Curare. (Curara)
By Constantine Hering — The Guiding Symptoms of our Materia Medica
A powerful poison used by the South American Indians upon their arrows.
Supposed to have been first introduced into Europe by Sir Walter Raleigh, in 1595, who became acquainted with it in Guiana.
"Authorities differ as to the composition of this poison. Probably several totally different kinds of poison are designated by the same name. According to M. Goudot, who learned the mode of preparation from an Indian tribe, it is made by adding to the concentrated juice of a creeping plant called Curari, the poison obtained from the virus bags of some of the most venomous serpents. Another author and traveler, M. de Castellnau, who witnessed the preparation of the poison by another tribe, says that it is composed of the inspissated juice of the Cocculus toxicoferus, and of a new species of Strychnos. Further observations will doubtless show that there is a great difference in the effects of different specimens of curara poison. M. Roulin asserts that the poison is obtained from a species of toad by half roasting the animal over a slow fire, when the venom exudes from the pores of its skin and is carefully collected on small wooden knives and preserved in small earthenware vessels.
The curara poison, which has found its way to Europe, is usually a brownish-black, resinous looking substance, something like the extract of liquorice. It seems to keep well for an indefinite length of time. A heat of 212° does not seem to destroy its power. The active principle is soluble in all animal fluids whether acid or alkaline. The aqueous and alcoholic solutions are of a fine red color, the former the darkest. A peculiar substance called Curarine has been obtained from it". --Bernard, B. J. H., vol. 16.
Fragmentary proving of the 500th by Mc Farland.
Proving in the Nouvelles Données, par L. T. Houat, translated by S. Lilienthal, H. M. , Vol. 4, pp. 137 and 177.
CLINICAL AUTHORITIES.
- Ptosis , Freeman, Hom. Rev., v. 9, p. 511 ; Ozæna , Hardenstein, Hom. Clinics, v. 4, p. 100 ; Facial and buccal paralysis , Freeman, Hom. Rev., v. 9, p. 561 ; Paralytic failure of power to swallow , Freeman, Hom. Rev., v. 9, p. 562 ; Schirrhous ulcer of os uteri , Hardenstein, Hom. Clinics, v. 4, p. 104 ; Vaginitis , Hardenstein, Hom. Clinics, v. 4, p. 102 ; Debility and cough of phthisis , Freeman, Hom. Rev., v. 9, p. 564 ; Paralysis of deltoid , Freeman, Hom. Rev., v. 9, p. 562 ; Nervous debility , T. F. Allen, Organon, v. 3, p. 108 ; Paralysis , Freeman, Hom. Rev., v. 9, p. 562 ; General motor paralysis , Freeman, Hom. Rev., v. 9, p. 562 ; Epilepsy (nine cases) in conjunction with Acid mur., Kunze, Hah. Mo., v. 12, p. 405 ; Epilepsy (five cases) cured by injections, Benedict, B. J. H., v. 24, p. 684 ; Lyssa humana , Zeitsch. f. Med., 52, 1875.
MIND [1]
Indecision, no longer wishes to think and act for herself. θ Nervous debility.
Very much depressed about herself, desire only to shut herself up away from people. θ Nervous debility.
Despairing. θ Ulcer of os uteri.
Hydrophobia.
SENSORIUM [2]
Instant giddiness ; falling down in a swoon or fainting while standing or walking.
INNER HEAD [3]
Nervous headache ; lancinating, piercing pains all over head, forcing him to lie down and stretch himself ; head drawn backward, with stiffness of neck ; painful oscillation of brain, as if it were full of fluid ; neuralgic pains, starting in front and radiating to neck and face ; violent blows in region of cerebellum.
Sharp sticking pains over right eye, extending backwards over right side of head. θ Nervous debility.
Head beats like a hammer, with vomiting of bile.
Vertical and frontal headache. θ Paralysis.
Occasional rush of blood to head. θ Nervous debility.
Congestion of blood to head, with pulsative vibrative pains and loss of consciousness.
OUTER HEAD [4]
Head drawn backward, with stiffness of neck, swinging and trembling of hands. θ Headache.
SIGHT AND EYES [5]
Eyes haggard, sunken. θ Nervous debility.
