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INTRODUCTION
COMMON NAME : ERGOT OR RYE , SPURRED RYE
Ergot is a fungus, from family Clavicepitaceae, botanical name being
Claviceps purpura. Secale Cor is made from the plant
Rye infected by Claviceps. Rye is a grass that was
first cultivated rather late in human history, perhaps as recently
as 2000 to 3000 years ago. It is still grown extensively in northern
Europe and Asia. It lacks the proteins that make wheat suitable
for living, and rye bread is denser and usually darker than the
wheat bread, hence called Black Bread.
Ergot appears as black grain size fungal structures. In late spring,
these ergots germinate and form tiny spore producing mushroom like
structures. Infectious spores are carried by wind currents to the
host during the flowering stage. Infection of the cereal flowers
may produce a secondary phase called Honeydew. Honeydew
is a shiny sticky liquid that oozes from infected flowers and contains
large numbers of ergot spores. The spores spread to adjacent flowers
and heads by insects and rain splash particularly to the open flowers
of rye. Ergot that germinates in June can infect early flowering
weed grasses, which produce honeydew when cereals are flowering.
It gives out a sickening heavy smell. Its colour
is externally purplish black. Internally it is pinkish white. It
has a nauseous and slightly acrid taste.
After an overdose of ergot or medications derived from ergot or
from eating flour milled from ergot infected rye, humans and livestock
may develop Ergotism, a condition sometimes called
as St. Anthony’s Fire. The symptoms include Convulsions,
Miscarriages and Dry Gangrene and may be Death. It contains the
crystalline alkaloid Ergotamine, Ergotinine and the amorphous alkaloid
Ergotoxine.
Dr. Stearns of Waterford, New York introduced it in 1807 as a substance,
which he had used for several years to expedite lingering labors
when pains had subsided and were incomplete to expel the foetus.
It is justly regarded as unfortunate if the labor does not come
to an end soon after the administration of the Ergot, since if it
be delayed there is reason to believe that the child will be poisoned
by it.
“These poisonous effects are said to be due to the oil of the Ergot,
which if given alone to a parturient woman, does not cause contraction
of the uterus, but does poison the foetus. Whereas on the other
hand the Ergot, deprived of its oil, acts on the uterus, but does
not poison the foetus. This phenomenon has not been explained as
yet....“(Dr. Carol Dunham)
Ergot is the common name given to the sclerotium
formed by that fungus. The sclerotium is the fungal mass that replaces
the seed of the plane, it may have somewhat the same general configuration
as the seed but is a larger, dark colored and hard.
Ergot
has had several uses in the field of medicine. There are reports
as far back as 1582 of European and Chinese midwives using it to
reduce hemorrhage following childbirth. It has also been used to
induce abortions. Two of the alkaloids of ergot, ergotoxine and
ergotamine have also been found to have medical uses. Ergotamine
and to a lesser extent ergotoxine, were found to be remarkable in
the treatment of migraine headaches. However both ergotamine and
ergotoxine cause gangrene with chronic use. It must therefore be
used only under strict medical supervision.
One of the most famous derivatives of ergot was lysergic acid.
In 1938, two Swiss researchers, Hofmann and Stoll, derived d-lysergic
acid diethymanide (LSD). It was thought to be relatively uninteresting
until Hofmann accidentally ingested a small quantity of the drug.
He was the first person to go on an “acid trip”. LSD is the most
famous psychotomimetic drug and was used widely in North America
and Europe through the 70’s. After ingesting LSD, the user will
experience optical changes, inability to concentrate, phases of
uncontrollable laughter, anxiousness and the quite typical experience
of the subject standing outside of the body watching these events.
Senses are also enhanced. The “trip” lasts for about 8 hours with
a state of self-centeredness that lasts for an additional 5 hours.
The first major outbreak of dancing mania was in Aix-la-chapelle
in July of 1374. A group of people was seen to dance uncontrollably
in the streets, foaming at the mouth and screaming of wild visions.
