IRCS In e na ional Resea ch Communica ions Sys em MAY 1973
ASCORBIC ACID: EFFICACY IN THE
PREVENTION OF SYMPTOMS OF RESPIRATORY
INFECTION ON A POLARIS SUBMARINE
B. El io ,
Depa men o Oph halmology, [Jps ø e Medical Cen e ,
S a e Uni e si y o New Yo k, Sy acuse,
New Yo k,13214, U.S.A.
Respi a o y Sys em
In ec ions
(73-s ) I2-:3-I
Nu i ion
Vi amin and Essen ial Fa y Acids
Re qui em en s ønd D e ic iencies
(73-s)3 -2-2
En i onmen al Physiology
Mili a y Medicine
(73-s) 28-22-I
Fo ep in ç please quo e:
(73-s) 2-3-I
Pøpe eceí ed: I} h Ap il, 1973
To de e mine i asco bic acid (AA) in doses o 2 g ams/day has any alue in p e en ing espi a o y symp oms
a double blind s udy was ini ia ed on a Pola is subma ine. Each ship has wo c ews and as he one on
pa ol e u ns, he o -c ew is lown ¡om he Uni ed S a es o mee he ship. When his second c ew a i es
hey a e exposed o new espi a o y i uses and a la ge ou b eak o colds occu s which has been documen ed
by a e iew o 360 pa ol epo s.
Volun ee s we e asked o pa icipa e in a double blind s udy in which enous blood would be d awn
o i al se ology s udies, and ei he 500 mgs o AA o a ci ic acid placebo would be aken ou imes a
day. Se en y ou o a 140 man c ew olun ee ed and we e andomly placed in ea men o placebo
g oups. Be hing on he ship was de e mined by senio i y, and non-pa icipan s, placebo, and AA g oups
we e in e mingled. Bo h AA and placebo capsuls looked iden ical and when opened he con en s we e
simila in as e and appea ance.
The i s sample o blood was d awn and he men gi en hei medica ion one day p io o he c ew being
lown o Eu ope. F om his ime un il he end o he s udy all pa icipan s we e seen by he au ho a
leas weekly so espi a o y symp oms could be eco ded, and he people eminded o ake hei capsuls
egula ly. The second se o bloods we¡e d awn h ee weeks in o he s udy and a ìnal enipunc u e was
done a he end o he en h week when he s udy was e mina ed.
The e we e 37 and 33 pa icipan s in he AA and placebo g oups espec i ely, and he g oups we e
simila wi h espec o age and smoking habi s. Fi e d opou s occu ed in he placebo g oup, and in he
i amin g oup wo men did no ake he capsules as di ec ed o a sho pe iod o ime. Da a om he d op-
ou s and abo e wo a e included o he weeks hey we e ully pa icipa ing in he s udy.
The e was no consis en di e ence be ween g oups in he incidence o unny nose o sneezing. Man-
days o mo bidi y o hoa seness, so e h oa s, non-p oduc i e cougþs, and p oduc i e coughs was 36,
LO7 ,42 and 72 in he placebo g oup wi h only 37%,28%,4OVo and3l% as much mo bidi y in he AA
g oup. The Wilcoxon Sequence Tes wi h a one ailed es ejec ed he null hypo hesis o equal e ec i e'
ness o he AA and placebo o so e h oa s and p oduc i e coughs (P=.01 5 5 and .0327) bu no o
hoa seness o non-p oduc i e coughs. Complemen ixing i e s o in luenza, pa ain luenza ypes 1,2, and
3, M. pneumoniae, and adeno i us an igens did no e eal any di e ence be ween g oups.
My hanks o he Na y Medical Field Resea ch Labo a o y, Camp I-e June, N.C., o pe o ming he
i al se ology s udies, D . Ian Kea eny om S an o d Uni e si y q help wi h he s a is ics, and Com nande
Thomas N. Ma kham, MC, USN om he Subma ine Medical Resea ch Labo a o y o sugges ing and
guidance in his s udy.
l. Wilkens, D. D. (1969), Na y Subma ine Medical Cen e , G o on, Conn., Repo #560.
