Time and again, appropriate sanitation practices are of primary importance to the country’s health care system

Time and again, appropriate sanitation practices are of primary importance to the country’s health care system. 
Cholera – a rapid lethal dehydrating diarrheal disease that had killed millions across the Indian subcontinent and Europe. The disease said to be first broke out in Jessore (now in Bangladesh) in 1817 followed by the outbreak in Europe. European scientist Robert Koch went on a mission to understand this devastating disease examining thousands of patients who succumbed to it. He claimed to have discovered the bacillus that was causing cholera.

It was in 1950’s when Dr.Sambhu Nath De, a Kolkatta based scientist played a fundamental role in discovering the cholera toxin. After obtaining Doctorate and returning back to Kolkatta from London, he began working at Bose Institute with the resources and technology available. His ‘rabbit intestinal loop model’ work laid the foundation for his groundbreaking work in understanding cholera and related diarrheal diseases. At Bose Institute, His extensive studies on endotoxins of cholera bacteria strengthened the understanding of cholera pandemic and provided the foundation for oral rehydration salts therapy that saves millions of lives. 

“De’s clinical observations led him to the bold thought that dehydration was a sufficient cause of pathology of cholera that the cholera toxin can kill ‘merely’ by stimulating the secretion of water into the bowel,” said Nobel Laureate Professor Joshua Lederberg who had nominated the Indian scientist multiple times for the Nobel Prize. 

“It is the cornerstone of current anti-toxin vaccine research,” writes MSS Murthy, who wrote the book ‘Sambhu Nath De: The Discovery of Cholera Toxin’ published recently.

Despite being nominated a couple of times for the Nobel Prize in Medicine, he never got the nod.

“De did not believe in Koch’s poison theory, according to which the cholera bacterium produced an exotoxin that killed the victims. In fact, it took 76 years to find out the nature of the toxin produced by Vibrio Cholerae. It was Sambu Nath De who successfully proved that the toxin produced by Vibrio Cholerae was an enterotoxin (a cytotoxin specific for the cells of the intestinal mucosa). Not only that, he made a special type of loop, these loops are known as a ligated intestinal loop in medical terms. Using such type of loops De proved that Vibrio cholera produced one type of endotoxin which is responsible for the diarrhea seen in cholera patients. He was also able to explain why cholera often led to dehydration. It was a totally new finding and opened up a new direction in medical research”, writes Dhrubajyoti Chattopadhyay for Vigyan Prasar. 

Recognition for his contribution to medical science came later, and he was even invited to deliver a talk during the Nobel Symposium in 1978.

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