Related entry: The Ergot-Mould
Ergota.—Secale cereale semen purgo parasitico corruptum? L. The ergot, a peculiar excrescence supposed to be produced by a parasitical fungus, D.
Synonymes.—Clavi siliginis, Lonicerus; Secalis mater, Thalius; Secale luxurians, Bauhin, Pinax, lib. i. sect. iv. p. 23; Grana secalis degenerati, Brunner; Secale cornutum, Baldinger; Clavus secalis vel secalinus; Secale maternum, turgidum vel temulentum; Ergota, Ph. Lond. et Ed.; Spur; Spurred or horned Rye; Ergot of Rye; Cockspur Rye; Cockspur.
History.—No undoubted reference to ergot is found in the writings of the ancients. The disease produced by it is supposed to be referred to in the following passage: "1089. A pestilent year, especially in the western parts of Lorraine, where many persons became putrid, in consequence of their inward parts being consumed Anthony's fire. Their limbs were rotten, and became black like coal. They either perished miserably, or, deprived of their putrid hands and feet, were reserved for a more miserable life. Moreover, many cripples were afflicted with contraction of the sinews [nervorum contractio]." [Extract from the works of Sigebert, in the Recueil des Histor. des Gauls et de la France, tom. xiii. p. 259. A passage somewhat similar to the above, with the addition of the following, "the bread which was eaten at this period was remarkable for its deep violet colour," is quoted by Bayle (Biblioth. Thérap. tom. iii. p. 374) from Mézerai, Abrégé Chronologique. But I cannot find the passage in the first and best edition of Mezeray's Abrégé Chron. 3 vols. 4 to. 1668; or in his Histoire de France; or in his Mémoires Hist. et Critiques. Whether or not it be in the second and less perfect edition of Mezeray's Abrégé Chronologique, I am unable to decide, not having seen this work.]
The first botanical writer who notices ergot [The etymology of the word ergot is very doubtful. Whiter (Etymologicon Universale, ii. 594) thiks that it is derived from arguo, and is attached to such terms as urgeo. It was anciently written argot.] is Lonicerus. [Kreuterbuch, p. 885, Franckfort, 1582.] It seems to have been employed by women to promote labour pains long before its powers were known to the profession. Camerarius [Actes des Curseux de la Nature, art. 6, obs. 82, quoted by Velpeau.], in 1683 [Dierbach, Neuest Entd. in d. Mat. Med. 130, 1837.], mentions that it was a popular remedy in Germany for accelerating parturition. In Italy and France, also, it appears to have been long in use [Beyle, Bibl. Thérap. iii. 375. Velpeau, in his Traité complet de l'Art des Accouchemens, gives an excellent literary history of ergot.].
Botany.—The nature and formation of ergot are subjects on which botanists have been much divided in opinion.
1. Some regard ergot as a fungus growing between the glumes of grasses in the place of the ovary.—Otto von Munchausen [Hausvater, i. 332, 1764-1773.], Schrank [Baiersche Flora, ii. 571, 1789.], De Candolle [Mém. du Mus. d'Hist. Nat. ii. 401, 1815.], Fries [Syst. Mycol. ii. 268, 1822.], Wiggers [Inq. in Secale Corn. Götting. 1831, in Christison's Treatise.], and formerly Berkeley [English Flora, vi. Part ii. 226, 1836. Mr. Berkeley is now of the opinion that the ergot is produced by Oidium abortifaciens (see ante, p. 944); and in Lindley's Medical and Oeconomical Botany, p. 14, 1949.], adopted this opinion, and described ergot as a fungus under the name of Spermoedia Clavus [Erroneously quoted in the Pharm. Lond. 1836, as Anicula Clavus.], Fries (Clavaria Clavus, Münch.; Sclerotium Clavus, De Cand.). Fries and Berkeley, however, evidently entertained some doubts respecting its nature; for the first suggests that the genus Spermoedia consists of "semina graminum morbosa" and the second says, "it appears to be only a diseased state of the grain, and has scarcely sufficient claim to be admitted among fungi as a distinct genus." The latest writer who has adopted this view is Guibourt [Hist. Nat. des Drogues, 4me édit. t. ii. p. 72, 1849.], who concludes that ergot is not an ovary or altered grain, but a fungus which, after the destruction of the ovary, is grafted in its place on the peduncle.
Against this opinion may be urged the circumstance noticed by Tessier [Quoted by De Candolle.], that a part only of the grain may be ergotized. Moreover, the scales of the base of the ergot, the frequent remains of the stigma on its top, and the articulation of it to the receptacle, prove that it is not an independent fungus, but an altered grain [Quekett, in Proceedings of the Lin. Soc. Dec. 4, 1838.].
2. Some regard ergot as a diseased condition of the ovary or seed.—The arguments adduced against the last opinion are in favour of the present one. Though a considerable number of writers have taken this view of the nature of ergot, there has been great discordance among them as to the causes which produced the disease.
α. Some have supposed that ordinary morbific causes (such as moisture combined with warmth) were sufficient to give rise to this diseased condition of the grain. Tessier [Mém. Soc. Roy. Médec. 1776, p. 417; 1777, p. 587.] and Willdenow [In Christison's Treatise on Poisons.] appear to have been of this opinion.
β. Some have ascribed the disease to the attack of insects or other animals. Tillet, Fontana, Réad, and Field [Referred to by Christison, op. cit.], supported this view, which, I may add, has subsequently been satisfactorily disproved.
γ. Some, dissatisfied with the previously assigned causes of the disease, have been content with declaring ergot to be a disease, but without specifying the circumstances which induce it. Mr. Bauer [MS. British Museum; also, Trans. of the Linn. Society, vol. xviii.], who closely watched the development of ergot during eight years (1805-13), and has made some beautiful drawings of it in different stages, arrived at this conclusion; as also Phoebus [Deutschl. kryptogam. Giftegewachse, Berlin, 1838.].
