Ergotism
Encyclopedia
Ergotism is the effect of long-term ergot
Ergot
Ergot or ergot fungi refers to a group of fungi of the genus Claviceps. The most prominent member of this group is Claviceps purpurea. This fungus grows on rye and related plants, and produces alkaloids that can cause ergotism in humans and other mammals who consume grains contaminated with its...

 poison
Poison
In the context of biology, poisons are substances that can cause disturbances to organisms, usually by chemical reaction or other activity on the molecular scale, when a sufficient quantity is absorbed by an organism....

ing, traditionally due to the ingestion
Ingestion
Ingestion is the consumption of a substance by an organism. In animals, it normally is accomplished by taking in the substance through the mouth into the gastrointestinal tract, such as through eating or drinking...

 of the alkaloids produced by the Claviceps purpurea
Claviceps purpurea
Claviceps purpurea is a fungus that grows on the ears of rye and related cereal and forage plants. Consumption of grains or seeds contaminated with the fruiting structure of this fungus, the ergot sclerotium, can cause ergotism in humans and other mammals.. C...

fungus
Fungus
A fungus is a member of a large group of eukaryotic organisms that includes microorganisms such as yeasts and molds , as well as the more familiar mushrooms. These organisms are classified as a kingdom, Fungi, which is separate from plants, animals, and bacteria...

 which infects rye
Rye
Rye is a grass grown extensively as a grain and as a forage crop. It is a member of the wheat tribe and is closely related to barley and wheat. Rye grain is used for flour, rye bread, rye beer, some whiskeys, some vodkas, and animal fodder...

 and other cereal
Cereal
Cereals are grasses cultivated for the edible components of their grain , composed of the endosperm, germ, and bran...

s, and more recently by the action of a number of ergoline
Ergoline
Ergoline is a chemical compound whose structural skeleton is contained in a diverse range of alkaloids including a few psychedelic drugs . Ergoline derivatives are used clinically for the purpose of vasoconstriction and in the treatment of migraines and Parkinson's disease...

-based drugs. It is also known as ergotoxicosis, ergot poisoning and Saint Anthony's Fire. Ergot poisoning is a proposed explanation of bewitchment.

Causes

The toxic ergoline derivatives
Derivative (chemistry)
In chemistry, a derivative is a compound that is derived from a similar compound by some chemical or physical process. In the past it was also used to mean a compound that can be imagined to arise from another compound, if one atom is replaced with another atom or group of atoms, but modern...

 are found in ergot-based drugs
Medication
A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...

 (such as methylergometrine, ergotamine or, previously, ergotoxine). The deleterious side-effects
Adverse effect
In medicine, an adverse effect is a harmful and undesired effect resulting from a medication or other intervention such as surgery.An adverse effect may be termed a "side effect", when judged to be secondary to a main or therapeutic effect. If it results from an unsuitable or incorrect dosage or...

 occur either under high dose
Dose (biochemistry)
A dose is a quantity of something that may impact an organism biologically; the greater the quantity, the larger the dose. In nutrition, the term is usually applied to how much of a specific nutrient is in a person's diet or in a particular food, meal, or dietary supplement...

 or when moderate
Moderate
In politics and religion, a moderate is an individual who is not extreme, partisan or radical. In recent years, political moderates has gained traction as a buzzword....

 doses interact with potentiators such as azithromycin
Azithromycin
Azithromycin is an azalide, a subclass of macrolide antibiotics. Azithromycin is one of the world's best-selling antibiotics...

.

Historically, eating grain
GRAIN
GRAIN is a small international non-profit organisation that works to support small farmers and social movements in their struggles for community-controlled and biodiversity-based food systems. Our support takes the form of independent research and analysis, networking at local, regional and...

 products contaminated with the fungus
Fungus
A fungus is a member of a large group of eukaryotic organisms that includes microorganisms such as yeasts and molds , as well as the more familiar mushrooms. These organisms are classified as a kingdom, Fungi, which is separate from plants, animals, and bacteria...

 Claviceps purpurea
Claviceps purpurea
Claviceps purpurea is a fungus that grows on the ears of rye and related cereal and forage plants. Consumption of grains or seeds contaminated with the fruiting structure of this fungus, the ergot sclerotium, can cause ergotism in humans and other mammals.. C...

also caused ergotism.

