SPECIAL ARTICLE

The Administration of Large Doses ofAscorbic Acid in the Prevention and

Treatment of the Common Cold

Part IIEdme Regnier, M.D.

Beginning at about the age of sevenand following a tonsillectomy I beganto be plagued with otitis media ofwhich I suffered from 50 to 60 boutsover the next 20 years. These recur-rent infections were treated by a seriesof different methods including Cubebcigarette smoke blown into the ear bymy mother, the local application ofheat, sulfadiazine in nasal sprays andthe earlier and later forms of injectedpenicillin which was useful as soon asI suffered from a sore throat if takenat the first signs of infection, but onlyfor the secondary bacterial componentof my double infection which beganwith a vims which appeared to pass thesentence which was executed by thebacteria. I stumbled upon the employ-ment of ascorbic acid because of theadvertisements for the bioflavonoidsand vitamin C as beneficial in the pre-vention -and treatment of the commoncold. It was apparent that the mixturediminished the symptoms of the com-mon cold for me and for my wife, butnot enough for us to continue with itsemployment, Would larger doses per-haps be more effective?

The doses were increased as eachincrement proved itself as giving betterresults until I reached a maximum andsatisfactory effect. I did not permitmyself to be dissuaded by the gloomyconclusions of others, whose work I

continued to recognize had shown onlythat vitamin C had not been helpfulagainst colds at the dosage used in theirstudies, and not the unmeasured gen-erality that this drug had been provenutterly useless against colds.

I was then able to suppress colds, atwill, in five subjects. There is no doubtthat we really suffered from colds dur-ing these suppressed versions of thedisease, because we continued to beawarebut just awareof whateversymptoms had been characteristic ofour formerly unmodified colds. Al-though running of the nose would bepractically non-existent, on rare occa-sions a single drop might appear at thenares; however, not -a trace of "itchi-ness" had accompanied it in its rolldown the turbinates. The thickenedstage of nasal discharge was neverreached. Sneezing and coughing werequite unusual. A throat did not pro-ceed to "soreness" but, in some cases,there was a slight sensation of its pres-ence. Hoarseness was uncommon.Headache was inconsequential. Ma-laise, if at all recognizable was usuallyso minor as to be undeserving of thename. Secondary bacterial invasionsdid not occur.

I learned that the treatment had tobe initiated early enough and neededto be continued at a high level for sometime and then withdrawn or diminished

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REGNIER-ASCORBIC ACID 949

only gradually. It was noted that theinfection so treated although suppress-ed appeared to last longer. When nottreated the duration was usually fromfive to seven days, but when treated allevidence of the viral infection was notgone until eight to eleven days hadpassed. It was as though the suppres-sion of the inflammatory response wasat the expense of some delay in thedevelopment of a completed immunityto the causative viruses. It seemed alsothat despite the delay of immediate im-munity the development of the usualseveral weeks' of resistance was in noway retarded.

There were two objections to thetreatment, It was expensive in that thecost of the drugs was more than $25,00for each cold; and there were two vari-ables, the bioflavonoids and the as-corbic acid, Was it possible that thevitamin C alone was responsible forthe obvious effects, or was there asynergistic action of the so-called vita-min P? The texts suggested that thelatter substance demonstrated littlepharmacological activity, although adeficiency was thought to cause an in-crease in the permeability of capillarywalls, It did not seem to me that theflavone factor in lemon juice (citrin)and in Hungarian red pepper and con-sisting of a mixture of flavones, erio-dictyol and hesperidin could be of anygreat importance,

Nevertheless, I initiated a double-blind study using ascorbic acid alone,ascorbic acid plus bioflavonoids, fla-vonoids only and, fourthly, a lactoseplacebo with the two "vitamins" pres-ent either alone or together in 200 mgquantities, It was shortly obvious thatthere was no need to continue double-blind techniques. The continued stud-ies were done by the single blindmethod, As noted in the introductoryremarks, a cold is a tenuous entity. Itstreatment required -a high degree ofinformality with much use of the tele-phone to encourage the subjects to

continue to discipline themselves asregards the use of the ascorbic acid.Attention was intensive and supervisionessential. At no time was any subjectrequested to take a dosage of ascorbicacid which had not been exceeded bymembers of my family and by me with-out ill effects.

I limited myself to 22 subjects, anumber I could carefully supervise.Almost all were of professional stature.The majority were adults whose agesranged from 30 to 50, with the ex-tremes being five children younger than12 (whose treatments were supervisedby -adults) and the oldest subject was73 years of age.

