It would be difficult to find an adult today who has not heard of Oral Rehydration Solution (ORS), or does not know that Oral Rehydration Therapy (ORT) is what we should rush to provide to save the life of someone who has started passing watery stools.
It was not so simple prior to the 1970s! Cholera epidemics came as waves and spread across the world, ravaging populations. Survival then hinged on whether one could get quick access to a hospital for intravenous saline drips.
One of the flash points of the cholera story was when an outbreak occurred in a refugee camp near the India-Bangladesh border during the 1971 war. A young pediatrician called Dr Dilip Mahalanobis, was tasked to treat thousands of children with diarrhea in a make-shift hospital that had just 16 bed, and a very limited supply of intravenous fluid bottles!
Necessity became the mother of invention, when Dr Mahalanobis started feeding dehydrated children with an oral solution made from water, sugar and salt. He noticed that the death rate dropped from a whopping 30% to 3%!
The idea of trying oral rehydration solution in children who were pouring watery stools from the other end had seemed ridiculous then and had defied conventional logic. His approach had its basis on laboratory experiments that had shown glucose and sodium, if given together, to help each other get absorbed via a glucose-sodium co-transporter at the intestinal cell’s brush border. It could then drag water into the body partly reversing the fatal effects of dehydration.
ORS is now a household name, and is made up of a mixture of glucose, salt (sodium chloride), and Potassium chloride in exact proportions that can be made into a solution with water. It now comes in few new avatars as well: mixed with lycine, rice powder, zinc, selenium, or in a hypo-osmolar (diluted) form.
Scientists unanimously agree that ORS has been the crowning discovery of the medical profession of the last century and has saved more lives than any other. It continues to save a million lives annually.
Paradoxically, the scientific paper written by Dr Mahalanobis was rejected by a scientific journal when first submitted. And more disturbing is that he died last month at 87 in Kolkata unsung, without getting a Nobel or any national (Padma) award!
