IT IS 1932 and Richard Gill is crouching on the rainforest floor. He watches as a man lifts a steaming pot off the fire. It has been simmering for days, but now it is ready. The man takes a whip-thin dart and dips it into the tarry black concoction. The paste sticks easily to the tip.
It was the first time Gill had witnessed this ritual but it was not to be the last. His former job as a rubber salesman had brought him to Ecuador, and when he found himself unemployed after the crash of 1929, he and his wife Ruth had used their savings to buy some land in the Ecuadorian Andes. He often visited his neighbours, the Canelo. At 2 metres tall, he towered over the native people, but he was humble and keen to learn. He worked hard to win their trust and respect.
Gill was fascinated by how the Canelo lived, and particularly by their use of plants. He had studied medicine for a while and although he had decided against becoming a doctor, he retained an interest in the subject. Some drugs had already made it out of the Amazon into modern medicine, including quinine and the emetic ipecacuanha. There must be many others, Gill thought. He knew that several plants went into the pot to make the substance they used to coat the darts that they fired out of long blowpipes, and something in the mix certainly had a large biological effect. Skilled hunters could bring down an animal 30 metres away. They called it 鈥渢he flying death鈥�. To the outside world, it was curare.
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鈥淕ill was fascinated by the Canelo and worked hard to win their respect鈥�
鈥淎 mere skin prick by a dart laden with the flying death, and any jungle beast suitable for hunting by this method is painlessly dead in a matter of seconds,鈥� wrote Gill in his account, , published in 1940.
Curare had been known to European explorers as early as the 1500s. Alexander von Humboldt, who had watched Orinoco river tribes preparing it in 1832, understood its medical potential. The active ingredients are alkaloids that evolved to deter herbivores, but which also happen to block the receptors between nerves and skeletal muscles in animals. A high-enough dose causes paralysis. The animal鈥檚 lungs stop working and although its heart continues to beat, it suffocates.
The Gills enjoyed life in the Andean foothills, in the shadow of the Tungurahua volcano. But they were not to remain there. On a return visit to the US, and shortly after falling from his horse, Gill began to experience odd symptoms: a tremor in his hands, then numbness in his legs mixed with painful muscle spasms. 鈥淥ne morning I woke up and my right side wasn鈥檛 there,鈥� he wrote. 鈥淪uddenly, and for a long time, I became as helpless as a baby.鈥� The doctor diagnosed multiple sclerosis, and suggested a drug that had shown promise in recent experiments and might help ease the pain: curare.
The problem was getting hold of the stuff. There was no supply of curare in the US: it was only known from the few small samples brought from various parts of the Amazon. What鈥檚 more, no one knew exactly which plants went into the concoction or how to prepare it properly. Adding to the confusion was that every sample seemed slightly different, and prejudice against such 鈥減rimitive鈥� treatments was widespread. 鈥淭here were still the ritual-bound, die-hard scientificos who were content to let curare remain the mysterious flying death of the dark jungles,鈥� Gill wrote.
Gill realised that his knowledge and experience put him in a unique position. He decided that he would return to the jungle and bring back a supply of curare. Given that he couldn鈥檛 walk, it was no small challenge.
But with a self-imposed programme of physiotherapy, Gill started to improve, one finger at a time. After two years he was able to walk awkwardly, on crutches. All the while, stuck in the US, he made plans, calculating what he would need for a major expedition into some of the most challenging terrain on the planet. He also convinced Sayre Merrill, a wealthy Massachusetts businessman, of the importance of his mission. Merrill agreed to fund the entire expedition.
Finally, walking with a stick, Gill re-entered the Ecuadorian jungle in 1938. With him were his wife, 75 porters, 36 mules, 12 canoes and quantities of equipment and goods to trade. They headed east, deep into the Amazon basin. At times, they had to blindfold the mules to get them across swaying suspension bridges. At others, they braved white-water rapids.
Eventually the expedition set up a base camp close to a village. Because Gill was known and trusted, the people agreed to prepare curare for him in exchange for cloth, knives and other goods. Gill noted which plants were gathered for the curare mixture and took samples of each, along with scores of others that he thought might have medical uses.
Four months later, the returned with more than 10 kilograms of processed curare. He sent the botanical specimens to Boris Krukoff at the New York Botanical Garden. One is still part of the herbarium collection (pictured): four wide leaves and a sturdy vine, accompanied by a blow dart. It is Chondrodendron tomentosum, which we now know to be one of several species containing alkaloids with curare-type action.
Gill brought back enough curare paste for chemists to study its properties and tease apart the molecular structure of the main active ingredient, tubocurarine. A firm called E. R. Squibb and Sons standardised and marketed curare as Intocostrin. Doctors used it to treat spastic paralysis and also to prevent the frequent fractures seen in psychiatric patients during electroconvulsive shock therapy.
But its biggest impact was in surgery. In January 1942, Canadian anaesthetist Harry Griffith published a landmark paper about his experience of administering Intocostrin before abdominal surgery. It had always been hard to ensure a patient remained totally still under anaesthetic, and it usually meant pushing them ever deeper into unconsciousness 鈥� a risky step. With the paralysing effect of curare, surgeons found they could work more safely with totally still patients. It also meant they could use much lower doses of anaesthetic.
It became possible to perform operations that before would have been too time-consuming to be safe. The stillness of the patient meant that ever more complex procedures, such as eye operations and neurosurgery, became possible.
During the second world war, an anaesthetist called John Halton working in Liverpool, UK, heard about Intocostrin from an American doctor stationed in the country. His combination of anaesthetic, painkiller and muscle relaxant became known as the Liverpool technique. It remains the mainstay of anaesthesia today.
Gill does not record using curare on himself. A post mortem after he died in 1958, aged 57, showed the diagnosis of multiple sclerosis had been correct, although Gill鈥檚 symptoms seem to have been mild in later life. He spent the rest of his life promoting curare as a treatment. Although public recognition for his endeavours never really came, his contribution was noticed by those who felt its influence. In a letter to Gill in 1943, Griffith wrote: 鈥淚 should like to express the very great appreciation of our surgeons, anaesthetists and patients for the very useful work you have done in making the drug available to us.鈥� Surgery had entered the modern era
This article appeared in print under the headline 鈥淭he flying death comes to America鈥�
