A Plowboy interview with Linus Pauling about nutrition, vitamin C, and the medical establishment.
A Plowboy interview with Linus Pauling, Nobel prize scientist.
Two years ago, the editors of the distinguished British journal New Scientist ranked two-time-Nobel-Prize-winner Linus Pauling as one of the top twenty scientists of all time . Few students of the history of science would question the wisdom of this assessment. For much of what is known today about the physical nature of chemical bonds . . . the structure and function of hemoglobin . . . the three-dimensional conformation of DNA (the genetic substance) . . . the biological hazards associated with the atmospheric testing of nuclear weapons . . . and the health-promoting effects of large doses of vitamin C . . . can be attributed to Linus Pauling's pioneer work in these areas. As one scientist summed it up, "The forty years of Pauling contributions to chemistry and medicine make up perhaps the single most profound and enlightening body of research an American — perhaps anyone mdash; ever put together."
Linus Pauling's love affair with science probably began in 1910, at the age of nine, when — after Linus had read every book in the house — his perplexed father (a Portland, Oregon druggist) wrote to the editor of the local newspaper, asking if the editor could suggest a book list for a boy with "extraordinary interest and ability in reading". By the time the young Pauling had entered the Oregon Agricultural College (now the Oregon State University in Corvallis), his interest in-and aptitude for — science had begun to blossom in full force: As an undergraduate, Pauling helped support himself by teaching chemistry at the college. (It was — in fact — in a college chemistry course that he was teaching that Linus Pauling first met Ava Helen Miller, now his wife.)
After obtaining his bachelor's degree in 1922, Pauling worked toward — and, in 1925, received — his doctorate at the California Institute of Technology, then — for 18 months — studied in Munich, Zurich, and Copenhagen as a Guggenheim Fellow. In 1927, Dr. Pauling returned to Cal Tech as an Assistant Professor of Theoretical Chemistry. He remained on the Cal Tech faculty until 1964.
Between 1964 and 1973, Dr. Pauling held teaching posts at the Center for the Study of Democratic Institutions in Santa Barbara (California), the University of California at San Diego, and Stanford University. At the present time, Linus Pauling is Research Professor and Chairman of the Board of Trustees of The Linus Pauling Institute of Science and Medicine in Menlo Park, California.
Dr. Pauling has written several books (including The Nature of the Chemical Bond; The Architecture of Molecules; No More War!; Vitamin C, the Common Cold, and the Flu; and two college chemistry texts) and more than 400 articles, technical reports, and monographs. His achievements in science and medicine have brought him 29 honorary doctorates, honorary membership in the scientific societies of a dozen countries, and countless awards . . . including the 1954 Nobel Prize for Chemistry, and the 1962 Nobel Prize for Peace. (No other individual — living or dead — has ever received two unshared Nobel Prizes.)
In recent years, Linus Pauling has become well-known — some would say notorious — for his outspoken views on nutrition, vitamin C, and the medical establishment. MOTHER editor Kas Thomas had a chance to "sample" some of those views last October when he spoke with the two-time Nobel laureate at the Pauling ranch near Big Sur, California. What follows is an edited transcript of that conversation.
Dr. Pauling, most people — it seems — think of your name in connection with nutrition and medicine. Isn't it true, though, that you've had no formal training in these fields?
Yes, that's true. I've never had a course in biology. No course in biochemistry, either.
You think of yourself as a physical chemist . . . is that right?
Yes. I was trained in chemistry, physics, and mathematics. My Ph.D. was with a major in chemistry and minors in physics and math. And my first two books — The Structure of Line Spectra and Introduction to Quantum Mechanics — were essentially physics, rather than chemistry.
When — and how — did you first become interested in problems of a biological nature?
For many years — well, from 1922, when I began my graduate work, until about 1932 or 33 — I worked largely with inorganic substances . . . mostly rather simple substances that had ten, twenty, or thirty atoms in each molecule. But then — about 1934 — I began to wonder about the large molecules in living organisms . . . protein molecules with thousands of atoms in them.
The first work in this area that I published was a study I had made of the combining power of hemoglobin for oxygen. As you know, the red cells in our blood pick up oxygen because they contain molecules of the protein hemoglobin. It turns out that the hemoglobin-oxygen equilibrium curve has a strange shape, and I worked out a theory to explain that.
Next, I decided to study the interactions of hemoglobin molecules with magnetic fields, which I did. C.D. Coryell — one of my students — and I had made a surprising discovery: namely, that arterial blood is repelled by a magnet, while venous blood is attracted. Coryell and I published several papers on this in the 1930's.
