Ergotism
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robot Adding: [[gl:Ergotismo]]
{{Infobox_Disease |
Name = {{PAGENAME}} |
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DiseasesDB = 30715 |
ICD10 = {{ICD10|T|62|2|t|51}} |
ICD9 = {{ICD9|988.2}} |
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OMIM = |
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eMedicineSubj = |
eMedicineTopic = |
MeshID = D004881 |
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'''Ergotism''' is the effect of long-term [[ergot]] [[poison]]ing, traditionally due to the [[ingestion]] of the [[alkaloids]] produced by the ''[[Claviceps purpurea]]'' [[fungus]] which infects [[rye]] and other [[cereal]]s, and more recently by the action of a number of [[ergoline]]-based drugs. It is also known as '''ergotoxicosis''', '''ergot poisoning''' and '''Saint Anthony's Fire'''. Ergot poisoning is one of the [[Medical and psychological explanations of bewitchment|explanations of bewitchment]].
==Causes==
The [[toxic]] ergoline [[Derivative (chemistry)|derivatives]] are found in ergot-based [[medication|drugs]] (such as [[methylergometrine]], [[ergotamine]] or, previously, [[ergotoxine]]). The deleterious [[side-effects]] occur either under high [[dose]] or when [[moderate]] doses interact with [[potentiators]] such as [[azithromycin]].
Traditionally, eating [[grain]] products contaminated with the [[fungus]] ''Claviceps purpurea'' also caused ergotism.
Finally, the alkaloids can also pass through [[lactation]] from mother to child, causing ergotism in infants.
==Symptoms==
The [[symptoms]] can be roughly divided into [[convulsive]] symptoms and [[gangrenous]] symptoms.
===Convulsive symptoms===
Convulsive symptoms include painful seizures and [[spasms]], [[diarrhea]], [[paresthesia]]s, itching, headaches, [[nausea]] and vomiting. Usually the gastrointestinal effects precede [[central nervous system]] effects. As well as seizures there can be [[hallucination]]s resembling those produced by [[LSD]] (lysergic acid diethylamide, to which the ergot alkaloid ergotamine is an immediate precursor and therefore shares some structural similarities), and mental effects including [[mania]] or [[psychosis]]. The convulsive symptoms are caused by [[clavine]] [[alkaloid]]s.
===Gangrenous symptoms===
The dry [[gangrene]] is a result of [[vasoconstriction]] induced by the ergotamine-ergocristine alkaloids of the fungus. It affects the more poorly vascularized [[distal]] structures, such as the fingers and toes. Symptoms include [[desquamation]], weak [[peripheral]] [[pulse]], loss of peripheral [[sensation]], [[edema]] and ultimately the death and loss of affected [[Tissue (biology)|tissues]].
==History==
[[Epidemic]]s of the disease were identified throughout history, though the references in classical writers are inconclusive. Rye, the main [[Vector (biology)|vector]] for transmitting ergotism, was not grown much around the [[Mediterranean]]. When Fuchs 1834 separated references to ergotism from [[erysipelas]] and other afflictions he found the earliest reference to ergotism in the ''Annales Xantenses'' for the year 857: "a Great plague of swollen blisters consumed the people by a loathsome rot, so that their limbs were loosened and fell off before death."
In the Middle Ages the gangrenous poisoning was known as ''ignis sacer'' ("holy fire") or "[[Anthony the Great|Saint Anthony]]'s fire", named after monks of the [[Order of Saint Anthony (Ethiopia)|Order of St. Anthony]] who were particularly successful at treating this ailment. The 12th century chronicler [[Geoffroy du Breuil of Vigeois]] recorded the mysterious outbreaks in the [[Limousin (province)|Limousin]] region of France, where the gangrenous form of ergotism was associated with the local [[Saint Martial]] as much as Saint Anthony.
The blight, named from the cock's spur it forms on grasses, was identified and named by [[Denis Dodart]] who reported the relation between ergotized rye and bread poisoning in a letter to the [[French Royal Academy of Sciences]] in 1676 ([[John Ray]] mentioning ergot for the first time in English the next year), but "ergotism" in this modern sense was first recorded in 1853.
Notable epidemics of ergotism, at first seen as a punishment from God, occurred up into the 19th century. Fewer outbreaks have occurred since then, because in developed countries rye is carefully monitored.
There is evidence<ref>Timothy Taylor, 2003. 'The Buried Soul: How Humans Invented Death' (Fourth Estate Ltd)</ref> of ergot poisoning serving a [[ritual]] purpose in the [[Human sacrifice|ritual killing]] of certain [[bog bodies]]. Found in [[peat]] swamps, [[Grauballe Man]] and [[Tollund Man]] have been preserved so well that large amounts of rotten cereals and weeds have been extracted from their stomachs, clearly showing force-feeding and primitive sedation.
