acid is given. It is odourless and tasteless, soluble in water and boiling alcohol, but not at all in cold alcohol. Good ergot contains about 4 to 4.5 per cent. of the acid. Ergot also con

FIG. 16.

tains scleromucin (2 to 3 per cent.), sclererytherin, scleroiodin, picrosclerotin (poisonous), sclerocrystallin, and scleroxanthin (inert), and an alkaloid, ergotinine (Maisch).

Physiological Effects.-The effects of ergot are not well under

stood, especially as regards its action on the nervous system. In medicinal doses it acts most conspicuously on the circulation and on the female system, in which it excites powerful contractions of the uterus. After labour has commenced, in ten or twenty minutes from its administration, it increases the violence, frequency and continuance of labour pains, which usually never cease until the child is born. Administered before labour, it frequently originates the process, though its effects in this respect are less constant. And even in the unimpregnated uterus it produces painful contractions, and evinces an influence over morbid conditions of the organ by checking uterine hæmorrhage and expelling polypi. Ergot induces contraction of the unstriped or involuntary muscular fibre wherever found, causing contraction of the bloodvessels everywhere, and it is thus available generally as a remedy in cerebral and spinal congestions, hæmorrhages, tumours, morbid growths and enlargements. In large doses it produces vomiting, purging, increased peristalsis, and a marked sedative effect on the circulation, slowing the heart, probably by direct action on the cardiac muscle, and causing an enormous rise in the blood pressure, through the contraction of the arterioles and stimulation of the vaso-motor centres of the cord and medulla; decided toxic doses lower the blood pressure, by depressing the heart and vaso-motor centres (Wood, H. C.). In excessive quantities it acts as an acro-narcotic poison on both sexes. When it is used for a

length of time as an article of food it produces a peculiar morbid condition, termed ergotism, which assumes two forms, one attended with convulsions, the other with dry gangrene of the limbs.

Medicinal Uses.-From its action on the pregnant uterus, ergot has long been used in obstetric practice. With few exceptions ergot had better not be administered while any product of conception remains within the uterine cavity, because, while causing contraction of the muscular fibres of the fundus, which would produce expulsion of the uterine contents, it also causes contraction of the sphincter-like fibres of the cervix, and thus presents an obstacle to the emptying of the uterus. As the intermittent contractions of the uterus become continuous and

tetanic under the influences of a large dose of ergot, it is obvious that rupture of the uterus may occur if the resistance offered to the expulsion of the uterine contents is sufficiently great. Partly on this account, and partly because the tetanic contraction of the uterus induced by ergot would interfere with the circulation of the foetus, it should never be administered during the first stage of labour. During the second stage of labour, it may be given if the expulsive pains are feeble and inefficient (uterine inertia), when there is a proper conformation of the pelvis and soft parts, when the os uteri, vagina, and os externum are dilated or readily dilatable, and when the presentation of the child is such as to offer no great mechanical impediment to speedy delivery. In these cases it is best to administer it in small doses (mgviij-x of the fluid extract), as when thus given it simply intensifies the natural uterine contractions without causing them to become continuous. It has also been used in the second stage of labour in women subject to flooding, given just before delivery, but even in these cases it is better to withhold the drug until the placenta is expelled, as otherwise the uniform contraction induced may lead to its retention.

After the third stage of labour is completed, if hæmorrhage is likely to occur from uterine inertia, ergot is one of the best remedies we possess, as the tetanic contractions which it produces permanently arrest the bleeding by compressing the orifices of the vessels. It has been used in the hæmorrhage due to abortion, but as the bleeding will only stop when the uterine cavity is empty, and as ergot delays this by preventing dilatation of the cervix, the tampon and other means are preferable. When, after an abortion, the placenta is retained by adhesions so firm that it is impossible to destroy them, a tampon may be employed and ergot given simultaneously. Ergot has also been used to cause the expulsion of polypi, and even of interstitial fibroids from the uterus. In speaking of its administration in the latter class of tumours Emmet says: "It should never be given in large doses until after the uterine canal has been dilated, and until it is found that the tumour projects sufficiently to warrant the belief that it may become pedunculated by uterine contraction" (Princip. and Practice of Gynecol.,