L2
May 1973 Jou nal o
In e na ional Resea ch
Communica ions
MEDICAL SCIENCE
ç:
Edi o ial Boa d
Linus Pauling
S and o d Uni e si y
U.S. on Eule
Ka olinska Ins i u e
R.Y. Calne
Uni e si y o Camb idge
P. Beeson
Uni e si y o Ox o d
Si Cha les Dodds
The Middlesex Hospi al
Medical School
E. S ead
Duke Uni e si y
W.I. C ans on
S . Thomas's Hospi al
Medical School
J.C. Beck
McGill Uni e si y
E.J.M. Campbell
McMas e Uni e si y
J. Adams
Geo ge Washing on Uni e si y
W.J. Oli e
Uni e si y o Michigan
P. Dejou s
Cen e Na ional de la Reche che
Scien i ique S asbou g
B.K. Anand
All India Ins i u e
o Medical Sciences
F. G oss
Uni e si y o Heidelbe g
S.M.M. Ka im
Uni e si y o Singapo e
Edi o s
D.F. Ho obin MA, D.Phil.
BM, B.Ch. Uni e si y o
Newcas le Medical School
M. Fo dyce, MB, ChB.
Royal Lancas e In ì ma y
J.P. Eakins, MA, M.Sc.
I.M. Gillib and Ph.D
Ca oline Smi h M.Sc.
Publßhe
M.C.S. Buckingham
A ma ked inc ease in he mo ali y om lung cance has been shown in all
coun ies whe e eliable s a is ics a e a ilable. In England a d Wales o e
30,000 people die o i each yea . The possible ways o con olling his dis-
ease a e (1) o p e en i by emo ing he known causa i e ac o s; (2) o
de ec o diag ose he disease a an ea ly s age be o e widesp ead dissemina-
ion has occu ed and (3) o imp o e he esul s o ea men . We know some-
hing o he causa i e agen s, he mos impo an being obacco smoking; bu
human beings, being human, e use o accep he ad ice o he medical p o-
ession. E en i hey did s op smoking now i would be many yea s be o e
he e was a ma ked educ ion in he incidence o he disease. Radical abla i e
ea men can only be e ec i e i he disease is con ìned o he ches and
he e o e e e y a emp mus be made o diagnose he malignancy a an ea ly
s age o e en o de ec i be o e symp oms de elop. (1). Un o una ely mos
clinicians a e p esen ed wi h an es ablished disease and in hese pa ien s we
can only use he exis ing me hods o ea men and a emp o imp o e hese
o ìnd new ones.
The e a e h¡ee al ema i es o be conside ed; we can gi e adical ea men
aimed a a cu e; pallia i e ea men o elie e dis essing symp oms in hose
pa ien s whe e a cu e is no possible;and whe e he e is no chance o a cu e
and no dis essing symp oms, no ac i e ea men is gi en. Only abou 12% o
pa ien s seen in he hospi al ou pa ien depa men a e sui able o su gical
e adica ion o hei¡ umou s.
Radical ea men
In pa ien s wi h ope able lesions i has been es ablished ha su ge y is he
p e e ed me hod o ea men whe e a b onchoscopic biopsy has e ealed a
squamous umou and ha adio he apy gi es sligh ly be e esul s wi h
anaplas ic lesions. (2). In oa cell umou s he esul s a e be e wi h adio-
he apy. (3).
Radical adio he apy can be gi en when he umou is s ill con ined o he
ches . Deeley and Singh (4) epo ed an 8Vo,3 yea suwi al a e in 513 inop-
e able lesions; in squamous umou s i was lo%.The de elopmen o mega-
ol age adia ion echniques makes i possible o gi e cance icidal doses o
la ge umou s in he ches . Howe e , he policy o adio he apy is o kill
malignan umou s and o cause as li le damage as possible o no mal issues.
(5, 6). Radia ion echniques ha e been de eloped la gely by ial and e o bu
u he wo k mus make use o. con olled clinical ials. we ha e ca ied ou a
p og essi e se ies o sm¿Il ca e ully con olled ials using a pai ing sys em (7, 8),
each pa ien being pai ed wi h ano he ha ing exac ly he same combina ion
o ac o s known o a ec he p ognosis. The se ies has in es iga ed o is in he
cou se o in es iga ing:
To al umou dose
In anaplas ic lesions a umou dose o 3,000 ads gi en in 20
ea men s o e 28 days was ound o gi e be e esul s han
4,000 ads gi en wi h he same ac o s. Likewise in squamous
lesions 4,000 ads was p e e able o 5,000 ads. The e was a
highe incidence o adia ion ib osis in he high dose g oups. (9).
F ac iona ion
The nex s ep was o change he ac iona ion egime, wice
weekly ea men being compa ed wi h daily ea men o 5 days
pe week. To achie e he same biological e ec he o al o e all
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