Danny Boyle once said that he wanted his audiences to leave the cinema with a "life-affirming" buzz. For some leaving a preview screening of the British director's latest tour de force, about an adventurer who amputates his arm with a multi-tool, it seems the abiding emotion may have been more akin to queasiness and a distinct wobbliness of leg.
Such is the explicit and realistic nature of the climactic limb-severing scene in 127 Hours, a retelling of the remarkable survival of the mountain climber Aron Ralston after he became trapped in a ravine in the wilds of Utah, that up to three filmgoers at the Toronto International Film Festival fainted at the film's unerring depiction of snapping bone and tendon.
Reviewers have been fulsome in their praise for the newest creation from Oscar-winner Boyle, whose previous films such as Trainspotting and Slumdog Millionaire have not shied from a gritty depiction of life in the less glamorous corners of Edinburgh and Mumbai.
But it seems the Briton may have excelled himself in his depiction of the moments when Ralston, delirious after more than five days' lying with his right forearm trapped by a boulder, used a second rock to break his radius and ulna bones before taking the less-than-razor-sharp blade of his multi-tool to his soft tissue and then finally snipping away his tendons with the pliers.
A critic for the movie industry website TheWrap.com, who witnessed the three faintings at a screening on Sunday night, wrote: "Make no mistake, the scenes of Aron Ralston taking off his own arm to free himself after a fall are among the most realistic of graphic gore ever put on film, and not for the faint of heart. You could clearly see people in shock, struggling to stay in their seats, working to get past the intensity of what was going on in front of them. The sequence is never gratuitous, just very realistic... These were clearly audience members who could not take it."
Ralston, who is played by Spider-Man star James Franco, survived his 2003 ordeal despite having to climb down a 65ft wall after the amputation and hike to alert the emergency services. He documented the saga in a book, Between a Rock and a Hard Place.
Fox Searchlight, the studio which made the film, was unavailable to comment on the audience responses, choosing instead to highlight the "standing ovations and rave reviews" for 127 Hours, which has become an early tip for the Oscars. Cinemagoers were not the only ones to be moved by the amputation scene. At a press conference following the Toronto screening, Ralston said: "The experience of the very gruesome arm-removing [was], like, 'Whoa, I can't believe we're watching this!' I was ecstatic to be getting out of there. And at that point, I'm sitting there in the theatre and I'm munching my popcorn."
Cinema's most shocking
Michael Haneke usually lets bad things happen off-screen but in Hidden he graphically illustrates the pain of Majid, one of the central characters, when, without warning or hesitation, he slits his own throat, causing blood to spurt everywhere and shocked viewers to look away in horror.
Robert De Niro and Christopher Walken play Russian roulette against each other twice. Their second match-up sees Walken shoot himself. It's the tension as much as the blood that is so disturbing.
The nine-minute scene in which Monica Belucci is raped in a murky subway is as unrelenting as it is brutal. Its length makes it almost unbearable to watch and caused many viewers to leave their seats and head for the exits.
It's just as excruciating to watch a seemingly innocent girl sit, waiting days for the telephone to ring, as it is to see her cut the feet off a businessman using piano wire in Takashi Miike's horror film.
American History X
When a neo-Nazi tells a man to "bite the curb" one suspects that something bad is about to happen, but it doesn't prepare anyone to see him stomping on his victim's head to crack his head and jaw open in a sickening display of mindless violence.