Considering that gangrene is caused by depriving tissues of their nutrient fluid, the blood; that the tissue starvation as occurring under the toxic effects of Ergot is known to be brought about by the contraction of the blood-vessels-Ergotin or Secale Cornutum must be looked upon as eminently homoeopathic to all such cases where arterial spasms lie at the bottom of the pathological disorders. We know besides that under the full toxic effects of the drug the temperature is below the normal standard;; there is, moreover,(*Allen’s Cyclopaedia of Pure Materia Medica.*) great anxiety and fear of death; the face, in some victims, is pale, sunken, hippocratic, with anxious expressions; there is profuse, cold sweat over the whole body, extreme debility, prostration and restlessness; in short the collapse of Ergot, whenever produced in a subject, is not easily distinguishable from an Arsenic collapse.
Like all violent poisons, Secale is twofold in its destructive effects upon the human organism viz. neurotic and haematic; and we can, in many cases, hardly tell, which of the two elements is prevalent in the ensemble of its pharmacodynamism.
Ergot produces besides, violent convulsions, accompanied by chilliness and offers thus another feature of similarity to spasmodic cholera; for as far as can be judged from the pathogenesis, the convulsions seem to be idiopathic, and not like those produced by Cuprum-subsequent to gastro-intestinal irritation. On the other hand, Ergot it not altogether without any disturbing influence upon the digestive organs; it produces, as we have seen, nausea, violent vomiting and pains in the stomach and sometimes they are attacked with violent diarrhoea. The nature of the evacuations is here again not choleraic; nevertheless it could hardly be denied, that on the whole there is much of the Ergot effects which strikingly the main features of cholera.
You might feel inclined to ask me: What is the use of running after other drugs with half and three-quarter resemblance to cholera, since we have already so many of them? My answer is if we had enough of them then our mortality in cholera would not be what it is; a mortality of somewhat near thirty per cent. in an acute disease like cholera, shows that there is something deficient in our treatment. I say deficient, where some others might have expected me to say, there is something wrong altogether. But the very fact, that we do save 24 out of every fifty patients who would otherwise have been doomed to die and who do die under any other, but homoeopathic treatment, shows that our system is the right one provided we have the means to carry it out properly. Now Homoeopathy has always insisted upon paying as much attention to the individuality of the patient, as to the pathological individuality of the disease. The very fact that only a certain number of patients do benefit by our treatment, shows that the rest of them have been in some respects, otherwise constituted than those who have been saved; else, why this difference in the result, since the remedial means applied have actually been the same in all cases.
Happily we know on the other hand that just as there are no two patients alike to all therapeutic intents and purposes, so there are no two drugs alike, with respect to their physiological action on the healthy; so that in the measure as we extend our knowledge of specific drug action, we extend at the same time the sphere of our therapeutic knowledge and usefulness.
To return to the drug under discussion we find in Secale Cornutum certain particularities, which might lead us to administer the drug in certain particular cases of cholera, or rather to certain particular patients, with far greater advantage, than we could ever expect to derive from any of the remedies previously analysed by us. Secale causes arterial contraction by acting directly on the arterial muscular coat, and not as is the case in cholera, and all the other drugs mentioned before, by irritation of the sympathetic system of nerves. We know this from the experiments of Brown Sequard, who has shown that division of the sympathetic does not materially affect the arterial contractions produced by Secale. As to convulsions of the voluntary muscles arising under its influence, opinions seem still to be divided, in how far these phenomena are to be considered as purely neurotic. Some authors maintain that the convulsions are caused by cerebral and spinal anaemia, which anaemia is supposed to be brought on by the arterial contraction of the cerebral and spinal blood-vessels; just as some authors attribute the choleraic spasm to impoverishment of the blood in consequence of the choleraic discharges. Anyhow it is established beyond doubt that Secale exerts an irritating influence upon the muscular coat of the blood-vessels-arterial as well as venous and, indeed upon the unstriped muscular fibre throughout the body, exciting everywhere a persistent and long lasting contraction.
Such being the case, we shall find Secale best suited to constitutions, where the arteries are apparently assailed by a process of degeneration. Women at the climacteric period suffer often in consequence of such a beginning degeneration of the arteries; and men between 50 and 60 give often out no uncertain signs in the same direction. We may then be induced in the case of such patient to administer Secale, just as we have seen, that in another class of patients-the chlorotic-Cuprum may have the preference to other allied remedies; and yet in another class of patients-the malarial cachectic-Arsenic might have to be administered, in so far as the individuality of the patient may determine the choice of the remedy.
Let it be understood that Ergot in spite of all apparent similarity to cholera in many of its prominent toxic effects, cannot stand the test of a thorough-going comparison with the fundamental disorder of the last named disease. Not to say anything of the evacuations peculiar to the two abnormal conditions-cholera and Ergot poisoning-the very spasms of the arteries, which occur in both, materially differ from each other. The arterial spasms of cholera are due, as has been so often stated to morbid irritation of the vaso-motor centres; while in Secale we have seen from the experiments of Brown Sequard that neither the vaso-motor centres not the sympathetics have any thing to do with the same occurring under its influence the contractions being solely due to irritation of the unstriped muscular tissue of the vessels.
But while Secale can never be enlisted among the rank of cholera remedies on homoeopathic ground, it can be made serviceable as an excellent therapeutic auxiliary on the very same ground. In order to understand this, we need only remember that an injury however inflicted, directly or indirectly, may prove equally hurtful. The arterial coats that have been unnaturally contracted under the influence of a morbidly excited vase-motor nervous system may not always be in a condition to resume their natural calibre as soon as the sympathetics themselves have ceased to be morbidly excited. Such a return to their natural calibre on the part of the arteries, after the removal or cessation of the extraneous, nervous influence, can only be expected to take place in virtue of the elasticity of the arterial coat. Now this elasticity may be damaged by atheromatous deposits within the walls of the blood-vessels, in the class of patients described before; something is therefore still to be done in such cases, after al injurious, nervous influence had been removed, be it by medication or by the vis medicatrix nature. And here Secale, by its direct action on the arterial coat, may do for us, what no remedy, homoeopathic to cholera, could do; for the simple reason, that none of those remedies act on the arterial coat; they, all of them act like the cholera attacks a woman whose menses are habitually profuse or a woman who is just menstruating, we should never lose sight of Secale- alone or as an intercurrent remedy. Cholera originating from a – diarrhoea contracted after child-birth may also find its suitable remedy in Secale Cor.
But it is not only in patients of the above description that Secale may be called for; any cholera subject may, now and then, be in a condition, as to require Secale. You remember no doubt what I told you in one of my previous lectures about the effect the enormous loss of water in cholera patients must necessarily have upon muscular contractility and tissue elasticity in general. You will then be able to judge for yourself about the importance of the drug under discussion in the treatment of cholera. You will, moreover, after what I said on the subject, be in a position to understand an observation made by the late Dr. Russell, for which he could not account, considering that he himself could not at that time have been acquainted with Brown Sequard’s experiments.
Dr. Russell writes as follows:-
Secale Cornutum, or Ergot of Rye is a medicine in which we have great faith in some of the worst varieties of cholera. We have seen the most decided advantage from its administration… while we would recommend Cuprum and Veratrum to be given rather by themselves than in alteration we should feel inclined to give Secale alteration we should feel inclined to give Secale alternately with Arsenicum. It is not easy to give a reason for this, beyond the observation, that so given we have seen more benefit to the patient, than from either singly; and we do not think that the two medicines interfere. We should give it strong, in the first second, or third dilution; a dose every half hour alternately with Arsenic; and thus in cases particularly of women where there is great prostration and violent watery discharges.
