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Jack Judah
09-17-2015, 08:07 AM
The MC in my Western gets shot in the face during a street fight. He survives the shooting, but is horribly scarred for life. This is a true story, but not one photo of the guy is known to exist. All we know for certain is that the scars were rather impressive.

The shot was fired at close range, penetrated the MC's left cheek, took out a chunk of his jawbone (and presumably a tooth or two), before exiting through the other cheek. There's no record of a long recovery period. Newspapers suggest he was arrested within days of the incident (you should have seen the other guy ;)), and spent at least one night in a jail cell. Which boggles my mind. I guess I'm soft, but I would imagine getting shot in the face to be pretty traumatic.

Weapon: .36 Remington Navy; Ammunition: ball; Range: Roughly 4 ft.

So, here are my questions:
1) If anybody out there has been that monumentally unlucky, I would of course like to hear from anyone who has experience a similar wound.
2. For the medicos out there: The story is set in the 1870s. What kind of medical treatment would that kind of wound receive?
3. What would the recovery time be for something like this?
4. I keep waffling on the possibility of powder burns. At that close of a range, and using black powder, I tend to think there may have been burning involved. Is that likely? Or way off?
5. Finally, and this is the most important: What kind of scarring would we expect from such a wound?

Thanks in advance, folks.

culmo80
09-17-2015, 09:51 AM
Your story reminded me of a Civil War General (I'm a Civil War Buff) who was shot through the face and survived: John Brown Gordon. Here's the snippet from Wikipedia:

Assigned by General Lee to hold the vital sunken road, or "Bloody Lane", during the Battle of Antietam (https://en.wikipedia.org/wiki/Battle_of_Antietam), Gordon's propensity for being wounded reached new heights. First, a Miniť ball (https://en.wikipedia.org/wiki/Mini%C3%A9_ball) passed through his calf. Then, a second ball hit him higher in the same leg. A third ball went through his left arm. He continued to lead his men despite the fact that the muscles and tendons in his arm were mangled, and a small artery was severed by this ball. A fourth ball hit him in his shoulder. Despite pleas that he go to the rear, he continued to lead his men. He was finally stopped by a ball that hit him in the face, passing through his left cheek and out his jaw. He fell with his face in his cap and might have drowned in his own blood if it had not drained out through a bullet hole in the cap. A Confederate surgeon thought he would not survive but after he was returned to Virginia, he was nursed back to health by his wife.

For the scarring, if you look at his main photo on Wikipedia, he has his head turned with his "good side" facing the camera, but you can still see his left cheek and how it is clearly sunken in from the wound.
Now, Brown was likely wounded by a larger caliber round than what you're talking about. He likely was wounded by a .57 caliber or .58 caliber minie ball, but the wound for your character would probably be similar.
Bullets in those days had a lower velocity than they do today. Getting shot back then would throw you back from the force of the impact, whereas today, a 5.56 is likely to pass right through you.

There might be powder burns. Sometimes when a man was shot at close range, his clothes could catch fire. There's no absolute on this one though.

Recovery. Brown required several months of recovery, but as you'll notice, he was wounded 4-5 times. There was another Confederate general who suffered a similar wound: Patrick Cleburne.

Cleburne served at the Battle of Shiloh (https://en.wikipedia.org/wiki/Battle_of_Shiloh), the Battle of Richmond (https://en.wikipedia.org/wiki/Battle_of_Richmond) (Kentucky), where he was wounded in the face when a minie ball pierced his left cheek, smashed several teeth, and exited through his mouth, recovering in time to participate in the Battle of Perryville (https://en.wikipedia.org/wiki/Battle_of_Perryville).

The time between the battles of Richmond and Perryville was only about 7 weeks.

Of course, I would assume medical care and treatment to be better in the east than out west (there were more doctors and hospitals in a place like Tennessee than, say New Mexico territory. So it depends on where your character is, exactly. And a general officer would get better care than a private soldier.

I can't comment on the type of care, but hopefully some of this has been useful.

Jack Judah
09-17-2015, 10:41 AM
Your story reminded me of a Civil War General (I'm a Civil War Buff) who was shot through the face and survived: John Brown Gordon.

Thanks much, from a fellow Civil War buff!

I remember the name. How can you forget a Confederate general named John Brown? But I don't think I ever knew he took one to the face. His wound sounds remarkably similar. I definitely see what you mean about the sunken cheek. And that was the entry wound. Whew. He was damned lucky!

