Wound Ballistics: The Science of Injury and the Mystery of Exploding Bullets

1018Johnkinder-FBToday’s guest post is written by John Kinder, Associate Professor of History and American Studies at Oklahoma State University. He is the author of Paying with Their Bodies: American War and the Problem of the Disabled Veteran (University of Chicago Press, 2015). On Tuesday, October 17, Kinder will give his talk, “A History of American War in Five Bodies.” To read more about this lecture and to register, go HERE.

On March 11, 1944, an American soldier in the 182d Infantry was digging a foxhole on the island of Bougainville when a Japanese bullet ricocheted and hit him in the ankle. The wound didn’t look that serious. There was almost no blood. Still, it was better to be safe than sorry. Medics bandaged the wound, loaded the soldier onto a litter, and started down the hill to the aid station. He was dead before they reached the bottom.

I recently discovered this story in a volume on wound ballistics published by the US Army Medical Department in the early 1960s. Wound ballistics is the study of the physiological trauma produced by modern projectile weapons. It achieved quasi-scientific status in the late nineteenth century, as military physicians and other self-proclaimed wound experts carried out experiments to measure and ultimately predict what happened when chemically-projected metal collided with living human tissue.

Early on, much of their research involved shooting ammunition into pine boards or the carcasses of  animals to estimate the casualty-causing potential of various armaments. Over time, however, wound ballisticians developed increasingly sophisticated techniques for mapping the body’s vulnerability to different weapons and fine-tuning the production of physiological trauma.

Dog

Microsecond X-ray of the femur of a dog after it has been shot by an 8/32-inch steel ball travelling at 4,000 feet per second. The bone has been shattered despite the fact that it was not actually hit by the steel ball. In order to understand the mechanisms of human injury, World War II-era scientists carried out ballistics experiments on a variety of “model” targets including living dogs, cats, pigs, and horses, as well as blocks of gelatin and tanks of water. 

In the process, they also managed to solve one of the most head-scratching mysteries in nineteenth-century military medicine. The mystery emerged in the mid-century, when growing numbers of observers began to notice a peculiar phenomenon: soldiers were dying from what initially appeared to be relatively minor “through-and-through” wounds. High-velocity bullets seemed to enter and exit the body with only minimal damage. Upon autopsy, however, surgeons discovered extensive internal trauma—pulped tissue, ruptured veins, shattered bones—far outside of the track of the bullet. How was this possible? As early as the 1840s, critics charged that the wounds must be the product of “exploding bullets,” which were subsequently banned by international treaty in 1868. In later years, physicians speculated that the internal explosions were caused by compressed air or heat, but nothing could be proven.

Cat

Microsecond X-ray of a thigh of a cat that has been shot by a 4/32-inch steel ball at an impact velocity of 3,000 feet per second. The dark area is the temporary cavity formed as the ball passes through the muscle tissues. X-rays like this one helped wound ballisticians explain the “explosive effect” that mystified nineteenth-century military physicians. 

By the 1940s, scientists were able to use X-rays and high-speed cameras to solve the mystery once and for all. They discovered that, around 200-400 microseconds after a high-speed bullet strikes a human body, a temporary cavity begins to form around the bullet path. This cavity, which expands and contracts in a fraction of a second, can be more than 20 times the volume of the permanent wound track, resulting in the explosive damage to nearby tissue and bone. And, thanks to the elasticity of human skin, the bullet’s entrance and exit wounds might be nearly closed over by the time the patient reaches medical attention. It was remarkable discovery—not least because it affirmed wound ballisticians’ belief that, when it came to understanding injury, the human eye was no match for a scientist and a machine.

To this day, practitioners of wound ballistics like to justify their work in humanitarian terms. The goal of their research, they often say, is to help military surgeons and body armor manufacturers cut down on unnecessary deaths. All of this is true—to a certain extent. From the very start, however, the field of wound ballistics has played a more ominous role in military history. If wound ballistics is the science of injury, it is also the science of injuring others. Understanding the body’s vulnerabilities has allowed warring nations to develop deadlier antipersonnel weapons: armaments designed to pulverize, poison, burn, shred, emulsify, and eviscerate the bodies of one’s enemies.

