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    Oral rehydration therapy: the scientific and technical basis.

    Hirschhorn N

    [Unpublished] 1983. Presented at the International Conference on Oral Rehydration Therapy, June 7-10, 1983, Washington, D.C. 8 p.

    Oral rehydration therapy (ORT) is based on the principle that when a child has diarrhea, it loses body fluids. Therefore, if one mixes some salts and sugar in water and feeds the solution to the child, making sure the child continues to take food or breast milk, the condition should be corrected. This principle was discovered through: 1) observation that children with dehydration drink the OR solution vigorously and greedily and when nearly hydrated, slow down and go to sleep; 2) based on that observation, values were gauged on scales of time, length, amount, and degree; 3) a hypothesis was postulated by thinking through the implications of a measured observation and asking questions about the amount of fluid needed; 4) different measurements were tested; and 5) the results of scientific testing were used for the widest possible benefit. ORT has been found preferable to the intravenous route because it can be given by people with little formal education, needs no sterile equipment, is inexpensive, safer, and can allow parents to participate in child care. The method by which the intestines absorb the OR salts is discussed. OR packets are packed in flat aluminum foil packets, paid for and stockpiled by UNICEF. The amount of salt in the formula is sufficient to replace sodium and water losses in severe dehydration although adults may need to drink extra amounts. The formula has proved useful in various conditions, climates, and physical states, and ORT has also come to imply restoration of a normal diet. It is suggested that in order to reduce the prevalence of malnutrition, an enriched ORT be developed that combines salt, potassium bicarbonate, glucose or a simple starch, and peptides or a simple protein. With this formula diarrhea is lessened, there is less waste of nutrients in regular food, and more protection of intestinal enzymes. In addition common local foods may be adapted to form an enriched ORT.
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