A history of neuromuscular block and its antagonism

Abstract

Fifteenth century South American explorers knew of the indian arrowhead poison ourari or curare. The eighteenth century physician Bancroft brought samples of crude curare from South America, and in 1808 Brodie showed that it was safe if ventilation continued artificially. In 1846, Bernard demonstrated that curare acted where the nerve impulse reached the muscle, the neuromuscular junction. In 1912, surgeon Lawen used curare for tracheal intubation and surgical procedures. The idea did not catch on. In the 1930s, Gill brought curare from South America to the US. With Squibb chemists, pharmacologist McIntyre purified the crude extract as Intocostrin, which Holaday assayed for potency with the rabbit head drop test. By standardizing the concentration, this allowed Intocostin's study. In 1939, psychiatrist Bennet reported that Intocostrin prevented compression fractures from convulsive therapy. Cullen then tried Intocostrin in dogs, but because it seemed to cause bronchspasm said it had no place in anesthesia.