My observations suggested that itmight be best to spare children coldscompletely where possible by quickcontrol of the upper respiratory infec-tions of the adults of the family andordinarily to permit the cold to run itsunmodified course if a child did catchone, even though the children are themost likely patients to develop secon-dary bacterial infections, In any case,even for adults, the suppression ofcolds by ascorbic acidat least as itstands at presentis not a form oftreatment ideally suited to the capaci-ties of every last patient. The patientmust persist in taking his medicine asordered and for the prescribed time.

Surely I am aware of the possibledanger of interfering with the develop-ment of naturally occurring antibodiesor immune responses. Although therehas not been a single serious conse-quence to the suppression of colds byascorbic acid in more than 400 suchtrials, I still hesitate to state that pro-longation of the activity of the virusmay not give the organisms time andopportunity to modify their nature sothat an attack on another organ orsystem might occur. In actual practicethere has been what probably amountsto a small increased incidence of tran-sient muscle involvement, or sorenessof -the back or stiffness of the neck,

950 REVIEW OF ALLERGY, VOLUME 22, OCTOBER, 1968

both of which, of course, may occurwith untreated infections with virusesof the upper part of the respiratorytract.

The 22 subjects mentioned have beenstudied systematically and under con-ditions which were as controlled as ispossible in a clinical investigation ofan affection such as the common cold.Some acted as what are commonlytermed their own controls in that theywere sometimes permitted to sufferfrom untreated colds and at other timeswere treated by one or the other of thefour trial "drugs" used successively innew colds. Equally valuable for com-parative purposes were the clinicalcourses of several individuals eachtreated differently at one and the sametime during the course of a specificupper respiratory infection which af-fected several or all of the members ofone household.

None of the subjects was studied forless than three years, and for almost all,the duration of observation was four orfive years. In the past all had experi-enced from one to four colds each yearwith the usual number being three.While it was taken for granted -that thememory of the incidence of past in-fections may have been exaggerated,the minimal expected number of coldsof the group overall was estimated tobe approximately 225. But during thefive-year period of observation therewere -actually only 160 upper respira-tory tract infections. The validity ofthe treatment employed cannot bebased on the reduction of expectedcolds, but if this is true it would cer-tainly suggest that the program hadsome sort of value as a prophylacticmeasure too.

Of the 160 "cold incidents" therewere 23 which could not be includedin the results, because for the particu-lar cold the subjects did not correctlyfollow the particular treatment pre-scribed for them. Some of these oc-curred at the beginning of the study

when the discipline involved in thetaking of the drug according to sched-ule was being established and some atthe end when some of the subjects wereable to recognize the fact that they werebeing treated with a placebo and re-fused to proceed with a useless type oftherapy.

The Method of TreatmentWithin the first 24 hours of a typical

infection which the patient recognizesas his usual early symptoms of a cold,and the sooner the better, the beginningdose of ascorbic acid of 600 or 625 mgis taken every three hours, Ascorbicacid is available in various tabletstrengths and the patient may take, forexample, three of the 200 mg tabletsor two and one-half of the 250 mg tab-lets. The medication will work equallywell when a single 200 mg tablet istaken every hour or when two tabletsare administered every two hours, butthis more frequent ingestion onlymakes for unnecessarily complicatedtreatment schedules. On the otherhand, experience has taught me thatfour of the tablets taken every fourhours are not as satisfactory, for thereason that during the earlier and moreviolent stages of the infection, the pa-tient often becomes aware somewherenear the end of a three-hour periodthat symptoms are recurring or are im-minent. It is actually sometimes pleas-ant to look forward to the next dose tobe taken. The need for a three-hourschedule of doses parallels laboratoryobservations and data that the levels ofascorbic acid in the plasma have re-turned to normal after the ingestion ofquite large quantities in this time (E.N. Todhunter, R. C. Rabbins and J. A.Mclntosh. J Nutrition 23:309 1942).If the amount of ascorbic acid taken atbedtime is increased to 750 mg, thereis no need to awaken the patient atnight for the "missed" dose providedthat the first dose of the next day isalso raised to 750 mg. Experience has

REGNIERASCORBIC ACID 951

shown that a sustained release capsulefor overnight effect is thus not needed,but its eventual availability would seemto have an obvious application in thetreatment schedule.