δ. Others have referred the production of the disease to the presence of a parasitic fungus. This opinion, which appears to me to be the correct one, and which must not be confounded with that entertained by De Candolle and others (vide supra), has been adopted and supported by Léveillé in 1826 [Ann. de. la Soc. Linn. de Paris.], by Dutrochet [Mémoires pour servir à l'Histoire anatomique et physiologique des Végét. et des Animaux, vol. ii. p. 161, 1837.], by Mr. John Smith [Trans. Linn. Society, vol. xviii.], and by the late Mr. Edwin Quekett [Ibid.]; and more recently by Fée [Mémoire sur l'Ergot du Seigle, et sur quelques Agames qui vivent Parasites sur les Epis de cette Céréale, 1er Mém. Strasbourg, 1843. See Pharm. Journ. vol. v. p. 282, 1946.] and by Corda [Beitrag zur Kenntniss der Brandarten der Cerealien und des Mutterkorns, in the Oekonomische Neuigkeiten und Verhandlungen, No. 83, published at Vienna, 1946.]. But though the writers just mentioned agree in considering ergot to be a disease of the ovary or seed, caused by a parasitic fungus, considerable difference exists among them as to the real nature of the parasite [I have given an abstract of M. Fée's opinion in the Pharmaceutical Journal, vol. v. p. 282.].
The statements of Léveillé, Phillipar [Traité Organogr. et Phys.-Agr. sur la Carie, le Charbon, l'Ergot, &c. 8vo. Versailles, 1837.], Smith, and Quekett, leave, I think, but little doubt that ergot is a disease of the grain caused by the presence of a parasitical fungus. This view is supported by the observations of Wiggers, that the white dust (sporidia, Quek.) found on the surface of ergot will produce the disease in any plant (grass?) if sprinkled in the soil at its roots. Mr. Quekett (see ante, p. 87) infected grains of corn by immersing them in water in which the sporidia of the Oidium abortifaciens were contained. The plants which were produced by the germination of the grains were all ergotized.
Mr. Quekett, who most carefully examined the development of ergot, says that the first appearance of the ergot is observed by the young grain and its appendages becoming covered with a white coating composed of multitudes of sporidia (Fig. 184 A, p. 87) mixed with minute cobweb-like filaments (Oidium abortifacicns, Fig. 184, H I, p. 87). This coating extends over all the other parts of the grain, cements the anthers and stigmas together, and gives the whole a mildewed appearance. When the grain is immersed in water, the sporidia fall to the bottom of the liquid. A sweet fluid—at first limpid, afterwards viscid—is found in the affected flower at this stage; and, when examined by the microscope, is found to contain the sporidia just referred to (Phillipar, Smith, Quekett). Phillipar says this fluid oozes from the floral centre; and Mr. Quekett, who at first thought that it had an external origin, was subsequently convinced that it escaped from the ergot or the parts around it.
If we examine the ergot when about half-grown (Fig. 210), we find it just beginning to show itself above the paleae, and presenting a purplish-black colour. By this time it has lost in part its white coating, and the production of sporidia and filaments has nearly ceased. At the upper portion of the grain, the coating now presents a vermiform appearance, which Léveillé [Quoted by Richard, Elém. d'Hist. Nat. 1. 332.] describes as constituting cerebriform undulations. These are beautifully depicted in Mr. Bauer's drawings (Fig. 210, A D E).
Léveillé regards this terminal tubercle of the grain as a parasitical fungus, which he calls the Sphacelia Segetum. But these undulations are merely masses of sporidia; for if a little be scraped off with a knife, then moistened, and examined by the microscope, we find nothing but myriads of sporidia. The ergot now increases in a very rapid manner.
Corda has confirmed the observations of Messrs. Smith and Quekett; but, as I have already stated (see ante, p. 87), he considers the fungus to be a new species of Hymenula (of the sub-order Hymonophycetes), to which he has given the name of H. clavus.
To the agriculturist, an important subject of inquiry is the predisposing causes of ergot. Very little of a satisfactory nature has, however, been ascertained on this point. One fact, indeed, seems to have been fully established—viz. that moisture, which was formerly thought to be the fertile source of the spur, has little, if anything, to do with it [Phillipar, op. cit. 126; also, Bauer, MSS.]. Moreover, the disease is not peculiar to rye. Many other grasses (Phoebus has enumerated 31 species) are subject to it. In the summer of 1838, I found the following grasses, growing in Greenwich marshes, ergotized: Lolium perenne, Dactylis glomerata, Alopecurus pratensis, Festuca pratensis, Triticum repens, Arundo phragmites, Hordeum murinum, and H. pratense. Professor Henslow found it in wheat which had been sent to the miller [Report on the Diseases of Wheat, p. 20, from the Journal of the Royal Agricultural Society of England.]. l am indebted to him also for fine specimens of ergot on Ammophila arundinacea. But the disease is not confined to the Gramineae: the Cyperaceae are also subject to it, and perhaps, likewise, Palmaceae [Phoebus, op. cit. 105.].
Commerce.—Ergot is imported from Germany, France, and America. The late Mr. Butler, of Covent Garden Market, told me that about 1 ½ tons were imported in the year 1839.
Description.—When we examine a number of ears of ergotized rye, we find that the number of grains in each spike which have become ergotized varies considerably: there may be one only, or the spike may be covered with them [Phillipar, op. cit. p. 96.] . Usually, the number is from three to ten.
The mature ergot (Fig. 211) projects considerably beyond the paleae. It has a violet-black colour, and presents scarcely any filaments and sporidia.
The spurred rye, or ergot (ergota) of commerce, consists of grains which vary in length from a few lines to an inch, or even an inch and a half, and whose breadth is from half a line to four lines. Their form is cylindrical or obscurely triangular, with obtuse angles, tapering at the extremities (fusiform), curved like the spur of a cock, unequally furrowed on two sides, often irregularly cracked and fissured. The odour of a single grain is not detectable, but of a large quantity is fishy, peculiar, and nauseous. The taste is not very marked, but is disagreeable, and very slightly acrid. The grains are externally purplish-brown or black, more or less covered by a bloom, moderately brittle, the fractured surface being tolerably smooth, and whitish or purplish-white. Their sp. gr. is somewhat greater than that of water, though, when thrown into this liquid, they usually float at first, owing to the adherent air. The lower part of the grain is sometimes heavier than the upper.
