India's 20th Century Medical Pioneers (that you've probably not heard of) | #183

+ the history behind a 100 year old soap brand 👉👉

Dec 02, 2023

Hola friends,

The Sushruta Samhita, is a Sanskrit text on medicine and surgery. It is generally accepted by scholars that there were several ancient authors collectively called "Suśruta" who contributed to this text. The text details various surgical techniques, including rhinoplasty (reconstructive nose surgery) and procedures for cataracts.

Sushruta Samhita is generally dated to 600 BCE. All this to tell you that India has had a long history with medical research and innovation. This week’s newsletter, we take a look at some pioneers from India and their contributions.

Things we learnt this week 🤓

We’ve all had our bouts with a stomach bug. You lose appetite and consequently the body loses energy. The solution - ORS. We can thank Dr Dilip Mahalanabis for what the Lancet journal has called “the most important medical discovery of the 20th century.” During the 1971 Bangladesh Liberation War, Dr. Mahalanabis faced a critical challenge in refugee camps, where cholera and diarrhea outbreaks were rampant due to poor sanitation and limited clean water. With intravenous fluid stocks depleting and insufficient trained staff for IV treatments, Dr. Mahalanabis innovated a lifesaving solution. He utilized his research on water absorption enhancement through a sugar and salt solution, creating an oral rehydration solution (ORS) using simple ingredients: glucose, sodium chloride (table salt), and sodium bicarbonate (baking soda). This ORS, stored in large drums for easy access, significantly reduced the fatality rate in his camp to 3%, compared to 20-30% in others relying solely on IV fluids. In India, July 29 is commemorated as ORS Day, celebrating this critical medical advancement. Also, before his death the good doctor donated his life’s savings of Rs 1 crore to Institute of Child Health (ICH), Kolkata where he had begun his journey as a pediatrician.
What’s your favourite ORS flavour?

In the 1980s, India faced a significant health challenge with cataracts causing 80% of all blindness. Fast forward to today, and cataract surgery is widely accessible, with over 8.3 million operations performed in 2022-2023. This transformation owes much to Dr. Govindappa Venkataswamy, an ophthalmologist who not only performed over 100,000 eye surgeries during his career but also founded Aravind Eye Care in 1976. Inspired by models of mass-scale efficiency like Coca-Cola and McDonald's, Dr. Venkataswamy envisioned Aravind as a means to deliver millions of sight-restoring surgeries. They’re known for their innovative practices, such as an 'assembly line' system in operating rooms. Here, Aravind surgeons, performing over 2,000 surgeries a year, can complete up to 50 cataract operations daily, with each surgery taking as little as five minutes. This efficiency is achieved through a dual-bed system in each operating room, allowing for continuous surgery with minimal downtime. Dr V was the visionary who gave others the gift of vision.
Two visionaries!

Yellapragada Subbarow, an Indian biochemist, made significant contributions to cancer treatment and other medical fields in the mid-20th century. Born in 1896 in Andhra Pradesh, India, Subbarow faced early challenges, including financial struggles and family responsibilities. He attended Madras Medical College, supported by friends and family, and later moved to the U.S. for research at Harvard.
- Subbarow's notable work at Lederle Laboratories includes:
  Developing Teropterin - a derivative of synthetic folic acid, which showed promise in treating cancer of the esophagus.
- The development of Methotrexate - a key drug for various cancers, psoriasis, rheumatoid arthritis, and ectopic pregnancies.
- His research during World War II led to diethylcarbamazine for filariasis
- His legacy also includes the Fiske-Subbarow method for measuring phosphorus in tissues and the synthesis of folic acid. Source.