Black spots before vision (patient quite myopic), especially < from reading. θ Nervous debility.
Ptosis on right side.
HEARING AND EARS [6]
Different noises in ears, as of whistling, or crying of animals.
Unbearable earache ; loses consciousness.
Lancinating nervous pains, starting from ears, and reaching down to legs, obliged to lie down.
Internal otitis, driving one crazy ; purulent discharge.
SMELL AND NOSE [7]
Ozæna, with fetid lumps of pus, of six years standing.
UPPER FACE [8]
Dull, anxious expression, with clay-colored skin. θ Ulcer of os uteri.
Redness of face, head beats like a hammer, after fever.
Aching of right side of face. θ Paralysis.
Facial and buccal paralysis ; in some cases with difficulty in swallowing.
LOWER FACE [9]
Blueness of lips, body purple, with fever.
TASTE, SPEECH, TONGUE [11]
Tongue deep red, cracked and bleeding.
Tongue and mouth drawn to right side. θ Paralysis.
INNER MOUTH [12]
Dry mouth. θ Diabetes.
PALATE AND THROAT [13]
Paralytic failure of power to swallow.
APPETITE, THIRST. DESIRES, AVERSIONS [14]
Appetite variable. θ Paralysis.
Thirst and great hunger with the fever.
Great thirst, especially evenings and at night. θ Diabetes.
EATING AND DRINKING [15]
Amelioration after first mouthful of food.
HICCOUGH, BELCHING, NAUSEA AND VOMITING [16]
Hiccough frequent and annoying. θ Nervous debility.
Nausea in morning. θ Nervous debility. θ Paralysis.
Gastric troubles, nausea after eating, or in morning.
Dry, spasmodic cough provokes vomiting.
Vomits green bile all night, nasty taste ; bad feeling in stomach ; so weak, cannot stand or her feet.
SCROBICULUM AND STOMACH [17]
Rheumatic pain in pit of stomach, at times quite sharp, followed by nausea.
Shooting in stomach. θ Diabetes.
Digestive functions entirely prostrate, cannot bear anything on stomach, pyrosis, pain and distension after eating ever so little ; can eat only cornmeal mush and drink coffee. θ Ulcer of os uteri.
ABDOMEN AND LOINS [19]
Wearing ache from throat to left hip. θ Paralysis.
STOOLS AND RECTUM [20]
Diarrhœa, with constant urging, fetid, thin, mush-like feces, excessive pain in hemorrhoidal tumors. θ Ulcer of os uteri.
Extreme watery diarrhœa.
URINARY ORGANS [21]
Clear and frequent urine, with digging, crampy pains in kidneys ; shooting in stomach ; dry mouth ; great thirst, especially evenings and at night ; sugar in urine, with great emaciation.
Diabetes, acute cases.
FEMALE SEXUAL ORGANS [23]
Ulcer of os uteri, funnel-shaped, upper diameter one inch ; whole neck of womb of a horny-like character, dark red, purplish, gnawed as if from mice all over surface of ulcer ; two small opaque pustules of size of pea on inner edge, containing in middle a translucent bloody fluid. Ichorous discharge, corroding, fetid ; indurations of abdominal parietes towards inguinal and ovarian regions, excessively painful to touch. Vaginal corrugations tumefied, reddish, inflamed ; very sensitive hemorrhoidal fissures and swelling of rectum and anus. General appearance of scirrhous cachexia. Digestive functions entirely prostrate.
Diarrhœa with constant urging. Excessive pain in hemorrhoidal tumors ; bearing down of womb, pains and shocks, sharp shooting stitches ; quivering in womb ; burning in womb and all around it ; dull, anxious expression ; aching in all the limbs and body ; rigors at 2 A. M., no more sleep ; some fever ; seldom moisture, except under arms ; despairing.
Ulcerations on os uteri ; smarting in vulva and thighs ; shooting and digging pains in womb.
Indolence, does not like to work or move about ; night sweats ; repugnance to sexual intercourse. θ Vaginitis.
Menses very capricious, either too soon or too late.
During menses colic, headache, pains in kidneys, general malaise and hypochondriasis.
Scanty, thick, purulent, foul smelling leucorrhœa, in clots.