1. The internal part or body of the ergot: this is composed of the hexagonal or rounded cellular tissue. The cells have the shape and regularity of the normal cells of the albumen, but they are considerably smaller (Corda saya they are only 1/35th of the size), and contain, instead of starch, from one to three globules of oil, which are lighter than water and soluble in ether (Fig. 212, d, and 214). If the structure of ergot be examined after the grains have been dried and re-moistened, the tissue presents a very irregular appearance.
2. The violet or blackish coat of the ergot: this consists of a layer of longitudinally elongated delicate cells (see Fig. 212, c).
3. The bloom, which to a greater or less extent, covers the violet coat of the ergot: it resembles the bloom of plums, and may be readily wiped off. According to the late Mr. Quekett, it consists of the sporidia of the Oidium abortifaciens (Fig. 184, A). But Corda describes it as consisting of two parts: a layer of cylindrical, undivided cells (sporophores or basidia, Fig. 212, b), supporting the spores (Fig. 212, a, and Fig. 213).
In considering the metamorphosis which the normal rye grains have undergone by becoming ergotized, it appears that the seed coats and gluten cells (Fig. 206, a b c, p. 129) have been replaced by a layer of dark cells (Fig. 212, c); that the large cells of the albumen (Fig. 207, d, and Fig. 208, p. 129) have been replaced by the small cells of the ergot (Figs. 212 d, and 214); that the starch grains of the cells of the albumen (Fig. 208, and Fig. 209) have been replaced by drops of oil in the cells of the ergot (Fig. 212, d, and Fig. 214); and that the little body at the top of the ergot (Fig. 210, F a), which Phoobus calls the Mützchen, is the remains of the hairy crown of the grain, of the stigmata, and of the withered elevated pericarp.
Thus the entire organization of the grains is changed, and at the same time their effects on the animal body are altered; for while sound rye is edible, nutritive, and healthy, ergotized rye is unwholesome and poisonous, producing raphania and abortion.
Deterioration.—The ergot of rye is fed on by a little acarus, which is about one-fourth of the size of a cheese-mite. This animal destroys the interior of the ergot, and leaves the grain as a mere shell. It produces much powdery excrementitious matter (Quekett). In four months 7 ¼ ounces of this fecal matter of the acarus were formed in seven pounds of ergot. I have some ergot which has been kept for eleven years in a stoppered glass vessel without being attacked by the acarus, and it has all the characteristics of good ergot. It is advisable, however, not to use ergot which has been kept for more than two years.
Composition.—Ergot was analyzed, in 1816, by Vauquelin [Ann. Chim. lii. 337.]; in 1817, by Pettenkofer [Buchner's Repert. iii. 65.]; in 1826, by Winkler [Christison, On Poisons.]; in 1829, by Maas [Schwartze, Pharm. Tabell. 2er. Ausg. 460.]; in 1831, by Wiggers [Phoebus, Giftgewächse, 102; Journ. de Pharm. xviii. 525, 1832.]; and more recently by Chevallier [Dierbach, Neuest. Entd. in d. Mat. Med. 1837, p. 129.]. The results obtained by Chevallier were analogous to those of Wiggers.
|Vauquelin's Analysis.||Wigger's Analysis.|
|Pale yellow matter, soluble in alcohol, and tasting like fish-oil.||Ergotin|
|White bland oil, very abundant.||Peculiar fixed oil|
|Violet colouring matter, insoluble in alcohol, soluble in water.||White crystallizable fat|
|A fixed acid (phosphoric?).||Cerin|
|Vegeto-animal or nitrogenous matter, prone to putrefaction, and yielding ammonia and oil by distillation.||Fungin|
|Free ammonia, disengaged at 212 °F.||Vegetable osmazome|
|Peculiar saccharine matter|
|Gummy extractive, with red colouring matter|
|Superphosphate of potash|
|Phosphate of lime, with trace of iron|
1. Ergotin was procured by digesting ergot with ether, to remove the fatty matter, and then in boiling alcoho. The alcoholic solution was evaporated, and the extract treated by water. The ergotin remained undisolved. It was brownish-red, with an acrid bitter taste, and, when warmed, had a peculiar but unpleasant odour. It was soluble in alcohol, but insoluble in water or ether. It is probable, therefore, that it is a resinoid colouring matter. It proved fatal to a hen.
Nine grains of it were equal to an ounce and a half of ergot. It appears, then, that though a poisonous principle, it is probably not the agent which acts on the uterus, for the latter is soluble in water, whereas ergotin is not. It is possible, however, that it may be rendered soluble in water by combination with some other body.
2. Oil of Ergot.—As this is now used in medicine, its properties will be described hereafter (see p. 143).
There are no good grounds for suspecting the existence of either hydrocyanic acid or phosphate of morphia in ergot, supposed by Pettenkofer.
Chemical Characteristics.—Ergot is inflammable, burning with a clear yellowish white flame. The aqueous infusion or decoction of ergot is red, and possesses acid properties. Both acetate and diacetate of lead cause precipitates in a decoction of ergot. Iodine gives no indication of the presence of starch. Nitrate of silver causes a copious precipitate soluble in ammonia, but insoluble in nitric acid. Tincture of nutgalls also produces a precipitate, (tannate of ergotin?) Alkalies heighten the red colour of the decoction.
Physiological Effects.—Great discrepancy is to be found in the accounts published respecting the influence of spurred rye on man and animals. While the majority of experimenters or practical observers concur in assigning to it energetic powers, others have declared it harmless.
α. On Vegetables.—Schübler and Zeller have tried its effects on plants, and I infer from their statements that they found it poisonous [Marx, Die Lehre v. d. Giften, ii. 107.].
β. On Animals.—Accidental observation and direct experiment concur in showing that in most instances spurred rye acts as a poison to the animal economy. But, as Phoebus correctly observes, we cannot call it a violent poison, since drachms and even ounces are required to destroy small animals (e. g. rabbits and pigeons).