No doubt, some readers might be wondering about the soldier at Bougainville, the one who died after a light wound to the ankle. Was he too a victim of the “exploding bullet” phenomenon? As it turns out, his death can be chalked up to a more quotidian threat: human error. Today, we can only speculate about the medics’ actions: perhaps they were in a hurry, or perhaps they were exhausted after a brutal day of fighting, or perhaps—and this is my guess—they were so used to seeing war’s butchery that this soldier’s injury appeared inconsequential by comparison. Whatever the reason, they failed to apply a tourniquet to the wounded man’s leg.

Shortly after the litter party started down the hill, the soldier’s ankle began to hemorrhage. As blood drained from his body, he said that he felt cold. Within minutes, he was dead.

References:
1. International Committee of the Red Cross. Wound Ballistics: an Introduction for Health, Legal, Forensic, Military and Law Enforcement Professionals (film). 2008.
2. Kinder, John. Paying with Their Bodies: American War and the Problem of the Disabled Veteran. Chicago: University of Chicago Press, 2015.
3. Saint Petersburg Declaration of 1868 (full title: Declaration Renouncing the Use, in Time of War, of Explosive Projectiles Under 400 Grammes Weight”). November 29-December 11, 1868.
4. United States Army Medical Department. Wound Ballistics. Washington DC: Office of the Surgeon General, Department of the Army, 1962.

Images:
Dog X-ray: Newton Harvey, J. Howard McMillan, Elmer G. Butler, and William O. Puckett, “Mechanism of Wounding,” in United States Army Medical Department, Wound Ballistics (Washington DC: Office of the Surgeon General, Department of the Army, 1962), 204.
Cat X-ray: Ibid, 176.

Mental Health in the Metropolis: The Midtown Manhattan Study

By Paul Theerman, Associate Director, Center for the History of Medicine and Public Health

How can we improve urban health? That is one of the missions of the New York Academy of Medicine, and a question public health professionals have been asking for decades. One of the landmark urban health studies, Mental Health in the Metropolis: The Midtown Manhattan Study, was published more than half a century ago.1 The study was intended to be a deep and exhaustive look into the mental health of residents in one of the most urban environments in the country, Midtown Manhattan. In many ways it was to be a model of the state of urban health throughout the country.2 And it was shaped by the medical experience of World War II.

Title page of Mental Health in the Metropolis, 1962.

Title page of Mental Health in the Metropolis, 1962.

Many veterans developed mental illnesses over the course of the war. Dr. Thomas A. C. Rennie, associate professor of psychiatry at Cornell University Medical College, saw many cases directly. He organized rehabilitation services for veterans during the war, and in 1944 published When He Comes Back and If He Comes Back Nervous.3 This booklet was followed by Mental Health and Modern Society,4 a professional discussion of the effects of war on society. In his war and postwar experience, Rennie encountered many people suffering from mental difficulties, and concluded that the long and extended psychoanalytic approach would never treat them effectively, for lack of time and resources.

Dedication of Mental Health in the Metropolis to Thomas A. C. Rennie.

Dedication of Mental Health in the Metropolis to Thomas A. C. Rennie.

Instead, Rennie began to look at the relationship between mental health and the social community.5 In the process he created a new field—social psychiatry. In 1950, he was appointed the first professor of social psychiatry at Cornell, arguably holding the first position of this kind anywhere in the United States.6 He conceived the Midtown study this same year, and launched it in 1952. Upon Rennie’s sudden death from a cerebral hemorrhage in mid-1956, the program was continued by Dr. Alexander Leighton, a colleague, medical sociologist, and psychiatrist at Cornell. The study ended in 1960, with publication of its results in 1962.7 It was a large undertaking; overall, the project utilized the services of some 200 people.

What did the study look like? In the words of the lead author, sociologist Leo Srole of SUNY Medical Center Brooklyn (SUNY Downstate), “An investigation focused upon Midtown can, in a special sense, be likened to an intensive case study. Here a community, rather than an individual, is the case.”8 Mental health was investigated as an outcome of community function and dysfunction, as much as or even more so than of the individual. That community was studied along many lines: age, sex, marital status, socioeconomic status, “generation-in-the-U.S.,” and various frames of origination: rural or urban, nationality, and religious affiliation. Researchers also assessed access to and outcomes of mental health and psychiatric care by surveying community residents and treatment workers. Their work seemed to show that Midtown held large numbers of untreated ill individuals, most of whom still functioned at an acceptable level. But definitive results were difficult to come by, and more studies were called for.

