Note on some experiments with ergotine / by Sydney Ringer and Harrington Sainsbury.

  • Ringer, Sydney, 1835-1910.
Date:
1884
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Licence: Public Domain Mark

Credit: Note on some experiments with ergotine / by Sydney Ringer and Harrington Sainsbury. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    [Reprinted for the Author from the British Medical Journal, Jan. 19th, 1884.] NOTE ON SOME EXPERIMENTS WITH ERGOTINE. By SYDNEY RINGER, M.D., F.R.C.P., Professor of Medicine in University College, London ; AND HARRINGTON SAINSBURY, M.D., M.R.C.P., Assistant-Physician to the North-West London Hospital. It is needless to discuss the evidence of the clinical value of ergotine; its use as an ecbolic and as a hemostatic is on most hands admitted. But the question in this, as in many other cases, is: How does the drug act 1 Do the contractions of the uterine fibres indicate a peripheral, i.e., local, action ; or do they represent a reflex act ? Similarly—admitting that vascular spasm results from the action of ergot—is this spasm the result of direct action on the plain muscular fibres of the arterioles ; or is it produced medi- ately through the nervous system ? As to the physiological data on the subject of the action of ergot Hermann {Lehrbuck der Toxicologie, 1871, pp. 381 et seq.) speaks very doubtfully. According to him, the action on the vessels is uncertain—i.e., as to whether they do or do not contract. Simi- larly, as to the action on the heart, and the effect on blood-pressure, the results, according to Hermann, are both doubtful and contra- dictory. _ Wood, in his Treatise on Therapeutics (1881), discusses the subject at some length; and we must refer to this treatise for more detailed consideration of the question ; suffice it here to say that the balance of evidence is in favour of the following two propositions : 1. Ergot causes spasm of the arterioles. 2. It produces very decided rise in blood-pressure. As to the action on the heart, it appears that ergot, in full doses causes unquestionably a fall in the frequency of the contractions. Eberty ascribes this to stimulation of the vagi; but on this point, as Hermann shows (op. cit., p. 387), his statements are somewhat con- tradictory. Rossbach (quoted by Hermann) describes a curious inco-ordinate action of the heart, in particular of the ventricle. At times, this latter showed peristaltic waves proceeding from base to apex. These experiments were made on the frog with Wenzell’s ecbohn This description by Rossbach recalls the action of digitalis on the heart; but it is certain that a systolic heart, if it occur, is a rare event after the administration of ergot; whilst, on the other hand, diastolic arrest has been in many cases recorded. It appears, further, that a primary fall in the blood-pressure is in many cases witnessed after the direct introduction of ergot into a vein. This primary fall is explained by Wood as a result of a weakening of the cardiac muscle from the direct action of the drug upon it. Thus ien, ergot would resemble the digitalis-group in its action on r°?c ,Pressure ancl. on tlie arterioles; but it would contrast with the -tn,ltSCtion on the heart We must, however, not orget that digitalis, the most characteristic member of the group named after it, does occasionally arrest the heart in diastole. Boehm linvinfPfam!? *lhlS e*cePtional result as due to reflex inhibition, g i d after section of the vagi, diastolic arrest was ;“eSSCd tr°P <Wood, p. 137). It is clear that the same explanation may be advanced in the case of ergot; and this is the