I tear up every time I read the shockingly poetic description of the first time someone managed to successfully (albeit temporarily) reverse lethal dehydration via the administration of IV fluids. The account comes from Dr. Thomas Latta during an 1832 cholera outbreak in Britain:
As soon as I learnt the result of Dr. O’Shaughnessy’s analysis, I attempted to restore the blood to its natural state, by injecting copiously into the larger intestine warm water, holding in solution the requisite salts, and also administered quantities from time to time by the mouth, treating that the power of absorption might not be altogether lost, but by these means produced, in no case, any permanent benefit, but, on the contrary, I though the tormina, vomiting and purging were much aggravated thereby, to the further reduction of the little remaining strength of the patient;
The reference to Dr. O'Shaughnessy is regarding O'Shaughnessy's then-recent experimental confirmation that what cholera patients were dying from was specifically the depletion of water, salt, and bicarbonate.
People had been attempting to introduce depleted salts and fluids into dehydrated patients for a while at this point, but cholera prevents you from absorbing these things intestinally the way you normally would; trying to skip the stomach and go straight to the intestines just irritated the system, triggered more vomiting/shitting, and accelerated the losses.
So Dr. Latta got creative:
Finding thus, that such [intestinal injection], in common with all the ordinary means in use, was either useless or hurtful, I at length resorted to throw the fluid immediately into the circulation…..
Forget the intestines! He's gonna go straight to the veins!
The first subject of experiment was an aged female, on whom all the usual remedies had been fully tried, without producing one good symptom; the disease, uninterrupted, holding steadily on its course, had apparently reached the last moments of her earthly existence, and now nothing could injure her—indeed, so entirely was she reduced, that I feared I would be unable to get my apparatus ready ere she expired.
Having inserted a tube in the basilic vein, cautiously—anxiously, I watched the effects; ounce after ounce was injected, but no visible change was produced. Still persevering, I thought she began to breathe less laboriously, soon her sharpened features, and sunken eye, and fallen jaw, pale and cold, bearing the manifest impress of death’s signet, began to glow with returning animation; the pulse, which had long ceased, returned to the wrist; at first small and weak, by degrees it became more and more distinct, fuller, slower and firmer, and in the short space of half an hour, when six pints had been injected, she expressed in a firm voice that she was free from all uneasiness, actually became jocular and fancied all she needed was a little sleep; her extremities were warm, and every feature bore the aspect of comfort and health.
Sadly he didn't immediately realize that he had to keep monitoring the patient to periodically inject more saline until she was fully out of danger, so his patient died just under 6 hours after her miraculous recovery. It would be many decades of further trial and error before IV injections really became the miracle cure they are today. But what an amazingly vivid description of that nigh-magical first success!
Here's where my information is from, if you want to know more:
The “bench to bedside” (BTB) paradigm of translational medicine (TM) assumes that medical progress emanates from basic science discoveries t
