text: ascorbic acid has important properties in that the dry crystals are stable in the air for a very long period of time . however , once ascorbic acid enters into solution , it is capable of undergoing oxidation in a variety of reactions . the tendency of ascorbic acid to be oxidized increases with increasing ph . (&# 34 ; the antioxidant vitamins &# 34 ;, crc critical review , food sciences & amp ; nutrition , march 1979 , pp . 271 ). ascorbic acid is added , according to this invention , to the appropriate carrier at milligram levels , which is completely compatible with the ph of the vaginal cavity . although it has not been determined how ascorbic acid functions to detoxify bacterial toxins , it is known that ascorbic acid possesses relatively strong reducing power as is shown in its ability to decolorize many dyes . ( merck index , 8th ed .). these kinds of reactions may be accelerated by alkalies , iron ions and copper ions . in order to achieve the same chemical effect as ascorbic acid , very strong chemical reducing agents would be required . also , ascorbic acid is capable of reducing the disulfide bonds in proteins and toxins to free sulphydral groups , thus resulting in their biological inactivation ( charles e . clark and t . j . smith , &# 34 ; effects of ascorbic acid ( aa ) on diphtheria toxin and intoxicated hela cells ,&# 34 ; journal of nutritional science , vitaminology , 22 ( 1976 ) 313 - 319 ). the above described reducing power is probably the reason that compounds which are manifested as disagreeable odors are changed in character to a form which is non - offensive . ascorbic acid has demonstrated biological activities that are capable of completely inactivating diphtheria exotoxin in vitro ( ibid ) at concentrations of 90 micrograms ascorbic acid per milliliter . in order to achieve the same effect , strong reducing agents such as para - methylaminophenyl sulfate or 2 - mercaptoethanol would be required . however , compounds such as these would cause deleterious effects on biological tissues if administered to humans . there appears to be no known approach to tss prevention using ascorbic acid . this new use of a very safe product has been discovered , according to this invention , to posses essentially fully and complete prophylactic power for prevention of tss . we do not know the mechanism by which ascorbic acid renders the staphylococcal toxins ineffective , but we are aware that ascorbic acid will act as a reducing agent , an antioxidant and a free radical sequestering agent . we also , from in vitro testing , know that it does inactivate the causative agents in toxic shock syndrome . ascorbic acid is known to oxidize to dehydroascorbate . by a series of intermediate reaction steps , a protein or toxin , may interact with the ascorbic acid and any intermediates to break the disulphide bond and produce reduced sulfhydral group . it is necessary to emphasize that this invention is a result of discovery and that the actual mechanism of detoxification is not yet known . in addition to the staphylococcal toxins , menstrual blood contains a variety of proteins which are broken down to malodorous and toxic substances . it is also possible that ascorbic acid plays an important role in inactivating these endogenous toxic proteins before they are absorbed into the body . in the foregoing disclosure there has been no reference to catalytic agents and in fact catalytic agents are believed to be unnecessary in most instances . there are sufficient metallic ions present in most environmental situations to serve any catalytic requirements of the oxidation of ascorbic acid . nevertheless , in order to assure completion of the test results , and in actual commercial use it is recommended that some additional cupric ++ ion be provided in order to assure a complete reactions sequence . again , there are many possible and unknown reactions of ascorbic acid and toxins , but from a careful review of the observed action according to this invention , and from extensive theoretical studies , the above effect is probably at least one of the major reactions taking place in this invention . in this reaction sequence , ascorbic acid is the reductant , and the cupric ++ ion is the pro - oxidant which initiates the reaction . the cupric ++ ion is reduced to the cuprous + ion ( cu + ), along with molecular oxygen . for each molecule of ascorbic acid that is oxidized to dehydroascorbate , a molecule of hydrogen peroxide is liberated . hydrogen peroxide is a powerful oxidant when in the presence of cuprous + ion and is capable of generating hydroxyl radicals according to the reaction below : on the product side of the equation , the hydroxyl free radical (. oh ) that is formed is very reactive and is known to participate in reactions that irreversible inactivates proteins . it is recognized , however , that this invention is based upon laboratory observation of the inactivation of a toxin and the substantiation of such by laboratory animals . accordingly , the above theory is supplied as the best explanation that reasonable minds conceive , but the invention herein disclosed is based upon actual testing and not on the above theory . there are a number of inter - related reaction sequencces , in addititon to the ones described above , that could contribute to the toxin inactivation . as a means for supporting the presentation made herein , a supply of enterotoxin f was obtained from dr . bergdoll at the university of wisconsin . eighteen rabbits were injected intravenously with 10 micrograms per kilogram of body weight of staphylococcal entertoxin f . nine of the rabbits developed severe diarrheal illness and died within 72 hours . three additional rabbits developed severe diarrhal illness but survived . six rabbits developed no grossly detectable signs of illness . the ten micrograms per kilogram dose therefore appears to be close to the ld 50 ( lethal dose in half ) for this group of rabbits . fifteen rabbits were then injected with 10 micograms per kilogram of the same toxin which had been preincubated for one hour at room temperature with 1 . 