368 MATERIA MEDIC A AND THERAPEUTICS. 



2. ACTION IN THE BLOOD, AND SPECIFIC ACTION. 



The active principles of ergot enter the blood, but exert 

 no appreciable change on it. Thence they pass into the tissues 

 and organs, and set up well-marked symptoms, if given in full 

 doses for a sufficient time. The parts chiefly affected are the 

 central nervous system, respiration, circulation, intestines, and 

 uterus. The highest centres (cerebral) are not directly in- 

 fluenced by ergot. The spinal cord is distinctly affected, a 

 series of nervous phenomena being the result during life, and 

 definite changes found in the posterior (Burdach's) columns after 

 death. The patient first complains of creeping sensations in the 

 limbs, as if an insect were running along the skin; sudden 

 painful cramps or twitching of the legs follows ; the gait becomes 

 staggering (ataxic) ; and convulsions, with loss of sensibility 

 and motion, may follow. These spinal effects are chiefly seen 

 in cases of chronic ' ' ergotism," where the drug has been con- 

 sumed in large quantity in rye bread ; but they indicate its. 

 mode of action, and may be met with clinically. The motor 

 and sensory nerves and muscles are themselves unaffected. Re- 

 spiration becomes infrequent after large doses, and death occurs 

 by asphyxia. The heart is reduced in frequency by ergot, 

 sometimes twenty to thirty-six beats per minute, and becomes 

 feeble and irregular at last, possibly through the vagus, more 

 probably through failure of the ganglia and want of venous 

 charge. The arteries become distinctly smaller under ergot 

 according to some authorities, by vaso-motor stimulation ; 

 according to other authorities, by active venous dilatation, which 

 drains the blood from the arteries, and causes them passively to 

 contract. The blood pressure falls steadily. The intestine is 

 peculiarly blanched under ergot, and consequently excited to 

 peristaltic movements. The uterus becomes similarly anaemic, 

 and contracts actively, especially if pregnant, and still more 

 if parturition have commenced, when long and powerful pains 

 are developed. These effects of ergot on the bowels and womb 

 have been also referred to stimulation of their spinal centres. 

 The body temperature falls. Gangrene frequently results 

 from the protracted use of ergotised meal as an article of 

 diet. 



3. SPECIFIC USES. 



Ergot is used chiefly to control haemorrhage and to excite 

 or increase uterine contraction. As a haemostatic, acting 

 apparently by lowering the blood pressure, it is extensively 

 employed in haemoptysis, haematemesis, menorrhagia, and 

 intestinal haemorrhage, where the hypodermic injection of 



