ANNIVERSARY REVIEW: 50 years since the discovery of bromocriptine.

Ergotism is the long-term ergot poisoning by ingestion of rye or other grains infected with the fungus Claviceps purpurea and more recently by excessive intake of ergot drugs. It has either neuropsychiatric or vascular manifestations. In the Middle Ages, the gangrenous poisoning was known as St. Anthony's fire, after the order of the Monks of St. Anthony who were particularly skilled at treating the condition. In 1917, Prof. Arthur Stoll returned home to Switzerland from Germany, to lead the development of a new pharmaceutical department at Sandoz Chemical Company. Stoll, using the special methods of extraction learned from his work with his mentor Willstetter, started his industrial research work with ergot. He succeeded in isolating, from the ergot of rye, ergotamine as an active principle of an old popular remedy for excessive post-partum bleeding. The success of this discovery occurred in 1918 and was translated into a pharmaceutical product in 1921 under the trade name Gynergen. In subsequent work, Stoll and his team were leaders in identifying the structure of the many other alkaloids and amines produced by Claviceps purpurea This was the cultural background and scientific foundation on which bromocriptine was discovered.

Análisis de la enfermedad dermatológica en 8 Cantigas de Santa María del Rey Alfonso X el Sabio. Parte I: introducción, el monje resucitado «lac virginis», el ergotismo y la lepra / Dermatologic Diseases in 8 of the Cantigas of Holy Mary of Alfonso X the Learned - Part 1: Introduction, the Monk Revived by the Virgin's Milk, Ergotism, and Leprosy

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[The Piscine Probatica, a painted canvas of the Hotel-Dieu of Rheims, documentation of an epidemic at the end of the 15th century]. / La piscine probatique, une toile peinte de l'hötel-Dieu de Reims Témoignage d'une épidémie de la fin du XVème siècle d'Ignis Plaga.

The Piscina Probatica theme is the highly distinctive iconography in an impressive painted canvas from the ancient Rheims hôtel-Dieu, dating back to the late 15th or early 16th century. In the first place, it is interesting to note that the actual site of the pool has been located, so that archaeological findings bring confirmation to testament scriptures. Through the choice of the painted-canvas medium, and thanks to his great pictorial skill, the anonymous Rheims artist has given us a document of exceptional value, concerning the signs and symptoms of an illness which wrought havoc in the Rheims area in his own lifetime, namely ignis plaga or "mal des ardents". Other great artists of the same period, such as J. Bosch, have testified to the horror of the illness. As a matter-of-fact, the illness has been fully documented, from the 17th century onwards, and the medical expert H.A. Tessier, also acting as an agricultural expert, has demonstrated that ergotized rye is responsible for the fatal condition known as ergotism, and for the heavy toll it has levied on human lives in the course of centuries.

[Dancing manias. Between culture and medicine]. / Manie taneczne. Miedzy kultura a medycyna.

Dancing mania is a clinical and cultural phenomenon which occurred in Western Europe between 13th and 18th centuries. The term dancing mania is derived from the Greek words choros, a dance, and mania, a madness. An Italian variant was known as tarantism as victims were believed to have been bitten by tarantula spider. Although symptoms of dancing manias were well documented in contemporary writings the exact aetiology of dancing plaques is still unclear. Several causes for dancing mania have been postulated: demonic possession, the bite of tarantula, ergot poisoning, epilepsy, mass hysterias, exotics religious cults. The article contains a review of hypothesis of epidemic dances included both medical and psychological factors.

[Saint Anthony's Fire or gangrenous ergotism and its medieval iconography]. / Le feu Saint-Antoine ou ergotisme gangreneux et son iconographie médiévale.

The frequent epidemics of ergotism were called Holy Fire or st-Antony's Fire in the Middle Ages, because of the burning sensations resulting in gangrene of limbs. It was caused by eating rye bread contaminated with the fungus Claviceps purpurea. The hospitable Order of st-Antony was founded near Vienne in France with 300 establishements in Europe until 1777. In coptic and byzantine art st-Antony is the father of the monks, whereas in Occident he is the the master of fire, thaumaturgic, resulting a very important iconography in statuary and painworks in all regions, especially in Lorraine, the catholic and tridentin Lotharingia and in Corsica thanks to the franciscan pastoral. Woodcuts show not only the temptations of st-Antony, with strange and diabolic scenes, patients with gangrenous limbs. Germanic woodcuts of the 15th century show patients with different stages of ergotism and hands and feet like ex-voto. Triptycs of H. Bosch and M. Gunewald are witnesses of the frequency and seriousness of this disease still at the beginning of the 16th century.

