Abstract The specific effect of curare was demonstrated by Bernard1 in 1857. It is agreed that the peripheral paralysis caused by curare is due to block of nervous impulses at the myoneural junction. The demonstration of this specific effect led to the use of curare from 1857 to 1867 in the treatment of convulsive conditions, such as epilepsy, rabies, tetanus, chorea, strychnine poisoning and various tics.2 Curare was quickly discredited because of ignorance of action of the drug, timidity in its use, improper dosage and spacing of doses (since the effect of the drug is transient) and the fact that unassayed curare or curare of poor quality was used. The aforementioned conditions do not constitute the field of indication for curare. The medicament has a specific place in drug therapy, in which its specific action is utilized. This is the reduction of spasm and plastic muscular rigidity in patients References 1. Bernard, C.: Note sur la curarine et ses effets physiologiques , Bull. gén. de thérap. 69:23, 1865. 2. Jousset: Du curare au point de vue thérapeutique , Bull. gén. de thérap. 69:294 and 396, 1865. 3. West, R.: (a) Pharmacology and Therapeutics of Curare and Its Constituents , Proc. Roy. Soc. Med. 28:565, 1935 4. Pharmacological Study of Derivatives of Two Specimens of Tubo-Curare, and Examination of Four Members of Genus Strychnos and One Rubiaceous Plant Associated with Curares of British Guiana , Arch. internat. de pharmacodyn. et de thérap. 56:81, 1937. 5. Tsocanakis, G. D.: De l'action thérapeutique du bromhydrate de cicutine et du curare dans les états spasmodiques , Thesis, Paris, no. 211, Paris, Amédé LeGrand, 1923. 6. Kairiukschtis, V., and Kutorga, V.: Versuche die Muskelrigidität beim Parkinsonismus durch Injektion von Kurare zu beseitigen , München. med. Wchnschr. 74:537, 1927. 7. Bremer, F.: The Tonus and Contracture of Skeletal Muscles , Arch. Surg. 18:1463 ( (April) ) 1929.Crossref 8. de Almeida, O., and Moussatché, H.: Action du curare sur les contractures , Compt. rend. Soc. de biol. 117:499, 1934. 9. Steindler, A., and Lindemann, E.: Alterations of the Action Current of Skeletal Muscles Following Sympathetic Ramisection , J. Bone & Joint Surg. 11: 1, 1929. 10. It must be understood that the doses mentioned are for the spastic and not for the normal person. It is likely that such doses would be toxic to a normal person. 11. Dr. Paul Hoefer and Dr. Tracy J. Putnam noted changes in the electromyogram which persisted even up to twenty-four hours after injection of curare. 12. Rosenblueth, A.; Lindsley, D. B., and Morison, K. S.: A Study of Some Decurarizing Substances , Am. J. Physiol. 115:53, 1936. 13. Briscoe, G.: The Antagonism Between Curarine and Prostigmin and Its Relation to the Myasthenia Problem , Lancet 1:469, 1936. 14. It will be noted that no distinction is made between pyramidal and extrapyramidal rigidities of muscle. This distinction is unnecessary since the action of curare is peripheral. The effect of curare on athetoid movements is pointed out elsewhere. 15. Putnam, T. J.: Results of Treatment of Athetosis by Section of Extrapyramidal Tracts in the Spinal Cord , Arch. Neurol. & Psychiat. 39:258 ( (Feb.) ) 1938. 16. Altamirano, F.: Nuevas apuntas para el estudio del coralin—erytrina coralloides , Gac. méd. de México 23:369, 1888. 17. Folkers, K., and Major, R. T.: Isolation of Erythroidine, an Alkaloid of Curare Action, from Erythrina Americana Mill. , J. Am. Chem. Soc. 59:1580, 1937.
Archives of Neurology & Psychiatry – American Medical Association
Published: Feb 1, 1939