It has proved poisonous to flies, leeches, birds (geese, ducks, pigeons, common fowls, &c.), and mammals, (dogs, cats, pigs, sheep, rabbits, &c.) Birds and mammals refuse to take it, even mixed with other kinds of food. Diez [Quoted by Phoebus, op. cit. p. 106.] gives the following as the symptoms produced by it in dogs who are compelled to swallow it: "Great aversion to it, discharge of saliva and mucus from the mouth, vomiting, dilatation of the pupil, quickened respiration and circulation, frequent moanings, trembling of the body, continual running round, staggering gait, semi-paralysis of the extremities, especially the hinder ones, sometimes diarrhoea; sometimes hot anus, increased formation of gas in the alimentary canal; faintness and sleepiness, with great thirst, but diminished appetite. Death followed under gradually increasing feebleness, without being preceded by convulsions. To the less constant symptoms belong inflammation of the conjunctiva, and the peculiar appearance of turning round in a circle from right to left." Similar observations as to its injurious operation have been made by Robert [Christison, op. cit.]. In some cases abscess and gangrene of various parts of the body, with dropping off of the toes, and convulsions, have been noticed. A strong decoction injected into the vein of a dog caused general feebleness, paralysis of the posterior extremities, vomiting, and death [Gaspard, Journ. de Phys. Expér. ii. 35.].
But there are not wanting cases apparently showing that spurred rye has no injurious action on animals. The most remarkable and striking are those related by Block [Phoebus, op. cit. p. 107.]. In 1811, twenty sheep ate together nine pounds of it daily for four weeks without any ill effects. In another instance, twenty sheep consumed thirteen pounds and a half daily, for two months, without injury. Thirty cows took together twenty-seven pounds daily, for three months, with impunity; and two fat cows took, in addition, nine pounds of ergot daily, with no other obvious effect than that their milk gave a bad caseous cream, which did not yield good butter. These statements furnish another proof to the toxicologist that the ruminants suffer less from vegetable poisons than other animals.
Another interesting topic of inquiry is the action of ergot on the gravid uterus of mammals. Chapman [Elem. of Therap. i. 489, 4th edit.] says "it never fails, in a short time, to occasion abortion." We have the testimony of Percy and Laurent, that a decoction injected into the veins of a cow caused the animal to calve speedily; and in one out of three experiments, Mr. Combes has stated, the ergot caused the abortion of a bitch [Neal, Researches respecting Spur or Ergot of Rye, p. 90.]. Diez [Phoebus, p. 106.] found that it caused uterine contractions in dogs, rabbits, and sows. Large doses given to bitches induced an inflammatory condition of the uterus, and destroyed both mother and her young. However, in opposition to these statements, we have the evidence of Chatard, Warner, Villeneuve, and others, who failed in producing abortion with it [Neal, op. cit.].
I am indebted to the late Mr. Youatt, formerly Veterinary Surgeon to the Zoological Society, for the following note respecting the effects of ergot on animals:—
"I have, for the last six or seven years, been in the habit of administering the ergot of rye to quadrupeds in cases of difficult or protracted parturition, in order to stimulate the uterus to renewed or increased action. In the monogastric, if I may venture to use the term, I have never known it fail of producing considerable effect, even when the uterus has been previously exhausted by continued and violent efforts. In the ruminant, with its compound stomach or stomachs, I have witnessed many a case of its successful exhibition. I have had recourse to it in the cow, the sheep, and the deer, both foreign and domestic. Parturition has not always been accomplished, from false presentations or other causes, but the uterus has in every case responded—it has been roused to a greater or less degree of renewed action. On the other hand, there are cases recorded by veterinary practitioners, in which it has been given in very large quantities without producing the slightest effect. I have always attributed this to a certain degree of forgetfulness of the construction of the stomachs of ruminants. If the medicine, as is too often the case, is poured hastily down, and from a large vessel, it breaks through the floor of the oesophagean canal and falls into the rumen, and there it remains perfectly inert. But if it is suffered to trickle down the oesophagean canal, although a portion of it may still enter the rumen, the greater part will flow on through the oesophagean canal and the manyplies into the fourth or villous stomach, and produce the desired effect."
y. On Man.—These may be noticed under two heads: 1, effects of single doses; 2, effects of its continued use as an article of food.
1. In single or few doses. Hertwig [Sundelin, Heilmittell. i. 513, 3te Aufl.], Lorinser [Edin. med. and Surg. Journ. xxvi. 453.], Jörg [Gebrauch inn. Reizm. z. Beförd. d. Geburt. 1833.], and Diez [Phoebus, op. cit.], who have endeavoured to ascertain the effects of ergot by experiment, agree in stating that, in doses of from half a drachm to two drachms, nausea, inclination to vomit, dryness of the throat, great thirst, aversion to food, uneasiness or actual pain in the abdomen, occasionally alvine evacuations, weight and pain in the head, giddiness, in some cases stupor and dilatation of pupils, have resulted from its use. It deserves, however, to be noticed, that these effects have not been observed by some experimenters [Keil, Diss. inaug. de Secali Cornuto, Berol. 1822, quoted in Sundelin, Heilmittell.; also, Dr. Chapman, Elem. of Therap. vol. i. p. 488, 4th edit.].
The effects produced by the use of single or a few doses of ergot may be conveniently arranged under four heads.
α. Effects on the uterine system. (Uterine contractions.)—The action of spurred rye on the uterus, when labour has actually commenced, is usually observed in from ten to twenty minutes after the medicine has been taken, and is manifested by an increase in the violence, the continuance, and the frequency of the pains, which never cease until the child is born; nay, they often continue for some minutes after, and promote the speedy separation of the placenta and the firm contraction of the uterus in a globular form. The contractions and pains caused by ergot are distinguished from those of natural labour by their continuance; scarcely any interval can be perceived between them, but a sensation is experienced of one continued forcing effort. If, from any mechanical impediment (as distortion), the uterus cannot get rid of its contents, the violence of its contraction may cause its rupture, as in the cases alluded to by Dr. Merriman [Syn. of Diff. Part. p. 197, 1838.], Mr. Armstrong [Lond. Med. Gaz. Aug. 4, 1838.], and Mr. Coward [Ibid., Nov. 27, 1840. Did the ergot cause the rupture, in the case related in the Lancet, vol. i. 1836-7, p. 824, by Mr. Hooper?].
