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The Dubious Quick Kill, part 1
 
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Sword wounds and the circulatory system

by

Maestro Frank Lurz

Frank Lurz bio


The enemy before you consistently carries his guard a bit high. Is it carelessness, or is he baiting you? You effect a small step backward and, just as you had hoped, your opponent attempts to close the measure. His leading foot begins to lift from the ground when, with the speed of a lightning bolt, you suddenly straighten your sword arm and direct a feint toward the man's flank, just under his hand. Seized with panic he parries wildly, but the hostile blade finds only thin air. With perfect timing you've eluded his parry and, disengaging to the high line you drive a killing thrust, with a vigorous lunge, deep into your antagonist's chest. To your surprise you feel almost no resistance to your blade as it disappears beneath the fabric of his blouse. Stunned, the hapless swordsman freezes in his tracks as he realizes in that instant that his life on this earth is over. "La!" You deftly pull your weapon out of the man's body and, triumphant, you are about to turn and leave the ground when, to your amazement, your foe recovers himself and returns to the guard! Eyes wide and mouth agape, you stand motionless in disbelief and, in that brief interval of inaction, the dying man desperately lunges forward, in one last heroic effort, and runs you through. You stagger briefly and then begin to fall; seconds rush in to arrest your fall and terminate the combat. They cradle you in their arms and, although your vision begins to blur, you look up to see the expressions of anguish and desperation on their faces. As consciousness ebbs away a last thought runs through you mind: "This isn't how it was in the movies!"

The foregoing scenario, while in itself a fiction, broadly describes the outcomes of numerous duels, and almost certainly more than many of us interested in such things might expect. For those of us who have taken up the courtly weapon with more interest in fencing than just its practice as a sport, such outcomes might well seem disquieting; after all, we've been taught that fencing tempo lies at the heart of every attack, defense and counterattack. If we deliver our thrust one or more tempi ahead of our adversary, we're doing just as our maestri told us--aren't we?

How do we reconcile fencing theory with the anecdotes passed down through history? Can we trust what was reported by seconds and the principals who survived? How credible is the "evidence?" Take for example the case of the duel fought in 1613 between the Earl of Dorset and Lord Edward Bruce.1 According to the Earl's account, he received a rapier-thrust in the right nipple which passed "level through my body, and almost to my back." Seemingly unaffected, the Earl remained engaged in the combat for some time. The duel continued with Dorset going on to lose a finger while attempting to disarm his adversary manually. Locked in close quarters, the two struggling combatants ultimately ran out of breath. According to Dorset's account, they paused briefly to recover, and while catching their wind, considered proposals to release each other's blades. Failing to reach an agreement on exactly how this might be done, the seriously wounded Dorset finally managed to free his blade from his opponent's grasp and ultimately ran Lord Bruce through with two separate thrusts. Although Dorset had received what appears to have been a grievous wound that, in those days, ought to have been mortal, he not only remained active long enough to dispatch his adversary, but without the aid of antibiotics and emergency surgery, also managed to live another thirty-nine years.

Never happen in a thousand years? Maybe. After all, Dorset himself told the story. If fishermen tend to exaggerate, surely duelists will. However, consider the duel between Lagarde and Bazanez. After the later received a rapier blow which bounced off his head, Bazanez is said to have received an unspecified number of thrusts which, according to the account, "entered" the body.2 Despite having lost a good deal of blood, he nevertheless managed to wrestle Lagarde to the ground, whereupon he proceeded to inflict some fourteen stab wounds with his dagger to an area extending from his opponent's neck to his navel. Lagarde meanwhile, entertained himself by biting off a portion of Bazanez's chin and, using the pommel of his weapon, ended the affair by fracturing Bazanez's skull. History concludes, saying that neither combatant managed to inflict any "serious" injury, and that both recovered from the ordeal. One could hardly be criticized for believing this story to be anything more than a fiction.

While the previous tale seems amazing enough, hardly anyone can tell a story more incredible than that witnessed by R. Deerhurst.3 Two duelists, identified only as "His Grace, the Duke of B " and "Lord B ", after an exchange of exceptionally cordial letters of challenge met in the early morning to conduct their affair with pistols and swords. The combat began with a pistol ball inflicting a slight wound to the Duke's thumb. A second firing was exchanged in which Lord B was then wounded slightly. Each then immediately drew his sword and rushed upon the other with reckless ferocity. After an exchange of only one or two thrusts, the two became locked corps a corps. Struggling to free themselves by "repeated wrenches," they finally separated enough to allow the Duke to deliver a thrust which entered the inside of Lord B 's sword arm and exited the outside of the arm at the elbow. Incredible as it may seem, his Lordship was still able to manage his sword and eventually drove home a thrust just above Duke B 's right nipple. Transfixed on his Lordship's blade, the Duke nevertheless continued, attempting repeatedly to direct a thrust at his Lordship's throat. With his weapon fixed in His Grace's chest, Lord B now had no means of defense other than his free arm and hand. Attempting to grasp the hostile blade, he lost two fingers and mutilated the remainder. Finally, the mortally wounded Duke penetrated the bloody parries of Lord B's hand with a thrust just below Lord B 's heart.

