I have hitherto said little on this subject, because it seems to be isolated by its nature, and the remarks upon it come most conveniently under a separate head. Ergot has been long used, in various parts of the Continent of Europe, by midwives, for the purpose of facilitating delivery; but the attention of the profession was first distinctly drawn to the subject by Dr. Stearns, of Saratoga County, New York; and the influence and use of the medicine were familiar to the profession in America, long before it attracted particular notice in Europe. The first published notice of it by Dr. Stearns was in 1807 (N. Y. Med. Repository, xi.); an elaborate paper upon its use in promoting labour, arresting hemorrhage, etc., by Dr. Oliver Prescott, was published in 1814 {Med. and Phys. Journ., xxxii. 90); and, according to Dr. Pereira, the medicine was not used in England until 1824.

The effect of ergot in producing painful uterine contraction has been already mentioned. it is most strikingly manifested in the pregnant state, at the normal period of delivery. it comes on, according to Prescott, at periods varying from 8 to 20 minutes after the administration of the medicine; and continues from half an hour to an hour and a half. The contractions differ from the ordinary labour-pains in their continu-ousness; scarcely any interval of repose occurring, until the gradual cessation of the influence of the medicine. The question here presents itself, whether this influence is exerted upon the unimpregnated uterus. Prescott and others have maintained that it is not. But their opinion is contradicted by the positive statements of others, that bearing-down pains are sometimes felt in the region of the womb, and rending pains in the thighs. Another question, of great importance, is whether the medicine is capable of bringing on abortion. Directly opposite statements have been made on this point, both as regards the human subject and the lower animals; but, though we may believe those who maintain the negative of this question, so far as their own observation has extended, yet it is impossible to refuse credence to others who have witnessed the effects referred to. The truth probably is, that the peculiar influence of ergot on the womb is exerted through the nervous centres; and is likely to be most effective, when, in the normal state of the system, these very centres are disposed to the condition in which it is the tendency of the medicine to place them. in this physiological state, they may be supposed to be more susceptible, than under ordinary circumstances, to an impression of the same character as that which they are prepared to receive from the womb at the full period of gestation. The effect of ergot will, therefore, be much more likely to be felt at this time than at others. But the fact appears to be that, though less apt to excite uterine contraction at other periods, it is capable of producing the effect, in some instances, at any stage of utero-gestation, and even in the unimpregnated state of the uterus. Testimony is too strong to the point, that it is capable of producing abortion, to admit of denial; but it certainly cannot be relied on for the purpose; and would probably fail in the great majority of cases.

The employment of ergot to assist in tedious labours would seem to follow from a knowledge of its powers. Yet opinion is not entirely accordant on this point. injury both to the mother and child is apprehended. The painful and vehement uterine contractions, with the corresponding efforts of the mother, are thought in various ways to react injuriously upon the system, and, among other results, to endanger rupture of the womb, and congestion of the brain with consequent puerperal convulsions. The death of the foetus is supposed frequently to result from the violent and unremitting compression, arresting the circulation of the cord, or cutting off the supply of blood by temporarily obliterating the vessels of the uterus itself. Statistics too have been brought fearfully to bear against this use of ergot. There has no doubt been much exaggeration. As the medicine has been most employed in difficult labours, offering some unusual impediment to the ordinary performance of the function, it is very probable that many, and much the greater number of fatal results have been mere coincidences, and that they would have occurred without the use of the medicine. But both reason and experience unite in the conclusion, that ergot may do great mischief; and that an instrument of so much power for evil must be used with caution,'and careful discrimination. The rules laid down for its use by the most experienced obstetricians, who advocate a resort to it, are the following. The case must always be beyond the efforts of nature unaided. The os uteri must be dilated, and the outer passages lubricated. The presentation must be natural, or at least not such as in itself to present any obstacles to safe delivery. There must be no mechanical impediment, such as morbid growths, rigidity of the tissues, or disproportion between the size of the head and the outlets through which it must pass. The measure should not be resorted to early, where no serious danger is apprehended from delay; and due patience should be exercised in awaiting the efforts of nature. Dilatation of the os uteri is not insisted on by all; as it has been asserted that the medicine has a tendency to induce this condition. But it is obvious that, should it fail to do so, the greatest danger might be apprehended for the foetus; and cautious practitioners insist on this prerequisite. it is said that the membranes must not be ruptured.

The circumstances which are thought to justify the measure are, 1. lingering labour when the efforts of nature have ceased, or are quite inadequate, and when the above conditions are presented; 2. immediate danger from flooding, with failure of the natural pains, and without malposition of the placenta; 3. when the death of the foetus is well ascertained, and the patient is in danger from exhaustion or constitutional irritation; 4. when, from previous experience in the case of the individual, there is reason to fear alarming hemorrhage immediately after delivery; 5. retention of the placenta from deficiency of uterine contraction; and 6. dangerous hemorrhage following delivery. in reference to this last application, namely, to post-partum hemorrhage, Dr. John W. Beck, who speaks from a very large experience, states that there is no remedy equal to it. (Dublin Med. Press, June 17, 1863.) But, even under some of the circumstances here mentioned, many practitioners would advise the preferable application of instruments, if they were at hand, and the skill requisite for their use existed. A resort to ergot has been strongly recommended in cases of puerperal convulsions, with a view to hasten delivery; and a number of successful cases have been recorded. Having no experience in these cases, I do not pretend even to offer an opinion; but I can see no danger from the narcotic properties of the drug, which have been urged against its use; for we have no evidence whatever that its influence is irritant or congestive upon the brain; but rather the reverse. Dr. Ch. C. Hildreth, of Zanes-ville, Ohio, believes that there is an antagonism between ergot and chloroform inhalations in their action on the uterus, and that either of these may be advantageously given to counteract undue effects of the other; ergot being used to excite contraction when suspended under the use of chloroform, and the latter to allay inordinate contraction produced by the former. (Am. Journ. of Med. Sci., April, 1866, p. 262.)

For the expulsion of clots of blood remaining in the uterus, and of the dead foetus in protracted cases of abortion, in the earlier stages of pregnancy, there can be no objection to its use.

In reference to the same property of causing contraction of the uterus, ergot is frequently employed, in other conditions than those connected with childbirth. Thus, it has been recommended for the expulsion of hydatids, and for forcing out uterine polypi from the cavity, so as to bring them within reach of an operation for their extraction. indeed, cases are said to have occurred, in which polypi have been completely expelled by the uterine contraction.

But the most important application of ergot, in cases of unimpregnated uterus, is to the suppression of hemorrhage. it is certainly among the most efficient remedies in this affection. Even the hemorrhage attendant upon cancer of the womb will frequently yield to it. in effecting the suppression, it not unfrequently produces painful contractions of the uterus, showing that this influence is not confined to the state of pregnancy. The suppression is often very prompt, and is probably effected by a contraction of the uterine walls, so as temporarily to close the vessels.

Through the same influence, it may prove useful in leucorrheal discharges from the womb. The secretion must be suspended, if the supply of blood is cut off, or materially diminished.