Gunshot Wounds

These may be punctured, contused, or lacerated. Round balls make a

larger opening than those which are conical. Small shot fired at a short

distance make one large ragged opening; while at distances greater than

3 feet the shot scatter and there is no central opening. The Lee-Metford

bullet is more destructive than the Mauser. The former is the larger,

but the difference in size is not great. The Martini-Henry bullet

w ighs 480 grains, the Lee-Metford 215, and the Mauser 173. Speaking

generally, a gunshot wound, unlike a punctured wound, becomes larger as

it increases in depth; the aperture of entrance is round, clean, with

inverted edges, and that of exit larger, less regular than that of

entrance, and with everted edges.



In the case of high-velocity bullets from smooth-bore rifles, including

the Mauser and Lee-Metford, the aperture of entry is small; the aperture

of exit is slightly larger, and tends to be more slit-like. There is but

little tendency to carry in portions of clothing or septic material, and

the wound heals by first intention, if reasonable precautions be taken.

The external cicatrices finally look very similar to those produced by

bad acne pustules.



The contents of all gunshot wounds should be preserved, as they may be

useful in evidence. A pocket revolver, as a rule, leaves the bullet in

the body.



Wounds inflicted by firearms may be due to accident, homicide, or

suicide. Blackening of the wound, singeing of the hair, scorching of the

skin and clothing, show that the weapon was fired at close quarters,

whilst blackening of the hand points to suicide. Even when the weapon is

fired quite close there may be no blackening of the skin, and the hand

is not always blackened in cases of suicide. Smokeless powder does not

blacken the skin. Wounds on the back of the body are not usually

self-inflicted, but a suicide may elect to blow off the back of his

head. A wound in the back may be met with in a sportsman who indulges in

the careless habit of dragging a loaded gun after him. If a revolver is

found tightly grasped in the hand it is probably a case of suicide,

whilst if it lies lightly in the hand it may be suicide or homicide. If

no weapon is found near the body, it is not conclusive proof that it is

not suicide, for it may have been thrown into a river or pond, or to

some distance and picked up by a passer-by.



A bullet penetrating the skull even from a distance of 3,000 yards may

act as an explosive, scattering the contents in all directions; but the

bullet from a revolver will usually be found in the cranium.



The prognosis depends partly on the extent of the injury and the parts

involved, but there is also risk from secondary hæmorrhage, and from

such complications as pleurisy, pericarditis, and peritonitis. Death may

result from shock, hæmorrhage, injury to brain or important nervous

structures.