. Annals of surgery. so as torender the pressure on the skin less severe, and thus avoid the risk ofsloughing, which sometimes followed the use of Morels instrument. Butthe greatest improvement in the tourniquet was that made in 1718 by theillustrious J. L. Petitâle grand Petit, as he has been sometimes called todistinguish him from other less famous surgeons of the same nameâandthough, with its wooden plates and screw, we should think it but a rudecontrivance, it was in all essential points the same instrument as thetourniquet employed at the present day. Many other tourniquets have found the
. Annals of surgery. so as torender the pressure on the skin less severe, and thus avoid the risk ofsloughing, which sometimes followed the use of Morels instrument. Butthe greatest improvement in the tourniquet was that made in 1718 by theillustrious J. L. Petitâle grand Petit, as he has been sometimes called todistinguish him from other less famous surgeons of the same nameâandthough, with its wooden plates and screw, we should think it but a rudecontrivance, it was in all essential points the same instrument as thetourniquet employed at the present day. Many other tourniquets have found their way into thearmamentarium of the surgeon, such as Signoronis, Lister^Cartes, Higgenbottoms, Tufifnells, Skeys, and Esmarchsand their modifications. Some have had in view direct pres-sm-e upon the main artery of the limb but most have been,after all, but a slight improvement upon the garrot or Spanish * Read in the Clinical and Pathological Section of the ClevelandAcademy of Medicine, March 4. Fig. The pneumatic tourniquet. PNEUMATIC TOURNIQUET. 70I windlass. The one most commonly used is the Esmarch rub-ber band and chain or a simple rubber tube. These are cer-tainly sufficient so far as controlling hemorrhage is concernedbut are often so applied, either through ignorance, carelessnessor perhaps unavoidably, as to cause very serious results, amongwhich nerve palsy may particularly be mentioned. Thus whenapplied tightly above the elbow, musculospiral palsy may resultand, if below the knee, peroneal nerve palsy sometimes follows. In children particularly the need of some more suitableand more safely regulated pressure is manifest and, with thisespecially in view, I present for consideration a pneumatictourniquet which, I think, will do aw-ay with some of the moreobvious dangers of the older form of tourniquet. In the Medical News, March 26, 1904, Dr. Harvey Gush-ing calls attention to a pneumatic tourniquet, which he haddevised, based upon the well-known armlet
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