am going to follow my hunch. I want my children to achieve normal growth but neither of them to be excessively large; I want my son to have slender hips and my daughter to have something genuine to put inside her brassiere; it is my belief that adequate nutrition in general and vitamin E in particular may help these wishes to come true.

Another hunch started years ago when a professor in biochemistry class stressed that when the ovaries were inactive, the body fat of women became redistributed; they developed middle-age spread and perhaps piano legs and ankles either long before or during middle age. Since I suspected vitamin E was related to ovarian hormone production, I have recommended 100 units of this vitamin after each meal to dozens of women whose weight was correct but whose faces were too thin and hips too large. Although vitamin E may not have done the trick, the weight of most of these women has been redistributed, which was all they or I care about.

I suspect that the middle-age spread of men is often not so much the result of age or too many calories as of an undersupply of hormones caused by cumulative multiple deficiencies of which vitamin E is one. This change from a former physique, I believe, is analogous to the transition from the narrow hips and Hat abdomen of the bull to the broad hips and sagging abdomen of the steer. Although a hereditary tendency may exist, this theory can perhaps be supported by the fact that many men begin to thicken through the waist at ages of thirty-five or forty, whereas the general build of others does not change until the age of sixty-five, if at all.

Many physicians have reported successfully treating irregular menstruation and excessive or scanty flow with vitamin E. The vitamin has been particularly effective in resolving menstrual difficulties at adolescence or at menopause. When generous amounts of this vitamin are given one or two years after the menopause, normal menstruation may recur. I warn such women who consult me to expect the return of menstruation; otherwise they sometimes get panicky, thinking they have uterine cancer. A few women have conceived after dietary improvement, although menstruation had ceased a year or two earlier. Since the irate husband of one shouted at me, “You and your d– vitamins,” I also warn women that unplanned pregnancies may occur.

I have another hunch that when general nutrition is poor and vitamin E is undersupplied, the onset of menopause is early, whereas it may be markedly delayed if the intake is generous. Among my personal friends whose diets have been unusually adequate, I know of no woman whose menopause has set in before the age of fifty-three to fifty-five. Furthermore, I suspect aging occurs rapidly at menopause when vitamin E is undersupplied and, conversely, that women with delayed menopause stay physiologically young. One woman whose nutrition I have checked annually since 1936 is still menstruating at sixty-two years of age; she can pass for forty any day.

In animals, vitamin E is important in aiding the liver to detoxify a variety of harmful substances. The amino acid, methionine, has been considered one of the body’s most important detoxifying agents. Vitamin E, however, has been found to be 400 times more effective than methionine. Far larger amounts of vitamin E are necessary to maintain normal liver function than normal sex function. Jaundice in humans, resulting from the toxic effects of such drugs as atabrine or bromides, has responded so favorably to large amounts of vitamin E as to indicate the wisdom of taking vitamin-E capsules along with any drug which must be used.
Vitamin-E deficiencies in animals take various forms in different species; enzyme systems also vary with different species. The brain is most affected in chickens and turkeys obtaining too little vitamin E; encephalomalacia is produced. This abnormality, known to experienced poultrymen as crazy chick disease, develops spontaneously in farm flocks. Cattle and monkeys, undersupplied with vitamin E, develop severe heart disease long before sexual function becomes abnormal.

If females of most species are given too little vitamin E during pregnancy and their young in turn are undersupplied with the vitamin, the voluntary muscles of the young become abnormal; when the deficiency is severe, these muscles stop growing, and a condition known as muscular dystrophy 3 develops. Dys means to stop; trophy means growth. Normal muscle cells are often replaced by woody, fibrous tissue which has no power to contract. Muscular dystrophy has been produced in such widely varied species as guinea pigs, rabbits, mice, rats, ducks, hamsters, calves, pheasants, pigs, dogs, and even kangaroos. The rabbits and kangaroos can no longer hop, the rats and mice cannot run, and the ducks and pigs stop waddling. Only in the guinea pig and rabbit can this disease be corrected by giving vitamin E; in all other species, permanent nerve damage occurs. The onset of the disease is slow and insidious; it cripples rather than kills. Although this disease is purposefully produced in the laboratory, animals develop it under field conditions. These animals eat food from the same land we get our food from; the disease may develop in animals which we ourselves may eat as food.

Such research indicates that vitamin E plays a role in building normal muscles and perhaps in maintaining muscle tone. I have a hunch that the lack of vitamin E may be one cause of poor posture seen in perhaps 95 per cent of our population, from the wobbly-headed infant born of a malnourished mother to its stooped grandparents. Do you know of a baby clinic where 10 infants of normal weight can be found without potbellies? Do you know of a classroom of 20 youngsters, none with protruding stomachs and angel-wing shoulder blades? Have you seen a high-school room where all the students stand erect and walk with grace? I would gladly cross the continent to see anyone such group. I find many children, especially adolescent boys, whose intake of protein and other nutrients appears to be adequate but whose posture is atrocious; improvement usually follows when this vitamin is given.

As we examine the findings of animal experiments, let us think of similar abnormalities in humans. Since vitamin E is destroyed by rancidity, deficiencies are most readily produced by feeding rancid fat; other animals given vitamin E with the rancid fat remain in excellent health. Animals in which deficiencies are thus produced lack strength and energy; their hair becomes dull and later falls out; the thyroid arid pituitary glands become underactive. The need for oxygen is tremendously increased. Nerves are so injured that some animals, particularly old ones, walk with a waddling g.a:it, lacking co-ordination; sometimes they develop tremors arid unusual sensitiveness to pain; since vitamin A in the body is destroyed without vitamin E, vitamin-A deficiencies, such as severe eye infections, often occur. The animals develop skin lesions, become emaciated, and may suffer from intestinal hemorrhages and diarrhea long before sexual disturbances are evident; they die early. One can easily find all of . these abnormalities in humans. Who can say that an undersupply of vitamin E does not contribute to their cause?

Autopsy shows abnormal changes in the bone marrow, lymph nodes, spleen, nerves, and sometimes brain cells. The heart muscles, studied in detail, have been found to have undergone such degenerative changes that scientists have made the statement: “These alterations justify the use of vitamin E in the treatment of certain cardiac conditions.” The most characteristic finding is chocolate or cocoa-brown bits of pigment deposited throughout the voluntary muscles, heart, testicles, and walls of the uterus; the liver and adrenals are described as “loaded” with pigmentation. These pigments form when oxygen breaks down essential fatty acids, a chemical change similar to that of fats becoming rancid outside the body. The pigment itself is made of these breakdown products from essential fatty acids combined with lecithin, cholesterol, and certain amino acids. Pigmentation occurs long before sexual function becomes abnormal; it is greatly increased by a diet low in protein, by one high in fat but containing few essential fatty acids, by the giving of certain male or female hormones, and by age. The more severe the vitamin-E deficiency, the more severe the pigmentation becomes. Dr. Hickman refers to these pigments as “dirt” left when “organic housekeeping” becomes untidy.

