LINUS PAULING, VITAMIN C, AND THE MEDICAL ESTABLISHMENT

A thesis presented
by
William Burton Hamner
to
The Committee on History and Science
in partial fulfillment of the requirements for the degree of Bachelor of Arts
Harvard University
Cambridge, Massachusetts
March 25, 1983

ACKNOWLEDGEMENTS
I would like to thank my parents for teaching me the difference between truth and
falsehood, and for inspiring the interest which made this work possible.
I would very much like to thank Dr. Linus Pauling for his courage and perseverance in
fighting for the welfare of all people, and for his graciousness in granting an admiring but
rather confused young man the chance to talk to him about his views on science and its
social context.
Most of all, I would like to thank my fianct, Annette, for her invaluable assistance in
preparing this thesis, and for many other, better reasons.

TABLE OF CONTENTS
chapter page
Introduction. 1
The Effects of Vitamin C on Disease 4
PART ONE
VITAMIN C: THE BOOK
Orthomolecular Medicine 7
Pauling and Vitamin C 12
Vitamin C and the Common Cold 16
The Nature of the Evidence 27
Quackery, Heresy, and 35 Orthomolecular Unorthodoxy
PART TWO
VITAMIN C: THE MOVIE
Prologue 42
The Response to Orthomolecular 45
Psychiatry
The Medical Establishment and Vitamin C 50
The Eyes of the Public 61
PART THREE VITAMIN C: THE CRITIC'S REVIEW
The Nature of the Response 64
Conclusion 81
Appendix 84
Bibliography 95

CHAPTER 1
INTRODUCTION
The controversy over the effects of vitamin C or ascorbic acid in the prevention and
treatment of illness other than scurvy remained largely a scientific debate among medical
researchers until Linus Pauling, Nobel Laureate in Chemistry (1954) and Peace (1962) and
one of the most famous scientists in the world, wrote Vitamin C and the Common Cold.' In
his book Pauling developed a theory of the optimal daily allowance of vitamin C for
humans, described the implications of his theory for human health, and presented
evidence that his hypothesis that vitamin C could prevent and alleviate a large percen¬tage
of colds was correct.
Pauling's prestige brought his book national attention and made it a best-seller. Pauling
said in his book that the medical estab¬lishment had ignored the evidence about the uses
of vitamin C, which confirmed the feelings of many people that the medical establishment
was more interested in its profits than the public's health. Pauling also said that the
Recommended Daily Allowance of vitamin C, set by the Food and Nutrition Board of the
National Research Council, was much too low to maintain good health.
The medical establishment responded in heat and anger to Pauling's claims. The evidence
for his theory was attacked and his recommendations for the use of vitamin C were called
unjustified and socially irresponsible. He was accused of being in collusion with the vitamin
and health food manufacturers and promoters.
This thesis is an answer to the question of whether Pauling's charge that the medical
establishment was ignoring the benefits of Vitamin C use is correct, and, if he is right, why
such a situation should exist. It is also an evaluation of Pauling's development of
"orthomolecular medicine," an approach to the treatment of illness that is fundamentally
different from the methodology and approach of orthodox medicine.
The use of very large doses of vitamin C, from one to twenty grams (g) in size, to prevent
and cure the common cold is an example of orthomolecular medicine known as
megavitamin therapy. The response of the medical establishment to Vitamin C and the
Common Cold is representative of the its response to the concept of ortho-molecular
medicine and megavitamin therapy. Their reaction is similar to that of other interests
which have been challenged in the past by scientists who have gone public with their
claims.
In the first part of the thesis, Vitamin C: The Book, the rela¬tionship of vitamin C therapy
for colds to the more general concept of orthomolecular medicine will be shown. Because
the contents of Vitamin C and the Common Cold seem to have been seriously
misunderstood by the medical establishment, the theoretical and practical aspects of the
book will also be explained.
In the second part of the thesis, Vitamin C, The Movie, the response of the medical
establishment to the concept of orthomolecular medicine and its use in treating illness will
be presented. As this response has been aimed at persuading the public that the posi¬tion
of the public is the correct one, I shall analyse their arguments for logical and factual
consistency. The results will be shown in Table 1.
In the third part of the thesis, Vitamin C: The Critic's Review, I will analyse the reasons why
Table I looks the way it does. I will also present some historical information pertinent to the
phenomenon of Linus Pauling and the efforts of vested interest groups and the
establishment to control him and others like him. Finally, the prac¬tical implications of my
thesis for the reader will be explained.

1 Linus Pauling, Vitamin L. and the Common Cold, San Francisco: W.H. Freeman, 1970.

CHAPTER 2
THE EFFECTS OF VITAMIN C ON DISEASE
The large, well-controlled studies of Anderson, et al in Toronto (1972, 1974, 1975)1
confirm conclusively the findings of Cowan, et al (1942), Ritzel (1961), and Coulehan (1974)
that daily supplementation with vitamin C, increased during colds, significantly reduces the
duration and severity of colds and less significantly reduces their incidence. The
conclusiveness of the evidence for a beneficial effect of vitamin C was established with the
third trial of Anderson et al, (1975), who concluded that "Taken in conjunction with the
positive results of other investigators, there is now little doubt that the intake of additional
vitamin C can lead to a reduced burden of winter illness."
The reduction is not as large as that postulated by Pauling (1971b) that 1 gram of vitamin C
per day would lead to 45% fewer colds and 60% fewer days of sickness; Anderson, et al
(1972, 1975) reported a 7%-10% decrease in incidence of colds and a 25%-30% decrease in
their severity. Pauling in his second book on the subject, Vitamin C, the Common Cold and
the Flu, showed that fourteen controlled trials of vitamin C in treating colds demonstrated
an average 35% reduction in illness from regular vitamin C ingestion.2
1References to scientific journal articles may be found in the journal bibliography, page 95,
listed by author and year.
2Linus Pauling, Vitamin Q, Ike Common Cold, and the Flu, San Francisco: W.H. Freeman,
1976. Page 182.

6
metabolization of large amounts of the vitamin, and its complete lack of toxicity for normal
people, support Pauling's theory that human Vitamin C requirements were set by
evolutionary factors at approximately 1 to 2 grams per day. These considerations also
imply that most people should have a much higher intake of the vitamin than they get in
their normal diets.
The premises of Pauling's theory have not been challenged. However, the implication of his
theory that Vitamin C in the amounts required for optimal health will reduce illness have
been attacked. The medical establishment has insisted for years that there is no benefit
from the use of large doses of ascorbic acid. This position has been held with decreasing
success as the evidence for a beneficial effect of large doses has increased. Nonetheless, it
has been argued that the evidence is inconclusive, that theoretical risks outweigh potential
benefits, and that the use of "megadoses" of vitamin C is unjustified.
These statements have been supported by fallacious arguments and by misrepresenting
the evidence. It is hypothesized that the reaction of the medical establishment has been
influenced by a theoretical bias against vitamin therapy, the conflict of such therapy with
the platform of elitist control over health, and by the effect that megavitamin use might
have on the profits of the drug industry.

(72
5
The evidence supports Pauling's theory that vitamin C, or ascorbic acid, potentiates the
immune reaction of the body to disease as well as his claim that it will prevent and cure a
substantial percentage of colds. The most well-documented effect of ascorbic acid is its
effect on leucocytes. The review by Thomas and Holt (1978) of this effect shows that
leucocyte ascorbic acid levels are severely depressed under many conditions of ill health,
including viral infection, steroid therapy, and leukemia. Dietary supplementation with
ascorbic acid increases the phagocytic activity of leucocytes, and appears to stimulate the
production of interferon, as Pauling hypothesized.3
The oldest myth about ascorbic acid, that it is excreted after the body has attained a state
of "saturation", has no basis in fact. The studies of Johnson and Silva (1934) and Ahmed
(1936), and more recently, Harris et al (1976), show that no more than 30 to 50% of an
administered megadose of ascorbic acid is excreted as ascorbic acid. The latter authors
reported that healthy women metabolized 70% per cent of a 10 gram dose of ascorbic acid.
No side effects of ascorbic acid besides a small laxative effect have been demonstrated in
man. Many side effects have been postulated; however, none have actually ever been seen
to occur as a result of "megavitamin C" use (Thomas and Holt, 1978; Anderson, 1979). The
therapeutic and prophylactic effects of ascorbic acid, its action in potentiating the immune
system, the demonstrated
3Pauling, 1970. Page 38.

PART ONE

VITAMIN C: THE BOOK

CHAPTER 3
ORTHOMOLECULAR MEDICINE
Linus Pauling became interested in the effect of large doses of vitamins in treating illness in
the course of his research on the molecular basis of disease. This avenue developed as a
result of Pauling's theoretical and experimental inquiry into the structure of large
molecules such as proteins.
In the second half of the 1940's Pauling heard about sickle-cell anemia, a disease
characterized by the sickle shape of diseased red blood cells. He thought that the
hemoglobin protein might be responsible, and discovered that in fact the disease was
caused by an aberration on the surface of the protein that caused them to bind together
into large sickle-shaped aggregations (Pauling et al, 1949).
Pauling decided that he did not want to compete with his students and coauthors on the
subject of hereditary hemolytic anemias. So, he says,
"I decided...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. I chose to work on
mental illness, on the grounds that almost everybody was doing research on cancer while
practically nobody was doing anything in the area of mental illness."'
1Linus Pauling, interview, Mother Earth News, Jan./Feb. 1978. Page

8
Pauling received a grant of $450,000 from the Ford Foundation, and set up a group at the
California Institute of Technology in 1954. The group was to explore Pauling's belief that,
"significant progress can be made in the attack on mental deficiency by... fundamental
research employing the most powerful techniques of modern chemist-try... to understand
the causes and workings of certain abnormal molecules.“2
During this period Pauling became aware of the work of Abraham Hoffer and W.H. Osmond
in Canada on the use of niacin in the treatment of schizophrenia. Hoffer and Osmond had
found that massive doses of niacin were often beneficial to schizophrenics, and eventually
began to also administer massive doses of Vitamin C to patients, with similar positive
results.3
Pauling says,
"This intrigued me. I was fascinated by the idea that these substances, which you usually
take in very small amounts -- I believe the Recommended Daily Allowance for niacin is 16
mg daily and for vitamin C 45 mg -- could have valuable health-promoting effects when
ingested in amounts 100 or 1000 times
greater than the usual intake.... My initial interest in
Vitamin C was essentially my scientific interest, in that I'm always looking for something
new, something that made an impression... 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 a good
27ime, "Genes and Mental Defectives", Sept. 10, 1956. Page 110.
3Hoffer, Abraham. Niacin TheraDv11.1 Psychiatry, Springfield: Charles C. Thomas, 1962.

9
deal of evidence to support the idea that large doses of vitamins could be clinically
useful."4
"Orthomolecular Psychiatry" Pauling has said:
"The use of very large amounts of vitamins in the control of disease has been called
megavitamin therapy. Megavitamin therapy is one aspect of orthomolecular medicine. It is
my opinion that in the course of time it will be found possible to control hundreds of
diseases by megavitamin therapy."5
In 1968 Pauling published his paper "Orthomolecular Psychiatry" in Science (Pauling 1968).
This paper was the culmination of Pauling's theoretical exploration of the nature of mental
disease. Orthomolecular psychiatry, or using "the right molecules in the right amounts,"
involves "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 concentration
necessary for the best of health."6
One example of orthomolecular medicine is the treatment of phenylketonuria, a disease
resulting from a genetic defect which decreases the effectiveness of a liver enzyme that
catalyzes the oxidation of the amino acid phenylalanine to another, tyrosine. This results in
abnormally high body levels of phenylalanine, which cause among other things mental
deficiency and severe eczema. The disease is controlled by reducing the amount of
phenylalanine in the diet,
4Pauling, interview, 1978 op. cit. 5Pauling, 1976. Page 90.
6Pauling, interview, 1978 op. cit.

10
bringing internal levels down to normal.
In "Orthomolecular Psychiatry" Pauling cited a large number of studies which showed that
mental disease, particularly schizophrenia, could possibly be caused and at the very least
greatly influenced by an inadequate or excessive amount of particular chemicals in the
brain, and could be cured or alleviated by the use of orthomolecular methods to restore
the proper balance of chemical concentrations. He hypothesized that:
"A physiological abnormality such as decreased permeability of the blood-brain barrier for
the vital substance or increased rate of metabolism of the substance in the brain may lead
to a cerebral deficiency and mental disease. Diseases of this sort may be called localized
deficiency diseases. It is suggested that the genes responsible for abnormalities
(deficiencies) in the concentration of vital substances in the brain may be responsible for
the increased penetrance of the postulated gene for schizophrenia, and that the so-called
gene for schizophrenia may itself be a gene that leads to a localized deficiency in one or
more vital substances."
Pauling suggested that to treat schizophrenia, megavitamin therapy could be used raise the
concentration of nutrients in the body, causing increased penetrance of physiological
barriers by vital substances, and resulting correction of localized cerebral deficiencies.
Pauling's proposals for the treatment of disease are different from those generally used by
the American Medical Association and the American Psychiatric Association in that, first,
his methods do not involved synthetic drugs at all but natural body substances, many of
which are easily manufactured; second, they allow the patient to treat himself, often to the
point of being able to eliminate the costs and discomfort of continued orthodox medical
treatment.

11
Moreover, the methods Pauling espouses are aimed not at controlling the symptoms but at
actually correcting the defective mechanisms of the body which create those symptoms. As
such, it is a more fundamental and safe method of treating disease than many of the
methods and synthetic chemicals used in orthodox medical treatment.

CHAPTER 4
PAULING AND VITAMIN C
In March of 1966 Dr. Irwin Stone overheard a talk given by Pauling at the dinner honoring
Pauling's reception of the Carl Neuberg Award in New York. Pauling's comments that he
hoped to live long enough to see the discoveries of the next 15 or 20 years inspired Dr.
Stone to write him, saying that he wished Dr. Pauling would live another fifty years. Stone
enclosed reprints of four papers he had recently published on the relationship between
Vitamin C and good health (Stone, 1965, 1966a, 1966b, 1967), and prescribed a high level
Vitamin C regimen which he said would cure Pauling of colds forever.
Pauling thought Stone's papers made good sense, and he and his wife began taking three
grams a day of Vitamin C as Stone suggested. They discovered, somewhat to their surprise,
that Stone was right.
"My wife and I both noticed an increased feeling of wellbeing 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 catching bad colds over those years."1
Pauling has said, "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."2
ibid.
2Stuckey, W. "Plain Harold and Linus Superstar," Science Digest, August, 1976. Page 25.

13
This situation became apparent to Pauling during the period from 1966 to 1970. In
November 1969 Mademoiselle magazine ran an article quoting Dr. Frederick J. Stare, head
of the Nutrition Dept. at the
Harvard University School of Public Health, as saying, "Vitamin C and colds - that was
disproved twenty years ago." Stare described a study done at the University of Minnesota
by Cowan, Diehl and Baker (1942),
misrepresenting the study's size, duration, methodology, and conclu¬sions.3
Inspired by this bias to check further into the medical literature, Pauling found a 1967
editorial in Nutrition Reviews (1967) which reviewed ten studies of the effect of ascorbic
acid on colds.
The editor of Nutrition Reviews at the time was Frederick J. Stare. The author of the
editorial concluded that the studies showed that there was no conclusive effect of ascorbic
acid in curing the common cold, nor any evidence for a general antiviral or symptomatic
prophy-
lactic effect. In six of the seven controlled studies reviewed, the authors are reported as
being of the opinion that ascorbic acid seems
to be more beneficial than the placebo. The editorial author claims in each case without
stating why that the report is inconclusive. Moreover, in discussing the study of Ritzel
(1961), the author erroneously reported only a 39% reduction in the number of days illness
and a 36% reduction in the number of colds. The correct values were, respectively, 61%
and 65%, or more than twice as much.4
3Pauling, 1976. Page 3.