VOICE AND LARYNX. TRACHEA AND BRONCHIA [25]
Frequent hoarseness ; suffocating attacks, with sensation as if larynx were stopped up. θ Cough.
Burning and shooting in larynx ; hoarseness which occasions almost complete loss of voice. θ Cough.
Sensation of roughness and dryness in whole course of respiratory passages.
RESPIRATION [26]
Shortness of breath. θ Nervous debility.
Respiration difficult, stitching pains in right side. θ Cough.
Dyspnœa from weakness of respiratory motor nerves, as in phthisis and emphysema.
COUGH [27]
Short, hacking cough, no expectoration, always dry, with soreness of walls of chest, < in damp weather, or laughing. θ Nervous debility.
Cough, dry, spasmodic, shakes whole body, provokes vomiting, and is often followed by fainting.
Chronic cough, always troublesome in morning. θ Nervous debility.
Cough < by breathing cold air, laughing, moving and eating.
Cough with white gelatinous expectoration. θ Paralysis.
Debility and cough, with free gray expectoration, in phthisical patient.
Expectoration yellow, gray, greenish, bordering upon black.
Expectoration of red blood, often without cough.
INNER CHEST AND LUNGS [28]
Burning heat in chest with sensation of distension. θ Cough.
Severe pains in lungs, especially left ; sharp piercing pain through chest, always much < in damp weather ; shortness of breath ; chronic cough. θ Nervous debility.
HEART, PULSE AND CIRCULATION [29]
Precordial anguish, with palpitation and stinging pains in heart. θ Cough.
OUTER CHEST [30]
Great soreness of chest, can hardly bear pressure of stethoscope. θ Nervous debility.
NECK AND BACK [31]
Dull, tired ache in shoulders and across back ; numb, tired pains up and down spine and in head. θ Nervous debility.
Pain in loins. Paralysis.
UPPER LIMBS [32]
Complete paralysis of right deltoid muscle ; no pain ; after an apoplectic attack.
Pain and numbness on left side of chest and left arm ; tongue and mouth both drawn to right side ; both eyes and both ears fairly good ; grasp of left hand fair ; vertical and frontal headache ; right face aches at times ; fear of falling forward on rising ; nausea in morning ; appetite variable ; perspires with every exertion ; pain in loins ; prolapse of uterus for several years ; wearing ache from throat to left hip ; cough with white gelatinous expectoration.
Arms and fingers weak, as after a long illness ; arms become numb, and as if sprained or broken at elbows ; this pain extends to shoulders and across back a dull tired ache ; feeling as if heavy weights were hanging to arms ; same pains up and down spine and in head, numb tired pains ; similar pains in knees ; desire to stretch elbows, but muscles of arm are sore ; feeling along arm as if it had been burnt ; pains much < in damp weather. θ Nervous debility.
Leaden heaviness in arms, with increasing difficulty in playing piano. θ Nervous debility.
In evenings, arms and hands swollen, more painful and heavy. θ Nervous debility.
Great weakness especially of wrists and hands. θ Nervous debility.
LOWER LIMBS [33]
Legs tremble and give way in walking.
Sciatica, with great stiffness.
Corns. θ Nervous debility.
LIMBS IN GENERAL [34]
Aching in all the limbs and body. θ Ulcer of os uteri.
Paralysis of extremities with burning heat and chills.
REST. POSITION. MOTION [35]
Lying : in bed < aching in feet and back.
Lie down and stretch : pain in head forcing him to.
Always desires to put her feet out of bed.
Cannot stand : so weak.
Standing : fainting.
Laughing : cough, soreness of chest <.
Rising : fear of falling forward.
Stretch : desire to stretch elbows.
Moving : cough < ; crampy pains.
Does not like to move.
Motion : perspires.
On least movement : crampy pains in hips.
Walking : fainting while walking ; legs give way.
NERVES [36]
Nervous Debility.
Debility of the aged, great failure of strength ; no cough, pain, or disordered digestion.
After being bitten by a dog suspected to be rabid, muscular restlessness, spasms, hydrophobia, and photophobia, and instead of the anguish she was in good humor ; (cured by injections, which were followed by symptoms of paralysis, from which patient had not entirely recovered even after a few months).
