ERGOT OF RYE – SPURRED RYE – COCKSPUR.
(Secale, rye; cornu, a horn or spur. Fr., ergot, a spur, cock;s spur.).
Secale cor., the common rye affected with ergot, or “a morbid growth arising from a diseased condition of the ovary of various grasses, caused by a fungus” (Century) and occurring principally in fertile years when hot weather frequently alternates with warm rains. Part of our symptoms are the poisonous effects from eating bread made from the diseased grain or from the use of the tincture, fluid extract, etc.; the rest from provings or clinical reports. In 1885 (therefore not in Allen’s Encyclop.), Dr. H. C. Allen, then of the University of Michigan, made for the Am. Inst. Transactions what he speaks of as a fragmentary proving, in which seventy-two persons, male and female, took part. An interesting statement is the one made in reference to one of the provers with the 200 potency.
Dr. Allen says: “This prover,” Mrs. H., “knew the potency but not the drug. She was perfectly convinced that in the 200 potency no drug was capable of producing medicinal symptoms on the healthy, and persisted in repeating her experiments to verify or disprove former results.” Among the numerous symptoms contributed by this prover are the following: “Menses a week too soon (always regular before to a day); many clots; offensive in odor; a cold cadaverous smell.” The chief interest in the action of ergot centers about its power to produce tonic contractions of involuntary muscle fibre; the arterioles are violently and persistently contracted, causing dry coldness of the surface nd 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).
Dunham speaks of two forms of ergotism, the spasmodic and the gangrenous, and in reference to the latter, says: “The gangrenous form commences with dull pain and weariness of the limbs, with heaviness and stupidity of the face. The skin acquires an earthy or jaundiced hue. The extremity about to be affected (sometimes it is the nose) becomes cold, and the skin over it gets dusky red. Then gangrene begins in the inside of the end of the extremity (or of the nose) and extends outwards to the skin. It also extends upward to the trunk. The parts affected shrivel, dry up, become black and harden until they look like those of a mummy. They separate from the living flesh without haemorrhage and by a clean line of division. ” Death is sometimes preceded by diarrhoea.” Ergot affects the peristaltic muscles of the intestines, causing cramp and vomiting, and the gravid uterus contracts violently and continuously, that is, without intermissions, as found during normal labor. Convulsions are liable to occur in ergotism and paralysis and anesthesia, with paraesthetic sensations of formation and intolerance of heat result; and especially trembling and paraplegia.
Ergotism caused cold skin and great internal heat, but the latter being the unconscious sensations, we have as one of the characteristic indications for the remedy an aversion to being covered. The skin is cold to the touch but the patient has a sensation o burning up internally and is aggravated by heat and will resist any attempt that may be made to cover him up warmly.
A pathogenetic symptom reads: ” Pain worse from heat applied to any part, and if on a cold day any additional covering was laid upon him while asleep, he woke almost instantly and threw it off” (33). There is an Secale cor. great restlessness (160), associated with great debility and prostration. Ergot produces convulsions and in Secale cor. there is a general tendency to hysterical spasms of the extensor muscles, or a paralysis of the flexor muscles (the appearance being the same in both), or we have contraction of the hands, feet, fingers and toes. It is useful in paraplegia, with cramps in the feet and calves, numbness (146), a “fuzzy feeling” and formication (82). Cramps in the calves (71) are common in Secale cor., associated with coldness of the extremities and cold sweat and we have numbness and tingling in the fingers and feet as if they were asleep (71).
Secale cor. is of especial value in diseases of putrescence, with haemorrhage or oozing of dark blood and threatening collapse (34), but with rapid and flighty pulse (110), often with hiccough (116), sometimes with unnatural hunger (119) and thirst, or as a pathogenetic symptom reads, “appetite unnatural even when dying from exhausting stools,” but always with coldness of the surface to touch, a sense of burning up internally and an aversion to being covered. Frequently in these conditions there is vomiting, sudden and violent, with cold sweat (185), similar to what is found under Tabacum, where we have the “deathly nausea,’ only in Secale cor. there is burning in the stomach, while in Tabacum there is coldness. There may be in Secale cor. retraction of the walls of the stomach preceding the vomiting. The stools are watery, sudden, gushing (59) and involuntary, with unquenchable thirst and vomiting. The stools are usually painless, but very offensive, even putrid (59) and exhausting (58), a collapsed state, icy-coldness externally, and, very characteristic of the remedy here as well as in many other conditions, the intolerance of being covered. There is often found suppression of urine (200). With these symptoms Secale cor. is of value in diarrhoea, especially in puerperal and typhoid conditions, in dysentery and in true cholera (31). “Ergot seems to lessen the coagulating function of the blood,” says Farrington, “and will cause haemorrhages, the flow being dark, fluid and persistent,” and Secale cor. is to be thought of in a haemorrhagic diathesis, with haemorrhage from the uterus or any of the cavities of the body.
You all know of the powerful effect of ergot on the gravid uterus and how it causes powerful and persistent contraction. You also know of the great danger in using it when there is not full dilation of the os; but I would like to quote from the Handbook in this connection, where Allen says: ” During labor or uterine haemorrhages ergot should be used with great discretion; it is extremely dangerous when there is albuminuria, for it is liable to bring on convulsions; if used too freely during labor it is extremely apt to cause puerperal metritis.” If your experience is at all similar to mine, you will have reason to regret the use of ergot every time that it is not absolutely necessary. If it is used, even in small amounts (10 drops in half a glass of water and taken in teaspoonful doses), as a time-saving scheme, you will find that what you gain in one stage you will lose in the other and during the period of convalescence. In post-partum haemorrhage I would not hesitate to employ it if necessary, and in fact always have it ready, but when I can avoid its use, I also avoid trouble for the patient as well as for myself.
The lochia in Secale cor. is offensive (153), greenish and purulent, and it has made some brilliant cures in puerperal fever (155) when there was danger of putrefaction, with putrid discharges, coldness, intolerance of covering, suppressed urine and tendency to collapse. The menses may be irregular as to time, and are usually profuse and associated with severe pressing-down pains, and it is to be thought of in menstrual colic (138), with coldness and intolerance of heat, “better when the flow appears” (Hering). Secale cor. has cured various tumors of the uterus and appendages, either with profuse menstruation, or with haemorrhage of thin, black, often fetid blood, with expulsive pains. Dunham says: “In cancer uteri (202) it arrests haemorrhage nd relieves the terrible burning pains at night which torment the patient. This it does in small doses, even the 200th.” It is to be thought of in haemorrhage from the lungs (27) when the blood is dark (28) and venous, and in gangrene of the lungs (29). It has a cough, apparently due to spinal anaemia, and pressure on the spine causes pain all though the chest. (171). In carbuncles with gangrenous degeneration (82), in senile gangrene (82) and in leprosy, Secale cor. is to be thought of with the dry, cool and shrunken skin and aggravation from heat or warm applications. I use Secale cor. 30th.