Therapeutic measures promoting recovery from the physiologic disturbances of infantile diarrhea.

ALTHOUGH the improvements in fluid therapy have seemed to result largely from recent clinical observations, actually the fundamental ideas were developed by research on experimental animals in laboratories of physiology, biochemistry, pharmacology and clinical medicine. In many aspects, the progress has depended on laboratory work using physiologic and biochemical methods but applied with a point of view arising from clinical experience. The opportunities for this type of research came largely with full-time medicine in clinical departments. I was led to the use of potassium in fluid therapy by studies which were carried out on experimental animals throughout a period of 10 years in association with Drs. Yannet, Harrison and Miller. We had the excellent technical assistance of Miss Carey, Miss Coville and Mr. lannucci and Mr. Barringham. During these years, the knowledge of the metabolism of water and electrolyte was advancing rapidly under the leadership of Gamble, Van Slyke, Peters, Loeb, Hastings, Fenn, Adolph, Butler, Homer Smith, and Newburg to mention only a few. In 1945, I summarized this knowledge of body water and electrolytes as related to clinical problems. Through the courtesy of Dr. Park, I came to Baltimore on VJ day to work for 60 days with the facilities of the pediatric department at Johns Hopkins. The study of diarrhea was made possible by the nurses, the resident, Dr. Govan, the head of the laboratory, Dr. Kaydi, and a superb technician, Mrs. Radcliffe. Through Hansen's generosity, Flett, Pratt, Wiese, Alice Gamble and I later extended these observations in Texas. We were able to show that deficiency of potassium occurs in diarrhea, that potassium may safely be used parenterally or orally and that improved results follow its use.