Makes me wonder what the difference in scarring would be between the entry and exit wound. Especially if it took a piece of jawbone with it. That could get ghoulish quick.


Bullets in those days had a lower velocity than they do today. Getting shot back then would throw you back from the force of the impact

I keep trying to imagine being on the receiving end of that. Just the muzzle flash, smoke and noise alone would be enough to rock your world. The actual impact? I imagine it would be like literally getting kicked in the teeth by a mule.


There might be powder burns. Sometimes when a man was shot at close range, his clothes could catch fire. There's no absolute on this one though.

They sure did. That's what made me wonder if the heat would be sufficient to seriously burn someone at four feet. I've only shot black powder a few times. The fire and brimstone makes an impression. It's an experience when you're behind the gun. I can't imagine having front row seats to the fireworks.


There was another Confederate general who suffered a similar wound: Patrick Cleburne. The time between the battles of Richmond and Perryville was only about 7 weeks.

Seven weeks. These guys were dedicated, you've got to give them that.

My MC is in Pioche, NV. Apparently he spent the night after the shooting (and possibly the remainder of the day of) in a jail cell. There were two "surgeons" practicing in the town, so he would have had access to decent care, if behind bars. Glad it was him and not me.

Thanks for the leads. I appreciate it! They will be very useful.

Adversary
09-17-2015, 12:55 PM
Seven weeks. These guys were dedicated, you've got to give them that.


Well, when you're hard, you're hard. Might be a difficult thing to sell these days, as we are getting softer at a drastic rate, but back then, there was only so much the hospital could do for you, and again, if you're just goddamn hard, and there is still shit to be done, well, if the body allows (broken teeth/torn face hardly keeps a hard man from walking, fighting, shooting, etc.), you just fucking do it. Back then, the main limitation, and generally what kept the iron bastards from continuing on, was infection or disease. Even in horrid conditions, even back then, that could still be hit or miss. One guy gets sick, the other doesn't. Its certainly within your creative license to decide their fate, like in the stabbing thread. Write what you need. A bullet in the brain, on the other hand, is probably going to end the story for your MC pretty damn efficiently.

culmo80
09-17-2015, 03:34 PM
I have a replica Springfield 1861 rifled-musket. It's a blast to shoot! It does emit a lot of smoke and there's a bit of "flame" when the round leaves the muzzle.
I've been to a couple of Civil War reenactments (Chickamauga, and the 150 Manassas reenactment). It's really a sight to see a volley of a hundred or so muskets. I can only imagine what a couple thousand must have looked like.

King Neptune
09-17-2015, 04:15 PM
It might not leave all that much of a scar. Take a look at pictures of Sir Richard Francis Burton, the soldier, writer, and diplomat. He wasn't shot through the face, but he took a spear through the left cheek, and I think it went through the right but not very far. He spent a while running around holding the spear until he got help removing it; the point was barbed. That happened in Somaliland in the 1840's. At the time he and hius expedition were waiting for a British ship that was supposed to carry them to Zanzibar.

https://en.wikiquote.org/wiki/Richard_Francis_Burton

WeaselFire
09-17-2015, 04:52 PM
First, what do you need for your story? The wound was survivable, scarring could be variable. Black powder burns don't leave scars, maybe pock marks but nothing significant. But scarring depends on flesh tears, missing parts and how they fit back together when healed. Do you need a specific description, general marking or something in between? Write it and you'll likely be believable.

As for healing time, most of the issue is wound care. No major arteries so we're just talking infection possibilities. Keeping the wound clean, changing dressings and potentiall;y using poultices would prevent major healing issues. Provided he can get reasonable feeding during recovery of the jaw, broths and soups would be fine, he can heal withing 6 weeks to being able to use his jaw and gte around, upt o a year for full recovery, minus any lasting debilitations you need to give him for your story line.

Jeff

Katharine Tree
09-18-2015, 06:19 AM
When we were in high school, a friend's sister was shot in the face while sitting on their grandmother's front porch in the woods. A hunter thought she was a deer. Unfortunately I know nothing about her recovery or scars ...

