To the Editor:—
The paper by Speigel and Lewin in The Journal, October 6, contributes valuable information on the neglected subject of tourniquets, which admittedly was not fully settled by my research because of obstacles encountered. The following remarks may assist toward clarifying some points:
The described nerve lesions were evidently not due to asphyxia within the time (one and one-half hours) mentioned by the authors but were evidently due to direct pressure. The location of neuromas and other details indicate that the tourniquet application was of the old-fashioned kind, namely a rather broad tube of poor elasticity wrapped two or more times around the limb in separate turns. This method combines the evils of narrow and of broad tourniquets. My use of a narrow, highly elastic tube in two superimposed turns is not customary and has never been proved to cause permanent paralysis or contracture.