Finally, the alkaloids can also pass through lactation
Lactation
Lactation describes the secretion of milk from the mammary glands and the period of time that a mother lactates to feed her young. The process occurs in all female mammals, however it predates mammals. In humans the process of feeding milk is called breastfeeding or nursing...

 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 spasm
Spasm
In medicine a spasm is a sudden, involuntary contraction of a muscle, a group of muscles, or a hollow organ, or a similarly sudden contraction of an orifice. It is sometimes accompanied by a sudden burst of pain, but is usually harmless and ceases after a few minutes...

s, diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...

, paresthesia
Paresthesia
Paresthesia , spelled "paraesthesia" in British English, is a sensation of tingling, burning, pricking, or numbness of a person's skin with no apparent long-term physical effect. It is more generally known as the feeling of "pins and needles" or of a limb "falling asleep"...

s, itching, mental effects including mania
Mania
Mania, the presence of which is a criterion for certain psychiatric diagnoses, is a state of abnormally elevated or irritable mood, arousal, and/ or energy levels. In a sense, it is the opposite of depression...

 or psychosis
Psychosis
Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...

, headaches, nausea
Nausea
Nausea , is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting...

 and vomiting. Usually the gastrointestinal effects precede central nervous system
Central nervous system
The central nervous system is the part of the nervous system that integrates the information that it receives from, and coordinates the activity of, all parts of the bodies of bilaterian animals—that is, all multicellular animals except sponges and radially symmetric animals such as jellyfish...

 effects. As well as seizures there can be hallucination
Hallucination
A hallucination, in the broadest sense of the word, is a perception in the absence of a stimulus. In a stricter sense, hallucinations are defined as perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception, in that they are vivid,...

s resembling those produced by LSD
LSD
Lysergic acid diethylamide, abbreviated LSD or LSD-25, also known as lysergide and colloquially as acid, is a semisynthetic psychedelic drug of the ergoline family, well known for its psychological effects which can include altered thinking processes, closed and open eye visuals, synaesthesia, an...

 (lysergic acid diethylamide, to which the ergot alkaloid
Alkaloid
Alkaloids are a group of naturally occurring chemical compounds that contain mostly basic nitrogen atoms. This group also includes some related compounds with neutral and even weakly acidic properties. Also some synthetic compounds of similar structure are attributed to alkaloids...

 ergotamine is an immediate precursor and therefore shares some structural similarities), although ergot's hallucinations more strongly resemble a delirious and psychotic state, whereas LSD is not psychomimetic. The convulsive symptoms are caused by clavine alkaloid
Alkaloid
Alkaloids are a group of naturally occurring chemical compounds that contain mostly basic nitrogen atoms. This group also includes some related compounds with neutral and even weakly acidic properties. Also some synthetic compounds of similar structure are attributed to alkaloids...

s.

Gangrenous symptoms

The dry gangrene
Gangrene
Gangrene is a serious and potentially life-threatening condition that arises when a considerable mass of body tissue dies . This may occur after an injury or infection, or in people suffering from any chronic health problem affecting blood circulation. The primary cause of gangrene is reduced blood...

 is a result of vasoconstriction
Vasoconstriction
Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels, particularly the large arteries, small arterioles and veins. The process is the opposite of vasodilation, the widening of blood vessels. The process is particularly important in...

 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
Desquamation
Desquamation , also called skin peeling, is the shedding of the outermost membrane or layer of a tissue, such as the skin.-Skin:Normal, nonpathologic desquamation of the skin occurs when keratinocytes, after moving apically over about 14 days, are individually shed unnoticeably...

 or peeling, weak peripheral
Peripheral
A peripheral is a device attached to a host computer, but not part of it, and is more or less dependent on the host. It expands the host's capabilities, but does not form part of the core computer architecture....

 pulses, loss of peripheral sensation, edema
Edema
Edema or oedema ; both words from the Greek , oídēma "swelling"), formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body that produces swelling...

 and ultimately the death and loss of affected tissues
Tissue (biology)
Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...

. Vasoconstriction is treated with vasodilators.