It was also learned that when thethree-hour interval was exceeded andlarger individual doses were thus need-ed, -there was the disadvantage thatthey caused pyrosis (heartburn). Thiswas easily relieved by a small quantityof bicarbonate of soda in water.

When ascorbic acid is used at thedosages described and for only shortperiods of time, gastrointestinal dis-turbances are the only side effects com-monly noticed. After several days ofthese high dosage levels, there may bean excess of abdominal gas, which mostpatients infinitely prefer to the symp-toms of the cold which they are awarewould distress them were they nottaking their ascorbic acid. It should benoted that other common methods oftreating cold symptoms are not free ofside effects, especially those of a sym-pathomimctic type,

After the patient has taken the largecjoses prescribed for the initial stagesof the cold for some three to four days,it is possible for him to diminish thequantity of ascorbic acid. The three-hour schedule is still adhered to, butthe dose of the vitamin is reduced to375 to 400 mg. If (the reduction ofthe close has been premature, typicalcold symptoms will reassert themselveswithin a period of 12 hours or less.Should this occur, it is necessary to re-turn to the initial size doses as soon aspossible; and despite them the symp-toms may not be re-aborted for as longas 12 to 18 hours (laboratory data,Todhuntcr, et al, op. cit).

Should there be no recurrence of thetypical symptoms when the dose hasbeen reduced and maintained -at thelower level for two or three days, thena further reduction in the quantity ofascorbic acid taken may be attemptedwith the new doses taken at the three-

hour intervals but consisting of only200 or 250 mg. After several days ofthis dosage level the interval may beincreased ito four and six hours betweenthe tablets of 200-250 mg dosage, andif there is no evidence of any recur-rence of the typical symptoms the useof the ascorbic acid may cease by thetenth to twelfth day of -treatment.

It is interesting and should be re-membered that as the ascorbic aciddoses are reduced there may occuronly rarelyone or two atypical symp-toms which may not be recognized asaccompaniments of a viral infection.There may be painful twinges of themuscles in unusual locations or "odd"headaches. These call for immediateincrease in the dosage of the ascorbicacid as well as for a prolongation of thetreatment period. If these complica-tionsif so they may be termedarerecognized for what -they are, then thepatient learns by practice to watch hisown progress more carefully and to re-duce the doses of the vitamin lessquickly, in which case, with subsequentrespiratory tract viral infections, suchcomplications will appear less and lessoften. There are no practical objec-tions to the continuation of the highinitial doses entirely throughout theperiod of treatment. I felt that it is onlyjudicious to employ as little of the drugas may be necessary. I was also inter-ested in the determination of what thelowest effective dose might be.

On one occasion I kept a cold activefor approximately 27 days, alternatelysuppressing it and permitting it to recurby altering the amounts of ascorbic acidI took. It was interesting -that each timeI attempted to re-suppress the infectionit became more difficult for me to doso. And finally I was forced to resortto pencillin to prevent the old "spin-off" of a viral infection into a bacterialinvasion affecting my ears.

To repeat, I have learned that it isadvisable (and still safe) to err on theside of prescribing too large a dose of

952 REVIEW OF ALLERGY, VOLUME 22, OCTOBER, 1968

ascorbic acid in the later stages of aviral infection rather than too small aone. It seems to me that if one takesit upon himself to exercise a pharma-cological authority which may actuallyextend the duration of an infection be-yond the limits which would naturallyoccur if the infection were permitted torun its natural course, then modified asthat infection may now be, one mustalso assume full responsibility for see-ing to it -that the ailment is thoroughlyrestrained until it is finally vanquishedby the normally developed immunologi-cal response.

ResultsIn the treatment of 137 observed

colds the prescribed doses were proper-ly -taken. In 34 of these the treatmentconsisted of commercial duo-CVP, andthe cold was satisfactorily suppressedin 31 instances. In another 50 coldsthe treatment consisted of ascorbic acidalone either as supplied by the U. S.Vitamin and Pharmaceutical Corpora-tion, New York, or later, of otherbrands purchased locally and at ran-dom. Of these 50, the colds were nicelysuppressed in 45. Of the eight failuresin these two "successful" trials, sixcan be accounted for and will berecalled in the Discussion below.

There was no overt clinical differencebetween the colds suppressed by theascorbic acid employed alone and thosewhere it was combined with flavonoids.It made no difference what brand ofvitamin C was taken as long as it wasfresh. Among 29 medications with bio-fiavonoids alone, the cold was in noway visibly modified from what wouldhave been ordinarily expected in 28 ofthe instances.

