The older the surgeon, the greater becomes his respect for a drop of blood. All cutting operations on the extremities should be bloodless ones, and all elsewhere as nearly so as possible. Every drop of blood saved is a safeguard against shock; and bloodless work permits the same speed and facility of dissection that one could employ on the dead body.
At one time Petit's tourniquet, or some other, similar in principle, was the chief means for accomplishing this end. In emergency a Spanish windlass, made by loosely knotting about the limb a towel or other strong piece of cloth and then twisting a stick in it until all circulation ceases, is equally effective. Later came the use of the Esmarch rubber bandage; and until within the past few years, was for a time in regular use among surgeons. With this the blood was entirely stripped from the limb. Beginning
DAWBARN RHM. THE TECHNIQUE OF BLOODLESS WORK. JAMA. 1901;XXXVI(6):357–359. doi:10.1001/jama.1901.52470060001001
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