为什么生病的身体需要大量维生素 C

发表于 分类于 阅读次数： 本文字数： 6.2k 阅读时长 ≈ 23 分钟

The Third Face of Vitamin C

维生素 C 的三种表现

Robert F. Cathcart, M.D.

罗伯特-F-卡斯卡特医学博士

Journal of Orthomolecular Medicine, 7:4;197-200, 1993.

《正分子医学杂志》（Journal of Orthomolecular Medicine），7:4;197-200，1993 年。

Copyright ©, 1994 and prior years by Dr. Robert F. Cathcart. Dr. Cathcart gave his permission “to distribute via the internet as long as material is distributed in its entirety and not modified.”

Robert F. Cathcart 博士版权所有 ©，1994 年及之前。卡斯卡特博士允许 “通过互联网传播，只要材料是完整的，未作修改”。

摘要

Bowel tolerance to orally ingested ascorbic acid increases with the toxicity of diseases. Bowel tolerance with a disease such as mononucleosis may reach 200 or more grams per 24 hours without it producing diarrhea. A marked clinical amelioration or cure is achieved in many disease processes when threshold doses near bowel tolerance are given. In a sense, it is the reducing equivalents carried by free radical scavengers that quench free radicals, not the free radical scavengers themselves. Ascorbic acid can be dramatically useful in quenching free radicals because it is usually tolerated in amounts necessary to provide the reducing equivalents necessary to quench almost all the free radicals generated by severe disease processes. Vitamin C functions are incidental at these dose levels; the benefit is from the reducing equivalents carried. To the extent that free radicals are either essential to the perpetuation of a disease or just part of the cause of symptoms, the disease will be cured or just ameliorated. These effects are even more dramatic from intravenous sodium ascorbate.

肠道对口服抗坏血酸的耐受性会随着疾病毒性的增加而增加。单核细胞增多症等疾病的肠道耐受性可达到每 24 小时 200 克或更多，而不会产生腹泻。在许多疾病的治疗过程中，如果服用的剂量接近肠道耐受量的临界值，就能明显改善临床症状或治愈疾病。从某种意义上说，淬灭自由基的是自由基清除剂所携带的还原等价物，而不是自由基清除剂本身。抗坏血酸在淬灭自由基方面的作用非常显著，因为它的耐受量通常足以提供淬灭严重疾病过程中产生的几乎所有自由基所需的还原当量。在这些剂量水平下，维生素 C 的功能是附带的；其益处来自于所携带的还原当量。如果自由基对疾病的持续存在至关重要，或者只是导致症状的部分原因，那么疾病就会被治愈，或者只是有所改善。静脉注射抗坏血酸钠的效果更为显著。

Keywords: vitamin C, ascorbate, acute induced scurvy, bowel tolerance, titrating to bowel tolerance, the ascorbate effect, free radical scavengers, reducing equivalents.

关键词：维生素 C、抗坏血酸盐、急性坏血病、肠道耐受性、滴定到肠道耐受性、抗坏血酸盐效应、自由基清除剂、还原当量。

引言

A clinical experience prescribing doses of ascorbic acid up to 200 or more grams per 24 hours to over 20,000 patients during the past 23 year period has revealed its clinical usefulness in all diseases involving free radicals. The controversy continues over the value of vitamin C mainly because inadequate doses are used for most free radical scavenging purposes. Paradoxically, the non controversial use of minute doses of vitamin C in the prevention and treatment of scurvy has set the minds of many against more creative uses.

在过去的 23 年中，临床经验表明，抗坏血酸对所有涉及自由基的疾病都有临床疗效，每 24 小时可为 20,000 多名患者提供高达 200 克或更多的抗坏血酸。关于维生素 C 价值的争议仍在继续，主要是因为大多数清除自由基的药物剂量不足。矛盾的是，在预防和治疗坏血病时使用微量维生素 C 并没有引起争议，这使许多人开始反对更有创意的用途。

I have found vitamin C exceptionally useful in a very high dose range. Its usefulness is in three such distinct realms that I will describe them as the three faces of vitamin C.