14
Linus Pauling wrote Vitamin C and the Common Cold, out of personal irritation with a
doctor who refused to acknowledge the evidence suggesting that vitamin C had a
preventive and therapeutic
effect on illness. In 1969, three years after Pauling and his wife began taking high dose
vitamin C on the advice of Irwin Stone, he was invited to speak at the opening ceremonies
of the Mount Sinai Medical School in New York. Pauling gave a short 10-15 minute talk in
which he mentioned the value of Vitamin C in preventing colds as something important to
medicine. Victor Herbert, one of the professors, attending the ceremony wrote Pauling
"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 dollars a year?' And he asked, 'Can you show me a single double-
blind study which indicates that Vitamin C has any more value than a placebo in fighting
colds?"
When he got around to checking the literature, Pauling found not one but six double-blind
studies, in which neither patients nor doctors knew if the patient was receiving a placebo
or the vitamin, which showed that vitamin C was more effective than the placebo in
fighting colds. Pauling sent this information to Herbert citing specifically a paper by Ritzel
(1961). First, according to Pauling, Herbert would not look up the paper, claiming he was
too busy. Upon receiving the paper forwarded him by Pauling, Herbert wrote him saying he
was not impressed by the work, but giving no reasons for his opinion. A further exchange
of letters followed, in which Herbert

15
claimed that Ritzel had probably, again without giving evidence, designed the study
incorrectly.
"The upshot of this whole thing," says Pauling, "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
and in two months wrote Vitamin C and the Common Cold."5.
Pauling wrote Vitamin and the Common Cold for much the same
reasons that he campaigned against the dangers of radioactive fallout in the 1950s. In each
case he was motivated by his concern for human welfare, and by his irritation with an
established interest group which was denying that its activities were actually hurting the
peo¬ple.6

ibid. Linus Pauling, personal interview, January 1, 1983.

CHAPTER
VITAMIN C AND THE COMMON COLD
Judging by the reaction of a number of reviewers, Vitamin and
the Common Cold is an easily misunderstood book. Although it is short and clearly and
easily written, the line of argument Pauling puts forward is rather complex, especially in
the structure of his specific premises. Therefore, in order to clarify the nature of
Vitamin Ana the Common Cold, I will first summarize very briefly
Pauling's order of argument. Then I shall divide my analysis into two parts. Pauling builds a
theory of Vitamin C action in man by synthesizing a great deal of information. Each
important premise will be measured against the weight of criticism it might have received,
if any, in the ten years following the publication of Vita-
min and the Common Cold. Pauling's logical addition will be
evaluated. Is it correct? Does it need to be modified?
Then I shall ask, what are the implications of Pauling's theory? Pauling worked out his
theory after seeing the evidence; by analyzing his case in the opposite directions we can
tell if the theory he built explained the implications he saw in the studies done on Vitamin
C and colds. Having examined the theory, we will examine the evidence to see if it supports
the hypotheses that Pauling draws about the effect of ascorbic acid on the common cold.

17
Finally, Pauling's recommendations for curing the common cold will be discussed, and the
possible success of the regimen evaluated.
It has proved difficult for the medical establishment to understand Pauling's arguments,
perhaps because of the order of his exposition. He presents chapters on: the Common
Cold, Scurvy, The Discovery of Vitamins, the Properties of Ascorbic Acid, Ascorbic Acid and
the Common Cold, Vitamin C and Evolution, Orthomolecular Medi-cine, Human
Biochemical Individuality, Vitamin C and Drugs Compared, and How to Control the
Common Cold.
The discussion of scurvy, vitamins and orthomolecular medicine, while informative, is
extraneous to the case he is making. Biochemical individuality is a necessary consideration
in evaluating the implications of the theory developed in Vitamin C and Evolution, and The
Properties of Ascorbic Acid. Evidence that the theory is correct is collected in Ascorbic Acid
and the Common Cold. The action implications of this confirmation are presented in
Vitamin C and Drugs Compared, and How to Control the Common Cold.
I. The Theory of Human Ascorbic Acid Requirements
Pauling's theory of vitamin C action in man is, essentially, that evolutionary and
environmental factors have created in man the need for an intake of from 250 mg to 10 g
of ascorbic acid a day for optimum health. He arrives at this position through reasoning by
analogy and consideration of specific evolutionary advantages to an organism which does
not have to synthesize vitamins.

18
Man, the higher primates, and a very small number of other animals, including the guinea
pig, are the only organisms which cannot synthesize ascorbic acid. How could this come
about? Pauling draws on an extremely interesting experiment in evolutionary competition.
Zamenhof and Eichhorn (1967) studied competition between two strains of a bacterium,
Bacillus subtilis, which differed only in a single characteristic, the ability to synthesize the
amino acid tryptophan. One strain could synthesize tryptophan; the other had lost the
biochemical machinery necessary to synthesize it.
When the two strains were grown together on a medium which had every nutrient except
tryptophan, the mutant Bacillus strain which had lost the ability to make its own
tryptophan died out. It could not survive in such a deficient environment, regardless of
competition from the normal strain. However, when the two strains were grown together
on a medium containing adequate tryptophan, something surprising happened. The
mutant strain, which did not carry around the now superfluous machinery for synthesizing
tryptophan, survived, and the normal strain died out after an average of about 50
generations. Zamenhof and Eichhorn concluded that the burden of using the machinery for
tryptophan synthesis was disadvantageous to the strain possessing this ability, and
hampered its competitive ability to the extent that it failed in competition with the less
burdened mutant strain.
The common ancestor of man and the higher primates must have

19
the ability to synthesize ascorbic acid. If no competitive advantage was gained the mutant
type would have died out. This ancient animal and its descendants could only have
survived if their environment contained enough ascorbic acid. The fact that no ascorbic
acid-synthesizing primates have survived is testimony to the fact that the environment
contained enough ascorbic acid that the mutant strain had a selective advantage over the
normal type.
We can assume that any organism would not synthesize more ascor¬bic acid than it needs,
that is, more than the optimal amount, for to do so would be a wasteful expenditure of
energy. In order for a mutant to replace the normal type the diet must have contained at
least the optimal amount of ascorbic acid; any lesser amount would be suboptimal and
would offset the advantage gained by losing the synthesis machinery.
The fact that most species of animals have not lost the ability to manufacture their own
ascorbic acid shows that the supply of ascorbic acid available generally in foodstuffs is not
sufficient to provide the optimum amount of this substance. Presumably enough is
synthesized so that the combined ingested and synthesized amounts of ascorbic acid are
optimal for the animal.
The question remains, then, how much ascorbic acid existed in the diet of man's ancestors?
There are two ways of estimating this,
by analogy and by extrapolation. I have shown that there could not have been less than the
amount of ascorbic acid synthesized by the normal type in the diet of a mutant if it was to
survive. This

20
provides an opportunity to work backwards by analogy from the amount of ascorbic acid
synthesized by other animals to the amount that must have been in the diet of man's
mutant forebears. Pauling quotes Irving Stone (1966) about the amount of ascorbic acid
synthesized by the rat. This creature synthesizes between 26 and 58 mg per day per
kilogram of body weight. "If the assumption is made that the same rate of production
would be proper for a human being, a person weighing 70 kg should ingest between 1.8
and 4.1 g per day under ordinary circumstances."1
This assumption has been questioned. Beaton and Whalen (1970) note that the
extrapolation should be based on metabolic size, or w0.75 , not on weight. Beaton and
Whalen note, however, that even so the amount a man should need is still substantially
greater than the Recommended Daily Allowance of the Food and Nutrition Board. I
calculate that the amounts necessary using Beaton and Whalen's values for extrapolation
are from 1.3 g to 3.1 g per day of ascorbic acid as the amount ingested by man's ancestors.
This of course assumes that the biochemical processes for which ascorbic acid are used are
essentially the same in the rat as in the human being, but this assumption is quite
reasonable (the rat is one of the most useful experimental animals in the testing of drugs,
for example).
Pauling also calculates the amount of ascorbic acid in man's ancestral diet by extrapolating
from the average amount of ascorbic acid contained in 110 raw natural plant foods. The
amount of
1 Pauling, 1970. Page 41.

21
vitamins contained in 2500 kilocalories worth of these plant foods, about the amount of
energy required per day for a man, is found to be around 3 times the RDA of most
nutrients. However, the amount of ascorbic acid in this much plant food is 2.3g, or 42 times
the RDA. "Therefore," says Pauling, "I conclude that 2.3 g per day is less than the optimum
rate of intake for the adult human being."2
This conclusion only holds, however, if we assume that man's ancestors ate nothing but
vegetables. However, if we assume that only 50% of the ancestral diet was fresh
vegetables, the rest being meats, nuts, and grains, then we are still left with evidence that
our ancestors received over a gram a day of vitamin C in their food. The amount is lower
still if the fresh vegetables were generally of types low in Vitamin C content. However,
Bourne (1949) has noted that gorillas receive about 4.5 g of ascorbic acid per day in their
diet; this lends weight to the hypothesis that man's ancestors also had a relatively high
vitamin C intake.
In considering the amount of Vitamin C that is optimal for an individual, Pauling notes that
biochemical individuality is capable of producing widely-differing responses to the same
amounts of a substance. To support this he describes the work of Williams and Deacon
(1967), showing that there is at least a twenty-fold range in the Vitamin C needs of
variability in humans of the amount of Vitamin C needed to prevent scurvy, a variability
which is due possibly to "conditioning" or increased metabolism of Vitamin C due to a
period
2Pauling, 1970. Page 63.

22
of high intake, or to congenital diseases which reduce the amount of Vitamin C which is
required to prevent scurvy. This evidence, he concludes, also points to a twenty-fold
variation in optimal allowances of Vitamin C in humans.
Pauling concludes: "The optimum daily intake of ascorbic acid for most human beings lies
in the range of 2.3g to 9 g. The amount of individual biochemical variability is such that for
a large population the range may be as great as from 250 mg to 10 g or more per day"3
It has been reported that some physicians question this conclusion, arguing that man is
capable of adapting to different environments, which provide different nutrients .4 But a
moment's reflection on human history will convince the reader otherwise. It is not possible
that our vitamin C requirements could have adapted to keep pace with the rapid change in
diet since the Industrial Revolution, when whole populations first started depending
exclusively on foods supplied by others often days after its harvesting.
As can be seen, Pauling's theory of human vitamin C requirements is an approach which
can be used for determining the necessary daily allowances of all vitamins. Pauling saw
evidence which inspired him to look at Vitamin C specifically, not just as one of a class of
substances whose deficiency induces disease. The general case for Vitamin C is not that it
reduces the incidence and severity
3Pauling, 1976. Page 63.
4O'Neil, P. "Vitamania". Life, September, 1971. Pages 72-80.

23
of colds, but that most people today are suffering from a severe vitamin deficiency induced
by rapid changes in dietary habits. Given such a situation, it is hardly surprising that illness
in the population can be reduced by raising the level of nutrition back up to where it was
optimized by evolution.
The evidence for the reduction of colds is not a conclusive argument in itself; an
explanation why such is the case must be acceptable. Equally, the argument cannot be
negated by merely ques-toning the validity of the evidence. If the general theory still
stands, then all that a critic can prove is that a particular piece of evidence does not
confirm the predictions of the theory. This by no means invalidates the theory, especially if
the theory is of the statistical evolutionary kind that Pauling has developed. It usually just
forces proponents to find another piece of evidence to confirm
it.
II. Confirmation of the Theory
The Pauling theory of human vitamin C requirements is prior to
the confirmation of that theory by the evidence he supports it with. Now we need to look
at the implications of the theory to see if the evidence confirms it.
Pauling notes in the chapter on the Properties of Ascorbic Acid that ascorbic acid has been
shown to be essential to the formation of
the colloidal substance which serves as a pliable cement to bind tissue cells together. In the
absence of ascorbic acid the cells tend

24
to separate, causing the hemorrhaging typical of scurvy symptoms.
Ascorbic acid is necessary for the healing of wounds and the formation of strong scar
tissue, as would be expected from its cellular binding properties. It has been used in large
amounts for the treatment of burns, injuries, infections, rheumatism disease, allergies,
back troubles, and infectious diseases.
Pauling states:
"Part of the mechanism of protection against disease is the destruction of bacteria by
certain white cells in the blood, the phagocytes. In order to be effective in this way, the
phagocytes must have a certain concentration of ascorbic acid in them. This fact provides a
partial explanation of the effectiveness of ascorbic acid in providing protection against
bacterial infection.... I have formulated the hypothesis that the effectiveness of ascorbic
acid in providing protection against virus diseases results from its function in the synthesis
and activity of interferon in preventing the entry of virus particles into the cells."5
Pauling notes that his hypothesis has not been tested; however, some form of functional
hypothesis is necessary to explain the evidence that ascorbic acid increases resistance to
viral infection.
It has been claimed that ascorbic acid is a panacea (Stare, 1971) a new nostrum (Passmore,
1971), that is, a magic bullet whose advocates think it can cure anything.
"One may ask how it is that Vitamin C can protect 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 carried out by three people - R.H. Yonemoto, P.E. Chretian, and
T.F. Fehniger - at the National Cancer Institute. These
5Pauling, 1970. Pages 37-38.

25
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 3
days showed a doubling in their rate of lymphocyte production."'
Obviously, one of the most important functions of vitamin C is in potentiating the reactions
of the immune system. Again, we need to relate this to Pauling's theory of Vitamin C
requirements. If it is true that our immune system evolved with a daily intake of over a
gram of ascorbic acid, which seems reasonable, then an intake at the current RDA of 45 mg
puts the immune system under a severe handicap. From the study Pauling describes above
and the known information about the requirements of ascorbic acid for proper phagocytic
activity, an intake at the amount of the RDA forces the body to function with its immune
system at less than half-strength. Further, we should expect that such an intake would in
general cause the intercellular cement to be weaker, and cells thus more susceptible to
invasion by viruses and bacteria.
III. Ascorbic Acid and Colds
If Pauling's evolutionary theory is correct, then a widespread increased intake of ascorbic
acid should lead to a decrease in the number of infections in a population. Pauling
describes two controlled trials which show that an increase in vitamin C intake caused a
substantial decrease in the number and severity of colds in the study group. In the third
appendix to Vitamin D_And. ,the Common Cold
6Pauling, 1978, op. cit.

26
Pauling describes the results of eight more studies which show that administration of
ascorbic acid in varying amounts generally increased resistance to cold viruses.
In response to the criticism of his evidence by reviewers Paul¬ing published a paper on
"The Significance of the Evidence about Ascorbic Acid and the Common Cold" (1971).
Pauling averaged the P values for the results of 14 double-blind trials of ascorbic acid and
concluded that the evidence rejected the null hypothesis that ascor¬bic acid has no effect
on colds. This is an interesting change in Pauling's argument - the emphasis has changed
from a positive state¬ment that high-dosage vitamin C can prevent colds to a simpler proof
that Vitamin C has an effect on colds and should therefore be recom¬mended for
preventing and treating them. Although the evidence does not show that Vitamin C will
cure a particular cold, it will help prevent and alleviate them. The facts that it is quite
harmless and reasonably efficacious justify its use.