In 22 of 24 instances in which thelactose-filled capsules alone were takenthe colds were seemingly untemperedand ordinary.

All medications were issued in theorange duo-CVP capsules, except thatduring the later studies white tablets

of ascorbic acid were sometimes used.Not only were the capsules identical,no matter what they contained, but theschedules were identical as describedherein; and any drugs which had notbeen taken were returned to me beforethe next cold appeared and needed tobe treated.

In this small group of subjects therewas not one who failed to obtain suc-cessful results as regards his sympto-matic response if his intake of ascorbicacid was both sufficient and well-timed.Judgment as to the successful suppres-sion of the symptoms of a cold must,at some point, be subjective and can-not be a quantitative and thereforemeasurable value, but as far as thesubjects themselves were concernedthere was no question on -this point be-cause the suppression of .the symptomswas so gratifying.

In contradistinction to the studies ofothers, no attempt was made to identifythe specific virus or viruses responsiblefor any infection. Clinically, the coldsshowed a considerable, though charac-teristic variety and were, as noted pre-viously, spread through a period of fiveyears or more. The majority of thesubjects resided in Massachusetts, butsome lived in Pennsylanvia and severalin Hawaii. It seems reasonable to as-sume that -there was in this sample -afair representation of the many virusesknown to cause "colds." It should benoted that when treated the clinicalcourses of the patients, no matter wherethey resided, were very similar indeed,allowing for minor differences of noimportance. I do not wish to imply thatascorbic acid should be thought of asa general anti-viral agent. I only as-severate that it may be employed tosuppress the symptoms of a cold quiteeffectively. Now that we know howwidely organisms which do not syn-thesize it vary in their needs for it, onlyadditional studies can tell us how farits usefulness can be extended.

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Some Theoretical Considerations on theRole of Ascorbic Acid

I have dutifully listed the textbookdescriptions of the functions of ascorbicacid and have added to those some ofthe more modern concepts of its actionsand the variations in its requirementsin human beings, I saw no point inexpressing my personal opinions untilthe body of this communication hadbeen written. I do have some ideas ofmy own which are based on what Ihave observed and have developedalong the lines of logic, Studies mayprove them to be true, at least in part,but I must disclaim any certainty ifonly because overconfidence in similarspeculations made in the past and latershown to be inaccurate acted only asobstacles to the use of higher doses ofthe vitamin than had customarily beenadministered.

Two possibilities suggest themselves,and it may be that neither is justifiable.If we limit our speculations to oneaspect, the method of action, it is ob-vious that ascorbic acid suppresses thesymptoms of the viral infection whichis known as the common cold. Themost obvious causes of these discom-forts are those associated with inflam-mation, As an example, there is thehoarseness which results from an exu-dation of plasma and cells into thevocal cords and the surrounding mu-cous membranes. If it is true thatascorbic acid decreases the permeabil-ity of capillary vessels, then therewould be less than the normal inflam-matory response when it is taken. Itmay also be true that despite in vitrostudies to the contrary, ascorbic acidmay render individual tissue cell mem-branes less permeable to the viruses, inwhich case there might be what mightbe termed a double-barreled action.Here there would be a lessened cellpenetration, and therefore fewer repli-cations of the viruses, as well as thedecreased permeability of the capillarywalls which is itself another aspect of

cell-wall effect. The first of these, di-minished respiratory cell penetrability,might explain the prophylactic successof-ascorbic acid administration, and thesecond, decreased permeability ofcapillary walls, its symptom-suppres-sive action.

If these suppositions have any vali-dity, they make for reasonable explana-tions of some of the failures and partialfailures in this method of treatment ofcolds. Too small a quantity of ascorbicacid would not do what was intendedor, what amounts to the same thing, ifthe ascorbic acid has been oxidized orhas otherwise deteriorated, the dosestaken are not what they appear to be.It is too much to demand of the vitaminto expect it to be effective when thehumidity of the ambient air is so low(Lubart, J. New York J Med 62:8161962) that we have damaged mucousmembranes, or when there is a secon-dary inflammation caused by exposureto fumes or high levels of smog, or ifthere is a swelling occasioned by anallergic response. Consideration mustalways be given to the possibility thatall of the ascorbic acid administered isnot absorbed when there is an abnor-mality of the contents of the intestinaltract as there might be if a food suchas yoghurt has been ingested in anylarge quantity recently. And we wouldhave no right to expect ascorbic acidto be effective in the presence of amixed viral-bacterial infection or whenthe infection is chiefly or only bacterialin type.