我发现维生素 C 在高剂量范围内特别有用。它的作用体现在三个截然不同的领域，我将它们描述为维生素 C 的三种表现。

  1. vitamin C to prevent scurvy (up to 65 mg/day.)

  2. 预防坏血病的维生素 C (最高 65 毫克/天）。

  3. vitamin C to prevent acute induced scurvy and to augment vitamin C functions (1 to 20 grams/day.)

  4. 预防急性坏血病的维生素 C 并增强维生素 C 的功能 (每天 1 至 20 克）。

  5. vitamin C to provide reducing equivalents (30 to 200 or more grams/day.)

  6. 提供还原当量的维生素 C (30 至 200 克或更多/天）。

One might criticize the wisdom of my use of these massive doses but Klenner had successfully utilized them previously. The works of Irwin Stone, Linus Pauling, and Archie Kalokerinos have supported many of my observations. It was apparent that in all the studies yielding negative or equivocal results, inadequate doses were used. In some studies, doses barely bordering on adequate, tease the investigator with statistically significant but not very impressive beneficial results.

也许有人会批评我使用这些大剂量的方法是否明智，但克伦纳之前已经成功地使用过这些方法。欧文-斯通（Irwin Stone）、莱纳斯-鲍林（Linus Pauling）和阿奇-卡洛克利诺斯（Archie Kalokerinos）的著作支持了我的许多观察结果。很明显，在所有产生负面或模棱两可结果的研究中，都使用了不足的剂量。在一些研究中，剂量勉强接近足够，但却给研究者带来了统计上有意义但并不令人印象深刻的有益结果。

My early discovery was that the bowel tolerance to ascorbic acid of a person with a healthy GI tract was somewhat proportional to the toxicity of their disease. Bowel tolerance doses are the amounts of ascorbic acid tolerated orally that almost, but not quite, cause diarrhea. A patient who could tolerate orally 10 to 15 grams of ascorbic acid per 24 hours when well, might be able to tolerate 30 to 60 grams per 24 hours if he had a mild cold, 100 grams with a severe cold, 150 grams with influenza, and 200 grams or more per 24 hours with mononucleosis or viral pneumonia (1, 2). Marked clinical benefits in these conditions occur only at the bowel tolerance or higher levels. I named the process whereby the patient determined the proper dose as titrating to bowel tolerance. These increases in bowel tolerance in the vast majority of patients normally tolerant to ascorbic acid (perhaps 80% of patients) are invariable. The marked clinical benefits are noted only when a threshold dose, usually close to the bowel tolerance dose, is consumed. I call this benefit the ascorbate effect.

我的早期发现是，肠道健康的人对抗坏血酸的耐受性与其疾病的毒性成正比。肠道耐受剂量是指口服抗坏血酸后几乎不会引起腹泻的耐受量。一个病人如果身体健康，每 24 小时可以口服 10 到 15 克抗坏血酸，那么如果他患了轻度感冒，每 24 小时可以口服 30 到 60 克抗坏血酸；重感冒时可以口服 100 克抗坏血酸；流行性感冒时可以口服 150 克抗坏血酸；单核细胞增多症或病毒性肺炎时，每 24 小时可以口服 200 克或更多抗坏血酸（1, 2）。只有在肠道耐受或更高水平时，这些病症才会出现明显的临床疗效。我将患者确定适当剂量的过程命名为根据肠道耐受性滴定。在绝大多数对抗坏血酸有正常耐受性的患者中（可能有 80% 的患者），肠道耐受性的提高是不变的。只有达到临界剂量（通常接近肠道耐受剂量）时，才会有明显的临床疗效。我把这种益处称为抗坏血酸效应。

Most patients are started at first with hourly doses of ascorbic acid powder dissolved in small amounts of water. Later, after the patient has learned to accurately estimate the dose necessary to achieve the ascorbate effect, comparable doses of tablets or capsules are also used. Where patients are intolerant to adequate amounts of ascorbic acid orally and the severity of the disease warrants it, intravenous sodium ascorbate is used.

大多数患者开始时每小时服用少量溶于水的抗坏血酸粉末。后来，当患者学会准确估计达到抗坏血酸效果所需的剂量后，也会使用同等剂量的片剂或胶囊。如果患者不能耐受足量的口服抗坏血酸，且病情严重，则需要静脉注射抗坏血酸钠。

Failures are related to individual difficulties in taking the proper adequate doses. I now have had 22 years (1994) to gather clinical experience and to reflect on this phenomenon.