In 1936, I was invited to come to New York to lecture at the Rockefeller Institute for Medical Research about this work on hemoglobin. At that time, Karl Landsteiner — the man who discovered the major blood groups, A, B, AB, and O, and who subsequently received the Nobel Prize for this discovery-was a member of the Rockefeller Institute for Medical Research, and he attended my lecture. Afterwards, he asked me if I would come to his laboratory and talk with him about immunology . . . an area in which he had been doing a lot of work.
I did talk to him, and I tried to understand the problems he was worrying about. In fact, I was so fascinated by these problems that I began to work on them myself after I returned to California. By 1940, I had a very active group of people working with me at Cal Tech on problems of immunology . . . that is, problems involving antibodies, antigens, antitoxins, allergies, things of that sort.
So that was one way in which I got into biological and medical fields.
Didn't you — at one time — do some pioneer work on sickle-cell anemia?
Well in 1945, I had the idea that sickle-cell anemia — contrary to what other people thought — was not a disease of the red cells, but a disease of the hemoglobin molecule itself . . . which — we now know — it is. In 1949, my students and I published a paper on that subject — "Sickle Cell Anemia, a Molecular Disease" — In Science. That paper led to a tremendous amount of work, involving hundreds of people, on the problem of abnormal hemoglobins.
How did you happen to go from this to problems of nutrition?
One of the co-authors of the sickle-cell anemia paper — one of the students in my lab at Cal Tech — was a young medical doctor by the name of Harvey Itano. Dr. Itano, who was an officer of the U.S. Public Health Service, came to my lab in 1946. He took his Ph.D. with me and — afterwards — continued on in my lab as a postdoctoral fellow, supported by the Public Health Service.
Well, in 1954 I think it was, the Public Health Service called Dr. Itano back to Washington, and he had to leave Pasadena. Since he would be working on his own in Washington, I decided that I didn't want to compete with him in the field of the hereditary hemolytic anemias and that I should look for some other diseases that might well have a molecular basis. I remember thinking, too, that I might as well study some important diseases while I was at it.
Cancer, of course, was a possibility, and also mental illness. Ultimately, I chose to work on mental illness rather than cancer, on the grounds that almost everybody was doing research on cancer while practically nobody was doing anything in the area of mental illness. This was 23 years ago.
So in 1954, I got a grant from the Ford Foundation and set up a little group of people to work on the molecular basis of mental disease. This work went on for ten years, until — in 1964 — I left the California Institute of Technology.
At any rate, it was during this period that I learned of the work of Hoffer and Osmond. These two researchers — working in Canada — had found in the early 1950's that very large doses of niacin were often beneficial to patients suffering from schizophrenia. Eventually, Hoffer and Osmond began to administer massive doses of vitamin C to their patients, too. Both niacin and vitamin C were helpful in controlling the symptoms of schizophrenia.
This intrigued me. I was fascinated by the idea that these substances, which you usually take in very small amounts — I believe the Recommended Dietary Allowance for niacin is 16 milligrams daily and for vitamin C, 45 milligrams — could have valuable health-promoting effects when ingested in amounts 100 or 1,000 times greater than the usual dietary intake.
What did you do then?
I began scouring the literature to find out whether other vitamins or naturally occurring substances might be effective in promoting good health when taken in large quantities. Here, I didn't go to the textbooks on nutrition and medicine . . . I went to the original papers — the original scientific reports upon which the textbooks are based — to see what the investigators themselves had observed. Not even what they had concluded, but what they'd observed and reported. Perhaps surprisingly, I found that there was a good deal of evidence to support the idea that large doses of vitamins could be clinically useful.
Is this when you coined the term "orthomolecular"?
Yes, that's right. In 1967, I wrote a paper —"Orthomolecular Psychiatry" — which appeared in the April 19, 1968 issue of Science, and that was when I introduced the word "orthomolecular". Orthomolecular, I said in my article, means — literally — "the right molecules in the right amounts". In practice, it means altering the amounts of the naturally occurring substances — vitamins, amino acids, and so on — in the human body until you find what corresponds to the concentrations necessary for the best of health. I thought this could be an important enough field of medicine to justify its having a name. I chose the word "orthomolecular" because it was broader in scope than the term "megavitamin", which was already being used in a different context.
What made you become interested in vitamin C — ascorbic acid — specifically?
Well in March of 1966, I was in New York to accept the Carl Neuberg Medal. At the award dinner, I gave a speech. I was talking about the many remarkable scientific discoveries that had been made in the past fifty years — and that continue to be made, of course — and I went on to say that I hoped I would live long enough to see what would be discovered in the next fifteen or twenty years.
A month later — in April — I got a letter from a biochemist, Irwin Stone, who had attended the award presentation in New York. Apparently the things I had said about wanting to live another twenty years touched him, because in his letter he told me that he would like to see me remain in good health not for fifteen or twenty years, but for fifty more years! He gave a description of a high-level ascorbic acid regimen that he had developed during the preceding three decades, and said that if I would take large amounts of vitamin C it would improve my health. To support his claim, he enclosed reprints of four research papers that he had recently had published on the relationship between vitamin C and good health.