Great weakness and prostration, burning in hips, and crampy pains on least movement.
(OBS :) Frequent epileptic fits with convulsions, loss of consciousness, lasting from a quarter to half an hour, followed by somnolence of many hours, or even mental disturbance for two days.
(OBS :) For four years fits of "petit mal", and for the last five months, seven fits of complete epilepsy of great intensity.
(OBS :) Two brothers, suffering from a disease intermediate between raging mania, chorea major, and epilepsy, had fits twice a day, of one to three hours, in which partial loss of consciousness and delirium were present, but generally with retention of consciousness, involuntary movements, springing, pirouetting, creeping, scratching on the floor, etc., between which intervened paralytic symptoms, numbness, aphonia ; besides these fits, there was general weakness, especially in morning.
Pure paralysis ; nervous debility, from loss of fluids, or exhausting illness.
Double facial and right lateral paralysis (in consequence of repeated epileptic attacks), swallowing and articulation also affected.
Instant giddiness ; paralysis of the lower extremities and in fact everywhere.
Considerable general motor paralysis, no pain.
Paralysis from mechanical injury.
(OBS :) Traumatic tetanus.
Progressive locomotor ataxia.
SLEEP [37]
Nights restless, always desires to put feet out of bed, especially towards morning.
Cannot sleep late enough to obtain a good night's rest ; dreams of fire and of the business of the day ; < from lying long in bed, must get up as her feet and back ache. θ Nervous debility.
TIME [38]
At 2 A. M. : rigors.
Morning : nausea ; cough troublesome ; heat > ; general weakness.
At 2 or 3 P. M. : fever continuing into night ; 4 P. M., fever.
In evenings : arms and hands swollen ; great thirst.
At night : restless ; great thirst ; heat < ; cold and bloody sweat.
All night : vomits green bile.
TEMPERATURE AND WEATHER [39]
Aggravation by dampness, damp weather, change of weather, or cold wind.
Open air : heat <.
Cold air : cough < by breathing.
Damp weather : cough and soreness of chest < ; soreness and pains in arms <.
FEVER [40]
Sensation of shivering, starting from stomach and spreading over whole body.
Chill : without thirst ; commencing on abdomen and spreading all over.
Rigors at night, about 2 o'clock ; no more sleep ; some fever ; seldom moisture, except under arms. θ Ulcer of os uteri.
Burning heat accompanied by partial and transient chills, incoherent speech, and often by paralysis of extremities.
Pernicious fever, with constant chilliness.
Incoherent speech, with burning heat and chills.
Yawning and stretching, hot head and hands, convulsive paroxysms and fainting.
Burning in hips, great weakness and prostration, crampy pains on least movement.
Lips get blue, and body purple, with fever ; after fever (every day at 4 P. M.), gets very red in face, and head beats like a hammer.
Daily fever, commencing at 2 or 3 P. M., and continuing well into night.
Fever with thirst and great hunger.
Heat : with thirst ; especially in head, on back and legs.
Heat < at night or in open air, less in morning.
Perspires with every exertion. θ Paralysis.
Sweat cold and bloody, especially at night.
ATTACKS, PERIODICITY [41]
Attacks : suffocating.
Apoplectic attack followed by paralysis of right deltoid.
Acute spasmodic affections.
Instant : giddiness and falling.
Frequent : annoying hiccough ; clear urine ; hoarseness ; epileptic fits with convulsions.
Occasional rush of blood to head.
At times : right face aches ; quite sharp rheumatic pains in pit of stomach.
Quarter to half hour : duration of epileptic fits.
One to three hours : duration of fits.
Many hours : somnolence following epileptic fits.
Twice a day : fits.
Two days : mental disturbance after epileptic fits.
In five months : seven fits of complete epilepsy.
Several years : prolapse of uterus.
Four years : fits of "petit mal".
Six years : ozæna.
LOCALITY AND DIRECTION [42]
Left : ache from throat to hip ; pains in lung ; numbness and pain side of chest and arm.
Right : sharp sticking pains over eye, extending backwards over side of head ; ptosis ; aching side of face ; tongue and mouth drawn ; stitching pains in side ; paralysis ; complete paralysis of deltoid muscle.
