Since the industrial preparation of synthetic vitamin C, placed at the disposal of experimenters as a chemically and physiologically defined product, this vitamin has been the subject of widespread and productive research.
Several works, published during two last years, revealed that there is a relationship between the metabolism of vitamin C and certain infectious states (Rudy; Harris).
The status of vitamin C in the organism is depressed during infections such as pneumonia, measles, scarlet fever, diphteria, typhus, and tuberculosis (Schroeder; Harde, Rothstein and Ratish; Grunke; Otto; Mouriquand, Sedallian and Cœur).
Plaut and v. Bulow noted a reduction in the status of Vitamin C in the cerebrospinal spinal fluid of malaria patients; a reduction which corresponds to a general impoverishment of vitamin C in the organism.
However, a certain number of experiments, which for the moment are in the domain of the laboratory, showed that vitamin C plays an important part in the protection of the organization against certain infectious agents or their toxins. According to whether the status of the vitamin is elevated or depressed, the resistance of the organization increases or decreases.
Thus McConkey and Smith showed that the resistance of the guinea-pig to tubercular infection is decreased in the presence of an hypovitaminosis-C.
These authors administered tuberculous saliva to guinea-pigs subjected beforehand to a regime free of vitamin C, [as well as to] normal guinea-pigs.
The first exhibited an ulcerous intestinal tuberculosis thereafter, whereas the others were unscathed.
This protective action of vitamin C is also exerted with respect to diphteric toxin: v. Jeney, Gagyi and Baranyai experimented on 80 guinea-pigs subjected to a scorbutigenic regime. On the 3rd day of the regime, 40 of these animals received ascorbic acid daily; on the 4th day, the 80 animals received an lethal dose of diphteric toxin. Those which received ascorbic acid showed much more resistance to the toxin than the others.
Herbrand administered to guinea-pigs a lethal dose of diphteric toxin at the end of 40 hours.
The animals survive if one then injects them, every 6 hours over 2 days, with 3 cubic centimeters of a preparation which contains 50 milligrams of ascorbic acid per cubic centimeter.
Jungeblut and Zwemer, again, show that amounts from 0.5 to 5 milligrams of ascorbic acid make the guinea-pig immune to diphteric toxin.
Other research reveals that vitamin C can directly influence certain pathogenic agents, on which it exerts an inhibiting action.
Thus Misses Grootten and Bezssonoff announced that the presence of a small quantity of ascorbic acid in the culture medium (80 milligrams per liter) prevents the development of the bacillus of pertussis [whooping-cough].
Hanzlik and Terada showed on pigeons, Harde and Philippe on rabbits, Schwarz and Cislaghi, and Jungeblut and Zwemer on guinea-pigs, that the injection of lethal doses of diphteric toxin is inoffensive if one mixes beforehand the toxin with a certain quantity of ascorbic acid.
In the same way, Jungeblut subjected monkeys to intracerebral injections of the poliomyelitis virus mixed with ascorbic acid. The addition of 5 to 10 milligrams of ascorbic acid inactivated the virus and prevented paralysis. Below 1 milligram the ascorbic acid is without effect; above 50 milligrams it is toxic.
These recent concepts have not yet been clinically established, and their therapeutic applications are limited apparently to the observations of Bronkhorst and Gottlieb.
Bronkhorst announced the beneficial effects of vitamin C in intestinal tuberculosis, where its administration is quickly followed by an increase in weight, as well as by notable improvement of the blood picture and general state of the patients.
Gottlieb cured, by daily administration of vitamin C in intramuscular injections of 100 milligrams, two children of 6 and 15 years suffering serious diphteria, whose condition had suggested a grave prognosis.
The role which vitamin C plays in infectious phenomena, the inhibiting action that it exerts on various pathogenic agents, the effects that we obtained during some of our training at the University Dermatological Clinic of Geneva, where we used it systematically in a great number of skin afflictons, prompted us to to administer it to patients stricken with herpes and shingles (1).
(1) the preparation used during this research is Redoxon “Roche” (Laroscorbine).
The results obtained enable us henceforth to regard vitamin C as the drug of choice for these afflictions.
Obs. I. — Miss H... S., 24 years.
