ERGOT AND ITS USES.
A honey-like substance glues together the stamens, and this is the fungus sclerotium, which constitutes ergot. The fungus is the result of the ger mination of a spore of the claviceps purpurea (Fig. 247.) The same fun gus has been found on wheat by Mialhe. (Fig. 248.) Physiological Effects.—Without entering into special details, it seems advisable to state briefly our knowledge in regard to the physiological effects of this drug, which are constant, whether it be used as powder, aqueous extract, or as ergotine. Since the experiments of Holmes, in 1869, much has been written on the subject of ergot, and it has been proved over and over again that the drug acts with greatest intensity on the uterine system when gravid, and then on the circulatory, respiratory nervous and digestive systems. In our description we will follow Bailly, who has carefully studied the subject.
The matrons of certain European countries and of America early de termined the property of ergot of awakening uterine contractions, but it was first announced to the profession by Desgranges of Lyons (1818.1829), then by Sterns of New York (1818); although Prescott first, in 1815, studied the rapidity and duration of its action, and laid down the indica tions for its employment.
One of the indispensable conditions for the action of ergot is the de velopment of the uterus and of its cavity under the influence of preg nancy, or of the presence of a foreign body such as a polyp, blood, or vegetations. The uterine fibre must, indeed, be hypertrophied, the cularis developed as well as the vessels, and therefore it is particularly at full term that the drug acts best and most completely. The further from term, the less the effect of ergot on uterine contractility.
A further point is that ergot has the property of over-exciting the mus cular fibre already in a state of action. All authorities do not agree that ergot may excite uterine contractions, that the drug is a true cient. The general opinion to-day is that, while ergot may in a measure excite contractions, it does not suffice of itself to determine labor, and that it is simply an adjuvant to other means of provocation of labor.
When, on the other hand, contractility is already present, its action is in contestable; it reinforces uterine contractions at every part of the uterus, as well the body as the cervix, with an intensity directly proportionate to the development of the uterine fibre. While Prescott denied abso lutely the action of ergot on the empty uterus, Trousseau, Maisonneuve, l'idoux, C. Paul, Chapman, Muller, Peronnier, Joffi, Cabini, Pignocca, Bozzoni, Spargani, Laborde, Pitou, admit this, as well as, in a measure, I'. Dubois.
Together with this favorable action of ergot, there is another which is unfavorable. The drug, indeed, does not only re-enforce and prolong uterine contractions, but also changes their physiological character br suppressing those intervals of repose which separate the normal uterine contractions. As long as the uterus is under the influence of ergot, it remains in a state of retraction, of tension, tetanic so to speak, which induces uterine and foetal circulatory disturbances, which are dangerous to the fatus. Instead of suppleness and resiliency in the intervals of contractions, the uterus remains hard—in a word, as Bailly expresses it, from intermittency, we have remittency.
The action of ergot varies with the different preparations used. When the powdered drug, or Bonjean's ergotine, is administered by the mouth, it is only at the expiration of ten to twenty minutes, as Prescott has ob served, that we note the effect, while where the drug is administered subcutaneously, it is at the end of two to three minutes that it is effective. The duration of the action varies from one half bout to one hour and a half, according to the dosage. Yvon's solution has seemed to us to act the soonest, and to be the most transitory of all the, preparations.