History

Epidemic
Epidemic
In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...

s of the disease were identified throughout history, though the references in classical writers are inconclusive. Rye, the main vector for transmitting ergotism, was not grown much around the Mediterranean. When Fuchs 1834 separated references to ergotism from erysipelas
Erysipelas
Erysipelas is an acute streptococcus bacterial infection of the deep epidermis with lymphatic spread.-Risk factors:...

 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 "Saint Anthony's fire
Saint Anthony's fire
Saint Anthony's fire may refer to one of the following diseases:*Ergotism...

", named after monks of the Order of St. Anthony
Hospital Brothers of St. Anthony
The Hospital Brothers of St. Anthony, Order of St. Anthony or Canons Regular of St. Anthony of Vienne , also Antonines, were a Roman Catholic congregation founded in 1095 or so, with the purpose of caring for those suffering from the common medieval disease of St...

 who were particularly successful at treating this ailment. The 12th century chronicler Geoffroy du Breuil of Vigeois
Geoffroy du Breuil of Vigeois
Geoffroy du Breuil of Vigeois was a 12th century French chronicler.He was trained at the Benedictine abbey of Saint-Martial of Limoges, the site of a great early library....

 recorded the mysterious outbreaks in the Limousin
Limousin (province)
Limousin is one of the traditional provinces of France around the city of Limoges. Limousin lies in the foothills of the western edge of the Massif Central, with cold weather in the winter...

 region of France, where the gangrenous form of ergotism was associated with the local Saint Martial
Saint Martial
Saint Martial was the first bishop of Limoges in today's France, according to a lost vita of Saturnin, first bishop of Toulouse, which Gregory of Tours quotes in his History of the Franks.-Life:...

 as much as Saint Anthony.

The blight, named from the cock's spur it forms on grasses, was identified and named by Denis Dodart
Denis Dodart
Denis Dodart was a French physician, naturalist and botanist. Trained at the University of Paris, he gained his doctorate of medicine in 1660 and was elected to the French Academy of Sciences in 1673. In botany he is notable for his early studies of plant respiration and growth...

, who reported the relation between ergotized rye and bread poisoning in a letter to the French Royal Academy of Sciences in 1676 (John Ray
John Ray
John Ray was an English naturalist, sometimes referred to as the father of English natural history. Until 1670, he wrote his name as John Wray. From then on, he used 'Ray', after "having ascertained that such had been the practice of his family before him".He published important works on botany,...

 mentioned 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 occurred up into the 19th century. Fewer outbreaks have occurred since then due to rye being carefully monitored in developed countries.

There is evidence of ergot poisoning serving a ritual
Ritual
A ritual is a set of actions, performed mainly for their symbolic value. It may be prescribed by a religion or by the traditions of a community. The term usually excludes actions which are arbitrarily chosen by the performers....

 purpose in the ritual killing
Human sacrifice
Human sacrifice is the act of killing one or more human beings as part of a religious ritual . Its typology closely parallels the various practices of ritual slaughter of animals and of religious sacrifice in general. Human sacrifice has been practised in various cultures throughout history...

  of certain bog bodies. Found in peat
Peat
Peat is an accumulation of partially decayed vegetation matter or histosol. Peat forms in wetland bogs, moors, muskegs, pocosins, mires, and peat swamp forests. Peat is harvested as an important source of fuel in certain parts of the world...

 swamps, Grauballe Man
Grauballe Man
The Grauballe Man is a bog body that was uncovered in 1952 from a peat bog near to the village of Grauballe in Jutland, Denmark. The body itself is that of an adult male dating from the late 3rd century BC, during the early Iron Age, and he had been killed by having his throat slit open...

 and Tollund Man
Tollund Man
The Tollund Man is the naturally mummified corpse of a man who lived during the 4th century BC, during the time period characterised in Scandinavia as the Pre-Roman Iron Age. He was found in 1950 buried in a peat bog on the Jutland Peninsula in Denmark, which preserved his body. Such a find is...

 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; an outbreak in Ethiopia
Ethiopia
Ethiopia , officially known as the Federal Democratic Republic of Ethiopia, is a country located in the Horn of Africa. It is the second-most populous nation in Africa, with over 82 million inhabitants, and the tenth-largest by area, occupying 1,100,000 km2...

 occurred in mid-2001 from contaminated barley
Barley
Barley is a major cereal grain, a member of the grass family. It serves as a major animal fodder, as a base malt for beer and certain distilled beverages, and as a component of various health foods...

