The Effect of the Application of Tourniquets on the Hemodynamics of the Circulation.

The treatment of acute left ventricular failure by morphine and venesection frequently produces as dramatic relief of symptoms as does the intravenous administration of glucose in a case of insulin shock. Cases which have not responded to morphine alone may recover promptly after the removal of from 500 to 800 cc. of blood. Many clinicians (1, 2, 3, 4) believe that pooling of blood in the extremities by means of tourniquets is as effective as phlebotomy in the treatment of left ventricular failure. While this is a widespread clinical impression, experiments demonstrating that a significant quantity of blood is pooled in the extremities by venous tourniquets are lacking. Without this knowledge there is no rational basis for comparing the efficacy of these two forms of therapy. The purpose of this study is, therefore, to measure the amount of blood pooled in the extremities by venous tourniquets and to determine whether this amount is sufficiently large to be of clinical significance. The dye method was used for the determination of the blood volume, and tourniquets were used to separate the blood circulating in the extremities from that of the remainder of the body.