失败与个人难以服用适当足够的剂量有关。现在，我已经有 22 年（1994 年）的时间来积累临床经验，并对这一现象进行反思。

I want to emphasize the importance of this increasing bowel tolerance with increasing toxicities of diseases. The sensation of detoxification one experiences at these doses is unmistakable.

我想强调的是，随着疾病毒性的增加，肠道耐受性也在增加，这一点非常重要。在这些剂量下，人们所体验到的排毒感觉是无与伦比的。

The effect is so reliable and dramatic in the tolerant patient as to make obvious the fact that something very important, that has not been widely appreciated before, is going on.

对耐受性好的病人来说，这种效果是如此可靠和显著，以至于让人清楚地认识到，有些非常重要的事情正在发生，而这些事情以前并没有得到广泛的重视。

三种表现

Vitamin C probably always functions by being an electron donor. At the lowest dose level (the first face), it is necessary as a vitamin to prevent scurvy. It is essential for certain metabolic functions which are well described and mostly non controversial.

维生素 C 的功能可能始终是电子供体。在最低剂量水平（第一面），它是预防坏血病所必需的维生素。维生素 C 对于某些代谢功能是必不可少的，这些功能已经得到了很好的描述，而且大多没有争议。

At a second level (the second face) vitamin C is still used as a vitamin but larger doses are necessary to maintain its basic vitamin C functions because the vitamin is destroyed rapidly in diseased or injured tissues where there is an overabundance of free radicals. I described the resulting state of deficiency, if the vitamin C is not replaced, as acute induced scurvy (1, 2). There is ample evidence of this depletion of vitamin C by stress and disease as recently reviewed in the literature.

在第二个层面（第二面），维生素 C 仍作为维生素使用，但需要更大剂量才能维持其基本的维生素 C 功能，因为在自由基过多的病变或受伤组织中，维生素会被迅速破坏。如果不补充维生素 C，我将由此导致的缺乏状态描述为急性坏血病（1, 2）。有大量证据表明，压力和疾病会消耗维生素 C，最近的文献对此进行了综述。

Additionally, the recent extensive research on vitamin C has concerned itself with certain functions that may be augmented by higher than minimal doses of vitamin C (20). Strangely, any usefulness of these larger than minimal doses of vitamin C remain mostly neglected by clinicians. This level is from about 1 to 20 grams a day. Benefits vary from person to person.

此外，最近关于维生素 C 的广泛研究关注的是某些功能，这些功能可能会通过高于最小剂量的维生素 C 得到增强（20）。奇怪的是，临床医生大多忽视了这些大于最小剂量的维生素 C 的作用。这个剂量约为每天 1 至 20 克。益处因人而异。

At this second level, as in studies reviewed by Pauling (11) and more recently by Hemil (20), there may be expected a slight decrease in the incidence of colds but a more significant reduction in the complications and the duration of colds. Personally, I am impressed by the number of patients (but certainly not all) who tell me that they have not had a cold for years since reading Pauling’s book and taking vitamin C. Patients with chronic infections frequently have those infections cured for the first time. Antibiotics work synergistically with these doses. A surprising number of elderly persons benefit from doses of this magnitude and may indeed have what Irwin Stone described as chronic subclinical scurvy (10).

在第二个层面上，正如鲍林（11）和最近的海米尔（20）所回顾的研究一样，预计感冒的发病率会略有下降，但并发症和感冒持续时间会有更显著的减少。令我个人印象深刻的是，有很多病人（当然不是全部）告诉我，自从读了鲍林的书并服用维生素 C 后，他们已经好几年没有感冒了。抗生素与这些剂量的维生素 C 协同作用。令人惊讶的是，很多老年人都能从这种剂量的维生素 C 中获益，他们可能真的患有 Irwin Stone 所描述的慢性亚临床坏血病（10）。

The third level of doses (the third face) is virtually undiscussed in the literature but is the most interesting. These doses range usually from 30 to 200 grams or more per 24 hours. The most important concept to understand is that while incidentally at these dose levels the vitamin C performs all the functions of levels one and two, it is mostly thrown away for the reducing equivalents it carries (3). With these doses it is possible to saturate the body with reducing equivalents, neutralize the excessive free radicals, and drive a reducing redox potential into involved tissues. Inflammations mediated by free radicals can be eliminated or markedly reduced. In many instances patients with allergies or autoimmune disease have their humeral immunity controlled while their cellular immunity is augmented (19). To the extent that free radicals are either essential to the perpetuation of a disease or just part of the cause of symptoms, the disease will be cured or just ameliorated.