CHAPTER 6
THE NATURE OF THE EVIDENCE
Because the controversy over the effects of megadoses of vitamin C has concentrated on
the evidence Linus Pauling has gathered to support his thesis that it should be widely used
to prevent and treat illness, an explanation of the nature of his evidence is required. It will
be seen that the controlled trial, the only widely-accepted test of therapeutic effects, is
unlikely to show that vitamin C use can prevent or cure all colds because of the inherently
idiosyncratic response of individuals to specific vitamin C doses. The implications of this for
the vitamin C controversy will be discussed.
Pauling relies on two studies, those of Cowan, et al (1942), and Ritzel (1961), for proof that
vitamin C can prevent and alleviate the common cold. Both of these studies were
controlled trials with randomization of the subjects.
Speaking of methods for evaluating the effect of a substance on illness, Dr. Henry E.
Simmons, director of the FDA's Bureau of Drugs, asserted, "If I had to pick one method, I
would choose the controlled trial. It provides the best assurance of efficacy that I know
how to make late in the 20th century"1
1Harvey, J.H., American Self-Dosage Medicines, Laurence, Kansas: Coronado Press, 1974.
Page 54.

28
The best kind of controlled trial in therapy evaluation is the double-blind trial, where
neither the patient nor the administering physician knows whether the patient is receiving
the actual therapeutic agent or a placebo. All the records are kept by a third party who is
not associated with the patient-doctor interaction. This is the only form of trial which can
eliminate the placebo effect, where a patient or doctor is so convinced that treatment is
taking place that sometimes astounding recoveries can occur even when the therapy is
fake.
Studies done in England and the U.S. have shown that the power of placebos is amazing .
Rachman and Philipps, in their book psychology and Medicine, describe several studies
which show that large numbers of people experience powerful effects, beneficial or
adverse, when they take inert substances disguised in the form of pills. Also, there is
independent evidence that the attitude of the prescribing doctor to his tablets and the way
in which this attitude comes across to the patient are in fact important factors in the
patient's reaction to placebos.2
Dykes and Meier (1975) note that this is an especially important consideration in those
situations where evaluation depends substantially on a subjective report by the patient, or
where there is a substantial element of judgement required of the investigator:
"The evaluation of symptoms of the common cold involves both
of these elements, and it has been generally recognized that

29
only carefully controlled studies can provide useful evidence on the prophylaxis and
therapy of this condition.... Because of the great variability in experience with colds from
one subject to another, and because of the considerable subjectivity inherent in the
evaluation of a cold, even a slight fault in experimental design or procedure may open the
way to a bias of considerable magnitude."
The question of significance of the results of a study is also important. The highest
generally accepted level of statistical significance is when P = .05, that is, when the
probability that a deviation as large as the one observed would not occur more than five
times in a hundred if there were no differences due to the treatment. As Pauling (1973) has
said, however, "It is not necessary that the results of a study be significant at the
customary level of P =.05 (which is quite arbitrary) in order to constitute evidence." If the
probability that a deviation larger than the one noticed in a controlled study is greater than
.05, that does not mean that the deviation is not due to the agent being tested. For
example, if the P level is 0.10, a level at which most investigators would reject the evidence
as too uncertain, the probability that the agent was responsible for the deviation is still
90%. This is a high level of probability. As Pauling says, though, investigators have
arbitrarily made the demanded level of probability 95% or higher, so that they can be as
certain as possible that the agent under investigation is responsible for the effects seen.
This is important to the vitamin C controversy because almost every study that has ever
been done on the effects of vitamin C has shown some effect of the vitamin. However, in
some of the studies

30
the effect has not been significant at the P < .05 level, and the investigators have concluded
that no effect has been shown. For example, Anderson, et al (1972) reported that their
study of the effect of one gram per day and more during illness of vitamin C showed a 7%
decrease in the number of colds of the vitamin group as compared to a placebo group. This
difference was not statistically significant, as the probability that such a result would occur
at random was about eight times in a hundred. This does not mean that no effect was
shown; however, the results of Anderson, et al were cited as proving that vitamin C does
not decrease the incidence of colds (Thomas and Holt, 1978).
There is general agreement that in order to test the effectiveness of ascorbic acid the best
studies are those which involve large numbers of people over extended periods of time
(Anderson, 1974; Dykes and Meters, 1975). Such studies minimize the probability of
individual variations affecting the results.
What should be expected from such studies? Pauling's theory of Vitamin C requirements
assumes that a daily intake of 2 g per day of Vitamin C is less than optimum for most
people, and that the optimal amount may range from .250 mg to 10 g per day.
No studies have been done which have given subjects more than two grams of vitamin C
per day. Thus according to Pauling's theory, which has not been challenged, no studies
have been done which have given optimum amounts of Vitamin C to even half of the
people involved. Hughes (1977) has made the only acknowledgement of this:

31
"It would appear that no matter how perfectly one structures a survey of this type the
results are unlikely to approach an all-or-none type of response. A number of factors could
contribute to this situation: (1) Ascorbic acid could be effective against only a small
proportion of the viruses involved in the common cold: (2) a genetic factor could establish
a biochemical individuality in terms of an infection-ascorbic acid response; (3) the
relationship could be of a secondary or "derived" nature involving one or more of the AA
metabolites - about which very little is known - or a quite separate 'mediator' molecule."
All three of Hughes' suggestions are quite reasonable. I have a feeling, though, that his
third suggestion concerning AA metabolites may be very important. Most people believe
that Vitamin C above the body's daily needs is excreted in the urine. This belief has been
fostered by the medical establishment, in direct contradiction of the evidence (Abt and
Farmer 1938; Stare, 1971; Wolf, 1981). The studies of Johnson and Zilva (1934), Ahmed
(1936), and Harris et al (1976) show that when 1 g to 10 g of Vitamin C is administered,
only 30 to 50% of the vitamin is excreted.
Harris et al administered 10 g of ascorbic acid a day to healthy women, and found that not
more than 30% was excreted. Thus at least 7 grams must have been metabolized. Harris
(1979) states that increasing the dosage of does not increase the blood plasma
concentrations of the vitamin. Hume and Weyers (1973) show that the amount of
leucocyte (white blood cell) vitamin C does not increase, regard-
less of dosage size. This inconsistency is confusing; what happens
to all that vitamin C? It must be metabolized, but, as Hughes says, very little is known about
such metabolites. If Pauling's theory of Vitamin C requirements is not correct, then a
theory must be

32
developed to explain why the human body can metabolize five grams of Vitamin C a day.
In his conclusions about the evidence for a beneficial effect of Vitamin C on colds Pauling
cited Dr. Edmund Regnier's observation that a person must not suddenly stop taking large
doses of Vitamin C (Regnier, 1968). This is because of a well known rebound effect: when
the body adjusts the metabolization rate of vitamin C upward to compensate for additional
vitamin C in the diet, as the above discussion shows it does, sudden cessation of vitamin
supplementation causes the body pool of Vitamin C to be used up faster.
T.W. Findley (1976) has raised this point in connection to large-scale field trials:
"If one accepts Pauling's reasoning that cessation of daily intake of vitamin C results in
abnormally low levels of the vitamin haphazard ingestion of the tablets may well prove
deleterious to the health with increased susceptibility to illness on the days when blood
levels are low after failure to ingest the daily dose. Any illness might lead to failure to
ingest the vitamin at a time when it is most effective, the early stage of illness; this may be
also be the time when failure to take Vitamin C could be actually unhealthy."
As Pauling writes in Vitamin L. and the Common Cold, "1 g taken at once when the first
sniffle is noticed may protect, 1 g two hours later may fail to protect".3 Most of the large-
scale trials of vitamin C were done by giving people tablets to take in their homes; results
were evaluated using cards on which the subjects described the incidence and severity of
colds. One must suppose that the vitamin
3Pauling, 1970. Page 102.

33
and control groups are equally likely to miss a pill or two, or a few days worth of doses.
Both groups should have experienced the same likelihood of rebound effects from missing
a dose. If a benefit from ascorbic acid is shown then this consideration implies that the
ascorbic acid would have been even more effective if every dose was taken on schedule.
However, if no effect of ascorbic acid is shown, there is a possibility that each of the test
groups missed enough doses to cancel out the effect of the ascorbic acid. This conclusion is
by no means proven. However, it cannot be discounted.
The medical establishment has insisted that well-controlled double blind studies are the
only way of determining whether ascorbic acid has an important clinical effect on colds.
According to the theory of vitamin C requirements such trials are unlikely to give even half
of a typical population the optimum amount of protection against colds. The doubtful
ability of a large population to take all its pills all the time creates the possibility of rebound
effects leaving a delinquent subject more than usually susceptible to illness.
I conclude that Hughes' hypothesis is correct. It is impossible for such a study to show all-
or-none response; the doses are too low, and the trial structure is unable to cope with the
unique characteristics of ascorbic acid. Significant effects as compared to a placebo can be
shown, but they are unlikely to be large, for the same reasons. This seems to imply that a
substantially different
approach will have to be developed to evaluate accurately the effectiveness of vitamin C in
preventing and alleviating illness in large populations. At the least, the criteria demanded
in the testing of drugs cannot be used without modification in the evaluation of vitamins.
In its enthusiasm to show that vitamin C is useless in fighting colds the medical
establishment has often translated "no statistically significant effect" as "no effect". This
seems to be a necessary ruse on their part, for complete honesty would demand that they
admit that the overwhelming majority of studies done on the effect of Vitamin C in fighting
colds have shown some real effect.
In concluding my discussion of the nature of Pauling's evidence, I must make one thing very
clear. Pauling has made no errors in reporting studies or the statements of researchers. He
has made errors I think only twice: in extrapolating the optimum amount of vitamin C in
rats to man by weight rather than metabolic size (the correct method still supports his
conclusions); and in assuming that man's early ancestors were herbivorous and not
omnivorous (again, the difference does not affect his theory). I have not found any others,
nor has the medical establishment, who would very much like to do so. The theory of the
Vitamin C requirements of man has not been challenged; orthodox medicine has been
limited to claiming that his theory is unproven and his recommendations unjustified.

CHAPTER 7
QUACKERY, HERESY, AND ORTHOMOLECULAR UNORTHODOXY
Cortez F. Enloe, editor of Nutrition Today, wrote in a 1971 editorial that he had been at a
recent conference where Vitamin _Q And the Common Coati was the rage of conversation.
Not one person, he found, "would admit to having even read the book.". Enloe found much
to admire in Pauling's "heretical little book"; his peers obviously were not willing to stoop
to an acquaintance with "heresy."
Vitamin .Q and the Common Cold has been characterized as a sales pitch by a paid tool of
quacks (Bing, 1971; Jukes, 1975b; White, 1975b), and Pauling has been called socially
irresponsible for writing it (Stare, 1971). The fact that a Nobel Prizewinner should be
engaged in such activities leaves some sadly shaking their heads (White, 1975).
Given the rigor with which Pauling makes his case, and his consistent accuracy and
comprehensiveness of fact, we must ask what is meant by "unorthodox" here. The ten-
point profile of health quackery developed by Prof. Young describes the fundamental
nature of most of the health unorthodoxies of the past. Therefore, we may use this tool to
see if the definition of unorthodoxy as applied to Vitamin L, (Young, J.H., "Laetrile: A
Historical Perspective", in G.E. Markle and J.C. Petersen, politics, Science, and Cancer: The
Laetrile Phenomenon. Boulder, Colorado: Westview Press, 1980, for the American
Association for the Advancement of Science. Quotations explaining headings are Young's.

36
and the Common Cold carries the same implications as it did for the "toadstool
millionaires."
1. Exploitation of fear:
"Quacks have traditionally scared their victims with disturbing language, frightening
pictures, and grim statistics, stressing pain and threat of death."
Objectively, Pauling's work does not fit this category. He is clinical in describing the
symptoms of colds and scurvy, and quite matter-of-fact in his estimations of the annual
economic costs of the common cold.
Promise of painless treatment and good results:
Pauling not only promises that ascorbic acid is virtually painless and certainly harmless, but
that the literature shows that it works. He also invokes the promise of Utopia, as a world
without colds would be to anyone in the middle of a bad one. To attain Utopia, he does
propose both a plausible mechanism and historical precedence for the complete
disappearance of colds from a population. However, Pauling does not claim that ascorbic
acid is a certain cure for colds. He claims that it raises the natural powers of resistance, so
that a greater proportion of the people would never get colds, and most of those that do
should get better faster.
Claims of a miraculous scientific breakthrough:
"Marvelous new discoveries are dime-a-dozen in the literature of quack promotions."

37
Pauling does nothing except present the existing evidence for public scrutiny, and offers
more evidence to support the implications it has.
4. One Cause/One Therapeutic System
"Quacks often win allegiance to their doctrines by promising to end confusion and doubt
and to make complexity simple and comprehensible to the untutored mind. Disease, the
quack says, has but one cause. One treatment, therefore, is all that is needed to fight it."
Ascorbic acid is an essential nutrient which potentiates the body's immune system. Use of
large doses, Pauling says, will make it much less likely that one might catch most diseases.,
Specifically, low levels of ascorbic acid have been shown to increase susceptibility to
infection, and high levels to reduce it. Certainly Pauling never says that any disease but
scurvy is caused by ascorbic acid deficiency.
5. The Galileo Ploy:
"The unorthodox say the orthodox are wrong; just as earlier critics condemned pioneering
explorers, inventors, and scientists. We are, the unorthodox assert, today surrounded by
blind men but are destined to be the heroes of future generations."
Pauling wrote his book because he felt that the orthodox establishment was deliberately
holding a blind eye to the evidence. However he never equates his efforts with any kind of
self-gratification other than that of seeing the health of more people improve. It should be
remembered here that Pauling is the only person to have won two unshared Nobel Prizes.
He has been accused of being a lover of

38
the limelight;2 if such is his reason for publicizing megavitamin therapy then we must also
assume that such was his reason for discovering the cause of sickle-cell anemia, the
complementarity of antibodies and antigens, the general theory of anesthesia, and his 40-
year campaign for nuclear disarmament, all of which brought him national attention.
6. The Conspiracy Theory:
"The scientific establishment doesn't dare recognize the validity of my great discovery, the
quack claims, for it will undermine their power and prestige and eliminate their jobs."
In considering the reasons for the lack of enthusiasm among physicians for an effective,
harmless, cheap substance, Pauling says, "Another factor has probably been the lack of
interest of the drug companies in a natural substance that is available at a low price and
cannot be patented" In 1960 Pauling called for socialized medicine and condemned the
prevalence of economic self-interest over concern for the patient's welfare in the AMA.14
A possible economic conspiracy is implied by Pauling; he also suggests fear of toxicity and
preference for sure cures as sources of bias. An argument that will be advanced later in the
discussion of orthodox resistance to megavitamin therapy will show a political difference
between medicine and other sciences which makes Pauling's implication one of
professional rather than purely scientific conspiracy.
2Stuckey, op. cit.
3Pauling, 1970. Page 4.
New York Times, June 1, 1961.

39
7. Shifts to adjust to circumstances:
"Quackery has never felt obliged to retain a given posture if some change might offer
greater prosperity or safety. In the 19th century a cold cure that wasn't selling became a
stomach remedy and reaped huge profits."
So far no medical evidence has appeared to alter Pauling's opinion that he is right;5 it is
unlikely that any will, if his theory of evolutionarily-developed optimal intakes is correct.
8. Reliance on Testimonials:
"Through history the testimonial has been a major weapon in the arsenal of quackery.
When someone just like you or me says, with urgent sincerity, 'I was cured,' the persuasive
power ranks high."
Despite claims by orthodoxy that Pauling’s theory relies mainly on testimonials (Passmore,
1971; Stare,1971; Medical Letter, 1970; Thomas and Holt, 1978), the only such evidence is
his statement in the introduction of Vitamin S. and, the. Common Cold that taking 3 g a day
of vitamin C made him and his wife feel better. Pauling also does not claim that he has
been cured of colds, although he says he thinks he has beaten one or two off with vitamin
C.6
9. Distortion of the ideas of freedom:
"Before food and drug laws were enacted, quacks waved the banner of 'freedom' to smear
criticism aimed at them by physicians and pharmacists."
The freedom to use megavitamin therapy for serious illness has
Pauling, personal interview, January 1, 1983. Pauling, 1978, op. cit.