3d ed., p. 567). By neglecting these precautions he has seen. peritonitis produced. It is best to administer it hypodermically in these cases. In subinvolution, especially when menorrhagia is present, ergot combined with potassium bromide is useful. From its action on unstriped muscular fibres it is much employed in hæmorrhages generally; in gonorrhea; congestive dysmenorrhoea; paralysis of the bladder, especially when due to overdistension; purpura; diabetes insipidus; and lately, with marked success, in hypertrophy of the prostate; by hypodermic injection, in the cure of aneurism and varix, and as a means of checking broncho-pulmonary hæmorrhage. It is also used in renal, intestinal, and uterine hæmorrhage. In hæmatemesis it may also be employed, but is inferior to other remedies. In paralysis dependent upon congestion of the spinal cord, and in acute myelitis, it is often of great service. Ergot exercises a dangerous sedative influence on the child during labour (owing to the interference of the passage of blood from the placenta during violent uterine contraction), and its use may sometimes produce foetal death, if the obstetrician is not careful to listen frequently to the foetal heart, and deliver with the forceps should any sign of asphyxia be present (Spiegelberg).

Administration.-Ergot may be given in labour, in the dose of gr. v-xx, in powder, every twenty minutes, till its effects are produced, or three doses are taken: in other diseases the dose is from gr. iij-v. It may be safely given, in chronic diseases, for a long period, without danger of ergotism; the indication of the maximum dose having been reached in the female is the production of uterine colic, when the dose should be diminished. The fluid extract is the best preparation; dose, myv-f3j or more.* The extract is made by evaporation of 500 parts of fluid extract over a water-bath at a temperature not exceeding 122° F. until it is reduced to 100 parts; dose, gr. v-xv. The

* For hypodermic use, the fluid extract should be reduced by evaporation to one-sixth of its weight, and sixty grains of this extract should be dissolved in four fluidrachms of water; four minims of this aqueous solution represent one grain of extract and six grains of ergot; or the fluid extract may be carefully filtered, and used in doses of ngx; or the extract may be dissolved in water and filtered; it is five times as strong as the fluid extract.

BARK OF COTTON ROOT.

233

wine (vinum ergota) contains powdered ergot, 15 parts, in 100 parts by weight of the preparation. Dose, f3j-jv. The preparations used under the name of ergotin are of uncertain strength.

USTILAGO.

Ustilago maydis (Nat. Ord. Fungi), Corn Smut or Corn Ergot, is a fungoid growth upon the Zea Mays or Indian Corn (Nat. Ord. Graminacea). It is found in irregular masses, growing upon all parts of the plant, but most frequently upon the fruit, and consisting of a blackish gelatinous membrane, inclosing numerous dark globular and nodular spores. It has a disagreeable odour and taste, and contains a fixed oil, probably sclerotic acid, a crystalline principle, etc. (Maisch).

Its effects are supposed to resemble those of ergot, and it has been successfully used in the same class of cases.

GOSSYPII RADICIS CORTEX-BARK OF COTTON ROOT.

Gossypium herbaceum (Nat. Ord. Malvacea) is a native of Asia, cultivated extensively in tropical and semi-tropical countries, and with great success in the South Atlantic and Gulf districts of the United States. By cultivation, different varieties of this plant have been produced. The root should be collected immediately after the cotton is harvested, and the ROOTBARK should be of a yellowish-brown colour externally, internally much lighter; when chewed, it has a slightly sweetish, astringent taste. It contains chromogene (when fresh), becoming a red resin, a yellow resinous colouring matter, fixed oil, gum, sugar, tannic acid, etc. It has long been recognized by southern physicians as possessing decided influence in exciting uterine contractions. Dr. J. C. Martin, however, from experiments on frogs, rabbits, and guinea-pigs, concludes that it has no action. on the motor or sensory nerves, nor on the reflex functions; that the circulation and muscles are uninfluenced by it, and that it possesses no oxytocic properties (Am. J. Med. Sc., Jan., 1882). Prochovnik, however, finds it an efficient substitute for ergot, although its expulsive power is not so great. He recommends it especially in hæmorrhage after abortion, and in uterine