After reeling from the enormity of the
terrorist attacks on the World Trade Center buildings in New York
on September 11, most Americans who were finally regaining their composure
were sent reeling again from the postal anthrax attacks. While nearly
everyone insists they are continuing to live their lives without altering
their daily schedules, a continual low-grade worry over the well-being
of ourselves, families, and friends has imposed itself on many of
our psyches.
The idea of an untreatable, killer epidemic
sweeping across the nation is certainly frightening. However, I will
attempt to show you that our treatment options might not be as bleak
or limited as they might seem to be. Let’s first consider some of
the known information about anthrax and smallpox, which are perhaps
two of the most significant bioterrorism agents.
ANTHRAX
Anthrax is a bacterial disease that occurs
primarily in one of four forms: cutaneous (skin), inhalation (lung),
gastrointestinal, and oropharyngeal (mouth and throat). It is readily
transmissible in a spore form that readily germinates into growing
bacteria when a receptive host environment is encountered. So far
the only two forms of this disease resulting from the postal attacks
have been cutaneous and inhalation.
The cutaneous form of anthrax can occur
on any exposed skin surface, progressing eventually to a blackened,
ulcerated lesion. The blackened appearance of this lesion accounts
for the name "anthrax," which comes from the Greek word
for coal. Untreated, it can result in death about 25% of the time.
When treated with antibiotics death is rare.
Except in the context of a widespread
bioterrorist attack, inhalation anthrax is extremely difficult to
diagnose. The incubation period can range from 1 to 6 days, initially
presenting with flu-like symptoms. The next phase of the disease can
proceed very rapidly to death after lung symptoms present. Difficulty
breathing, coughing up blood, chest pain, and profuse sweating are
common symptoms at this point. The infection then proceeds to a blood
poisoning that will further proceed rapidly to death even if antibiotic
therapy is finally initiated. Although anthrax appears to be treatable
by antibiotics in the early stages of the disease, the advanced inhalation
form of this disease will typically not respond to such therapy, and
death will result. An anthrax vaccine has been developed, but it is
really only available to the military at this time. Furthermore, we
are told that purified, antibiotic-resistant forms of anthrax for
military use exist. Fortunately, such forms of anthrax do not yet
appear to have been disseminated in any fashion.
Inhalation anthrax is especially deadly
because of its rapid progression after the initial lung symptoms appear.
This is largely due to the fact that anthrax is an infection that
not only grows, but also produces potent toxins (Bhatnagar and Batra,
2001; Brossier and Mock, 2001; Mock and Fouet, 2001). In fact, the
coughing up of blood is a reliable indicator that the toxins are being
produced in critical amounts deep in the lungs. The antibiotic therapy
for the anthrax organism has no effect on bacterial toxins that have
already been produced. Antitoxin therapy, a treatment intended to
neutralize a toxin, was tried in the past, but this therapy is not
currently available. A good recent review of anthrax as a biological
weapon was compiled by Inglesby et al. (1999).
Interestingly, the 21st edition
of the Cecil Textbook of Medicine, copyright 2000, considers
penicillin as the drug of choice for anthrax. Cipro (ciprofloxacin),
which is currently being highly touted in the news, is listed along
with a number of other antibiotics as being indicated primarily for
the treatment of anthrax victims who are allergic to penicillin. However,
ciprofloxacin and doxycycline are the antibiotics commonly recommended
when there is a known or suspected exposure. More recently, doxycycline
is being promoted as the oral prevention antibiotic of choice, in
the hopes that any antibiotic-resistant microbes that eventually result
might then be susceptible to ciprofloxacin.
SMALLPOX
Smallpox, a deadly viral disease, is
also being mentioned as a leading candidate for another bioterrorist
attack. The established therapy available for smallpox is to vaccinate
before infection or fairly early after infection. Immune globulin
therapy is also available to hopefully lessen the degree of infection
and resulting illness. If these measures fail, supportive therapy
is the only remaining traditional option. Either the patient’s immune
system eventually wins, or the patient dies. Furthermore, the patients
who are fortunate enough to survive face significant skin scarring
after the characteristic skin lesions finally resolve.
