Dr. Harold Griffith and Sir Robert Macintosh: a British response to curare's introduction to anesthesia

Curare's implementation into anesthesia care by Dr. Harold Griffith was facilitated by the availability of medical-grade curare, the demonstration that it could provide safe muscle relaxation in psychiatric patients undergoing "shock therapy," and the foresight of a Squibb scientist who realized its potential in the operating room. Griffith's demonstration that curare safely provided muscle relaxation in surgical patients eliminated the need for dangerously high doses of anesthetic gases. This helped pave the way to "balanced anesthesia," whereby small doses of selectively acting drugs are given to achieve specific ends.Curare's initial reception by anesthesiologists, particularly in the UK, was frosty owing to its lingering reputation as a lethal poison associated with witchcraft. We recently unearthed a scathing review of Griffith's work housed in the Wellcome Collection (London, UK). That review, requested by Sir Robert Macintosh, Oxford University's inaugural Nuffield Professor of Anesthesia, was authored by his colleague, Dr. Stuart L. Cowan. In hindsight, this disparaging assessment is especially fascinating: Why was this review so negative when curare would have such a remarkable positive impact on medicine? In the present Special Article, we present the above British response to curare's introduction to anesthesia and trace curare's remarkable journey through the contributions of explorers, scientists, and clinicians preceding the review to help put it in perspective.