Fortunately, you have a lot of leeway in how you imagine this turning out. It could be anything from a few days of grotesque swelling followed by a few weeks of inability to eat solid food--this would be if his jaw was fractured but healed in place--to literally missing everything from the cheekbone down on one side of his face. Such injuries happened and people lived with them for years. The inside of the mouth, tongue, palate etc. were exposed. I'd guess these people took care to keep their mouths hydrated, kept a dribble-cloth close by, and had some trouble eating, but *shrug*.

One note is that in the 19th century, a lot of food was softer than it is now. Jokes about grandmas cooking vegetables to death? It was to accommodate people with tooth pain and many missing teeth. If you read a Victorian cookbook, most of the vegetable recipes are essentially baby food. So in a settled-up place (not like Nevada) it wouldn't have been hard for a person missing half his face to find food he could eat without chewing. Out on the frontier, though ... well. I guess there were overcooked beans? And cornmeal mush?

Missing half one's jaw would probably prevent a person from speaking intelligibly, too. I'd go with the minimal scarring scenario, for a MC. Ugly cheeks. Upper and lower teeth don't engage the way they should. Slurs his words.

About treatment: my knowledge tends more toward the general "bush medicine" stuff rather than specifically 19th century, but ... best case scenario, the wound would be cleaned and bound with fresh bandages regularly. Willow bark tea was a popular analgesic and anti-inflammatory, though it's also an anticoagulant, so a doctor might be judicial with it in the early stages of recovery. I'd guess that the inside of his injured cheeks would be packed with gauze, at least at the beginning. Also, this is the 19th century, so need I say laudanum, laudanum, laudanum? It's constipating, don't forget that.

You might look up the case of Alexis St. Martin (https://en.wikipedia.org/wiki/Alexis_St._Martin), a man who was shot in the stomach (and survived) in the early 19th century. His doctor wrote an account of the case and probably talks about treatment. The Wikipedia entry even says "After bleeding him and giving him a cathartic, Beaumont marked St. Martin's progress." So there's that. Maybe you can find the rest on Gutenberg or Google Books?

Jack Judah
09-18-2015, 07:33 AM
Well, when you're hard, you're hard. Might be a difficult thing to sell these days, as we are getting softer at a drastic rate. . .

True, true, and true. It's the believability, or lack therof, that worries me. I guess I shouldn't complain. You know you've found an interesting story when you keep having to tone down the truth in order to keep the audience's disbelief suspended. This afternoon, I was doing more research on the incident. Apparently he spent the night of the shooting in jail, IN THE SAME CELL as the guy who shot him. The town wits thought that was hilarious, especially when the newspaper reported that the two had "refused to get along" over the course of the evening. So yeah, "iron bastard" sums up the type nicely.

Jack Judah
09-18-2015, 07:46 AM
I have a replica Springfield 1861 rifled-musket. It's a blast to shoot! It does emit a lot of smoke and there's a bit of "flame" when the round leaves the muzzle.
I've been to a couple of Civil War reenactments (Chickamauga, and the 150 Manassas reenactment). It's really a sight to see a volley of a hundred or so muskets. I can only imagine what a couple thousand must have looked like.

A 'bit' of flame? And just a bit of a mule kick too, I bet.:D Never fired a period muzzle loader. Only modern stuff. I bet that is a lot of fun. The smoke is the thing that always sticks with me when I shoot anything blackpowder. And they say the old powder was even smokier than what we have today. Really is amazing anybody could hit a bull in the butt once the shooting started.

I'm jealous, never made it to a reenactment. I can't imagine what a couple thousand firing in volley would sound like. You'd feel that all the way down to your toes, I think. My second grade teacher was a reenactor. Both she and her husband were part of the cast of Gettysburg. Her husband was one of the guys in Armistead's brigade. I imagine that was about as close to the real thing as anybody could get. I always remember her face when she talked about watching them film Pickett's Charge.

Jack Judah
09-18-2015, 07:52 AM
It might not leave all that much of a scar. Take a look at pictures of Sir Richard Francis Burton, the soldier, writer, and diplomat. He wasn't shot through the face, but he took a spear through the left cheek, and I think it went through the right but not very far. He spent a while running around holding the spear until he got help removing it; the point was barbed. That happened in Somaliland in the 1840's. At the time he and hius expedition were waiting for a British ship that was supposed to carry them to Zanzibar.

https://en.wikiquote.org/wiki/Richard_Francis_Burton

I did not know that. I didn't think it was possible, but he just got that much cooler. Unfortunately, I can't cop out and have my MC's scars heal too much. All the sources agree, after the shooting, he was one scary looking SOB.

