The Usage of Ergot (Claviceps purpurea (fr.) Tul.) in Obstetrics and Gynecology: A Historical Perspective

Abstract

In the past centuries consumption of bread made of ergot-infected flour resulted in mass poisonings and miscarriages. The reason was the sclerotia of Claviceps purpurea (Fr.) Tul.—a source of noxious ergot alkaloids (ergotamine and ergovaline). The authors have searched the 19th century medical literature in order to find information on the following topics: dosage forms of drugs based on ergot and their application in official gynecology and obstetrics. The authors also briefly address the relevant data from the previous periods as well as the 20th century research on ergot. The research resulted in a conclusion that applications of ergot in gynecology and obstetrics in the 19th century were limited to controlling excessive uterine bleeding and irregular spasms, treatment of fibrous tumors of the uterus, and prevention of miscarriage, abortion, and amenorrhoea. The most common dosage forms mentioned in the works included in our review were the following: tinctures, water extracts (Wernich’s and Squibb’s watery extract of ergot), pills, and powders. The information documented in this paper will be helpful for further research and helpful in broadening the understanding of the historical application of the described controversial crude drugs. Ergot alkaloids were widely used in obstetrics, but in modern times they are not used in developed countries anymore. They may, however, play a significant role in developing countries where, in some cases, they can be used as an anti-hemorrhage agent during labor.

Methods of Lysergic Acid Synthesis—The Key Ergot Alkaloid

“…Typically, ergot has been described as “harmful spots on the spikes” and “poisonous grass causing miscarriage”. Hippocrates identified a plant disease in the 4th century BC, which he called melanthion —and described the inhibitory effect of ergot on postpartum bleeding [ 3 ].…”

“…Symptoms present in gangrenous form, include diarrhea, sensory disturbances, slow heart rate, shortness of breath, paralysis of the respiratory center, ischemia affecting the limbs, thrombotic changes followed by gangrene, loss of limbs, and death. In the case of the systolic form, symptoms comprise of sensory disturbances, muscle tremors, headache, abdominal pain, slow heart rate, and, at the same time, strong nervous excitation [ 3 , 4 ].…”

Ergothioneine, where are we now?

“…The water-soluble thione/thiol ergothioneine (ET) was first isolated in 1909 by Charles Tanret [1], from the ergot fungus Claviceps purpurea. This fungus is notorious for the toxicity of some of its metabolites to humans, causing ergotism [2], which has even been linked to the Salem witch trials [3]. However, ergotism has nothing to do with ET, which is instead very safe for human consumption and is synthesized by a range of other fungi and some bacteria (reviewed in [4][5][6][7][8][9]).…”

Global Impact of Ergot Alkaloids

“…Their most prominent use has been the treatment of migraines and controlling post-partum bleeding in the 18th and 19th centuries. In a current review of the past gynecological and obstetric uses of ergot alkaloids, Smakosz et al [ 13 ] defined a potential role for the application of ergot alkaloids in modern obstetrics. In addition to clinical uses of ergot alkaloids, research assessing the sustainable production of ergot alkaloids in desirable formulations is needed.…”