Richard A. Cash, who saved millions from dehydration, has died

“We’re enamored by high technology,” he said at the Council on Foreign Relations. “And we’re not in love with low-tech. Low-tech is always seen in our eyes as second-class. Why would you do this, when you could do that? And I would argue just the opposite.”

Noteworthy that others tried to gatekeep thier low tech approach and experimental efforts. So much "perfection, enemy of the good" in expert circles.

People tried oral rehydration before with isotonic solutions, even going as far as matching the concentration of minerals in plasma. It didn't work well for cholera.

The amazing discovery was that just a bit of glucose made the world of difference.

Regarding the dehydration work see:

> Oral rehydration therapy (ORT) is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea.[1] It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium.[1] Oral rehydration therapy can also be given by a nasogastric tube.[1] Therapy can include the use of zinc supplements to reduce the duration of diarrhea in infants and children under the age of 5.[1] Use of oral rehydration therapy has been estimated to decrease the risk of death from diarrhea by up to 93%.[2]

* https://en.wikipedia.org/wiki/Oral_rehydration_therapy

This caught my attention. From the article:

     Other doctors and nurses found their experiment [drinking water w/ sugar+salt] bizarre and tried to stop them.

And maybe it was that. But I also found this talk from Dr Cash; he gives other examples of resistance (along with their causes).

    Whereas, in one country I went to, Jamaica, I was puzzled, even though I was working at that time for PAHO, that there was terrific opposition. It seemed that they wouldn’t cooperate with anything. Even they wouldn’t give my assistant a bed in the residence quarters. 

    So I found out gradually—I was investigating this—and I found out several things. One is, the head of the hospital was so skeptical about this working that he had made a hundred dollar bet with his residents that it would fail. So obviously there was an incentive for it to fail. (Laughs.) 

    Secondly, the head of hospital stores, I found out, was making a lot of money on kickbacks from the IV company. So he had no interest in terms of resource flow of substituting oral for IV. 

Also mitigated many millions of hangovers, including my own.

Too bad the commercial nature of “sports drinks” have dialed up the sugar and broke away from the clinical goal of rehydration.

What a legacy to leave behind. RIP Mr. Cash, thank you for your contributions to humanity. May many others follow in your footsteps.

https://archive.ph/wTJu9

So I had cholera.

I was in a cholera study at the University of Maryland for a week. Read a lot of sci fi, played ping pong and drank fluids with electrolytes. There is a first phase which is uncomfortable but otherwise, as the docs said, cholera is a piece of cake if treated with hydration.

I met him in the late 1970s. I was too young then to understand his work at the time, but he was one of the few famous people I have met who genuinely cared about other people. He was as one of the good ones. RIP.

On a side note, his Wikipedia page has one of the worst, low res leading photographs for a topic I've ever encountered on that site. Surely a man of his stature deserves better?

In poor countries the government sometimes runs TV ads explaining how to make the rehydrating solution this at home. This simple program saved millions of children.

Boil the water, add sugar and salt... Voila

I also have a feeling that the pH of rehydration drinks should be low (acidic). To an extent, my body knows pretty well what's good for it. The salt+water tastes terrible, add a little acid and it's delicious. Maybe it takes a little load off of the digestive system by providing the acid that would otherwise need to be generated.

Another unsung hero that contributed to improve the world, IMHO it's a beautiful example of the fact that in the end it's not the degree of sophistication (even of the road to find it is steep) that really matters but how it translates into positive outcome in the physical world that eventually matters. Rip

Reminds me of Norman Borlaug.

Talk about leaving a dent.

for a few moments I was thinking "saved millions of dollars from dehydration". The title could be clearer if it said "saved millions of people from dehydration".