Ergotism — The Clinical Picture

Abstract

The modern therapeutic use of ergotamine goes back to the 1930s, but the history of ergotamine goes back to the beginning of the European Middle Ages. Guggisberg (1954) and Wilkinson (1985) have described the use of ergotamine in detail. The poisonings in the Middle Ages and the placement of ergotamine in the cultural history of Europe have been described by Andersson (1982). Throughout the centuries epidemices of ignis infernalis have swept across Europe leaving thousands dead or crippled. Ergotism still exists, though the symptoms today are different in character and milder because ergotamine is now made synthetically in a pure form. Today the symptoms are caused mainly by wrong prescription of ergotamine to patients suffering from different types of headache. Ergotism is, however, very frequent. Andersson (1973) stated that 10% of headache patients in his clinic had ergotism symptoms. The picture has not changed to this day. Wilkinson (1985) reported that 4% of patients coming to the City of London Migraine Clinic in the years 1976–1981 had ergotism symptoms.