40
been fought for by unorthodox medical and political groups.? These
groups have been instrumental in preventing the Food and Drug Administration from
classifying vitamins as drugs or requiring limits on their strength. Pauling has supported
these political actions,
but denies that he has any association with these groups beyond the sharing of a belief in
the right of people to know the facts and to maintain their health themselves.8 The
president of the American Medical Association has said that Pauling is a spokesman for one
of these political groups (White, 1975), a charge that was obviously false and seriously
implicates its author (Sackler, 1976).
10. Large sums of money are involved:
"It was Oliver Wendell Holmes who termed 19th Century nostrum vendors 'toadstool
millionaires'. They might not make a million, but money was their goal."
Ascorbic acid is not patentable and is relatively cheap. It is made in the U.S. by only four
companies, the largest of which, Hoffman-Larouche, Inc., supports the Linus Pauling
Institute of Science and Medicine with $100,000 per year, which is about 5% of its
operating budget.9 Of course, money is also the objective of the drug industry which
makes thousands of chemicals for the treatment of
disease, and of many doctors and health specialists.
Professor Young's profile of health quackery does not fit Vita-
gam Ana The Common cold at all well. Only in one category,
7Marckle and Petersen, 1980. Page 161.
8Pauling, 1970. Pages 105-109.
9Linus Pauling, personal interview, January 1, 1983.

41
conspiracy theory, does Pauling echo the arguments of health promoters and quacks of the
past. Pauling leaves it to Dr. Douglas Gildersleeve to make the accusation; Gildersleeve,
as an insider, describes his personal experiences that led him to his conclusion that the
medical establishment is resisting vitamin use because the drug industry, which advertises
in medical journals, and doctors themselves stand to lose money if people take vitamins
instead of patent medicines."
Russell V. Lee, Professor of Medicine emeritus at Stanford University, has noted that "in
making his points, [Pauling] has followed proper scientific guidelines -- review of the
literature, formulation of a hypothesis, experiments (on himself) to validate the non-
toxicity of these large doses, and conclusions based on these data" (Lee, 1971). As there
does not seem to be anything scientifically unorthodox about Vitamin sand I. Common
Cold, I can only conclude that the term as used by the medical profession can only mean
"Counter to our professional interests."

10Pauling, 1970. Pages 48-49.

PART TWO

VITAMIN C: THE MOVIE

CHAPTER 8
PROLOGUE
The debate over Pauling's evidence is one of "significance" and "conclusiveness." Both of
these are terms of opinion which are the prerogative of any person. My own concept of
what constitutes "good" science is firmly idiosyncratic; therefore, in tracing the history of
the scientific debate over the effects of vitamin C my definition of "good" science will be
merely that which is not logically fallacious. That is, I shall limit myself to examining
whether sources are cited or described properly, whether the author contradicts himself, if
experiment design is reflected in the conclusiveness of the author's opinion about his
results, whether generalizations are supported, and whether the author has his facts
straight. I assume an author is correct until and unless he is she is shown to be wrong, by a
sound argument.
A sound argument is any argument which S. Morris Engel, author
of With Good Reason: An Introduction Informal Fallacies,-1- would
not want to put in his book as an example. Engel defines many types of fallacious
arguments which are used to justify unfounded conclusions. One of these fallacies is of
particular relevance to the controversy over the effects and use of vitamin C in alleviating
illness. Engel defines the fallacy of an appeal to ignorance as an

43
assertion that an opponent's inability to disprove a conclusion is proof of the conclusion's
correctness. He gives as an example:
"The chiropractors have failed utterly in their attempts to establish a scientific basis for
their concepts. This ques-
tin can be therefore settled once and for all. Chiropractic has no basis in science."2
In other words, if you can't prove you are right, you must be wrong. This argument
assumes first that the speaker knows what is "right", second, that he can correctly discern
proof, and third, that the other will never be able to prove that he is right.
In a controversy over health, however, a corollary to this fallacy exists which can justify it. If
a proposed therapy has not been evaluated for safety, or is known to be toxic or
dangerous, it is logical to assert: "Since you can't prove you are right, and the safety of your
therapy is in question, you should not be allowed to dispense your therapy to un-informed
people. If you can prove that it is effective, then its benefits must be weighed against its
risks; if the balance is positive, then you are right to dispense the therapy."
To evaluate whether this argument may be used to control something like the use of
megadoses of Vitamin C, one thing, safety, must be known. The evidence of safety is prior
to that of efficacy; of course, if a drug is definitely useless it should not be recommended
even if it is safe. Whether "chiropractic" has a place in science is different from whether it
has a place in medicine, as I have shown.
2Engel, Page 125.

44
Whether Vitamin C has a basis in medicine depends on its safety and efficacy.
In describing the arguments used in the debate I refer definitions of informal fallacies to
Engel's book. I will try to define them as best I can.

CHAPTER 9
THE RESPONSE TO ORTHOMOLECULAR PSYCHIATRY
Pauling's paper "Orthomolecular Psychiatry" (Pauling 1968) drew a response which in
substance and style foreshadowed the response to Vitamin C and the Common Cold.
Donald Oken, of the National Institute of Mental Health, said in a letter to Science:
"The article, ‘Orthomolecular Psychiatry' illustrates elegant¬ly the pitfalls which occur
when an expert in one field enters another area. With his characteristic brilliance, Linus
Pauling describes a biochemical mechanism which could be responsible for some forms of
mental illness (or, indeed, for illness of many other types)...Unfortunately for Pauling's
thesis there is no adequate evidence to back up his view... The published reports
suggesting that vitamin therapy may be useful in mental illness, several of them cited by
Pauling, uniformly display serious methodological flaws,...which render them worse than
useless." (Koen, 1968).
Oken implied that Pauling's proposed therapy would increase the suffering of the mentally
ill: "The suffering of the mentally ill and the distress of their friends and families creates a
situation where in every new 'finding' appears to be a 'breakthrough' which is grasped as a
straw." Pauling is thus implied to be guilty of encouraging the hopes of these people with
false promises.
Finally, the conclusion that Pauling doesn't know what he's talking about:
"The article is replete with statements of personal belief and opinion. If the topic were
molecular biology, one could readily accept such views.... But it is unfortunately evident
that he is unfamiliar with the subtleties of methodology in a field in which he is
untrained.... It would be regrettable

146
if the impact of his prestige and brilliance in other fields led readers to believe otherwise
and to accept unwisely what remains on the basis of current knowledge, a wild
speculation."
As evidence of Pauling's ignorance of the field, Oken discusses the work of Ackerfeldt
(1957), which Pauling reviews. Ackerfeldt's studies, he says„ have "become a classic case in
the social psychology of mental health research; it is used as a proto-typical example in
teaching residents and students the dangers of lack of proper attention to controls."
But does Pauling cite Ackerfeldt's authority? No, in fact, he does not. Pauling describes how
researchers investigating Ackerfeldt's claim of discovery of a new test for schizophrenia
found that a positive result to the test "is due to a smaller concentration of ascorbic acid in
the serum of schizophrenics than of other persons. This difference has been attributed to
the poor diet and increased tendency to infectious diseases of the patients, and has also
been interpreted as showing an increased rate of metabolism of ascorbic acid by patients"
(Pauling 1968).
In the one example Oken gives of Pauling's inability to understand the methodology of
disciplines other than his own Oken ignores both what Pauling actually said in his paper
and the important implications the Ackerfeldlt case actually has for Pauling's thesis. Even
more damaging to Koen’s case is the fact that he ignores the conclusions of the authors
who he offers to support his claim that the studies relating possible vitamin therapy to
treatment of schizophrenia

117
"uniformly display serious methodological flaws... This point has been well-documented by
both Kety (1957) and Benjamin (1958)."
Kety (1957) says:
"It is not surprising that a dietary deficiency has been found to explain at least two of the
biochemical abnormalities recently attributed to schizophrenia. It is more surprising that
the vitamins and other dietary constituents whose role in metabolism has become so
clearly established, should so often be relegated to a position of unimportance in
consideration of the intermediary metabolism of schizophrenics."
The paper by Benjamin (1958), far from providing the serious critique of methodology
Oken claims, is a dedication ceremony address which gives a condensed history of
biological research in schizophrenia and bemoans the reductionist attitude of biologists
who seek a purely physical causal mechanism for schizophrenia. Benjamin also describes a
behavioral reaction of psychologists and psychiatrists which Oken obviously should have
read more closely:
"It is impressive to see how frequently the response to some over-simplified biological
hypothesis about behavior is not simply an appropriate skepticism or an impulse to give
evidence to the contrary, but rather an angry and anxious rejection, a response as to a
threat. Clearly it is often so perceived, as a threat on a social level to our group prestige
and coherence and on an individual level to our convictions and sometimes even to our
bodily integrity. Stop it, you're taking away my tools!"
Oken seems to have been so angered by Pauling's challenge, and so anxious to reply, that
he forgot to check if either his references or his examples actually supported the charges
he made against Pauling. It can be seen that Oken's response seems to be caused by pro-

48
fessional xenophobia; the claim that Pauling is out of his field is a defensive reaction
against an intrusion that threatens to overturn the foundations of Oken’s methodology.
Pauling as might be expected replied to Oken's accusations directly, (Pauling 1968a). He
lists the organizations which have provided the funding for his 12 years of research on the
molecular basis of mental disease, and his awareness of the wide opposition to his theories
expressed by Oken.
In response to Oken's insinuation that he is increasing the
suffering of the ill by giving them false hopes, Pauling pointed out that almost all the
synthetic drugs used in treating mental illness
have pronounced side effects. However, the situation is different for ascorbic acid, nicotinic
acid, nicotinamide and other natural nutrilites required for life. These materials, Pauling
says,
"are nontoxic (as safe and nontoxic as ordinary sucrose and sodium chloride). They are
cheap..., and they have fewer side effects than the drugs that are ordinarily prescribed. For
each mental patient there is a significant probability that improvement in health would
result from the provision of the optimum amounts of nutrilites, in addition to whatever
other therapy the physician might propose.... I believe that a psychiatrist who refuses to try
the methods of orthomolecular psychiatry, in addition to the usual therapy, in the
treatment of his patients is failing in his duty as a physician."
This is the most powerful argument Pauling has in defense of vitamin therapy for illness. He
has repeatedly insisted that, although the positive evidence for vitamin therapy may be
inconclusive , there is no reason not to try it; the treatment can only do good, and thus
arguments about statistically significant success rates or of conflicting reports of success
are practically irrelevant.
In July 1973 an American Psychiatric Association Task Force of five physicians and one
consultant issued a 54-page report titled Megavitamin and Orthomolecular Therapy in
Psychiatry, which purports to present both theoretical and empirical reasons for
completely rejecting the basic concept of orthomolecular psychiatry. Dr. Pauling's response
to the report (Pauling 1974) shows that Dr. Oken's peers have not noticed that Oken's
arguments have a rather strong smell to them. The Task Force members, like Oken, seem
to believe that the smell is the invigorating scent of ruthless and damning logic. They have
carefully applied Oken's factual and logical consistency to their task with only slightly less
obvious passion, and their report has lost none of the odor of Oken's criticism of
"Orthomolecular Psychiatry."

CHAPTER 10
THE MEDICAL ESTABLISHMENT AND VITAMIN C
The response of the medical establishment to Vitamin. Sc _and Ilk Common ColA, as I have
said, has concentrated not on Pauling's theory of human vitamin C but on the evidence he
has gathered to confirm it and on the implications his theory has for the health of the
public. Pauling's evidence for an effect of vitamin C on colds rests mainly on the controlled
trials of Cowan et al (1942) and Ritzel (1961), both of which showed a substantial reduction
in the number and sever¬ity of colds in groups of subjects who took vitamin C as compared
to groups who took a placebo.
The medical establishment has not tried to objectively evaluate Pauling's evidence, but
instead has tried to discredit it by falla¬cious arguments in order to advance their
conclusions that vitamin C is worthless and should not be recommended to the public. The
first method they have tried has been to say that the studies on which Pauling has relied
were not properly done, and thus can be disre-garded. The foundation of this argument
rests on the specific cri¬teria required for the acceptance of evidence pertaining to
proposed therapeutics discussed in the chapter on the nature of Pauling's evi-dence.
Having been unable, despite great efforts, to invalidate Pauling's evidence, the medical
establishment has turned to the ques-

51
tion of toxicity in order to advance their conclusion that the risks of vitamin C use are
greater than the benefits. This tactic has used evidence that vitamin C might cause
unpleasant side effects to sup¬port the claim that its widespread use cannot be
recommended.
In making both of these arguments the medical establishment, represented by the
American Medical Association and its journal (JAMA), orthodox nutritionists led notably by
Dr. Frederick J. Stare, editor of Nutrition Reviews, the Food and Nutrition Board of the
National Research Council, and the Food and Drug Administration which follows the
Board's recommendations, have misrepresented the facts, used fallaciously ambiguous
statements to misrepresent the evidence, resorted to special pleading in order to discredit
the evi¬dence, and, as Pauling claims, deliberately ignored the beneficial effects of vitamin
C in the treatment of disease.
The weakness of the arguments advanced by the medical establish¬ment has caused Dr.
Abraham Hoffer (1971) to observe:
"[These critics] use two sets of logic. Before they are prepared to look at Dr. Pauling's
hypothesis, they demand proof of the most rigorous kind. But when arguing against his
views, they refer to evidence of the flimsiest sort for the toxicity of ascorbic acid."
I. The Nature of the Response
In order to characterise the response of the medical establish¬ment to Pauling's book and
the interest it created, I have divided their statements into misstatements of fact, fallacies
of ambiguity, instances of special pleading, and irrelevant arguments designed to

52
disparage Pauling's interpretaton of the evidence. The relationships of the arguments and
their natures are summarized in Table 1.
Misstatements of Fact:
Under this heading I have put incorrect conclusions, misrepresentations of Pauling's work,
ad hominem attacks on his motives, incorrect citation of sources, correct citation of
incorrect sources, and unfounded generalizations. This is by far the largest type of
response to Pauling's arguments and to the general issue of whether or not vitamin C can
prevent and alleviate colds. Some researchers have misrepresented the results of their
own studies (Cowan, et al, 1942; Glazebrook and Thomas, 1942; Karlowski, et al, 1975);
others have incorrectly concluded that their studies are proof that vitamin C should not be
recommended to the general public (Anderson, 1974, 1979; Tyrell, et al, 1977). Many
reviewers, as I have said, have misrepresented Pauling's arguments as being based on
personal testimonials (Passmore, 1971; Stare, 1971; Medical letter, 1970; Coulehan, et al,
1974; Thomas and Holt, 1978). Some authori¬ties have incorrectly cited sources as proof
that Pauling must be wrong (Wolf, 1981; Thomas and Holt, 1978); many others have cited
incorrect sources without evaluating their contents (Coulehan, et al, 1974; A.M.A., 1975;
Thomas and Holt, 1978; Lancet, 1979). Finally, a number of "authorities" have stated flatly
that there is no evidence to support Pauling's claim (White, 1975; Jukes, 1975).1
53
Fallacies of Ambiguity
Engel defines fallacies of ambiguity as "arguments that are unsound because they contain
words that, either singly or in combina¬tion, can be understood in more than one sense."2
Many investigators
and reviewers of the effects of vitamin C on colds have advanced their conclusions that
vitamin C is not worth recommending by using ambiguous terminology which misleads the
reader. One example of this is stating that the evidence is "inconclusive" when in reality
the evidence is uniformly positive, but not uniformly statistically sig-nificant or rigorously
collected. Another example is implying that because no evidence of toxicity has been
found, no studies of toxi¬city have been performed. This is a particularly common, and
partic¬ularly shallow, fallacy of ambiguity. A variation of this has been the claim that
particular side effects can occur, when in fact they have only been hypothesized. Another
common ambiguity is the claim that significant effects are "minor" or not "important." Any
signifi¬cant result in the study of the effect of vitamin C in preventing and curing colds is of
great importance to millions of people.
Special Pleading
Engel defines special pleading as "applying a double standard; one for ourselves and one
for everyone else."3 The medical establish¬ment has been unable to hold its position in the
face of the increas¬ing weight of evidence for a significant effect of vitamin C. As the
2Engel, page 51. 3Engel, page 83.

