Use of Oral Fluids in Treatment of Diarrhea

The practicing physician cannot help but be somewhat surprised by the current interest and publicity given to oral rehydration therapy for diarrheal disease. Indeed, oral rehydration therapy has been used to some extent by all physicians who deal with diarrhea, and the history of its use as a folk remedy is probably as long as the history of diarrheal illness. Why, then, has interest in this rather mundane therapy reemerged? Only recently have we begun to understand how oral fluids are absorbed, and this has resulted in changes in the composition and indications for use of these fluids. Even though the need for fluid intake during an episode of diarrhea has appeared always to have been a part of folk medicine, the medical profession did not consider this practice until the early 19th century. In 1832, after William O'Shoughnessy, an Irish physician, described the chemical composition of the stools in cholera, Thomas Latta of Scotland attempted to treat cholera by the intravenous infusion of water and salts. Of the 15 cases he reported in The Lancet, five patients survived. Latta was criticized severely for this therapy, but it was pointed out (in discussion in The Lancet) that these five patients were saved from almost certain death.