Nutrition-wise, I believe in playing my hunches; I have played hunches about vitamin E for 23 years. One of them is that “liver spots,” which people get first on their hands and sometimes-usually later if at all-on their faces, necks, and backs, are cousins of the brown pigments produced in animals undersupplied with vitamin E. The only studies apparently made of brown pigmentation in humans is a post mortem examination of the testicles of twenty men and another of “brown atrophy” of the organs of elderly persons (ref. 1, P: 160); all the testicles showed pigmentation considered identical with that of experimental animals lacking this vitamin; the “brown atrophy” was also similar to that produced in old animals.

For several years I have looked for “liver spots” on every person who has consulted me; if such spots are present, I usually recommend that 100 units of natural vitamin E be taken after each meal. Months or years later many of these people have returned with all of the disfiguring spots gone. This spring I was consulted by a woman of fifty who had on her left cheek an irregular area of pigmentation % inch across; six weeks later there remained only the faintest suggestion of a shadow. The arms and hands of one woman of fifty-nine were literally covered with “liver spots” a year ago; recently, when lecturing on vitamin E, I asked her to stand before the audience and let them see her hands; the skin is like that of a baby’s; not a spot remains. Such spots seem to appear most quickly foUowing menopause, when the requirement for vitamin E is known to skyrocket; as in animals, the spots sometimes become markedly worse when in[ections of sex hormones are taken without vitamin E being simultaneously increased. In both men and women they become more severe with age. Conversely, I have never seen these spots on any person of either sex who has followed a good nutrition program for several years preceding the “liverspot age.”

More vitamin E is found in the body than any other vitamin. Dr. Henry A. Mattill of the University of Iowa College of Medicine has made the statement: 1 “Perhaps no other of the vitamins mysteriously affects so many and so varied body processes.” Apparently as part of an enzyme which helps to utilize fat, it appears necessary to the function of every cell. It is particularly concentrated in the pituitary, adrenals, and sex glands. Natural vitamin E also prevents vitamin A, linoleic acid, and perhaps other nutrients from being destroyed by oxygen in the body. If obtained in sufficient quantities, it is stored in body fat. Yet when humans are undersupplied with this vitamin, no recognized deficiency disease occurs.

No one doubts that humans need vitamin E. A hundred years ago, before our foods were refined, the daily intake was an estimated 100 to 150 milligrams. Authorities have variously suggested the requirements now to be 30, 60, and even 100 milligrams per day. Vitamin E, like vitamins A and D, can pass into the blood only when taken with fat and when bile is present in the intestine. The American diet supplies slightly less than 6.0 milligrams per 1,000 calories, or about 12 to 15 milligrams per day (p. 303 of ref. 1 below). The National Research Council ” recommends seven basic foods which, if consumed daily, supposedly supply adequate amounts of all nutrients; yet these foods furnish only 5.74 milligrams of vitamin E. The thousands of persons who eat no fat or whose bile flow is inadequate probably absorb little of even these small amounts. Most investigators claim that this vitamin is never toxic; 1,200 milligrams daily has been given to persons without signs of harm. Since vitamin E can be stored efficiently, massive doses would probably never be needed if diets were adequate enough to allow a small excess daily. As conditions are, however, deficiencies can be expected.

Relatively large amounts are required when new cells are forming; Dr. Kenneth C. D. Hickman of the University of Rochester has pointed out that the basic need for vitamin E is during the entire constructive period which reaches its height at adolescence. The need of the growing fetus causes the vitamin-E requirements to be tremendously increased during pregnancy. Even when all growth has stopped, a virile man produces as many as 200,000,000 sperm per ejaculation; the vitamin-E requirement of a man, therefore, may vary with his sexual vigor. It was brought out at the 1949 world conference on vitamin E that the requirement increases tenfold during menopause and that, to maintain health, the aging human may require 50 times the usual intake. I, as one aging human, am going to see that I get generous amounts of this vitamin.

Fruits contain almost no vitamin E. In most medical texts, lettuce is listed as the richest source; 30 heads might supply your minimum daily need. Less than a third of this vitamin found in vegetables is absorbed by humans. Most of the vitamin from grains is discarded when flours are refined, but if the wheat germ is retained, as in the “national loaf’ in England during World War II, little vitamin E is lost. The amount in prepared cereals is practically nil. When oils are highly refined or hydrogenated, much of the vitamin E is sacrificed. Low cooking temperatures harm it little, but 90 per cent is lost in deep-fat frying, as when doughnuts or potato chips are prepared. Even slight rancidity (p. 42) destroys the vitamin both outside and inside the body. The only dependable sources appear to be fresh-ground, wholegrain flour and cereals, wheat germ, and vegetable oils.

The scientific name for vitamin E is alpha tocopherol; other tocopherols with some vitamin value occur in nature. Natural vitamin-E concentrates, prepared by distilling vegatable oils, and synthetic vitamin E, are available in capsule form. The synthetic vitamin cannot prevent the destruction of vitamin A and unsaturated fatty acids (p. 342, of ref. 1, p. 180) in the body, perhaps the most important function of vitamin E. For this reason mixed tocopherols from natural sources are superior to the synthetic product even though 149 milligrams of the synthetic vitamin equal 100 International units of the vitamin from natural sources.

More than three decades ago it was discovered that when animals were deficient in vitamin E, the males became sterile; females lost their young. If the vitamin was supplied, normal pregnancies occurred, but fertility in males could not be restored. Years passed before attention was directed to subtle deficiency symptoms.

A few years ago in a rural area, I visited four old friends, all of whom had dentures which they put in “for company.” At mealtime the dentures were removed, and the food was gummed in comfort. If an adequate diet is adhered to and well absorbed, one set of dentures should fit during the remainder of one’s life.

The calcification 5 of a person’s bones, shown by dental X-rays, is probably a good index of the density of bones throughout the body. You might ask your dentist to compare your X-rays with those of some person whom he considers to have unusually well-calcified bones. Examine the bone structure both below and around your teeth; the denser bone casts a whiter X-ray shadow. If your own X-rays show poorly calcified bone, rigid adherence to an adequate diet may pay rich dividends.

