Secale Cornutum.

Properties: Uterine motor stimulant, hemostatic.

Physiological action: Ergot is a motor excitant and a hemostatic. Its influence is on the spinal cord circulation and unstriped muscular fibers, especially those of the uterus. It will cause tonic contraction of unstriped muscular fibers and produce artificial anemia. Ergot may cause both acute and chronic poisoning. In the acute form it produces marked gastro-intestinal irritation, causing nausea, vomiting, dizziness, drowsiness, dyspnea, purging, dryness of throat, thirst, difficult micturation. Arterial tension is raised greatly, pupils dilated, confusion of senses, pallor, headache, constriction of the sphincter vesical and tonic contraction of the, unstriped muscular fibers and especially so of the uterus result. There is pain in the chest and loins, cerebral anemia, coldness of skin, anesthesia, tetanic spasms and convulsions. In the chronic form there are neuralgic pains, numbness and coldness of limbs, formication of the skin, there may be delirium followed by exhaustion, convulsion or coma and death. In other forms the nutrition is cut off from some parts of the body by the excessive contraction of capillaries, especially of the lower limbs, resulting in muscular weakness, gangrene of limbs or the superficial parts. This form generally results fatally.

Use: As a parturient its action is upon the unstriped muscular structure of the uterus, producing powerful and persistent contraction; contracting the arterioles and consequently causing anemia of the organ. On account of its irritating effect on the muscular fibrillae, causing immediate contraction, it is our most active remedy for overcoming uterine inertia and hemorrhage. It can safely be used when there is fullness of circulation in the head, which manifests itself by flushed face, bright eyes, great restlessness and headache. Ergot should only be used after the first stage in labor and only then; if the os uteri is fully dilated; where there is uterine inertia or muscular relaxation. It should never be used in labor where there is mal-presentation, or any obstruction to the free delivery of the child, nor where the os uteri is hard and rigid with excessive debility, or in the first stage. If the parts are very dry it should not be used, nor if the os uteri is not fully dilated. As contractions produced by ergot are not regular but tonic and profound it should not be given where it is contra-indicated; as by its powerful and continued pressure on the child laceration of the cervix-uteri generally results as well as laceration of the perineum. It will also impair the circulation of the child by the continual and profound pressure. This sometimes results in cyanosis and even death of the child. Such continuous and powerful action on the muscles of the uterus may cause paralysis of the organ and thus cause post-partum hemorrhage. Its continuous profound action will certainly cause impairment of the organ in all cases, sub-involution often being the result. For these reasons ergot should be used with care and only when indicated. In threatened post-partum hemorrhage, a full dose of ergot may be given in the latter part of the second stage and repeated later on if necessary. The dose is from ½ to 1 teaspoonful. In post-partum hemorrhage it is one of our best remedies. To control hemorrhage in any form ergot is a valuable remedy. As it contracts the walls of the arterioles thus restraining the supply of blood to the open vessels, it is a valuable remedy in both active and passive hemorrhages. It acts, however, more powerfully upon the arterial coats than those of the veins. Ergot is a good remedy where indicated, but is very dangerous if contraindicated, or if its profound action is carried too far, or continued too long, as then by overstimulation the circulation in the parts is almost if not entirely checked; the muscles lose their power and paralysis of the parts may result.

The Materia Medica and Clinical Therapeutics, 1905, was written by Fred J. Petersen, M.D.