Reprinted from the MEDICAL RECORD, February 9, 1895. 
AN ELASTIC TOURNIQUET. 
By JOHN C. SCHAPPS, M.D., 
SURGEON TO DEPARTMENT OF ORTHOPEDIC SURGERY AND JOINT DISEASES, ST. 
mary’s hospital, Brooklyn, n. y. 
The instrument is a modification of the ordinary rub- 
ber tube in that each end is closed by a large ball of 
the same material vulcanized in. The gap formed by 
the edges is neatly filled, and the seam smoothly fin- 
ished. Lodgement for dirt is thus avoided. The tube 
should be about half an inch in diameter, with a thin 
wall (about No. 16 gauge). A length of three feet will 
answer for almost any case, though for hip-joint ampu- 
tation in a stout subject a longer one will be necessary, 
and for the limb of a small child a shorter one will be 
more convenient. The object of the balls, or knobs, is 
to make the instrument self-fastening. No clamp or 
tie of any kind is necessary. It may, therefore, be very 
rapidly applied,*and with such little skill as to be par- 
ticularly useful in emergencies. If it be drawn tightly 
and the ends simply tied together the balls will pre- 
vent their loosening. This, however, is not as rapid 
as the rolling hitch, or as that shown in the cuts. For 
the sake of clearness of method the tourniquet is 
represented as loosely put on. In actual use the first 
turn is stretched around the limb so that the last part 
of the turn crosses the first part a few inches from the 
knob (Fig. i). The limb is thus immediately con- 
stricted, and at the same time the ball, with the com- 
pressed air in the end of the tube, secures that end so 
that both hands are free for the application of turns 
2, 3, etc. These all cross the first part between the 
end A and the loop B, which is left uncovered and 
through which the last knob is thrust from below up- 2 
ward, and thus tightly grasped. In certain situations, 
as behind the Wyeth pins in hip-joint amputation, 
where the coils are piled on one another, it is necessary 
to have the loop B held out of the way. Should it not 
grasp the end tightly enough a pull on the first part, A, 
Fy1 
Fij 2. 
will make it fast. It will be frequently more conven- 
ient to leave free ends of several inches. In such 
cases the air contained in the tube prevents slipping. 
This instrument is made by Messrs. George Tiemann 
& Co., New York. 
498 Bedford Avenue, Brooklyn.