Correspondence between sick-well ratios for 12 socioeconomic status strata, reported in 4 groups, with highest SES marked “1” and lowest “12”. The “sick-well” ratio is found by comparing the numbers of “impaired” persons in a particular grouping, with the number of “well” persons. Two other rankings lie between these designations: “mild symptom formation” and “moderate symptom formation.” Mental Health in the Metropolis, Figure 5, p. 231. Click to enlarge.

Correspondence between sick-well ratios for 12 socioeconomic status strata, reported in 4 groups, with highest SES marked “1” and lowest “12”. The “sick-well” ratio is found by comparing the numbers of “impaired” persons in a particular grouping, with the number of “well” persons. Two other rankings lie between these designations: “mild symptom formation” and “moderate symptom formation.” Mental Health in the Metropolis, Figure 5, p. 231. Click to enlarge.

Mental Health in the Metropolis was the report of a large and complex analysis, marrying the different disciplines of psychiatry and sociology to understand and address medical problems using social means. As such it was a child of the war—the war that created mass problems, and suggested ways towards solving them. And it was the harbinger of studies to come.

References

1. Authored by Leo Srole, Thomas S. Langner, Stanley T. Michael, Marvin K. Opler, and Thomas A. C. Rennie, volume 1 in the Thomas A. C. Rennie Series in Social Psychiatry (New York: Blakiston Division, McGraw-Hill, [1962]).

2. Mental Health in the Metropolis, p. 338. The precise boundaries of the study area were not disclosed for reasons of confidentiality; it was described as “more or less midway up the length of Manhattan Island,” bounded by the business district, two major thoroughfares, and a river, and “almost wholly residential in character,” with 175,000 inhabitants (p. 72, and fn 14). Using the name “Midtown” to describe this community was surely inspired by the famous “Middletown” studies of Muncie, Indiana, done by Robert Staughton Lynd and Helen Merrell Lynd, and published in 1929 and 1935.

3. With Luther E. Woodward: New York: The National Committee for Mental Hygiene, [c1944].

4. Also with Luther E. Woodward: New York: Commonwealth Fund, 1948.

5. He was not the first to explore this connection, of course, and he profited from his work with Adolf Meyer of The Johns Hopkins Medical School from 1931 to 1941, Oskar Diethelm, “Thomas A. C. Rennie, February 28, 1904 — May 21, 1956,” Cornell University Faculty Memorial Statement, https://ecommons.cornell.edu/handle/1813/17813, accessed March 18, 2016.

6. Mental Health in the Metropolis, pp. viii.

7. Mental Health in the Metropolis, pp. 336–37.

8. Mental Health in the Metropolis, p. 28.

The Most Likely Victim…the Busy Man. Ads from Hygeia Magazine

By Johanna Goldberg, Information Services Librarian

This is part of an intermittent series of blogs featuring advertisements from medical journals. You can find the entire series here.

From 1923–1949, the American Medical Association published Hygeia, an educational health magazine for the American public.

Where today you might find Highlights Magazine, Men’s Health, or Prevention at the doctor’s office, Hygiea once filled that role. It frequently included activities to entertain youth, along with health-related articles for their parents. Schools and libraries subscribed—the magazine was a common classroom resource—as well as individuals. In 1950, the magazine became Today’s Health, which continued publication until 1976.1

Along with articles and activities, Hygeia included a wealth of advertisements. Here, we take a look at those focused on men and work. These ads often tie men’s health issues to work stresses (or, in one ad, boys’ health to school posture). One in particular, a Parke Davis and Company ad from March 1936, shows a commuting man reading a newspaper and states, “The greatest problem Medicine faces today is to get the average person to take advantage, in time, of the help it has to offer him.” This problem continues today: Men are more likely than women to smoke, drink, make other choices detrimental to health, and delay seeking medical attention.2 A series of Parke Davis ads—along with ads from other companies—shows the dangers for men who neglect medical problems, often choosing work over seeking care.

Parke Davis Ad in Hygeia Magazine, March 1936. Click to enlarge.

Parke Davis Ad in Hygeia Magazine, March 1936. Click to enlarge.

Other ads show men and boys in need of products that accentuate their manliness (like Ivory soap: “Most men don’t want to smell like ‘beauty shoppes’”) or provide them the energy needed to get through the workday or wartime (like General Mills, which offered materials on teaching nutrition to help prevent military rejections due to malnutrition).

