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Bullet and flesh – unequal opposition.

The first theory, why a bullet wound had such severe consequences (even if it did not kill immediately), was the thought of poisoning the tissues with lead and gunpowder. This is how they explained the severe bacterial infection of the wound channel, which was usually treated with hot iron and boiling oil. The suffering of the wounded from such “therapy” was repeatedly amplified up to a lethal pain shock. Nevertheless, by 1514, scientists were able to distinguish five properties of a gunshot wound: adustio, contusion, attrition, fractura and venenum. The barbarous technique of pulling out bullets and pouring boiling oil was only broken in the middle of the 16th century in France.

Surgeon Pare Ambroise in 1545 during the next battle faced an acute shortage of boiling oil for the wounded – some soldiers had to simply bandage. Not hoping for their recovery, the unfortunate, Pare after a while checked the bandages and was surprised. The wounds were in a much better condition relative to those who had enough “saving” oil. The Frenchman also denied the idea that the bullet during the flight is heated and further burns human tissue. Ambroise conducted, probably, the first experiment in wound ballistics, firing bags with wool, a pack and even with gunpowder. Nothing flared up and exploded, so the theory of burn effects was rejected.

Surgeon Pare Amboise
Surgeon Pare Amboise

 

The history of mankind provides a very extensive material for physicians and scientists to investigate the bullet impact on the flesh – in three centuries the largest were the Thirty Years ‘War of 1618-1648, the Seven Years’ War of 1756-1763, the military campaigns of Napoleon 1796-1814. and other small carnage.

One of the first full-scale tests of the action of the bullet on an object similar to human flesh was conducted by the Frenchman Guillaume Dupuytren in 1836. The military surgeon fired corpses, boards, lead plates, felt and found out that the gunshot has a funnel-like shape, facing a wide base to the outlet. The conclusion of his work was the thesis that the size of the output holes will always be greater than the input ones. Later (in 1848) this idea was challenged by the Russian surgeon Nikolai Pirogov, who, on the basis of his extensive experience and observations of the wounds of soldiers during the siege of the village of Salta, pointed out that the “Dupuytren effect” is possible only when a bullet hits the bone.

"NI Pirogov examines the patient DI Mendeleyev" I. Quiet
“NI Pirogov examines the patient DI Mendeleyev” I. Quiet

 

A piece of lead during this process deforms and breaks nearby tissues. Pirogov proved that when the bullet passes only through soft tissue, the outlet is always smaller and already entering. All these results of observations and experiments were valid for the middle of the XIX century – on the battlefields were dominated smooth-bore muzzle-loading guns with a round low-speed bullet (200-300 m / s).

A small revolution was made in 1849 by the Mignet bullet of a cone-shaped form and a noticeable higher flight speed. The hit of such a bullet in a man caused very serious damage, very reminiscent of the effect of the explosion. Here is what the famous Pirogov wrote in 1854: “I saw the fragmentation of bones in the Caucasus in shreds of Cossack bullets, but before the siege of Sevastopol, I did not see the fragmentation of cloth by bullets at such considerable distances.”

The bullets of Mine played their sad role for Russia in the Crimean War. But evolution did not stand still either there – the Dreise and Shamspo needle rifles already had a unitary cartridge with a small-caliber cylinder-cone bullet with a speed very high for that time – 430 m / s. It was with these bullets that the deforming bullet in the tissues, which caused additional suffering, began.

Cartridges for needle rifles. On the left Draze, in the center of Shaspo

Pirogov wrote in 1871: “Chaspo’s bullets incomparably undergo a change in form, disintegration and detachment of particles, and the wounds inflicted by these bullets from close distances of 50-100 steps are connected with the incredible destruction of the soft and hard parts of the body.” Explanation of the barbarous discontinuous effect of new bullets scientists put forward a lot of hypotheses:

– mushroom deformation and melting of the bullet;

– the idea of ​​the rotation of the bullet and the formation of the boundary layer;

– hydraulic theory;

– shock and hydrodynamic theories;

– hypothesis of air contusion and head ballistic wave.

The first hypothesis scientists tried to prove by the following provisions. The bullet, when it hits the flesh, deforms and expands at the head, pushing the boundaries of the wound channel. In addition, the researchers proposed an interesting idea, according to which a lead bullet fuses at close distances and particles of liquid lead, due to the rotation of the bullet, sprayed in the lateral directions. This is how a terrible funnel-shaped channel appears in the human body, expanding to the outlet. The next thought was the statement about the hydraulic pressure that occurs when a bullet hits the head, thoracic or abdominal cavity. Researchers brought this idea to firing on empty and water-filled banks. Effects are known to be completely different – a bullet through an empty tin can pass, leaving only neat holes, While a bullet filled with water simply tears. These deep errors were thwarted by the Nobel Prize winner Swiss surgeon Theodor Kocher, who, in fact, became one of the founders of medical wound ballistics.

