toxifera. Medical use George Harley (1829–1896) showed in 1850 that curare (wourali) was effective for the treatment of tetanus and strychnine poisoning. In 1857, Claude Bernard (1813–1878) published the results of his experiments in which he demonstrated that the mechanism of action of curare was a result of interference in the conduction of nerve impulses from the motor nerve to the skeletal muscle, and that this interference occurred at the neuromuscular junction. From 1887, the Burroughs Wellcome catalogue listed under its 'Tabloids' brand name, grain (5.4mg) tablets of curare (price: 8shillings) for use in preparing a solution for hypodermic injection. In 1914, Henry Hallett Dale (1875–1968) described the physiological actions of acetylcholine. After 25 years, he showed that acetylcholine is responsible for neuromuscular transmission, which can be blocked by curare.The best known and historically most important toxin (because of its medical applications) is d-tubocurarine. It was isolated from the crude drug – from a museum sample of curare – in 1935 by Harold King of London, working in Sir Henry Dale's laboratory. King also established its chemical structure. Pascual Scannone, a Venezuelan anesthesiologist who trained and specialized in New York City, did extensive research on curare as a possible paralyzing agent for patients during surgical procedures. In 1942, he became the first person in Latin America to use curare during a medical procedure when he successfully performed a tracheal intubation in a patient to whom he administered curare for muscle paralysis at the El Algodonal Hospital in Caracas, Venezuela. After its introduction in 1942, curare/curare-derivatives became a widely used paralyzing agent during medical and surgical procedures. In medicine, curare has been superseded by a number of curare-like agents, such as pancuronium, which have a similar pharmacodynamic profile, but fewer side effects. Chemical structure The various components of curare are organic compounds classified as either isoquinoline or indole alkaloids. Tubocurarine is one of the major active components in the South American dart poison. As an alkaloid, tubocurarine is a naturally occurring compound that consists of nitrogenous bases, although the chemical structure of alkaloids is highly variable. Tubocurarine and C toxiferine consist of a cyclic system with quaternary ammonium ions. On the other hand, while acetylcholine does not contain a cyclic system, it does contain a quaternary ammonium ion. Because of this shared moiety, curare alkaloids can bind readily to the active site of receptors for acetylcholine (ACh) at the neuromuscular junction,