Consulted on 10 December 1935 for a genital herpes lesion dating from the day before.
Circumference of the vulva and the labia are strewn with serous-filled blisters. The eruption is accompanied by a somewhat sharp burning sensation; impedes walking.
No local treatment.
The patient takes 4 tablets of ascorbic acid per day (1 tablet = 5 centigrams).
13 December, the eruption completely disappeared.
Obs. 2. — Mrs. P... Georgette, 24 years.
Presented on 10 July a herpes blister at the internal face of the left thigh, at margin of the vulva. No treatment. Thereafter, appearance in the vicinity of the first blister, at margin of the vulva and the anus, of new blisters that the patient comes to show on 17 July.
17 July: one noted at this time a voluminous plaque of about fifteen blisters with turbid contents. The patient complains of an extremely sharp burning sensation; walking is impeded.
1st intravenous injection of ascorbic acid, 0.10.
No local treatment.
18 July: great subjective improvement. One still notes the remnants of two incompletely desiccated blisters. The others disappeared.
2nd injection of ascorbic acid, 0.10.
20 July: complete recovery.
Obs. 3. — Mrs. S... Eugenie, 40 years.
Presented herpes of the right-lateral face of the neck. 4 years ago, she suffered over 1 month from herpes located in the same place.
One currently notes an erythematic plaque, infiltrated, raised in the center of which several blisters are grouped, the size of which varies from that of a grain of wheat to that of a lentil.
Redness appeared during the night from of 6 to 7 June, accompanied by a burning sensation, sharper now than at the beginning. The blisters date from 9 am.
9 June, 1st intravenous injection of 10 centigrams ascorbic acid.
No local treatment.
10 June, marked reduction in redness and œdema. The blisters are desiccated, except one which is progressing well to recovery.
2nd injection of ascorbic acid, 0.10.
11 June, disappearance of redness, œdema and burning sensation. Several crusts fell. Several desiccated blisters are still covered with crust, an incompletely desiccated blister.
3rd intravenous injection of ascorbic acid, 0.10.
June 12, recovery. Only the incompletely cured blister of the day before, and which is currently completely desiccated, is still covered with crust.
Obs. 4. — Miss D... Jan., 28 years.
Consulted on 25 March for a bulky herpes lesion of the mouth. The two lips, but particularly the upper lip, are strongly œdemateous and strewn with many blisters, merging in places.
The eruption is very painful.
25 March, 1st intravenous injection of ascorbic acid, 0.10.
26 March, great improvement. The lips are much swollen and less painful.
2nd intravenous injection of ascorbic acid.
27 March, disappearance of the œdema and pain. The majority of the blisters are dry.
3rd intravenous injection of ascorbic acid.
28 March, recovery. Still persistent are some crusts of variable size on the site of some desiccated blisters, from which the majority completely disappeared.
Obs. 5. — Miss F... Bernadette, 20 years.
Recovery approximately a week before of a herpes lesion of the right wing of the nose, which had lasted about fifteen days.
30 July: in the morning, beginning of a new lesion on the upper lip, on the right side. In the afternoon, appearance of blisters on the right wing of the nose.
31 July, one notes on the right side of the upper lip, which is strongly œdemateous, an irregular yellowish plaque of 1 approximately centimeter diameter, made of several merged blisters with turbid contents. In the medium of the lower lip, an open blister. On the right wing of the nose, an erythematic plaque strewn with blisters with serous contents. The right wing of the nose and the end of the nose to the circumference of the right nostril are reddened, are œdemateous, and very painful. The pain is less sharp at the lip.
1st intravenous injection of ascorbic acid, 10 centigrams.
On 1st August, the œdema of the nose and the lip is notably diminished. The redness of the nose has disappeared. The blisters are completely dry, except the left upper lip, where they are in the process of recovery.
2nd injection of ascorbic acid.
3 August, the eruption of the wing of the nose disappeared. One still notes with the upper lip, on the site of the completely cured lesion, a partly detached yellowish crust.
Obs. 6. — Child D... Andree, 13 years. Not regular [non-menstruating].
Present on the internal face of the upper right lip an ulceration of the size of a lentil, remainder of a large herpes blister dating from the day before. Two months prior the young girl presented a similar lesion at the same place.