Both sides : facial paralysis.
From ears reaching to leg : lancinating nervous pains.
Radiating to neck and face : neuralgic pains.
Spreading from abdomen : chilliness.
SENSATIONS [43]
As if brain were full of fluid ; noise in ears as of whistling or crying animals ; as if larynx were stopped up ; as if broken or sprained at elbows, extending to shoulders and across back ; as if weights were hanging to arms, spine and head ; feeling along arm as if it had been burnt.
Pain : in ears ; left side of chest and arm ; in loins ; in hemorrhoidal tumors.
Anguish : in precordial region.
Driving one crazy : internal otitis.
Lancinating : all over head ; ears to legs.
Piercing : all over head ; in chest.
Sharp sticking : in right eye.
Sharp shooting stitches : in womb.
Shooting : in stomach ; in larynx.
Severe pain : in lungs.
Sharp pain : in chest.
Blows : violent in region of cerebellum.
Pulsative pain : in head.
Beating : in head, like hammer.
Stitching : in right side.
Stinging : in heart.
Smarting : vulva and thighs.
Crampy pains : in kidneys ; in hips.
Rheumatic pains : in pit of stomach.
Digging pains : in kidneys ; in womb.
Nervous pains : ears to legs.
Aching : in limbs and body.
Dull tired ache : in shoulders and back ; in knees.
Wearing ache : from throat to left hip.
Soreness : walls of chest ; muscles of arms.
Burning : in larynx ; in womb ; in limbs ; in chest ; in hips.
Heat : in head ; in chest ; in back ; on legs ; in limbs.
Dryness : in respiratory passages.
Roughness : in respiratory passages.
Distension : in chest, with burning heat.
Bearing down : of womb.
Weakness : especially of wrists and hands.
Heaviness : in arms.
Numbness : of arms.
Numb tired pains : up and down spine and in head.
Swinging, trembling : of hands.
Quivering : in womb.
Vibrative feeling : in head.
Oscillation : of brain, painful.
Shocks : in womb.
Shivering : starting from stomach, spreading over whole body.
TISSUES [44]
Acute spasmodic affections of a very severe character ; tetanus.
Paralyzes motor portion of nervous system from periphery towards centre.
Paralyzes vaso-motor as well as musculo-motor nerves.
TOUCH. PASSIVE MOTION. INJURIES [45]
Touch : induration on abdomen painful.
Pressure : can hardly bear stethoscope.
After being bitten by dog : muscular restlessness, spasms, hydrophobia ; photophobia.
Mechanical injury : paralysis.
SKIN [46]
Body blue and yet fever.
Eczema.
STAGE OF LIFE, CONSTITUTION [47]
In older, scrofulous children.
Boy, æt. 12, and another, æt. 16, also two brothers, æt. respectively, 12 and 10 ; epilepsy.
Anna M., æt. 20, married 3 months, pregnant in seventh month ; vaginitis.
Stone cutter, æt. 20, for nine years ; epileptic fits.
Girl, æt. 24, eighty days after being bitten by a dog suspected to be rabid, lyssa humana (injections O. 2 grammes in 7 doses during five hours).
Lady, graduate of Conservatory of Stuttgart, where she practiced excessively ; nervous debility.
Laundress, æt. 30 ; paralysis of right deltoid after an apoplectic attack.
Mrs. Van N., æt. 30, three children, blond, blue eyes ; ulcer of os uteri.
Woman, æt. 35, had phthisis for many years ; debility and cough, with expectoration.
Mrs. J., suffering from scanty menstruation, pains in os uteri, watery, starchy leucorrhœa ; ozæna.
RELATIONS [48]
Antidoted by : Artificial respiration. Bromine and Chlorine destroy the poisonous effects. Tobacco or salt, applied topically, neutralize effects of Curare wounds.
It antidotes : Strychnia , but Chloral is better. Probably antidotal to Lyssin .
Compatible : after Arnica in paralysis from injury ; after Bellad . in paralysis after apoplexy ; Baryt. carb . is often indicated after Curare in nervous debility of the aged.
Compare : Nux vom. ; Aranea in fevers, < from damp or wet weather ; Ferrum in hammering pains in head.