Monday, July 14, 2014

The Effects of Bullet/Shell/Sabre

by Janet King, RN, BSN, CCRN.

The three primary causes of wounds in the Civil War were:
  • small arms ammunition: bullets, round balls, minie balls.
  • artillery fire: solid shot, case shot, canister; and
  • bayonet or sabre strokes.
It is said that the tactics of war always lag behind the weapons, and in the Civil War this was especially true. Soldiers were taught to fight as "massed" units and the range of the weapons and their destructive force was devastating on these masses.

The minie ball was a fairly recent invention at the onset of the war. Some 94% of the total combat injuries were attributed to this missile. It was designed to be fired from a rifled musket; was made of soft lead; traveled at a high velocity (for that era) of 950 ft/sec; and was accurate at 200 to 300 yards. As it traveled, it would spin from the rifled barrel of the musket and would deform and tumble on impact. Its effect on bone and tissue was incredibly devastating. It would smash, tear apart, and disintegrate what it hit. Most of the amputations that occurred were because of this great devastation.

Often there would be 1 or 2 inches of bone entirely pulverized or missing altogether after the ball impacted, and the only recourse the surgeon had was to amputate. One surgeon, describing such damage, wrote, "The shattering, splintering, and splitting of a long bone by the impact of the minie ball is in many instances, both remarkable and frightening." In addition to its destruction of bone and the mangling of skin and muscle, the ball would carry foreign material, i.e. pieces of uniform, bits of metal from belt plates, bone chips etc. into the surrounding wound and virtually guarantee an infected wound.

The other common small arms ammunition - round balls - were slightly less dangerous. The soldier might get "lucky" and the ball glance off the bone instead of shattering it. Also, if luck was with him, he would be hit in an extremity. Some 71% of Union wounded were so "fortunate." Why? Because, the lack of knowledge of bacteria and the difficulties of chest and abdominal surgeries in the Civil War era made the mortality very high for soldiers receiving wounds in those areas. For example - a soldier hit in the abdomen, where the ball struck the small intestine, and causing leaking of fecal material into the abdomen - had a 87% to 100% chance of his wound being a mortal one.

 Some surgeons advised that "When balls are lost in the capacity of the belly one need not amuse himself by hunting for them." Still, there were surgeons who questioned this stance. Eventually the majority of doctors would try some type of repair, if for no other reason than to give the patient one last chance. Some treatments did succeed, and others were miserable failures. The trial of "hermetically sealing" certain chest wounds ended when the mortality was determined to be 100%. Sometime, the surgeons realized, it was best to "let nature run its course."

The surgeons attended soldiers wounded in every body part including: damaged eyes; faces torn apart; jaws broken into bits; pelvic wounds that, because the bladder had been hit, leaked urine constantly onto the skin; intestines protruding from the abdomen and many others. Some surgeries had been done seldom if ever in their civilian practices and thus they had much to learn. Artillery fire accounted for some 5.5% of the Union wounded in the Civil War. This included artillery projectiles such as solid shot; canister, and spherical case shot; as well as torpedoes and grenades.

One surgeon stated the primary effect of artillery was the "demoralization of the troops under fire." Here he noted the psychological effect of war injuries. In WW I this would come to be known as "shell shock" and today would be listed as "post traumatic stress disorder." In the 1860s these terms and syndromes were not understood, and often the soldier was simply considered to be "demoralized" or "unnerved." In some cases the soldier was accused of cowardice. ( A mistake General Patton of WW II fame, would also make).

One soldier described his feelings of being under fire as "...I feared that if I ever lost control of myself under shell fire my mind would be shattered...To be under heavy shell fire was to me by far the most terrifying of combat experiences...Fear is many faceted and has many subtle nuances but the terror and desperation endured under heavy shelling are by far the most unbearable."

That soldiers did suffer long term psychological wounds from shell fire is well documented. Drunkenness, severe depression or "melancholia," desertion and other manifestations of mental health problems can be found throughout unit histories and in reviewing soldiers lives after the war ended.

Although the wounds from artillery fire were less numerous than small arms fire, they were more often deadly. A single round cannon ball - in one instance - killed the captain of one company outright, severed the orderly sergeant's arm, a corporal's leg and a private's head before bouncing off into the woods!

Some artillery projectiles were designed to explode either in the air or on the ground, creating a shrapnel effect where hundreds of bits of heavy iron or lead would be thrown into or over a group of soldiers (who were in their massed formations), wreaking havoc.

One soldier described the bursting of a shell - "...Clouds of smoke shot out from the redoubt and out of these - large, black balls rose upward...passed, shrieking shrilly. Through the dust and uproar I saw men fall, saw others mangled by chunks of shell, and saw one, struck fairly by an exploding shell, vanish!"

The effect of this shelling upon the body was to tear off limbs, slice through tissue and scatter metal fragments throughout wounds. At times metal and other fragments the shell hit - i.e. nails, wood etc. would be carried into the wound as well. All in all, the wounds were often torn, lacerated and mangled.

Less than 0.4% of Union casualties were the result of sabre or bayonet wounds. This, however, did not make them less deadly. Approximately 50% of such wounds occurred to the scalp, skull, face or neck. Sometimes the victim had been involved in "fierce hand to hand combat", but a large number of the cases were found to be due to "private quarrels, brawls, or inflicted by sentinels in the discharge of their duty." The surgeons found these injuries tended to "excite inflammatory action in deep seated tissues and cavities, with the danger of formation and confinement of pus from the injury to blood vessels, nerves and viscera and the possibility of pyemia, gangrene, and tetatnus."

Sabre blows to the head often resulted in the brain itself being injured with problems of epilepsy (seizures), loss of hearing or vision, and "impairment of the mental faculties or insanity" sometimes resulting. These problems were sometimes short-lived, but often stayed with the soldier throughout his life.

If the sabre or bayonet cut into a vital organ or major blood vessel, the soldier often bled to death. Corpses of men killed in such fashion upon the battlefield were "rare and conspicuous by their peculiarly contorted look."



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