They kept on dancing until they collapsed from exhaustion, but even
then they flailed about in agony until forcefully restrained. The
dancing caught on, and spread rapidly throughout France and the
Low Countries. The dancing mania, especially as described in Aix-la-Chapelle,
may have had a physical hypotheses, that the manic dancers (at least
some of them) were victims of ergot poisoning, or ergotiism. Ergotism,
which was known in the Middle Ages as “St. Anthony’s Fire”, is a
toxic condition in humans and animals which inadvertently eat rye
and other grasses parasitized by Claviceps purpurea
(ergot).
Ergot has been widely used for many centuries
for a number of different purposes ranging from its medical uses
to its recreational drug uses. It has also been the cause of great
many epidemics across Europe from the early 10th to the
late 19th century. Knowledge of this fungus has increased
throughout the years, however further research into the alkaloid
derivatives may still produce beneficial medical uses.
PHYSIOLOGICAL ACTION
This is a medicine for which no human proving has been done due
to its toxicity. The pathogenesis and symptomatology has been derived
from its effect on human race accidentally, by its effect on cattle,
lower animals and some proving on lower animals. There were so many
epidemics of ergotism, due to which the symptoms have been recorded and
have been confirmed in clinical practice. In almost every branch
of medicine it has been used for contractions during birth, dilation
of veins, decreasing blood pressure and treatment of migraines etc.
Since ancient times it was known to produce ergotism which then
was divided into two main groups, i.e., Gangrenous ergotism and
Convulsive ergotism and another being Hallucinogenic ergotism.(
Dr. Peter J Burfening , Ph.D).
In gangrenous bodily extremities turn
black, dry and become mummified, making it possible for infected
limbs to spontaneously break off at the joints. In convulsive ergotism
there were epileptic form seizures, violent retching, tongue biting
or unusual breathing patterns. This resulted in permanent nerve
damage, deformity and long recovery period. In hallucinogenic ergotism
, there were vivid hallucinations, nervousness, jerky movements,
persons used to perform strange dances with wild movements, hopping,
leaping and screaming until exhausted which often lead to unconsciousness.
Dr. Willard Ide Pierce writes : “The chief interest in the action
of ergot centers about its power to produce tonic contractions of
involuntary muscle fiber; the arterioles are violently and persistently
contracted, causing dry coldness of the surface and even gangrene
of the lower extremities, and we have records of terrible epidemics
of what are now believed to have been due to ergotism; that have
devastated sections of Europe from the ninth to the last century
(1089 – 1816). Depending on observations for years together the
action of Secale Cor on different parts of the body can be described
as follows:-
CEREBRO SPINAL NERVOUS SYSTEM: Muscular
Cramps, Epilepsy
It has a marked action on the brain and spinal cord. They are first
stimulated for a short time which is soon followed by paralysis.
This paralysis has often extended to the centres of respiration
and cardiac contraction; and in chronic poisoning the filaments
of sensory nerves are powerfully influenced. The first symptom of
this makes its appearance in the form of an ant creeping over the
skin. This formication continues during the whole course of sickness
and it is the last symptom which disappears.
There is involuntary twitching in various group of muscles, e.g.,
in the tongue and extremities. They soon pass into continuous contractions,
which specifically affect the flexors, so that the arm remains fixed
in a bent position. When the contractions pass off, a state of exhaustion
remains. But soon the painful convulsion returns and makes the patient
moan and groan continuously. The contractions come in simultaneously
in various group of muscles, like face, extremities, digestive tract
, uro-genital system etc.
CIRCULATION AND VASCULAR SYSTEM: Arterial
contraction , venous dilatation
Dr. P. Eberty had done a study of ergot on heart and cardiac system.
He found that in a frog , the injection of ergotine caused a diastolic
arrest of the heart and that the viscous was unable respond at all
to stimuli. Although the heart is a profoundly affected in acute
poisoning by ergot, yet death is probably not due to this cause,
since Dr. Wright found that even though the heart after death was
quiet, it commenced to beat as soon as the congestion was relieved
by an incision, and continued to beat for a few minutes.
It has unquestionable effect on the pulse and reduces it. This
has been confirmed by so many researchers. The amount of reduction
varies from 10-35 beats per minutes.
