places, penetrating the diaphragm, pericardium, and right ventricle, and dividing the aorta. The instrument had evidently been introduced and then turned in various directions.

209a. Size. The relation of the size of the punctured wound to the instrument producing it is also important. The depth to which the instrument penetrates may not only be less than the total length of the instrument, due to but partial introduction, but, if the tissues will allow of compression, as they usually do, the instrument, by depressing the skin, may produce a wound distinctly deeper than the length of the instrument. Again, the size of the skin opening may not merely be larger than the diameter of the weapon, due to cutting or tearing of the skin, but, if introduced just perpendicular to the skin, it may so stretch the skin as to make an opening which, after the removal of the weapon, becomes smaller than the diameter of the weapon, due to the contraction of the elastic skin.

209b. Shape. Usually needles and rounded instruments used to make punctured wounds do not make a round opening, but part the skin in the line of least resistance, as determined by the elastic fibers. in the skin, and so leave a wound that appears rather like one made by a bladed instrument, having two sides and two acute angles. In the arms and legs the direction of these slit-like wounds produced by puncture follows, in general, the long axis of the limb; and on the head and trunk is more or less perpendicular to the long axis of the trunk, but varies in the different regions. Similarly, in the deeper tissues these punctured wounds produce apertures determined by the direction of the fibers of the different layers, differing for each layer. Similarly, too, these wounds by rounded instruments are like those from bluntly angular weapons, such as bayonets, which, in the leg, for instance, no matter at what angle they happen to be rotated, tend to produce a linear wound, parallel to the long axis of the leg. The same effect is seen even in single-edged knives, which, while they may produce a wound in the form of an elongated triangle, the base corresponding to the back of the knife, yet often produce wounds with two sharp angles, if made by a double-edged blade. Hence, from the appearance of the wound it is possible to determine only approximately the shape of the instrument producing the puncture.

210. Incised. Incised wounds may be made by any instrument having an edge sharp enough to cut the skin, whether the weapon be

'See Hofmann, Gericht. Medicine, for a figure giving the direction of these wounds in the various parts of the body.

made of steel, as a distinct edged-tool, or whether it be a rough bit of iron, tin, glass, or even wood. If the weapon is of distinct weight, like a hatchet or an axe, in addition to the incision there is also a certain amount of crushing of the tissues. The edges of the wound are cleaner and more sharply defined in proportion to the sharpness of the instrument used. The separation of the edges of the wound depends upon the direction of the muscle fibers in the deeper structures which are cut. When the muscle is cut transversely, the ends of the muscle retract and give a wide gaping; while, if the incision is made parallel to the muscle fibers, there is merely the gaping due to the retraction of the elastic fibers in the skin. Wounds made with a knife or edge tool tend to be straight or evenly curved, while those with a piece of broken glass or scrap of tin are usually more irregular. 210a. Direction of incision. The direction of the incision may often be determined by a nick in the skin at the end where the knife was introduced, due to the elasticity of the skin giving way before the pressure of the blade. While at the other end of the cut the wound tails out towards its finishing point.

210b. Bleeding.-The bleeding from an incised wound is greater than that from either the punctured or the lacerated wound, because the blood vessels are cut freely across, and allow the easy escape of the blood.

210c. Irregular.- Wounds inflicted while the skin is thrown into folds because of the fullness of the skin or from the position of the body do not give a simple, straight, incision, even though the cut may have been straight; but show irregularities corresponding to the folds in the skin. There may even appear to have been several wounds, produced by a single stroke.

211. Lacerated.- Lacerated wounds are such as are produced by crushing, or tearing the tissues by some blunt instrument. They follow blows from directly applied blunt weapons, falls (where the ground acts as the blunt weapon), and they can also be produced by the crushing or tearing of the tissues when a person is caught in parts of machinery. Characteristic of these wounds are their irregular shape and great amount of tissue destroyed compared with the size of the opening in the skin. There is always a marked contusion of the tissues adjoining the open wound, and the edges of the cut are irregular. Very rarely do they give more than a suggestion of the instrument with which they were inflicted. Blows, or even falls, opening the scalp, usually give linear openings which simulate incised wounds. The edges of the wound, however, are not as clean

cut, and the contusion of the neighboring parts and often the exist ence of a fracture of the skull at that point may serve to distinguish between the incised and the lacerated wound. From the medical examination it may be impossible to tell whether a linear wound of the head, discovered immediately after a fight between two men, was caused by a blow with some blunt weapon, the fall following the blow, or a fall during the retreat of the man injured. In such cases the position of the wound, compared with the known relative position of the two parties during the quarrel, will be the chief fact upon which the decision can be based.

211a. Types.-Falls usually give multiple injuries, of which only those over bony parts may be open, lacerated wounds. Machinery injuries are often very extensive, and associated with the tearing off of large areas of skin, as in the cases where a woman's hair is caught in the belting of the machinery, and the entire scalp is torn off, or when the hand is caught and the skin and muscle tendons clear up to the elbow are torn away.

212. Gunshot wounds in general.- Gunshot wounds are those inflicted by missiles of any character propelled by the force from the explosion of gunpowder. The size of the missile. varies from the large cannon balls and shells, which may destroy large portions of the body, to the small bird shot, many of which may be lodged in the body without any great inconvenience. Naturally the character of the injury will depend upon the kind of shot, the distance from the body that the gun is, and the velocity with which the shot strikes the body.