No focal treatment.
3 tablets of ascorbic acid per day (15 centigrams). Cicatrisation complete in 3 days.
Obs. 7. — Miss P... Marguerite, 24 years.
Recurrent herpes of the upper lip in childhood. Since the patient is regular [menstrual], the herpes appears 4-5 days before the beginning of the [menstrual period] and generally evolves in a week.
The menses are irregular and are missed sometimes for 3-4 months. It so happens that the herpes appears at the times of the expected periods, even in their absence.
Desirous to verify the effect of ascorbic acid on as fresh a lesion as possible, we bid the patient present herself at the first symptoms of an eruption. She came in to us for consultation on 26 May, 1936.
We noted at that time a marked œdema of the upper lip on the left side, on which the lesion, in the process of formation, is presented in the form of a red congestive spot. Vesiculation not yet started; pruritis. The œdema of the lip began the day before, in the afternoon.
26 May, 1st intravenous injection of ascorbic acid, 0.10.
27 May, the œdema completely disappeared. A scarcely marked redness persists on the site of the papule.
2nd intravenous injection of ascorbic acid, 0.10.
28 May, the lip is completely normal.
The treatment of this patient continued in experiments until 30 June at a rate of 5 intravenous injections of ascorbic acid per week (total: 25 injections of 10 centigrams).
The [menstrual period] expected for 26 June was missed. The patient was re-examined on 27 July. She had not yet menstruated. The herpes did not repeat.
Obs. 8. — Mrs. Z... Jeanne, 44 years.
Recurrent herpes lesions of the upper lip since 1923. The outbreaks occur every approximately 3 months and last about eight days. For past 3 years, recurrent herpes on both buttocks, generally on the left. The lesions are deep, painful, the outbreaks more frequent and last longer: 2-3 weeks. The last eruptions which precede treatment go back to November 1935 and January 1936.
On 13 February 1936 the patient consults for an outbreak of herpes dating from February 11. She presents on the left buttock a slightly infiltrated erythematic plaque, on which one still sees the remainder of 2 blisters of herpes covered with yellowish crusts.
The 3 patients affected by recurrent herpes remain in observation, and will be the subject of later communication.
Obs. 1. — Miss L... Marguerite, 32 years.
During the night from the 7 to July 8, 1936, the patient is awaked by an itching on the left side of the thorax. She notes on this level an eruption that she dabs with eau de Cologne and for which she consults on July 8.
She presents at this time on the left side of the thorax a shingles which extends from the armpit to the centre. The eruption, pruriginous, consisted of ten small erythematic plaques, merged in places, and centered by a small vesicule.
8 July, 1st intravenous injection of ascorbic acid: 10 centigrams.
9 July, less pruritis that of the previous night. Redness almost disappeared. One notes in the armpit three new elements only consisted a small vesicule, without redness. The blisters of the day before are in the process of disappearing.
2nd intravenous injection of ascorbic acid.
10 July, the site of the lesions is still marked by slightly pigmented maculae. On some, one notes a thin yellowish pellicule [film], a remainder of the disappeared blisters. The patient still felt a light pruritis on the level of the armpit in the afternoon of July 9; currently nothing else.
3rd intravenous injection of ascorbic acid, 0.10.
The patient is re-examined on July 21. One notes still at this time on the site of 2-3 lesions, a faint pigmentary macula. No subjective symptoms since 9 July.
Obs. 2. — M. A... Oscar, 26 years.
Consulted on 6 July 1935 for a thoracic shingles dating from the day before. The eruption consisted of 3 broad erythemato-vesiculate plaques extending as a slightly oblique band from the spine to the end of the sternum. It is slightly painful.
Treatment: 4 tablets of ascorbic acid per day (20 centigrams).
9 July. Almost complete disappearance of redness. All the blisters are dry. The patient does not show any more any subjective symptom at the level of the eruption.
Obs. 3. — We treated the following patient with the University Dermatological Polyclinic of Geneva. Our director, Mr. Professor Du Bois, agreed to authorize our use of this observation for this publication. It is found here with the expression of our deepest gratitude.
Mr. G... Maurice, 25 years.
