Secale cornutum. Spurred rye. Ergot of rye. Ergot is the black horn-shaped spur originating in the ovary of Secale cereale, the common rye, and is the compact mycelium or spawn or Claviceps purpurea, a fungus which attacks the grain. Tincture of the spurs.
PATHOGENESIS
ERGOT contains an amorphous alkaloid, ergotoxin, C35H41O6N5 and its anhydride, ergotinine, C35H39O5N5, the latter of which is inert physiologically. Also ergotamine and a substance called tyramine, which has an action resembling adrenalin, and some other substances, amongst which is histamine. Ergotoxin is the most powerful of these ingredients and top it the principal action of ergot is due. It acts on the myoneural junctions of the sympathetic nerves in the uterus, intestines, bladder and arterioles. The pregnant is much more powerfully affected than the non-pregnant and virgin uterus. The general contraction of the blood-vessels is due to stimulation of the constrictor nerves that terminate in the vessel walls and gives rise to an increase in blood-pressure. The heart is less strongly acted on than the blood-vessels and the pulmonary arterioles are unaffected. The pupil is contracted from a direct action on the muscular fibres of the iris, in this state it is not affected by atropine. Peristalsis of the stomach and intestines is stimulated, but at the same time the intestines are blanched. both from constriction of their arterioles and from the contraction of their arterioles and from the contraction of the involuntary muscle fibres squeezing out the blood. Intestinal secretions are lessened-therefore, though peristalsis is increased, diarrhoea does not always occur. The uterus under the influence of ergotoxin contracts powerfully for a short time, contraction being followed by slow relaxation interrupted by numerous new contractions; the rhythmical contractions of pregnancy are made quicker and stringer; as the dose is increased they become stronger still and last longer, and with a large injection the uterus contracts very powerfully and may remain contracted for several minutes.
Ergotoxin resembles adrenalin in its action on involuntary muscle, but whereas adrenalin acts on both the motor and inhibitory nerve fibres in the muscle ergotin acts only on the motor.
When ergot is taken for a long time, as occurs from the prolonged eating of bread diseased with ergot, the contraction of the arterioles and the subsequent thickening of their walls produced by the drug, shut off the blood-supply from various parts and they become gangrenous. This occurs principally in the extremities, but the internal organs may be affected and cataract may from in the lens of the eye.
Another train of symptoms produced by chronic ergotism is found in the nervous system. First itching and tingling and a sensation as of insects running over the skin are felt; to these succeed numbness and local anaesthesia, which are followed by tonic contractions of different muscles and loss of muscular power, with staggering. These symptoms appear first in the hands and feet but afterwards spread over the body. Epileptic form convulsions sometimes occur and diminished or lost sight and hearing. Intellectual weakness often follows recovery from ergot poisoning and may amount to complete dementia. There are usually also vomiting and diarrhoea. Death takes place from asphyxia due to paralysis of the respiratory muscles.
The milk, saliva and other secretions are diminished by ergot, owing to lessened supply of blood to the organs concerned on account of the contraction of their arterioles.
General condition.-Patients poisoned by ergot exhibit extreme debility, prostration and restlessness, and are very anxious, with fear of death (ars.). There is rapid sinking of strength. The surface is cold and the skin shrivelled, withered and grey-looking. Though the surface is cold, the internal sensations are those of heat, so that though the patient is actually cold to the touch he cannot bear heat, wants cool air and throws off the coverings.
Head.-There is often confusion in the head and impaired power of thinking, and in chronic poisoning delirium may come on, which is usually of a terrifying nature.
The eyes are sunken and surrounded by blue rings, sight is obscured, the pupils may be dilated as a reaction from the contracted state, and various photopsies are present.
The face is pale, pinched and earthy-looking the lips bluish or deadly pale, the expression anxious.
Limbs.- Muscular twitchings when occurring usually commence in the face or hands and spread thence over the body. The fingers are either convulsively drawn into the palms or they are spread wide apart in abduction, the toes are drawn up toward the dorsum of the foot. Cramps occur in any of the muscles of the extremities, but chiefly in the flexors (except the toes). Sensation in the limbs is altered and numbness, coldness, insensibility, burnings and formication are felt, especially in the fingers and toes. The limbs feel heavy and tremble and the power of voluntary motion may be lost.
