The Controversial and Short-Lived Early Use of Rehydration Therapy for Cholera

Oral rehydration treatment has prevented the deaths of millions of infants in the developing world. During the cholera outbreak of 1832 in Britain, 3 important advances in fluid therapy transiently emerged: intravenous fluid therapy, oral salt and water treatment, and chemical analysis of body fluids. William Stevens provided uncontrolled evidence that fluids and salt could prevent death, and William O'Shaughnessy found that water, salt, and carbonate were lost from the body in individuals affected by cholera and could be seen to be reduced in serum. Thomas Latta introduced intravenous fluid therapy. Early attempts to introduce oral fluid therapy failed to become established as cornerstones of clinical medicine because of a lack of convincing science and because of personal animosities. From the period just after World War II through the 1970s, the modern era of rehydration of patients with cholera and dehydrating diarrhea slowly developed, a process that may represent the finest example of translational research applying biochemical and physiologic observations to the clinic.