25 - Salt Water

Intravenous or IV fluids are a ubiquitous treatment in medicine, and one of the most cost-effective treatments that we have, costing less than a cup of coffee in the developing world. But it wasn’t always this way. In this episode, called Salt Water, we go back to the second great cholera epidemic, where a young doctor developed IV fluids to help fight this mysterious disease, only to see his invention abandoned for over half a century. We also have a new #AdamAnswers about bloodletting. So join us for another rollicking adventure of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine!

Sources:

• Foex B. How the cholera epidemic of 1831 resulted in a new
  technique for fluid resuscitation. Emerg Med J 2003;20:316–318.
• Gill G. William O’Shaughnessy and the forgotten cure for cholera
  in the 1832 British epidemic.
• Letter from Lord Cavendish: Online at: http://mssweb.nottingham.ac.uk/elearning/view-text.asp?resource=HealthHousing&ref=pwh287&theme=3&view=text&page=1
• O'Shaughnessy, W.B. (1838–40). "Case of Tetanus, Cured by a Preparation of Hemp (the Cannabis indica.)". Transactions of the Medical and Physical Society of Bengal. 8: 462–469.
• Chan C, et al. Historical Epidemiology of the Second Cholera Pandemic: Relevance to Present Day Disease Dynamics. PLOS One: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0072498
• BB4: Diary of an Epidemic. Online at: http://www.bbc.co.uk/radio4/history/longview/longview_20030415.shtml
• Kresta R. The Origin of IV Fluids. Discover Magazine. Online at: http://blogs.discovermagazine.com/bodyhorrors/2016/05/31/intravenous-fluids-cholera/#.WX9z4JdtmUl
• Prasad V and Cifu A, Medical Reversal: Why We Must Raise the Bar Before Adopting New Technologies. Yale J Biol Med. 2011 Dec; 84(4): 471–478.

Further reading:

• r/AskHistorians thread: https://www.reddit.com/r/AskHistorians/comments/6nzbfz/if_bloodletting_was_rubbish_why_was_it_considered/
• Ending Medical Reversal by Cifu and Prasad. On Amazon at: https://www.amazon.com/Ending-Medical-Reversal-Improving-Outcomes/dp/1421417723