CURARE (INTOCOSTRIN) IN THE ACUTE STAGE OF ANTERIOR POLIOMYELITIS

Abstract

The efficacy of curare was tested in a hospital for communicable diseases during an epidemic of acute anterior poliomyelitis. Previous reports indicated that rapid results were to be expected. When the physical therapists who were treating our patients found little or no relaxation in the affected muscles, and the goniometric measurements showed no evidence of improvement, the dose of curare was cautiously increased in some patients. Larger doses than previously prescribed were tolerated with safety by some patients. Others, however, reacted alarmingly to small doses. This difference in therapeutic response may be explained by individual variations in response to a drug or by the fact that the concentration of the drug may rise rapidly, sometimes to unpredictable heights, before falling (Schlesinger).

The dangers of giving curare to patients with bulbar involvement, especially to those in which there is beginning bulbar or intercostal muscle weakness have been pointed out; also the probable cumulative effect when injections are given less than eight hours apart. The beneficial effects of small doses of curare, with which we obtained little or no muscle relaxation, cannot be confirmed or denied, when such doses are given for weeks in combination with physical therapy.