Jack Judah
09-18-2015, 07:58 AM
The wound was survivable, scarring could be variable. Black powder burns don't leave scars, maybe pock marks but nothing significant. But scarring depends on flesh tears, missing parts and how they fit back together when healed...

As for healing time, most of the issue is wound care...he can heal withing 6 weeks to being able to use his jaw and gte around, upt o a year for full recovery, minus any lasting debilitations you need to give him for your story line. Jeff

I didn't realize powder burns wouldn't scar. Really glad you mentioned that before I wrote a few key scenes. Six weeks to be up and around, and a year for full recovery matches his timeline perfectly. Thanks!

Jack Judah
09-18-2015, 08:16 AM
When we were in high school, a friend's sister was shot in the face while sitting on their grandmother's front porch in the woods. A hunter thought she was a deer. Unfortunately I know nothing about her recovery or scars ...

My God. I hope they caught the son-of-a-bitch and threw the book at him.




Fortunately, you have a lot of leeway in how you imagine this turning out. It could be anything from a few days of grotesque swelling followed by a few weeks of inability to eat solid food--this would be if his jaw was fractured but healed in place--to literally missing everything from the cheekbone down on one side of his face. Such injuries happened and people lived with them for years. The inside of the mouth, tongue, palate etc. were exposed. I'd guess these people took care to keep their mouths hydrated, kept a dribble-cloth close by, and had some trouble eating, but *shrug*.

This paragraph is a gold mine. Thank you! Definitely going to use the dribble-cloth idea.


One note is that in the 19th century, a lot of food was softer than it is now...Out on the frontier, though ... well. I guess there were overcooked beans?

So he was a flatulent drooler. No wonder the guy had an attitude problem! As for the soft food, don't forget matzah ball soup. He was a Jewish gunfighter after all.;)


Missing half one's jaw would probably prevent a person from speaking intelligibly, too. I'd go with the minimal scarring scenario, for a MC. Ugly cheeks. Upper and lower teeth don't engage the way they should. Slurs his words.

I've been toying with the idea of a speech impediment. I'm a bit worried about unintended comic effect, though. I'll have to ponder this'n for a while.


I'd guess that the inside of his injured cheeks would be packed with gauze, at least at the beginning. Also, this is the 19th century, so need I say laudanum, laudanum, laudanum?

Laudanum is definitely going to have a role to play in his arc. And later, Opium straight from the pipe.


It's constipating, don't forget that.

You're forgetting the beans.


You might look up the case of Alexis St. Martin (https://en.wikipedia.org/wiki/Alexis_St._Martin), a man who was shot in the stomach (and survived) in the early 19th century. His doctor wrote an account of the case and probably talks about treatment.

I just had to click on that while I was eating. :scared::tmi

King Neptune
09-18-2015, 04:06 PM
I did not know that. I didn't think it was possible, but he just got that much cooler. Unfortunately, I can't cop out and have my MC's scars heal too much. All the sources agree, after the shooting, he was one scary looking SOB.

Don't go wild with scarring. Burton's scar is clearly visible in the top photo on the page I linked. If he'd worn a beard, then it would have almost been covered. Speech problems from missing molars are minor.

culmo80
09-18-2015, 04:55 PM
Reenactments are interesting to be sure. At Chickamauga, there were no Union soldiers, only Confederates, so it was a one-sided battle ... again. At Manassas, there were two sides, but it was blazing hot...at least a 100 and humid. My wife worked as a medic and they were busy all weekend long treating these guys for heat-related injuries.

At both reenactments, the volleys were like a dull roar that you felt. But its the artillery that you really feel in your chest.

I'm an alumnus of VMI. I was a cadet there when they were filming Gods and Generals (the prequel to Gettysburg). They had to cover up the statue of Stonewall and cover the streets with dirt.
One of the things done at VMI is to have the rats (new cadets) march a bit of the ways to New Market and then form a line of battle on the field where on May 15, 1864, the VMI cadets became only the third military school in history to become an actively engaged military unit. Charging across that field, with modern-day 105s blasting away ... man, it was intense, but it was such a rush. I know it wasn't even close to being like how it was in 1864 (none of us died, of course), but I really got a feel for what it must have been like.
And we did give a rebel yell, or at least what we assume it to have been like!

culmo80
09-18-2015, 04:58 PM
A spear wound and a heavy caliber pistol ball wound wouldn't be similar. For one thing, the force of either weapon isn't even close. A spear might hit the cheek bone and be deflected into softer tissue. A ball will shatter that bone and keep moving.
As I posted earlier, you can see the wound sustained by John Brown Gordon in his wikipedia page. Clearly, his cheek is deformed, even with a beard.

