Urinary Excretion of Vitamin C in Pneumonia

Abstract

In previous work on the tissues of laboratory animals we have found the vitamin C content to be reduced in many infections and intoxications. This suggested that cevitamic acid acted not only as an oxidative factor, in normal respiratory processes—but also had a neutralizing rôle in various pathological conditions other than scurvy. Yavorsky, Almaden and King examined human tissues from autopsy for their vitamin C content, and noted that generalized infections were more common among those having a low vitamin C content in their tissues. Worringer and Sala reported scurvy in infants following diphtheria and pertussis. Ten cases of pneumonia were examined on the Pneumonia Service of Doctor Bullowa at Harlem Hospital. The method of Hess and Benjamin, and Birch, Harris and Ray was followed using the dye 2,6,dichlorophenolindophenol. These authors noted that in normal individuals after the ingestion of large doses of vitamin C it was rapidly eliminated in great quantities in the urine. Recently Harris and Ray found that when vitamin C was low in the diet individuals tend to excrete less vitamin C in urine than well-nourished ones. However, more reliable results as to the state of vitamin C saturation or unsaturation of the tissues can be obtained by examining the urinary excretion after administering large test doses of the vitamin. A normal excretion for adults per day the authors estimate as 15–30 mg. The technique of Harris and Ray was followed as closely as possible. Occasionally, however, it has been impossible to get every specimen of urine in the 24 hours, and this has been noted in our calculations. Of the 10 cases 5 were given no saturation test. Two of these were fatal cases. In the first, (a pneumococcus type I pneumonia with empyema) in 3 specimens of urine voided 12 hours before death 8.6 mg. of cevitamic acid was excreted suggesting a normal output.