So as an RT, and as someone who loves history, would you possibly be able to tell me how soldier's would've survived gunshot wounds in the Napoleonic era with the tools and medicine at them? Perhaps specifically, ones to the chest? Oh, there's plenty of problems and factors and low chances of survival, but I'd love to know the process and perhaps what would be involved to have a patient survive. Thank you if you can answer this! If not, no worries at all :)
Well, first of all if you got wounded in any way at any time before World War I you faced very long odds for survival. A chest wound is especially dangerous because there are so many vital organs packed tightly together that can be damaged.
Get shot in the heart and of course you are dead instantly. Get shot in the aorta, pulmonary arteries, superior vena cava, inferior vena cava, or subclavian artery and you’re going to bleed out within minutes. Get shot in the lungs and you could have a situation called a pneumothorax where air builds up inside the chest cavity or in between the pleura (the membrane that covers the lungs), causing the lung to collapse. The chest cavity could also fill with blood and bodily fluids resulting in the same. Thus you will die slowly gasping for breath on the battlefield.
One thing to take into consideration during this time was the ammunition used. Today we use small caliber high velocity ammunition with steel or copper jacketed bullets. Common military calibers today are 5.56x45mm NATO and 5.45x39mm Russian (Both are around .22 caliber). With a small bullet covered in hard metal moving at velocities around 3,000 feet per second, you tend to get small clean wounds. Back in the 18th and early 19th century, military muskets used large caliber soft lead round balls. The French, Austrians, Prussians, and Russians used .69 caliber muskets typically firing .65 caliber bullets, the British use .75 caliber muskets and typically fired .69 caliber bullets.
These large bullets moving at a relatively low velocity would cause large wound cavities with massive trauma. If the ball hit a rib, it could cause the rib to shatter resulting in bone shrapneling throughout the chest cavity. If one of your limbs got shot the bullet would just shatter the bones. Hence why surgeons usually amputated limbs, they didn’t have the technology or know how to repair say a shattered femur.
Anyway, odds are that if you got shot center of mass with a .65 or .69 caliber roundball, it would hit you like a freight train and put you right down, killing you almost instantly. But if you did survive, then you faced the problem of laying out on the battlefield for hours. At the time most militaries didn’t have dedicated combat medical units. It was usually left to civilians in the area to take care of the wounded. Typically civilians didn’t go out into a raging battle to remove the wounded. Sometimes your fellow soldiers might, sometimes drummers or other secondary personnel might be recruited to remove and take care of the wounded.The French were the only ones to have an organized military medical service with combat medics, ambulances, nurses, and surgeons, but due to the large scale of Napoleonic battles and the large number of resulting wounded they were always overwhelmed. For the most part if you were wounded you could expect to wait sever hours hours before being removed from the battlefield, and several hours waiting to see a surgeon. In that time while you are you could bleed to death, go into shock, become infected and septic, die of a pneumothorax, or die of exposure.
So if you did survive all of this, then the real horrors began; being sent to a field hospital. This could be a series of tents, a local courthouse, school, church, monastery, or even someone’s private residence. The big problem with summarizing common 18th and 19th century battlefield surgical techniques was that there were no common techniques. At the time there were many medical schools in Europe where students trained to become doctors and actually worked with cadavers (often obtained through grave robbing), but anyone could claim to be a physician or surgeon with few credentials or little education and everyone seemed to have their own ideas on what proper medicine was. A good case study was when US President James Garfield was shot in 1881, something like a dozen doctors showed up to treat the President, each with their own ideas on a course of treatment and each treatment being weirder and more bizarre than the last. Garfield actually died not from the gunshot wound, but from his doctor’s treatments, a point his assassin tried to argue in court.
So lets say you are lucky and you got a surgeon who actually knew what he was doing. Congrats! Now you get to experience the joys of surgery without anesthesia! The surgeon would clean out the wound, remove the bullet if it hadn’t exited the body, and remove any pieces of bone, cloth, or shrapnel. Then the wound on the lung would be sutured shut, or in some cases a thoracotomy would have been done where serously damaged lobes of the lung were removed and sutured shut. Then he would close up the chst wound and either leave a chest tube for drainage of blood or bodily fluids, or use a syringe like the one below.
Of course, this would have been done well before the discovery of germ theory and sterile technique. Surgeons hands would have been dirty, their instruments would have been dirty. Odds are you would die of an infection post-op. If you did get an infection surgeons might try and debride the wound (remove necrotic tissues). Some forward thinking surgeons might also try to use an anti septic. There were various chemicals that were used as anti septics, many useless or harmful, some not. Refined sugar was actually used as an anti septic at the time. Vinegar, alcohol, or wine could be used. Mercury or arsenic concoctions were common. But odds are once you got an infection you would go septic and die. Oh yeah, did I also mention bloodletting?
Needless to say your odds of survival in a field hospital were not good. During the Crimean War in British hospitals soldiers with chest wounds of any kind, whether bullet, bayonet, or sabre, had a 79% mortality rate (A History of Surgery by Harold Ellis P214) . I doubt the odds were much better in the Napoleonc Wars. So you were pretty much screwed.