54
statements of Cowen,et al (1942) and others show, they have responded by denying that
the evidence is actually important. This is a form of special pleading; they argue that they
can choose any standards of
significance they wish for the evaluation of the evidence. Thus well-collected significant
results become "minor benefits of ques¬tionable validity," a reduction in colds has "no
practical impor¬tance," and an almost completely uniform record of valuable therapeu¬tic
use is "inconclusive."
The most extreme case of special pleading is exhibited by those
medical reviewers who claim that the theoretical risks of megadoses of vitamin C are so
great that they outweigh their potential benefits
(Medical Letter, 1970, 1971; Beaton and Whalen, 1971; Chalmers, 1975; Dykes and Meiers,
1975; Thomas and Holt, 1978). As I have been say¬ing, nothing except a mild laxative effect
and possibly mild gastro¬intestinal upset has ever been demonstrated to actually occur in
man from megavitamin C use, and the medical establishment has continued
to make fallaciously ambiguous statements about the possibility of side effects. Most of the
medications recommended by doctors for the cure of colds can have very unpleasant side-
effects for a small per¬centage of people; moreover, most of these same drugs are highly
toxic in large amounts. Vitamin C has no known serious side effects in any dosage size that
would possibly be ingested by a person, and has been shown to help the body heal itself by
potentiating the
immune reactions To refuse to advise the public about the benefits of megavitamin C use
on the grounds that someone might react badly to it

55
is ridiculous, given the incredible number of toxic substances which are dispensed with
open hands by the pharmacuetical and drug com¬panies.
Irrelevant Thesis
Engel defines an irrelevant thesis as "an argument in which an attempt is made to prove a
conclusion which is not the one at
issue." Some of the reviewers who have criticised Vitamin L.
Common Cold have tried to discredit it by focusing on irrelevant issues and claiming that
they damage Pauling's argument. This is really a very silly way of trying to discredit an
argument, but it has had important consequences for the Vitamin C debate. The review by
Beaton and Whalen (1971), which claimed to show that Pauling's evidence was
inconclusive, focused on insignificant parts of the work of Cowan, et al (1942) and claimed
that because opinion differed over the significance of these irrelevant details, Pauling's
interpreta¬tion was invalid. Pauling responded to the "astounding misrepresen¬tation of
the well-controlled double-blind study of Cowan, et al," saying that he found it "shocking"
that medical authorities should be misrepresenting matters concerning the public's health
(Pauling, 1971b). Nonetheless, the review by Beaton and Whalen was cited by Coulehan
(1974), Thomas and Holt (1978), and the editors of Lancet (1979) as proof that Pauling's
evidence was invalid.
II. The Arguments of the Medical Establishment
4Engel, page 107.

56
In order to concisely demonstrate the nature of the arguments used by the medical
establishment to convince the public and the scientific community that Pauling is wrong, I
have listed some of the most prominent authors and articles in the controversy and the
vari¬ous arguments, described above, that they have used in Table 1. The data points in
the table refer to paragraphs in Appendix 1, in which I have quoted the author's words and
explained the significance of their arguments. This has been done to] give the reader a
feeling for the scope and intensity of the medical establishment's response.
Authors who have written in the Journal of the American Medical Association are marked
with a "J". It will be seen in examining the table that the period from 1974 to 1975 was a
very busy one for the AMA. During this period the regulations proposed by the Food and
Drug Administration to subject high-dosage vitamin supplements to medical review and
prescriptory control were being challenged in Congress by vitamin manufacturers, public
interest groups, and Linus Pauling and Professor Roger J. Willams. The AMA was the main
lobbyist for the attempt to subject vitamins to control of the medical establishment. The
position of the AMA over vitamins will be discussed in detail in the chapter on the nature of
the medical resistance to vitamins.

Arguments of
Misstatement
Author of
Fact TABLE 1 the Medical
Fallacy
of
Ambiguity Establishment*
Special Pleading Irrelevant Thesis
Cowan, et al. (1) (22) (30)
J (1942).
Glazebrook, et al. (2)
(1942).
Tebrock, et al. (23)
J (1956).
Nutrition Reviews. (3) (24) (34)
(1967).
Goldsmith. (4)(5)
(1961).
Bing, F. (7) (25)
(1970).
Medical Letter. (8) (26)
(1970).
Medical Letter. (9) (27)
(1971).
Passmore.
(1971).
Stare, F.T.
(1971)
Beaton and Whalen. (35)
(1971).
Coulehan. (13)
(1974).
Chalmers, T.C. (28) (31)
(1975).
Karlowski.
J (1975).
Dykes and Meyers. (29) (33)
(1975).
AMA Press Release.
j (1975).
White, P.L.
(1975).
Jukes, T.H.
J (1975).
Thomas and Holt.
(1978).
Laacet. (32)
(1979).
Ross, D.M. (21)
(1979).
III. The American Medical Association and Vitamin C Megatherapy
In 1975 the President of the American Medical Association, Phil¬lip L. White, wrote and
article in the Journal of the AMA entitled "Megavitamin This and Megavitamin That" which
discussed the Congres¬sional battle over the control of vitamins between the FDA,
supported by the AMA, and the supporters of House Bill S2801 which proposed to
eliminate the FDA's authority to regulate vitamins. At the time the A.M.A. was lobbying for
the FDA's proposed regulations to subject all vitamins containing more that three times the
Recommended Daily Allowance to the review of the medical establishment, which would
decide whether or not they should be available by presription only.
White (1975) states:
"Megavitamin therapy raises questions of propriety, regulato¬ry process, pharmacology
and toxicology as well as profes¬sional and public responsibility.... Impressive public
fig¬ures, from two-time Nobel Prizewinner Linus Pauling to members of Congress,
apparently support the concept.... None of us could have guessed that it would have
become popular to take gram quantities of vitamins in vain hope of preventing or curing a
multitude of diseases. If there were some objec-tive evidence that megavitamin therapy or
orthomolecular psychiatry produced benefical results, one would then use the role of
reason in evaluating the risk/benefit ratio. For the present, we can only conclude that there
is no benefit to massive daily doses of vitamins and that only one aspect can be evaluated,
namely, the risk."
White referred a detailed discussion of megavitamin therapy to an article in the same issue
of JAMA by Thomas H. Jukes.
Jukes (1975) in his article "Megavitamin Therapy," in JAMA

58
"Megavitamin Therapy is advocated, without basis, for treat¬ing numerous clinical
disturbances, including degenerative diseases... [and] to promote a desirable but mythical
condi¬tion of super health.... Megavitamin therapy... is largely based on an ancient and
cherished delusion of the laity, if a small dose of a medicament is good, a larger one must
be better.... Megavitamin therapy is advocated in the writings of Linus Pauling and the late
J.I. Rodale.... Pauling's theory of 'orthomolecular pshychiatryl [is] a concept not un¬like
Rodale's barrier proposal."
J.I. Rodale was the publisher of Prevention Magazine, a lay publica¬tion promoting
unorthodox health practices and holistic medicine.
Arthur Sackler (1975) wrote a letter to JAMA critizing Jukes' circumstantial ad hominem
article on Pauling. Jukes responded that he "did not link Pauling's name with that of
Rodale; I quoted both of them as theorizing that massive doses of vitamins penetrate
physio¬logical barriers." Jukes went on in his letter to say that "Pauling appeared on behalf
of the National Health Federation at the hearings I attended on Bill S2801 before Senator
Kennedy on August 1, 1974." (Jukes, 1975b). In a letter following this Philip White stated:
"The arguments in support of Senator Proxmire's bills have been provided by those who
stand to gain the most financially from the unrestricted sale of vitamins. Dr. Pauling has
been a spokesman for one of these groups."(White, 1975b).
Both Pauling and Sackler replied to this. Pauling stated:
"I have not been a spokesman for any group which stands to gain the most financially from
the unrestricted sale of vita¬mins. The statement that I have been a spokesman for one of
these groups is damaging to me and I ask that this letter be published in order to rectify the
damage as far as possible" (Pauling, 1976).

59
Sackler replied: "Dr. Jukes ' reply to my correspondence is pre¬cisely the type of
'discussion' to which I took exception and which has no place in science." Sackler points out
that Jukes misrepresents his statements that "orthomolecular psychiatry is a concept not
unlike Rodale's barrier proposal." Sackler states: "I submit that to link a hypothesis by one
of the world's greatest scientists with that of a layman of no scientific stature whatsoever is
to derogate by association."
Sackler also reprimands White:
"To raise the question of professional and public responsi¬bility and then to follow it with a
statement that 'no one thought the day would come when public figures would promote
something as outlandish as megavitamin therapy' appears to me an ad hominem
derogation of the scientist who raised the pos¬tulate of megavitamin therapy, Linus
Pauling. It is my be¬lief that JAMA could hayed addressed these issues... in a manner both
objective and impersonal, as befits reference to one of America's greatest scientists and
the traditions of scientific debate and not with polemics that ill-become both their authors
and JAMA itself."
The statements of White and Jukes, made five years after Pauling pub¬lished Vitamin g.
And. the, Common Cold, and three years after the stu¬dies of Anderson, et al (1972)
confirmed his hypothesis that vitamin C can prevent colds, are rather incredible. That they
are willing to stoop to libel in order to advance their conclusions shows that the medical
establishment is not just unable to grasp the theoretical implications of Pauling's work.
White and Jukes made their state¬ments as the strongest attempt of the medical
establishment to con¬trol vitamins, making high concentration forms unavailable without
prescriptions, was under attack. Their response is that of a tobacco

60
company executive who is asked if smoking causes cancer, that is, a vested interest which
has its profits threatened by public health concerns. Unlike a tobacco company executive,
though, White and Jukes claim to be responsible medical professionals, and would have
the public believe that they are protecting it from quacks and pro-fiteers. It is extremely
unfortunate, in my opinion, that the medi¬cal establishment has managed to keep
persuading the public that this
is true.

CHAPTER 11
THE EYES OF THE PUBLIC
The attacks of the medical establishment on Pauling's evidence and conclusions were
widely publicised and widely believed. An arti¬cle in Reader'A Digest repeated the claims of
the editors of the Med¬ical, Letter that EulinglA evidence was worthless, and stated that
people had actually developed kidney stones from taking vitamin C, which was untrue.1
The statements of the editors of the Medical Letter that Pauling's case was based on
uncontrolled trials and per¬sonal testimonials and that vitamin C could cause kidney stones
were also repeated in the New York Times (January 3, 1971).
In 1971 Consumer Reports published an article entitled "Vitamin C, Linus Pauling, and the
Common Cold."2 The article made, according to Pauling, ten false or seriously misleading
statements,3 and ended with an allegation of social irresponsibility:
"Whatever the merits of increasing Vitamin C allowances (and they should be explored), a
socially responsible approach would dictate that toxicity studies should precede any
ef¬forts to encourage people to take large amounts of the vita¬min."
The careful clinical study of Lowry and Bessey (1952) showed no side effects from taking 1
g per day for four months; no other investiga-
1Ross, W.S. "Vitamin C: Does It Really Help?", Reader'A Digest,
98: 129-132, 1971.
2Consumer Reports, February 1971. Pages 113-114.
3Pauling, 1976. Pages 130-133.

62
tors have reported actual side effects that implicate vitamin C use.
Consumer Reports relied on the statements of the medical authorities that no studies on
toxicity had been done. According to Pauling Con¬sumer Reports refused to publish a
correction of the false and
misleading statements in the article.
On November 25, 1971, the New York Times ran an article report¬ing the findings of
Schwartz, Togo and Hornick (1973) that volunteers who had been injected with cold viruses
after receiving 3 g per day of ascorbic acid for three days showed no protective effect of
ascor¬bic acid compared to controls. The author of the article, Jane Brody, said in the
leading paragraphs that Pauling's ideas were based on poorly-controlled studies, and
misinterpreted the study by
Schwartz et al by claiming that its results proved that Pauling was wrong. Pauling
responded that Brody had misinterpreted the study and made false statements (New York
Times, December 30, 1971).
In a sneeringly sarcastic article in Life Paul O'Neil ridiculed those who were inspired by
Pauling to become vitamin "cultists", cal¬ling them "amateur ecologists, manure
worshippers, and connoisseurs of the multi-vitamin capsule." Pauling himself, says O'Neil,
"has created a great many noisy critics among doctors and fellow scientists who say
anything is toxic if taken in big enough quantities, who warn that large amounts of Vitamin
C sometimes causes diarhhea and who belabor him for postulating a cure without
explaining how the mechanism supposedly works. Furthermore, they say, Pauling may be a
brilliant chemist, but he has no medical training."
4O'Neil, 1971, op. cit.

63
O'Neil is correct - Pauling's critics do make these simplistic, incorrect and irrelevant
statements.
In 1982 Jane Brody, author of the misleading report in the N.Y. Times claiming that Pauling
had been proven wrong (Nov. 28, 1971), repeated her unjustified allegations in the
Personal Health Column of the N.Y. Times (Jan 20, 1982). She states:
"Relying mostly on the experience of himself and his wife, and a few studies with serious
limitations in design, Dr. Pauling hailed vitamin C as the long overlooked panacea for the
peskiest of human conditions.... Some people have become ill from taking a remedy that
might actually be worthless for their conditions.... Vitamin C consumed above and beyond
body needs is excreted in the urine."
All of these statements are untrue or seriously misleading. Brody seriously misrepresents
the facts in this widely-read forum for pub¬lic health information.
It can be seen that the public has relied on the statements of the medical establishment to
some degree in evaluating the proposals Pauling has made. The point I want to make here
is that the public has to rely on the medical establishment in evaluating new health issues.
When the source of information that the public depends on becomes untrustworthy, we
should be grateful that people like Linus Pauling have taken it upon themselves to
campaign for the truth. Gratitude, however, needs to know why it exists. It is obviously
imperative that we understand why the medical establishment has been refusing to accept
the facts about vitamin C.
PART THREE

VITAMIN C: THE CRITIC'S REVIEW

CHAPTER 12
THE NATURE OF THE RESISTANCE
The resistance of the medical establishment to orthomolecular medicine and megavitamin
C, as I have shown, is not based on objectively-made decisions about the value of
megavitamin therapy. But what is the reason for the impassioned, often vicious response
Pauling has drawn?
Pauling has surmised that several factors may contribute to the lack of enthusiasm of the
medical establishment about a substance that was shown by the early 1960s to
significantly prevent and alleviate illness. He hypothesizes that:
"In the search for a drug to combat disease the effort is usually made to find one which is
100 percent effective... Also, there seems to have existed a feeling that the intake of
vitamin C should be kept as low as possible, although this vitamin is known to have
extremely low toxicity. This atti¬tude is of course proper for drugs -- substances not
normally present in the human body and almost always rather highly toxic -- but it does not
apply to ascorbic acid. Another factor has probably been the lack of interest of the drug
companies in a natural substance that is available at a low price and cannot be patented."1
I believe that Pauling is partially correct. One factor in the response of the medical
establishment that has become apparent to me is the bias against vitamin therapy in
general, due to the incredibly
active profiteering of vitamin promoters and manufacturers who seek to make money by
convincing the people that they are under-nourished
1Pauling, 1970. Pages 4-5.

