St. Anthony's fire and leprosy
Dinesh Kumar Jain in Homeopathy, 2022
Ergot is a fungus to which rye is particularly susceptible … The eating of bread made from contaminated rye was responsible in the past for many outbreaks of ergotism … The effects of ergotism are alarming and explain why the disease was once regarded with superstitious dread. The most usual symptoms of ergotism was gangrene which was a consequence of vasoconstriction and which resulted in fingers, toes or whole limbs becoming dried, shrivelled and black so that they sometimes fell off … It was for this reason (and perhaps also because the blackened limbs appeared to have been charred by fire) that ergotism was popularly known as St. Anthony's fire. St. Anthony's name was attached because it was believed that pilgrims to his shrine would be cured of this affliction. This promise did not go entirely unfulfilled for the act of pilgrimage ensured that the victim left the area in which the infected rye was growing. Ergotism is also associated with the occurrence of spontaneous abortions and with disturbance of central nervous function including convulsions and acute mania.
Ergot Alkaloids
Dongyou Liu in Handbook of Foodborne Diseases, 2018
Discontinuing all ergot-containing medications (as well as caffeine, nicotine, and β-blockers) will often lead to improvement and/or disappearance of associated symptoms (hallucination, delusions, arrhythmia, tachycardia, insomnia, perspiration, tremors, synesthesia, and vasospasm). However, if ergotamine-induced limb ischemia with pallor, coolness, and numbness persists, conservative treatment with nifedipine, sodium nitroprusside, prazosin hydrochloride, prostaglandins, clarithromycin, low molecular heparin, epidural infusion of bupivacaine, and sympathectomy may be considered [57,58]. Patients with thrombotic occlusion or distal embolization may be offered interventional therapy with aspiration of thrombotic material or thrombolysis. Use of antidepressants may help suppress the effect of lysergic acid diethylamide.
The Black Death and Other Pandemics
Scott M. Jackson in Skin Disease and the History of Dermatology, 2023
Whether ergotism was a strictly medieval phenomenon or also prevalent in the ancient world is one of the great unanswered questions about this topic; however, there is no reason to think that the C. purpurea was not present in ancient times since several textual references exist to ergot in ancient documents. A Babylonian tablet dated to 2500 BCE mentions in an inscription that “the women who gather noxious grasses” were “expelled from the city with the exorcists and mutterers of charms,” while a Sumerian tablet of the same period describes reddening of damp grain.74 An Assyrian tablet (660 BCE) alludes to a “noxious pustule in the ear of grain,” and the sacred book of the Parsees (Zoroastrian Persians) dating to 400 BCE references “noxious grasses that cause pregnant women to drop the womb and die in child-bed.”75 The Chinese were using ergot as early as 1100 BCE in obstetrics, and Hippocrates' melanthion may have been ergot as he knew of its benefits with postpartum hemorrhage.76 The ignis sacer of the Greeks and Romans, however, appears to refer to several different skin diseases that involve fiery pain or the spread of the condition like fire, but not the specific syndrome of ergotism that involves gangrenous necrosis of the extremities.
Biosensors for the detection of mycotoxins
Published in Toxin Reviews, 2022
Akansha Shrivastava, Rakesh Kumar Sharma
Ergot alkaloids are the secondary metabolites of fungi and these are produced by various species of Claviceps. The effect of this group of alkaloids has been shown in the middle ages called "Holy Fire" or "St. Anthony’s Fire", also known as the disease ergotism. Other alkaloids include ergometrine, ergotamine, and ergotoxine (Crews 2015, Miedaner and Geiger 2015). There are two forms of ergotism: Gangrenous, which affects the blood supply to extremities and convulsive, and ultimately affects the central nervous system. The fungal species which produce these alkaloids include Claviceps purpurea (rye and other cereals), Claviceps paspali (forage grass), Claviceps fusiformis, Claviceps gigantea, and Sphacelia sorghi (an anamorphic form of Claviceps). The clinical symptoms of ergotism are a manifestation in the form of gangrene, abortion, convulsions, suppression of lactation, and hypersensitivity (Berthiller et al. 2017). The ingestion of ergot occurs through infected cereals, commonly in the form of bread produced from contaminated flour. A recently reported another alkaloid from the same class, purpurolic acid from plant-parasitic sclerotia of Claviceps purpurea has been reported and considered as highly toxic for animal feed (Roberts et al. 2016). Ergot alkaloids contamination has been reported in rye food, wheat food, multigrain food, rye feed, wheat feed, and triticale feed. Among these samples, rye feed contained the highest amount of ergot alkaloids, i.e. 12,340 µg/kg (Malysheva et al. 2014).
‘Dopamine agonist Phobia’ in Parkinson’s disease: when does it matter? Implications for non-motor symptoms and personalized medicine
Published in Expert Review of Neurotherapeutics, 2020
Silvia Rota, Iro Boura, Lucia Batzu, Nataliya Titova, Peter Jenner, Cristian Falup-Pecurariu, K Ray Chaudhuri
In this review, we discuss the phenomenon of ‘Dopamine Agonist Phobia’ (‘DA Phobia’), a phenomenon we believe that affects mostly physicians, potentially leading to a reduced use of dopamine agonists (DAs), a category of drugs which can be beneficial to PD patients, especially in the context of ‘personalized medicine’ [4]. This specific phobia seems to be driven by a desire to avoid common side effects of DAs, such as sleepiness, postural hypotension, peripheral edema, and, more recently, neuropsychiatric behavioral issues, such as impulse control disorders (ICDs), which are reported to be more frequent compared to levodopa therapy [9]. Moreover, the potential impairment in decision-making processes occurring in patient on DAs might raise additional ethical and medico-legal concerns for the clinician [10]. There is no doubt that levodopa is the most effective drug treatment of motor symptoms, with efficacy greater than that of the DAs [11,12]. However, there is significant evidence that DAs can exert a beneficial effect on those NMS of PD with a dopaminergic contribution to their pathogenesis [13,14]. This effect of DAs to the overall treatment is under-recognized. Consequently, we focus on the potential clinical utility of non-ergot DAs for the management of specific NMS in PD, and we discuss on how ‘DA Phobia’ should be replaced by a more evidence-based use of DAs. For each DA, we provide the highest level of evidence, based on the Movement Disorder Society (MDS) criteria, for the studies available in the literature for the treatment of specific NMS and a rationale toward delivering personalized medicine strategy [15].
Lasmiditan: an additional therapeutic option for the acute treatment of migraine
Published in Expert Review of Neurotherapeutics, 2021
Daniele Martinelli, Vito Bitetto, Cristina Tassorelli
Ergot alkaloids are being less and less prescribed due to their potentially severe side effects (the so-called ‘Ergotism’: nausea and vomiting, thoracic constriction, angina, psychosis), so the main options for migraine patients are NSAIDs (with PCM) and triptans. They both have pros and cons: NSAIDs are not ‘mechanism-specific’, they are intended to fight pain regardless of its nature and so they lack the specificity of action a patient typically seeks. On the other hand, their prolonged use is associated with well-known side effects, gastrointestinal bleeding, and renal function impairment above all. On the other side, triptans play a role on crucial steps in migraine pathophysiology, but their mechanism of action may lead to the well-known side effects discussed above. So, all in all, side effects, lack of efficacy or specificity and contraindications summarize the list of limitations of the current pharmacological treatment options for the symptomatic therapy of migraine attacks. For these reasons, over the last decade new approaches have been pursued, in an effort to expand the non-pharmacological approach to pain [24].