Vitamin C In Acute Poliomyelitis

EDWARD GREER, M.D.

Robinson, Illinois

From the Edward Greer Hospital.

Since maximum immunity from the Salk vaccine cannot be expected until the third dose given preferably seven months after the second, it seems appropriate to describe several serious cases of polio treated successfully with massive doses of vitamin C.

M.E. was admitted to this hospital September 28, 1950 with the following symptoms: nausea and protracted vomiting, headache, pallor, dehydration, temperature 104°, absent knee jerks, weakness of extensors of thigh. Wbc 11,000, spinal fluid cloudy with white cells 120, 70% lymphocytes. She was given twenty 0.5 gm tablets of ascorbic acid with milk on admission. Shortly her nausea improved and vomiting did not occur thereafter. Ten grams of ascorbic acid were given with each meal and at bedtime and at midnight with milk until her temperature became normal, October 3, 1950. There were no residua.

S.M., age 12 years. Temperature 103°, nausea and persistent vomiting, absent knee and ankle jerks, weakness of leg musculature to the extent that falling occurred when the patient attempted to walk. Spinal fluid examination showed cloudy fluid with 120 white cells, the majority being lymphocytes. Twenty 0.5 gm tablets of ascorbic acid were given every 3 hours with milk. This medication was continued for the next 3 days with gradual fall of temperature to normal. There was return of deep reflexes and normal strength of musculature with no residua. Medication was continued for approximately 10 days.

W.J., age 10 years, admitted September 9, 1952. He and his older brother had just returned from a vacation in Michigan where a polio epidemic was in progress. The older brother was just recovering from an illness which started like the patient’s. He was less severely ill than the patient, but examination revealed slight paresis of one lower extremity. The patient’s signs and symptoms were: nausea, vomiting, temperature 103°, elevated white blood count and typical spinal fluid findings. The aforementioned therapy was instituted, with like results. The older child, although less severely ill, had a slight permanent weakness of one leg, which, in my opinion, occurred because therapy was started too late in the course of the disease.

C.G., age 5 years, oldest daughter of the author, was first ill on July 5, 1953. The first symptom was a febrile convulsion, temperature 104°. Treatment of Dilantin gr. 1½, phenobarbital gr. ¼ twenty 0.5 gm ascorbic acid tablets was given. Signs and symptoms subsided so abruptly that therapy was discontinued the next day. That afternoon her fever again rose to 103°, nausea, vomiting and leg aches occurred, preconvulsive irritability and flippant manner became noticeable and therapy was again instituted and maintained for about one week, until all signs and symptoms subsided.

Spinal fluid examination was not done because of the febrile convulsions.

R.E., age 43 years, admitted September 13, 1953. His presenting complaint was pain in the back running down the right leg following spading a garden. My first impression was a sprain of the right sacroiliac region. His pain was so severe that leg traction was applied. The next day the pain better but on examination of the leg, deep reflexes were absent, and slight flaccid paralysis was noted. Temperature rose to 102°. Spinal fluid revealed cloudy fluid with 150 white cells, predominately lymphocytes. A diagnosis of poliomyelitis was made and confirmed by medical and orthopedic consultants. Twenty 0.5 gm ascorbic acid tablets every 3 hours were begun and continued for about 10 days with no increase in paralysis and only slight residual weakness in the right leg.

Conclusion

Patients receiving these large doses of ascorbic acid will, after several days, when their increased tissue demands are fulfilled, excrete excess vitamin C in their urine. This will give a false 1 or 2 plus Benedict’s test for sugar. Slight gastroenteritis with flatus and anal irritation are noted when the body needs are exceeded. When these symptoms occur the intake of vitamin C should be gradually reduced accordingly. It is advisable after such severe illnesses to give at least four .5 gm vitamin C tablets with meals for one month, then perhaps two with meals for several additional months to hasten and aid convalescence. Summary: Large doses of vitamin C have proven beneficial in the management of five serious cases of acute poliomyelitis.

From Medical Times, Volume 83, November 1955, Number 11, pp. 1160-1161