Ergot sometimes fails to excite uterine contractions. The causes of failure are, for the most part, conjectural. The quality of the ergot, peculiarities on the part of the mother, and death of the foetus, have been assigned as such. The two first will be readily admitted; but why the remedy should be altogether inert "where the foetus has been for some time dead, and putrefaction to any extent taken place," [Dr. Bibby, in Merriman's Synopsis, p. 198.] cannot be readily explained. Its occasional failure has been urged by the late Dr. Hamilton [Pract. Observ. relating to Midwifery, part ii. p. 84, 1836.] as an argument in favour of his notion that ergot acts "in no other way than by influencing the imagination." But, on the same ground, the sialagogue power of mercury might be denied. Dr. Hamilton's erroneous estimate of the powers of ergot is referable to a want of experience of its use; for he admits that he has only had two opportunities in practice of making a fair trial of it. There is usually much less hemorrhage after delivery, when ergot has been employed, than where it has not been exhibited. The lochial discharges are also said to be less; but this is certainly not constantly the case. Moreover, it has been asserted "that the menstrual discharge has not recurred after the use of the ergot in certain cases of protracted parturition." [Dr. J. W. Francis, in the 3d American edition of Denman's Midwifery, 1829.] But the inference intended to be conveyed here, viz., that ergot caused the non-recurrence, is not correct; at least, I am acquainted with several cases in which this effect did not follow the employment of spurred rye, and I know of none in which it did.
Ergot has been charged with causing the death of the child; but the charge has been repelled by some experienced practitioners as being devoid of the least foundation. "The ergot," says Dr. Hosack [Essays, vol. ii. 296.], "has been called, in some of the books, from its effects in hastening labour, the pulvis ad partum; as it regards the child, it may, with almost equal truth, be denominated the pulvis ad mortem; for I believe its operation, when sufficient to expel the child, in cases where nature is alone unequal to the task, is to produce so violent a contraction of the womb, and consequent convolution and compression of the uterine vessels as very much to impede, if not totally to interrupt, the circulation between the mother and child." However, Dr. Chapman [Elem. of Therap. i. 488, 4th edit.] strongly denies this charge, and tells us that in 200 cases which occurred in the practice of himself and Drs. Dewees and James, the ergot was used without doing harm in any respect; and, he adds, "no one here believes in the alleged deleterious influence of the article on the foetus." It is not improbable, however, where the impediment to labour is very great, that the violent action of the uterus may be attended with the result stated by Dr. Hosack. Dr. F. H. Ramsbotham [Lond. Med. Gaz. vol. xiv. p. 84.] has suggested that the poisonous influence of ergot may be extended from the mother to the foetus, as in the case of opium. He also states [Ibid., June 15, 1839.] that of 36 cases in which he induced premature labour by puncturing the membranes, 21 children were born alive; while, in 26 cases of premature labour induced by ergot only, 12 children only were born alive. This fact strongly favours the notion of the deleterious influence of the ergot on the foetus.
Given to excite abortion, or premature labour, ergot has sometimes failed to produce the desired effect. Hence, many experienced accoucheurs have concluded that, for this medicine to have any effect on the uterus, it was necessary that the process of labour should have actually commenced [Bayle, Bibl. Therap. iii. 550.]. But, while we admit that it sometimes fails, we have abundant evidence to prove that it frequently succeeds; and most practitioners, I think, are now satisfied that in a large number of cases it has the power of originating the process of accouchement. Cases illustrating its power in this respect are referred to by Bayle [Op. cit. p. 550.]; and others are mentioned by Waller [Lancet, 1826, vol. x. p, 54.], Holmes [Ibid., 1827-28, vol. ii. p. 794.], Ramsbotham [Lond. Med. Gaz. xiv. pp. 85 and 434; also, Lond. Med. Gaz. June 15, 1839.], Müller [Dierbach, Neuesten Entd. in d. Mat. Med. i. 139, 1837.], and others.
The action of ergot on the unimpregnated uterus is manifested by painful contractions, frequently denominated "bearing-down pains," and by the obvious influence which it exercises over various morbid conditions of this viscus; more particularly by its checking uterine hemorrhage, and expelling polypous masses. Tenderness of the uterus, and even actual metritis, are said to have been induced by it [Dr. Negri, Lond. Med. Gaz. xlv. 369.].
β. Effects on the Cerebro-Spinal System. (Narcotism).—Weight and pain in the head, giddiness, delirium, dilatation of pupil, and stupor, are the principal a symptoms which indicate the action of ergot of rye on the brain. Dr. Maunsell [Lond. Med. Gaz. xvi. 606.] has published five cases (viz., two which occurred to Dr. Churchill, one to Dr. Johnson, and two to Dr. Cusack), in which delirium or stupor resulted from the use of ergot (in half-drachm and two-drachm doses), and was accompanied by great depression of pulse [See, also, Dr. Cusack, in Dubl. Hosp. Rep. vol. v. p. 508.]. Trousseau and Pidoux [Traité de Thérap. i. 546.] found that under the repeated use of ergot, dilatation of pupil was the most common symptom of cerebral disorder. It began to be obvious in from twelve to twenty-four hours after the commencement of the use of the medicine, and sometimes continued for several days after its cessation. The cerebral disorder is frequently preceded by the uterine contractions, and remains for some time after these have subsided.
γ. Effects of ergot on the Circulatory System.—I have known increased frequency and fulness of pulse, copious perspiration, and flushed countenance, follow the use of ergot during parturition. But in most instances the opposite effect has been induced; the patient has experienced great faintness, the pulse has been greatly diminished in both frequency and fulness, and the face has become pale or livid. In one case, mentioned by Dr. Cusack [Dr. Maunsell, Lond. Med. Gaz. xiv. 606.], the pulse was reduced from 120 to 90. Dr. Maunsell has referred to four other cases. These effects on the circulatory system were accompanied with cerebral disorder, of which they were probably consequences. Similar observations, as to the power of ergot to diminish the frequency of the pulse, have been noticed by others [Merriman, Synopsis, pp. 201 and 203, 1838; Trousseau and Pidoux, Traité de Thérap. i. 547.].
