gunshot wound to ribs/liver - late 19th cent.

Hopefully I've researched this enough for medically-knowledgeable people not to throw the book across the room, even found period sources with people (rarely) surviving similar injuries, but I might as well check here.

The unfortunate victim is a young woman, reasonably healthy, who is shot with a black-powder military rifle at fairly close range (mass firing squad). I have the bullet hitting a little below her right breast around the 8th rib or so, maybe the costal cartilage, which would put it at liver. That would cause a lot of bleeding - I assume it would take a while to be fatal? Would the bullet go through? She is wearing ordinary working-class clothing so probably a corset but not tight-lacing. I could have it deflected toward her side by one of the stays (spring steel), would that be more likely to cause it to lodge rather than exit?

Result I want is to have her be left for dead (the soldiers get attacked just after so they don't have time to double-tap/bayonet), be found some time later and barely survive. She's cared for by an experienced war nurse but there's no access to a doctor for at least several days. Antiseptics had been discovered only a few years prior so the nurse be sort of experimenting...maybe using vinegar or some other weak acid if they don't have phenol on hand? I would like her to eventually recover, though it would like take a while.

Anyway, I need to go ahead and write the damn thing and use what works for the story, but I want to keep things in the realm of plausibility.

Oh crap, I should probably do something else then. No bleu cheese or time travel Guns would be more powerful and so it should go through. I could be evil and have the bullet go in between the stays in front, but hit one in the back which traps the bullet or makes it bounce around.

I had something far less tasty in mind for the secret sauce. The place had a serious fly infestation (what do you expect when there's corpses left rotting in the summer heat?) so maggots could get into the wound and start munching on infected tissue. There's also the fact she's an uncooperative patient - I'd imagine getting drunk would be very bad?

I actually got the idea from Army case records from the Wild West, where the survivors were treated with carbolic acid which is what Lister used. So they could use that. I could have them try to get to a hospital - unfortunately it's the one where the army came through and killed everybody, but there should be supplies to salvage.

This character is in a life-threatening situation regardless. A less-serious wound could easily turn bad if I need it to, especially given a temporary breakdown of civilization.

ColoradoGuy said:

As an ICU doc I deal with a lot of liver injuries, generally from blunt trauma after motor vehicle accidents and the like. The bleeding from fractured livers is actually quite variable. These days only about 10% even get an operation, even for grade IV (the worst) injuries. Today a penetrating injury like your character's would be explored in the operating room, but even then the bleeding is variable. You could have it nick the liver and your scenario would be plausible enough to use. Believe me, weird stuff happens with trauma. Your main issue is that bullets cause blast injury to internal organs and tend to shatter things. But still, I think your scenario is fine. As long as the intestines aren't punctured the infection risk would be much less.

FWIW, these days we tend to leave bullets where they end up if digging them out would cause more injury. Back then they thought it was important to get the bullet out, which it isn't. Bullets are sterile by themselves -- infection comes from bits of clothing and such that get dragged into the wound.

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Thanks. How would the same injury be different if it was a stab wound instead of a gunshot? No blast issues but probably more infection - esp. for a bayonet that had been used on other people.

Marlys said:

Go to Google Books and read actual accounts by 19th-century doctors--I learned a ton there when I was researching my MC's battle wounds, most from the Civil War. I found discussions of various types of torso wounds, approximate survival percentages, individual cases and how the doctors treated them, whether the soldiers were taken directly for treatment or lay on the battlefield for a while, etc. etc.

Try search terms gunshot wound liver and set it to return only results from the 19th century. You can tinker with the search to narrow the time period down or to investigate other possibilities, but that should give you a good start. Seriously fascinating stuff.

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The Internet Archive also has a medical history library online, where I found this resource (browsing through it gave me the idea that this could be survivable, actually): https://archive.org/details/reportofsurgical00unituoft

It looks like the U.S. Army took to using carbolic acid as an antiseptic right after the Civil War - think of how many lives could have been saved if it had been discovered just a few years earlier. Note that there are sections on all kinds of injuries and operations, not just combat wounds (the STD section is downright horrifying), plus there's a whole section on arrow wounds that could be helpful for a lot of periods.

Thanks to all who responded.