Koher after many experiments and calculations in the eighties of the XIX century proved that melting the bullet by 95% does not matter for the affected tissue, since it is negligible. At the same time, the surgeon after firing gelatin and soap confirmed the fungal deformity of the bullet in the tissues, but this was also not so significant and did not explain the “explosive effect” of the wound. Koher in a strict scientific experiment showed a slight effect of bullet rotation on the nature of injury. The rifle bullet rotates slowly – only 4 turns per 1 meter of track. That is, there is no particular difference from which weapon to get a bullet – rifled or smooth-bore. The mystery of the interaction between the bullet and human flesh remained covered with darkness.

Until now, there is an opinion (formulated at the end of the 19th century) about the effect on the wound of a boundary layer located behind a flying bullet and forming a turbulent flow. When penetrating into the flesh such a bullet with its “tail” part carries with it tissues, crippling the organs. But this theory did not explain the lesions of organs and tissues located at some distance from the bullet head. The next was the theory of hydrostatic pressure, which explains very simply the behavior of the bullet in the tissues – it is a small hydraulic press that creates explosive pressure upon impact, spreading in all directions with equal force. Here you can just remember the school thesis that there are 70% of water in a person. It would seem that the impact of the bullet on the flesh is explained quite simply and intelligibly. But,

Here is what the native military doctor had to say at that time: “We are convinced in the most obvious way that it (the impact of a bullet flesh) is always equal to the product of mass and speed … Mass, speed and accuracy are the three conditions by which destructive action is generally determined throwing bodies. ” Thus was born the shock theory of the action of firearms, created in Russia. The greatest value in it was given to the speed of the bullet, from which both the striking force and the penetration were directly dependent. The most densely covered with this topic was surgeon Tile Vladimir Avgustovich, who conducted very “visual” experiments with unfixed corpses. The skulls were previously trepanized, that is, holes were “cut out” in them, and then shots were fired in the areas located near the hole. If you follow the theory of hydraulic shock, then as a result, the brain substance would have partly simply flown through the previously prepared hole, but this was not observed. As a result, they came to the conclusion that the kinetic energy of the bullet is the main impact factor on the living flesh. Thiele in this connection wrote: “The more vigorous the impact force of the bullet, the greater reserve of kinetic energy is supplied with tissue particles.” Just at this time, at the beginning of the 20th century, comparative studies of the damaging effect of a 10.67-mm lead bullet on the Berdan rifle with an initial velocity of 431 m / s and a 7.62 mm shell bullet were carried out. 1908 to Mosin’s rifle (the speed of the ammunition is 640 m / s). Thiele in this connection wrote: “The more vigorous the impact force of the bullet, the greater reserve of kinetic energy is supplied with tissue particles.” Just at this time, at the beginning of the 20th century, comparative studies of the damaging effect of a 10.67-mm lead bullet on the Berdan rifle with an initial velocity of 431 m / s and a 7.62 mm shell bullet were carried out. 1908 to Mosin’s rifle (the speed of the ammunition is 640 m / s). Thiele in this connection wrote: “The more vigorous the impact force of the bullet, the greater reserve of kinetic energy is supplied with tissue particles.” Just at this time, at the beginning of the 20th century, comparative studies of the damaging effect of a 10.67-mm lead bullet on the Berdan rifle with an initial velocity of 431 m / s and a 7.62 mm shell bullet were carried out. 1908 to Mosin’s rifle (the speed of the ammunition is 640 m / s).

Nikolai Ivanovich Pirogov
Nikolai Ivanovich Pirogov

 

Both in Russia and in Europe, work was done to predict the nature of gunshot wounds from shell bullets in future wars, and to develop methods of therapy. The lead bullet in the hard shell appeared much more “humane” than the classic bezobolochchnoe, as it rarely deformed in the tissues and did not cause a pronounced “explosive effect.” But there were also skeptics from surgeons, rightly asserting that “humane is not a bullet, but the hand of a military field surgeon” (Nicht die Geschosse sind human, human ist die Bechandlung des Feldarztes). Such comparative studies made the British think about the effectiveness of their 7.7-mm shell shells against Li-Enfield against mountain fanatics in northwestern India on the border with Afghanistan. As a result, they decided to leave the bullet head open from the shell, and also to apply cross-shaped incisions on the shell and grooves. Thus appeared the famous and barbaric “Dum-Dum”. The International Hague Conference of 1899 banned as a result “bullets that are easily unfolding or flattening in the human body, of which the hard shell does not fully cover the core or has incisions”.