δ. Other effects of ergot.—Nausea and vomiting are not uncommon consequences of the exhibition of ergot when the stomach is in an irritable condition. Various other symptoms have been ascribed to the use of ergot; such as weariness of the limbs and itching of the skin [Trousseau and Pidoux, op. cit. i. 547.].
2. Effects produced by the continued use of ergot as an article of food (Ergotism, Fr. Raphania, Linn., Vog., Cull., Good; Convulsio raphania, and Eclampsia typhodes, Sauv.; Morbus spasmodicus, Rothm.; Morbus convulsivus, malignus, epidemicus, cerealis, &c., Alt.; Kriebelkrankheit, or the creeping sickness, Germ.).—Different parts of the continent, e. g. France (especially in the district of Sologne), Silesia, Prussia, Bohemia, Saxony, Denmark, Switzerland, and Sweden, have been, at various periods, visited with a dangerous epidemic (known by the names above mentioned), which affected, at the same time, whole districts of country, attacking persons of both sexes and of all ages [Tissot, Phil. Trans. vol. lv.; Rothman, Aman. Acad. vi. 430.]. So long back as 1597 (Tissot), the use of ergotized rye was thought to be the cause of it. Various circumstances have appeared to prove the correctness of this opinion [Mém. de la Soc. Roy. de Méd. i. 1777.], which has been further confirmed by the effects of ergot on animals, as well as by the occurrence of a disease similar not identical with ergotism, in consequence of the use of damaged wheat [Phil. Trans. for 1762; Henslow, op. supra cit.]. Yet several intelligent writers have not acquiesced to this view; and the circumstances mentioned by Trousseau [Traité de Thérap. i. 527.], and by Dr. Hamilton [Practical Observations relative to Midwifery, part ii. p. 85.], are certainly calculated to throw some doubts over the usually received opinion.
Ergotism assumes two types; the one of which has been denominated the convulsive, the other the gangrenous ergotism. Whether these arise from different conditions of the ergot, or from peculiarities on the part of the patient, or from the different quantity of the ergot taken, we are hardly prepared now to say. In convulsive ergotism, the symptoms are weariness, giddiness, contraction of the muscles of the extremities, formication, dimness of sight, loss of sensibility, voracious appetite, yellow countenance, and convulsions, followed by death. In the gangrenous ergotism there is also experienced formication; that is, a feeling as if insects were creeping over the skin, voracious appetite, coldness and insensibility of the extremities, followed by gangrene [Christison, Treatise on Poisons; Orfila, Toxicol. Gén.; Phil. Trans. 1762; Henslow's Report on the Diseases of Wheat, in the Journal of the Royal Agricultural Society of England, vol. ii. 1841.].
Uses.—To Dr. Stearns, of the United States, is due the credit of introducing ergot of rye to the notice of the profession as an agent specifically exciting uterine contractions [New York Med. Repos. vol. xi. 1807; quoted in the United States Dispensatory.]. In 1814, a paper was published by Mr. Prescott [Med. and Phys. Journ. vol. xxxii. p. 90, 1815.], on the effects of it in exciting labour-pains, and in uterine hemorrhage. It was not employed in England until 1824. The following are the principal uses of it:—
1. To increase the expulsatory efforts of the womb in protracted or lingering labours.—"When the delay of delivery is ascribable solely to the feeble contractions of the uterus, ergot is admissible, provided, first, that there be a proper conformation of the pelvis and soft parts; secondly, that the os uteri, vagina, and os externum, be dilated, or readily dilatable, and lubricated with a sufficient secretion; and, lastly, that the child be presenting naturally, or so that it shall form no great mechanical impediment to delivery. A natural position of the head is not an absolute essential for the use of ergot, since this medicine is admissible in some cases of breech presentation [Dr. F. H. Ramsbotham, Lond. Med. Gaz. xiv. 86.]. The circumstances which especially contraindicate or preclude the use of this medicine are those which create an unusual resistance to the passage of the child: such are, disproportion between the size of the head and of the pelvis, great rigidity of the soft parts, and extraneous growths. Moreover, "earliness of the stage" of labour is laid down by Dr. Bigelow [Quarterly Journal of Literature, Science, and Arts, ii. 63.] as a circumstance contraindicating the use of ergot. The proper period for its exhibition is when the head of the child has passed the brim of the pelvis. Some practitioners assert that a dilated or lax condition of the os uteri is not an essential requisite for the exhibition of ergot. It has been contended that one of the valuable properties of this medicine is to cause the dilatation of the uterine orifice; and cases are not wanting to confirm these statements [Bayle, op. cit. p. 539.].
2. To hasten delivery when the life of the patient is endangered by some alarming symptom.—Thus, in serious hemorrhages occurring during labour, after the rupture of the membranes, and where the placenta is not situated over the os uteri, the ergot is especially indicated [Dr. Blundell, Lancet for 1827-28, vol. i. p. 805: Dr. F. H. Ramsbotham, Lond. Med. Gaz. vol. xvi. pp. 86 and 692.]. It has also been employed to accelerate delivery in puerperal convulsions. Five successful cases of its use are recorded by Bayle [Bibl. Thérap. iii. 448 and 548.], on the authority of Waterhouse, Mitchell, Roche, Brinkle, and Godquin. But the narcotic operation of ergot presents a serious objection to its use in cerebral affections.