When milled the ergot is reduced to a red powder, obvious in lighter grasses but easy to miss in dark rye flour. In less wealthy countries ergotism still occurs: there was an outbreak in [[Ethiopia]] in mid-2001 from contaminated [[barley]]. Whenever there is a combination of moist weather, cool temperatures, delayed harvest in lowland crops and rye consumption an outbreak is possible. [[Russia]] has been particularly afflicted.
Poisonings due to consumption of seeds treated with [[Mercury (element)|mercury]] compounds are sometimes misidentified as ergotism, such as the case of mass-poisoning in the French village [[Pont-Saint-Esprit]] in 1951: The incident is described in [[John Grant Fuller]]'s book ''[[The Day of St Anthony's Fire]]''.<ref name="isbn0-09-095460-2">{{cite book |author=Fuller, John |title=The day of St Anthony's Fire |publisher=Hutchinson |location=London |year= |pages= |isbn=0-09-095460-2 |oclc= |doi=}}</ref>
According to Snorri Sturluson, in his ''Heimskringla'', King Magnus, son of King Harald Sigurtharson, who was the half brother of Saint King Olaf Haraldsson, died from ergotism shortly after the Battle of Hastings.
==Salem Witchcraft Accusations==
The [[convulsive]] symptoms that can be a result of consuming ergot tainted rye have also been said to be the cause of accusations of “bewitchment” that spurred the [[Salem witch trials]]. This medical explanation for the theory of “bewitchment” is one first propounded by [[Linnda R. Caporael]] in 1976 in an article in [[Science]]. In her article, Caporael points out that the convulsive symptoms, such as crawling sensations in the skin, tingling in the fingers, [[Vertigo (medical)|vertigo]], tinnitus aurium, [[headaches]], disturbances in sensation, hallucination, painful muscular contractions, [[vomiting]] and [[diarrhea]], as well as psychological symptoms, such as [[mania]], [[melancholia]], [[psychosis]] and [[delirium]] were all symptoms reported in the Salem witchcraft records. Caporael also notes the abundance of rye in the region as well as perfect climate conditions for the tainting of rye.<ref>{{cite journal |last=Caporael |first=Linnda |authorlink=Linnda R. Caporael |title=Ergotism: The Satan Loose in Salem |journal=Science |volume=192 |year=1976 |month=April |doi=10.1126/science.769159 |pages=21 |pmid=769159 }}</ref> In 1982 historian Mary Matossian revitalized Caporael’s theory in her article in ''[[American Scientist]]''. In her article, Matossian builds on Caporael’s theories and also notes that according to English folk tradition all the symptoms of “bewitchment” resemble the ones exhibited in those afflicted with ergot poisoning.<ref>{{cite journal |last=Matossian |first=Mary |title=Ergot and the Salem Witchcraft Affair |journal=American Scientist |volume=70 |year=1982 |month=July-August }}</ref>
The medical explanation of ergotism causing “bewitchment” has been subject to debate, and has been criticized by several scholars. Within a year of Caporael’s article, the historians Spanos and Gottlieb refuted Caporael’s theory in the same journal that she had published in. In Spanos and Gottlieb’s rebuttal to Caporael’s article, they concluded that there are several flaws in the explanation of [[ergot]] poisoning as a result of accusations of “bewitchment.” The most notable flaw is that if the food supply was contaminated, the symptoms would have occurred on a house-by-house basis, not just in particular individuals. Spanos and Gottlieb also note the fact that ergot poisoning has additional symptoms not mentioned by those claiming affliction and that the proportion of children afflicted were less than in a typical ergotism epidemic.<ref>{{cite journal |last=Spanos |first=Nicholas |coauthors=Jack Gottlieb |title=Ergotism and the Salem Village Witch Trials |journal=Science |volume=194 |year=1976 |month=December |doi=10.1126/science.795029 |pages=1390 |pmid=795029 }}</ref> Other problems have also been raised with Caporael’s theory. The anthropologist H. Sidky noted the problem that ergotism had existed for centuries before the Salem witch trials, and that its symptoms would have been recognizable during the time of the Salem witch trials.<ref>{{cite book |last= Sidky |first= H.|title= Witchcraft, Lycanthropy, Drugs and Disease: An Anthropological Study of the European Witch Hunts |publisher= [[Peter Lang]] |year= 1997 | }}</ref>
==References==
{{reflist|2}}
==External links==
*[http://www.damninteresting.com/?p=586 "Bad Rye and the Salem Witches]
{{Poisoning and toxicity}}
[[Category:Toxicology]]
[[Category:Neurology]]
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