206 
ON THE TORSION OF ARTERIES FOR THE PUR¬ 
POSE OF ARRESTING HEMORRHAGE. 
By W. B. Costello, Bsq. y London. 
[Communicated to the Westminster Medical Society , Feb. 8, 1834.] 
It was originally my intention, in bringing the subject of the 
torsion of the arteries under the notice of the Westminster Me¬ 
dical Society, to state merely what I had seen of that process 
during a visit which I have lately made to Paris; and to express, 
in addition, my gratitude to M. Amussat, for his kindness in 
directing the experiments I then performed, under his eyes, on 
this interesting point. But in meditating on the subject, I have 
found it so deserving of an ample expose in this country, that I 
have resolved upon giving such a view of it as will connect it 
with the other haemostatic processes now in use in surgery, most 
of which are of very high antiquity. 
The arrestation of the current of blood, according to that ex¬ 
cellent observer, Jones, depends on the formation of a conical 
clot in the arterial tube ; on the retraction and contraction, or 
puckering, of its extremity, and on the pressure of the parts 
surrounding the cut end of the vessel. When these causes are 
sufficient, as they often are, to stop hemorrhage from small ves¬ 
sels, of course all other means are dispensed with. Koch, of 
Munich, is in the habit of relying on this spontaneous ceasing 
of the flow of blood, and favours it by the position of the limbs, 
in cases of amputation, as well as by the application of cold 
lotions. 
Hemorrhage is also stopped by laceration. Of this we have 
an example in the removal of certain tumours, where the vessels 
that supply them, or with which they are connected, might for¬ 
bid the use of the knife. When a limb is torn off, the vessels 
which have been drawn violently out retract in some degree, and 
no blood flows. In this we have an instance of the influence of 
laceration and retraction combined. It is well known, that w hen 
" littering/’ certain animals separate themselves from their 
young by gnawing asunder the umbilical cord; and Jones has 
shewn, that, if an artery be pinched and jagged, the internal 
tunics are torn, and assist the formation of the clot, and pre¬ 
vent hemorrhage. 
Again, if a small divided artery be drawn out, and turned 
down on itself, until the clot has had time to form, the blood 
ceases to flow r . This method has been successful in the inter¬ 
costal artery, and others of small caliber. Styptics of various 
kinds and in various modes have been used for the same purpose. 