65
and therefore subject to disease which can be cured by buying the promoter's miraculous
vitamins. As Pauling says, the search is usu¬ally made for a drug which is 100 percent
effective; the quack claims of health food promoters therefore draw a strong response
from medi¬cal authorities who wish to prevent people from being misled in their concern
over their health.
The Food and Drug Administration has been the active force in preventing quacks from
enriching themselves off the fears of sick (or merely concerned) people. In evaluating the
claims made by vitamin promoters the FDA has relied on the medical establishment to
define standards of efficacy and safety. But the medical establishment has some very
strong theoretical biases, and this has interfered with its ability to make correct decisions
about vitamins. One of these biases is that it is unwilling to differentiate between drugs
and vitamins, which as Pauling says are not at all similar.
The medical establishment also does not want its control over the health of the people to
be undermined by promoters selling thera¬peutics. A position of elitist control has been
demanded by the med¬ical establishment, on the grounds that specialists are the only
ones who can properly evaluate the incredible profusion of medications and "health foods"
which has appeared in this century. But this position has been maintained not for the good
of the public, but for the good of the specialists. The American medical establishment is a
monopoly in the classic sense, and this has been nowhere more apparent than in its efforts
to control and suppress vitamin use. The history of

66
these efforts shows conclusively that the response of the medical establishment to
vitamins has been aimed at monopolizing and per¬petuating its control over the health of
Americans, even to the point where the public actually suffers because of it.
This professional monopolization attempt is thrown into perspec¬tive when the control
strategies used are compared to those developed by others in response to threats to their
control. Linus Pauling's struggle to publicize the dangers of radioactive fallout, and Rachel
Carson's alarms about the effects of DDT on the ecosystem and the blind rush of lethal
environmental technology, both drew responses from vested interest groups identical in
many respects to that of the medical establishment in the vitamin C controversy.
I. The Fight Against Quackery.
James Harvey Young's well-documented histories of health quack¬ery and promotion, The,
Medical Messiahaa and American Self-Dosage Medieines,a show that the FDA and the
Federal Trade Commission have had an uphill battle against the incredibly profitable trade
in spurious therapeutics and preventatives promoted by unscrupulous manufacturers and
entrepeneurs. As laws were passed tightening the regulations governing foods and drugs
and more and more dangerous drugs were limited to use by prescription, the trade in over-
the-counter medications has become the real battlefield between regula-
2Young, J.H., The Medical Messiahs. Princeton: Princeton Univer¬sity Press, 1967.
3Young, 1974. op. cit.

67
tors and promoters.
The discovery and publicizing of vitamins opened up the door to a new flood of marketing
which caused particular problems. First, vitamins were necessary to maintain health, as
opposed to drugs which are only used to restore it. Vitamin use by the public could hardly
be banned. Second, there was very little information about the effects of vitamins in the
body, especially when taken in large amounts. Nonetheless, promoters immediately began
making outrageous claims for vitamins, the vast majority of which were completely
spurious.
It becomes obvious when reading about the history of food and drug regulation that
without such regulations the people would have been poisoned by the thousands by the
toxic effects of patent medi¬cines pushed by greedy promoters playing on legitimate
health con¬cerns. This has been prevented by regulatory demands for correct labelling,
honest advertising, consumer safety, and evidence of effectiveness. The first three
demands have not been subjects of debate; the last, however, has provided more than
enough fuel for controversy.
The Bureau of Consumer Protection of the Federal Trade Commis¬sion has maintained:
"It is an unfair practice to make performance or efficacy claims for a product without
conducting prior scientific tests adequate to establish the truth of those claims. It is not
sufficient if, by happenstance, the claims for a product turn out to be true. To make claims
without prior testing

68
treats the public as guinea pigs."
This position was modified by the full FTC. Individual testing by each manufacturer would
not be required so long as a "reasonable basis" underlay claims for a therapeutic. The
safety of the thera¬peutic for consumer use, of course, was a prior requirement
admin¬istered by the FDA. For a definition of "reasonable basis", the government has
relied on the medical establishment.
II. The Position of the Medical Establishment
The amounts of vitamins and nutrients necessary for health have been dictated to the
government by the Food and Drug Board of the National Research Council, established in
1941. The Board sets Recommended Daily Allowances of these substances to prevent
dietary deficiency diseases, allowing somewhat more than the minimum neces¬sary
amounts to compensate for individual variability and losses in foods during processing. The
Board has firm evidence about the minimum necessary amounts of vitamins; it has
repeatedly insisted that this is all that is needed to maintain good nutritional health.
If I may offer a reasonable analogy, this is equivalent to say¬ing that all you need to do to
maintain your car is put just enough oil in it so that it actually moves. The Food and
Nutrition Board and the medical establishment have refused to conduct trials to find out if
the human body might run better with larger amounts of nutrients in it. I think this is due
to the fact that there is no
4Young, 1974. Page 42.
uniform or dramatic improvement in health in people who increase their vitamin intake,
and because some vitamins, especially A and D, can be dangerous when taken in very large
amounts.
The medical establishment has a strong bias against recommending anything as a
therapeutic which does not have concrete proof of therapeutic efficacy behind it, as befits
the marketing of drugs. It is obvious that this principle, if unmodified, would also create a
bias against the ingestion of concentrated substances such as vita¬mins as preventatives,
rather than as therapeutics. The established practice of medicine does not have a
theoretical framework for coping with this revolutionary approach to health, or any
revolutionary approach to health.
Cortez F. Enloe, Jr. editor of Nutrition Today, has discussed this bias in relation to vitamin C
and Pauling's hypothesis (Enloe, 1971). The comment of Benjamin (1958) that many
orthodox doctors have reacted in fear and anger to a perceived personal threat seems
substantiated by Enloe's observations.
Enloe says that when he tried discussing Vitamin the Com-
mon Cold at a medical meeting just after its publication, "not one physician would admit to
having read the book." Enloe says that the commendable point of Pauling's book is not that
he offers proof for his alleged cure:
"What is important is that Pauling is a genius in chemis¬try... he has succeeded in bringing
into question the validi¬ty of the fundamental principles upon which all of our
as¬sumptions about minimum daily requirements, if not most of the assumptions that
support our knowledge of nutrition, are

70
based. [Pauling] leaves no avenue of intellectual insight unexplored. He examines our
vitamin C requirements in health and disease in their relation to evolution, orthomolecular
medicine, biochemical individuality, and drugs. You can look through the best textbooks in
nutrition and you won't find the subjects even mentioned."
Enloe notes that the difference between medicine and, say, phy¬sics is that medicine
demands rigorous proof before it will accept a theory. Physics, in contrast, begins with
theoretical explorations which are then confirmed or not by experiment.
"With our currently popular style of facing medical problems, it is doubtful whether Dr.
Einstein would ever have got by a National Institute of Health grants board.... Instead of
be¬ing willing to undertake experiments to see if many of these suppositions [about
vitamin C] were valid, our profession has been prone to reject them out of hand because
they are based on unproved theory."
Pauling's conclusions about the best method to cure a cold are actually a minor part of a
generalized hypothesis about the ascorbic acid requirements of man and the higher
primates. He says:
"That's something these physicians don't understand. What I have done with Vitamin C is
to organize a large body of in¬formation about Vitamin C, not just to look at a single clinical
trial but to assess the whole body of knowledge about Vitamin C in order to draw
conclusions that seem jus¬tified.... Fred Stare's been saying for forty years that large doses
of vitamins have no value. He doesn't want to admit that this was wrong."
As I have shown, the medical establishment has not tried to evaluate Pauling's theory of
human vitamin C requirements; instead it has attacked his evidence on the mistaken
assumption that discredit-
5Linus Pauling, personal interview, January 1, 1983.

71
ing the trials he has used as evidence will prove that his theory is wrong.
It is likely that the medical establishment has developed its theoretical bias, i.e. its demand
for conclusive proof of efficacy before it is willing to try administering a proposed
therapeutic, because of the neccessity of separating the spurious claims of quacks from the
truly efficacious medications that have been developed. Further, in the days when vitamins
were new and mysterious sub¬stances, there was a sound rationale for rejecting the
widespread use of their purified forms because of the unknown risks which might have
been involved.
However, the medical establishment has held to its position even after good evidence of
efficacy and non-toxicity has appeared. I believe that this has been the case partly because
of an inability of orthodoxy to adapt to new circumstances of health care due to theoretical
inertia. However, this is not the only reason. The use of vitamins to prevent and treat
illness has conflicted with the attempts of the medical establishment to maintain a
complete monopoly over the ability of the public to maintain its health.
III. The Medical Monopolizers.
Helga Nowotny has commented on an interesting argument used by "pure" scientists to
protect their positions from those who criticize their elitist exclusiveness:
"Impressionistically, I have detected a certain amount of
nostalgia in the reactions to anti-science. A by-gone state

72
of science is often evoked, and ideals are being upheld which no longer seem rooted in
social reality. This is especially so with regard to an often-heard remedy. Everything would
be well with science and its relations to society, the to take care of itself. closely to the
corrupting influence of poli¬tics and power could be cut loose. By separating off criti¬cism
of the those directed against applications, science could be protected from is a naive wish,
but understandabl9 as the strategy of an argument based on social rationality."
Nowotny's impressions seem to ring true. The opposition of scientists to legislative review
of research or censorship of the international flow of technological discoveries with
military poten¬tial, an example which has appeared in the last few years, is charac¬terized
by the fear of losing the authoritative monopoly to unquali¬fied laymen.
This argument exposes a fundamental difference between medicine and the rest of the
sciences. Unlike the leaders of the other sci¬ences, the medical authorities have thrived on
government control of the discipline. The practice of medicine is a legally enforced
mono¬poly. It is against the law to dispense most drugs without a license granted by state-
approved licensing boards who enforce regulation with the full power of law. Researchers
in medical science are as jealous of their freedom to run their own research as other
scien¬tists, but the practice of medicine is an area where the government is asked to
control practitioners. This is done to prevent quacks from injuring people by giving them
either toxic or worthless medica¬tions. But the result is that the medical establishment has
been the
6Nowotny, H. "Science and Its Critics: Reflections on Anti-Science," in H. Nowotny and H.
Rose, Counter-Movements „In the Sci-
ences. Dordrecht: D. Reidel, 1979. Page 7.

73
judge of what constitutes effective and safe medical practice, and the Food and Drug
Administration has enacted regulations to enforce those definitions.
J.L. Berlant has applied the Weberian theory of monopolization to the medical
establishment, showing that medical methods and stra¬tegies, and the resistance of the
American Medical Association to health reforms such as community plans, government
health insurance, and other economic proposals, are monopolization strategies which are
designed to maintain the exclusiveness and high profits of the medi¬cal establishment.?
Berlant's analysis shows I think conclusively that the medical establishment is not in the
business of protecting the public, but is in the business of protecting its professional
interests.
J.P. Newhouse confirms Berlant's conclusion that the medical establishment is a successful
monopolizer: "The most important feature of the medical care marketplace from the
vantage point of economics is that the structure of existing health insurance has severely
abridged price competition."8
Both Berlant and Newhouse show that the American Medical Associ¬ation has been the
major legislative force in maintaining the exclusiveness and high profits of the profession.
One of the strong¬est arguments the AMA has used to do this has been its appeal to the
7Berlant, J.L., Profession Ana Monopoly: A. Study at Medicine ja IlLe United States an Great
Britain. Berkely: University of Califor¬nia Press, 1975.
8Newhouse, J.P., The Economics of Medical Care: A Policy Perspec¬tive. Philippines:
Addison-Wesley, 1978.

74
necessity of an elite profession of specialists who are the only ones who can evaluate the
complexities of modern medicine. The public, it is argued cannot be trusted to take care of
itself.
The position of the Acting Director of the National Cancer Institute shows that the medical
elite consider themselves the only reliable judges of the effectiveness of any medication:
"The average citizen in the country does not have the resources and technical skills
necessary to select, develop and test materials for the treatment of disease. Neither does
he have the background that will enable him to make en¬lightened decisions concerning
the selection and use of therapeutic agents. The selection, development, testing,
evaluation, marketing, prescribing, and administration of ma¬terials for disease treatment
is an area in which large in¬stitutions and skilled professionals are uniquely qualified to
take the measures necessary to protect the interests of the public."9
I think this statement shows very clearly why the medical estab¬lishment does not think
the public should be treating itself with vitamins, even if such treatment is effective and
safe. Medical spe¬cialists are pot uniquely qualified to administer vitamins to the public;
the criteria required of drugs do not apply to vitamins. There is no reason why the public
should depend on the medical pro¬fession for the selection, development, testing,
evaluation, etc. of vitamins, especially those which have been shown to be harmless even
in large amounts. Once the public is informed of the risks which might result from vitamin
ingestion, if any, it has no need to depend on the medical establishment to maintain its
nutritional health.

75
Such a course puts the public outside of the dependence on the medi¬cal establishment
which doctors would like to foster.
Orthodoxy makes no distinction between the case of the cancer patient who must rely on
highly toxic forms of therapy for his life and the cold sufferer or the consumer worried
about adequate daily nutrition. Nor have I found any difference in consideration of the
consumer use of drugs and of nutrition supplements in the statements of the medical
authorities.
The most incriminating evidence that the response of the medical profession to the use of
vitamins is monopoly-oriented at the expense of the public is that first, the medical
establishment acting through the FDA has attempted to deny, in the face of conclusive
contradic¬tory evidence, that the public might need vitamins, and second, it has attempted
to prevent vitamins in large doses from being available without a prescription.
Widespread vitamin C deficiencies had been noticed as early as 1938 (Abt and Farmer,
1938). Surveys done in the 1940s showed widespread malnutrition among the nation's
poor. A nation-wide, ran¬domized survey done in 1955 revealed that nearly half of
America's families fell below the RDA with respect to at least one essential nutrient.10 In
1963 it was known that "a high percentage of the gen¬eral population does not now have
ascorbic acid intakes which meet the RDA." (Nutrition Reviews, 1963).
loYoung, 1967. Page 339.

76
In 1961 the Nutrition Foundation, an orthodox medical institu¬tion, announced a multi-
million dollar campaign to convince Americans that they did not need vitamins, saying that
the great abundance of foods available to Americans ensured that they received a
balanced diet. (New York Times, April 25, 1961). The next year the FDA, act¬ing in response
to lobbying from the AMA and other orthodox medical groups, announced that it was
tightening the labelling rules on vita¬mins and limiting the claim of "special dietary value"
to only eight of the vitamins; the FDA also said that dietary supplements were not needed
in the U.S. diet (N.Y. Times, Nov. 22, 1962).
The position of the AMA at this time was becoming more firmly fixed in its ideology.
Rosemary Stevens has commented on the unwil¬lingness of the AMA to face the realities
of malnutrition and the real need in some groups for inexpensive nutritional
supplementation:
"The American medical profession of 1965 was running in its political thinking at least three
decades behind the social implications of specialized medicine.... Before 1965, report after
report from governmental and other sources exposed the plight of the elderly, but the
AMA had continued to take the position that the aged (and other dependent groups) were
by no means as sick, as in need of medical attention, or as financially needy as other groups
were claiming. This atti¬tude was more than a rationalization of pecuniary narrow-
mindedness or vested interest; it was a statement that organ¬ized merkiicine was the
proper interpreter of the nation's health."
Stevens makes it clear that the AMA was protecting its authori¬tative control over health.
However, the many surveys of nutritional
77
habits in America had made it clear that the aged were one of the
most severely malnourished groups of people in the country. Their poverty meant that
they would particularly benefit from vitamin sup¬plementation which would at least
reduce the severity of sickness
enhanced by malnutrition. I think Stevens is wrong in underestimat-
ing the vested interest of the AMA. As events showed, the AMA and the nutritional
authorities tried not only to convince the people
that they were not as sick as some claimed, but actively tried to convince them not to
improve their health by taking vitamins to at least give them the Recommended Daily
Allowances which the medical establishment itself set.
In 1966 the FDA announced new regulations based on the recommen¬dations of the Food
and Nutrition Board requiring vitamin labels to say:
"Vitamins and minerals are supplied in abundant amounts by the foods we eat. The Food
and Nutrition Board of the Na¬tional Research Council recommends that dietary needs be
sa¬tisfied by foods. Except for persons with special medical needs, there is no scientific
basis for recommending routine use of vitamin supplements."
Agency spokesmen said that many Americans had thought incorrectly that there might be
nutritional benefit from taking vita¬mins in excess of the minimum requirements. In fact,
they said, such excesses do no good. It was proposed to make illegal the statement:
"that significant segments of the population of the U.S. are suffering or are in danger of
suffering from a dietary defi¬ciency of vitamins and minerals." (N.Y. Times, June 18, 1966).

