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St. Anthony's fire

Ergotism is the effect of long-term ergot poisoning, classically due to the ingestion of the alkaloids produced by the Claviceps purpurea fungus which infects rye and other cereals, and more recently by the action of a number of ergoline-based drugs. It is also known as ergotoxicosis or ergot poisoning. more...

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Medicines

Causes

The toxic ergoline derivatives are found in ergot-based drugs (such as methylergometrine, ergotamine or, previously, ergotoxine). The deleterious side-effects occur either under high dose or when moderate doses interact with potentiators such as azithromycin.

Classically, eating cereals or cereal-based products contaminated with the fungus Claviceps purpurea also caused ergotism.

Finally, the alkaloids can also pass through lactation from mother to child, causing ergotism in infants.

Symptoms

The symptoms can be roughly divided into convulsive symptoms and gangreneous symptoms.

Convulsive symptoms

Convulsive symptoms include diarrhea, paresthesias, itching, seizures, headaches, nausea and vomiting. Usually the gastrointestinal effects precede CNS effects. As well as seizures there can be hallucinations and mental effects including mania or psychosis. The convulsive symptoms are caused by clavine alkaloids.

Gangrenous symptoms

The dry gangrene is a result of vasoconstriction induced by the ergotamine-ergocristine alkaloids of the fungus. It affects the more poorly vascularized distal structures, such as the fingers and toes. Symptoms include desquamation, weak peripheral pulse, loss of peripheral sensation, edema and ultimately the death and loss of affected tissues.

History

Epidemics of the disease were identified throughout history, though the references in classical writers are inconclusive. Rye, the main vector for transmitting ergotism, was not grown much around the Mediterranean. When Fuchs separated references to ergotism from erysipelas and other afflictions he found the earliest reference to ergotism in the Annales Xantenses for the year 857: "a Great plague of swollen blisters consumed the people by a loathsome rot, so that their limbs were loosened and fell off before death." In the Middle Ages the gangrenous poisoning was known as ignis sacer ("holy fire") or "Saint Anthony's fire", named for the 4th century hermit of Egypt. The 12th century chronicler Geoffroy du Breuil of Vigeois recorded the mysterious outbreaks in the Limousin region of France, where the gangrenous form of ergotism was associated with the local Saint Martial as much as Saint Anthony. The blight, named from the cock's spur it forms on grasses, was identified and named by Denis Dodart who reported the relation between ergotized rye and bread poisoning in a letter to the French Royal Academy of Sciences in 1676 (John Ray mentioning ergot for the first time in English the next year), but "ergotism" in this modern sense was first recorded in 1853. Research by Linnda Caporael (1976) suggests that many of the people whose accusations resulted in the 1692 Salem witch trials in Massachusetts were genuinely suffering hallucinations and other symptoms of convulsive ergotism. Similar eruptions of ergotism also occurred in Essex and Fairfield counties in Connecticut that damp and cool season, though in Connecticut no one went to the stake. Notable epidemics of ergotism, at first seen as a punishment from God, occurred up into the 19th century. Fewer outbreaks have occurred since then, because in developed countries rye is carefully monitored. When milled the ergot is reduced to a red powder, obvious in lighter grasses but easy to miss in dark rye flour. The last reported outbreak in an industrialized country, which caused more than 200 cases and 4 deaths, occurred in 1951 in Pont St. Esprit, France. In less wealthy countries ergotism still occurs: there was an outbreak in Ethiopia in mid-2001 from contaminated barley. Whenever there is a combination of moist weather, cool temperatures, delayed harvest in lowland crops and rye consumption an outbreak is possible. Russia has been particularly afflicted.

Read more at Wikipedia.org


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ERGOT (ON RYE)
From Alabama Heritage, 7/1/05 by Davenport, L J

A FRIEND BROUGHT ME A SMALL TIN box from a flea market in southwestern Alabama. It immediately brought to mind funky dance steps, hippie acid trips, relentless witch hunts, and footloose cows ....