Fragile bones break easily. Although most people expect to have pyorrhea sooner or later, few expect broken bones. Unfortunately, breaks do occur. When bones are so poorly calcified that teeth are lost from pyorrhea, the condition of the bones throughout the body can degenerate but little more before they may crumble or break at any minor twist or fall. Millions of Americans, including thousands of relatively young persons and almost every person sixty years old and older, have porous bones. It makes no difference except perhaps to some physicians whether or not the porosity is of such a degree that the condition can be called osteoporosis. Formerly it was believed that bones naturally became porous with age. When experimental animals are kept on adequate diets, however, the longer they live, the stronger their bones become. Such evidence indicates that poorly calcified bones are the result of nutritional deficiencies; elderly persons have eaten faulty diets more years than has the younger person; hence the condition is more universal among them.

Since bones cannot be seen, few people trunk of whether theirs are well or poorly calcified. The difference in bones, however, is almost unbelievable. I used to lecture at a dental college where there is a large collection of skulls. The bones of some are so dense and heavy that they appear impossible to crack with a sledge hammer. Other skulls in this collection are so thin and porous that light shines through them; in fact they would make excellent lampshades, Any orthopedic physician or X-ray specialist can tell you that poorly calcified bones are extremely common.

If you think bones do well without care, you should go through an orthopedic hospital and talk with patients; you would soon be convinced that anything which helps to build strong bones and prevents such misery as you would find is worthwhile. Let me tell you about a few cases I have known personally.

A woman in her late thirties hobbled in to see me not long ago and, after putting her crutches aside, told me the following story. Several years ago she had somehow twisted her leg while walking across a lawn; the femur, or thigh bone, had broken near the pelvic joint. She lay in the hospital month after month before healing was sufficient for her to walk with crutches; in time they were discarded. Then one day, without warning, she simply fell in a heap. This time the bone had crumbled at the spot where it had been broken before. A plastic head was put on the femur which involved deep, drastic, and expensive surgery; the gold pin which held it in place showed clearly in the X-rays. Again months were passed in hospital beds before she graduated to crutches, but pain in that joint remained acute. She had been told that the pain was probably caused by calcium forming in rough deposits over the plastic head of the femur; .she came to me requesting a calcium-free diet. She left with a nutrition program which included generous amounts of both calcium and vitamin D and was as adequate in all respects as I could make it. Only three days later she phoned to say the pain had completely disappeared. A month later she came to see me, carrying a cane; she walked, however, without using it and without a limp. Do you suppose she believes that any nutrient which helps to maintain normal bones is unimportant?

A plasterer, forty-two years of age, who had fallen from scaffolding, used to come on crutches to hear me lecture. He too had broken his femur; months had passed without healing. The jagged ends of the bone kept breaking apart. Apparently in desperation, his physicians put a steel plate around the bone to hold the ends together, but X-rays cannot be taken through such a plate to see whether healing has occurred. Eventually the plate had been removed, but the bone still had not knitted. Infection, called osteomyelitis, set in, and operation after operation followed. Great deep scars about two inches apart and each a foot long went round his entire thigh. The wound from the last operation was still draining; the bone was badly infected, and amputation had been recommended. During all these tragic years, he had never once been given vitamin D; certainly he had not been in the sunshine. No diet had been recommended rich in calcium, in protein necessary to form bone base, or in the B vitamins needed to insure that adequate hydrochloric acid could be produced to help the absorption of what little calcium he chanced to obtain. No extra vitamin C had been given to help prevent or fight the infection. When his nutrition was made adequate, improvement was rapid. He now walks to work but with a limp he will have throughout life. Do you suppose he thinks that vitamin D is a nutrient only for babies?

I have seen perhaps two dozen similar cases, most not so severe but many equally tragic. The elderly persons whose hip bones crumble after a minor fall, usually in a bathtub, seem to me most pathetic. The easy breaking of bones and/or their slow healing are, in my opinion, completely unnecessary. Yet such fire insurance, which in this case should cost no more than a dollar or two per year, is usually purchased, if at all, only after the house is burned. The adult who is ignorant of the advantages of vitamin D usually pays both figuratively through the nose and literally through the pocketbook.

Perhaps I am making a mountain out of a molehill, and “vigorous adults leading normal lives” do not need vitamin D. A friend jokingly implied as much once when I had mentioned something about saving teeth; he remarked, “Some of the nicest people I know wear dentures.” He is undeniably right. In fact, there are some 32,000,000 nice people in these United States wearing dentures. I myself would gamble that all of these 32,000,000 nice people wish they had 32 nice teeth stuck firmly in their own jaw bones.

Long ago it was learned that excessive amounts of vitamin D can be toxic. A toxic dose for adults appears to be 300,000 to 800,000 units per day provided this quantity is taken daily for several months: Toxicity causes vomiting, diarrhea, and sluggishness; calcium is withdrawn from the bones, the amount in the blood becomes excessively high, and much is lost in the urine. These symptoms are prevented if generous amounts of vitamin C are supplied. Fear of toxicity has caused the National Research Council to recommend only 400 units daily for persons of all ages.

Almost nothing is known of the amount of vitamin D which can be taken advantageously by an adult. Dr. Johnston 2 of the Henry Ford Hospital in Detroit studied the needs of adolescent girls, some of whom had ceased growing. He found that even though a generous amount of calcium was supplied by the diet, if no vitamin D was taken, more calcium was excreted than was eaten. When the vitamin was supplied, the amount of calcium absorbed into the blood paralleled the vitamin-D intake. For example, when 650 units of vitamin D were given daily for a time, and later 3,900 units were given, the quantity of calcium absorbed was increased tenfold. In some cases 1,950 units of vitamin D were given with more calcium than could be obtained from an average quart of milk (1,343 milligrams); still no calcium whatsoever was retained in the body; this amount of calcium was well absorbed when vitamin D was increased to 3,900 units daily.

Unfortunately, Dr. Johnston did not study the calcium absorption when still larger quantities of vitamin D were given. His studies indicate, however, that the adult can profit by taking at least 4,000 units of this vitamin daily. It is entirely possible that the ideal intake may be nearer 7,000 units per day; since this amount is certainly not toxic, it appears wise to err on the side of obtaining slightly too much rather than too little. Aside from the need during pregnancy and lactation, I suspect the. highest requirement is during the menopause; the calcium intake is usually lower then than during adolescence. Hot flashes, night sweats, leg cramps, irritability, nervousness, and mental depression, so frequently experienced at this time, can usually be overcome in a single day by giving calcium and vitamin D; when the calcium intake is already adequate, vitamin D alone can relieve these symptoms.

