Tourniquet

“ Behind the cottage we found a soldier with his left leg torn to fragments. He had lost a great deal of blood, and he was still bleeding from a large artery, in spite of the efforts of a number of soldiers round who were applying tourniquets without much success. The ordinary tourniquet is probably the most inefficient instrument that the mind of man could devise—at least, for dealing with wounds of the thigh out in the field. It might stop haemorrhage in an infant, but for a burly soldier it is absurd. ”

“ In fact, in the second case, the tourniquet itself was left behind."
"Yes," Hewitt replied, "I loosened it myself—but, unfortunately, I was too late."
"Well, now," Peytral went on, "in Hayti, in my time, Mayes's enemies had a habit of dying suddenly in the night, by strangulation, and a tourniquet was always the instrument. And just as murder was quite a popular procedure in that accursed place, so strangulation by tourniquet became for a while the most common form of the crime. It was rapid, effective, and silent, you see. ”

“ A tourniquet should never be applied tighter or left on longer than is absolutely necessary.
The screw tourniquet of Petit is to be preferred when it is desired to intermit the flow through the main artery as in operations for aneurysm.
When a tourniquet cannot conveniently be applied, or when its presence interferes with the carrying out of the operation--as, for example, in amputations at the hip or shoulder--the haemorrhage may be controlled by preliminary ligation of the main artery above the seat of operation--for instance, the external iliac or the subclavian. ”

“ Bleeding may also be stopped to some extent by elevating the wounded part. A tourniquet may be improvised by using the compress, running a stick or the bayonet through the band, and taking up the slack by twisting. ”

“ A tourniquet is a common thing enough—no more than a band with screw fittings, and there was nothing to show that the tourniquet used was any different from a thousand others; and I can see no particular reason why a doctor should commit a murder like this any more than any other man ”

“ Just as I was in the act of falling, a number of our fellows, seeing what had happened, rushed up and carried me hastily into the camp hospital, where a tourniquet was applied and the doctor sent for. The time was then a quarter-past three, and the doctor did not arrive till after seven o’clock. I rather fancy if an accident of that sort had occurred in an English prison camp containing over four hundred German officers, it would not be necessary to wait almost four hours before the arrival of a qualified doctor.
At the best of times a very tight tourniquet is distinctly uncomfortable. ”

“ With the limb still elevated the tourniquet is firmly applied, a part being selected where the vessel can be pressed directly against a bone, and where there is no risk of exerting injurious pressure on the nerve-trunks. The tourniquet should be applied over several layers of gauze or lint to protect the skin, and the first turn of the tourniquet must be rapidly and tightly applied to arrest completely the arterial flow, otherwise the veins only are obstructed and the limb becomes congested. In the lower extremity the best place to apply a tourniquet is the middle third of the thigh ”

“ He will cause a sufficient number of tourniquets, or temporary substitutes for them, to be distributed to such men of the different divisions, and in each top, as may be appointed to receive them; and he will take care that the persons in his division, and such others as the Captain may direct, are instructed in the use of tourniquets, to prevent, as far as possible, any dangerous loss of blood before the Surgeon or his Assistants can attend to wounded men. ”

“ A tourniquet, which will stop the blood for a time, is made by tying a strong thong, string, or handkerchief firmly above the part, putting a stick through, and screwing it tight. If you know whereabouts the artery lies, which is the object to compress, put a stone over the place under the handkerchief. The main arteries follow pretty much the direction of the inner seams of the sleeves and trousers. ”

“ All this can, under ordinary circumstances, be avoided by the use of the scalp-tourniquet. As used by Cushing it consists of a rubber ring fashioned after the style of an Esmarch’s tourniquet, encircling the head and passing from the lower frontal region in front, above the ears, to the lower occipital region behind. A median tape, passing from glabella to occiput, prevents any tendency for the tourniquet to slip down over the eyes, at the same time acting as a convenient landmark for the superior longitudinal sinus. ”