78
There is no other way to describe this action except as a pure power play on the part of the
medical establishment. To make it a crime to state the well-known fact that many people
have nutritional deficiencies, which could be cured by vitamin use, seems to me to be
conclusive proof that the medical establishment was trying to main¬tain its profits at the
expense of the people's health. That such a move was beyond the bounds of acceptable
behavior was emphasised by the fact that the proposed regulations were defeated by
plaintiffs who proved in court that the FDA had not even held public hearings on the
matter, as required by law.
Taken in conjunction with the position of the medical establish¬ment already described
over the Congressional fight to remove vita¬mins from the regulatory compass of the FDA
and the AMA, and the statements of Drs. White and Jukes that no evidence for a beneficial
effect of vitamins exists and that Linus Pauling is a spokesman for groups who stand to
make money from the unrestricted sale of vita¬mins, the above discussion shows I think
conclusively that the medi¬cal establishment as represented by the AMA and the leading
medical journals have actively and deliberately tried to mislead the public about the effects
of vitamin C, indeed, about all vitamins, in order to maintain its monopoly over the public's
right to heal itself.
IY. The Strategies At Scientific Repression.
When Linus Pauling presented his petition signed by over 11,000 scientists calling for an
end to atomic weapons testing to the Secre¬tary General of the United Nations in 1958, he
was attacked by

79
right-wing scientists and politicians who claimed that he was a Com¬munist sympathizer.
Most importantly for the purposes of this thesis, it was claimed that he had no right to say
that radiation was harmful to the public health. Dr. Joel Hildebrand, a past president of the
American Chemical Society, claimed that not 1 per cent of the scientists who signed the
petition had a specialist's knowledge of the subject.12
When Rachel Carson's book Silent SDringla was published, it drew a reaction from the
chemical industry and from chemists which was remarkably similar to that of the medical
establishment to Vitamin
the Common Cold. Carson, too, wrote her book because the estab¬lishment was refusing
to listen to voices crying in alarm that its policies were damaging the environment and,
ultimately, the people." The main response of her opponents was that she was not a
scientist, and therefore was to be ignored. One review of Silent Spring was entitled,
"Silence, Miss Carson."15
Frank Egler, a prominent historian of ecology, has written of the response to Silent Spring:
There has been defense and counter-defense, a focusing upon minutiae, distortion,
innuendo, bias, claims of emotionalism themselves written with extreme and apparent
emotion... The story of pesticides in 1962-63 is that of the angry, emotion¬al, and sales-
conscious reacton of the industry and its dis-
12"Congress Is Told How Pressure Grew to Ban Bomb Tests," Q. News and Jorld Report,
June 14, 1957. Pages 75-78.
13Carson, Rachel. Silent SDrina. Boston: Houghton-Mifflin, 1962. "Graham, F., Since Silent
Spring. Boston: Houghton-Mifflin.
15Darby, W.J. "Silence, Miss Carson." Chemical and Engineering Pews, 40: 60-62, October,
1962.

80
ciples in government and agriculture, aided albeit innocently by the obsessively scientific,
not that of the cool and calm progress of scientific knowledge through a democratic
so¬ciety. n16
I am sure that one day a prominent nutritionist will say much the same of the controversy
over the effects and requirements of vitamin C. However, it does not seem likely that
specialists in any discipline which is closely connected to an industry, especially ones as
large and powerful as the chemical and drug industries (which are rather closely related)
will ever be able to learn from such observa¬tions. In the meantime, I suggest that the
reader be aware that the traditional exclusiveness of science has been and probably will
con¬tinue to be abused by those who disguise their vested interests as scientific
skepticism. In particular, the claim that a challenge is invalid because the author is
"unqualified" should be recognised for what it is: the mark of a closed and fearful mind.

CHAPTER 13
CONCLUSION
Linus Pauling has developed a new approach to the treatment of mental disease and viral
infection called "orthomolecular medicine." The fundamental difference between this
approach and that of orthodox medical treatment of illness is that the substances Pauling
recom¬mends for treating disease are natural, that is, found in the human body. They are
also largely non-toxic, relatively cheap to make in large amounts, and unpatentable.
Pauling has hypothesized that many forms of illness occur because of imbalances of these
substances in the body. For example, he thinks that schizophrenia may be caused by
localized cerebral deficiencies of particular substances, and that systemic deficiencies,
particularly in the immune system, may lead to decreased resistance to infection by viruses
responsible for the com¬mon cold and other diseases.
According to Pauling, these deficiencies may be alleviated by megavitamin therapy, or the
ingestion of very large amounts of the non-toxic vitamins, such as niacin and ascorbic acid
(vitamin C). The latter substance potentiates the action of the immune system in fighting
disease and may have other beneficial properties such as stimulating the cellular
production of interferon.
Pauling thus recommended in his widely-read book, Vitamin and
the Common Cold, that the regular ingestion of much larger amounts of

82
vitamin C than the Recommended Daily Allowance be made a regular practice to maintain
the immune system at its optimal level of func¬tioning, and said that the daily dose should
be greatly increased at the onset of infection to fight it off. He supported this contention
with evidence that the human body was adapted to use large amounts of vitamin C
because of its evolutionary history and by showing that almost all animals synthesize
vitamin C in large amounts, which implies that man also has a similarly large demand for
the vitamin. Further, Pauling said, well-done studies of the effects of vitamin C show that
its regular ingestion in large amounts reduces the incidence and severity of the common
cold.
For his suggestions Pauling was attacked by the medical estab¬lishment, which denied that
any evidence for a beneficial effect of vitamin C existed and said that its use should not be
recommended. Pauling was also personal attacked by medical authorities who stated that
he was in collusion with the vitamin industry and its lobbyists, who were seeking to create
a state of "vitamania" with spurious claims that many people were malnourished and that
vitamins had powerful therapeutic properties.
The response of the medical establishment has been marked by numerous misstatements
of fact and fallacious arguments which have been used to justify its position. A review of
the history of the medical response to vitamin use and to Pauling's proposal of the use of
orthomolecular medicine shows that the response has been one that of a vested interest
group which is primarily interested in protec-

83
tiung its elite control over health matters, and which is blinded by this interest to
developments that might change the stucture of health care in the United States. It is
concluded that intelligent, well-educated doctors are ignoring the evidence that vitamins
are of great value in preventing and treating illness because of an entrenched bias against
public self-medication and an inability to grasp the implications of theoretical approaches
to medicine, and because they are strongly influenced by the interests of the drug
industries who stand to lose money if people start using vitamins instead of patent
medicines to cure their illnesses.

84
APPENDIX
The Statements of the Medical Authorities
Cowan, et al (1942) discovered that the subjects in their study who received Vitamin C had
31% less illness than the control group. In a discussion of their paper printed in the same
jour¬nal, one of the investigators, Dr. Diehl, states: "We certainly were not able to
demonstrate that the vitamins were of any value." The statement by Dr. Diehl, and the
statement in the summary that vitamin C had no important effect, is a misrepresentation
of the data.
Glazebrook and Thomson (1942) also misrepresent their data. They gave 335 students in a
school 200 mg of ascorbic acid a day for six months, keeping 1,100 others as controls. Table
1 of their study shows that 21% of the vitamin group developed colds, compared to 26% of
the controls. The authors state eroneously , "It is obvious, therefore, that Vitamin C had no
effect on the incidence either of common colds or tonsillitis." This is obvi¬ously wrong, but
it is repeated in the summary.
Nutrition Reviews (1967). The conclusion of Glazebrook and Tho¬mas (1942) that their
study showed no effect of ascorbic acid is reported; no mention is made of the fact that the
data of these two researchers directly contradicts their conclusion. The study of Ritzel
(1961) is incorrectly reported. The decrease in illness of the vitamin group is reported as
30%; the correct amount is 65%. The author of the review also states: "There is no
evidence for a general, anti-viral or symptomatic prophylac¬tic effect of ascorbic acid." This
is a direct self-contradiction. In six out of 10 of the studies reviewed the authors describe
positive evidence for such an effect. The author does not succeed in proving that any of
these studies can be disregarded entirely. The statement that "There is no evi-dence for a
general, anti-viral or prophylactic effect of ascor¬bic acid" is simply wrong..
Goldsmith (1961) published a comprehensive review entitled "Human Requirements for
Vitamin C and Its Use in Clinical Medi¬cine." While noting the many uses of Vitamin C in
treating injuries, she states that Vitamin C seems to show "no beneficial effect on the
incidence and cure of the common cold,"' citing the study of Franz et al (1956). This was an
incorrect cita¬tion: Pauling's 1976 analysis of the data.of Franz et al shows that the
decreased duration of the colds of the vitamin group

85
amounts to 36% less illness for the vitamin group than the pla¬cebo group.
Goldsmith (1961) states: "There is no danger of toxicity from Vitamin C in amounts much
larger than those needed for rehabilita- tion or maintenance because of the rapid excretion
of the excess from the kidneys." The studies of Johnson and Zilva and Ahmed show that
Goldsmith's unsupported hypothesis is wrong. The fact that the safety mechanism she
postulates does not exist, of course, does not mean that there is a danger of toxicity from
large amounts of Vitamin C.
In November 1969 Mademoiselle Magazine published an article on Vitamin C. The article
quoted Frederick J. Stare of Harvard, editor of Nutrition Reviews and "one of the country's
Big Names in nutrition" as saying:
"Vitamin C and colds - that was disproved twenty years ago. I'll tell you about just one very
careful study. Of five thousand students at the University of Minneso¬ta, half were given
large doses of Vitamin C, half a placebo. Their medical histories were followed for two
years - and no difference was found in the frequency, severity or duration of their colds."
The study Stare was referring to was that of Cowan et al (1942). This study involved only
about four hundred students, lasted 6 months, involved use of only 200mg/day of vitamin
C, which is not a large dose, and showed that the vitamin group had 15% fewer colds per
subject. Stare totally misrepresented this "very careful study" to a national publication.
Franklin C. Bing, M.D. (1970) reviewed Pauling's book in the Journal of the American
Medical Association. He wrote:
"Here are found... the clear incisive sentences of an advertiser with something to sell... The
research which Pauling is recommending, it would seem, is not a study to determine the
facts, but a compilation of data for him to fit into the pattern of his argument."
The first statement by Bing is a circumstantial ad hominem attack (Engel, p. 111), implying
that Pauling has hidden motives for publizing his data.
The Medical Letter (1970) a publication on drugs and therapeu¬tics for physicians financed
by the drug industry, published a review similar in nature to Bing's:
"The book is an enthusiastic and uncritical endorse¬ment... Pauling's conclusions are
derived from uncon¬trolled or inadequately controlled studies, and from personal
experience.... A controlled trial of the ef¬fectiveness of Vitamin C against upper respiratory
in¬fections must be conducted over a long period and in-

86
elude many hundreds of persons to give meaningful results. No such trial has been
performed."
Both of these claims are wrong; Pauling cites the studies of Cowan et al (1942) and Ritzerl
(1961) which show meaningful results.
The Medical Letter (1971) published another article entitled "Vitamin C - Were the Trials
Well Controlled and Are Large Doses Safe?" The author(s) attempted to discredit Pauling's
evidence by showing that it was uncontrolled. The author(s) give as rea¬sons for rejecting
the study of Cowan et al (195 42) that the study was not double blind (Pauling quotes Dr.
Cowan's statement that the study was double-blind (Pauling, 1976, p. 51)), and that the
allocation of subjects to the vitamin and placebo groups was not randomized, although
Cowan et al describe their method of randomization in their paper. The paper by Ritzel
(1961) which Pauling relies on was submitted to five anonymous "experts" whose
disparaging and incorrect comments were printed in the article. One of the anonymous
reviewers states that "the population of subjects is not characterized as to age, sex, etc."
Ritzel states that the subjects were all schoolboys. Ritzel does not document his study
methods in great detail, which is a minor flaw. This however does not invalidate the great
benefit the vitamin group received or Pauling's conclu¬sions about the evidence (Pauling,
1970, p. 44), as the anonymous reviewers say it does. The second article in Medical Letter
like the first, misrepresents the evidence in order to prove its conclusions.
Passmore (1971) seems rather confused. Passmore says, "The
claim appears to rest on the subjective impressions of Dr. Paul¬ing, Mrs. Pauling, Dr. Irwin
Stone, Dr. Szent-Gyorgyi and others who feel well and say that they have few colds when
taking one gram or more of ascorbic acid daily." This is strange, for there are no
testimonials in the book from anyone except Dr. Pauling about the personal feeling of well
being he or she is experienc¬ing from Vitamin C. Passmore also says: "Pauling's claim is not
supported by any theoretical concept of how the vitamin might work at the molecular
level." This is incorrect, as he would have known if he had read the book.
Frederick T. Stare (1971) in "Not Quite Cricket", is directly insulting. He says, Pauling's
comments of recent times, "have disappointed us by the irresponsible way they arouse
false hopes in those who have diseases which Pauling feels can be success¬fully treated by
his 'vitamin therapy'.". Stare goes on to say that Pauling does not provide acceptable
scientific evidence with appropriate controls to support his testimony. Interest¬ingly,
Passmore (1971) describes Ritzel's work, cited by Paul¬ing, as "well done." His own peers
evidence Stare's misstate-
ments. Stare states that "most scientists knowledgeable in Vitamin C and its metabolism
know that in amounts of more than

87
25 to 30 mg per day Vitamin C is readily excreted in the urine, and much more of it is
excreted as the intake is increased." This statement is incorrect, as was shown in the 1930s.
Beaton and Whalen (1971) state that, "the author and his critics seem to agree on one
central point - at the moment there is no scientifically valid evidence that Pauling's
proposed prophy¬laxis will work." Pauling points out that this is wrong: "In my book I
stated that... no large scale study had been carried out with ascorbic acid in large amounts
(i.e. greater than 1 g per day)." (Pauling, 1971b) The reviewers also say that the amounts
Pauling proposed, 1 to 2 g per day, have never been subjected to controlled clinical tests.
Coulehan et al (1974) stated that the studies on which Pauling had relied in drawing his
contusions were defective, citing the reviews of Beaton and Whalen (1971) and the
Medical Letter (1970, 1971) as evidence. Neither of these reviews showed that the studies
actually were defective, as a careful reading and knowledge of the facts would have
proved. Coulehan et al misrepresent Pauing's work by accepting unjustified criticism of it.
Karlowski et al (1975) did a nine-month trial of 1 g/day prophy¬lactic ascorbic acid on
employees of the National Institute of Health. The vitamin group had from 16% to 21% less
illness than the placebo group, and 16% fewer colds. However, the study was flawed by the
ability of subjects to distinguish by taste whether they had placebo or ascorbic acid tablets.
The authors conclude "that ascorbic acid had at best only a minor influence on the
duration and severity of colds, and that the effects might be explained well by a break in
the double blind." They also say that "the effects of ascorbic acid on the number of colds
seems to be nil." Karlowki et al misrepresent their own evidence, much as other
investigators have done in evaluating the efficacy of Vitamin C in curing colds.
Dykes and Meiers (1975) in the summary of their article "Ascor¬bic Acid: Evaluation of its
Efficacy and Toxicity." state:
"Although one study tentatively supports the hypothesis that doses of ascorbic acid may be
efficacious, a second study by the same group did not confirm the significant findings, and
no clear reproducible pattern of efficacy has emerged from the review of all the evidence.
Simi¬larly, there is currently little adequate evidence of either the presence or absence of
serious adverse reac¬tions to the such doses, although many such reactions have been
hypothesized. The unrestricted use of ascor¬bic acid for these purposes cannot be
advocated on the basis of the evidence currently available."
The paper by Dykes and Meiuer seriously misrepresents the evi-
dence. Dykes and Meier insinuate that the studies of Cowan et