Vitamin D can be stored in the body provided an excess is obtained. For example, in England during World War II mothers were given cod-liver oil for their babies. Uncooperative babies sometimes burp up the oil, which stains clothing and smells bad; the oil is a nuisance for a busy, tired mother to give. Despite the fact that the oil was supplied free, severe bone abnormalities developed. English physicians, desperately trying to solve this problem, studied the effect of giving single massive doses of vitamin D by mouth to tiny infants in the doctors’ offices. Many similar studies were made later on the Continent and in America. It was found that a single dose of 300,000 units of the vitamin promoted good bone growth for a year, indicating efficient storage of the excess; this amount was never found to be toxic.

Since vitamin D is stored, the cheapest source I know of for adults is a capsule of 25,000 units each which can be taken once a week, as after breakfast on Sunday. When the requirements are unusually high, as during adolescence, pregnancy, and menopause, such a capsule might be taken to advantage every Wednesday and Sunday. These capsules, although available,” are so little used that druggists often tell customers they cannot be sold without a prescription. The Food and Drug Administration has asked that the 50,000 unit capsules of vitamin D be sold only on prescription but not the 25,000 unit capsule. Since vitamin D, like vitamin A, cannot be absorbed unless in the presence of fat and bile, this vitamin should be taken after a meal containing some fat.

The positive results gained by taking adequate vitamin D throughout adult life are identical with the advantages of having ample calcium, to be discussed in chapter 21. Since adults can absorb calcium without vitamin D, the taking of this vitamin is similar to buying fire insurance: you hope you will never need it, but if you do, it is wonderful to have.

An advantage is that vitamin D helps to prevent tooth decay. All decay is apparently caused by sugar being broken down by bacteria-produced enzymes into lactic and pyruvic acids; any acid can combine with calcium. If the saliva can reach the area where the acids are being formed, and if it contains ample amounts of dissolved calcium, these acids are neutralized by the salivary calcium, and no decay results. Dental erosion appears to be prevented in the same manner. Although the subject is still controversial, an increasing amount of evidence 4 indicates that both the enamel and dentin of mature teeth can be built up provided the nutrition is adequate; probably the two most important nutrients in such rebuilding are calcium and vitamin D.

Ample vitamin D undoubtedly plays an important role in the prevention of pyorrhea. If the diet is made adequate and all infection is removed, even severe pyorrhea can usually be arrested. Although pyorrhea is a disease involving infection and resulting from multiple nutritional deficiencies, the loss of teeth is caused by decalcification of the bones. When too little calcium is supplied the tissues, minerals are withdrawn from the jaw bones; the bones themselves become smaller and recede from around the teeth. As the bones recede, the gums likewise recede, exposing more of the tooth surface. The teeth appear longer than they should be, and the gums cannot fit tightly around the base of each tooth. Eventually, so little bone structure remains that it cannot hold the teeth firmly in place; the teeth, though they may be free from decay, become loose and must be removed.

Even when the teeth and all infection are removed, the destruction of jaw bones does not cease, nor does this destruction cease to be a problem. Dentures can fit well only when sufficient jaw bone remains on which to anchor them. If the nutrition is poor, so much bone tissue can be lost even six months or less after perfectly fitting dentures are made that the dentures shift, wobble, or refuse to stay in place. One of the delightful memories of my childhood is an occasion when a malnourished Methodist minister, apparently believing that the gospel was more effective when thundered, shouted his upper dentures into the congregation. An innocent dentist was probably blamed even by this good Christian; at least a dentist usually is. It is not a dentist’s fault that a person’s diet cannot maintain normal bone structure.

Often set after set of dentures have to be made as the destruction continues. Furthermore, persons whose bones are undergoing rapid destruction are so deficient in calcium that they are nervous wrecks; often they cannot stand to wear dentures no matter how well they fit. For a time a dentist referred to me many patients who complained that new dentures did not fit. As soon as the patients’ diet was made adequate and their nerves relaxed, there were no more complaints.

It is undisputed that vitamin D aids the absorption of calcium, favors its retention, and improves its utilization.

Certainly it is a fact that calcium is needed by adults; this mineral helps to relax nerves, induce sound sleep, and decrease sensitiveness to pain. The National Research Council concedes that small amounts of vitamin D are desirable for people working at night, for elderly persons, and for nuns and others whose clothing shields them from the sunlight. According to this Council, however, “vigorous persons leading normal lives” appear not to need vitamin D. What about the almost vigorous person leading an almost normal life? It seems to me the scientific scientists are indulging in unscientific double talk here.

Vitamin D is scantily distributed in foods. There is some in egg yolks provided the hens sat in the sunshine and preened their feathers well; .50 to 200 eggs daily might supply your needs quite adequately if modern hens were not forced to live in shaded cages. Caviar contains some vitamin D; there is a little in the milk from cows pastured on high mountain slopes. Artificially produced vitamin-D milk is excellent, but as a sole source it has little value in my opinion. Fish-liver oils are the only natural foods containing sufficient quantities of this vitamin to promote health; that is, if you call them natural foods as my children do.

Vitamin D can be produced in foods or oils by exposure to ultraviolet light; the commercial concentrate, viosterol, is made bv such a method. This vitamin is formed by ultraviolet light from sunshine in the oils on the skin, provided you have oils on your skin and the shortest rays from the sun reach the earth. In winter, these rays do not penetrate our atmospheric blanket; during the summer they reach the top of the Empire State Building but usually not the street below it. Sunshine would be an excellent source of this vitamin if it were not for the facts that people are surrounded by smog, wear clothes, live in houses, have bathtubs and hot-water heaters, and listen to soap operas.

Most medical textbooks say that vitamin D is formed by sunlight on the oils in the skin although it was proved 16 years ago 1 that the oils must first be on the skin, then exposed to ultraviolet light, and later absorbed back into the body. If persons take a bath before going into the sunshine, the oils are washed off, and no vitamin D is formed; if they do not bathe before exposure to sunshine but bathe immediately afterward, the oils are removed before the vitamin can be absorbed into the body. Most of the oils appear to be washed off by cold water, and still larger quantities by warm water; warm soapy water does the job thoroughly. Time was when wood was hard to split, water hard to carry, and soap hard to make (and smelled too bad to use anyway); the Saturday-night bath was then a family institution. During the remainder of the week the oils stayed on the skin and absorbed any ultraviolet rays which reached them. The early settlers described the Indians as being great of stature with teeth “as even as piano keys,” both the advantages of having no hot-water heaters and no soap. Now as a nation we are bath-happy and soap-happy; I, for one, call it progress.