Chill, Fever, &c.-Profuse, cold, clammy sweat may occur over the whole body or there may bee burning sensations in any part, as “If sparks were falling on the patient.”
Digestion.-The appetite remains good in cases of chronic poisoning and in often voracious, there is great thirst, with desire for lemonade and sour things. The epigastrium is sensitive to touch, burning and pressure, or cramping pains are felt in the stomach, the abdomen feels swollen and pain in the lower abdomen compels a doubled-up position there is an inclination to colic and to Diarrhoea of stools that are very offensive, thin and olive-green in colour and that are extremely exhausting. There are weakness and relaxation of the rectum and anus so that the later remains wide open.
Urine.- A similar paralytic condition is present in the fundus of the bladder and leads to retention of urine. Urine is pale and watery. It will be observed that these states of relaxation and paralysis occurring in cases of chronic poisoning are the reverse of the contraction of involuntary muscle caused by acute poisoning. In the same way the passive haemorrhage from relaxed vessels and capillaries of chronic poisoning contrast with the contracted arterioles that are the result of the primary action of ergot. The over-stimulated muscle nerve junctions after a time become exhausted and relaxation and paralysis succeed contraction. Both primary and secondary conditions are used as indications for the employment of secale in homoeopathic practice.
THERAPEUTICS.
In the orthodox school ergot has long been used to expedite labour and to prevent post-partum haemorrhage. It is used criminally to produce abortion. For these purposes it is given in substantial doses. Its use as an ecbolic is not without danger to the tissues of the mother and the life of the child, and other measures to prevent post-partum haemorrhage have been found more efficient; it has in recent years been supplanted by pituitary extract or pituitrin in these cases.
Sexual.- Secale is used homoeopathically for excessive after-pains and for hour-glass contraction of the uterus, with retained placenta. It is also recommended to be given, in high dilution, during labour when the pains are weak or ceasing where the passages are lax and open but expulsive power has gone. The haemorrhages for which secale is indicated are passive, continuous oozing of black, fluid blood from surfaces or orifices. Thus it is useful in menorrhagia when the discharge consists of copious dark, fluid blood, with forcing labour-like pains in the abdomen, and when the menses do not cease at the proper time but continue as a watery, blood-stained discharge during the whole time between the periods; the symptoms are worse from warmth.
“Secale is useful in puerperal metritis when the discharges are putrid and associated with cold, clammy skin, tympanites, suppression of urine and tendency to collapse. One of its principal employments has been to prevent abortion and it seems to be especially efficacious when there is threatening of miscarriage at the third month of pregnancy. It is also a remedy for dysmenorrhoea with forcing-down pains and flow of dark fluid blood, accompanied with coldness and fainting. It has been used in prolapsus uteri when the characteristic modalities have been present and also for suppression or non-appearance of the milk. Other suppressions may indicate it, when characteristic secale symptoms accompany them, ex. gr., of tears, lochia, and sweat.
Secale is indicated in post-partum haemorrhage of the passive kind, where the blood is dark and does not clot, and comes away not in gushes but in a continuous oozing, worse from any movement and often accompanied by fainting; the patient wants the bedclothes to be taken off, to breathe cool air and to be fanned. Other haemorrhages of the passive kind usefully treated with secale are persistent epistaxis when dark blood flows continually and there are a small thread-like pulse and great prostration; epistaxis occurring in young people who are debilitated or in old people and drunkards; also passive oozing of blood from the surface of indolent ulcers with burning pains, sloughing surfaces and foul discharges.
Edwin Awdas Neatby founded the Missionary School of Homeopathy and the London Homeopathic Hospital in 1903, and run by the British Homeopathic Association. He died in East Grinstead, Sussex, on the 1st December 1933. Edwin Awdas Neatby wrote The place of operation in the treatment of uterine fibroids, Modern developments in medicine, Pleural effusions in children, Manual of Homoeo Therapeutics,