0 milligram of ascorbic acid . none of the fifteen animals so challenged showed any signs of illness whatsover . on the basis of these data , ascorbic acid has demonstrated a statistically significant effect in neutralizing the staphylococcal enterotoxin f . it must be emphasized that testing of this invention on a human host can never be completely conclusive for the simple reason that there is no means of predicting which person may develop tss . however , it has been completely established that it is the toxin entering the blood stream that causes the toxic shock syndrome . it is submitted that by injecting the toxin into test animals results in a complete and conclusive means for establishing the toxicity effect upon the living animal . therefore , the destruction of the toxin &# 39 ; s ability to affect the animal is likewise fully and conclusively established . therefore , this invention is a prophylactic that can be safely used in substantially unlimited concentration because of its known compatibility with the human system , even in massive doses , and accordingly , having been established in its ability to inactivate the causative toxins of tss , it is safe to use on the general public as a prophylactic for the delerious toxins that are often produced by staphylococcal bacteria . to a solution of ascorbic acid prepared at a concentration of 1 . 0 milligram per milliliter in a 120mm phosphate buffer ph 7 . 4 containing 1 mm cupric chloride , add the appropriate amount of toxin , based on a dose of 10 micrograms of toxin per kilogram of body weight , to a 1 . 0 ml volume solution of ascorbic acid , so that it can be easily injected . for example , 30 micrograms of toxin per milliliter of ascorbic acid solution to be administered to a 3 kilogram rabbit . this step can be accomplished using any of the soluble forms of ascorbic acid , such as the free - acid or the sodium salt . care should be taken to keep the ph at about the 7 . 4 range to be compatible with intravenous injection . in addition , the solution of ascorbic acid should be protected from light . the crystalline form of ascorbic acid when used in commercial distribution , will not be effected by light , but in this protocol the solution should be protected from light , the toxin and the combination of toxin with ascorbate should be kept at room temperature for 1 hour to simulate time in the vagina prior to toxin absorption . at the end of that time , the entire material injection intravenously into the rabbit . this procedure will allow the interaction ( s ) to occur between toxin molecule and the ascorbate molecule . the injection into the animal is of the entire 10 micrograms per kilogram dose of the toxin . in order to place the ascorbic acid into position to serve as an effective prophylactic , it must be placed in the area where lesions may form at the time the toxins are known to form . accordingly , it is desirable to place the crystalline form of the ascorbate on a carrier device that may reside in the vagina during menses , as a napkin over the vulva , in birth control sponges , panty liners , spermicidal gels , and douche , among others . the popular available tampon is an ideal carrier which requires no new technology to construct . it has been found that the interstices of the tampon , whether the woven or molded non - woven fabric , is controllable to entrap the crystals of the ascorbic acid in a quantity ranging from 100 to 5 , 000 milligrams , and that lower quantity limit has been found to be sufficient for the intended purpose . the method of using the tampon as a prophylactic for the staphylococcal toxin is to simply provide the commericially available tampon as an insertable carrier for the vaginal of a human host . the ascorbic acid is added to the assorbent material either by surface dusting or placing a quantity of material within the body of the absorbent material , and inserting the tampon carrier into the vagina during menses . also , a solution of ascorbic acid may be used to soak the carrier , and when dry the crystalline material remains . the dry method is perfect for tampon , napkins , liners , and similar fibrous wear . it is necessary that the ascorbic acid be available to the cervix and vaginal mucosa of a human host in an effective amount , whether on the surface or within the body of the tampon . for those who do not wish to use a tampon , or possibly during light periods of menstrual fluid production near the end of the cycle , it has been found to be effective to incorporate the ascorbic acid with a carrier which does not have an ingredient that will deleteriously react with the acid . as an example , a base of inert aqueous pharmaceutical material as set forth below serves as a suitable carrier . therefore this invention is prophylactic that can be safely used in substantially unlimited concentration because of its known compatibility with the human system , even in massive doses , and accordingly , having been established in its ability to inactivate the causative toxins of tss , it is safe to use on the general public as a prophylactic for he deleterious toxins that are often produced by staphylococcal bacteria . the problem remains , then , of how to place ascorbic acid where it is needed without introducing side effects or destroying the effective properties thereof . although manual topical application is within the penumbra of this invention , such application is not very practical . this invention therefore , embraces the concept of combining ascorbic acid with the carriers which are products available in commercial usage . examples of such products are in three categories : another category of use which is of great value is the intravenous ascorbic acid therapy