Did Dr. Stone's statement that you could live fifty more years surprise you?
Oh yes (laughter). I didn't believe it. I'm not sure that I don't believe it still. But I read his papers-the four papers that he sent — and they made good sense. And, of course, my wife and I both began taking large doses of vitamin C . . . three grams a day, which was what Dr. Stone had recommended.
Did you notice anything different after starting the " high-C" regimen recommended by Dr. Stone?
My wife and I both noticed an increased feeling of well-being . . . and we discovered that we no longer caught colds. Prior to receiving Dr. Stone's letter, I had been taking 100 milligrams of vitamin C a day for thirty years . . . but this obviously wasn't enough to keep me in a state of optimum good health, because I kept catching bad colds over those years. After I started taking three grams of the vitamin each day, however, I no longer got colds.
Was this when you first began "crusading" for vitamin C, then?
Oh no. I didn't take a public stand on vitamin C and the common cold until several years later. What happened was that in 1969, I was invited to speak at the opening ceremonies of a new medical school in New York . . . the Mount Sinai Medical School. They had invited several people to speak at this ceremony, so I only had about ten minutes — maybe fifteen — to speak, but in my short talk I mentioned the value of vitamin C in preventing colds as something important to medicine, to health in general.
Well, one of the professors who attended the ceremony wrote me a very strongly worded letter attacking me for having made the statement about vitamin C. He said, "Do you want to support the vitamin quacks that are bleeding the American public of hundreds of millions of dollars a year?" And he asked: "Can you show me a single double-blind study that indicates that vitamin C has any more value than a placebo in fighting colds?"
I wrote to this fellow and told him that no, I couldn't show him any studies, but that I hadn't really looked at the literature, either. And I didn't pursue this for two or three months . . . but it kept bothering me. Finally — after several months — I got around to checking the medical literature . . . and I found six double — blind studies, every one of which showed that vitamin C did in fact have more value in preventing colds than a placebo. And by "double-blind", I mean that neither the people dispensing the pills nor the people receiving them knew which pills contained the vitamin C — and which ones were the placebos — until the end of the study. The records were kept, in other words, by a third party.
So again, I wrote to this fellow — I didn't expect to go beyond this, you see — and said that I had found that there were several studies backing me up, one of which was a 1961 study — written in German — by Ritzel. I gave him the reference to Ritzel's paper, and I thought that that would end the matter.
The professor wrote back and said that he was too busy to hunt up the reference to Ritzel. Well, I made a Xerox copy of Ritzel's paper and mailed it to him, so he wouldn't have that excuse (laughter). Then he wrote to me, saying, "I am not impressed by the work of Ritzel. " I wrote back and said, "I'm not impressed by your saying that you're not impressed by the work of Ritzel. " After all, the boys in Ritzel's study who got the vitamin C had only a third as much illness due to colds as the boys who got a harmless placebo . . . and the numbers in the paper have high statistical significance. You can't just say you're "not impressed" by the work . . . you have to have a reason.
Well, the professor wrote and said that Ritzel didn't give the age of his subjects, nor their sex . . . which happens to be untrue. I wrote the professor and said that because I had lived for a year and a half in Germany after receiving my Ph.D., I could read Ritzel's German without trouble, and it seemed clear to me that Ritzel said that his subjects were all boys in their teens. So then the professor wrote to me and said well, there were two ski camps in the study, and perhaps Ritzel gave the vitamin C to the boys in one ski camp and the placebo to the boys in the other ski camp, and maybe the camps were different in some way, and . . . Well. I wrote to Ritzel about that, and he said — essentially — "How silly can you get. "
Here's this man, this professor — I didn't identify him when I wrote my book — Victor Herbert, who to this day keeps writing papers and giving speeches saying that no one benefits from taking extra vitamins . . . and he won't look at the evidence.
The upshot of this whole thing is that I finally became sufficiently irritated by this fellow that I decided I ought to do something about it. So I sat down one summer — here, downstairs in my study — and in two months wrote a book, Vitamin C and the Common Cold.
That was in 1970?
Yes, the summer of 1970. I started writing on the first of July, and the book was published on the 17th of November.
You know, I think my interest in the vitamins has developed to the extent that it has partially because of the obvious failure of the medical and nutritional establishments to look at the facts. It irritates me that there should be such a situation anymore. To me, it means that there's an opportunity here to do some worthwhile work. If Victor Herbert and these other physicians — and even the "authorities" who write the textbooks and reference books in medicine and nutrition-just ignore the observations that have been made regarding vitamin C and the common cold . . . then — I feel — here is something that will be worthwhile for me to work on.
