The late nineteenth and early twentieth centuries were the height of European colonial activity in the Middle East. This was a period during which the British were involved in the affairs of Egypt and the Sudan as they formed alliances in the region for economic purposes. In 1820 the British and the Gulf-region sheikhs established economic pacts that would guarantee the British access to Gulf-region resources and in 1839 they annexed Aden. The British went to war with Iran in 1856 over rights of way to India and China through Iran and later, in 1907, England and Russia would vie for power in Iran and divide it for their interests. The Italians entered the Middle East also at the beginning of the 20th century, establishing presence in Libya through a series of campaigns over a twenty year period.
The French, in turn, gained control over Algiers in 1830 and also pressed into Lebanon in 1860. In 1881 the French established a protectorate in Tunisia and would through the northern gateway of Africa establish a presence in what are today the modern nations Senegal, Mauritania, Chad, the Republic of Congo, the Central African Republic, Niger, Guinea, Mali, Cote d’Ivoire, and Benin. France’s intention was to establish a firm east-west axis of control across the African continent in opposition to the British Empire’s north-south axis of power. The two imperial powers were at odds, though by 1904 the two had reached a series of agreements under the Entente Cordiale which eventually led the way for Britain to support France’s grab for Morocco as a French protectorate. Previously, in 1869, the French and British had collaborated with their financing to assist the Egyptians in construction of the Suez Canal. 
The colonies of the Middle East were exploited for their resources and their strategic location as well as for the wealth of their artistic traditions, brought back to Europe in the antiquities trade. Sometimes with the assistance of their hosts, the British and other European powers returned to their countries with cultural treasures 
Most of us think of using a tourniquet to stop bleeding in emergency situations. The device is often used in life saving measures but like many medical items it has an interesting history. The development of the tourniquet would not have been possible without the work of English surgeon William Harvey who deciphered the human circulation system in 1628. Jean Louis Petit developed the first tourniquet in 1718 to stop blood flow at surgical sites. His invention used a screw device to apply the pressure and he named it after the French verb tourner which means to turn.
Generally, Joseph Lister is credited as being the first to use a tourniquet apparatus to create bloodless surgeries in 1864. In 1873 a tourniquet was developed by Friedrich von Esmarch that did not use screws to stop the blood flow and was a popular device but was shown later to occasionally cause limb paralysis. In 1904 Harvey Cushing invented a device that used compressed gas to inflate a bladder similar to a blood pressure cuff that stopped the blood flow. His tourniquet could be removed quickly and decreased the instances of limb paralysis.
In 1908 August Bier developed a technique that employed two tourniquets to provide regional anesthesia to isolate a limb and then infuse it intravenously. This technique was refined as a single tourniquet application by Hamilton Holmes in 1963. Currently the two tourniquet technique is applied often and is commonly known as the Bier Block or Bier’s method. In the 1980s James McEwen developed a tourniquet controlled by microprocessors which has dramatically increased the safety of tourniquet use. The first patent for an electronically controlled device in the U.S. was issued to McEwen in 1984.
The use of emergency tourniquets to treat limb trauma are usually a last resort since they cut off blood to the affected area. This can kill the tissue below the tourniquet and lead to the loss of the limb if applied incorrectly. The history of the tourniquet is one of trial and error but we are fortunate enough to live in an age where medical science has made their use as safe and effective as possible.
Tags: 1864, 1873, 1904, 1908, 1963, 1980s, August Bier, Bier Block, Bier's Method, emergency tourniquets, Hamilton Holmes, Harvey Cushing, History of Surgery, History of the Tourniquet, James McEwen, Jean Louis Petit, Joseph Lister, limb paralysis, Surgical History, Tourniquet, William Harvey