文献中几乎没有讨论第三级剂量（第三面），但这是最有趣的。这些剂量通常为每 24 小时 30 克至 200 克或更多。要理解的最重要的概念是，虽然在这些剂量水平上，维生素 C 可以顺便执行第一和第二级的所有功能，但它主要是被扔掉了，因为它携带的还原等价物 (3)。使用这些剂量可以使体内的还原当量达到饱和，中和过多的自由基，并在相关组织中产生还原氧化还原电位。由自由基引发的炎症可以消除或明显减轻。在许多情况下，过敏症或自身免疫性疾病患者的体液免疫得到控制，同时细胞免疫得到增强（19）。如果自由基对疾病的持续存在至关重要，或只是导致症状的部分原因，那么疾病就会被治愈或只是有所改善。

The list of diseases involving free radicals continue to grow. Infections, cardiovascular diseases, cancer, trauma, burns both thermal and radiation, surgeries, allergies, autoimmune diseases and aging are now included. It is more difficult to think of a disease that does not involve free radicals. Progressive nutritionists routinely give vitamin C, vitamin E, beta carotene, selenium, NAC, etc. to counter free radicals. I certainly agree with this practice. However, there is one important concept neglected.

涉及自由基的疾病越来越多。感染、心血管疾病、癌症、创伤、热烧伤和辐射烧伤、手术、过敏、自身免疫性疾病和衰老现在都包括在内。要想找出一种不涉及自由基的疾病就更加困难了。进步的营养学家通常会服用维生素 C、维生素 E、β 胡萝卜素、硒、NAC 等来对抗自由基。我当然同意这种做法。然而，有一个重要的概念却被忽略了。

In the spirit that if you throw a bucket of water on a fire, it is the water that puts the fire out, not the bucket; it is the reducing equivalents carried by the free radical scavengers that quench the free radicals, not the free radical scavenger itself.

就像把一桶水泼到火上，是水把火扑灭了，而不是水桶；是自由基清除剂携带的还原等价物熄灭了自由基，而不是自由基清除剂本身。

Most of the reducing equivalents utilized by non enzymatic free radical scavengers do not come from the ingested free radical scavengers but come through glycolysis, the citric acid cycle, NADPH, FADH2, glutathione, etc. Dietary free radical scavengers carry in on ingestion only a small percentage of the total reducing equivalents carried by those scavengers during their lifetime in the body. After their first pass neutralizing free radicals, the free radical scavenger must be recharged with reducing equivalents made available in the mitochondria.

非酶自由基清除剂利用的大部分还原当量并非来自摄入的自由基清除剂，而是通过糖酵解、柠檬酸循环、NADPH、FADH2、谷胱甘肽等途径获得。膳食中的自由基清除剂在摄入人体时所携带的还原当量只占清除剂在体内存在期间所携带还原当量总量的一小部分。在第一次中和自由基后，自由基清除剂必须用线粒体中的还原当量来充电。

Consider the following: Early in this study a 23-year-old, 98-pound librarian with severe mononucleosis claimed to have taken 2 heaping tablespoons every 2 hours, consuming a full pound of ascorbic acid in 2 days without it producing diarrhea. She felt mostly well in 3 to 4 days, although she had to continue about 20 to 30 grams a day for about 2 months. Subsequently, all my young mononucleosis patients with excellent GI tracts have responded similarly and have had equivalent increases in bowel tolerance during the acute stage of the disease.