Is it your contention that no studies have been done which disprove the idea that vitamin C helps prevent colds? Do no such studies exist?
I discussed all of the controlled trials I could find in the literature in my last book, Vitamin C, the Common Cold, and the Flu. There were 14 controlled trials altogether. All involved two groups of subjects — a " vitamin C" group and a "placebo" group — and none of the subjects of either group knew whether he or she was receiving ascorbic acid tablets, or tablets of a harmless but indistinguishable placebo, such as citric acid. And every one of these 14 studies showed some protective effect by vitamin C greater than the placebo. That's not to say that they all got the same result: For one thing, the various investigators used different amounts of vitamin C, so you wouldn't expect all the studies to show the same amount of protective effect. Even those that used the same amount of ascorbic acid got different results . . . because they were studying different populations under different conditions. But the main thing is, every study showed some protective effect of vitamin C against colds . . . even those in which the investigators said they didn't get a protective effect.
Wait a minute . . . you mean some investigators drew the wrong conclusion from their own results?
Can you give me an example?
Well for instance in 1942, Cowan, Diehl, and Baker of the University of Minnesota published a report in the Journal of the American Medical Association. In it, they described the results of a controlled, double-blind study in which they found that persons who received 200 milligrams of vitamin C per day experienced 31% less illness than the persons in a control group who got a placebo. But in the summary of their paper — which is the only part that would be read by most of the people who read the Journal of the American Medical Association anyway — Cowan, Diehl, and Baker say: "This controlled study yields no indication that large doses of vitamin C have any important effect on the number or severity of infections of the upper respiratory tract." They didn't say that they had observed this 31% decrease in the amount of illness in one group . . . they apparently didn't consider this effect to be important, even though the numbers do have statistical significance. They couldn't say "showed no effect", of course, because that would have been false. Instead, they said "no important effect".
This statement in the summary of the paper by Cowan, Diehl, and Baker has become the basis for a lot of misinformation. Because if you look in one of the standard medical texts, it says "Cowan, Diehl, and Baker found in 1942 that massive doses of vitamin C have no effect on the incidence of colds." The authors of the book, in other words, have left out the word "important" . . . and of course by doing this, they've misrepresented the work of Cowan, Diehl, and Baker, who — as I have said — have misrepresented their own work to a certain extent.
Cowan, Diehl, and Baker are just one example of investigators who have misinterpreted their own results. I quote other examples in my latest book.
It seems odd that Cowan, Diehl, and Baker refer to 200 milligrams of vitamin C as a "large" dose . . . isn't that really just a fairly small amount of the vitamin to take?
That's right. It's only a little more than four times the Recommended Dietary Allowance set down by the Food and Nutrition Board of the National Research Council. The RDA for vitamin C is now 45 milligrams. That's the amount that — if taken daily — will prevent most people from dying of scurvy.
The attitude of the National Research Council — and of the medical establishment in general — seems to be that as long as you're not dying of scurvy, you're OK . . . you're getting enough vitamin C.
That seems to be their attitude. And, of course, that attitude is wrong.
I take it, then, you share Dr. Irwin Stone's view that the human race as a whole suffers from "hypoascorbemia" . . . vitamin C deficiency. Is that true?
Yes, I agree with him.
Many medical authorities find it hard to believe that the human race as a whole could be suffering from a vitamin C deficiency. What evidence is there for this belief?
Well first you have to realize that only a few animals other than man are wholly dependent on diet for their vitamin C. Cats, dogs, cows, pigs, rats, snakes, and other animals make their own vitamin C . . . they don't need to obtain it in their diets. Only human beings, monkeys and apes, guinea pigs, a few types of birds, and one species of Indian fruit-eating bat require ascorbic acid in their diet. And with the exception of the human beings, these animals get plenty of vitamin C every day in their food.
Take the gorilla, for instance. Back in 1949, G.H. Bournehe's the father of Peter Bourne, who's one of President Carter's appointees — pointed out that the gorilla obtains about 4.5 grams of vitamin C per day in his natural foods . . . bamboo shoots and other green plants. On a body-weight basis, this corresponds to about two grams a day for humans.
Likewise, Irwin Stone has shown that rats — which, remember, do not need to ingest vitamin C — make an amount of ascorbic acid corresponding, on a body-weight basis, to between two and four grams per day for a 70-kilogram man. That's when the rat in question is not under stress. Under stress, a rat will synthesize a much larger amount of ascorbic acid,
I have checked the amounts of vitamins present in 110 raw, natural plant foods . . . and I've found that an amount of these plants corresponding to one day's food — 2,500 calories — for an adult human being contains — on the average — 3.3 times the RDA of thiamine, 3.4 times the RDA of riboflavin, 2.3 times more niacin than the current RDA for that vitamin, and 51.0 times the RDA of vitamin C. In other words, if you ate 2,500 calories' worth of these 110 natural plant foods-and we can assume that our ancestors probably had a diet very much like this — you'd be ingesting 2.3 grams of vitamin C.
