Olivia Fraser Barsby is a biology and anthropology student at 平特五不中, specializing in conservation, ecology, evolution and behaviour.聽
Blowdart poison and modern anaesthesia: at first glance, you might not think they have much in common. And that鈥檚 fair鈥攖heir connection runs further and deeper than I鈥檇 ever imagined. But hey, surgery would look a heck of a lot different today without this relationship鈥攁ll thanks to 鈥渃urare.鈥�
Indigenous natives in Ecuador鈥攕pecifically, the peoples鈥攈ave long used to hunt in the rainforests of the Amazon. What makes this practice so effective, though, is the dipping of the darts in a poison that kills their targets. Curare is an umbrella term for certain extracts of tropical plants with paralytic properties and is thought to in a host of regional preparations. normally harmless when ingested, curare immobilizes its target when injected (i.e., via a blowdart)鈥攑erfect for hunting.
Curare (pronounced khyr-rah-ree) acts as a muscle relaxant鈥攊ts active ingredient is a chemical compound called . Normally, our muscles contract thanks in part to a chemical messenger called acetylcholine, which delivers messages from motor neurons鈥攖he cells that tell our muscles what to do鈥攖o the muscles themselves. For this delivery to happen, acetylcholine has to bind to special receptors. However, D-tubocurarine also binds to these receptors, essentially blocking acetylcholine from telling your muscles to contract and paralyzing them temporarily.
This can be seen to have a practical use in medicine pretty quickly鈥攕urgery is a lot easier when muscles are in a relaxed state. Take, for example, a relatively common procedure like an appendectomy. In order to get to your inflamed appendix, surgeons will have to slice through your abdominal muscles. We don鈥檛 all have abs of steel, but it鈥檚 still easier to cut through relaxed muscle tissue than muscles that are tensed.
Though curare has been for centuries, and with the compound began in the 1700s, we might have one particular individual to thank for its introduction into a clinical context. Richard C. Gill was into a family of doctors in Washington, D.C. in 1901. He followed in their footsteps and began to study medicine at Cornell until he was bitten by a travel bug and dropped out after his second year. After going back to finish a B.A. in 1927, Gill worked for the American Rubber Company in Peru for two years before he and his wife Ruth bought land in Ecuador and decided to make a permanent move.
At the age of 31, while back visiting the States, Gill and began experiencing a host of neurological symptoms, including a tremor. Other state that he had multiple sclerosis that manifested around this time. Either way, Gill was determined to find a way to treat his condition. His neurologist suggested travelling back to Central America in search of a plant that he thought might be able to help. Gill was finally well enough to travel back to Ecuador in 1936 and eventually came back to the U.S. with of plant product two years later鈥�25 pounds of paste that he would give to a pharmaceutical company called E.R. Squibb & Sons for research purposes and 75 pounds of botanicals that he would give to the New York Botanical Garden.
Back when they first moved to Ecuador, the Gills built a hacienda鈥攁 colonial estate, basically鈥攁nd began farming on the land they had bought. They developed relationships and trading affiliations with the Canelos Quichua and Achuar peoples in Pacayacu and Sarayacu that would prove critical for the transportation of all that curare back to the U.S. After the two-year long expedition, D-tubocurare was isolated from the imported curare and synthetic forms were made and sold. However, E.R. Squibb & Sons didn鈥檛 get much from practicing anaesthesiologists at the time.
Gill became with this lack of interest, which he thought stemmed from curare鈥檚 historical unpredictability. Before his expedition, the curare involved in research was trickling out of the Amazon in tiny amounts and differing combinations. Scientific attitudes created harmful misconceptions around its traditional blowdart hunting use. Because there was no effort to understand the distinctive regional types of curare鈥攔emember, it鈥檚 a general term used to refer to a host of plants with the same active ingredient that are sometimes combined in different amounts鈥攖he research surrounding it wasn鈥檛 valued.
In the end though, all it took was one medical team to try: Harold Griffith and Enid Johnson at the Homeopathic Hospital in Montreal. On a winter day in early 1942, used curare to supplement their use of an anaesthetic called cyclopropane. The combination worked wonders鈥攖he patient鈥檚 muscles were relaxed enough to make the surgery and recovery processes that much simpler. Though neither cyclopropane (too flammable) nor curare (effective synthetic versions are now available) are directly used in clinical settings today, they helped to form the basis for current anaesthetic practices: a triple cocktail of narcotics, analgesics and muscle relaxants.
Anaesthesiologist argues that a personality like Gill鈥檚 was necessary to advance the use of curare in a clinical context. His connection to the Achuar and Canelo peoples in Ecuador was necessary in order to realize the potential role of muscle relaxants in contemporary anaesthetic practices. Interestingly, Gill never revealed the names of the ingredients, nor the locations of his teachers, perhaps because he did not want to exploit these relationships or go back on any deal that had been made. It is important to recognize and reflect on the fact that European and North American settlers continue to benefit from the discovery of curare, a compound made by Indigenous peoples on their traditional lands. Surgical practices would not have evolved the same way without them and their knowledge.