GeorgeK
09-18-2015, 08:53 PM
I'm a retired surgeon and have taken care of GSW's. I also used to be a Civil War reenactor and got shot in the face by a farb from about 4 feet away (reenactors will know what farb means)

The powder wounds didn't scar but they did do some tattooing which most people simply mistake as freckles. The worst part initially was that the powder was still burning until I got a canteen of water and poured it over my face. There were also a lot of eye dr appointments and a few days of bandages and not knowing if I'd be able to see when they took off the bandages. Mine was a black powder blank from a revolver (don't know what type) front on, not at an angle, not from the side. Your character was shot from the side and so probably would have been spared the eye injuries.

If the character's entry wound is cheek to cheek it would depend on the trajectory whether it nicked the jaw, broke the jaw or took out any teeth. A Navy 36 black powder revolver, unless it was overloaded probably would not go through the other side if it hit the main part of the jaw, assuming a healthy jaw (and granted that could be a big assumption), so presumably it just nicked the jaw, which if it was the lower par of the jaw probably wouldn't take out any teeth, but it could have been the lower part on one side and the upper part on the other. The good thing is that mouth wounds actually tend to heal pretty well in terms of surviving although there would be scarring. When I was a kid one of my neighbors had taken a bayonet in WW2 in a cheek to cheek fashion and he basically had big pits in either cheek

GeorgeK
09-18-2015, 08:59 PM
A ball will shatter that bone and keep moving. .That depends on the weapon used and the strength of the bone that it hits. Black Powder weapons for the most part (especially including revolvers) will be low velocity rounds and a 36 doesn't have all that much mass.

GeorgeK
09-18-2015, 09:02 PM
Speech problems from missing molars are minor.Especially in the 1800's when it was more common to encounter people who'd lost teeth

King Neptune
09-18-2015, 09:52 PM
And we did give a rebel yell, or at least what we assume it to have been like!

There is a sound movie of some elderly Confederate veterans giving Rebel yells. If you are ever inclined to gave one again, then you probably should check it out.
https://www.youtube.com/watch?v=s6jSqt39vFM

Jack Judah
09-19-2015, 02:49 AM
Reenactments are interesting to be sure. At Chickamauga, there were no Union soldiers, only Confederates, so it was a one-sided battle ... again.

Hey now, there were two sides showed up the first time. Only one brought real generals is all.


At Manassas, there were two sides, but it was blazing hot...at least a 100 and humid. My wife worked as a medic and they were busy all weekend long treating these guys for heat-related injuries.At both reenactments, the volleys were like a dull roar that you felt. But its the artillery that you really feel in your chest.

Maybe it's because I'm from a dry climate, but Eastern summers are borderline intolerable to me -- and that's in jeans and a t-shirt. I cannot imagine going through real exertion under the conditions they did, buttoned up in wool like they were.


I'm an alumnus of VMI. I was a cadet there when they were filming Gods and Generals (the prequel to Gettysburg). They had to cover up the statue of Stonewall and cover the streets with dirt.

Didn't know they filmed those scenes on location. I was one of the few who actually enjoyed the movie (barring the wooden acting, ridiculous dialogue, and terrible matte backgrounds). Then again, as a kid, I wore out several VHS copies of Gettysburg, so I desperately wanted to see Gods and Generals succeed. Mainly so I could see Last Full Measure on the screen. Don't think there's any hope of that now, though.


One of the things done at VMI is to have the rats (new cadets) march a bit of the ways to New Market and then form a line of battle on the field where on May 15, 1864, the VMI cadets became only the third military school in history to become an actively engaged military unit. Charging across that field, with modern-day 105s blasting away ... man, it was intense, but it was such a rush. I know it wasn't even close to being like how it was in 1864 (none of us died, of course), but I really got a feel for what it must have been like.

