Influence of Arsenicals,Bismuth and Iron on the Plasma Ascorbic Acid Level

Several reports indicate that the poisonous effects of a number of drugs like benzene, lead, 1 phenylcinchoninic acid, 2 and glycerol 3 and especially the arsenicals1 may be counteracted successfully by giving suitable doses of ascorbic acid.

From examination of the urine Dainow 4 concluded that patients who showed symptoms of intolerance to arsenicals were in a state of hypovitaminosis C. By administration of ascorbic acid, these hypersensitive patients became able to tolerate neoarsphenamine. Other investigators 5 6 7 8 9 10 11 reporting similar observations, emphasize the fact that in certain hypersensitive cases ascorbic acid gave favorable results after other methods of detoxification such as the administration of glucose, invert sugar, and calcium or sodium thiosulfate had failed.

After a suitable method for determining plasma ascorbic acid had been developed, studies were commenced in 1938 on syphilitic patients showing symptoms of intolerance to arsenicals. A more extended systematic study of this problem was recently made possible in connection with our Nutritional Survey of the syphilitic patients attending the Municipal Social Hygiene Clinic, Chicago.∗

It was noted early in the work that patients hypersensitive to neoarsphenamine in whom treatment had to be discontinued because of severe reactions‡ required exceedingly large oral doses of ascorbic acid† to bring their plasma levels up to optimal values (1.0 mg % or above). When showing severe symptoms of intolerance, a decline of the plasma level occurred in spite of the oral administration of ascorbic acid during treatment. It was frequently observed that a marked lowering of the plasma level followed the administration of neoarsphenamine in patients showing no intolerance to the drug (Fig. 1).

When bisniuth was given in doses routinely used for aiitiluetic treatment, no appreciable effect was observed either on the plasma ascorbic acid or hemoglobin levels.