A third stream of advertisements depicts men as trustworthy medical professionals, even in times of war. The lab coat-wearing Walgreen pharmacist is “a specialist in accuracy.” Sealtest Company doctors offer physicals “as rigid as those in the army.” Wartime doctors, says one Wyeth ad, will remain abroad once the war is done to “prevent epidemics” or return home to care “for casualties of the world’s greatest war.”

When women move into the workplace during the war years, the ads that follow show them as competent employees and a feminizing influence on the workplace. “Let’s not ration loveliness,” advises a 1943 ad from Luzier’s, a cosmetic and perfume company. “With more and more women doing the work of men in defense jobs and in the armed forces, not to mention the thousands of women in various branches of OCD, it is desirable that we cling to those nice habits of personal care…which are such an integral part of the loveliness of American womanhood.”

Click on an ad to enlarge the image.

Neglect of medical problems:

Eastman Kodak ad inHygeia Magazine, January 1936. Click to enlarge.

Eastman Kodak ad in Hygeia Magazine, January 1936. Click to enlarge.

American Seating Company ad inHygeia Magazine, June 1936. Click to enlarge.

American Seating Company ad in Hygeia Magazine, June 1936. Click to enlarge.

Metropolitan Life Insurance ad in Hygeia Magazine, December 1936. Click to enlarge.

Metropolitan Life Insurance ad in Hygeia Magazine, December 1936. Click to enlarge.

Parke Davis ad in Hygeia Magazine, April 1945. Click to enlarge.

Parke Davis ad in Hygeia Magazine, April 1945. Click to enlarge.

Parke Davis ad in Hygeia Magazine, August 1945. Click to enlarge.

Parke Davis ad in Hygeia Magazine, August 1945. Click to enlarge.

SoftLite Lenses ad in Hygeia Magazine, December 1945. Click to enlarge.

SoftLite Lenses ad in Hygeia Magazine, December 1945. Click to enlarge.

Metropolitan Life Insurance ad inHygeia Magazine, October 1948. Click to enlarge.

Finally, a man who gets medical attention and follow his doctor’s advice! Metropolitan Life Insurance ad in Hygeia Magazine, October 1948. Click to enlarge.

Accentuating “manliness”:

Ivory Soap ad in Hygeia Magazine, January 1932. Click to enlarge.

Ivory Soap ad in Hygeia Magazine, January 1932. Click to enlarge.

Lifebuoy Health Soap ad in Hygeia Magazine, May 1932. Click to enlarge.

Lifebuoy Health Soap ad in Hygeia Magazine, May 1932. Click to enlarge.

Energy boosts:

Kellogg's Kaffee Hag ad in Hygeia Magazine, February 1931. Click to enlarge.

Kellogg’s Kaffee Hag ad in Hygeia Magazine, February 1931. Click to enlarge.

General Foods ad in Hygeia Magazine, January 1932. Click to enlarge.

General Foods ad in Hygeia Magazine, January 1932. Click to enlarge.

Bordens Malted Milk ad in ad in Hygeia Magazine, December 1932. Click to enlarge.

Bordens Malted Milk ad in ad in Hygeia Magazine, December 1932. Click to enlarge.

General Mills ad in Hygeia Magazine, August 1945. Click to enlarge.

General Mills ad in Hygeia Magazine, August 1945. Click to enlarge.

Medical professionals:

Sealtest Milk Metropolitan Life Insurance ad inHygeia Magazine, September 1943. Click to enlarge.

Sealtest Milk Metropolitan Life Insurance ad inHygeia Magazine, September 1943. Click to enlarge.

Wyeth ad in Hygeia Magazine, January 1945. Click to enlarge.

Wyeth ad in Hygeia Magazine, January 1945. Click to enlarge.

Walgreen ad in Hygeia Magazine, February 1948. Click to enlarge.

Walgreen ad in Hygeia Magazine, February 1948. Click to enlarge.

Women in the workforce:

General Electric ad in Hygeia Magazine, February 1943. Click to enlarge.

General Electric ad in Hygeia Magazine, February 1943. Click to enlarge.

Luzier's ad in Hygeia Magazine, July 1943. Click to enlarge.

Luzier’s ad in Hygeia Magazine, July 1943. Click to enlarge.

References

1. Hansen K. Newsstand: 1925: Hygeia. Available at: http://uwf.edu/dearle/enewsstand/enewsstand_files/Page4115.htm. Accessed October 30, 2015.

2. Men’s Health. Available at: https://www.nlm.nih.gov/medlineplus/menshealth.html. Accessed October 30, 2015.