Smallpox is considered a significant
threat as it has a case-fatality rate of 30% or more among unvaccinated
persons. Furthermore, since routine smallpox vaccination ceased in
the United States more than 25 years ago, the degree of continuing
protection from very old vaccinations against contracting smallpox
now is less than clear. Some experts feel the protection is largely
gone (Henderson et al., 1999).
The ability of smallpox to be a potent
biological weapon was already demonstrated long ago. During the French
and Indian Wars from 1754 to 1767 British forces in North America
were able to initiate smallpox epidemics among the American Indians
(Stearn and Stearn, 1945). Blankets used by smallpox victims eventually
reached the Indians, and death rates exceeding 50% were seen after
some of the tribes were successfully infected.
The smallpox patient is most infectious
to others from the onset of the characteristic rash through the next
7 to 10 days (Mack, 1972; Mack et al., 1972). This rash is preceded
by high fever and a symptom complex that could certainly be confused
with the flu. Especially progressive smallpox infections can result
in widespread hemorrhage and death within only 5 to 6 days of the
onset of the rash.
Smallpox vaccinations are not without
risk (Lane et al., 1969). Encephalitis (brain inflammation), severe
skin rashes, and even a progressive, sometimes fatal, infection directly
resulting from the inoculation can all occur. A non-toxic alternative
to this vaccination would be highly desirable.
The current rareness of both anthrax
and smallpox is highlighted by the fact that the 2001 edition of Conn’s
Current Therapy does not even mention either of these diseases.
Few physicians have any first-hand clinical experience in the treatment
of these diseases.
TREATMENT ALTERNATIVES
Vitamin C, typically as ascorbic acid
or sodium ascorbate, should prove to be highly effective against both
of these conditions. I say "should" only because their rareness
has prevented any single vitamin C researcher from encountering enough
cases to conduct a meaningful study and publish it. However, the likelihood
that both of these conditions could be completely cured, even in their
advanced stages, is compelling. Consider the following information:
The medical literature has clear documentation
that high enough doses of injectable vitamin C are almost always effective
in curing any of a number of viral infections still considered today
to be incurable. Klenner (1949) completely cured 60 out of 60 cases
of infantile polio in North Carolina in the middle of a polio epidemic.
Several infants already had neurological involvement, but nevertheless
recovered completely. Klenner (1951) was also able to bring about
a complete recovery by administering enough vitamin C to one five
year-old polio victim who had already been paralyzed in both legs
for over four days. Klenner (1949, 1953, 1971, and 1974) also reported
the repeated ability to rapidly cure viral diseases such as encephalitis
(often presenting in the comatose state), herpes infections, acute
hepatitis, measles, and mumps. Klenner found that his only inadequate
responses to treatment were overcome by increasing the vitamin C dose
and/or going from an oral to an injectable form of vitamin C. Cathcart
(1981) also reported an incredible success in the treatment of many
viral diseases for which no specific anti-viral agents exist today.
Of particular interest, he reported that he never had a case of viral
hepatitis fail to respond to intravenous vitamin C. Furthermore, he
never observed a single case of acute hepatitis treated appropriately
with vitamin C to persist long enough to evolve to the status of chronic
hepatitis. Finally, although no specific studies looking at the effects
of vitamin C on smallpox could be found, Kligler and Bernkopf (1937)
were able to determine that relatively small doses of vitamin C could
easily kill the vaccinia virus, which is the virus in the vaccine
that induces immunity to smallpox.
Vitamin C has also been documented to
rapidly resolve a number of non-viral infectious diseases that do
not readily resolve in the absence of vitamin C therapy. Diptheria
(Klenner, 1949 and 1971), whooping cough (Otani, 1936 and 1939; Ormerod
et al., 1937), and tetanus (Klenner, 1954) all have responded very
well to vitamin C. Of great interest as well is that all three of
these infections are associated with very significant microbe-generated
toxins, much like anthrax. Jungeblut and Zwemer (1935) found that
vitamin C both inactivated diphtheria toxin in the test tube and protected
guinea pigs against the fatal outcome of being injected with otherwise
fatal doses of diphtheria toxin. Dey (1966) showed that enough injected
vitamin C would completely protect rats from otherwise fatal doses
of tetanus toxin.