It is a fair question to ask why as-corbic acid administration is not effec-tive when begun only during the thirdor fourth days or later in the viral in-fection. The answer is that it may bepossible to diminish the extent of addi-tional exudation, but many cell changesand much edema have already occurredand are not reversible, and there hasbeen an opportunity for a maximumreplication of the viruses.

It might also be asked whether there

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is not something of a risk in electing tolimit the amplitude of the natural in-flammatory response and perhaps suffera diminution of the immunity whichmight otherwise have been acquired.It must be remembered that the virusesin question are not, in the ordinarysense of the word, lethal; and the con-sequences of their presence are moreoften annoying rather than disablingexcept in special cases and epidemicswhere virulent organisms are wide-spread. In such circumstances are wenot wise in doing what we can to hinderthe evolvement of the inflammatory re-action which serves as a base for moreserious effects and secondary infectionseven if this has been accomplished atthe cost of a temporary delay of someimmunity. In any case, such immunityor lack of it can be shown to applyonly to the one virus under considera-tion and to its several related viruses,and not to any of the others with whichthe patient can subsequently becomeinfected.

DiscussionAs the reader will have noted, it was

not possible to write the usual type ofexposition paper on the use of ascorbicacid in the treatment of the symptomsof colds, because at every step alongthe road some discussion was neces-sary. What follows is also discussionbut in terms of the work of other in-vestigators and of some of my ownobservations which have not beentouched upon, and which I think needemphasis.

If I am correct in the interpretationof my studies and a daily dose of fivegrams of ascorbic acid, at least at thebeginning, is needed to suppress thesymptoms of the common cold satis-factorily, and if the schedule describedmust be scrupulously followed- then itis not at all astonishing that the resultshere reported differ from those of otherinvestigators. These were studies con-cerned with the employment of one

gram or less daily and one investigationin which three grams were used anddiscovered to be ineffective, from whichdata it was perhaps too generally con-cluded that vitamin C was without anyuseful effect upon colds.

I must insist that the exact quantityof the drug administered is critical, asis the schedule critical; smaller doses ofascorbic acid or longer intervals be-tween doses may actually prolong theoverall duration of symptoms of thecold itself. In other words, if the re-quired amount of the vitamin is notgoing to be taken, it is much better notto take any ascorbic acid at all.

Mention has been made of thepyrosis and production of intestinal gaswhich may be -associated with high as-corbic level intake. The texts suggestthat all excess amounts of vitamin Care rather casually excreted in theurine, but they rarely deal with anysuch dosage quantities as are requiredfor the alleviation or suppression of thesymptoms of colds. Because I was notable to find many references to the useof doses as large as those I foundnecessary, I needed to do some study-ing of the gastrointestinal effects ofascorbic acid for myself.

I have personally taken five gramsor more of ascorbic acid daily for sev-eral periods of as much as six months.Another member of my family took thesame quantities but for not quite aslong a time. There seems to be nodoubt that the normal intestinal floramay be converted into a predominantlyanaerobic type which produces an ex-cess of intestinal tract gases that areboth annoying and persistent (LorraineGall, IBM Space Systems Laboratory,Washington, D. C., personal communi-cation).

It has been known that ascorbic acidtaken in a daily range of three to fourgrams may alter serum electrolytes aswell as lead to a decrease in -the motilityof (he intestinal tract (Danhof, I. E.,University of Texas, personal com-

REGNIERASCORBIC ACID955

munication), This effect of the vitaminmay well account for the flatulencewhich, while only occasional, occurstoo often to be thought of as coinci-dental. It was especially prominent intwo subjects who persevered in takinglarge doses of ascorbic acid for muchmore than the recommended limit of12 days. Excess gas is never more thantransient if one sticks only to therecommended no-more-than-12-daycourses.

The dangers in interpretation of theprophylactic use of any drug are wellknown, because there is no method ofbeing certain that the disease in ques-tion would necessarily have afflictedthe subject. It is, however, known thatthe so-called immunity to viral infec-tions of the upper respiratory tract isshort-lived and, in fact, that some onlyconfer immunity against themselvesand perhaps for closely related viruseswhich have not changed antigenically.

