An infusion of the bark of the Strych nos to.rifera caused the same effects as curara and curarine.
Curine has no apparent effect on motor nerves, but acts on the heart like vera trine or drugs of the digitalis group. Tillie (Med. Chron., Mar., '91).
In poisoning by curara muscular power is notably diminished. Grehant and Quinquaud (La Sem. Med., Apr. 22, '91).
The action of the drug on muscle tissue is a factor in the general paralysis induced. According to Reichert, doses insufficient to cause motor paralysis may increase the temperature, or primarily increase and secondarily diminish it. The use of quantities just sufficient to abolish voluntary motion act differently in different animals: the temperature from the first may be increased or de creased, or primarily increased and sec ondarily decreased, or primarily dimin ished and accordingly increased; gener ally there occurs a notable diminution or a decided increase, the former effect pre dominating-.
A variety- of curara from Colombia causes absolute paralysis of the muscle of the heart, the respiration continuing; and absolute paralysis and rigidity of the skeletal muscles at a much earlier period than happens in the case of an animal whose circulation ha.s been arti ficially arrested; also exemption of the motor nerves from paralysis until after dea.th and until the muscles show signs of poisoning. In an experiment upon a rabbit the effects produced were mark edly different from those caused by ordi nary curara. With the new drug the motor weakness only appeared near death; but there was marked action on the heart, as well as an early total pa ralysis of muscles and onset of rigidity. Tillie (Jour. Anatomy and Physiology, Oct., '93).
Medicinal doses render the pulse more full and exceedingly rapid,—there is marked dilatation of the blood-vessels of the skin and the various glands,—and the blood-pressure, though little affected by small doses, is decidedly lowered by large ones. The action on the circula tion is due to diminished inhibition on the heart, owing to paralysis of the ends of the vagi, while the accelerator nerves are stitnulated. It elevates temperature.
Immoderate doses cause great mus cular weakness and paralysis of all the voluntary muscles. The ends of the motor and sensory nerves are paralyzed, the former being soonest affected. Be yond a slightly-diminished contractility, the voluntary muscles are but little in fluenced. The spinal cord may be par alyzed by toxic doses, although the brain-centres remain unaffected until carbonic-acid narcosis sets in. It is like wise a powerful respiratory depressant, paralyzing the ends of the motor nerves distributed to the respiratory muscles; if the doses are lethal, the paralysis be comes central, finally producing death by its action on the respiratory muscles.
Butler ("Text-book of Mat. Med., Then, and Phan," '96).
Poisoning by Curara.—In. poisoning the movements of the heart are greatly accelerated, the pulse weak and dicrotic, the temperature high, respiration de pressed; extreme muscular weakness en sues, with inco-ordination of movements; urine is saccharine; paralysis of extremi ties and respiratory muscles supervene, and death ensues from the latter cause.
Treatmen,t of Curara treatment of the poisoning consists chiefly of artificial respiration and the employment of tetanizing agents, such as strychnine and picrotoxin. Alcoholic stimulants may be indicated. Caffeine, atropine, and chloral are sometimes of benefit.
Therapeutics.—Curara is more em ployed in the physiological laboratory than as a medicament pure and simple, and study of the drug on therapeutic lines has, in a measure, been inhibited because of its unreliable composition; so true is this latter that the caution is gen erally given that before any one sample is employed in the human subject its strength should first be tested on one of the lower animals. lIerck, however, puts out a reliable article: one that is care fully tested ere it is offered for therapeu tic purposes. It is a powerful remedy for good when employed in convulsive diseases, such as hydrophobia, traumatic tetanus, and epilepsy, and sometimes yields good results in paralysis agitans, locomotor ataxia, nervous debility, and the dyspepsia of emphysema.
Case of a boy, aged 16 years, who had suffered with epilepsy since infancy and in whotn the attacks occurred at inter vals of a few minutes. After all other 1 remedial measures had been exhausted ',/,0 grain of curara was injected hypo dermically, when the attacks recurred at intervals of hours instead of minutes. After six injections of curara, at five day intervals, in doses of 1/. or 7,, grain, complete relief was had; after several months no return of the epilepsy was experienced. Dobrorarow (La Senn Mal., June, '94).
It would seem, from Tillie's re searches, that a preparation from the bark of Stryehnos toxifera would afford a remedy of the same scope as curara, and one, moreover, that would be uni form in strength. TJsed judiciously, it would probably be a valuable addition to the list of antispasmodics, one espe cially available in neuropathies.