Klenner never encountered a virus he
could not cure, although he used doses of vitamin C that are considered
outrageously high today, even though such doses are nevertheless decidedly
non-toxic. His initial dosing of vitamin C would go as high as 700
mg/kg body weight, which could exceed 70 grams for a large man. Furthermore,
he would repeat this high dosing in only a few hours if no drop in
fever or clear clinical improvement resulted. He never reported any
toxicity from vitamin C dosed in this fashion. However, he repeatedly
reported that initially unresponsive patients did finally respond
when enough vitamin C was administered frequently enough. From the
very current scientific literature we know that 60 grams of vitamin
C can be repeatedly infused without toxicity over only an 80-minute
period. Furthermore, 50-gram intravenous doses of vitamin C can be
given daily for 8 weeks without any side effects other than improved
health (Casciari et al., 2001).
My own clinical experiences with intravenous
vitamin C infusions allow me to completely believe all of the data
that Klenner and others have accumulated. Many feel vitamin C did
not deliver as promised when Linus Pauling’s recommendations of a
few grams of vitamin C a day did not end up curing or completely preventing
the common cold. To be sure, it did make those infected feel better,
and it shortened the durations of their symptoms. It did also lessen
the likelihood of getting a cold. Once entrenched in the body, however,
the common cold results in a very high titer of virus particles. A
few grams of vitamin C will help the immune system cope, but it is
not remotely enough to promptly eradicate the virus load present.
However, several hundred grams of vitamin C intravenously daily for
2 to 3 days can be expected to knock out the common cold in most people.
The next time you have already been sick with a cold for a few weeks,
you will appreciate what a remarkable clinical response this is.
After determining your best daily dose
of vitamin C by following the bowel tolerance method outlined by Cathcart
(1981) and after taking that daily dose regularly, the likelihood
of contracting any infectious disease, anthrax and smallpox included,
is remote. For many people, this will translate to a total daily dose
of vitamin C of 8 to 15 grams taken in divided doses, although some
people will require more. The recommended form of vitamin C would
be sodium ascorbate, although ascorbic acid would be perfectly acceptable.
I do not recommend high doses of calcium ascorbate.
If you are exposed to a very high dose
of infectious organisms, the maintenance doses of vitamin C noted
above can be overwhelmed and clinical infection can still result.
The simple answer then is to start vitamin C infusions at up to 700
mg/kg at a time as often as is necessary to obtain a positive clinical
response. Lesser amounts and less frequent dosing can be used if the
clinical picture is not severe. Obviously, the administration would
have to be very vigorous in an inhalation anthrax patient who has
already developed lung symptoms and death may be only hours to a day
or two away. Certainly, in the case of anthrax, there is no reason
not to take all prescribed antibiotics as well, but the antibiotics
will have little effect if large amounts of anthrax toxin have already
been produced. The vitamin C would be essential at that point. In
viral diseases where bleeding complications occur, the bleeding will
often occur at those sites in the body where vitamin C levels are
lowest, or even nonexistent. It is absolutely characteristic for such
"focal" sites of scurvy to hemorrhage, and nothing short
of very large doses of vitamin C given very quickly can be expected
to save the patient at that point.
Regardless of any skepticism that the
reader may have toward such high-dose vitamin C therapy, it is absolutely
unthinkable not to try it or add it to whatever protocol is being
administered to the patient. At the very least, all acute infectious
diseases rapidly metabolize vitamin C, and all acutely ill patients
are consequently deficient in vitamin C. The administration of vitamin
C should always be undertaken when acute vitamin C deficiency is a
certainty, even if one does not believe that enough vitamin C can
be a definitive therapy by itself.
Hydration is also extremely important,
both in health and disease. Furthermore, vigorous hydration (2 to
4 quarts of water daily) will augment the effectiveness of the vitamin
C therapy. Just about the only time high doses of vitamin C can cause
problems is if the patient is not kept very well hydrated. Remember
that patients with high fever lose body water rapidly. Most other
medicines have more side effects in the face of dehydration as well.
There are many other supplements and
nutrients that can augment the anti-microbial effects and immune-bolstering
effects of vitamin C, which is beyond the scope of this issue of the
newsletter. Just don’t neglect the most important one: vitamin C.
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