There were curious theories in the history of wound ballistics. Thus, the mentioned theory of the head ballistic wave explained the damage of tissues by the influence of a layer of compressed air that forms before a flying bullet. It is this air that tears the flesh before the bullet, widening the passage for it. Again, all Russian doctors denied it.

"Surgeon EV Pavlov in the operating room" I. Repin
“Surgeon EV Pavlov in the operating room” I. Repin

 

E.V. Pavlov in the Military Medical Academy had an exquisite experience. The author applied a thin layer of soot to the sheets of cardboard with a soft brush, and placed the sheets on a horizontal surface. Then followed a shot from 18 steps, and the bullet was to pass directly over the cardboard. The results of the experiment showed that blowing off soot (not more than 2 cm across) was possible only if the bullet passed 1 cm above the cardboard. If the bullet rose 6 cm higher, the air did not affect the soot at all. In general, Pavlov proved that only with a shot at the target air masses in front of the bullet can somehow affect the flesh. And even here the powder gases will have a greater effect.

Such is the triumph of national military medicine.

Researchers of wound ballistics with time came to the aid of the perfect technique – high-speed shooting, which allows to create video with a frequency of 50 frames per second. In 1899, the western researcher O. Tilman used such a camera to capture the process of wounding the brain and skull by a bullet. It turned out that the brain first increases in volume, then it collapses, and the skull starts to crack after the bullet has flown out of the head. Tubular bones also continue to disintegrate for some time after bullet discharge from the wound. In many ways, these new research materials were ahead of their time, although they could shed a lot of light on the mechanism of wound exposure. Scientists in those days were carried away by a slightly different theme.

The discovery of the head ballistic wave, formed during the supersonic flight of the bullet (more than 330 m / s), was another reason for explaining the explosive nature of gunshot wounds. Western researchers in the early XX century believed that the compressed air pillow before the bullet just explains the significant expansion of the wound channel relative to the caliber of the ammunition. This hypothesis was refuted at once from two directions. Firstly, in 1943 BN Okunev recorded with the help of a spark photo the moment of the passage of a bullet over a burning candle, which did not even stir.

Secondly, they conducted a complex experiment abroad, firing two clay blocks with the same bullets from the same weapon, one of which was in a vacuum – the head wave could not naturally form under such conditions. It turned out that there were no visible differences in the destruction of the blocks, which meant that the dog was not buried at all in the region of the head wave. And already completely nailed in the cover of the coffin of this hypothesis domestic scientist VN Petrov, who pointed out that the head wave can be formed only in the case when the bullet moves faster than the speed of sound propagation in the medium. If the air is about 330 m / s, then in human tissues, sound propagates at a speed of more than 1500 m / s, which excludes the formation of a head wave before the bullet. In the Military Medical Academy in the 1950s, not just theoretically substantiated this position,

At this stage, the explanation of the wound ballistics of the ammunition by the physical laws of external ballistics was passed – all realized that living tissues are much denser and less compressible than the air environment, and therefore the physical patterns there are somewhat different.

It is impossible not to tell about that snatch in the wound ballistics, which happened just before the beginning of the First World War. Then the mass of surgeons in all European countries was concerned with the evaluation of the damaging effect of bullets. Based on the experience of the Balkan campaign of 1912-1913, doctors drew attention to the German pointed spitz of the Spitzgeschosse or the “S-bullet”.

Spitzgeschosse or "S-bullet"
Spitzgeschosse or “S-bullet”

 

At this rifle ammunition the center of mass was displaced to the tail part, which caused the bullet to roll over in the tissues, and this, in turn, sharply increased the volume of destruction. One of the researchers to accurately fix this effect in 1913-14 produced 26 thousand shots on the corpses of people and animals. It is not known whether the center of gravity of the “S-bullet” was shifted specifically by the German gunsmiths, or it was accidental, but in medical science a new term appeared-the side effect of the bullet. Up to this time they knew only about the direct. The side effect is tissue damage outside its own wound channel, which can cause severe damage even with bullet wounds. A conventional bullet, moving in the tissues rectilinearly, consumes its kinetic energy in the following proportions: 92% in the direction of its movement and 8% in the lateral direction. An increase in the share of energy expenditure in the lateral direction is observed in dull-headed bullets, as well as in ammunition, capable of somersaulting and deforming. As a result, after the First World War, the basic concepts of the dependence of the severity of a gunshot wound on the amount of transferred kinetic energy to tissues, the velocity and the vector of transmission of this energy were formed in the scientific and medical environment.