There are to be found in any medical library many books and thousands of articles concerning the need of vitamin D by children. Except for a few articles and short paragraphs on diseases known as osteomalacia, meaning literally bad bones, and osteoporosis, meaning porous bones, the need of adults for vitamin D is rarely mentioned. These diseases are identical except in degree; bad bones are worse than porous bones. In both, so few minerals are available that the bones become porous and honeycombed; the persons so afflicted may become shorter and may suffer from muscle cramps, twitches, and even convulsions, or tetany. Osteoporosis is usually painless, but in osteomalacia pain is experienced, especially in the hips; such pain is customarily spoken of as rheumatism; spontaneous fractures and breaks may occur. This disease is common in China and India, particularly when the need for minerals is increased by pregnancy and «becomes more piteous” (p. 684 of ref. 2, p. 36) with each child, especially when the mother “suckles her infant in the vain hope of thus warding off her tragic fertility.” Skeletal remains indicate that the Norse colony founded by Eric the Red in Greenland gradually became extinct because the pelvic deformities of women suffering from osteomalacia hindered childbirth; it is thought that the colonists did not eat the local diet of fish and fish-liver oils; too little vitamin D could be obtained from the Arctic sun. Osteomalacia results from famines and food shortages during and after wars. It occurs in American and English cities “where solitary old people live in proud self-respecting poverty rather than apply for charity” (p. 684 of ref. 2, p. 36). This disease can be cured by vitamin D alone, but to speed recovery calcium and phosphorus are customarily given with the vitamin.

Sir Robert McCarrison, the great English physician, wrote of osteomalacia in India among the Mohammedan women observing the custom of purdah. These women veil their faces at adolescence and rarely go outside their homes. No milk or other food rich in calcium is eaten. Vitamin D, however, either from sunshine or cod-liver oil, so increases the absorption and utilization of the meager dietary calcium that health is restored. Here, at last, is proof that vitamin D alone, without any increase in calcium or phosphorus, can help adults as well as rapidly growing children.

Americans have no more cause to worry about osteomalacia than about scurvy; 60 per cent or more of our population, however, obtain too little calcium in their diets. Much of this supply fails to reach the blood. Calcium is tricky in that it does not dissolve easily; your teeth and bones, even though washed by saliva or tissue fluid, do not dissolve. Unless calcium from food is dissolved, it remains in the intestine and is lost in the feces. The calcium supply to the tissues can be increased by eating more foods containing calcium or by obtaining ample vitamin D; both should be adequate.

Although I have never been up a night with a sick child, I know of nothing which brings me greater comfort as a mother than the knowledge that vitamin C can help in emergencies. Other mothers feel the same. For example, a friend’s little boy, then the only child, died of meningitis. Three children were born later. The mother’s fear that something would happen to one of these children was ruining her life and theirs. During polio season they were not allowed to go to a pool or mingle in crowds. The mother gathered files of articles concerning diseases from newspapers and magazines; she became overcautious about sanitation and still lived in fear and dread. 1 saw her recently for the first time in years; the children were at a park, swimming. I commented on her change of attitude.

“I never worry about them any more,” she answered. “At the first sniffle I give extra vitamin C. The kids haven’t been sick a day in two years.”

My first personal experience with massive doses of vitamin C came when my Geordie, then five years old, had the mumps. One morning when we awoke, the evidence was unmistakable. Starting at 7 A.M., I gave him 1,000 milligrams of “melted” vitamin C and a little calcium powder in ;4 glass of pineapple, apricot, or orange juice every hour except when he slept, making a total of 10 grams during the day. By that evening, all swelling was gone, and there was no further sign of illness. Within the next two months every member of our family including me-which proves I am younger than you think I am-had the one-day mumps. The children have now weathered most of the childhood “diseases” in the same delightful fashion. There has been no irritability, nausea, or vomiting; no meals have been missed; after vitamin C has been given, there has been no fever.

My only other personal experience occurred a year ago when I returned from an out-of-town trip to find that my daughter Barbara, then three years old, was ill. She had appeared to be well when put to bed, but when she was checked shortly before my return, her breathing was labored, her skin Hushed and burning, and her rectal temperature 1040 F. Fortunately, she was thirsty. I immediately gave her 2,000 milligrams of vitamin C in juice. Her temperature appeared to be normal within 15 minutes; she slept soundly the remainder of the night, awoke full of her usual vivacity, and went to play school that morning. She had no further evidence of illness. The amounts of vitamin C I have found effective with my children may be inadequate for youngsters who have received smaller amounts of this vitamin. I try to keep their tissues saturated at all times; at least I cannot recall having seen a bruise on either child.

The quantity of vitamin C to take depends on the type . and severity of the illness and whether it is of short duration or chronic. Large amounts are usually needed at first to saturate the tissues; the quantities can later be reduced. Persons suffering from arthritis, asthma, or other chronic diseases have often taken drugs for months or even years; these drugs must apparently be detoxified before vitamin C is available to the tissues. For example, two years ago I was consulted by a man who had come to California for his health in 1927. He had suffered with severe asthma for several years before and continuously since that time; he told me that during this entire period he had taken mugs daily. Although I planned the most adequate diet for him that I could and recommended what I considered to be massive doses of vitamin C, he showed little improvement from September until December; his symptoms then disappeared and have not returned. It is my belief that results were slow in his case and similar cases because of the drugs remaining in his body.

The quantity of vitamin C most advantageous under all circumstances for all persons can probably never be known. Our requirements vary daily. Almost every person is exposed to chemicals from water purifiers, smog, smoke, or smoking; from arsenic, DDT, and other pesticides, traces of which are found in fruits, vegetables, meats, and milk; many people take drugs occasionally; and most of us are threatened by one or more infections per year. Each individual must find his own dosage, depending upon his own symptoms and the number of toxic substances he is exposed to. If you are going to use massive doses over a prolonged period, however, do it only when your diet is adequate in every respect and with your physician’s permission and under his care. During normal times, use natural sources first: a glass of orange juice daily; salads; and fresh fruits for desserts and midmeals. Watch for bruises; if they occur, know that your intake of vitamin C is not meeting your needs; then supplement your natural sources if you need to.