That would be something to experience. I envy you your alma mater. Lot of history in those halls.

Have you seen Field of Lost Shoes yet? I've heard good things about its portrayal of New Market. Had it in my Netflix cue for weeks, keep meaning to watch it.

Jack Judah
09-19-2015, 03:13 AM
I'm a retired surgeon and have taken care of GSW's. I also used to be a Civil War reenactor and got shot in the face by a farb from about 4 feet away (reenactors will know what farb means)

You are definitely the guy I needed to talk to then. Thanks for responding!


If the character's entry wound is cheek to cheek it would depend on the trajectory whether it nicked the jaw, broke the jaw or took out any teeth. A Navy 36 black powder revolver, unless it was overloaded probably would not go through the other side if it hit the main part of the jaw, assuming a healthy jaw (and granted that could be a big assumption), so presumably it just nicked the jaw, which if it was the lower par of the jaw probably wouldn't take out any teeth, but it could have been the lower part on one side and the upper part on the other.

I've done some digging since my OP. Was able to find a portion of the doctor's report cited in another source: "The doctor found that 'the ball which struck Levy entered a little to the right of the chin, glancing around and fracturing the lower jaw bone before lodging in the muscles of the lower neck.'"

The ball in the neck was news to me. Assuming it went through the cheek, off the jaw bone, what kind of damage are we talking about to his neck? Also. . .I feel like this is a case of conflicting reports. He couldn't have an exit wound in the cheek if the round ended up lodged in his neck, right?

Jack Judah
09-19-2015, 03:16 AM
Don't go wild with scarring. Burton's scar is clearly visible in the top photo on the page I linked. If he'd worn a beard, then it would have almost been covered. Speech problems from missing molars are minor.

It really isn't that bad, all things considered. I'm surprised. When I picture a spear wound, I expect more damage than that. Either he was ridiculously lucky, or. . .Actually I can't think of an or here. He WAS ridiculously lucky.

King Neptune
09-19-2015, 03:37 AM
It really isn't that bad, all things considered. I'm surprised. When I picture a spear wound, I expect more damage than that. Either he was ridiculously lucky, or. . .Actually I can't think of an or here. He WAS ridiculously lucky.

Lucky? I don't think so. If he'd been lucky, then someone else would have caught the spear. He was healthy and healed well. I believe that it had a simple spearpoint with barbs on the back, and it made a fairly smooth entry, and it was eventually pushed through, so the barbs didn't rip his face up. Imagine a machete going through your mouth from side to side, and it would be similar. Sew up the outside carefully and feed carefully for a few weeks, and it would be healed.

Katharine Tree
09-19-2015, 06:35 AM
The human body is amazingly good at healing from simple slice-type wounds, provided they don't get infected. Just this morning I was trying to find a particular 4" surgical scar on myself, and couldn't.

Infected wounds, wounds that are repeatedly re-opened, wounds that are missing tissue and can't close adequately, burns ... that's the stuff that scars badly.

GeorgeK's note about black powder "tattooing" is a really nice detail to keep in mind. I had heard of that before, but didn't remember it.

Also, if that bullet was lodged in his neck, there's a fair chance they just left it there. It might gradually migrate elsewhere and eventually, years later, surface and just pop out.

GeorgeK
09-19-2015, 09:47 PM
You are definitely the guy I needed to talk to then. Thanks for responding!



I've done some digging since my OP. Was able to find a portion of the doctor's report cited in another source: "The doctor found that 'the ball which struck Levy entered a little to the right of the chin, glancing around and fracturing the lower jaw bone before lodging in the muscles of the lower neck.'"

The ball in the neck was news to me. Assuming it went through the cheek, off the jaw bone, what kind of damage are we talking about to his neck? Also. . .I feel like this is a case of conflicting reports. He couldn't have an exit wound in the cheek if the round ended up lodged in his neck, right?Unfortunately, "a little to the right of the chin," is not proper medical terminology and so I can't be sure what it means. My guess is that they are looking at a left profile of the patient's face and that the bullet broke the jaw under canine or the premolar and then followed the inside curve of the jaw to redirect the trajectory and have the bullet lodge in the right side of the neck. It's not unusual for bullets to do such things. They don't really ricochet per say inside a body but when they enter a fascial plane at an acute angle they can be redirected by the fascia.

