Abstract
Many thanks to Alastair Michell for drawing attention to O'Shaughnessy’s 1832 suggestion that mild cholera could be treated with salts in solution taken orally. 1 It is true that the statement at the beginning of the article is inappropriately more definite than it should have been. I meant (and should have written), ‘historians tell us’ not ‘history tells us’, and I'm sorry for any misunderstanding this might cause.
The statement later in the article, ‘oral rehydration therapy with salt and sugar, believed to have been first used in 1960’, reflects current thinking. Experiments in the 1940s and 1950s showed that sugar is needed for uptake of electrolytes given parenterally, and this was found later to be true of oral administration. Until the late 1980s, the name ORT was reserved exclusively to WHO- and UNICEF-supplied packs containing glucose as well as salts. Early oral rehydration attempts may not have worked well in the absence of sugar, which could partly explain why it was generally ignored after the 1830s. I surmised that if Drysdale had any success in the 1849 epidemic in Liverpool, it might have been because he used whey, which contains lactose as well as potassium and sodium salts. 2
The text in the James Lind Library will be modified appropriately after looking at O'Shaughnessy and will reference Michell's letter.