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CURARE
(Chondrodendron tomentosum - Menispermaceae)
From Arrow Poison to Surgical Muscle
Relaxant
It was from Sir Walter Raleigh’s
expedition up the Orinoco, Venezuela in 1595 that curare first gained
its fearful reputation. The trip’s historian described in
detail the horrific manner of death that resulted and the plant
was also named as a poisonous herb in a book written by one of the
party. La Condamine, the French explorer (and mathematician) was
the first to collect it in the late 18th century. He recognised
that it was the vine that was of prime importance and that it would
kill in less than a minute only if it entered the bloodstream, but
not otherwise. There was no danger in eating the animals afterwards
however.
Shortly after, in about 1800, at Esmerelda in Venezuela, Von Humboldt,
the Prussian naturalist and explorer, observed a brujo pounding
the vine fibres into a yellow runny mush to which he added water.
The substance was allowed to stand so as to evaporate the liquid.
Adding the juice of another plant resulted in a black, sticky molasses
type material and this was the substance they stuck to their arrows.
It could be tasted though without danger, being only dangerous in
the blood stream. But he was unable to make a botanical identification.
In the early 1800’s, the entertaining and eccentric English
squire, Charles Waterton, who gained fame by riding a captured alligator,
had observed the Maconsis making curare. In England, together with
a doctor, Ben Collins Brodie, he administered it to a donkey, which
collapsed and stopped breathing within minutes. Swiftly Brodie cut
the donkey’s windpipe and they inserted a bellows and pumped.
The donkey sat up. Two hours were spent like this until the poison
wore off and the donkey recovered. After its experience, it was
put to pasture for services to medicine.
By 1938, explorers had decided that the genus of vine ‘chondrodendron’
was the probable source. At that time, there existed only two species
of this vine. A British chemist had isolated the active ingredient
in 1935 and he named it d-tubocurarinechloride, ‘tubo’
referring to bamboo tube and indicating that it was the curare kept
in one. Around this time an American Richard Gill and his wife Ruth
bought a ranch in Ecuador and learnt the Quichua language, friendship
with the locals being the result. A small accident to his wife led
him to try local methods of medicine, which left him thoughtful
and so he noted carefully the plants used. Just before he was to
return to the States, Gill suffered a fall from his horse. It was
the beginning of an incomprehensible paralysis that was to last
months. In the States, his doctor made a chance remark about the
possible power of curare to help him and it dawned on Gill, that
his friends in Ecuador would know about the plant. It was the motivation
needed and Gill made the most extreme efforts to recover.
He returned to Ecuador, mounted an expedition and by barter and
persuasion collected about 75 different specimens. By comparing
ingredients used by several brujos, he identified the one recurring
plant, ‘tonispa pala ango’, a very thick woody vine
that wound through many trees. The New York Botanic Garden identified
it as ‘chondodendron’ of the moonseed family Menispermaceae.
Frustratingly, curare could relax limbs that had been crabbed and
frozen for years but only worked temporarily. Side effects were
so dangerous that they could suffocate a patient. However, an enthusiastic
supporter of Gill, Abram Bennett, tried it as a treatment for schizophrenia
and in so doing, established that at least it could be used without
causing harm to patients.
In 1942, curare finally found its place in medicine – as a
muscle relaxant during surgery. It was particularly suitable during
abdominal surgery, where the muscles were difficult to relax. A
Canadian doctor and anaesthesiologist first took the calculated
risk of administering it to an appendicitis patient - without either
the doctor or patient’s knowledge. Curare was to become an
important part of anaesthesia and a molecule on which other anaesthetics
were to be based. After Gills efforts to sell curare to the drug
companies had been rebuffed and scientists and governments had sidelined
him, he spent the rest of his life trying to turn curare into a
cure that he could administer to himself. He finally died in 1958
either of a typical multiple sclerosis or of amyotrophic lateral
sclerosis.
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