Fig. 99.—The horse-shoe tourniquet.
In Signoroni’s Horse-shoe tourniquet (fig. 99) the extremities of the shoe can be approximated to each other by a rack screw working a hinge. The ends are furnished with pads, one broad and flat to bear on the limb away from the artery, the other rounded to compress the vessel itself. This tourniquet does not arrest the whole circulation in the limb. It can therefore be applied for a longer time than Petit’s. However, it easily slips out of place, and soon becomes very irksome and painful.
Fig. 100.—Lister’s tourniquet for compressing the aorta.
The Abdominal Tourniquet of Professor Lister is a very effectual contrivance for compressing the aorta during amputation through the hip joint, and operations where a tourniquet cannot be placed on the limb. It consists (see fig. 100) of a semicircular bar, with a broad pad to fit on the lumbar vertebræ behind, while in front it holds a long screw-pin carrying a pad. This instrument passes round the left side, and its pad is forced down into the abdomen, one inch to the left of the umbilicus, until the aorta is compressed against the spine.
Fig. 101.—Carte’s tourniquets for femoral aneurism.
Carte’s Tourniquets (fig. 101) are employed to control and diminish the flow of blood through an aneurism. They are intended to be worn for several days, and are fitted with many contrivances for obtaining a continuous pressure on the artery without completely arresting the flow of blood. They are always used in pairs; in the figure, one presses the external iliac on the pubes, the other the femoral artery. The first is fastened to the body round the hips, the second round the thigh. They are constructed as follows: an arm attached to a pad reaches round the limb to the artery, over which it supports a ball and socket joint turning in any direction, but fixed by a screw clamp. This joint has a long screw carrying the compress down to the artery. There is a little play of the screw in the ball of the joint, controlled by india-rubber bands, that the compress may yield slightly before the arterial pulse. In the solidification of an aneurism by this means, the flow of the blood is intended to continue; hence the current through the vessel need not be completely obstructed by the pressure of the tourniquet, and the elastic bands prevent that pressure from becoming insupportable.
Fig. 102.—An improvised tourniquet.