88
al (1942), Ritzel (1961), and Coulehan (1974) were not properly controlled. They do now
show this to be true or that their insinuations justify rejecting the significants findings of
these investigators. In their summary Dykes and Meier state that the second study of
Anderson et al (1974) did not confirm the significant findings of the first. This is not
surprising; the second study did not repeat the methods of the first, but used a different
experimental organization. Most importantly, Anderson et al conclude that their
observations are compatible with an effect of small magnitude from the prophylactic and
the therapeutic regimens they tested, with an effect of somewhat greater magnitude from
the combined regimen. Also the authors note that there were a number of problems in the
trial and the analysis of the results that implicate their findings some¬what. The statement
in the summary of their paper by Dykes and Meier that Anderson et al could not repeat
their findings thus misrepresents the second study of Anderson et al.
On March 10, 1975, the American Medical Association issued a press statement with the
heading, "Vitamin C will not prevent or cure the common cold." The basis for this
statement was the two papers by Karlowski et al and Dykes and Meier published that day
in the Journal of the American Journal Association. Neither paper supports the statement
of the AMA that vitamin C will not prevent or alleviate the common cold: the first
demonstrated a 20% reduction in illness from ascorbic acid, and the second incorrectly
reviewed the trials already performed to draw the conclusion that "no clear reproducible
pattern of efficacy has emerged from a review of all the evidence."
White (1975) states:
"None of us could have guessed that it would have become popular to take gram quantities
of vitamins in vain hope of preventing or curing a multitude of diseases. If there were some
objective evidence that megavitamin therapy or orthomolecular psychiatry produced
benefical results, one would then use the role of reason in evaluating the risk/benefit ratio.
For the present, we can only conclude that there is no benefit to massive daily doses of
vitamins and that only one aspect can be evaluated, namely, the risk."
White would have to be blind or illiterate to justify this statement, made five years after
Pauling summarized the evidence and three years after the study of Anderson, et al (1972)
con¬firmed that Pauling was right. However, White is President of the American Medical
Association.
Jukes (1975) in his article "Megavitamin Therapy," in JAMA wrote:
"Megavitamin Therapy is advocated, without basis, for treating numerous clinical
disturbances, including de-

89
generative diseases... [and] to promote a desirable but mythical condition of super health...
Megavitamin therapy... is largely based on an ancient and cherished delusion of the laity, if
a small dose of a medicament is good, a larger one must be better.... Megavitamin therapy
is advocated in the writings of Linus Pauling and the late J.I. Rodale.... Pauling's theory of
'orthomolecular pshychiatry' [is] a concept not unlike Rodale's barrier proposal."
J.I. Rodale was the publisher of Prevention Magazine, a lay pub¬lication promoting
unorthodox health practices and holistic medicine. As Sackler (1976) pointed out, this is an
ad hominem derogation of Linus Pauling, who cannot be compared to a layman when
evaluating his scientific hypotheses.
Thomas and Holt (1978) reviewed the information about "Vitamin C and Immunity: An
Assessment of the Evidence". While the authors give a good discussion of the physiological
effects of Vitamin C, they thoroughly misrepresent Pauling's hypothesis and the studies
that have been done on the effect of vitamin C on colds. The authors quote Chalmers
(1975) as showing that many of the trials which have been done are ill-conceived and
poorly con¬trolled. Chalmers does not show this; in fact he evaluates 8 controlled studies
without showing either that they were "ill-conceived" or poorly controlled. Thomas and
Holt state: "There is general agreement that ascorbate supplementation is ineffec¬tive in
reducing the incidence of colds and winter illness." They cite the review of Beaton and
Whalen (1971), which does not show that this is true, and the studies of Anderson (1972,
1975), Wilson and Loh (1973) and Karlowsky (1975), who show that ascorbic acid does
reduce the incidence of colds, to support this statement. The authors state, "In summary,
there is evi¬dence for a positive role for ascorbate in some aspects of host defense, but no
justification for prolonged or even short-term megatherapy." This statement contradicts
the earlier statement of the authors that "there is general agreement that ascorbate
supplementation does produce a reduction in the severity of symptoms following
infection."
In 1979 the Lancet published an editorial stating:
"The theoretically harmful effects of megadose ascorbate are as numerous as the
potentially beneficial effects... There seems at present little justification for long¬term
acorbic acid mega- therapy in cold prophylaxis in the general population. Perhaps it will be
possible to define a subpopulation in which the benefits justify the risks."
Which, we might add, are all hypothetical. The author of the editorial misrepresents the
significance of the evidence about the value of ascorbic acid in reducing illnes; controlled

90
studies such as those of Anderson et al (1972, 1975) show a sig¬nificant benefit of reduced
illness from megatherapy.
David M. Ross, in a 1979 article entitled "The Megamyth of Megavitamins". reported a
speech on Megavitamin therapy by Dr. George Wolf of MIT. According to the article, Dr.
Wolf said that Pauling's evolutionary argument that man developed a 2 gm daily demand
for Vitamin C because of his vitamin-C rich environment was wrong, because most vitamin
C is just excreted. When Pauling responded challenging this claim (Pauling, 1979) Wolf said
that the study of Hodges et al showed that excess Vitamin C was excreted. This is a
misrepresentation of the evi¬dence: Hodges et al, as has been discussed, showed only that
not all of a megadose is incorporated into the body pool of ascorbic acid. The studies of
Johnson and Zilva (1934), Ahmed (1956) and Harris (1976) show that at least half of a
megadose is not excreted as ascorbic acid.
The summary of the paper by Cowan et al (1942) reads: "This con¬trolled study yields no
indication that either large doses of
vitamin C or large doses of vitamins A, B t , B , C, D, and
nicotinic acid have any important effect on the nuiber or sever¬ity of infections of the
upper respiratory tract when admin¬istered to young adults who presumably are already
on a reason¬ably good diet." Cowan et al found that subjects who took vita¬min C had
significantly fewer colds than those who took place¬bos. The difference ammounted to
one-third of a cold per per¬son, which is significant if not dramatic. Their summary is
therefore misleadingly ambiguous.
Tebrock, Arminio and Johnston (1956) reported their evaluation of the usefulness of
bioflavonoids and ascorbic acid in the treatment of the common cold in JAMA. They found
no significant effect of either on colds. However, they say, "Thus far there is no convincing
evidence that bioflavonoids or ascorbic acid can alleviate a cold when used alone or in
conjunction with other therapies." This statement is unsubstantiated. The authors in their
introduction cite Brody (1953), who describes the significant results observed by Cowan et
al Therefore Tebrock et al must have known that there was strong evidence for an effect of
Vitamin C on colds. I think that the statement that "there is no convincing evidence" for a
beneficial effect of ascorbic acid is supposed to mean "no significant and valid evidence." If
this is in fact the author's intention, they are committing a fallacy of ambiguity (Engel, p.
51), that is, using a key word that can be understood in more than one sense. The results of
Cowan et al, which Tebrock et al must have known
about, are significant and valid. A statement that there is no "conclusive" evidence for a
positive effect of ascorbic acid, unless it is sup- ported by either a definition of "conclusive"
or by significant and valid evidence that impeaches the positive evidence for ascorbic acid,
is a fallacy of ambiguity, for it

91
implies that there is no justification for ascorbic acid use.
Nutrition Reviews (1967) published an editorial about ascorbic acid in 1967. The summary
of the anonymous article states: "There is no conclusive evidence that, in the absence of
severe ascorbic acid depletion, ascorbic acid has any effect on the incidence, course, or
duration of colds." The article reviews ten studies, of which eight show a positive effect of
ascorbic acid in preventing colds. The author of the article claims that the studies were
poorly done, but does not show that they were.
Bing (1970) in his review of Vitamin .Q Ana the Common Cold states: "When used as
recommended by Prof. Pauling, neither the safety of all dosage forms, nor the efficacy or
ascorbic acid in any form has been proved..." Bing does not show anything to prove that
Pauling's evidence is not conclusive, nor does he mention that no evidence of any toxicity
has been found. His statement that safety and efficacy have not been proved is
misleadingly ambiguous.
The editors of Medical Letter (1970) wrote:
"When 4 to 12 g of Vitamin C are taken daily for acidif¬ication of the urine, however, as in
the management of some chronic urinary tract infections, precipitation of urate and
cystine stones in the urinary tract can occur. Very large doses of vitamin C, therefore,
should be avoided in patients with a tendency to gout, to forma¬tion of urate stones, or to
crystinuria."
This statment is wrong. Not a single case of has been reported in the medical literature of a
person who formed kidney stones because of a large intake of vitamin C. Moreover, the
possibil¬ity that they might occur is eliminated if vitamin C is taken as sodium ascorbate,
which does not acidify the urine. It is of course proper to discuss the possibility that side
effects might occur. To state that specific side effects can occur implies that they have
occurred. As no one has even seen this hypothet¬ical possibility actually occur, the editors
of Medical Letter are not justified in stating anything more conclusive than "A possible side
effect of pure vitamin C might be the formation of kidney stones in patients with
tendencies to gout, urate stones, or cystinuria." The statement that vitamin C can cause
kidney stones, or any other merely hypothetical and undocumented side effect, is thus a
fallacy of ambiguity.
The Medical Letter (1971) statement that Vitamin C can cause kidney stones, a fallacy of
ambiguity, is repeated.
Chalmers (1975) reviewed the data from 8 trials of vitamin C "considered well enough
gathered to be creditable." In the sum¬mary of his paper Chalmers states:
"Differences in mean prorated numbers of colds per year and durations of illness were 0.09
+ 0.06, and 0.11 +

92
0.24, respectively, favoring ascorbic acid over the placebo...In most studies the severity of
symptoms was significantly worse in the patients who received the placebo. Since there
are no data on the long-term toxi¬city of ascorbic acid when given in doses of 1 g or more
per day, it is concluded that the minor benefits of questionable validity are not worth the
potential risk, no matter how small that might be."
The last sentence of the summary argues that because no data on toxicity exists, therefore
Vitamin C use is not justified. This is a fallacy of ambiguity; as Chalmer states in his article
valid studies have not shown any toxicity from doses of ascorbic acid as large as 3 to 6 g
per day. Chalmers implies that toxi¬city has not been investigated, a state of affairs which
would justify his conclusion, not the correct meaning: no toxic effects have been found by
valid investigations.
The statement of Dykes and Meier (1975) that there is little adequate evidence of the
presence of serious adverse reactions to ascorbic acid is also unjustified. They note that the
sub¬jects who participated in the clinical trials of ascorbic acid remained free of any side
effects. They should have finished the statement, that no side effects have ever been
reported. The review by Dykes and Meier does not show that there any grounds for
rejecting the use of ascorbic acid in the treatment of colds.
Cowan, et al (1942) published an account in the Journal of the American Medical
Association (JAMA) of a study they had made of the incidence of colds in students at the
University of Min¬nesota during the winter of 1939-40 who were taking either 200mg/day
of ascorbic acid, other vitamins, a combination of the two, or a placebo. In their paper they
state:
"It will be noted that the students who took Vitamin C throughout the 'cold season'
experienced only 1.9 colds annually during the study...the controls re- ported an average of
2.2 colds per person a year during the study. The actual difference between the two groups
during the year of the study amounts to one third of a cold per person. Statistical analysis
of the data reveals that a difference as large as this would arise only 3 or 4 times in a
hundred (.iP<.05) through chance alone. One may therefore consider this as probably a
significant difference, and Vitamin C supplement to the diet may therefore be judged to
give a slight advantage in reduc-ing the number of colds experienced. However, one may
well question the practical importance of such a differ¬ence."
In the summary of their paper the authors say that no important effect of vitamin C was
found. This is an example of special

93
pleading, or maintaining double standards of significance, one for doctors who don't want
to believe their own evidence and one for the the rest of the scientific community and the
public which has to trust it.
Chalmers (1975) states in the summary of his paper that that his review of the evidence
shows that vitamin C very significantly reduces the symptoms, and less significantly the
incidence, of the common cold, but he claims that "minor benefits of question¬able
validity" do not justify the use of vitamin C because of its unproven risks. Chalmers distorts
the facts to enable him to make an appeal to fear of side effects, and flaunts the
con¬ventions of scientific evaluation and validity in order to advance his conclusion that
vitamin C should not be used.
The author of an editorial in the Lancet (1979) states that because "no conclusive evidence
for a beneficial effect exists," the theoretically harmful effects of megadoses of vita¬min C
outweigh for the present their potential benefits. Such an evaluation depends for its
justification on the correctness of the statement that "no conclusive evidence exists;" as I
have showed that this is a fallacy of ambiguity in the case of vita¬min C, the statement in
the Lancet is an instance of special pleading.
Dykes and Meiers (1975) also state that there is no justifica¬tion for vitamin C use because
"no clear reproducible pattern of efficacy exists" and it has many potential risks. Dykes and
Meiers, as I have shown, thoroughly misrepresent the studies done on vitamin C and do
not succeed in their attempts to discredit the positive evidence for a therapeutic and
preventive effect.
Nutrition Reviews (1967) claimed in an editorial that the study of Ritzel (1961) on the
incidence of colds in schoolboys taking vitamin C supplements was inconclusive because:
"the assessment was largely based on subjective reports from participants and only limited
clinical observations were made." Not only is this not true of Ritzel's study, but it is not
even a flaw. Most of the large trials of Vitamin C as prophylaxis or therapy have evaluated
only the subjective reports of the subjects, because it is extremely difficult to make
continuous clinical observa¬tions of large numbers of human subjects. Significant results
may instead be obtained by comparing the subjective experiences of randomized groups
with each other. Thus this evaluation of Ritzel's work is really an irrelevant thesis: The
argument is advanced by the weight of irrelevant or invalid criticism.
G.H. Beaton and S. Whalen (1971) say of the existing trials of vitamin C: "A few are
wellcontrolled. But even here, Pauling and his critics differ in the interpretation of the data
and, more particularly, on how it relates to his basic premise." The discussion by Beaton
and Whalen of the study of Cowan et al, and
94
their interpreation of the study's significance to Pauling's basic premise, inspired Pauling to
respond (1971):
"Beaton and Whalen make an astounding misrepresentation of the carefully-controlled
double-blind study by Cowan et al... by introducing a confusing discussion of an
insignificant matter. Cowan, Diehl and Baker asked their subjects to make an estimate of
the number of colds that they had had during the preceding year, and the averages of
these estimates are given in the paper. It is pure nonsense to lay any weight on these
values for estimating number of colds during the preceding hyear, based upon the memory
of the subjects. Yet Bea¬ton and Whalen have chosen to introduce in their review a table
comparing these unreliable numbers of colds dur¬ing the period of the investigation, and
have minimized the discussion of the reliable decrease in incidence of colds during the
period of the study."
Beaton & Whalen also attempt to implicate Pauling's choice of important results by noting
that the number of symptoms was slightly higher for the vitamin group than for the control
group, and suggest that this be considered as an alternative to measuring the decrease in
number and severity of colds. As Pauling points out, the difference in the number of
complica¬tions was insignifcant, "and accordingly, cannot be used as an argument for
impeaching the statistically significant results of the careful study by Cowan, Diehl and
Baker."

APPENDIX

95
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