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View Full Version : A bullet wound and an arm injury (17th century setting)



Faide
09-13-2011, 01:07 AM
All right, I'm working on a swashbuckling mannerpunk/low fantasy, time period based on mid 17th century Spain. Some of the major players get wounded, and I don't know enough about medicine/anatomy to accurately wound them, so I have a few questions. Better to ask than to screw up. Without further ado:

- One is shot in the back from a roughly 50-60 meter distance; I'm not sure where--somewhere that looks fatal, but isn't fatal enough to kill him, as he's supposed to survive. How long will it take for him to recover (assuming the wound doesn't get infected and so on), and how badly will this cripple him, if at all? Also, if he's shot in a tricky spot, would the bullet be pulled out or not?

- For another, I need a wound or two (sword/dagger, not bullet) that'll limit the use of his sword arm and maybe the neck as well. Would a deltoid/biceps cut do it for just the arm, or should I go for the shoulder/back instead? Mainly thinking about the infraspinatus, maybe the teres minor/major here, and of course the trapezius. Again, how fatal, and how long would it take to recover sufficiently?

- Lastly, especially for the last one, would the doctor stitch the wound up, just clean and bandage it, or apply some sort of poultice?

Thanks in advance.

Anne Lyle
09-13-2011, 01:20 AM
For a serious but not fatal wound, a bullet that penetrates a lung would cause pneumo-thorax - potentially fatal but also potentially recoverable. At least, that was the advice I was given here when I wanted to have someone survive a fatal-seeming rapier wound. Of course the tip of a rapier would not damage ribs, unlike a bullet, and leaves no metal behind either. Maybe a shattered shoulderblade is more plausible? Hard to tell at a distance if the bullet has entered his ribs or not. Or just below the ribcage would perhaps be better - a lucky shot on the target's left side could clip through flesh without hitting any major organs, but again, the shooter isn't going to know how badly hit the target is.

Black-powder projectiles are relatively slow, so hydrostatic shock is much less of a problem. The main issue is avoiding arteries, like the one in the armpit, and bones - splinters will make healing next to impossible, I would think. I can't see how you could get shot in the infraspinatus/teres area and not break bones, which would be very nasty.

I went for the trapezius - "through and through", as they say on CSI - when I wanted my hero to be shot badly enough to lose the use of one arm temporarily but something that could easily be patched up.

I imagine the doctor would stitch it if possible (depends on the size of the wound and the potential to re-join the skin) - not sure about poultices, as my hero has access to non-historical healing :)

Drachen Jager
09-13-2011, 01:32 AM
I would say the ball would have enough punch to go straight through, so no need to worry on THAT account.

HOWEVER, those muskets were not like modern firearms. If someone shoots you with an M-16, using military ammo and it goes straight through, missing any major organs, well you'll be hurting, but you'll recover. After all, the bullet is only .223 inches and doesn't expand on impact. Muskets in that era were .5 - .8 inches, and the soft lead balls tended to fragment or mushroom on impact, causing wound channels 50% larger than the bullet diameter.

I just don't see how a person could be shot straight through the body and survive with seventeenth century medicine. I suppose if it grazed his head he might survive, that would provide enough blood to make most observers believe he's dead, especially if his hat covers the wound, they might just assume it had killed him.

Some doctors would use boiled wine or spirits to disinfect a wound, but most antibiotics were based entirely on folklore, so it was very hit and miss. Depends on the doctor and his education.

Drachen Jager
09-13-2011, 01:41 AM
For a serious but not fatal wound, a bullet that penetrates a lung would cause pneumo-thorax - potentially fatal but also potentially recoverable. At least, that was the advice I was given here when I wanted to have someone survive a fatal-seeming rapier wound.

A rapier leaves a quarter-inch hole with very little tissue damage. A musket leaves a half inch or larger hole, where the flesh is literally ripped away through the wound channel and the explosive force of the impact causes a temporary wound cavity often ten or twenty times the size of the projectile.

