As a rule, an ordinary attack of epilepsy cannot be aborted. All that can be done is to remove all tight articles of clothing, to place a pillOw under the patient's head, and to take care that he does not injure himself in his convulsive struggles. All attempts made \ vi t h the object in view of relieving the convulsive rigidity of the fingers or limbs are of no value whatever ; neither may anything be accomplished by sprinkling the patient with cold water.
EPSOM SALTS.—See MAGNESIUM, SALTS OF.
ERGOT-POISONING.—Ergot is a poisonous, mould-like fungus which grows over and into the grain of rye and replaces its substance. It is a horn-shaped, usually curved body, dark violet on the outside and white inside ; and it is most poisonous immediately after the harvest.
Rye infected with ergot is often ground into flour and used for food (particularly in impoverished countries), with the result of acute or chronic poisoning. During the Middle Ages, in years when the crops were bad and widely infected, veritable epidemics of ergot-poisoning occurred.
The symptoms of acute poisoning by ergot are chiefly connected with the gastro-intestinal canal, as salivation, retching, vomiting, and ; and with the nervous system, as itching sensations resembling the creeping of ants on the arms and legs, headache, and vertigo.
In some severe attacks, convulsions, delirium, and unconsciousness may occur. The poisoning terminates in recovery in a few days, rarely in death.
Chronic ergot-poisoning (ergotism) is observed in two chief forms. True ergotism is characterised principally by a most annoying itching in fingers and toes, also in the trunk and limbs, and by extremely painful muscular spasms which may be aggravated to epileptiform convulsions and lock jaw. A second general type, gangrenous ergotisni, shows symptoms of itching, pains in the back, and convulsions, followed by dry gangrene of the or toes, which may even drop off. Not only fingers and toes, but also hands, feet, arms and legs may suffer by this dry gangrene. The timely suspension of the use of food stuffs containing ergot stays the disease, and recovery takes place. Continued use of such foodstuffs, on the other hand, will lead to nrotracted illness, and may even cause death under symptoms of convulsions and exhaustion. Even in cases of benign course, however, there may remain trem bling and numbness of the fingers, curvature of the limbs (see Fig. 132), and weakness of the nervous system.
At the first sign of poisoning, the inges tion of food containing ergot must be stopped, and a physician should be con sulted. Bread containing ergot is usually damp, and full of violet spots ; it smells disagreeably, and leaves an unpleasant, tickling sensation in the throat. The
disease is prevented by careful cleansing of the grain, and by cautioning and instructing the populace. Owing to improved methods of cultivation, strict hygienic inspection. and to the importation of sound grain during years of failure of the crops, epidemics of ergotism are now rare. In Russia, Italy, and Spain they still occur, less frequently in other parts of Europe, while this form of poisoning is practically unknown in England.
ERUCTATION.—Belching of wind ; one of the most frequent and disagreeable evidences of gastric disturbance. The material belched forth consists of air or of various gases—nitrogen, hydrogen, carbonic acid, sulphuretted hydrogen, etc. Air is always to be found in the stomach, being swallowed alone or with the food. The other gases are formed in the stomach by the fermentation or putrefaction of various food remnants. In a normal, healthy stomach, there is practically no stagnation of the contents, and bacterial disintegration does not take place. Fermentation is usually the result or accompaniment of gastric weakness, especially of dilatation of the stomach. Very often acids (hydrochloric, acetic, etc.) are also belched forth, and may be recognised by their acrid or burning taste when they enter the mouth. These acids are evidences of fermentation of the contents of the stomach. The eructation of air, as a rule, is only the result of abnormal nervous irritability of the stomach, and therefore has not the same importance attached to it as the belching of other gases or acids. The so-called heartburn, which is also a form of acid eructation, may be associated with nothing but a hyperacidity of nervous origin. It is a not infrequent accompaniment of hasty eating, particularly if a large part of the diet has consisted of hot bread and fatty foods.
The difference in the varieties and causes of this condition makes it evident that there can be no single method of overcoming it, but that ment in each instance must be directed to the original causative factor. Where gastric fermentation is present, it is necessary first of all to improve the atonic condition of the stomach. This may he accomplished by washing out the stomach, in addition to other methods. In acid fermentation the hyperacidity may be neutralised by various alkaline remedies, such as bicarbonate of soda, and by strict adherence to a prescribed diet. In all cases it is extremely necessary to regulate the bowels carefully. Sedatives are often useful in the nervous variety of eructation. The details of treatment should always be referred to the medical attendant.