2463. The Dose And Mode Of Administration

Ergot may be given in the form of either of the officinal preparations, or in that of oil (Ol. ErgotAe, obtained by evaporating an Ethereal Tincture at a very gentle heat), in doses of xx. - 1., or in Extract (Ergotine) (gr. v. - x.). The most convenient form is that of infusion, made by infusing gr. xx. - gr. xxx. of the powder for ten minutes in fl. oz. iij. of boiling water. Dr. Ramsbotham§; observes, that if the infusion be allowed to stand more than twenty minutes it is apt to nauseate. Villeneuve|| administered it in the form of enema, and considered this the most preferable mode, when much irritability of the stomach was present. The above doses may be repeated for three times, at intervals of half an hour; but gr. xxx. of the powder, or its equivalent of the other preparations, should never be exceeded; for if, in this quantity, it does no good, more will be useless, and probably injurious.

2464. The circumstances under which it proves useful, and those in which it is inadmissible, have been judiciously set forth by Dr. Churchill.

Ergot may be safely given: -

1. When The Pains Are Feeble And Inefficient Without Especial Cause

2. If The Os Uteri Be Soft And Dilatable

3. If There Be No Obstacle To A Natural Delivery

4. If The Head Or Breech Present, And Be Sufficiently Advanced

5. If There Be No Head Symptoms, Or Excessive General Debility

Ergot should not be given: -

1. If The Os Uteri Be Hard And Rigid

* Theory and Practice of Midwifery, p. 202.

Dub. Journ. of Med. Sciences, vol. xxvii. p. 224.

Facts and Obs., p. 195. § Obstetric Medicine, p. 219. || Loc. cit.

2. If The Presentation Be Beyond Reach

3. If There Be Mal-Presentation

4. If The Pelvis Be Deformed

5. If There Be Any Serious Obstacle To Delivery In The Soft Parts

6. If There Be Head Symptoms Or Much General Irritation

The period at which it is generally the most advantageous to administer Ergot, is when the head of the child has passed the brim of the pelvis; but its use is by no means confined to this period. Dr. Meigs* advises that it should be given only at the moment, or just before the birth of the child, in order to secure, if possible, a permanent and good contraction of the womb after labour, in women who are known in their preceding labours to have been subject to alarming HAemorrhage. It is less applicable to first labours than to subsequent ones.

2465. Modus Operandi

Ergot, independent of its action on the cerebro-spinal system, appears to exercise a special action on the uterine contractile fibre. Some consider that it acts specially upon the nerves of the uterus. Dr. Tyler Smith observes that the blood is the true channel through which the Ergot acts, and that the organ which it reaches and affects through this channel is the spinal centre.