See this video http://www.youtube.com/user/BarnesBulletsLLC to give you an idea of what happens as a bullet passes through flesh. It's nothing like a rapier, or an arrow.

Anne Lyle
09-13-2011, 02:34 AM
True - I realised there would be a big difference after I started writing my reply!

Of course we haven't even gotten to the issue of cloth fragments being driven into the wound...

http://tudorstuff.wordpress.com/2009/09/25/the-musket-use-in-battle-a-dreadful-injury/

That's one big f-off bullet!

Anne Lyle
09-13-2011, 02:40 AM
Also this:

"Although musket wounds were less common than sword wounds they were much more likely to be fatal. When musket shot hit pike staffs it sent jagged wooden splinters flying deep into the nearby bodies. On entering the body musket balls also shattered bones turning the fragments into internal missiles. When travelling at full velocity heavy musket balls made an entry wound about half an inch wide. Musket balls were poorly cast and often tumbled through the air describing a spiral path. This spiral often continued in some poor unfortunate's body - a deep spiralling wound is almost impossible to clean. Bits of bone or teeth from those struck often wounded those next to them in the ranks. In addition musket wounds almost invariably turned gangrenous. There were two reasons for this - firstly the ball often had bits of dirty cloth wadding adhering to it and in any case would take scraps of the victim's clothing deep into the wound. Secondly as well as puncturing flesh and smashing bone the musket ball also crushed the flesh around the entry wound bruising it. This had the effect of sealing blood vessels - musket wounds did not bleed very much - but the crushed flesh would die and rot unless cut away. Sometimes a whole limb would have to be cut away."

http://www.marquisofwinchesters.co.uk/Ecwr-Guidelines/Guildelines-Playing-Wounded.html

Basically, you just don't want to get shot, full stop.

Drachen Jager
09-13-2011, 02:46 AM
Basically, you just don't want to get shot, full stop.

Well, that goes without saying. But if you HAD to be shot, you'd be far better off picking a modern military firearm than a 17th century musket. They had shorter ranges, less accuracy and far slower rates of fire, but they pretty much dropped whatever was in their path.

When I was in the army I talked to a medic once who said that part of their training was to watch some of the worst-case scenarios for bullet wounds, one instance, from Vietnam told of a soldier who was shot in the chest, the vacuum left behind by the bullet sucked his dogtags right into the wound.

Anne Lyle
09-13-2011, 02:57 AM
Unfortunately you don't get the option of picking modern weapons when writing historical-based fiction!

Oh, and sorry, Faide, I overlooked the bit about the second wound being a blade, not a bullet. With blades, you have much more control over the size of the wound. I would reckon a long slice across the bicep would incapacitate his arm temporarily but not bleed excessively, and would be fairly straightforward to stitch up. Cuts are easier to clean than stab wounds, by a long chalk.

Or the muscles over the shoulderblade, as you suggested - having had a a major abdominal operation (Caesarian) many years ago, I can attest that sliced-open muscles severely limit your movement, even after they've been stitched!

Faide
09-13-2011, 02:16 PM
I severly underestimated the damage a musket can do, I see. Well, that certainly opens for a lot of fun scenes, and the first guy should be happy, as he now won't get shot--he'll be stabbed instead :)

Thanks a lot, both of you--this has been immensely helpful.

Anne Lyle
09-13-2011, 02:26 PM
You're welcome! Of course, now I'm worried I'll get emails complaining that my hero should have died of the musket wound he sustains *sigh*

...wanders off, hoping she can tweak it in the galleys before it goes to press...

boron
09-13-2011, 06:26 PM
A shot at the very top of the upper back would likely damage some muscles, bones and quite likely the axilary artery or vein.

