Reprint from THE ST. LOUIS CLINIQUE for January 1893. 
ABORTION : 
ACCOMPANIED WITH UNUSUAL REFLEX MOTOR DISTURBANCE 
OF THE ARM. 
Reported by CHAS. W. MURPHY M. D. Salem, Ind. 
A Paper read at the Washington County Medical Society, Salem, Ind. 
December 1892. Abortion - Accompanied with Unusual Reflex Motor Dis- 
turbance of the Arm. 
REPORTED BE CHARLES W. MURPHEY, M. D. 
Read before the Washington Co. Medical Society, Salem, Ind. Dec. 1892. 
Ordered a hot vaginal injection. A 
speculum was then introduced and by 
means of dressing forceps the embryo 
was removed. As soon as this was ac- 
complished the clonic contractions of 
the flexor muscles of the arm ceased. 
The appendages of the foetus were all 
removed by scraping the cavity of the 
womb with a dull curette and, having no 
iodine with me, a two per-cent solution 
of carbolic acid was used to paint the 
cavity. Hemorrhage occurring rather 
freely, a strip of iodoform gauze was 
packed into the womb which controlled 
it promptly. Iodoform was freely used 
around the cervix and three or four 
cotton tampons applied. The reflex 
arm movement did not return, but mus- 
cular soreness was experienced for sev- 
eral days. The tampons were removed 
on the second day after application, 
antiseptic injections were ordered, and 
she made a good and complete re- 
covery. 
The above case is reported not with 
a view to pointing out any excellency 
in its management, for the treatment of 
the abortion is open to some criticism ; 
but more especially to show the peculiar 
and unusual reflex phenomenon in the 
arm. The immediate cessation of the 
clonic contraction upon the withdrawal 
of the foetus, and without any knowl- 
edge of the patient as to what I was 
doing, clearly demonstrates to any mind 
the consequential relation existing be- 
tween the two. Hilton in his masterly 
work on " Rest and Pain " explains the 
reflex pains that may occur in the knee 
Mrs. M., aged 33, anemic, of rather 
feeble natural organization and mother 
of four children; was called hurriedly 
to see her Sep. 6th, 1892. On reaching 
the bedside I obtained the following 
history : Missed catamenia three weeks 
before, and ten days previous to visit 
symptoms of abortion commenced, the 
hemorrhage and pain gradually increas- 
ing until the morning of visit, when the 
hemorrhage became so profuse as to 
cause syncope. As the hemorrhage was 
not very free while present, and as she 
had just passed a large clot, 1 took it 
for granted without an examination that 
the embryo or fcetus had escaped, and 
ordered rest in bed and equal parts of 
ergot and black haw, to be given in tea- 
spoonful doses every two to four hours, 
according to the profuseness of the 
flow. 
Two days later I was called to see her 
again. Found she had wasted but little 
since commencing the medicine which 
she had been taking every four hours. 
The uterine discharge was offensive. 
The night previous, a ten o'clock, a 
clonic rapidly convulsive movement of 
the whole right arm commenced, de- 
priving her entirely of sleep. Her hus- 
band was trying to hold the arm still 
but with only partial success. Having 
some years ago a case of tonic contrac- 
tion of the left arm clearly attributable 
to chronic endometritis, it occurred to 
me at once that the symptoms might be 
the result of uterine irritation. A dig- 
ital examination revealed a portion of 
the embryo hanging through the cervix. ABORTION. 
and hip joints, the loins and posterior 
part of the sacrum, by the connection 
of the sacral and lower lumbar ganglia 
of the sympathetic, with the sciatic and 
obturator on the one hand, and the 
nerves distributed to the uterus and 
ovaries on the other. On the same hy- 
pothesis we may explain the reflex mo- 
tor disturbance of the arm by the irri- 
tation of the womb being communicated 
to ganglia, and from ganglia to spinal 
cord, along which it is transferred or 
ascends to motor cells corresponding to 
the brachial plexus, from which is issued 
-the motor impulses producing the 
clonic contractions of the arm. 
In conclusion, it is quite likely the 
physical conditions and relations of the 
foetus to the uterus were almost ident- 
cal at the time of first visit as at my 
last, and had I made an examination at 
that time as I should have done, this 
article in all probability woidd never 
have been written.