Ergot, Spurred Rye. The chemists have never agreed regarding the constituents of ergot. Dr. Edward R. Squibb has done more than any other man to perfect an ergot product for therapeutic use. The fluidextract contains a trace of acetic acid, which supposedly fixes the trimethylamine of ergot. The solid extract is a thoroughly reliable preparation also. "Ergotin" is a purified fluidextract adapted to hypodermic use, but rather thick for such use. It is very active. The sp. m. is quite alcoholic and not adapted to hypodermic use. It is free of acetic acid and ergot fat. It mixes clearly with water, and is suitable for the action in both large and small doses but must not be combined with alkalies. "Lloyd's Ergot' is especially adapted to hypodennic use, as it contains no fat, alcohol, and inorganic salts. Its menstruum is glycerine and water, and it contains 0.20% of phenol. Parke, Davis & Co. put up ergot in hermetically sealed glass bulbs for hypodemic use. Boujean's Ergotin is practically the same as the German Pharmacopoeia extract. Ergot is used too much in obstetrics and too little for its other indications. It is only necessary to say that ergot causes contraction of unstriped muscular tissues in all parts of the body to open up for it a wide field in therapeutics. Look up in your works upon histology how widely this tissue is distributed in the body, and you will appreciate ergot. Briefly, it is found in the hollow viscera and the bloodvessels. Hemorrhage of a non-traumatic nature from mucous membranes is best treated with a few full doses, or I fK "Lloyd's Ergot" hypodermically in extreme cases. In cerebral apoplexy give such doses at frequent intervals until the full physiologic action of use in the case is reached. Do not temporize with apoplexy, even of mild type. If you use "Ergotin," it is best to dilute it a little with glycerine and water before injecting. For the relief of shock, ergot is most valuable. Shock is a vaso-motor paralysis with relaxation of the sphincters and non-striated tissues generally. Give in somewhat less dose than in apoplexy, but give it hypodermically. A dose just before general anesthesia reduces the danger of shock. It is a good thing to give ergot before a laparotomy, as the bowels move better afterwards, due to the stimulated peristalsis. Heat prostration responds well to large doses of ergot, since there is vascular relaxation. Dr. A. B. Conklin gives the indications for ergot in cases of shock and collapse, as follows: "A pale, cool, relaxed skin, bathed in cold, clammy perspiration, the mucous secretions being likewise increased, with involuntary passages from the bowels and bladder. The pulse is soft and easily compressed, rapid, feeble, and possibly intermittent: The heart's action is increased in frequency, but lacking in force, and well expressed by the word fluttering. Its cavities are not filled, and the heart lacks blood on which to act, instead of being itself weak. The vessels must be made to return to their normal caliber, thus restoring blood pressure."

Thus we can see the value of ergot in collapse from severe diseases in an algid, congestive, or paralytic stage. Delirium tremens and the induced mania is conquered more quickly by ergot than by narcotics. Insomnia from cerebral hyperemia, salivation from mercury, the diarrhea of fright, meningitis, congestion of the brain, miliary aneurisms, and other diseases in which the circulation is at fault in the way ergot corrects are all directly benefited by its use. Very often it is well to alternate it with small doses of belladonna. The walls of hollow viscera and the sphincters being amenable to the action of ergot, it is ofttimes indicated in pulmonary vesicular emphysema, relaxed laryngitis, lack of intestinal peristalsis, incontinence of urine, enlarged spleen, relaxed pelvic viscera, and rectal tissues, relaxed scrotum, spermatorrhea, and other relaxed states of organs.

In obstetric practice it arrests hemorrhage after delivery. Works upon obstetrics should be consulted for the detailed indications in that sphere of work. Ergot is contraindicated where tonicity of non-striated tissues exists, in high blood pressure, or when endocarditis exists, or degenerative changes have occurred in the heart or vessels. Spinal anemia, or cerebral or spinal neurotic states, contraindicate ergot. Large doses too long continued are apt to cause retention of urine. Spasmodic affections are aggravated by ergot. Dose: F. E., ec. tr., or Lloyd's Ergot, 20 I. to 2 fK; ext., 5 to 10 gr. ; Boujean's, I to 5 gr.; Yvon's Ergotin (fluid), 5 to I5 I .; "Ergotole," 5 to 20 I.. Small doses of ergot are seldom effective.