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Robert Phillips

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Robert Phillips
(dob - )
Born in
Year of Discovery: 1968
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Image Courtesy: Lasker Foundation

His Early Research Paved the Way for A Practical Treatment for Cholera

Phillips may have been doing what came naturally when he did his groundbreaking research. Both his father and his uncle were physicians. The two were partners in a medical practice, consisting of a clinic and a small hospital, which adjoined Phillips' boyhood home in Clear Lake, Iowa. Combining this rich medical tradition with a keen mind, Phillips was perfectly prepared to tackle the complexities of cholera. Phillips saw the futility of intravenous (IV) therapy. Though IV therapy was the only method available to rehydrate cholera patients, it was costly and required a clinical setting. Phillips' early experiments with Oral Rehydration Therapy (ORT) proved the ability of glucose to be absorbed within the gut of cholera patients - and, though he would minimize this detail in his reporting, to enhance sodium absorption. Glucose became a key component of ORT, and Phillips' early work set the stage for the full development of ORT as the simple, cost-effective, standard treatment of cholera worldwide.

Cholera is a deadly disease that spread from the Ganges delta in India in the 1800s to the rest of the world. It has been responsible for seven pandemics worldwide, resulting in millions of deaths. One of the primary means by which it kills is dehydration, as a result of severe diarrhea and vomiting. In fact, cholera can take someone's life in as little as four hours following onset of symptoms. Undeveloped nations are particularly at risk, as lack of pure drinking water combined with inadequate sanitation facilities allows the disease to spread rapidly.

Until the mid-1960s the only accepted treatment was intravenous therapy, a costly and highly technical method. Oral Rehydration Therapy (ORT) burst onto the scene as a lifesaving alternative thanks to the efforts of Robert Phillips, David Nalin, and Richard Cash. Phillips laid the foundation in clinical trials in the Philippines in the early 1960s. His work revealed the critical importance of glucose in the oral Rehydration process. Nalin and Cash expanded on these findings while working in Bangladesh (then East Pakistan) treating victims of a cholera outbreak. Though the conditions were not optimal, and they faced resistance from their colleagues, Nalin and Cash proved that intravenous therapy was unnecessary - the same results could be achieved through a simple solution administered by mouth. A mixture of clean water, salt and sugar became the low-tech solution to a global health crisis, and it is estimated ORT has saved over 50 million lives since.

Phillips first directly encountered cholera in 1947, while stationed in Egypt. An outbreak of cholera spread rapidly and 30,000 people were soon infected. Despite Phillips' coordination of a massive vaccine airlift form the United States the impact was devastating: 20,000 of those afflicted lost their lives. Phillips quickly established a small clinical trial, treating 40 of the sickest patients with IV therapy. Only three patients died, well below the rate of death in the general population. This further sparked Phillips' belief that cholera could be defeated, and he continued to intervene in cholera epidemics throughout the world. It was in 1961, while treating cholera patients in the Philippines, that Phillips came to realize a new treatment approach must be found. IV therapy was simply too expensive and required too much clinical support. So he and his colleagues began trials with ORT in early 1962. These studies established the critical importance of glucose in the treatment and laid the foundation for further development of ORT. Reflecting on the significance of their studies, Phillips predicted, "...one may be able to develop an oral treatment regimen which in the average case might completely eliminate the requirements for intravenous fluids."

Though Phillips was instrumental in establishing the foundation for ORT, his work was not without cost. In 1963 he continued his study of the importance of glucose being a primary component of the Rehydration therapy. But, convinced it was important to also show the simplicity of the protocol, Phillips insisted on conducting the research without laboratory support. This was a drastic departure for the normally precise scientist and the results were devastating - five of the 40 patients died of pulmonary edema (a buildup of fluids in the lungs), which led to congestive heart failure. The combination of the IV therapy, which they continued to use for safety, and the ORT appeared to have produced the fluid overload. Phillips was demoralized and came to seriously question the effectiveness of Oral Rehydration Therapy. In the ultimate irony, it was under Phillips' leadership, at the Pakistan-SEATO Cholera Research Laboratory (PS-CRL) in Dacca, that Nalin and Cash confirmed his earlier work. Though Phillips was still doubtful, and at times actually slowed their progress, Nalin and Cash finally provided the clinical proof necessary to validate Oral Rehydration Therapy. Phillips' long journey was over and the world had the treatment it needed to effectively combat cholera.
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Introduction by Tim Anderson


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Table of Contents

Introduction
Links to More Information About the Scientist
Key Insight
Key Experiment or Research
Key Contributors
Quotes by the Scientist
Quotes About the Scientist
Anecdotes
Fun Trivia About The Science
The Science Behind the Discovery
Personal Information
Science Discovery Timeline
Recommended Books About the Science
Books by the Scientist
Books About the Scientist
Awards
Major Academic Papers
Curriculum Vitae
Links to Science and Related Information on the Subject
Sources

 








Links to More About the Scientist & the Science

Time Magazine article discussing Phillips' research:
http://www.time.com/time/magazine/article/0,9171,842267-2,00.html

Military Medicine, by McCallum, referencing Phillips:
Military Medicine

Abstract of a book on cholera mentioning Phillips' research:
http://www.cababstractsplus.org/abstracts/Abstract.aspx?AcNo=19842013455




Sliders & Images here




Image Flow Here




Key Insight




Key Experiments or Research

 



Key Contributors

The Team
Explore other scientists who furthered this lifesaving advance.

Lifesavers Who Developed Oral Rehydration Therapy

David Nalin
Had the key insight ORT would work if the volume of solution patients drank matched the volume of their fluid losses.
Richard Cash
Provided crucial collaboration, working with Nalin on the key experiments.
Norbert Hirschhorn
Proved that patients could self monitor their intake of the solution.
David Sachar
Proved that coupled glucose/sodium/water absorption were intact in cholera patients.



Quotes by the Scientist




Quotes About the Scientist




Anecdotes




Fun Trivia About the Science




The Science Behind the Discovery



Personal Information



Scientific Discovery Timeline




Recommended Books About the Science




Books by the Scientist




Books About the Scientist

 



Awards




Major Academic Papers Written by the Scientist



Curriculum Vitae



Links to Information on the Science





Sources/References