J.D.B. News Letter

(By Our London Correspondent)

The outbreak of ergot poisoning at Manchester due to eating rye bread is described in the “British Medical Journal” by Dr. James Robertson and Dr. Hugh T. Ashby.

It was noticed, they write, that the disease is confined to the Jewish population of the city, and it is found that the symptoms are only met with in that portion of the Jewish community which uses rye bread as an article of diet. In no case is the condition met with among those who eat white bread.

We have carefully collected and recorded cases, they state, and have had analytical and physiological tests made on the rye in order to prove the cause of the symptoms met with. Early in the investigations it was observed that the general symptoms complained of were coldness in the extremities, numbness and lack of sensation in the fingers–a sensation like an insect creeping over the skin–headaches, depression, gastric disturbances, shooting pains, twitchings in the limbs, and staggering gait. It was further observed that the patients who complained of these symptoms were, Jews and later that these Jews ate black or rye bread. On the other hand, none of the symptoms complained of were observed among that portion of the Jewish population who ate white bread. It was then suggested that the rye bread might be the source of the trouble. From this is was concluded that the symptoms were due to ergot, which, as is well known, so readily contaminates the rye. It was also noticed that the symptoms were much more pronounced in the Russian, Polish and German-born Jews than in the English-born Jews. This is explained by the fact that black bread is the bread commonly used on the Continent, whereas in this country its place is taken by white bread. Further, on account of its slightly bitter taste the black bread proves more palatable than the comparatively tasteless white bread. In addition to this, black bread is found to be more satisfying and is a little cheaper than white bread.

In some households it is found that one member may show no symptoms of ergotism whatever, whilst all the other members of the family are variously affected. Questions elicit the information that the unaffected member does not eat rye bread. In many of the cases first seen rye bread was stopped as an article of diet; this was followed by an early diminution in the symptoms, and a complete disappearance of them in most cases.

Rye is by far the most susceptible grain to infection by the parasitic fungus Claviceps Purpurea. The grain is infected just as the flowers are opening, and the fungus enters at the end of the grain. The infection is only possible at this time, as the shell later becomes too hard for the fungus to penetrate.

The symptoms observed in these Jewish patients, they proceed, correspond very closely with those produced by chronic ergot poisoning. The severity of the symptoms produced seem to increase with age, children being slightly and elderly people more acutely affected. This may be due to the elderly people having taken rye bread for many years. The foreign-born Jews, who have always eaten rye bread are the most affected.

The first symptoms of coldness of the extremities combined with numbness are especially observed in tailors, buttonholers, etc., who find because their fingers are numb they have difficulty in keeping up their work. They often notice that they prick their fingers without feeling it.

Raynaud’s disease amongst the Jews during this winter would appear to be more prevalent than heretofore. We have also come across a man, aged 47, who has a definite dry gangrene of both hands. The gangrene of this man is not associated with diabetes or any similar condition, and it is possible that, as a rye bread consumer, his gangrene is due to ergot poisoning.

It has been observed that these cases quickly improve when rye bread as an article of diet is discontinued.

A large number of the symptoms are due to general contraction of the arteries all over the body, and it is probable that if the poisoning should become more severe such serious conditions as Raynaud’s disease and gangrene will become more frequent. Ergot has the power of contracting the pregnant uterus, and it is likely that chronic ergot poisoning may cause abortions in early pregnancy. Unfortunately no record is available of these cases as the Notification of Birth Act only applies to children born after the expiration of the twenty-eight week of pregnancy.

“Epidemic Ergotism is well known as an affliction of medieval Europe,” the “Brithish Medical Journal” writes in an editorial article, “but it has been generally assumed that this is one of the plagues that the advance of civilization has banished. It will therefore come as a surprise to many to real the account of a recent epidemic of ergot poisoning described by Drs. Robertson and Ashby. This epidemic has occurred, moreover, not in the wilds of Eastern Eruopen, but in Manchester.

“Records of epidemic ergotism date back to the ninth century, and all through the Middle Ages terrible out-breaks of poisoning occurred amongst ryecating population after wet summers. Large numbers were killed in those epidemics, and many only surrived after losing the greater portion of their limbs from gangrene. Before the advent of steam transport the unfortunate inhabitants of districts which depended on rye often found themselves faced, after a wet summer, with the alternative either of starvation or of poisoning from the consumption of eigotised rye. The improvement of communications due to the advent of steam transport naturally reduced the frequency and severity of such epidemics, but it did not abolish them, for several have been recorded during the last half-century in Eastern Europen.”