I know this little thing/A myriad men will save/ O Death where is thy sting?/The victory, O Grave?
These lines by British doctor Ronald Ross (1857-1932) inscribed on a wall of SSKM (formerly Presidency General) Hospital, Calcutta, commemorates his epochal discovery of the life cycle of the malaria parasite for which he was awarded the Nobel Prize for physiology or medicine in 1902. In the 1950s, a doctor from the same city was instrumental in discovering the cholera toxin. He had shown that dehydration was a sufficient cause for death, contributing immensely to the understanding of cholera and other diarrhoeal diseases. That doctor, Sambhu Nath De (1915-85), however, did not receive the Nobel Prize despite being nominated for it more than once, nor any other major recognition.
De’s achievement should be gauged in the context of the devastation cholera has been causing since “the first well-defined cholera pandemic began in August 1817 in Jessore, now in Bangladesh”. Even in 1950, out of 1,76,307 cases, 86,997 deaths were reported from India, with the fatality rate of 49.34 per cent. Fifteen years later, though the number of deaths was still as high as 12,947, the fatality rate reduced to 29.9 per cent. Thereafter, things started improving drastically — with few deaths and the fatality rate becoming insignificant. What happened in between? Sambhu Nath De: The Discovery of Cholera Toxin by MSS Murthy (2018) gives a complete picture of what De achieved and how, placing his work in its historical context. Murthy was inspired to probe deeper into De’s work by Prof. P Balaram, director of the Indian Institute of Science, Bengaluru.
In the book, Murthy chronicles how the understanding of the deadly disease started evolving since the time cholera hit Europe in the 1830s. Its outbreak in Egypt in 1883 saw France setting up a commission under Louis Pasteur and Germany under Robert Koch. Koch came afterwards to Calcutta, examined many patients and victims and claimed to have discovered the cholera-causing bacillus. Koch, ultimately proven wrong, had mixed up the cause with the effect. After nearly 75 years, De “developed a successful animal model to identify the site of action of the bacteria and also discovered the cholera toxin”.
Raised in a village near Calcutta, De obtained a scholarship to study at the Calcutta Medical College in 1935. MN De, a professor at the college who later became his father-in-law, noticed his calibre and sent him for PhD at the University of London in 1947. After his doctorate, De returned to Calcutta, where he started working with his co-workers and reinvented and perfected a technique called “the rabbit intestinal loop model”, which is still used for studying the enterotoxicity of various agents.
In England on a fellowship in 1955, De presented his paper on cholera and E. coli at the Patholo-gical Society of Great Britain which was highly acclaimed. His Professor, GR Cameron, described him “as probably the best of the experimental pathologists of India”. Subsequently, he returned home to join Calcutta Medical College as professor-director of pathology. After discharging his academic duties, he’d go to the Bose Institute to pursue his goal, and succeeded in discovering the cholera toxin.
De’s discovery of cholera enterotoxin and its significance could not be grasped immediately. But Murthy writes, “It is the cornerstone of current anti-toxin vaccine research.” De was nominated for the Nobel Prize a number of times by Joshua Lederberg, who won the 1958 Nobel Prize in Medicine. De’s work provided the theoretical foundation for the oral rehydration salts therapy that saved millions of lives in the developing world. While his contribution was drawing international acclaim, De felt disheartened at home for many reasons. Prof. Balaram points out that De could not extend his fundamental work to its natural conclusion possibly because of the “scientifically inhospitable environment.”
De retired in 1973 at the age of 58. In 1977, he wrote: “I am now running a grocery shop, viz. a clinical diagnostic laboratory at my residence…” In his Nobel Symposium talk (1978), he said: “I have been dead since the early 1960s. I have been exhumed by the Nobel Symposium Committee… I discontinued my work on cholera enterotoxin as soon as I felt that with the limited resources and technology at my disposal, it would be impossible for me to pursue it further as I desired…” In 1985, De passed away. While greatly inspiring, De’s life also raises questions about the climate of scientific research in India.
Amitabha Bhattacharya is a retired IAS officer