A shot in the middle of the right side of the upper back would damage the back and chest wall muscles and cause the right lung to collapse (pneumothorax). In the 17th century, this collapse would be neither detectable nor curable, so permanent. Such a pneumothorax by itself does not necessary cause much pain or bleeding or anything, and would only slightly affect breathing, since the left lung can do all the job. However, due to a slightly changed positions of the ribs and other bones and joints, the person would likely experience moderate pains that would likely interfere with sleeping and limit raising the right arm and turning the upper torso left and right, probably for several weeks.

Speaking from the experience of having (only) spontaneous pneumothorax...so...if you copy-paste the above in your book and I read it, I would hardly believe you. There would be likely some infection of the skin with abscessing, infection of the lung with coughing, fever, and quite possibly some broken rib with 6 weeks of the movement-limiting pain.

Faide
09-13-2011, 07:07 PM
You're welcome! Of course, now I'm worried I'll get emails complaining that my hero should have died of the musket wound he sustains *sigh*

...wanders off, hoping she can tweak it in the galleys before it goes to press...

Good luck :D


if you copy-paste the above in your book and I read it, I would hardly believe you.

No worries--I'll do more research and adapt it to the setting. Thanks a lot, though, it's a good starting point.

I've moved away from him being shot (after having seen that video Drachen Jager linked to and read the articles linked to by him and Anne) and I'll have him stabbed instead.

WriteKnight
09-13-2011, 11:59 PM
Yeah, I wouldn't shoot someone in center mass in a 17th century setting and expect any kind of survival odds. "Knicking or grazing" a limb... maybe. In your case, I'd leave off the body shot if he has to survive.

I've seen a blade pass through upper arm/shoulder and come out the other side. "Through and through" - It bled pretty well, though the audience thought it was fake. He was taken to ER, cleaned and stitched. Funny - the ER doc cleaned the entry, but missed the exit wound - as it was smaller. He didn't miss it for long, as it kept bleeding. The blade was exactly one inch wide at the widest - with a tapered point of course. Not particularly sharp - which didn't count for much. (No, it wasn't me who delivered or received the wound - but the sword is next to my desk.)

GeorgeK
09-14-2011, 12:12 AM
Well, that goes without saying. But if you HAD to be shot, you'd be far better off picking a modern military firearm than a 17th century musket. They had shorter ranges, less accuracy and far slower rates of fire, but they pretty much dropped whatever was in their path.

When I was in the army I talked to a medic once who said that part of their training was to watch some of the worst-case scenarios for bullet wounds, one instance, from Vietnam told of a soldier who was shot in the chest, the vacuum left behind by the bullet sucked his dogtags right into the wound.

You do realize that your two paragraphs contradict each other? Modern weapons including all hunting and military rifles and some handguns are high velocity. Those will produce a shockwave inside the body and damage far more than a slow velocity musket. Some are even designed to tumble upon inpact making the bullet bounce around all sorts of places you wouldn't expect. With a low velocity wound, you might have a bullet get lodged in the paraspinal muscles and never penetrate the chest. However, if the person loading the musket uses a double charge you can get speeds that when combined with the mass of a 58 caliber can approximate high velocity. Getting shot through the chest with ANYTHING is probably going to kill you, high velocity or not. 17th century physicians would also do things like make poultices out of manure, so of course the wounds got infected.

Stopping power is something else and has to do with energy tranferred. A bullet that stops inside you is transferring all of it's energy to you and like getting slugged in the gut will likely take you off your feet. That is very different than the amount of damage that is being inflicted. It is a separate issue.

I helped take care of a guy who was the victim as he drove past, a pedestrian open fired. The paramedics brought the head rest for some reason, probably evidence and we were amazed that the wounds weren't worse. The headrest was blown apart, yet when we operated to debride, instead of finding bits of bullets what we found were the screws from the headrest knocked into the patient by the force of impact by the bullets on the headrest.

Anne Lyle
09-14-2011, 12:26 AM
Modern weapons including all hunting and military rifles and some handguns are high velocity. Those will produce a shockwave inside the body and damage far more than a slow velocity musket.

