338 ASCORBIC ACID 



observed a marked decrease in urinary excretion of ascorbic acid by typhus 

 patients during the period of high fever. There is evidence also of decreased 

 excretion of the vitamin by tuberculosis patients.^'"' '*^^ Increased utilization 

 of ascorbic acid in artificially induced fevers in guinea pigs was reported by 

 Dobbelstein.^'*'' The level in the blood dropped to half its normal value. 

 The same was true when the pigs were overheated in an incubating cham- 

 ber at 37.5°. The accelerated metabolism associated with the elevated tem- 

 perature was considered the cause of the increased consumption of the 

 vitamin. Other workers have also reported finding an increased need for 

 ascorbic acid in artificial fevers.*'*^"'*^^ 



e. Trauma 



Kramarov'*^ investigated the excretion of ascorbic acid by surgical pa- 

 tients and found that subjects with bone traumas excreted less ascorbic 

 acid than those with other types of injury, especially during the first few 

 days after injury. By the tenth day the excretion level was stabilized and 

 remained unchanged for a month. Andrae and Browne^^^ also studied ascor- 

 bic acid excretion after trauma in human subjects and found that the 

 injured patients had a low output even after large doses of the vitamin and 

 that retention was more marked after burns than after fractures. Repeated 

 assays showed that, after injury and with high intake of the vitamin, the 

 level in the blood fell, suggesting either rapid utilization or destruction. 

 The urinary excretion was related closely to the level in the blood. As a 

 possible index of the content in the tissues, the ascorbic acid \'alues of the 

 leucocytes were determined. In normal subjects they \'aried from 6.7 to 

 16.9 mg. per 100 ml., and on the high intake rose to 30 to 40 mg. within 7 

 days; in the subjects with traumas the values were low and failed to rise 

 above 20 mg. per 100 ml. after 15 to 20 days on the high intake. The reten- 

 tion was greatest immediately after injury and decreased later as new tissue 

 increased in the healing process, a fact which was considered as suggesting 

 the improbal)ility of the vitamin being used directly in the formation of 

 new tissues. 



«» F. H. Heise and G. J. Martin, Proc. Soc. Expll. Biol. Med. 34, 642 (1936). 



"1 G. Scoz, Boll. soc. Hal. biol. sper. 11, 908 (1936). 



"2 M. A. Abbasy, L. J. Harris, and P. EUman, Lancet II, 181 (1937). 



"3 E. H. J. Warns, Ned. Tijdschr. Geneesk. 82, 4426 (1938). 



"< O. Dobbelstcin, Z. ges. expll. Med. 107, 532 (1940). 



"6 K. Daum, K. Boyd, and W. D. Paul, Proc. Soc. Expll. Biol. Med. 40, 129 (1939). 



"6 Von Falke, Klin. Wochschr. 18, 818 (1939). 



*" S. L. Osborne and C. J. Farmer, Proc. Soc. Exptl. Biol. Med. 49, 575 (1942). 



"8 I. A. Kramarov, Khirurgiya 11, 27 (1940). 



"9 W. A. Andrae and J. S. L. Browne, Can. Med. Assoc. J. 55, 425 (1946). 