“ The tourniquet is held steady till he is firmly fixed, with each of his feet resting on one of the side ropes, and his hands clasping the centre one; and then he is left to make his way to the prizes at the other end. As long as he can keep himself exactly balanced all is well; but the least pressure more to one side than the other, destroys the equilibrium, and round goes the tourniquet.
Footnote 4: Be it remarked, that this is not entirely the case. In all parts at France frogs are still in high repute. The snail, escargot, is a favourite food of the people of Lorraine ”

“ The patient holds the arm out tensely while lying down and when the artery is tapped the blood spurts out rapidly. A tourniquet is applied to the upper arm when the medicine man thinks enough blood has flowed and the medicine man then sucks out the residue. ”

“ This rude tourniquet {225} may save life not unfrequently, by enabling the injured person to be transported even for some distance without fear of further bleeding." Position is a very important consideration in wounds, the bleeding sometimes being at once arrested by raising the injured limb above the level of the body. ”

“ The operator now seats himself on the stool just vacated by the dresser, who has carried away the leg, and seeks in the cut surfaces before him the end of the main artery on which to place a ligature. There is no flow of blood, only a little oozing, for the tourniquet holds life’s current hard and fast. Only five minutes’ uncontrolled flow of the current from that great artery now so perfectly compressed, and our patient’s career in this world would be closed for ever. ”

“ His mates were kept employed filling fresh cartridges to replace those discharged. The surgeon, with his assistants, prepared the cockpit for the wounded, making ready a number of tourniquets and pledgets for first intentions. A number of tourniquets were distributed about the gun-decks for use by the men who carried down the wounded. As a final preparation, the ship’s hatches were tripped up, so that the men could not run below to the security of the orlop-deck. The small fore and after hatches were left standing, to allow the powder-boys and messengers to pass down. ”

“ In a few seconds the gun muzzle is raised, and projects through its port-hole. When the object and distance are named, the captain of the turret takes aim, and then follows, in more or less rapid succession, ‘Elevate,’ ‘Depress,’ ‘Extreme elevation,’ or the reverse, ‘Ready!’—‘Fire!’ when the Thunderer is shaken to her centre, and twelve pounds ten shillings sterling go groaning uselessly into the deep, or crashing terrifically through the armour-plates of an unfortunate enemy. ”

“ When the pilot of an Aviatik launched himself to the rescue, all the ammunition of my carabine was exhausted. I had one cartridge left in my automatic revolver, and not a single bomb with which to return the compliments of the German's mitraille. My petrol-tank had been perforated. My single bullet missed him. The duel was too unequal, so I withdrew from the field, leaving him to cavalier the Flying Pig. We may meet again upon terms more equal, when French military aviators fight with machine-guns. And now to business. ”

“ H.M.S. DREADNOUGHT FIRING A BROADSIDE OF 12-INCH GUNS
But look inside this massive gun-hood, from which protrude forty feet of two sleek grey monster cannon, each of which is capable of hurling 850 pounds of steel and high explosive a distance of a dozen miles. Grouped round their guns in various attitudes are the bluejackets forming their crews. They are tanned and weather-beaten fellows, but there is a strained and tired look about their eyes. Here in the confined spaces of their turret they have eaten, slept, and whiled away the watches as best they might for many, many hours. ”

“ When your hand moves, it'll be as fast as the jump of a spark! And when that hand moves, the gun is going to come out clean in it. It's got to come out with it! You hear? It's got to! Your fingertips catch under the butt; they flick up. They don't draw the gun; they throw it out of the holster; they pitch the muzzle up, and the butt comes smack back against the palm of your hand. And in the same part of a second you pull the trigger. ”

“ On the afternoon of May 31st, we were doing gun drill in my turret. Suddenly came an order to put lyddite into the guns and follow the Control. During the next two hours as the battle developed we saw nothing. We were just parts of a big human machine intent upon working our own little bit with faultless accuracy. There was no leisure to think of anything but the job in hand. From beginning to end I had no suggestion of a thrill, for a naval action in a turret is just gun drill glorified, as I suppose it is meant to be. The enemy is not seen; even the explosions of the guns are scarcely heard. ”