It seems likely that sometime in the past — perhaps 20 or 25 million years ago — the common ancestor of man and the other primates lived in an environment where the available food contained large amounts of vitamin C. It also seems likely to me that these conditions favored the appearance and subsequent reproduction of a mutant animal that had lost the cellular machinery required to make ascorbic acid in the body. The mutant, you see, would have a selective advantage. . . it would not be encumbered by the "excess genetic baggage" represented by the genes responsible for ascorbic acid synthesis.
At any rate, I think that the human race was descended from such a mutant, and that — over the years — the human race has expanded its territorial range into areas where the food supply is deficient in ascorbic acid. So that now, we're all getting less vitamin C than we should be . . . than our ancestors did.
Contrary to what the medical establishment says, then, a mere 45 thousandths of a gram of vitamin C per day is not enough to keep an adult in "ordinary good health". Is that what you would say?
That's correct. What the physicians and nutritionists call "ordinary good health", I would call "ordinary poor health" in this case (laughter).
In your opinion, how much vitamin C should people be taking to maintain a state of optimum good health?
It varies from person to person. There is evidence that some people remain in very good health-that is, remain free of colds, the flu, and so on-through the ingestion of only 250 milligrams of vitamin C per day. Other people require larger amounts . . . up to five grams daily, or more.
How much vitamin C do you take every day?
I take ten grams a day, myself.
Ten grams! That sounds like an awful lot. Doesn't the body just excrete excess vitamin C anyway?
According to some of the authorities it does, but according to observation it doesn't. If you take more than 150 or 200 milligrams of the vitamin per day, then some fraction of what you ingest is excreted in the urine within a few hours . . . but it isn't 100% of the excess. In fact, if you take a large amount of vitamin C, only 62% of the ascorbic acid that gets into the bloodstream winds up in the urine . . . the other 38% remains in the body. The idea that supplementary vitamin C simply gets washed away in the urine is a misapprehension . . . one that's made quite often by nutritional "authorities".
Some vitamins — vitamin D, for example — are toxic if taken in large doses. Is this not true of ascorbic acid?
No, it isn't true of ascorbic acid. Vitamin C is one of the safest substances that there is . . . one of the least toxic substances known. It's less toxic than ordinary table salt — sodium chloride — or sugar . . . less harmful to one's health. Nobody knows what the "lethal dose" of vitamin C is. The LD50 for rats-the amount that kills 50% of the rats to which it is given is seven grams per kilogram of body weight. That corresponds to 490 grams-more than a pound-for a 70-kilogram man. And yet, many people have been given amounts of this vitamin on the order of 100 grams-either orally or by injection-without any harmful side effects.
Over-the-counter cold medicines, on the other hand, are by comparison quite toxic. Ordinary aspirin, for example — one of the least toxic of non-prescription drugs — is lethal in doses of 20 or 30 grams. A single five-gram dose of acetaminophen — the active ingredient in most of the popular non-aspirin pain relievers — can cause death by respiratory failure. Dextromethorphan — which is present in many of the cough medicines advertised on TV — can be fatal in doses of less than a gram. Then again, the belladonna alkaloids found in non-prescription sleeping pills and some cold medicines may be fatal to children in doses as low as ten milligrams. Bernard Rimland calls these and other popular chemotherapeutic agents "toximolecular medicines" . . . meaning involving toxic molecules instead of the "correct" molecules of orthomolecular medicine. I agree with his choice of words.
Some people have expressed the fear that too large an intake of vitamin C can lead to the formation of kidney stones. Is this fear warranted?
Ascorbic acid has almost nothing to do with kidney stones. The answer — in other words — is no, but I can amplify this a bit.
There are several kinds of kidney stones. The most common kind — the phosphate and carbonate stones — tend to form in alkaline urine, and you can keep them from forming merely by making your urine acidic. That's easy to do: All you have to do is take vitamin C in its ordinary form — as ascorbic acid — and you'll have acidic urine.
Then there are the rarer kinds of kidney stones. Of these, the most common types are the cystine and urate stones, which tend to form in acidic urine. If you're prone to have these kinds of stones, you should take your vitamin C in the form of sodium ascorbate, or take the vitamin along with an alkalizer so as to keep your urine alkaline. Of course, few people know in advance which kinds of stones they're prone to form — if any — but if you do know, you can protect yourself. And you can still take the proper amount of vitamin C.