3. To provoke the expulsion of the placenta when its retention depends on a want of contraction of the uterus.—In such cases, ergot has often proved of great advantage [Dr. Blundell, Lancet, 1827-28, vol. ii. 259; Bayle (Bibl. Thérap. vol. iii. 541) has recorded nine cases from Balardini, Bordol, Davics, Duchateau, and Morgan; and many others will be found in the medical journals.]. When the hemorrhage is excessive, the ergot must not be regarded as a substitute for manual extraction, since, during the time required for its operation, the patient may die from loss of blood [Dr. F. H. Ramsbotham, Lond. Med. Gaz. xiv. 738.]. In retention of the placenta from spasmodic or irregular contraction of the uterus, as well as from morbid adhesion, ergot is improper or useless [Dr. Jackson, Lond. Med. Gaz. iv. 105.].
4. To provoke the expulsion of sanguineous clots, hydatids, and polypi from the uterus.—Coagula of blood collected within the womb after delivery may sometimes require the use of ergot to excite the uterus to expel them, as in the case mentioned by Mackenzie [Neal, Researches, p. 88.]. Ergot is also valuable in promoting the expulsion of those remarkable formations called uterine hydatids [Acephalocystis racemosa, H. Cloq.], and which are distinguished from the acephalocysts of other parts of the body by their not possessing an independent life, so that when separated from their pedicles they die [Cruveilhier, Dict. de Méd. et de Chir. prat. art. Acéphalocystes, p. 260.]. A successful case of the use of ergot in this affection has been published by Dr. Macgill [Bayle, op. cit. p. 471.]. In uterine polypus, ergot has been exhibited with the view of hastening the descent of the tumour from the uterus into the vagina, so as to render it readily accessible for mechanical extirpation [Dr. H. Davies, Lond. Med. and Phys. Journ. vol. liv. p. 102, 1825.]; for it is well known that, until this is effected, the patient is continually subject to hemorrhage, which in some cases proves fatal. In some instances, ergot has caused the expulsion of a polypus [Lancet, 1828-9, vol. i. p. 24.].
5. To restrain uterine hemorrhage, whether puerperal or non-puerperal.—Ergot checks hemorrhage from the womb, principally, if not solely, by exciting contraction of the muscular fibres of this viscus, by which its blood-vessels are compressed and emptied, and their orifices closed. The experience of physicians and surgeons in all parts of the civilized world has fully and incontestably established the efficacy of ergot as a remedy for uterine hemorrhage [See the list of cases in Bayle's Bibl. Thérap. iii. 543.]. Maisonneuve and Trousseau [Bull. de Thérap. t. iv.; also, Trousseau and Pidoux, Traité de Thérap. i. 540.] have shown that the beneficial influence of ergot is exerted equally in the unimpregnated as in the impregnated state; proving, therefore, that the contrary statement of Prescott and Villeneuve is incorrect. Even in a case of cancer of the uterus, they have found it check the sanguineous discharge. In females subject to profuse uterine hemorrhages after delivery, ergot may be administered as a preventive, just before the birth of the child [Roche, Dict. de Méd. et Chir. prat. art. Ergot, p. 455.]. Even in placenta presentations, a dose or two of ergot may be administered previously to the delivery being undertaken [Dr. F. H. Ramsbotham, Lond. Med. Gaz. xiv. 660.]. 10 To restrain excessive discharge of the lochia or catamenia, this remedy is sometimes most beneficial.
6. To provoke abortion, and to promote it when this process has commenced and is accompanied with hemorrhage.—Under certain circumstances, the practitioner finds it expedient to produce abortion: as in serious hemorrhage during pregnancy, and in deformed pelves which do not admit the passage of a full-grown foetus. In such cases, the ergot may be employed with great advantage [Ibid., p. 434; also, Dr. Weihe, in op. cit. vol. xviii. 543.]. When abortion has already commenced, ergot may be employed to quicken the process and check hemorrhage.
7. In leucorrhoea and gonorrhoea.—Ergot was first given in leucorrhoea by Dr. M. Hall [Lond. Med. and Phys. Journ. May, 1829.]; and was subsequently employed by Dr. Spajrani [Lancet, Feb. 5th, 1831.] with success; and in eight cases by Dr. Bazzoni [Bayle, p. 509.], seven of these were cured by it. Dr. Negri [Lond. Med. Gaz. xiii. p. 369.] published seven successful cases of its use. Its efficacy has been confirmed by many other practitioners. Dr. Negri also used it with apparent benefit in gonorrhoea, in both the male and female. He concludes that "secale cornutum has a peculiar action on the mucous membranes; but, if exhibited when there is a state of acute inflammation, their morbid secretions maybe considerably increased; on the contrary, when a more chronic form of inflammation does exist, the secale cornutum may have a beneficial influence in arresting their preternatural discharge."
8. In hemorrhages generally.—The power possessed by ergot of exciting uterine contractions, readily explains the efficacy of this agent in restraining sanguineous from the womb; but it has also been used to check hemorrhage from other organs. In these cases it can only act as a sedative to the circulation, in a similar way to foxglove. A considerable number of cases have been published in proof of its power of checking hemorrhage from other organs (as the nose, gums, chest, stomach, and rectum) [See the cases of Drs. Spajrani, Pignacco, and Gabini, in the Lancet for 1830 and 1831; of Dr. Negri, in the Lond. Med. Gaz. xiii. 361.]. But, having found it unsuccessful in my own practice, seeing that in the hands of others it has also failed [Trousseau and Pidoux, Traité de Thérap. i. 546.], and knowing how difficult it is to ascertain the influence of remedies on hemorrhages, I think further evidence is required to prove the anti-hemorrhagic powers of ergot.
9. In amenorrhoea.—Some few cases have been published tending to show that ergot possesses emmenagogue properties [Neal, Researches, p. 79.]. It appears to me to be more calculated to cause than to relieve amenorrhoea.
10. In other diseases.—Ergot has been employed in various other diseases with apparent success; viz., intermittent fever [Dierbach, op. cit. p. 444.], paraplegia [Bayle, op. cit. p. 548.], &c.
ADMINISTRATION.—Ergot is usually given in the form either of powder or infusion. The decoction, less frequently the tincture, and still more rarely the extract, are also used. Latterly, the ethereal oily extract and oil have been used.