“ The working of the gun, including all the operations of loading and sponging, is effected by means of hydraulic pumps, which are all operated by one small steam-engine. The gun is placed with its trunnions resting on two heavy blocks of metal, which, being retained by guides, slide on large beams or girders built in the floor of the turret. In front and rear of the blocks are pistons, working in cylinders in the direction of the floor-beams. These pistons, under the influence of water-pressure, move the gun in and out of battery. The breech is raised and lowered by similar means. ”

“ Instantly the men spring up, the breech is thrown open, a jet of water is sent along the barrel, and another shell is thrown in. Meanwhile the officer in command of the barbette calls out, "Stand by for No. 2 gun." When No. 2 gun has been fired the telephone bell rings, and the voice from above is heard to say, "Both miles wide; try to hit something next time." "We are here to fire the gun, not to range it," mutters the captain of the turret as he makes a few hasty calculations and some adjustments. "Both guns at once, dead line ahead," comes the next [192] order. ”

“ To one who has lived in a wardroom a score of questions were on the tongue’s end. The turret is the basket which holds the precious eggs. A turret out of action means two guns out of action; a broken knuckle for the pugilist.
Constructors have racked their brains over the subject of turrets in the old contest between gun-power and protection. Too much gun-power, too little armour! Too much armour, too little gun-power! Off the Virginia capes we have pounded antiquated battleships with shells as a test, with sheep inside the turrets to see if life could survive. ”

“ By night all bayonets are to be fixed, and 50 per cent of the men on duty in the trenches are to be sitting on the firing platform with their rifles by their sides.
6. In case of an attack, especially at night, it should be impressed on the men that they should fire low; for one bullet that goes too low, at least 90 go too high. A bullet that goes too high is wasted, whereas a bullet that goes too low is a ricochet and is often more dangerous than any other kind of bullet. ”

“ The right-hand barrel of my gun for Turner himself; the left-hand barrel for the man next to him: such was the calculation; and then, if I still survived, I had the sword and the pistol left. Long deliberation under such circumstances is neither possible nor necessary. Both hammers were up, my finger was on the trigger, murderers were before, and the next instant I should have fired at any risk, and at any odds. ”

“ Neither vessel was able seriously to injure the other, and not a single shot penetrated the armour of either. The “Monitor” had the advantage of being able to out-manœuvre her heavier and more unwieldy adversary; but the revolving turret made firing difficult and communications were none too good with the pilot house, the position of which on the forward deck lessened the range of the two turret-guns. The machinery worked so badly that the revolution of the turret was stopped. After two hours’ fighting, the “Monitor” was drawn off, so that more ammunition could be placed in her turret. ”

“ What is the remedy? Why, have two ports in the turret for each gun, one on the level above the upper deck for firing, the other on a level below that deck for loading, by depressing the muzzle of the gun. ”

“ I'd say you hit his stomach with the third shot, and his right shoulder with the other. The can is of no moment, for cans are not dangerous; but when I show you how to reload, I want you to aim at the can, as if it were the buckle of a belt. You take to that Colt like a duck takes to water--and before you get home today you'll surprise yourself. Now, to eject the empties and to reload--and by the way, Miss Saunders, if I were you, carrying that gun as you must carry it, I'd leave one cartridge out, and let the hammer rest on the empty chamber. ”

“ The introduction of the breech-loader enabled the guns to be loaded in greater security, with greater speed, and without interfering with the aim or training of the gun, thereby rendering a more rapid fire possible. Ammunition hoists brought the charge and projectiles right into the turret or barbette more expeditiously and with greater precision than the best-drilled crew, and the men had simply to load the weapon and fire it. The human element came in here, however, in all its uncertainty, and, in spite of the greatest possible care, accidents occurred. ”