请看下面的内容：在这项研究的早期，一位 23 岁、体重 98 磅、患有严重单核细胞增多症的图书管理员声称，她每 2 小时服用 2 大汤匙的抗坏血酸，在 2 天内消耗了整整一磅抗坏血酸，却没有引起腹泻。3 到 4 天后，她就感觉基本康复了，尽管在大约 2 个月的时间里，她不得不继续每天服用 20 到 30 克左右的抗坏血酸。后来，我所有的年轻单核细胞增多症患者的胃肠道状况都很好，而且在疾病的急性期，他们的肠道耐受性也得到了同等程度的提高。

I believe that the loose stools caused by excessive doses of ascorbic acid orally ingested is due to a resulting hypertonicity of ascorbate in the rectum. Water is attracted into the rectum by the increased osmotic pressure and results in a benign diarrhea. With toxic illnesses, the ascorbate is destroyed rapidly in the involved tissues resulting in a rapid absorption from the gut. Of the ascorbate, what does not reach the rectum, does not cause diarrhea. Intravenous sodium ascorbate does not cause diarrhea and, in fact, increases bowel tolerance to orally ingested ascorbic acid while the IV is running. With hypertonicity of the ascorbate both in the blood and in the rectum, the osmotic pressure of the ascorbate is more equal on both sides of the bowel wall so no diarrhea results. If the diarrhea was cause by other metabolic processes, diarrhea would be caused by intravenous ascorbate.

我认为，口服过量的抗坏血酸会导致大便稀溏，这是因为抗坏血酸在直肠中的渗透压过高所致。由于渗透压增加，水被吸入直肠，从而导致良性腹泻。在中毒性疾病中，抗坏血酸会在相关组织中被迅速破坏，导致从肠道中迅速吸收。未进入直肠的抗坏血酸不会导致腹泻。静脉注射抗坏血酸钠不会导致腹泻，事实上，静脉注射抗坏血酸钠还会增加肠道对口服抗坏血酸的耐受性。由于血液和直肠中的抗坏血酸都处于高渗状态，抗坏血酸在肠壁两侧的渗透压更加均衡，因此不会导致腹泻。如果腹泻是由其他代谢过程引起的，那么腹泻则是由静脉注射抗坏血酸引起的。

It should be noted that in some cases of pathological diarrhea, ascorbic acid stops the diarrhea. Presumably in these cases some of the increased destruction of ascorbate is from free radicals in the bowel. However, in most toxic systemic diseases there is no reason to believe that the destruction of the additional ascorbate occurs directly in the bowel, so it is a safe hypothesize that this increased destruction occurs in the interior of the body.

值得注意的是，在某些病理性腹泻病例中，抗坏血酸能止泻。据推测，在这些病例中，抗坏血酸的部分破坏是由肠道中的自由基造成的。然而，在大多数中毒性系统疾病中，没有理由相信额外的抗坏血酸的破坏是直接发生在肠道中，因此，一个安全的假设是，这种增加的破坏发生在身体内部。

The increased tolerance to ascorbic acid orally provides an interesting and somewhat useful measure of the toxicity of a disease. Probably it is somewhat a measure of the free radicals involved in a disease. I describe a cold that at its maximum makes it possible for a patient to just tolerate 100 grams of ascorbic acid orally without diarrhea, a “100 gram cold.” Patients, appearing to be well, who have a tolerance over 20 to 25 grams per 24 hours probably have some subclinical condition which is being hidden by their own free radical scavenging system.

对口服抗坏血酸的耐受性增强，为衡量疾病的毒性提供了一种有趣而有用的方法。也许，它在某种程度上可以衡量疾病中的自由基。我曾描述过一种感冒，这种感冒在最大程度上会使患者仅能耐受口服 100 克抗坏血酸而不腹泻，这就是 “100 克感冒”。看似健康的病人，如果每 24 小时的耐受量超过 20 至 25 克，很可能患有某种亚临床病症，而这种病症被他们自身的自由基清除系统所掩盖。

Patients with chronic infections (and a normally strong stomach) can ingest enormous amounts of ascorbic acid. One of my chronic fatigue patients is functional only because of his ingestion of 65 pounds of ascorbic acid in the past 12 months. In 22 years, I, personally, have ingested approximately 361 kilos ( 797 lbs ) ( 4.3 times my body weight ) of ascorbic acid because of chronic allergies and perhaps chronic EBV.