There's also another rare kind of kidney stone: the oxalate stone. Studies have shown — in this connection — that people who take up to four grams of vitamin C a day do not excrete more than the normal amount of oxalate in their urine, while persons who take nine grams of the vitamin per day excrete about double the normal amount of oxalate in their urine. So there might be some additional tendency among people who are prone to have oxalate stones and who take large doses of vitamin C to form kidney stones of this type. As a matter of fact, however, no one has ever been reported to have gotten oxalate stones from taking vitamin C.
So you see, vitamin C has almost nothing to do with kidney stones. This is the sort of red herring that is frequently pulled out to frighten people away from vitamin C. It's silly, really.
Do you believe it might be possible — with the aid of vitamin C — to completely eradicate the common cold in the same way that, say, smallpox has been wiped out in most parts of the world?
Well I should think that it would be possible, yes. Of course, it might take a very long time, because cold viruses from one part of the world can be carried by travelers to other parts of the world, and we know — too — that in some countries, conditions are such that we can't possibly expect the proper amount of vitamin C to be made available to everyone. But ultimately, it might be possible to have a country in which nobody has the common cold.
You have to remember that the common cold spreads by people sneezing in each other's faces . . . but you don't get the cold if there aren't any cold viruses around. Now if a lot of people have colds, then almost everybody is certain to get a cold sooner or later. If only a few people in a given population have colds, however, then the number of other people who are exposed to the disease is smaller, and the amount of the virus to which they are exposed is smaller, so that protection against the common cold operates in a kind of "auto-catalytic" fashion. That is, the fewer the number of people who have colds . . . the fewer the number of people who'll catch colds.
Even if there are cold viruses around, though, you can keep yourself from getting colds if you take the right amount of vitamin C.
Pardon me for asking . . . but do you ever get colds these days?
I sometimes get what I think would become a cold if I were to allow it to develop. About once a year, I begin to feel as though I'm catching a cold . . . but as soon as I do, I increase my intake of vitamin C, and that stops it. I've taken as much as 40 grams of ascorbic acid in a day, if I felt I was "coming down with something".
One important point to remember about vitamin C — something I haven't mentioned so far in our discussion-is that it should be taken regularly, every day, and not stopped for a week. If you're taking large doses of vitamin C and then all of a sudden you stop taking it, the level of ascorbic acid in your blood rapidly drops within a day or two . . . it drops to a very low value, and during this time you become more susceptible to infectious diseases. So it's very important for you to keep your vitamin C intake up.
You mentioned "infectious diseases" just now. Are you implying that vitamin C protects against other diseases, besides the common cold?
The evidence is that it provides protection against all of the infectious diseases . . . that is, all bacterial and viral diseases.
You mean . . .
Measles, mumps, pneumonia, meningitis, chicken pox, serum hepatitis, infectious hepatitus, influenza . . . there are even published reports on the effectiveness of ascorbic acid in preventing and treating poliomyelitis.
One may ask how it is that vitamin C can protect a person against so many diseases. I think it probably does this largely-though perhaps not entirely — by potentiating the body's natural protective mechanisms. There is much evidence for this. One of the most interesting studies along this line was one carried out by three people — R.H. Yonemoto, P.B. Chretien, and T.F. Fehniger — at the National Cancer Institute. These workers studied the rate at which new lymphocytes — white blood cells-are produced by a person . . . and they found that people who were given five grams of vitamin C per day for three days showed a doubling in their rate of lymphocyte production.
This is an important observation, because the lymphocytes can rightfully be called the "policemen" of our body: They attack invaders and destroy foreign cells. They attack viruses — for instance — and bacterial cells, which are recognized as "foreign". They also attack and destroy cancer cells, malignant host cells. The changes that take place in a normal body cell when it becomes malignant, you see, include certain changes of the cell's outer surface, so that the cancer cell becomes recognizable to lymphocytes as an "abnormal" cell.
Does this mean, then, that vitamin C can also protect a person from cancer?
Several epidemiological studies have — in fact — shown a definite negative correlation between vitamin C intake and cancer. People who have a high intake of vitamin C have a much smaller age-corrected incidence of cancer than those persons who have a low daily intake of the vitamin. A low intake, in this case, being about 45 milligrams a day.
Ewan Cameron — a surgeon in Scotland — and I have been doing some cancer research of our own over the past six years or so. In fact, we authored a paper on this subject — vitamin C and cancer — not long ago.
You're referring to the paper which appeared in the October 1976 Proceedings of the National Academy of Sciences. . . is that correct?
Yes. In that paper, we compared the survival times of two groups of terminal cancer patients, all of whom had been pronounced "untreatable" by at least two independent clinicians. One group of 100 terminally ill patients was given vitamin C — ten grams per day per person — while a control group consisting of 1,000 terminal cancer patients got no supplemental ascorbic acid. Let me point out that the 1,000 patients who didn't get vitamin C were matched controls: That is, for each one of the 100 persons who did get the vitamin, we had ten control patients of the same sex, roughly the same age and having the same type of cancer. Ten matched controls for each "vitamin C" patient.
