ergotism - Causes, Symptoms, History

A condition which results from eating bread made from rye heavily infected with the fungus Claviceps purpurea, which contains ergot alkaloids. These substances constrict blood vessels, so that victims develop burning sensations in the limbs, gangrene, and convulsions. It also induces abortion in pregnant women. Ergotism is now rare, but epidemics occurred well into the 19th-c. Outbreaks caused great fear, and were referred to as St Anthony's fire, in the belief that a visit to the tomb of this saint would bring a cure.

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.

Causes

The toxic ergoline derivatives are found in ergot-based drugs (such as methylergometrine, ergotamine or, previously, ergotoxine).

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 gangrenous symptoms.

Convulsive symptoms

Convulsive symptoms include painful seizures and spasms, diarrhea, paresthesias, itching, headaches, nausea and vomiting.

Gangrenous symptoms

The dry gangrene is a result of vasoconstriction induced by the ergotamine-ergocristine alkaloids of the fungus.

History

Epidemics of the disease were identified throughout history, though the references in classical writers are inconclusive. When Fuchs 1834 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." 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. In less wealthy countries ergotism still occurs: there was an outbreak in Ethiopia in mid-2001 from contaminated barley.