THE NEW YORK TIMES – Richard A. Cash, who as a young public-health researcher in South Asia in the late 1960s showed that a simple cocktail of salt, sugar and clean water could check the ravages of cholera and other diarrhea-inducing diseases, an innovation that has saved an estimated 50 million lives, died on Oct. 22 at his home in Cambridge, Mass. He was 83.
His wife, Stella Dupuis, said the cause was brain cancer.
In the 1960s, diseases like cholera and dysentery killed some five million children worldwide per year, primarily through dehydration caused by diarrhea and vomiting. Patients could go “from a grape to a raisin” within hours, Dr. Cash often said.
It was widely understood that rehydration could save many of them, but that was easier said than done: intravenous drips, the standard method, required equipment, training and clinical settings that were often hard to come by in the impoverished communities where the diseases festered.
Dr. Cash, the son of a doctor, arrived in East Pakistan, today Bangladesh, in 1967 as part of a project through the U.S. Public Health Service. There he worked with another young American doctor, David Nalin, to respond to a cholera outbreak outside the capital, Dhaka.
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The two had already been researching a simple oral rehydration therapy and knew of other, previous efforts, all of which had failed. But they believed that the therapy held promise, especially in the face of mounting deaths.
They realized that a main problem was volume: Past efforts had resulted in too little or too much hydration.
Dr. Cash and Dr. Nalin conceived a trial in which they carefully measured the amount of liquid lost and replaced it with the same amount …