Jack Judah
09-20-2015, 02:57 AM
GeorgeK's note about black powder "tattooing" is a really nice detail to keep in mind. I had heard of that before, but didn't remember it.

Oh yes. Definitely going to be substituting it for the burn scars I'd initially intended. It's the kind of detail that adds an immediate sense of realism. Not to mention a chance for some symbolism to creep in. A budding gunfighter tattooed by gun powder in his first shoot-out? Talk about the Mark of Cain!


Also, if that bullet was lodged in his neck, there's a fair chance they just left it there. It might gradually migrate elsewhere and eventually, years later, surface and just pop out.

That's what I've been trying to find out. Records are an issue, they were lost in an explosion and/or fire a few months later. Yep. It was that kind of town. There doesn't seem to be any record of an extraction. Then again, digging bullets out of people was not an uncommon occurrence in the time and place, so it may not even have been noted if they did.

If they left it, I do feel like there's something clever to be done with the idea of him carrying around lead from his first fight.

Jack Judah
09-20-2015, 03:07 AM
Unfortunately, "a little to the right of the chin," is not proper medical terminology and so I can't be sure what it means.

I had a feeling you were going to comment on the remarkable specificity of the description. What's really funny is that, according to my source material, that's an exact quote from the doc's written report for the inquest. Makes you wonder if the good doctor's handiwork was any better than his record keeping.


My guess is that they are looking at a left profile of the patient's face and that the bullet broke the jaw under canine or the premolar and then followed the inside curve of the jaw to redirect the trajectory and have the bullet lodge in the right side of the neck.

So you're thinking it entered through the left cheek, then went through the mouth into the neck without leaving a visible exit wound? Just want to clarify that there would not, in fact, be an exit wound on the right cheek. I imagine I'm sounding like a fairly dim bulb at this point.

Jack Judah
09-20-2015, 03:13 AM
Lucky? I don't think so. If he'd been lucky, then someone else would have caught the spear.

A valid point.

You're right, whoever did the sewing must really have known what they were doing.


Imagine a machete going through your mouth from side to side, and it would be similar.

Ouch. Sounds like a new origin story for the Joker!

GeorgeK
09-20-2015, 02:49 PM
I had a feeling you were going to comment on the remarkable specificity of the description. What's really funny is that, according to my source material, that's an exact quote from the doc's written report for the inquest. Makes you wonder if the good doctor's handiwork was any better than his record keeping.



So you're thinking it entered through the left cheek, then went through the mouth into the neck without leaving a visible exit wound? Just want to clarify that there would not, in fact, be an exit wound on the right cheek. I imagine I'm sounding like a fairly dim bulb at this point.

That was also a point in history when it wasn't unusual for surgeons to not also be physicians. Surgery used to be the realm of the best of the best from Barber college. That is why medical diplomas in the US will say Physician and Surgeon because way back when, they were separate. Most likely the surgeon in question in your source was one of the old timers and that's why he didn't use proper medical terminology. So, in the big scheme of things, I'm not surprised at all.

I doubt that the bullet ever actually entered the mouth cavity or it would have lodged in the palate, back of the throat or exited the opposite cheek. It probably tracked just along the inside of the jaw bone, so yeah, no exit wound and the only visible scarring would be at the entry point. In general, assuming a bullet doesn't perforate part of the GI tract, GSW's tend not to be at any greater risk of infection than any other wound. The bullets themselves are, "clean," due to their temperature, so a stab wound from an obviously dirty blade is more likely to abscess than a bullet wound. For that reason it is also not necessary generally to get the bullet out. Basically if it's convenient, yeah grab it, if not then leave it unless it's in some particularly nasty place but with the technology of the time they'd have no way to tell that and would do far more damage looking for it as opposed to leaving it alone

Jack Judah
09-21-2015, 08:14 AM
I doubt that the bullet ever actually entered the mouth cavity or it would have lodged in the palate, back of the throat or exited the opposite cheek. It probably tracked just along the inside of the jaw bone, so yeah, no exit wound and the only visible scarring would be at the entry point.

Glad I asked. Now I've got a fairly firm idea of the picture I've got to draw for the reader. Doc GeorgeK, you're aces in my book. I appreciate the help!