The origin of the term “wound ballistics” (wound ballistics) is attributed to the American researchers Callender and French, who in the 30-40’s tightly engaged in gaps of gunshot wounds. Their experimental data again confirmed the thesis about the decisive value of the bullet velocity in determining the gravity of the “firearm”. It was also found that the loss of bullet energy depends on the density of the damaged tissue. Most of all, the bullet is “braked”, naturally, in the bone tissue, less in the muscle and even less in the lung. Especially severe wounds, according to Callender and French, can be expected from high-speed bullets flying at speeds over 700 m / s. It is these munitions that can cause true “explosive wounds”.

One of the first to record the predominantly stable behavior of a bullet of 7.62 mm caliber was the Russian scientists and physicians LN Aleksandrov and LB Ozeretskovsky from the Military Medical Academy named after M.Sh. S. M. Kirov. Firing clay blocks 70 cm thick, scientists found that the first 10-15 cm such a bullet moves steadily and only then begins to unfold. That is, most of the bullets of 7.62-mm in the human body move fairly steadily and, at certain angles of attack, are able to pass through. This, of course, sharply reduced the stopping effect of the ammunition on the enemy’s manpower. It was in the postwar period that the idea arose about the redundancy of the 7.62-mm automatic cartridge and the idea of ​​changing the kinematics of the bullet’s behavior in human flesh was ripe.

Lev Borisovich Ozeretskovsky – Professor, Doctor of Medicine, the founder of the national school of wound ballistics. In 1958 he graduated from the IV Faculty of the Military Medical Academy. SM Kirov and was sent to serve as a doctor of the 43rd separate infantry regiment LenVO. He started his scientific activity in 1960, when he was transferred to the position of junior researcher at the physiological laboratory of the 19th research and testing artillery test site. In 1976, for testing the complex of small arms, the 5.45-mm caliber was awarded the Order of the Red Star. A separate line of activity of the colonel of the Medical Service of Ozeretskovsky LB in 1982 was the study of a new type of combat pathology – blunt trauma of the chest and abdomen, protected by bulletproof vest. In 1983 he worked in the 40th Army in the Republic of Afghanistan.

To help in the difficult business of increasing the slaughter of the bullet came a complicated recording equipment – pulse (microsecond) radiography, high-speed filming (from 1,000 to 40,000 frames per second) and a perfect spark photo. The classical object of “shelling” for scientific purposes was ballistic gelatin, which simulates the density and consistency of human muscle tissue. Usually, blocks weighing 10 kg, consisting of 10% gelatin, are used. With the help of these novelties, a small discovery was made – the presence in the affected tissue bullet of a temporary pulsating cavity (temporary cavity). The bullet head, penetrating into the flesh, significantly moves the boundaries of the wound channel both along the axis of movement and to the sides. The cavity size greatly exceeds the caliber of the ammunition, and the lifetime and pulsation are measured in fractions of a second. After that, the temporary cavity “collapses”, and the traditional wound channel remains in the body. The tissues surrounding the wound canal receive their damage dose just during the shock pulsation of the temporary cavity, which in part explains the explosive nature of the “firearm”. It is worth noting that now the theory of a temporary pulsating cavity by some researchers is not accepted as a priority – they are looking for their explanation of the mechanics of a bullet wound. The following characteristics of the temporal cavity remain poorly studied: the nature of the pulsation, the relationship between the dimensions of the cavity and the kinetic energy of the bullet, and the physical properties of the affected medium. In fact, modern wound ballistics can not fully explain the relationship between the caliber of the bullet, its energy and those physical, morphological and functional changes,

In 1971, Professor A. N. Berkutov in one of the lectures very accurately expressed himself with regard to wound ballistics: “The unrelenting interest in the teachings of a gunshot wound is associated with the peculiarities of the development of human society, which, unfortunately, often uses firearms …” Neither to add. Often this interest is faced with scandals, one of which was the adoption of small-caliber high-speed bullets 5.56 mm and 5.45 mm. But this is the next story.

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