(Mr. J. W. Dowden's case.)
A charge of small shot is much more destructive to blood vessels, tendons, and ligaments than a single bullet, which in many cases pushes such structures aside without dividing them. In the abdomen and chest, also, the damage done by a full charge of shot is much more extensive than that inflicted by a single bullet, the deflection of the pellets leading to a greater number of perforations of the intestine and more widespread laceration of solid viscera.
When the charge impinges on one of the extremities at close range, we often have the opportunity of observing that the exit wound is larger, more ragged than that of entrance, and that its edges are everted; the extensive tearing and bruising of all the tissues, including the bones, and the marked tendency to early and progressive septic infection, render amputation compulsory in the majority of such cases.
At a range of from twenty to thirty feet, although the scatter is complete, the pellets are still close together, so that if they encounter the shaft of a long bone, even the femur, they fracture the bone across, often along with some longitudinal splintering.
Individual pellets striking the shafts of long bones become flattened or distorted, and when cancellated bone is struck they become embedded in it ([Fig. 62]).
The skin, when it is closely peppered with shot, is liable to lose its vitality, and with the addition of a little sepsis, readily necroses and comes away as a slough.
When the shot have diverged so as to strike singly, they seldom do much harm, but fatal damage may be done to the brain or to the aorta, or the eye may be seriously injured by a single pellet.
Small shot fired at longer ranges—over about a hundred and fifty feet—usually go through the skin, but seldom pierce the fascia, and lie embedded in the subcutaneous tissue, from which they can readily be extracted.
The wad of the cartridge behaves erratically: so long as it remains flat it goes off with the rest of the charge, and is often buried in the wound; but if it curls up or turns on its side, it is usually deflected and flies clear of the shot. It may make a separate wound.
Wounds from sporting guns are to be treated on the usual lines, the early efforts being directed to the alleviation of shock and the prevention of septic infection. There is rarely any urgency in the removal of pellets from the tissues.