The box once contained medicine derived from ergot, a fungus commonly infesting rye and related grasses. Our oldest recorded plant disease, ergot was first described (ca. 600 BCE) on an Assyrian cuneiform tablet as a "noxious pustule in the ear of grain." The fungus cannibalizes young rye ovaries, replacing them with its sckrotiablack, horn-shaped resting stages one to five centimeters long. In autumn the sckrotia fall to the ground to overwinter in the soil, sprouting up and sporulating the following spring. Spread by wind and insects, the spores promptly infect the next year's crop.

. . . Which is just another somewhat interesting fungal life cycle until we humans get involved. By eating ergot, intentionally or accidentally, we ingest at least forty different alkaloids, including some of the most powerful muscle contractors and vasoconstrictors ever discovered. Since ancient times, midwives have used ergot to accelerate childbirth contractions and halt postpartum hemorrhaging. Similarly, this "tin box" medicine treated the menstrual disorders amenorrhea and dysmenorrhea.

But there is often a very fine line between medicine and toxin. Ergotism-caused by the unknowing consumption of ergot-laced bread, beer, or pasta-has killed or maimed countless millions through the ages. The earliest known reference (857 GE) graphically bemoans "a great plague of swollen blisters that consumed the people by a loathsome rot, so that their limbs loosened and fell off before death." Called ignis sacer during the Middle Ages, this "holy fire" caused the excruciating sensation of burning limbs followed by ghastly gangrene, both results of vasoconstrictive alkaloids limiting blood/oxygen supply to the appendages. The Church quickly commanded a patron saint to the cause, lending to the disease the common name of St. Anthony's Fire. (Ergot apparently caused both Anthony's physical sufferings and his vivid visions.) Thousands of true believers-or at least those with intact lower limbs-trekked to Anthony's shrine in Egypt. And along the way, many experienced miraculous cures, just from eating better bread!

. . . Which leads me to those funky dance moves. Ergotism also manifested itself in a convulsive form, again based on that incredible collection of alkaloids. Here the symptoms were epileptic seizures, spastic movements, dance-like twitching, and formication. (Yes, you read that right-the feeling of being covered by ants.) So another saint arose, with this version of the ailment called St. Virus' Dance. (Did Vitus later become the patron saint of disco? I wonder.)

Sometimes the gangrenous and convulsive forms appeared together, and sometimes not. But either way, sufferers likely experienced intense hallucinations. And that's because, among those manifold alkaloids, ergot produces LSD, the exact same chemical savored by our hippie brothers and sisters. The most recent ergot outbreak struck rural France in 1951. People laughed or cried uncontrollably for days; one man spent three weeks counting pot lids in his kitchen, while another broke out of seven straight straitjackets. And many thought they could fly! (So ergot on rye makes for a very psychedelic sandwich.)

. . . Which raises numerous questions about the infamous witch hunts in this country and elsewhere. The historical record suggests that many of the affected communities suffered ergot infestations before their "witches" ran amuck. For example, everyday folks living near low, wet fields (which would naturally be more heavily ergotized) endured more numerous accusations of witchedness. And accused witches often reported being "bitten" by the Devil in the fingers, arms, or feet! Some danced and twitched spastically; others confessed (under rather painful pressure) that they "consumed" their bewitching powers as "black seed grains" in bread, beer, or porridge. But at the time, no scientist (or defense attorney) had connected those black seed grains with ergotism. Hundreds of convicted witches, consumed by the holy fire, were subsequently consumed by a less-than-holy one.

But, you ask, what about our bovine friends? Auburn University scientists recently discovered ergot growing on fescue in North Alabama pastures. Which is downright scary for cattle, who are similarly susceptible to ergot poisoning, especially during cold winter weather when their surface arterioles are already constricted. While we do not know the mental cruelties that livestock experience (although farmers describe some victims as being "overly belligerent"), the physical symptoms of ergotism certainly hold true: excitability, incoordination, and gangrene. The sad and gruesome result, fescue foot, reveals itself with the spontaneous abortion of calves and/or the sloughing of extremities-noses, ears, tongues, tails, and (especially) feet, which lends new meaning to the word "footloose."

. . . Which brings me to this two word Latinized ending: Ergo, ergot.

Larry Davenport is a professor of biology at Samford University, Birmingham.

Copyright University of Alabama Press Summer 2005
Provided by ProQuest Information and Learning Company. All rights Reserved

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