Although massive doses of vitamin C appear not to be toxic, much research must be done before any long-term harm can be ruled out. If harm is caused by massive doses, however, it appears to be far less than that done by a disease. Large amounts of this vitamin often act as a diuretic, causing excessive urination, corresponding dehydration, and extreme thirst. These symptoms are largely prevented if calcium is taken with the vitamin. If calcium is not taken, extreme nervousness sometimes results; therefore let us be cautious.

The greatest value of massive doses of vitamin C will never be shown by research or found in a laboratory. It is in the hearts and prayers of the parents of the nation. They will render silent tribute to the wonderful scientists and physicians who have brought them peace of mind.

Dr. Klenner, Chief of Staff at the Memorial Hospital in Reidsville, North Carolina, appears to have given the largest quantities of this vitamin to date, usually by injection.” It was my good fortune to visit with Dr. Klenner recently and hear him lecture. He showed slides of hospital records and fever charts and told of case after case of meningitis, encephalitis, polio, virus pneumonia, and serious complications following scarlet fever and other diseases treated with massive amounts of vitamin C. Many patients had not been expected to live; often penicillin, aureomycin, and other antibiotics had been given without success; in most instances, fevers ranged from 103 to 105° F. Within a few minutes after the vitamin was injected, fevers started to drop and temperatures often reached normal within a few hours. Usually the patient enjoyed the next meal and was ready to be discharged from the hospital in two or three days. The amount of vitamin given varied with the severity of the illness. The initial dose was usually 2,000 to 6,000 milligrams .( 2 to 6 grams), Iollowed four and eight hours later by a second and a third injection of 2,000 to 4,000 milligrams if the temperature did not remain normal; injections were continued around the clock when needed.

Dr. Klenner told of an eighteen-month-old girl suffering from polio. The mother reported that the child had become paralyzed following a convulsion, after which she soon lost consciousness. When Dr. Klenner first saw the child, her little body was blue, stiff, and cold to the touch; he could neither hear heart sounds nor feel her pulse; her rectal temperature was 100° F. The only sign of life he could detect was a suggestion of moisture condensed on a minor held to her mouth. The mother was convinced that the child was already dead. Dr. Klenner injected 6,000 milligrams of vitamin C into her blood; four hours later the child was cheerful and alert, holding a bottle with her right hand, though her left side was paralyzed. A second injection was given; soon the child was laughing and holding her bottle with both hands, all signs of paralysis gone. Dr. Klenner quite understandably speaks of vitamin C as “the antibiotic par excellence.” A physician who has obtained striking results in treating polio with vitamin C at the Los Angeles County Hospital matched Dr. Klenner’s enthusiasm with the remark, “If anything should be called a miracle drug, it is vitamin C.”

With his extremely ill patients, Dr. Klenner found that no vitamin C whatsoever could be detected in the blood only a few minutes after massive doses were injected; nor was any vitamin C found in the urine. It is his belief that this vitamin combines immediately with toxins and/or virus, thus causing the fever to drop. In cases where the fever rises again later, he believes that too little vitamin C has been given in the initial dose; that virus not destroyed multiplies and again causes the temperature to increase. For this reason, he emphasizes that if the original dose is sufficiently large, no further massive amounts need be given.

Many other investigators have studied the effect of massive doses of vitamin C. In an attempt to saturate the tissues, physicians have recommended as much as 1,000 milligrams every hour during the day from 1 to 3 days to persons suffering from arthritis, gout and almost any infectious disease, infection, or allergy, the same amount being repeated during subsequent acute attacks. They have also recommended that this quantity be taken immediately at the onset of a cold or any infection and that the vitamin be stopped as soon as the symptoms have disappeared. On the other hand, satisfactory results have been reported when an allergy or lead poisoning has been treated with as little as 300 milligrams daily. These problems, however, are medical ones; our problem is prevention.

Physicians have pointed out that patients with polio, for example, have often been sick several days before a doctor is called in and a diagnosis made. By the time such cases are cleared by a social worker and a March-of-Dimes committee and are actually checked into a hospital, they are in what has been described as “a sorry state.” Vitamin C has proved to be most effective when taken at the onset of an infection, at which time a patient rarely sees his physician. Relatively smaller amounts are needed than those required after an illness becomes serious. If sufficient quantities of the vitamin are obtained, often serious illness may be prevented. It appears desirable, therefore, for persons to learn when large amounts of vitamin C should be taken and how much should be taken. Such information has great comfort value.

I asked 15 physicians if they felt it wise to recommend that families keep high-potency, vitamin-C tablets in the medicine chest and use them at the onset of any illness. The most frequent reply was, “They are certainly safer than aspirin.” Several physicians remarked, “Tell people to take them when they need to, but the rest of the time to stick to orange juice and natural sources.” Others pointed out the importance of advising large initial doses rather than smaller frequent ones, the total of which might be larger than would be needed if the original dose were sufficient.

When persons are too ill to eat or retain food and/or to digest or absorb it easily, as were Dr. Klenner’s patients, injections of vitamin C are obviously advantageous. If the vitamin is taken immediately at the onset of an illness, however, such difficulties rarely arise. Occasionally undissolved tablets can be seen in the stools, particularly if diarrhea occurs. For this reason I usually tell people to bring one cup of water to a boil, add to it 50 tablets of vitamin C of 500 milligrams each or 100 tablets of 250 milligrams each, stir until the tablets are dissolved, pour the solution into a glass jar, and keep it refrigerated. Since tablets do not contain the enzymes found in natural foods, the synthetic vitamin is quite stable to heat. Each teaspoon of this solution would contain 500 milligrams; one or two tablespoons added to any sweet juice are quite palatable. Less vitamin C is needed if the solution is taken in fresh, canned, or frozen orange juice to which are added the juice of a lemon, sugar to taste, and perhaps W teaspoon of a calcium salt 3 (p. 181); the fresh citrus juices supply vitamin P, or rutin, which prevents vitamin C from being destroyed in the body by oxygen; the calcium helps to prevent the toxic substances from entering the cells. An adult can take tablets of both vitamin C and calcium. Since the vitamin is an acid, large amounts can cause severe burning of the throat and stomach. When more vitamin C is taken than is needed, the acid being thrown off in the urine usually causes a burning sensation when voided.