for toxin syndromes . tss is usually associated with women , during menses . statistical studies lead to the conclusion and the greatest number of female victims were those who had used super absorbant tampons during menses . the cause is considered to be the drying of the vaginal mucosa , resulting in lesions . s - aureus , which is always present in the vagina , produces the toxins pyrogenic exotoxin - c and enterotoxin - f . if the disruptives of the vaginal mucosa are open when the toxins are present , they enter the blood stream and tss results . &# 34 ; sanitary napkin &# 34 ; is a term used for a pad of absorbent material held in place over the vulva by belts or straps to catch the menstrual discharge . with the advent of insertable tampons , the sanitary napkin is often used only during high flow periods . there is relatively little danger of toxic poisoning when using exterior napkins because of the large flow , but more importantly there is little cause for mucosa disruption . nevertheless , toxin is often present and abrasions do occur . to prevent toxin poisoning , such napkins are provided with ascorbic acid physically entrapped in the interstices of the napkin . the object is to place an abundance of the acid in the area which contacts the flesh . dusting is the most direct and simple method when using woven fabric , and mixing with bonded non - woven slurry before molding is effective . to assure safety , it is recommended that at least 100 mg ascorbic acid are available to fluids reaching the surface of the napkin . this level will detoxify toxins in the greatest concentration known to develop . in a commercial napkin , as much as 5 , 000 mg have been found to produce no deleterious effect . the ascorbic acid may also be incorporated throughout the entire napkin by dusting the body of material during manufacture , or by wetting with the solution in an inert atmosphere and allowing to dry . dusting during or after manufacture is the recommended best procedure . the manufacture and use of an insertable tampon is fully described and claimed in u . s . pat . no . 4 , 585 , 792 as referenced above . panty liners are actually lighter versions of the sanitary napkin , and ascorbic acid is incorporated in the same manner . because a lesion may occur at any time , and by many causes , it is beneficial to include the ascorbic acid or derivatives thereof with all products of the four listed categories . as an example of a spermicidal composition which may carry ascorbic acid , a composition containing a vehicle and spermicide as set forth in u . s . pat . nos . 2 , 330 , 846 and 2 , 541 , 103 with about 100 mg to 500 mg ascorbic acid added , is effective for both spermicidal and detoxification functions . this invention is in the discovery for the means for safely and effectively eliminating the dangerous toxin of s - aureus , and the combination with a contraceptive carrier provides a product having a utility for dispersion and delivery to areas where toxin may be produced . the following are various vaginal preparations which are compatible with ascorbic acid added to give anti - toxic shock syndrome toxin protection . the sponge has interstices which are filled by compression and release , under inert gas atmosphere . another carrier vehicle to utilize the invention is the douche . the specifications for douche are : 4 ) ascorbic acid 0 . 1 - 10 . 0 mg / ml buffered to ph 4 - 6 with appropriate buffer ( e . e ., acetic acid / sodium acetate ) the douche may be prepared and stored under anaerobic conditions ( to enhance acid stability ) as a solution or as a powder to which water is added prior to use . ( 5 ) check ph , adjust to ph 5 with 0 . 1 n naoh or 0 . 1 n hc1 . ( 7 ) store in dark glass or plastic container to prevent degradation by light . directions : add contents of packet to 250 ml water , mix until powder dissolves , and use within 1 hour . in order to verify the results of testing using toxin produced by s - aureus , an experiment was performed using skin method of john p . craig . in this method , a bacterial toxin , i . e . cholera toxin from v cholerae , was injected intradermally into the shaved skin of rabbits . the toxin at doses of 1 and 5 nanograms was effective in causing vascular leakage in the skin . this toxin effect was completely blocked by mixing the toxin with ascorbic acid ( 0 . 01 mg / ml and higher ). other organic acids , such as pyruvic acid and maleic acid were not effective antitoxins at 1 mg . thus , the antitoxin activity of ascorbic acid is specific and not found with the other organic acids at even 100 times the concentration of the ascorbic acid . although toxic shocl syndrome can be essentially prevented if the disclosure above is followed faithfully , the toxic syndrome nevertheless will occur because of laxity and also from unsuspecting sources such as cuts , abrasions , boils and other skin eruptions . the syndrome is exceedingly distressful and does result in death in a considerably proportion of the numbers of persons who contract the disease . having seen the miraculous results of syndrome prevention as disclosed above , it has also now been discovered that those who nevertheless contract the disease , toxic shock syndrome is treatable , according to the further findings of this invention , by the intravenous administration by constant infusion of ascorbic acid . constant infusion apparatus and methods are well known to the medical arts , and widely employed in administering insulin . because human testing is prohibited at this stage of the development of the invention , the efficiency of this means of treatment was shown by treating five rabbits that had been given lethal toxic shock syndrome toxin injections . a 4 hour infusion of ascorbic acid in normal saline ( 10 mg ascorbic acid kg body weight / hour ) was effective in preventing death in any of the rabbits . a complete cure was accomplished .