1. PULVIS ERGOTAE; Pulvis Secalis Cornuti; Powdered Ergot.—This powder is only to be prepared when required for use. The dose of it, for a woman in labour, is twenty grains, to be repeated at intervals of half an hour for three times; for other occasions (as leucorrhoea, hemorrhages, &c.), five to ten or fifteen grains three times a day: its use should not be continued for any great length of time. It may be taken mixed with powdered sugar. It has had the various names of pulvis parturient (more correctly parturifaciens) pulvis ad partum, pulvis partem accelerans, obstetrical powder, &c.
2. INFUSUM ERGOTAE, D.; Infusum Secalis Cornuti; Infusion of Ergot.—Ergot, in coarse powder, ℨij; Boiling Water f℥ix. Infuse for one hour, in a covered vessel, and strain. The product should measure about eight ounces. The dose for a woman in labour is f℥ij, to be repeated at intervals of half an hour or an hour. Sugar, aromatics (as nutmeg or cinnamon), or a little wine or brandy, may be added to flavour it.
3. TINCTURA ERGOTAE, D.; Tinctura Secalis Cornuti; Tincture of Ergot.—(Ergot, in coarse powder, ℥viij; Proof Spirit Oij. Macerate for fourteen days, strain, express, and filter, D).—Five fluidrachms of this tincture contain one drachm of ergot. Dose ℨj to ℨiij.
Various other formulae have been published, [Dierbach, Neuesten Entd. in d. Mat. Med. i. 147, 1838.] some made with rectified, others with proof, spirit. In most of them the proportion of ergot is smaller than in the Dublin formula. One formula [Lehrb. d. Gynacologie, i. 280, 1827.] orders of Ergot, bruised, f℥j; Boiling Water f℥ij. Infuse for twenty-four hours, and add Rectified Spirit f℥iss. Digest for ten days. Half a drachm of this tincture is said to be equivalent to ten grains of the powder. One or two spoonfuls of a tincture of ergot (prepared by digesting ℥ss of ergot in ℥iv of rectified spirit), mixed with water, has been recommended as an injection into the uterus in difficult labour. It is to be introduced between the head of the child and the neck of the uterus. [Lancet, 1827-28, vol. ii. p. 435.]
4. TINCTURA ERGOTAE AETHEREA, L.; Tinctura Secalis Cornuti Aetherea; Ethereal Tincture of Ergot.—(Ergot, bruised, ℥xv; Ether Oij. Macerate for seven days; then express and strain, L.) Half a fluidounce of this tincture contains a drachm and a half of ergot. The dose is a teaspoonful. The objection to this preparation is that it is not miscible with water.
The ethereal solution of ergot, used by Dr. Lever [Lond. Med. Gaz. N. S. vol. ii. for 1839-40, p. 108.] to promote uterine contraction, is essentially a solution of the oil of ergot. It was prepared by digesting ℥iv of powdered ergot in f℥iv of ether during seven days. The tincture was submitted to spontaneous evaporation, and the residue dissolved in f℥ij of ether. The dose of this solution is from ♏xv to ♏xxx on a lump of sugar.
[5. VINUM ERGOTAE, U. S.; Wine of Ergot.—Take of Ergot, bruised, two ounces; White Wine a pint. Macerate for fourteen days, with occasional agitation; then express and filter through paper. This preparation is used as a substitute for the tincture. Dose, fℨj, or fℨij.]
6. OLEUM ERGOTAE; Oil of Ergot.—The liquid sold in the shops under the name of pure oil of ergot is obtained by submitting the ethereal tincture of ergot to evaporation by a very gentle heat. Its colour is reddish brown. Mr. Wright [Ed. Med. and Surg. Journal, vol. liv. p. 52.] states that this depends on the age of the ergot, and that when obtained from recent specimens it is not unfrequently entirely free from colour. Its taste is oily and slightly acrid. It is lighter than water, and is soluble in alcohol and in solutions of the caustic alkalies. It is probably a mixture of several proximate principles. I made a guinea-pig swallow a fluidrachm of it: the only obvious effect was copious and frequent diuresis. Two fluidrachms diffused through water and injected into the jugular vein of a dog, caused trembling of the muscles, paralysis of the hind, and great weakness of the fore legs, which lasted for more than two days. The respiration and action of the heart were exceedingly rapid. The saliva streamed copiously from the mouth. The pupil was strongly dilated before the experiment, and no obvious change in it was induced by the oil. Mr. Wright found the oil very energetic. A drachm, he states, injected into the jugular vein caused dilatation of the pupil, feeble, slow, and intermittent action of the heart, deep and interrupted respiration, general paralysis, insensibility to punctures, and death in two hours and forty minutes.
According to evidence adduced by Mr. Wright, the oil possesses the same influence over the uterus as that of the crude drug; that is, it occasions powerful uterine contractions. To produce this effect, it should be given in doses of from 20 to 50 drops in any convenient vehicle, as cold water, warm tea, or weak spirit and water.
7. EXTRACTUM ERGOTAE; Extractum Secalis Cornuti; Bonjean's Ergotine.—This is prepared by exhausting ergot of rye by means of water, and evaporating the liquors to the consistence of syrup. To this extract is to be added a considerable excess of alcohol, by which all the gummy matters and salts insoluble in alcohol are precipitated. From 100 parts of ergot, from 14 to 16 parts of extract, called, by Bonjean, ergotine, are obtained. The supernatant liquid is to be decanted and reduced in a water bath to the consistence of a soft extract. This extract is soft, reddish-brown, and homogeneous; has an odour of roast meat, and a slightly piquant taste. It may be employed medicinally in substance, made into pills, or dissolved in water. The dose of it is from five to ten grains. The aqueous solution of it is red, limpid, and transparent.
ANTIDOTE.—The proper treatment to be adopted in a case of poisoning by an overdose of ergot has not been accurately determined. The first object would be, of course, to evacuate the poison from the alimentary canal by the use of emetics or purgatives. As chlorine decomposes ergotin, Phoebus recommends the employment of chlorine water. In the absence of this, nitro-hydrochloric acid (properly diluted) might be exhibited. The subsequent treatment should be conducted on general principles.