. Whenever there is a combination of moist weather, cool temperatures, delayed harvest in lowland crops and rye consumption, an outbreak is possible.

Poisonings due to consumption of seeds treated with mercury
Mercury (element)
Mercury is a chemical element with the symbol Hg and atomic number 80. It is also known as quicksilver or hydrargyrum...

 compounds are sometimes misidentified as ergotism, possibly including the case of mass-poisoning in the French village Pont-Saint-Esprit
Pont-Saint-Esprit
Pont-Saint-Esprit is a commune in the Gard département in southern France. It is situated on the Rhône River and is the site of a historical crossing, hence its name...

 in 1951. The incident is described in John Grant Fuller's book The Day of St Anthony's Fire.

According to Snorri Sturluson, in his Heimskringla
Heimskringla
Heimskringla is the best known of the Old Norse kings' sagas. It was written in Old Norse in Iceland by the poet and historian Snorri Sturluson ca. 1230...

, 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
Battle of Hastings
The Battle of Hastings occurred on 14 October 1066 during the Norman conquest of England, between the Norman-French army of Duke William II of Normandy and the English army under King Harold II...

.

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”
Medical explanations of bewitchment
Medical explanations of bewitchment, especially as exhibited during the Salem witch trials but in other witch-hunts as well, have emerged because it is not widely believed today that symptoms of those claiming affliction were actually caused by bewitchment...

 that spurred the Salem witch trials
Salem witch trials
The Salem witch trials were a series of hearings before county court trials to prosecute people accused of witchcraft in the counties of Essex, Suffolk, and Middlesex in colonial Massachusetts, between February 1692 and May 1693...

. This medical explanation for the theory of “bewitchment” is one first propounded by Linnda R. Caporael
Linnda R. Caporael
Linnda Caporael is a professor at the Science and Technology Studies Department at Rensselaer Polytechnic Institute.-Educational background:Caporael studied psychology at the University of California, Santa Barbara and received both her B.A. and PhD. She studied human ethology at the Institute of...

 in 1976 in an article in Science
Science
Science is a systematic enterprise that builds and organizes knowledge in the form of testable explanations and predictions about the universe...

. In her article, Caporael points out that the convulsive symptoms, such as crawling sensations in the skin, tingling in the fingers, vertigo
Vertigo (medical)
Vertigo is a type of dizziness, where there is a feeling of motion when one is stationary. The symptoms are due to a dysfunction of the vestibular system in the inner ear...

, tinnitus aurium, headaches, disturbances in sensation, hallucination, painful muscular contractions, vomiting
Vomiting
Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose...

 and diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...

, as well as psychological symptoms, such as mania
Mania
Mania, the presence of which is a criterion for certain psychiatric diagnoses, is a state of abnormally elevated or irritable mood, arousal, and/ or energy levels. In a sense, it is the opposite of depression...

, melancholia
Melancholia
Melancholia , also lugubriousness, from the Latin lugere, to mourn; moroseness, from the Latin morosus, self-willed, fastidious habit; wistfulness, from old English wist: intent, or saturnine, , in contemporary usage, is a mood disorder of non-specific depression,...

, psychosis
Psychosis
Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...

 and delirium
Delirium
Delirium or acute confusional state is a common and severe neuropsychiatric syndrome with core features of acute onset and fluctuating course, attentional deficits and generalized severe disorganization of behavior...

, 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. In 1982 historian Mary Matossian revitalized Caporael’s theory in her article in American Scientist
American Scientist
American Scientist is the bimonthly science and technology magazine published since 1913 by Sigma Xi. Each issue includes four to five feature articles written by scientists and engineers. These authors review research in all fields of science...

. 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.

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 rebutted Caporael’s theory in the same journal. In Spanos and Gottlieb’s rebuttal to Caporael’s article, they concluded that there are several flaws in the explanation of ergot
Ergot
Ergot or ergot fungi refers to a group of fungi of the genus Claviceps. The most prominent member of this group is Claviceps purpurea. This fungus grows on rye and related plants, and produces alkaloids that can cause ergotism in humans and other mammals who consume grains contaminated with its...

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. 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.

External links

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