From observations made over a spanof a number of years it appears to methat when one is exposed to an obvioussource of infection, as when a patientsneezes in one's face, a dose of 600-750 mg of vitamin C will prevent apossible cold, especially when a seconddose of the same magnitude- is takenthree hours later, Should this simpleprophylactic program be followedfaithfully, colds will occur less fre-quently and there is often no need togo on to the treatment schedule whichhas been outlined, As noted, it is dif-ficult, if not impossible, to validatestatistically a program of prophylaxisunless the population studied as treatedand as controls is immensely large. Itis with some hesitation, then, -that Imention the experience of three nurseswho have taken the drug under mysupervision at a rate of 250 mg of as-coi'bic acid daily for four consecutiveseasons, In an environment where up-per respiratory tract infections are com-mon, especially that of a general hospi-tal (J. B. Thomas Hospital, Peabody,

Massachusetts), each has been com-pletely free of colds while most othernur6es working in the same milieu havebeen afflicted on one or more occa-sions, necessitating absence from duty*Each of the three was formerly subjectto frequent colds. Before going to thetheater where one may be exposed tomany people suffering from colds, aprophylactic dose may be taken beforeleaving home and another 750 mg doseupon returning, with a gratifying ab-sence of the usual possible infections.

As evidence of the harmlessness ofsuch a program, it should be mentionedthat one of the three nurses has takenvitamin C daily for 12 years, duringthe first eight on her own initiative andfor the remaining four under my super-vision. During the former period thedose was usually 100-200 nag daily.Proof that she had not developed animmunity from any visible subclinicalinfections was demonstrated when, atmy request, she ceased taking the as-corbic acid for one season during whichshe was afflicted with two colds. Ofthese, one was treated successfully bythe suppression method as outlined,and the other was permitted to run itscourse, which proved to be typical. Ofcourse, a "series" of one patient doesnot establish a hypothesis, but this pa-tient's history is mentioned because ofthe long use of the vitamin with noobvious harm.

When the physician-patient findshimself the unwilling host to one ormore symptoms which may or may notbe evidence of an upper respiratorytract invasion by a virus such as anunexplained gastroenteritis an other-wise inexplicable headache or an er-ratic muscle ache, it may be wise tobegin ascorbic acid therapy. If a dis-ease not restrainable by the vitamindevelops, this "insurance" has at leastbeen inexpensive and safe. And if thesymptoms are suppressed then one mayor may not choose to presume that themethod of treatment was successful.

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Since be can never exactly repeat thecircumstances and thus make a scien-tific and controlled experiment of theprocedure. But he may elect to con-tinue with the ascorbic acid therapytoo.

It must be remembered that vitaminC is easily oxidized and therefore maylose its potency, A bottle of tabletsobtained from the hospital pharmacymay have been opened months beforebeing dispensed. It is therefore wise topurchase the smallest quantity of tab-lets, usually 100, in a paper-sealedbottle from a drug outlet or large phar-macy which sells a large volume of thisand similar products. For the treatmentof each new cold it is best to begin withtablets from a new bottle.

Mention has been made of the specialsusceptibility of some women to coldsat certain times in the menstrual cycle.There seems to be a compensatory in-terval of about three days, pre-mens-trual, when there is a natural cold-suppressive state during which it is notnecessary to use ascorbic acid should acold occur.

SummaryWhat is usually referred to as the

common cold has been reviewed ingeneral terms, and the signs, symptoms

and the clinical course of viral infec-tions have been described.

The epidemiology of viral infectionshas been surveyed. The predispositionof human beings to viral infections hasbeen commented upon. The magnitudeof the problem of the common cold hasbeen given consideration.

The traditional treatment of the in-fections in question has been examinedand criticized.

The problem of scurvy has been can-vassed and the many roles of ascorbicacid explored. The requirements ofhuman beings for ascorbic acid havebeen discussed. My personal experi-ences with the use of ascorbic acid inthe treatment of viral and the preven-tion of subsequent bacterial infectionshave been delineated.

The method of treatment and pro-phylaxis of the common cold has beenoutlined and the results of both pro-phylaxis and treatment are analyzed.

Theoretical considerations of themethod of treatment and of some pos-sible drawbacks have been listed. Adiscussion of the roles of ascorbic acidin the prophylaxis and treatment of thecommon cold ends this review of thesubject.8 Broad Street Salem,Massachusetts