The chief effect of ergot is upon arteries and veins. It contracts
the arteries first and on the other hand there is a dilatation of
veins. The result is diminished quantity of blood in arteries and
corresponding increase in the contents of the veins. This was studied
in frogs and rabbits by Dr. Wernich, Dr. Holmes and was micrometrically
measured by Dr. Briesemann. Dr. Wernich sees in the dilatation of
the veins the primary, in the contraction of the arteries and the
action of the heart the secondary symptoms. The arteries therefore,
collapse from want of sufficient quantity of blood, the action of
the heart.
UTERUS: Viloent
Uterine contraction, abortifacient, haemoorragic tendancy
It produces violent contractions of uterus causing abortions. Through
the nerve centres of the brain and lumbar region of the spinal cord,
ergot has a powerful and fixed action upon the pregnant uterus.
It was proved by Dr. Schlesingher and Dr. Wernich, that, even in
the impregnated uterus of animals, movement take place under the
influence of ergotine. But those movements according to present
experience, these are not as primary effect of the poison, but as
secondary, and dependent on the arterial anemia produced by ergotine.
It might always be assumed that the influence of ergot upon the
movement of the uterus proceeds solely from an influence of the
poison upon the nerve centers of these movements in the lumbar region
of the cord and its higher situated parts, as well as in the brain.
The experiments of Dr. Schlesinger and Oser have proved that the
arterial anemia is to be regarded as the stimulating cause of the
movements of the uterus, and secondly, that the uterine contractions
are caused by excitement from the central organs. The abortions
produced by ergot are thus accounted for by its increasing uterine
contractions. The evidence of those who have used ergot for the
induction of premature labor in women tallies very closely with
that which is brought forward in regard to lower animals. Prof.
Ramsbotham states that he has a great number of trials and found
that expulsive action soon followed with very few exceptions.
INFLUENCE OF ERGOT ON FOETUS:
There are instances that ergot administered in tedious and difficult,
slow labors has proved very destructive to the life of the child.
Dr. Moore of New York says “It appears to be injurious to the child
at all times; for, in every case in which I have seen it exhibited,
the child has been stillborn.”
In fact if the cervix is not dilated and ergot is administered,
due to contraction of uterus gives pressure on the child which may
cause of the death. According to Dr. Meigs it should be employed
at the moment of, or just before, the birth of the child, in order
to secure a good contraction of the womb in women who are known
to be subject to hemorrhage.
DIGESTIVE SYSTEM: Increased peristalsis, diarrhea,
vomiting
The most evident symptom
in the early stage of the action of ergot is retching, vomiting,
diarrhea and profuse salivary secretion which are consequences of
the action of the poison on the sensory nerves of the mucous membrane
of the alimentary canal, these are excitement, communicated to the
motor and secretory regions.
In Dr. Wright’s experiments, the intestines were found in very
active peristalsis at the post-mortem examination of the poisoned
animals.
In rabbits it also produced very violent
peristalsis. It produced involuntary stools, which may be its affect
on the sphincter muscles of anus and bladder.
SKIN: (Gangrenous ergotism): Diaphoresis, Gangrene, Purpura,
Coldness of Skin
The symptoms which characterize
gangrenous ergotism as such often appear within from two to seven
days. An erypsipelatous redness shows itself on some spots in the
periphery, most frequently on the toes and feet, but also on the
fingers and hand, more rarely on the ears and the nose; soon after
the epidermis is raised like a bladder by serous exudation; the
ichorous contents of this are soon discharged, and a gangrenous
spot develops very rapidly at the affected spot. The part affected
is very painful but later on it becomes quite insensible. The gangrene
depends on the fact that the part affected is deprived of its blood
supply, and its nutrition thereby arrested, consequently, it must
pass into a state of decomposition. The only question is whether
it is inflammation which leads to gangrene, or whether the process
is of a non inflammatory character, resembling that which occurs
when all the vessels going to a limb are ligatured. When we consider
that the initial so called erysipelatous redness is simply dependent
on the cyanosis, and that these spots are not, as in a case of inflammation
hot and swollen, but on the contrary, they become very cold, and
warmth can not be restored in them, and that the affected limb is
not at all swollen, the hypothesis that such a gangrene is of an
inflammatory character may be rejected as there is no fever also.
TEMPERATURE:
Lowers down the temperature, hence there is coldness of the skin.
It may come down by 4-5 degrees. It is the result of its action
on the heart and vascular system.
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