What we observed was that the patients who received vitamin C lived — on the average — 4.2 times as long as the control patients. The average survival time for the control patients was only 50 days from the time they were declared untreatable. the "vitamin C" patients survived an average of more than 210 days.
Are any of the people who were involved with this study still alive?
Oh yes. Thirteen of the 100 "terminal" cancer patients who received vitamin C are still living. For some of those 13, it's been five years since they were pronounced "untreatable". That's pretty remarkable when you consider that all 1,000 of the control patients are dead now. Only three of the 1,000 lived more than a year after being pronounced untreatable, and those three have since died.
That's a mighty sobering observation.
Yes. Today, all of the cancer patients who come to Vale of Leven Hospital in Scotland — which is where the study was carried out — receive ten grams of vitamin C a day.
You know, one of the terminal cancer patients in that study deserves special mention. This man came to the hospital and was given ten grams of vitamin C a day, and — because he responded well to this treatment — his physician decided after six months to take him off of the vitamin. Well, within a month the cancer in his chest came back. His doctor gave him ten grams a day of vitamin C again, but he didn't respond this time, so his daily ration was increased to twenty grams. Within a month, the cancer had gone away again and the fellow was back at work. He's still alive — two years later — working as a truck driver. He's in perhaps better-than-ordinary good health (laughter). And he continues to take twelve and a half grams of vitamin C a day.
Do you think that perhaps more than 13 of the original 100 "test" patients in this study might have been saved if the 100 people had received, say, 20 grams of vitamin C daily instead of 10 grams?
I think that almost certainly more than these 13 persons could have been saved if the original 100 had gotten larger amounts of vitamin C. Then too, if these patients had started taking vitamin C at an earlier stage of their disease — before they were pronounced "untreatable" — I think there would have been a much greater chance of saving their lives.
Obviously, there ought to be some studies made as to what the proper dosage of vitamin C is in such cases. Dosage studies, of course, are done all the time with the synthetic chemotherapeutic agents, such as 5-fluorouracil and methotrexate. A great deal of research is done with these drugs to find out what the best dosage is . . . usually, they find the amount that's a little bit less than what would kill the patient because of the extreme toxicity of the drug. But with vitamin C, you can take 50 grams a day — day after day — without ill effects, so it may well be that persons with "hopeless" cancer should be taking much larger amounts than we used in our study.
Why do you suppose more medical researchers haven't tackled this problem already?
Well I just don't understand why. I tried to get the National Cancer Institute to carry out a controlled trial five years ago, but they wouldn't do it: They said they couldn't do it until some animal work had been done, and they asked "Why don't you apply for a grant to carry out some animal research?". So I applied . . . I worked for months filling out the application forms and finally sent them in, but my application was turned down. Every year I've applied. I've applied five times now and been turned down each time.
You know, It's funny. Say someone in the National Cancer Institute who has several million dollars to allocate decides to allocate it to some people who want to study the anti-cancer properties of a 2:1 mixture of 5-fluorouracil and methotrexate. Well, it's already been studied in the one-to-one ratio and the individual substances have been studied, and nearly all the doctors in the country are using these anti-cancer drugs on a day-to-day basis. Obviously, it's OK to allocate funds in this manner . . . you're not likely to get in trouble. But if I come along and say that I want money to do some work on vitamin C as an anti-cancer drug — and the guy at the National Cancer Institute gives me some money — Senator Proxmire may hold that up as an example of poor judgment — poor use of funds — and the fellow who allocated the money for my project will be on the spot.
The National Cancer Institute can decide who gets the money to do these things and who doesn't. But they're not willing to take a chance. They only want to bet on the sure things. And, of course, as long as they do that, they'll never make any really important discoveries.
Isn't it true that you've run into resistance also with the National Academy of Sciences? Didn't the editors of the Academy's Proceedings reject your first paper on vitamin C and cancer?
Yes, they did reject my first cancer paper, and it was rather odd. Especially when you consider that I had been the editor of PNAS once for five years, and I've been a member of the National Academy of Sciences since 1933. In 1914, the Academy decided that members had the right to have their papers published in the proceedings, and this policy of "free access to members" was followed for 58 years. And then — in 1972 — they decided to reject my cancer paper. So I ended up submitting the paper to Oncology, where it was finally published.
How did you and Dr. Cameron manage to get your most recent cancer paper — the one involving the 100 patients who got vitamin C, and the 1,000 matched controls — published in the Proceedings of the National Academy of Sciences?
We argued with them until we got in! (laughter).
Can we expect to see more papers by you and Dr. Cameron in future issues of the Proceedings?
