When I say modern times let’s say from the civil war until today.
What are the basis of the treatments ? and what were the advancments we made in medecine in the mean time for such treatments ?
In: Biology
Hi. The other answers here are pretty reasonable, I’ll try to add a little more. I’m an emergency paramedic and ED, for context. I do not represent my employers in any way, only myself.
There are only a few common ways that a traumatic injury is likely to kill you. To name a few, but not all:
– a vital organ is catastrophically destroyed
– you run out of blood
– you run out of breath
– infection
Your question asks about both a difference in mechanism (arrows vs gunfire) *and* timing (the past, versus today). That makes this question a little harder to answer. I’ll tackle the timing difference first.
Major trauma care has only really started to develop properly in the last two hundred years or so – first with the development of triage (deciding who to help first), then femoral splinting and other interventions in WW1, then the development of trauma systems since WW2, Korea and Vietnam. Despite all this history, the key changes have boiled down to:
– keep the blood inside the body
– keep the air in the right place
– prevent infections (with hygiene and antibiotics)
Honestly, not much else matters. If you do a modern military trauma course today, those are still the key lessons. A lot of people have been violently killed to learn such simple little facts. To illustrate this, the ambulance service I work for recently changed our management of “pulseless major trauma” to HOTT: Haemorrhage (bleeding), oxygen, tension pneumothorax (air in the wrong place), temperature. Nothing else is a priority. It’s really, really simple.
The infection difference is important, too, but not just related to these types of injuries. Any infection involving bone would have been nearly universally fatal, or resulted in amputation, until only about a hundred years ago. A splinter of an arrow forming an abscess might take months to kill you, but it’s very likely to either permanently disable or kill you one day. That just doesn’t happen so often these days. In fact, it’s really common for a soldier today to start receiving antibiotics before they’ve even left the battlefield.
But you also asked about the difference in mechanism – that is, what’s the physical difference between an arrow and a bullet? And there are lots. I’ll name a few.
– arrows fly slowly, well below the speed of sound, and much more of their energy comes from their weight. They may splinter or shatter on impact, but generally, wounds caused by arrows are relatively “simple” – for want of a better word.
– bullets, with the exception of specialist and handgun rounds, fly faster than the speed of sound and therefore behave very differently. Much more of their energy comes from their sheer speed. Most ‘normal’ bullets are quite soft, and will shatter, flatter or otherwise break up after entering the body. They also create a literal shockwave, which can damage tissues they didn’t even touch depending on the caliber of the bullet.
– even worse, bullets are rarely fired one at a time. It is common military training to “keep firing until the enemy changes shape or stops functioning”. It’s very common for wounded soldiers to have suffered many gunshot wounds, not just one.
– Finally, bullets leave a track rather than remaining lodged in the body. I don’t have much evidence to offer for this, but I suspect this probably makes specific types of injury (for instance sucking chest wounds, where a hole in your chest wall causes you to “breathe” ineffectively) more likely to happen.
This has changed the outcomes of military trauma care, but the basic goals are still pretty similar.
People who have been shot with bullets are more likely to have been outright killed by a massive injury, such as to the head or a viral organ (the heart or great vessels, for instance). These injuries are, and always will be, totally unsurvivable. This is because of the increased lethality and sheer number of shots that are likely to have been fired.
But interestingly, casualty statistics are also changing over time. Even in my lifetime and yours, fewer soldiers die of minor injuries than before as we get better at the basics: keep the blood in, keep the air in the right place, keep the infection out.
Hope this helps.
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