I met Bill Kaufman by letter in 1958, when I received a letter in which he pointed out an error I had made in our first report on the treatment of schizophrenia with vitamin B3. In our report we had written that as far as we knew, we were the first physicians to use these large gram dosages of nicotinic acid and nicotinamide. We should have known better. Bill wrote that he had been using these large gram doses since the mid 1940’s. I promptly wrote to apologize and asked for his reprints. Very soon two books arrived, both dealing with his use of this vitamin for the treatment of the arthritides and diseases of aging. They were amazing, well written, very precise, very clinical, and totally surprising. I had prided myself on being honest about prior claims in medicine and decided I could make amends only by writing a review of his books.

I sent my review to Bill to make sure of its accuracy and he returned it with many excellent suggestions for editorial changes. Bill was a much better writer than I was. I made these changes and then showed the article to the Chair of the Department of Medicine, Dr. Irwin Hilliard, at the College of Medicine, University of Saskatchewan, at Saskatoon. He read it and agreed that I should submit it for publication. It was accepted by the Canadian Medical Association Journal.¹ I also added a few patients of my own who, given this vitamin for other reasons, told me, to their surprise and to mine, that their joint pains and arthritis had also improved.

But this little paper of mine then got me into trouble with the Dean of Medicine, Dr. Wendell McCleod. A few months after my paper appeared we ran into each other in the corridor of the fifth floor of the hospital, the floor where I had my research laboratories. Wendell stopped me and spoke about my paper. He asked whether I had had anyone else read my paper before I submitted it. Strangely enough, this was one of the few times that I had asked other physicians to examine my papers. I replied that I had, and that Dr. Hilliard had agreed it was a good paper and should be submitted. Wendell promptly shot back that he did not think so. I became enraged and retorted that I did not give a damn what he thought about it and that no one was going to censor my papers. Then I asked him what was the matter. He replied that at a recent meeting in Toronto he had been attacked by several rheumatologists from the College of Medicine who questioned my right as a psychiatrist to prepare book reviews on arthritis. Wendell and I were friends and there was only a momentary cooling off but I became aware for the first time of the fierce jealousy between fields in medicine. Why should my medical degree, irrespective of my specialty, prevent me from expressing an opinion on other matters?

But this episode firmly fixed Bill Kaufman in my mind, and a few years later when I was in New York I met him. We had lunch together. From that moment on we were friends and whenever I could I would visit him at his office in that big city. After he retired we continued our relationship. I was really sorry when Charlotte, his loving wife, told me that at age 90 he had died.

This anecdote about my first connection with Bill will, I hope, make it easier for the reader to remember what Bill did, his major contribution, the proof that large doses of vitamin B3 were safe and, even more importantly, therapeutic for the arthritides and other diseases of aging.

Bill was one of three most eminent pioneers in orthomolecular medicine, long before the word was coined by Linus Pauling in 1968. He used nicotinamide in gram doses, usually four doses each day because it is so water soluble, for a large series of cases of arthritis with great success and published his two books before 1949. His CV is described in 20 pages. He published 66 papers in medical journals, more than 100 reviews of medical books for the International Archives of Allergy and Applied Immunology, of which he was editor for many years, 25 magazine articles, as well as poetry, radio programs, and unproduced plays. He won many honors and awards, including the Tom Spies Memorial Award in Nutrition in 1978, an Award of Merit by the American College of Allergies in 1981, and was cited for his work in Gerontology by the International Association of Gerontology in 1983.

Why was Bill Kaufman’s important discovery rejected? Only in the past few years was his discovery examined by a controlled study and confirmed. But during the years many orthomolecular physicians observed that their patients became better and I made his vitamin a permanent part of my arthritis regimen. I think there were several reasons his work was not recognized. First, by the time Bill began his work, the vitamin-as-prevention paradigm was fully established. This paradigm insisted that vitamins were to be used only for the classical deficiency diseases and only in small amounts, the recommended daily allowances. Bill’s work contradicted both of these essential pillars of that old paradigm. Arthritis is not a vitamin deficiency disease, or if it is, was never so recognized, and he used doses 1000 times larger than those needed to prevent diseases such as scurvy and pellagra. The old paradigm forbade any serious examination of this work. Secondly, about the same time the corticosteroid hormones were developed, were taken on by Merck and Company and the Nobel Prize was awarded to a scientist working for the Mayo Clinic in Rochester where the early studies of the effect of these steroids on arthritis was completed. The worldwide publicity was immense.

These steroids marked the introduction of the wonder drugs of that decade. The idea that steroids must be used became so well established that there was no time to even think about Bill’s work. This is a pity, for in contrast to the steroids, which even today have a limited use in acute cases, there is nothing as efficacious for many of these patients as vitamin B3 as described by Bill 55 years ago. But the most important reason is vitamins can not be patented. Think of the millions of arthritis sufferers who could have been helped if Bill’s work had caught on, if the steroids had not been developed, and so on.

We must honor Bill because of the great pioneering research he completed, using large doses of vitamin B3, what I call optimum doses, so long ago and with such great success. He was one of three most eminent pioneers. The others were Wilfrid and Evan Shute in Ontario with vitamin E for heart disease, and Fred Klenner in North Carolina with vitamin C for viral and other killing diseases, including polio.

–A. Hoffer, M.D., Ph.D., FRCP(C)

References

1. Hoffer A: Treatment of arthritis by nicotinic acid and nicotinamide. Can Med Assoc J, 81: 235-238, 1959.