208 MR. COSTELLO ON THE TORSION OF ARTERIES. 
of the artery. Of the application of ice and temporary ligatures 
I need say nothing. 
The operation of torsion has in its effects great analogy to the 
ligature, and seems capable of supplanting the ligature in many 
cases. It is simple, and in saying this we give it the highest 
recommendation that can be bestowed on a surgical process. 
The merit of its invention belongs, undoubtedly, to M. Amussat, 
and would, if he had no other of his numerous claims to fame, 
suffice to render his name illustrious amongst the surgeons of 
the present age. As I have said before, there is nothing new in 
crisping, jagging, or even turning on its axis, a divided artery, 
in order to stop hemorrhage; for from the time of Galen to our 
own time, this process was known, but the operation of torsion, 
—in the sense which is now attached to the word torsion, me¬ 
thodical in its arrangement and certain in its effects,—is an en¬ 
tirely new and most valuable hsemostatic process. 
M. Amussat having observed that in gunshot or contused 
wounds, or in great lacerations of the limbs, even large vessels 
rarely bleed, imagined, that by imitating this contusion of the 
vessel, the same effect must follow. In order to test this idea, 
he instituted a series of experiments, which, however, led to no 
decisive result. But he was struck on one occasion, in which 
he had twisted the artery, with the fact, that it furnished no 
blood; and thus an accident developed the truth which his rea¬ 
soning from other facts had anticipated. 
I shall now describe the manner in which M. Amussat prac¬ 
tises torsion. He seizes the divided vessel with a pair of torsion 
forceps, in such a manner as to hold and close the mouth of the 
vessel in its teeth. The slide of the forceps shuts its blade, and 
the artery is held fast. The artery is then drawn from out of the 
tissues surrounding it, to the extent of a few lines, and freed, 
with another forceps, from its cellular envelop, so as to lay bare 
its external coat. The index and thumb of the left hand are then 
applied above the forceps, in order to press back the blood in the 
vessel. He then begins to twist the artery. One of the methods 
consists in continuing the torsion until the part held in the for¬ 
ceps is detached. When, however, the operator does not intend 
to produce that effect, he ceases, after from four to six revolu¬ 
tions of the vessel on its axis for the small arteries, and from 
eight to twelve for the large ones. The hemorrhage instantly 
stops. The vessel which had been drawn out is then replaced, 
as the surrounding parts give support to the knot which has 
been formed at its extremity. The knot becomes further con- 
cealed by the retraction of the artery, and this retraction will be 
