Ergota, Ergot of Rye,—the sclerotium (intermediate fibrous stage) of Claviceps purpurea, a fungus replacing the grain of Secale cereale (rye), and growing within its flower. Dose, gr. x-xxx.
It contains, according to Kobert (1885) three active principles, Ergotinic Acid, affecting the nervous system, heart and respiration; Sphacelinic Acid, which produces gangrenous ergotism, stimulating the vaso-motor system; —and Cornutine, an alkaloid, which possesses the ecbolic action, and causes convulsive ergotism. The drug also contains a non-drying Oil, with Trimethylamine, and Lactic and Phosphoric Acids. The composition of Ergot is much disputed; and various names have been given to supposed alkaloids and principles believed to exist in it, a Ergotine, Ergotinine, Echelimme, Sclerotinic Acici, Scleromucin, Sclererythrin, Scleroxanthin, etc.
*Ustilago Maydis, Corn Ergot,—grown upon Zea Mays, the Indian corn or Maize; probably has a similar composition. One of its constituents is a volatile principle named Secaline, supposed to be identical with Trimethylamine.
- Extractum Ergotae, Extract of Ergot, (Ergotin); Squibb's is a good preparation and represents the power of the drug,—Dose, gr. hypodermically, gr. j-x per orem.
- Extractum Ergotae Fluidum, Fluid Extract of Ergot,—Dose, ʒss-ij.
- Vinum Ergotae, Wine of Ergot,—15 per cent. Dose, ʒj-℥j.
- *Extractum Ustilaginis Maydis Fluidum,—Dose ʒss-ij.
The Ergotin of Bonjean is very variable and often inert. Wigger's Ergotin is insoluble in ordinary menstrua, and is inert on the vascular apparatus, but causes enteralgia and gastro-enteritis. Tanret's Ergotinine is probably an active alkaloid; its dose is gr. 1/30-1/10.
Physiological Action,—is divided into two sets of phenomena, named respectively Acute and Chronic Ergotism, according as the drug is administered in large doses, or in small quantity for a considerable length of time. Ustilago has properties similar to those of the Ergot of Rye, as far as examined.
Acute Ergotism. In large doses Ergot acts as a gastro-intestinal irritant, causing nausea and vomiting, gastralgia, colic, thirst, difficult micturition, and purging. It slows the heart, raises the arterial tension enormously, dilates the pupils, and produces pallor, vertigo and frontal headache. Its action on the circulation is due to its inducing arterial anaemia; but whether by contracting the arterioles through local action on their muscular fibre, or by central stimulation of the vaso-motor system, or by causing venous dilatation, is disputed. It certainly stimulates the contraction of unstriped muscular fibre; especially affecting the sphincters and the uterus, causing continuous labor pains and tonic contraction of the sphincter vesicae, making micturition difficult, if not impossible. It also produces cerebral and spinal anaemia.
Chronic Ergotism occurs in two forms,—the Convulsive and the Gangrenous,—either usually excluding the other. The convulsions are tetanoid spasms of the flexor muscles, of the uterus, the muscular fibres of the intestines, and the muscles of respiration, ending in coma and death by asphyxia. The gangrenous form begins with coldness and numbness of the limbs, formication all over the body, loss of sensation and the special senses, bullae of blood and ichor, followed by dry or moist gangrene of the lower extremities, buttocks and other parts, epileptiform convulsions, coma and death. Autopsy shows changes in the posterior columns of the cord.
Therapeutics. Ergot has a wide field of usefulness. In—
- Conjunctivitis, and inflammations of mucous membranes generally,—given internally and applied locally, it proves of striking benefit.
- Lax Sphincters of the rectum and bladder,—are contracted by Ergot.
- Acute Dysentery in the congestive stage ,—is well treated by full doses-
- Hemorrhoids,—are well treated by Ergot locally, but not internally, as it promotes venous congestion when so administered.
- Hemorrhages of arterial type, not in the passive or venous form.
- Cardiac Hypertrophy without valvular lesion,—Ergot to slow the heart.
- Aneurism,—Ergot aids coagulation by slowing the blood-current.
- Mania due to cerebral hyperaemia,—Ergot is a very useful remedy.
- Headache, Migraine, etc., of congestive form,—Ergot acts very well.
- Myelitis and Spinal Congestion,—large doses prove very successful.
- Cerebro-spinal Meningitis,—Ergot is herein one of the very best remedies.
- Splenic Enlargement,—Da Costa has found that Ergot administered internally will reduce the size of an enlarged spleen.
- Diabetes Insipidus,—is best treated by Ergot, according to Da Costa, etc.
- Amenorrhoea,—when due to plethora, has been frequently cured by Ergot.
- Impotence,—due to escape of the blood from the dorsal vein of the penis.
- Incontinence of Urine,—from paralysis of the sphincter vesicae.
- Uterine Affections, as chronic metritis, subinvolution, fibroids and polypi, congestive dysmenorrhoea, etc.,—Ergot causes firm contraction of the organ, and promotes the absorption of inflammatory products.
- Obstretics. Here Ergot is much used, and often very injuriously. Producing continuous uterine contractions, instead of the natural ones (which are intermittent). it should never be used when there is any obstacle in front of the child. Dangers are—rupture of the uterus, laceration of the perineum, paralysis of the foetal heart. If employed during labor at all, which is now considered doubtful, it is only permissible at the end of the second stage, when the head is born, in order to promote uterine contraction and expulsion of the placenta, and to guard against post-partum hemorrhage.
A Compend of Materia Medica, Therapeutics, and Prescription Writing, 1902, by Sam'l O. L. Potter, M.D., M.R.C.P.L.