Although it has been known for centuries that a person dying of scurvy could make a startling and dramatic recovery if fresh foods were given him, vitamin C can bring about other startling and dramatic recoveries only recently discovered. Most of the research being done is still unpublished; only a few articles have yet reached the medical journals.  Aside from helping to build collagen, this vitamin appears to be a busybody with its fingers in every pie. When toxic or poison substances gain access to the body, adequate vitamin C, if available, detoxifies them, making them harmless. The toxic substance apparently combines with the vitamin, and the two are excreted together in the urine; this combination is now given the name of ascorbigen.  It has long been known that during infections and diseases, vitamin C disappears from the blood and urine; that the more vitamin C given, the less ill the person usually is, and the more quickly he recovers; and that 20 to 40 times more of the vitamin has to be given during illnesses to keep the tissues saturated than during periods of health. Furthermore, antibodies are unable to render bacteria harmless unless vitamin C is adequately supplied. Antibodies must be helped by a complement; if there is no vitamin C, there is no complement. Vitamin C seems equally helpful whether the disease is caused by virus or bacteria or is non-infectious, as is gout, arthritis, or a stomach or duodenal ulcer. Almost endless infections and diseases have been studied: colds, polio, rheumatic fever, tuberculosis, diphtheria, infections of the prostate, ears, eyes, sinuses and tonsils, the childhood diseases and many others. In every case, vitamin C appears to be the good little Christian ready tc soothe the aching brow.  It has been found that vitamin C can prevent or cure chemical poisoning. This vitamin has been valuable in correcting the toxic effects of lead, bromide, arsenic, benzene, and many other substances which sometimes gain access to the body, especially of persons doing industrial work.  Studies have proved that vitamin C helps to prevent allergies; if enough is given, it can detoxify the harmful effects of allergins which have entered the blood, whether they be pollens, dusts, dandruff, or foods. This vitamin seems to be equally effective in treating all varieties of allergies, whether rhinitis (stuffy nose and/or postnasal drip), hay fever, asthma, eczema, or hives; spectacular relief often results from massive doses of vitamin C. Even the effects of poison oak and poison ivy often disappear when sufficient vitamin C is taken.  Any foreign substance reaching the blood appears to be more or less toxic; the harm is prevented by vitamin C, but the vitamin itself is destroyed in the process. For example, every drug apparently destroys vitamin C in the body. When a drug promises to save your life, the vitamin destruction is unimportant; if it is being taken promiscuously without a physician’s prescription, both the drug and the vitamin loss may be unnecessary. It has been found that a single tablet of anyone of several drugs widely used and considered harmless can continue to destroy vitamin C in the body for three weeks after the drug is taken. The Journal of the American Medical Association carried an editorial entitled “Is Aspirin a Dangerous Drug?” I pointing out that aspirin had proved more dangerous in England and Europe than in America because our diets contained more vitamin C with which to detoxify it.  This vitamin appears to play no major role in producing energy; yet it helps to prevent fatigue. For example, a group of soldiers was given vitamin C until the tissues were saturated. Their performance was compared with that of a similar group not given the vitamin. After maneuvers involving carrying heavy equipment, walking miles, and climbing mountains, the soldiers given vitamin C experienced little fatigue, recovered quickly, and had no leg cramps, whereas the other soldiers suffered severely from cramps and fatigue and did not completely recover for days. The harmful “ashes” left from incompletely burned fats, known as acetone bodies, which accumulate in the tissues when the blood sugar falls below normal, is a major cause of fatigue; these acetone bodies are detoxified by vitamin C.  Vitamin C seems to help everything by being destroyed by everything. For a nutrition consultant, the situation as regards vitamin C becomes progressively more embarrassing. No one seems to be in danger of coming down with scurvy; yet almost every person has abnormalities which vitamin C has been proved to help. In order to do good work, a nutritionist seems to have to accept the fact that people think him a crackpot hipped on liver, yeast, orange juice, and vitamin-C tablets.  The quantity of vitamin C needed to detoxify a foreign substance depends upon the amount of that substance gaining access to the body. Relatively small quantities are required by the healthy person to prevent harm, particularly when adequate calcium is absorbed (p. 132). Many toxic substances, however, might enter the body simultaneously. For example, a person suffering from allergies and doing industrial work where toxic chemicals have reached his blood might suffer from a serious infection which prevents him from eating and for which he is given various drugs; his temporary need for vitamin C would be tremendous indeed. Fortunately, even massive doses of this vitamin are thought to be harmless; any excess not needed in the body is quickly lost in the urine.

Scar tissue formed in healing wounds and injuries is a connective tissue made of collagen which depends on both vitamin C and calcium for strength. During the First World War it was noticed that wounds healed slowly or failed to heal unless fresh foods were eaten. Experiments prove that speed of healing and strength of the scar tissue are directly proportional to the vitamin-C intake. Operative patients deficient in this vitamin not only heal slowly, but their wounds frequently break open. When 4,000 milligrams or more of vitamin C has been given daily to such patients, the speed of healing is often dramatic. Medical journals have urged all physicians to recommend large amounts of this vitamin before and after surgery.

Vitamin C is especially important in the healing of broken bones. When it is lacking, a collagen bone base fails to form; hence the ends of the broken parts are unable to knit. Such abnormal healing occurs frequently in older persons whose diets are notoriously deficient in multiple nutrients. Bones heal readily at any age when an adequate diet is given and steps are taken to assure normal absorption. Protein, calcium, vitamin D and other nutrients, however, are equally as important as are large amounts of vitamin C.

Although not yet understood, vitamin C apparently plays a role in maintaining normal vision. In healthy eyes, the vitamin is concentrated in the lens; the vitamin is lacking or reduced in the lens of persons having certain types of cataract. Experimental cataracts have been produced by a restricted vitamin-C intake. Marked improvement in eye infections and inflammation of the eyes often follows when large amounts of vitamin C are taken.

This vitamin cannot be stored in the body. The tissues, however, can be saturated as a sponge might be saturated with water. The state of saturation, in which every cell has all of this vitamin it can use, is considered to be most compatible with health. After saturation occurs, any excess vitamin C obtained is promptly thrown off in the urine. The amount of vitamin C found in foods, blood, or urine can easily be measured. The tissues of seemingly healthy persons whose diets have been inadequate frequently soak up as much as 4,000 milligrams of this vitamin before any is excreted; this amount is equivalent to 40 glasses of fresh citrus juice. After saturation, the amount of vitamin obtained minus that lost in the urine gives the requirement for a particular day. By this method requirements of different people under various circumstances have been studied.