Exactly. My impression is that a musket shot to the torso that misses the heart is unlikely to kill immediately, whereas a high-powered modern gun could potentially do so through shock alone. OTOH a black-powder weapon is more likely to produce a messy wound that's next to impossible to treat successfully with contemporary medicine.

Either way you really don't want to be shot in the torso - the main difference is in how long you live afterwards.

Drachen Jager
09-14-2011, 01:03 AM
GeorgeK

The 'tumbling on impact' thing is a myth. All bullets do it sometimes, but it's not consistent. That was just one of the ways they 'sold' soldiers on the stopping power of the 5.56mm and the story carried on.

Muskets in those days had muzzle velocities below what rifles today have, but more than pistols. Average muzzle velocity was about 1,200 - 1,800 whereas today it's 900 - 1,200 for pistols and 2,000 - 3,000 or so for rifles. But the difference beween being hit by a non-expanding 5.56 mm projectile and an expanding 18mm projectile is simply huge.

On the Thornily scale, the musket has a stopping power of 253, whereas a 7.62 mm rifle has only 104 and a 5.56 has a rating of 40.

There is no question the musket will do more damage than a modern military firearm, presuming the same shot placement.

GeorgeK
09-14-2011, 03:02 AM
GeorgeK

The 'tumbling on impact' thing is a myth. All bullets do it sometimes, but it's not consistent. That was just one of the ways they 'sold' soldiers on the stopping power of the 5.56mm and the story carried on.

Muskets in those days had muzzle velocities below what rifles today have, but more than pistols. Average muzzle velocity was about 1,200 - 1,800 whereas today it's 900 - 1,200 for pistols and 2,000 - 3,000 or so for rifles. But the difference beween being hit by a non-expanding 5.56 mm projectile and an expanding 18mm projectile is simply huge.

On the Thornily scale, the musket has a stopping power of 253, whereas a 7.62 mm rifle has only 104 and a 5.56 has a rating of 40.

There is no question the musket will do more damage than a modern military firearm, presuming the same shot placement.

I think that I've taken care of more bullet wounds, been hit by more and inflicted more than you. You are so horribly wrong that I'm putting you on ignore. There are several reasons that modern militaries no longer use black powder. None of them are that they are less effective at killing.

Drachen Jager
09-14-2011, 03:29 AM
And how many musket wounds have you treated?

Let's just say I'll defer to the scientists on this one, and you can stick with anecdotal evidence of one half of the debate.

Anne Lyle
09-14-2011, 03:37 AM
Pistols at dawn, boys? :)

HarryHoskins
09-14-2011, 03:39 AM
Pistols at dawn, boys? :)

Daughter of a bitch stole my line. :)

Drachen Jager
09-14-2011, 03:51 AM
Sorry, I get my back up for anti-science. The subject has been extensively studied, but he prefers his own incomplete experience over hundreds of scientific studies.

I'm sure he's very experienced with treating modern gunshot wounds, but unless he's also a time-traveller he can't possibly have the experience to render an expert verdict on this one. Considering his inability to competently render an opinion on the subject his 'horribly wrong' comment is more comedic than serious. I hope he does put me on ignore.

Kitti
09-14-2011, 04:38 AM
I didn't read through the entire thread, so maybe someone's already raised this point, but technically your character would be treated by a surgeon (or a military surgeon) NOT a doctor/physician - they practiced totally different types of medicine in the 17th century.

Anne Lyle
09-14-2011, 04:45 AM
Good point, Kitti - surgery and general practice were completely different disciplines. Surgeons were not doctors (is this why surgeons are still referred to as Mr?) - though given the parlous state of medical knowledge in this period, a good field surgeon probably had a better chance of saving your life!

Cath
09-14-2011, 04:51 AM
Hoo boy, how did this get out of hand?

Ok, ignore is the way to go if you don't like what another member is saying.

Drachen, George has taken himself out of the argument. I'd appreciate if you do the same.

