ONE OF the most difficult and universal problems in the management of musculoskeletal injuries is that of overcoming muscle spasm. Spasm accompanies almost every type of skeletal injury, causing the patient considerable pain and limitation of motion and interfering with the efforts of the physician to correct skeletal abnormalities. The attempts of orthopedists to relieve muscle spasm indirectly by the use of narcotics, immobilization, heat, and other agents leave much to be desired.
The capacity of curare to relax skeletal muscle directly has been known since the early descriptions of the paralytic effect of South American Indian poison arrows. In the past two decades considerable progress has been made in purifying and studying the active curare principle both pharmacologically and clinically.1 Relatively pure preparations of tubocurarine chloride are now commercially available and dosage schemes based on aqueous solutions of 3 mg. per cubic centimeter, which cause only minor side-effects,