Shingles intercostal on the right side, going back to 3 days, the time at which the patient presents himself at the Dermatological Polyclinic (4 September, 1935).
The eruption had been preceded by light pains during 2-3 days.
One notes, at two finger-beadths below the right nipple, a wide erythematic plaque strewn with blisters. A little behind is a similar plaque, smaller. A third plaque on the right side of the back, and a fourth in the immediate vicinity of the spine. The pains, which are not very sharp, nevertheless are more marked than at the beginning of the eruption.
No local treatment.
Four tablets of ascorbic acid per day (20 centigrams).
6 September, redness almost completely disappeared. The blisters on the back are in the process of desiccation; on the thoracic plaque some blisters are greatly increased in volume; others are in the process of disappearance.
9 September, all the blisters are in the process of recovery.
16 September, the patient, who could not return earlier because of his employment, arises completely cured. The pains ceased on 13 September. Only some crusts persist on the site of the disappeared blisters.
The preceding observations highlight the rapid — immediate, one can say — action of vitamin C on herpes and on shingles.
The administration of this vitamin makes it possible to stop and cure even intense outbreaks of herpes in the space of 2-3 days. It notably shortens the duration of a sometimes painful, always awkward, affliction, the evolutionary cycle of which usually progresses over 8 to 15 days. These timelines are exceeded further in the genital herpes of women.
The results obtained in recurrent and nonrecurrent herpes are identical. In both cases the ascorbic acid acts upon the outbreak in the same manner. It is not possible for us, in the current state of our research, to appreciate the influence which it can exert on the recurrences.
With two of our patients, a series of 12 and 10 injections proved insufficient to prevent [recurrences] (obs. 8 and 9). With a third, after 25 injections, a recurrent herpes cataménial did not appear at the time expected. Only this patient, dysmenorrheic, was not [menstrually] regular since the end of May, the date of the last outbreak. The effect of treatment on the recurrences will appear only at the time of the next [menstrual] period, according to whether or not they are accompanied by the usual herpes.
The administration of vitamin C in shingles, the more effective the earlier it is done, profoundly modifies the clinical evolution of this affliction.
It [vitamin C] acts not only on its [shingles’] cutaneous manifestations (erythema and blisters), which disappear with an unexpected rapidity, but also on the painful phenomena which generally accompany it [shingles].
Thus one of our patients, treated as of the first symptoms, did not feel any pain (obs. 1). A patient also put in treatment from the very beginning, but in which the eruption was already completely established and who showed light pains, suffered no longer upon of the administration of the vitamin (obs. 2). Another patient whose eruption went back 3 days as of institution of the treatment, and who complained about sharp pains enough, very quickly observed their reduction, then their complete disappearance under the influence of the drug (obs. 3).
How can one explain the remarkable action of ascorbic acid on herpes and on shingles?
Microbiological research of these last years showed that herpes is due to a neurotropic infiltrating virus.
In animals, whatever the point of inoculation, the virus infects the nervous system. In man, one could detect it in the cerebrospinal fluid.
The infectious nature of shingles is currently acknowledged, although the pathogenic agent of this affliction has to date evaded all research. Still, it is generally known that this agent, like the herpes virus, is filterable, and that it resides in the nervous system (Ravaut).
In addition, the work of Melka, and Plaut and v. Bulow revealed the presence of high quantities of vitamin C in the nerve centres and in cerebrospinal fluid. These quantities vary with the general status of vitamin C in the organism, and can be influenced by the administration of ascorbic acid.
Under these conditions, and in light of the research reported at the beginning of this article, it seems permissible to think that vitamin C exerts in situ, directly on the virus of herpes and the pathogenic agent of shingles, an inhibiting action comparable to that which it exerts on the poliomyelitis virus and on diphteric toxin.
W. BRONKHORST. — Radiological exploration of tuberculosis of the large intestine and its clinical importance. Nederl. Tijdschrift voor Geneeskunde, 1936, n. 12, pp. 1310-1311.
I. DAÏNOW. — Preliminary note on the desensitizing action of ascorbic acid (vitamin C). Ann. Dermat. and Syph. September 1935.
E. GOTTLIEB. — On vitamin C and diphteric toxin. Ugeskrift for Laeger, 1936, n. 9, p. 181.
GROTTEN and BEZSSONOFF. — Sensitivity of the bacillus of whooping-cough with respect to vitamin C and hydroquinol. C. R. Soc. Biol., 120, 1935, n. 29.
GRUNKER and OTTO. — Clinical importance of vitamin C. Med. Klinik, 52, 1936, n. 2.
HANZLIK and TERADA. — Protective measures against diphteric intoxication, J Pharm. Exp. Therap., 56, 1936, n. 3, p. 269.
HARDE and PHILIPPE. — Observations on the antigenic action of a diphteric mixture of toxin and vitamin C. C R. hebd. Acad meetings. Sci., 199, 1934. p. 738.
HARDE, ROTHSTEIN and RATISH. — Urinary elimination of vitamin C in pneumonia. Proc. Ploughshare. Exp. Biol. Med., 32, 1935, p. io88.
L. J. HARRIS. — Vitamins. Annual Review of Biochemistry, 1935.
W. HERBRAND. — Endocrinology, 16, 1935, p. 236.
VON JERNEY, GAGYI and BARANYAI. — The inhibiting action of ascorbic acid on diphteric intoxication in the guinea-pig. Dtsch. Med. Wschr., 54, 1936, n. 2.
JUNGERBLUT — Inactivation of the poliomyelitis virus in vitro by crystalline vitamin C (ascorbic acid). J Exp. Med., 62, 1935, n. 4, p. 517.
JUNGEBLUT and ZWEMER. — Inactivation of diphteric toxin in vivo and in vitro by crystalline vitamin C (ascorbic acid). Proc. Ploughshare. Exp. Biol. Med., 32, 1935, p. 1229.
Mc CONKEY and SMITH. — In Harris.
J MELKA. — On the content of ascorbic acid (vitamin C) in the various parts of the nervous system and peripheral nerves. Pflügers Arch., 237, 1936, p. 216.
MOURIQUAND, SÉDALLIAN and HEART. — Diphteric intoxication and ascorbic acid of the suprarenals. Presse Méd., 1935, n. 104, p. 2113.
PLAUT and v. BULOW. — Reduction in the level of the vitamin C in the cerebrospinal fluid during malaria as indication of an increase in the metabolic processes. Klin. Wschr., 1935, n. 37, p. 1318.
PLAUT and v. BULOW. — The influence of alimentation on the content of vitamin C of the cerebrospinal fluid. Z Ges. Neurol. Psychiatr., 152, 1935, p. 324.
PLAUT and v. BULOW. — Content of vitamin C of the various parts of the nervous system. Z Ges. Neurol. Psychiatr., 153, 1935, p. 182.
RAVAUT and DARRÉ. — Nervous reactions during genital herpes. Ann. Derm. and Syph., June 1904.
RAVAUT. — Chapter: Herpes and Shingles in New Dermatological Practice, pp. 271-298, Masson, Paris, 1936.
H. SCHROEDER. — Elimination of ascorbic acid in the healthy and sick organism. Verb. dtsch. Ges. inn. Med., 424, 1935.
SCHWARZ and CISLAGHI. — Experimental study of the biological action of ascorbic acid. Neutralizing effect on diphteric toxin. Minerva Med., 11, 1935, p. 202.
From Annals of Dermatology and Syphiligraphie — 7E Série — Volume 7 — No September — 9, 1936.
Note: the French idiom for the lesions being discussed often translates as “a herpes” or “a shingles”; for this translation, “herpes” or “shingles” may become the descriptive part of a compound noun, as for example, “a herpes lesion”, if not already used in conjunction with another noun. When the context clearly signifies whether herpes or shingles is being discussed, subsequent mentions may just be called “lesion”.
Dates in case histories, cited in the present tense, may occasionally be shifted to past tense.
Guérison may be rendered herein as either cure or recovery.
Erythema: generally, a redness of the skin produced by congestion of the capillaries, esp. inflammation.
Œdema = oedema = edema: swelling of tissue.
herpes cataménial = herpes occurring in conjunction with the menstrual period.
20 November, 2013.
Translation © 2005-2006 Alexander S. Templeton
Formatting © 2005-2006 AscorbateWeb