About 50 milligrams of vitamin C appears to be needed daily by the genuinely healthy adult to prevent scurvy, provided his tissues are already saturated; 75 to 100 milligrams is recommended by the National Research Council as the minimum intake. This amount can be supplied by a glass of fresh orange or grapefruit juice. The scurvy-preventing requirements of vitamin C appear to increase with advancing years, probably because absorption is often faulty and much of this vitamin is destroyed in the intestine when the stomach fails to produce normal amounts of hydrochloric acid. Studies show that the aged are appallingly deficient in this vitamin. Dr. Walter H. Eddy of Columbia University pointed out years ago that many signs considered typical of old age are actually symptoms of scurvy: wrinkles, or loss of elasticity of the skin; loss of teeth; brittleness of bones. Certainly the person who wishes to retain his youthfulness should see that his ascorbic-acid intake is ample.

The vitamin C in all plants is produced, by the aid of enzymes, under conditions of warmth and moisture at which the plant grows best. Unfortunately, the action of the enzymes is reversible; they can quickly destroy what they have made. After a food is harvested, the destruction of the vitamin occurs most rapidly under the same conditions as those at which the plant grew best, that is, in a heated market or a warm room. Furthermore, the enzymes destroy the vitamin by combining it with oxygen; hence, if a fruit or vegetable is peeled or chopped, the destruction is unusually rapid. The enzymes are kept inactive by refrigeration or are destroyed by heat at about 1400 F. Since the vitamin dissolves in water, much or all of it is lost when foods are washed slowly, soaked, or boiled. The average housewife, untrained in nutrition, is a genius at destroying vitamin C before the food can be swallowed.

For practical purposes, the best source of this vitamin is citrus fruits and juices. Fresh orange juice averages 130 milligrams for an eight-ounce glass; grapefruit and lemon and canned orange juice, about 100 milligrams. Frozen orange juice may be as rich as fresh or may contain little, depending on the type of oranges from which the juice came, the method of extraction, and the length of time it has been stored. Often culls, containing little vitamin C, are used for juice. In general, the sweeter oranges, to which no sugar need be added, have the highest vitamin-C content. Other juices, such as apple, pineapple, or grape, are not good sources, whether canned, frozen, or fresh. Tomato juice may supply 30 milligrams of vitamin C per glass or may contain none. A ripe pimiento or bell pepper or one California persimmon often contain 300 milligrams of vitamin C, whereas lh cup of guavas may supply 1,000 milligrams.

Tomatoes, both fresh and canned, all salad greens, fresh strawberries, and raw cabbage average 30 to 50 milligrams per serving. Green vegetables, such as spinach, Brussels sprouts, and broccoli, may be good sources, but 50 to 90 per cent is often lost in the water in which these foods are cooked. Apples, bananas, lettuce, potatoes, and peas may supply only 20 to 30 milligrams per serving but are important sources because of the quantities eaten. Foods such as butter, cheese, eggs, all breadstuffs, and dry beans lack ascorbic acid. Milk and cooked meat other than liver contain almost none.

Climate, soil, the degree of ripeness, storage, temperatures and methods of handling, cooking, canning or freezing all affect the vitamin-C content of foods. Little ascorbic acid is destroyed when foods are quickly frozen, but losses of 90 per cent may occur within an hour after the food has thawed. The variations are so great that tables of food analysis are of little value; hence they have been omitted.

Since citrus juices are the most dependable sources of vitamin C, a glass should be drunk daily by every child and adult. It is wise to serve a fresh salad at each lunch and dinner and to have appetizers of fresh fruit on the menu frequently. Studies have shown that people living on the Pacific Coast buy three times more vitamin C on the same budget than do those on the Atlantic Coast. Even today when frozen foods are widely used, fewer vitamin-C deficiencies occur in summer and fall when fresh foods are available than in winter and spring. This deficiency is especially common among the poor of all ages and the aged of all economic groups. If care is given to the purchase and preparation of food and the planning of menus, adequate vitamin C can be obtained even when little money is available.

The changes in collagen breakdown can be swift, harmful, and hidden. For this reason, a bruise should be interpreted as a danger signal, indicating that more vitamin C should be added immediately to your diet.

Although the word vitamin was not coined until this fi century, vitamin C has been known for over 200 years; its deficiency disease, scurvy, has played a major role in history. In 1754 James Lind wrote a treatise on scurvy recommending lemon juice for its prevention or cure. Despite the fact that we live in a land of plenty and our need for this vitamin can scarcely be called news, surveys show that three-fourths of our populations receive less than the minimum daily allowance recommended by the National Research Council.

All fresh, growing foods contain vitamin C, or ascorbic acid. The richest sources are citrus fruits, guavas, ripe bell peppers and pimientos, and the seed pods of wild roses, known as rose hips. During World War II, the English extracted quantities of vitamin C from rose hips, simultaneously using hops from beer for the B vitamins; a wit remarked that England’s magnificent strength was maintained by “her hips and her hops.” Tomato juice, cabbage, and fresh strawberries are fair sources. Scurvy has resulted whenever people have been unable to get fresh foods.

One function of vitamin C is to help form and maintain a strong cement-like material, known as collagen, which holds together every cell in your body. The amount of collagen required uses about a third of all the body protein. The collagen serves much the same purpose as cement does in a brick building except that the “concrete” in a healthy body is in the form of a stiff jelly, like gristle or a tough gelatin, known as connective tissue; thus every cell in your body “reposes” in a protective bed of jelly. This connective tissue is concentrated in the cartilage, the ligaments, the walls of all the blood vessels, the base of the bones and of the developing teeth, and gives all of these structures both great strength and elasticity. Although vitamin C is necessary for the formation of this tough jelly, adequate calcium must be present before the “[el” can set.’ Calcium is not part of the structure; it merely has a stiffening effect much as pectin does. In fact, pectin is to the plant world what connective tissue is to the animal body; neither can be formed without vitamin C or be strong in the absence of adequate calcium.

Strong connective tissue plays a role of far greater importance than has heretofore been appreciated. Cell walls are only a few molecules thick; almost any harmful substance can penetrate them, whether it be virus, poisons, toxins, dangerous drugs, allergins or other foreign materials which often gain access to the body. Strong connective tissue is not easily penetrated; thus the cells are protected. An undersupply of vitamin C, however, allows this tissue to break down; a lack of calcium allows it to weaken; protective doors are flung open, and pirates are invited in.

The walls of blood vessels must be able to expand or contract, depending on the amount of blood needed at a certain place and time; hence elas