Yes, I think so. Ewan is working on a couple of papers right now. One of them is a description of 20 case histories . . . people with cancer that he's been able to treat successfully with vitamin C. We have some other papers in the works, too, Dr. Cameron and I. Ewan is a non-resident fellow of our Institute, The Linus Pauling Institute of Science and Medicine.
What kinds of work are the scientists at the Linus Pauling Institute engaged in currently?
Well, we've done a good bit of work on improved methods of analysis of body fluids as a means of diagnosing disease. We continue to do quite a bit of work along those lines. The rest of the work that we do is in the fields of cancer and aging. We have some interesting animal studies in progress . . . nutrition in relation to skin cancer in mice, for instance. We're limited, however, by the fact that we don't have much money.
The Linus Pauling Institute is in need of funds?
Can people send donations directly to the Institute at 2700 Sand Hill Road, Menlo Park, California 94025?
Yes indeed. All donations are tax-deductible, too, because the Institute falls under Section 501(C)(3) of the Internal Revenue Code. Practically all of our cancer work is supported by private contributions.
All right. According to everything you've just said, vitamin C seems to be a powerful tool against not only the common cold, but the whole gamut of infectious diseases . . . and cancer, too.
That's right, and there's some evidence to indicate that vitamin C may be useful in preventing coronary disease, as well. It has been found, for instance, that an increased intake of ascorbic acid leads to a decrease in the concentration of cholesterol in the blood.
If what you say is true, vitamin C actually protects people against heart disease, cancer, and respiratory infections . . . our country's first, second, and fourth leading causes of death, respectively. What you're saying, in effect, is that if people would take the proper amount of vitamin C every day they would live longer. Is that right?
I have reached the conclusion that the regular ingestion of gram quantities of vitamin C should bring about a 75% reduction in the age-specific death rate. I take ten grams of vitamin C a day. I think that's enough to cut the probability of my dying to a quarter of what it might otherwise be. Every factor of one-half that you can achieve in the age-specific death rate corresponds to an eight-year increase in life expectancy . . . this was shown by the Englishman, Gumpertz, 150 years ago. Now if you can cut your age-specific death rate to 25% of what it should be — and I believe this is possible, if you take your vitamin C — you've increased your life expectancy by 16 years. That's with vitamin C alone. I'm sure that if people were to employ other health-preserving measures, they could live 25 more years.
You're talking about people living to be 95 or 100 years old, then.
That's right. Instead of living to be 70 or 75 years old — 70 for men, 75 for women — you'd live on to 95 or 100.
Some people might ask whether it would be desirable to live an extra 20 or 25 years. Would those extra years be productive and happy, in your opinion . . . or would they be something less than enjoyable?
I think that they would be pleasurable years . . . years of well-being, not deterioration. The process of aging is not well understood, but it has been observed that when people manage to live into their nineties, death is usually accompanied by a smaller amount of suffering than when people die at an earlier age. Very often, these older people seem to be in pretty good health and then they just die in their sleep, whereas younger people — persons in their forties or fifties — are more apt to get cancer and experience a year or two of misery, made worse — of course — by the anti-cancer drugs the doctors make them take, before they die.
On the other hand, I think that one might well question whether the next 25 years in the history of the world will be pleasurable ones to live through.
I gave a lecture about a year ago at the 100th anniversary meeting of the American Chemical Society. In it, I said that I thought there would almost certainly be a catastrophe of some kind within the next 25 or 50 years . . . a catastrophe which might destroy the human race.
Just what that catastrophe might consist of, I can't predict. I think the greatest problem facing the world today is — of course — the population problem . . . the problem of starvation. I expect we'll see mass starvation some time in the next few decades because of the failure of governments and people to recognize the need to limit the world's population.
If we are ever to address the population problem, however, the current waste of the world's resources on militarism must stop. I think that the recent fuss about the — "neutron bomb" — which isn't much different from other tactical nuclear weapons — is just a ploy to keep people from moving toward more general disarmament. Twenty years ago, the military experts were talking about "clean" nuclear weapons. This neutron bomb is just as much of a fraud as the "clean" nuclear weapons that they were agitating about then.
Paul Ehrlich has pointed out that the coming catastrophe could take many forms: the complete loss of oceanic fisheries, for instance, through over-fishing. Or severe weather changes brought about by governments to improve the yields of crops. Or the rapid destruction of the ozone layer.
I am forced — as I observe governments in their processes of decision — making — to conclude that the next century will probably be one in which the amount of suffering in the world reaches its maximum. Unless we are wiser than we have shown ourselves to be in the past, we shall encounter catastrophic problems in the years ahead. A hundred years from now, however, we shall — I hope — have solved these problems . . . and from then on, we may have a world in which every human being will have the opportunity to lead a healthy, long, and pleasurable life. That is what I hope.
Dr. Pauling, thank you very much.
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