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A History of Neuromuscular Block and Its Antagonism

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The Wondrous Story of Anesthesia

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”.

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Acknowledgment

This work was supported by the University of California Department of Anesthesia and Perioperative Care.

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Authors and Affiliations

  1. Department of Anesthesia and Perioperative Medicine, University of California, 521 Parnassus Avenue, 94143-0648, San Francisco, CA, USA

    James E. Caldwell MBChB

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  1. James E. Caldwell MBChB
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Correspondence to James E. Caldwell MBChB .

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Editors and Affiliations

  1. Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA

    Edmond I Eger II MD Emeritus Professor

  2. Departments of Anesthesia, Stanford University, Stanford, CA, USA

    Lawrence J. Saidman MD Emeritus Professor

  3. Geoffrey Kaye Museum of Anaesthetic History, Australian and New Zealand College of Anaesthetists, Melbourne, VIC, Australia

    Rod N. Westhorpe OAM, MB, BS FRCA, FANZCA Former Honorary Curator

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© 2014 Edmond I Eger, MD

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Caldwell, J. (2014). A History of Neuromuscular Block and Its Antagonism. In: Eger II, E., Saidman, L., Westhorpe, R. (eds) The Wondrous Story of Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8441-7_50

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  • DOI: https://doi.org/10.1007/978-1-4614-8441-7_50

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