[Ergotism in Limoges province around the year 1000]. / Le mal des ardents en province limousine aux environs de l'an mil.

Saint-Martial, a former bishop in Limoges, is supposed to protect from ergotism. His relies are still publicly shown every 7 year.

[Petit-Saint-Antoine, Parisian hospice for the treatment of ergotism from the 11th to the 16th Century]. / Le Petit-Saint-Antoine, hospice parisien soignant le mal des ardents du XIème au XVIème siècle.

Petit-Saint-Antoine was for six centuries a Parisian hospital specialized in the treatment of the so-called "mal des ardents", or ergotism.

[Issenheim's altarpiece: does the disease depicted on the altarpiece correspond to ergotism?]. / Apropos du retable d'Issenheim: la maladie représentée sur le retable correspond-elle a l'ergotisme?

The Issenheim altar by Mathias Grünenwald (Unterlinden museum in Colmar) shows various scenes from the life of St Antony, abbot. The Tentation panel has been considered as an illustration of the sacer ignis, or St Antony's disease (ergotism). In fact, it may more likely indicate an early representation of Syphilis, or the French disease, as discussed here.

[Ergotismus convulsivus. the convulsive type of ergotism illustrated by an example in the year 1738]. / Ergotismus convulsivus. Die krampfende Form der Mutterkornvergiftung an einem Beispiel aus dem Jahr 1738.

This paper describes cases of ergotismus convulsivus (the kind of poisoning from ergotized grain marked by convulsions), some of them fatal, in the year 1738. The origins of the formation of the ergotized grain as well as the symptoms of ergotism are presented. Comparisons to other epidemics of ergotism are drawn.

The history of ergot of rye (Claviceps purpurea) I: from antiquity to 1900.

This article outlines the history of ergot of rye up to 1900. Ergot is a fungal disease that affects many grasses but is particularly damaging to rye. It occurs as the result of an infection by the parasitic organism Claviceps purpurea, which produces characteristic black spurs on the grass. When incorporated into grain, the ergot fungus can cause severe outbreaks of poisoning in humans called ergotism. There are two main clinical forms of toxicity, gangrenous and convulsive, where coma and death often supervene: the death rate for ergotism has been reported to be between 10 and 20 per cent in major outbreaks. Historical accounts note that ergot could accelerate labour, stop postpartum haemorrhage and inhibit lactation. At the end of the nineteenth century ergot was still regarded as a 'glorious chemical mess', but help would arrive in the early 1900s and the complex jigsaw would be solved.

[Antony's fire (gangrenous ergotism) and medieval iconography]. / Le feu Saint-Antoine ou ergotisme gangreneux et son iconographie médiévale.

Ergotism was known as Holy Fire or St Antony's Fire in the Middle Ages, because of the burning sensations and limb gangrene it entailed. It was a frequent disorder, caused by eating rye flour contaminated by the fungus Claviceps purpurea. The Hospitable Order of St Antony was founded near Vienne in France, and counted 400 establishments in Europe by 1777. Ergotism is the subject of an abundant iconography, including statues and paintings. Woodcuts show the temptations of St Antony, with strange and diabolic scenes, and individuals with gangrenous limbs. Germanic woodcuts of the XVth century show various stages of ergotism and hands and feet. The tryptics of Bosch and Grunewald bear witness to the frequency and gravity of this disorder, at the beginning of the XVIth century.

[Saints and diseases: an onomastic relationship]. / Affezioni ultraterrene: Ignis Sacer e chorea Sancti Viti, il retaggio medievale del rapporto onomastico tra santi e infermità.

Praying saints to obtain soul salvation and body recovering was a common practice in medieval time. The history of certain diseases has been strictly related with devotion and pilgrimages. The current nomenclature of particular illnesses is an inheritance of that relationship. Epidemics of S. Anthony's fire, caused by eating contaminated rye bread, and S. Vitus' dance, maybe a kind of chorea, occurred frequently in the Middle Age. The durability of these onomastic associations and the survival of patronage on these sicknesses had a long evolution along the centuries, as shown by a multitude of medieval sources.