慢性感染患者（肠胃功能正常）可以摄入大量的抗坏血酸。我的一位慢性疲劳患者之所以能够正常工作，完全是因为他在过去 12 个月中摄入了 65 磅的抗坏血酸。22 年来，我个人因为慢性过敏，也许还有慢性 EB 病毒，摄入了大约 361 公斤（797 磅）（4.3 倍于我的体重）的抗坏血酸。

Considering the reducing equivalents carried by such amounts of ascorbic acid, one can only guess at the turnover rate of the non enzymatic free radical scavengers in a patient acutely ill with a 200 gram mononucleosis. However, one gains the impression that all the non enzymatic free radical scavengers would have to be rereduced many times a day.

考虑到如此大量的抗坏血酸所携带的还原当量，我们只能猜测 200 克单核细胞增多症急性患者体内非酶自由基清除剂的周转率。不过，我们的印象是，所有非酶自由基清除剂每天都要被还原很多次。

举个例子

Suppose you owned a farm and on one end of the property there was a barn and on the other end of the property there was a water well. One day the barn catches fire and neighbors come with buckets to set up a bucket brigade between the water well and the barn and are putting out the fire when the well goes dry.

假设你拥有一个农场，农场的一端有一个谷仓，农场的另一端有一口水井。一天，谷仓着火了，邻居们拿着水桶来到水井和谷仓之间，成立了一支水桶队，正在灭火时，水井干了。

My use of ascorbate is like thousands of neighbors coming from miles around, each with a bucketful of their own water, throwing their own water on your fire once, and then leaving.

我使用抗坏血酸就像成千上万的邻居从几英里外赶来，每个人都带着一桶自己的水，把自己的水泼到你的火上一次，然后就离开了。

结论

Because of the invariable (in patients tolerant to ascorbic acid) increasing bowel tolerance to ascorbic acid in patients roughly in proportion to the toxicity of their disease, there has to be something happening to ascorbate in the sick patient other than its being used as vitamin C in the classic sense. The amelioration or sometimes cure of different diseases appears related to the importance of free radicals in the perpetuation of the paticular disease.

由于（对抗坏血酸有耐受性的病人）肠道对抗坏血酸的耐受性不断增强，这与其疾病的毒性大致成正比，因此病人体内的抗坏血酸除了用作传统意义上的维生素 C 外，还一定发生了其他作用。不同疾病的缓解或治愈似乎与自由基在特定疾病的持续存在中的重要性有关。

The sudden marked benefit in many disease processes which is achieved at doses near to the bowel tolerance level suggests that a reducing redox potential is forced into the affected tissues only at those dose levels. This ascorbate effect only at the high dose levels is also suggestive that something other than classic functions of vitamin C is involved. This ascorbate effect is more compatible with principles of redox chemistry.

在许多疾病的治疗过程中，当剂量接近肠道耐受水平时，突然出现的明显疗效表明，只有在这些剂量水平下，受影响的组织才会产生还原氧化还原电位。这种抗坏血酸作用只有在高剂量水平时才会出现，这也表明除了维生素 C 的传统功能外，还涉及到其他一些功能。这种抗坏血酸盐效应更符合氧化还原化学原理。

Only a small percentage of the total reducing equivalents donated by non enzymatic free radical scavengers to neutralize free radicals, come in on the ingested nutritional free radical scavengers. Ascorbate is unique in that the body can tolerate doses adequate to supply the necessary reducing equivalents to quench the free radicals generated by severely toxic disease processes. The vitamin C is thrown away for the reducing equivalents it carries. Only in this way can the large amounts of free radicals generated by the most toxic disease processes be rapidly quenched.

在非酶自由基清除剂为中和自由基而提供的还原当量总量中，只有一小部分来自于摄入的营养性自由基清除剂。抗坏血酸的独特之处在于，人体可以耐受足够的剂量来提供必要的还原当量，以熄灭严重毒性疾病过程中产生的自由基。维生素 C 会被丢弃，以换取它所携带的还原当量。只有这样，才能迅速淬灭毒性最强的疾病过程中产生的大量自由基。