CWatts
09-21-2015, 02:58 PM
[snipped so not to spread misinformation further]

GeorgeK
09-21-2015, 09:49 PM
In this scenario, the guy could still be disfigured beyond the actual entry wound. Maybe his broken jaw doesn't heal properly? True

Damage to his facial muscles and skin tension could make the scar "pull" into a strange expression, or nerve damage could paralyse that side of his face.

For the classic example of doing more damage digging for the bullet, that's effectively what killed Pres. Garfield in 1881: https://en.wikipedia.org/wiki/James_A._Garfield#Treatment_and_deathNo not really. Wikipedia is not your friend. The motivations of people to edit wikipedia regarding medicine are not...honest or forthright. They may be people honestly believing that they know what's going on, but that does not mean that they know. People in the field either don't have the time to bother or get fed up with the hacks who keep changing things back to fiction.

The facial nerve exits the skull under the eye orbit and then spreads out to cover the muscles. This entry wound is on the jaw. There's really not much muscle in the area of question for this injury. There theoretically could be injury to arteries, but that's an area that has collateral circulation so likely would heal. It might not, in the big scheme anything is possible when you talk about the individual. It is theoretically possible there could be damage to the nerves regarding the tongue (not at the entry site, but as the bullet enters the neck) so it's reasonably plausible that he could develop a speech impediment, possibly even trouble swallowing things so that he may be able to eat soup, but not a steak. It's also plausible he could have a disfiguring result where there is basically a hole where the canine or premolar was which may or may not heal with a fistula from the mouth to the outside jaw even if the original injury did not actually enter the mouth cavity. With such an injury he'd probably essentially drool out the fistula or if it was large enough maybe dribble chewed food out of it, but paralysis of the facial muscles above the jaw? No, simply no. That's impossible unless he's the one human on the planet who's wired so radically different than anyone else. Venous anomalies are not all that unusual. Arterial anomalies are rare, but common enough that a good surgeon looks for them. Neurological anomalies outside of the central nervous system are pretty dang rare with only a few exceptions and the chin ain't one of them.

Also your link is not in regard to the original injury but rather iatrogenic injury which was not the question. I also already said that going around digging for bullets is dangerous and unnecessary.

Jack Judah
09-22-2015, 02:41 AM
Originally Posted by CWatts http://absolutewrite.com/forums/images/buttons/viewpost-right.png (http://absolutewrite.com/forums/showthread.php?p=9568704#post9568704) In this scenario, the guy could still be disfigured beyond the actual entry wound. Maybe his broken jaw doesn't heal properly?



I like that idea a lot. Adds more depth to the "look". Thanks!

And don't worry about the Wikipedia thing. I've been led down some pretty funny rabbit holes on there myself.

Jack Judah
09-22-2015, 02:45 AM
Wikipedia is not your friend...They may be people honestly believing that they know what's going on, but that does not mean that they know. People in the field either don't have the time to bother or get fed up with the hacks who keep changing things back to fiction.

Boy is that the truth. It's not just in the medical entries either. Some of the history articles on there are astoundingly wrong. It's to the point where I only chance wikipedia when I'm having a paranoid moment, and fact checking something in a subject I already know well.


It is theoretically possible there could be damage to the nerves regarding the tongue (not at the entry site, but as the bullet enters the neck) so it's reasonably plausible that he could develop a speech impediment, possibly even trouble swallowing things so that he may be able to eat soup, but not a steak. It's also plausible he could have a disfiguring result where there is basically a hole where the canine or premolar was which may or may not heal with a fistula from the mouth to the outside jaw even if the original injury did not actually enter the mouth cavity. With such an injury he'd probably essentially drool out the fistula or if it was large enough maybe dribble chewed food out of it

This is gold. Thanks again, Doc!

cmhbob
09-22-2015, 02:56 AM
Here's a Youtube video of a guy shooting an 1858 Remington, although he doesn't specify caliber. He fires three rounds at a paper target, then the camera zooms in long enough for you to see the powder debris on the target.

https://www.youtube.com/watch?v=KK6Qr7qmSvY

Jack Judah
09-22-2015, 03:13 AM
Here's a Youtube video of a guy shooting an 1858 Remington, although he doesn't specify caliber. He fires three rounds at a paper target, then the camera zooms in long enough for you to see the powder debris on the target.

https://www.youtube.com/watch?v=KK6Qr7qmSvY

Wow. That paper looked like it'd taken a good dose of bird shot. I did not expect that much pitting. Thanks for the vid!