Faide
09-14-2011, 11:45 AM
In any case, I leave the musket for the characters that'll be killed or need to amputate a few limbs.


Yeah, I wouldn't shoot someone in center mass in a 17th century setting and expect any kind of survival odds. "Knicking or grazing" a limb... maybe. In your case, I'd leave off the body shot if he has to survive.

I've seen a blade pass through upper arm/shoulder and come out the other side. "Through and through" - It bled pretty well, though the audience thought it was fake. He was taken to ER, cleaned and stitched. Funny - the ER doc cleaned the entry, but missed the exit wound - as it was smaller. He didn't miss it for long, as it kept bleeding. The blade was exactly one inch wide at the widest - with a tapered point of course. Not particularly sharp - which didn't count for much. (No, it wasn't me who delivered or received the wound - but the sword is next to my desk.)

Ouch. Just curious--did that impact on the movement of his arm in any way (pardon my awkward phrasing, it's a bit early)


I didn't read through the entire thread, so maybe someone's already raised this point, but technically your character would be treated by a surgeon (or a military surgeon) NOT a doctor/physician - they practiced totally different types of medicine in the 17th century.

My bad--we generally refer to any medical person as doctor (dentist or vet, it doesn't matter--it's a doctor!) in my dialect, and I tend to do that in English as well. But thanks for pointing out--I need to be more conscious of that.

Anne Lyle
09-14-2011, 02:19 PM
My bad--we generally refer to any medical person as doctor (dentist or vet, it doesn't matter--it's a doctor!) in my dialect, and I tend to do that in English as well. But thanks for pointing out--I need to be more conscious of that.

In modern-day settings, "doctor" is perfectly valid - a surgeon has gone through medical school, same as any other doctor, but specialising in surgery. However prior to the 18th century:

"Surgery had a lower status than pure medicine, beginning as a craft tradition..." (from Wikipedia)

http://en.wikipedia.org/wiki/History_of_surgery#Western_hemisphere

Military surgeons (field surgeons) had a lot of practical knowledge, hampered mainly by a complete ignorance of the causes of infection.

Kitti
09-14-2011, 04:23 PM
Did some poking around through my reference books this morning, to see if I could shed more light on the latter part of your question ("would the doctor stitch the wound up, just clean and bandage it, or apply some sort of poultice"). Alas, didn't find any medical treatises specifically on this sort of wound treatment, but I'm certain there would be stitches involved and probably a poultice - for instance, they understood that sugar was good for disinfecting small wounds, so they had some concept of disinfectant in wound management. There's apparently a very good book on military hospitals in early modern France by Brockliss and Jones which might give you specific info wound treatment.

More concretely, I found that the first permanent military hospital in Spain was founded in the 16th c (Pamplona). "Spain's preparations for the Armada included a medical staff of over eighty surgeons and two fully fitted hospital ships." Alas, the surgeons didn't get to be called don until the 1740s, which is after your time period. And, to further quote Lindemann, "It was in the military hospitals, with their strict organization and orderly regimen, that hospital medicine first arose. Most patients were available for experimentation; surgeons and physicians were able to make bedside observations undisturbed; and plenty of corpses could be postmortemed. Medicine, and especially surgery, flourished in the military hospitals and some of the greatest contributions to the surgical and medical literature of the day came from the circle of military surgeons..." (This from her Medicine & Society in Early Modern Europe, which is a good primer on medicine but doesn't have a ton on military medicine.)

WriteKnight
09-14-2011, 09:50 PM
Regarding the injury to the arm... he was able to use the arm, but with some discomfort. He tried to immobilize it most of the time, simply resting it in a sling. But a week later, he was on horseback riding with it. He could NOT wield a sword effectively however, and swapped hands to fight with his left hand, and use his right hand for reining the horse. It was probably three weeks before he could fight with the arm again.

It was lifting the arm, high over head for parries and such - that was particularly painful for the first weeks.