213. Cannon balls.— Injuries from cannon balls would almost inevitably occur under such circumstances that they would not be confused with wounds from small fire arms. They present large, lacerated, generally infected wounds, with such great destruction of tissue that they can be easily identified.

214. Small shot. Wounds from the multiple small shot of a fowling piece are also too characteristic to be mistaken for any other injury. It is chiefly important to be able to estimate the distance from the body at which the weapon was fired. Fowling pieces of the usual type are made to kill game (penetrate several sheets of brown paper) at a range of about 40 yards. At that distance the shot have penetration enough to kill the ordinary small game, and

Tardieu in his "Etude Médico-légale the different professions, due to masur les Blessures" devotes considerable chinery, boiling, freezing, fall of rocks, attention to wounds liable to occur in explosions, et cetera.

the shot are usually concentrated into an area 30 inches in diameter. They are rarely fatal beyond 100 yards. The muzzle velocity of the shot is, perhaps, 300 feet per second. If the gun be fired at a distance less than a foot from the body, it will produce one single wound at the surface, though deeper the shot will diverge. At a distance of 112 feet there will be some separate wounds on the skin. At a distance of a yard the shot will probably all enter separately, but may be included within a diameter of 3 or 4 inches. And this area over which the shot will spread will increase in proportion to the distance, so that at 15 yards the shot will be scattered over the entire trunk of a man, and, at 40 yards, about 30 inches, with many scattering shot outside that circle. When the gun is fired sufficiently near to the person for the charge to enter the body in one mass, before separating, the wound is of considerable extent and gravity. Its edges are ragged, contused, and blackened; and, as the shot diverge after entering the body, great laceration and injury of the parts underneath take place. At greater distances each shot will produce a distinct though trifling skin wound. Nevertheless, a single pellet may occasionally produce death. Thus, in a case related by Ollivier d'Angers, a thief, scaling a wall, received, at the distance of 15 paces, a charge of shot from a fowling-piece. He fell dead immediately. The charge had struck him in the breast, scattering over an extent of 3 to 4 inches, but one grain had penetrated the aorta over the attachment of the sigmoid valves, and another had traversed the anterior wall of this vessel. The wounds had the form of linear incisions, two lines in extent, and such as would be made by a fine double-edged and pointed instrument. If the shot have had to penetrate the clothing, especially if this be loose and thick, before entering the body, the usual character of a near wound from this cause will be modified; the shot is spread out of its course by this obstacle to a certain degree, and does not enter the skin in a mass, causing a round, tolerably regular opening, but being somewhat scattered, will either produce a large, lacerated wound, or a number of small wounds, according to the position in which the weapon is held.

215. Rifle and revolver bullets; smaller caliber jacketed bullets.Bullet wounds from a rifle ball vary markedly with the kind of bullet used. The modern army rifle is used with a small caliber, jacketed bullet of great velocity. The Krag-Jorgensen of the United States army, the Lee-Metford of the British army, and the Mauser of the Spanish and Boer armies all belong to this type. The bullets

are 6.7 to 8.2 mm. in diameter, and 30 to 32 mm. in length. They weigh from 10 to 16 grams, and have a muzzle velocity of 1,968 to 2,395 feet per second. They are capable of inflicting a mortal wound at a distance up to 5,000 yards (over 23⁄44 miles). They have a penetrating power five or six times that of the old 45-caliber lead bullets of the Springfield rifles. Moreover, the hard metal case prevents the deforming of the bullet. In consequence of these characteristics the bullet wounds are clean-cut perforations from the wound of entrance to the wound of exit. Even if a bone is encountered the bullet cuts a clean path through it.

At short range, however, (under 600 yards) the effect of these small caliber jacketed bullets is very different, producing very destructive, almost explosive, effects. Bones are shattered into many pieces, and the soft, solid organs, such as the brain, liver, kidney, and spleen, and the hollow organs filled with fluid, such as the bladder, stomach, and intestines, are widely ruptured. Moreover, these bullets rarely carry infection with them, so that the danger from infection is not great. The bullets are rarely deflected in the body from their straight course, even if they come in contact with a bone. The wounds of entrance and of exit are so much alike that it may be very difficult to determine from which side the ball entered. The hard. jacket of the ball also prevents the splitting of the bullet. Bullets deformed before they strike the body, by a ricochet impact, tear through the tissues, producing great laceration of the tissues, and usually carry infection with them.

Low

215a. Larger caliber lead bullets.-The old style rifles with the lead bullets of larger caliber, 32 to 48 (the figures representing hundredths of an inch) and slower muzzle velocity (1,000 to 1,500 feet per second) are similar in their effect to the revolver and pistol. It is with the revolver wounds that most civil cases have to deal. velocity lead bullets, on striking the skin, produce a depressed wound, usually smaller than the caliber of the bullet, and often darkened on the edges by the lead or the dirt. In its passage through the tissues the course of the bullet is often irregular, the ball being deflected by impinging on a bone or even on a fascial sheath, a nerve, or even an artery. At times the arteries, nerves, or tendons are pushed aside, while the veins are more often cut. The ball may be cut in two by an edge of bone or possibly by a fascial layer, the two portions then each following its own course.

The course of these bullets through the body varies so much, due to the deflection by the firmer tissues, that even