Classic illustrations: From St. Anthony's fire to ergometrine (Ergonovine).

Time I " minutes Fig. 1. Figure taken from: Moir, C. (1932): The action of ergot preparations on the puerperal uterus. Bnt. In the Middle Ages St. Anthony ministered to those suffering the torments of intense burning and gangrene of the fingers and toes. It was clearly a painful condition graphically described as St. Anthony's fire and was eventually related to 'black' bread made from rye contaminated with fungus. As early as the 16th century a liquid extract of the diseased rye was used by midwives to produce miraculous improvement in weak labor; it is not recorded whether any of them were accused as witches for such supernatural powers. The British Pharmacopoeia of 1898 described a method of preparing a watery 'extracturn ergotae liquidum' but ergotoxine for long believed to be the active principle was insoluble in water! The liquid extract did contain histamine (ergamine) and the situation was further confused by the fact that histamine and the ergot alkaloids ergotoxine and ergotamine could all be shown to have some oxytocic properties. An article in the Journal of Obstetrics and Gynaecology in 1927 stated: 'The specific alkaloid of ergot used in the form of ergotamine tartrate has been found to exert in the most striking way the action which has always been thought to characterize the drug'. The writers declared the liquid extract no more effective on the puerperal uterus than the yeast extract 'Marmite' and so by inference inactive. It was in 1932 that Chassar Moir first reported his experiments with ergot extracts. Using a rubber balloon in the puerperal uterus he measured the contractions produced by various concocti6ns. 'To contrast the effect of the active with the inactive ergot preparations, a watery extract of ergot was specially prepared in strict accordance with the regulations of the 1914 British Pharmacopoeia. Judged by all previous work this preparation ought to have been inert for analysis showed that it contained only a trace of alkaloid; the extract was used in three cases in doses of 4 drachms, 3 drachms and 2 drachms respectively. It was with the greatest surprise I found that, far from being inert, this preparation surpassed by great measure the activity of any drug I had previously used in the same manner. An equally surprising fact was that the effect appeared in a remarkably short time. In one case only four