Ergot
ERGOT, or Spurred Rye, the drug ergota or Secale cornutum (Ger. Mutterkorn; Fr. seigle ergoté), consisting of the sclerotium (or hard resting condition) of a fungus, Claviceps purpurea, parasitic on the pistils of many members of the Grass family, but obtained almost exclusively from rye, Secale cereale. In the ear of rye that is infected with ergot a species of fermentation takes place, and there exudes from it a sweet yellowish mucus, which after a time disappears. The ear loses its starch, and ceases to grow, and its ovaries become penetrated with the white spongy tissue of the mycelium of the fungus which towards the end of the season forms the sclerotium, in which state the fungus lies dormant through the winter.
The drug consists of grains, usually curved (hence the name, from the O. Fr. argot, a cock's spur), which are violet-black or dark-purple externally, and whitish with a tinge of pink within, are between 1/3 and 1 in. long, and from 1 to 4 lines broad, and have two lateral furrows, a close fracture, a disagreeable rancid taste, and a faint, fishy odour, which last becomes more perceptible when the powder of the drug is mixed with potash solution. Ergot should be kept in stoppered bottles in order to preserve it from the attacks of a species of mite, and to prevent the oxidation of its fatty oil.
The extremely complex composition of this drug has been studied in great detail, and with such important results that instead of giving ergot itself by the mouth in doses of 20 to 60 grains, it is now possible to obtain much more rapid and certain results by giving one three-hundredth of a grain of one of its constituents hypodermically. This constituent is the alkaloid cornutine, which is the valuable ingredient of the drug. Other ingredients are a fixed oil, present to the extent of 30%, ergotinic acid, a glucoside, trimethylamine, which gives the drug its unpleasant odour, and sphacelinic acid, a non-nitrogenous resinoid body. Of the numerous preparations only two need be mentioned - the liquid extract (dose 10 minims to 2 drachms or more), and the hypodermic injection. The latter does not keep well, and the best way of using ergot is to dissolve tablets obtained from a reputable maker, and containing some of the active principles, in pure water, the solution being injected subcutaneously.
Ergot has no external action. Given internally it stimulates the intestinal muscles and may cause diarrhoea. After absorption it slows the pulse by stimulation of the vagus nerves. It has indeed been asserted that the slow pulse characteristic of the puerperal period is really due to the common administration of ergot at that time. This is probably an exaggeration. The important actions of ergot are on the blood-vessels and the uterus. The drug greatly raises the blood-pressure by causing extreme contraction of the arteries. This is mainly due to a direct action on the muscular coats of the vessels, but is also partly of central origin, since the drug also stimulates the vaso-motor centre in the medulla oblongata. This action on the vessels is so marked as to constitute the drug a haemostatic, not only locally but also remotely. It may arrest bleeding from the nose, for instance, when injected hypodermically. Nearly all the constituents share in causing this action, but the sphacelinic acid is probably the most potent. Ergot is the most powerful known stimulant of the pregnant uterus. The action is a double one. At least four of its constituents act directly on the muscular fibre of the uterus, whilst the cornutine acts through the nerves. Of great practical importance is the fact that the cornutine causes rhythmic contractions such as naturally occur, whilst the sphacelinic acid produces a tonic contraction of the uterus, which is unnatural and highly inimical to the life of the foetus. Ergot is used in therapeutics as a haemostatic, and is very valuable in haemoptysis and sometimes in haematemesis. But its great use is in obstetrics. The drug should regularly be given hypodermically, and it is important to note that if the injection be made immediately under the skin, an abscess, or considerable discomfort, may ensue. The injection should be intra-muscular, the needle being boldly plunged into a muscular mass, such as that of the deltoid or the gluteal region. The indications for the use of ergot in obstetrics are highly complex and demand detailed treatment. It can only be said here that the drug should only in the rarest possible cases be given whilst the child is still in utero. This rule is necessitated by the sphacelinic acid, which causes an unnatural state of the organ. When it is possible to obtain pure cornutine, which is unfortunately very expensive, the precautions necessary in other cases may be abrogated.
Chronic poisoning, or ergotism, used frequently to occur amongst the poor fed on rye infected with the Claviceps. As it is practically impossible to reproduce the symptoms of ergotism nowadays, whether experimentally in the lower animals, or when the drug is being administered to a human being for some therapeutic purpose, it is believed that the symptoms of ergotism were rendered possible only by the semi-starvation which must have ensued from the use of such rye-bread; for the grain disappears as the fungus develops. There were two types of ergotism. In the gangrenous form various parts of the body underwent gangrene as a consequence of the arrest of blood-supply produced by the action of sphacelinic acid on the arteries. In the spasmodic form the symptoms were of a nervous character. The initial indications of the disease were cutaneous itching, tingling and formication, which gave place to actual loss of cutaneous sensation, first observed in the extremities. Amblyopia and some loss of hearing also occurred, as well as mental failure. With weakness of the voluntary muscles went intermittent spasms which weakened the patient and ultimately led to death by implication of the respiratory muscles. The last-known "epidemic" of ergotism occurred in Lorraine and Burgundy in the year 1816.
Note - this article incorporates content from Encyclopaedia Britannica, Eleventh Edition, (1910-1911)