In the Hollywood swashbucklers this scene might well have have ended at this point, if not long before, but real life often seems to have a more incredible, and certainly in this case, more romantic outcome. Locked together at close quarters and unable to withdraw their weapons from each other's bodies for another thrust, the two stood embracing each other in a death grip. At this point the seconds, attempting to intercede, begged the pair to stop. Neither combatant would agree, however, and there they both remained, each transfixed upon the blade of the other until, due to extensive blood loss, his Lordship finally collapsed. In doing so, he withdrew his sword from the Duke's body and, staggering briefly, fell upon his weapon, breaking the blade in two. A moment later, the "victorious" Duke deliberately snapped his own blade and, with a sigh, fell dead upon the corpse of his adversary.

Numerous similar accounts begin to make a case the prudent swordsman cannot afford to ignore. It would appear that delivering a thrust or cut to an opponent, without falling prey to his own blade in turn, may not be so very simple and easy a thing. If one is skillful (or fortunate) enough to accomplish this feat, how long after inflicting a wound with a rapier, sabre, or smallsword can one's adversary continue to pose a threat? Does the type of wound have any meaningful effect on the length of time during which a stricken foe may continue to deliver a killing cut or thrust? To prevent the opponent from executing a counterattack, delivering a riposte or renewing an attack, where and how might one strike to take the adversary immediately out of the combat?

Dynamics of Stabbing and Incising Wounds

Death from stabbing and incising ("cutting" or "slashing") wounds is mainly brought about through five mechanisms: massive hemorrhage (exsanguination), air in the bloodstream (air embolism), suffocation (asphyxia), air in the chest cavity (pneumothorax), and infection. Of these, exsanguination is the most common, with hemorrhaging confined principally to the body cavity because stabbing wounds tend to close after the weapon is withdrawn.4 The amount of blood loss necessary to disable totally an individual varies widely and may range from as little as one-half to as much as three liters.5

To reach a vital area it is first necessary to pass the blade through the body's external covering and whatever else lies between, and with regard to techniques in swordsmanship, an important consideration is the degree of force required to pass through intervening structures in order to reach vital structures with a sword-thrust or cut. In France, in 1892, this issue was raised during a trial conducted as a consequence of a duel fought between the Marquis de Mores and a Captain Meyer.6 The question arose on account of an accusation that the weapons used in the duel were "too heavy."7 While two physicians, Drs. Faure and Paquelin, testified that it did not require great strength to inflict a wound similar to that which took Captain Meyer's life, there was some difference of opinion expressed by a number of fencing masters called to testify on the matter of acceptable weights of weapons, and the force required to employ them in the delivery of a fatal thrust.

Even today, prosecutors trying homicide cases involving death by stabbing will sometimes attempt to convince juries that a deeply penetrating stab wound serves as an indicator of murderous intent by virtue of the great force required to inflict such wounds. It is generally accepted today among experts of forensic medicine, however, that the force requisite to inflict even a deeply penetrating stab wound is minimal.8 This opinion would seem to be supported by the experience of a stage actor who inadvertently stabbed a colleague to death during a stage performance of Shakespeare's play, Romeo and Juliet. The unlucky young man delivered a thrust at the very moment his vision was inadvertently obscured by a member of the cast. Although he claimed to have felt no resistance, a post mortem examination revealed that he had penetrated the chest of the victim to a depth of eighteen centimeters.9

Except for bone or cartilage which has become ossified, it is the skin that offers the greatest resistance to the point of a blade. In fact, once the skin is penetrated, a blade may pass, even through costal cartilage, with disquieting ease.10 Generally, of the factors governing the ease of entry, the two most important are the sharpness of the tip of the blade and the velocity with which it contacts the skin. While the mass of the weapon is a factor in penetration, the velocity of the blade at the moment of contact is of greater importance, since the force at impact is directly proportional to the square of the velocity of the thrust.11

Unlike injuries inflicted with pointed weapons, the depth of cutting wounds, produced by the edges of weapons like the sabre or rapier, is governed by a somewhat different set of dynamics which include the radial velocity of the blade at impact, its mass, the proficiency with which the blade is drawn across the body upon contact, and the distance over which the force of the cut is distributed. The greatest depth of penetration in many of these wounds is found at the site where, with maximum force, the blade first makes contact. As the edge is pushed or drawn, the force of the cut dissipates and the blade tends to rise out of the wound as it traverses the body.12 In the case of cutting wounds directed to the chest, the total force required to reach the interior of the chest is greater than that for a point thrust, not only because the force of the stroke is distributed across the length of the cut, but also because of the likelihood that the blade will encounter greater resistance afforded by the underlying ribs and the breastbone (sternum).13

Wounds to the Heart

Because exsanguination is the leading and most frequent cause of death in stabbing and incising wounds, it is not unreasonable to direct our attention initially to wounds to the cardiovascular system and further, to consider the evidence provided by the medical records and coroners reports of the current era. Let us first begin with a brief review of human anatomy. In an adult, the heart is approximately twelve centimeters long, eight to nine centimeters wide at its widest point, and some six centimeters thick. It is encased in a membranous sack, the pericardium, and rests on the upper surface of the diaphragm, between the lower portions of the lungs and behind the sternum. The organ is divided into four chambers: the left and right atria and the left and right ventricles. It is comprised almost entirely of muscle, and serves a vital function as a pumping mechanism to distribute blood throughout the body. It is unattached to the adjacent organs, but is held in place in the chest cavity, suspended by the pericardium and by continuity with the major blood vessels. The muscular walls of the heart are supplied with blood by the the right and the left coronary arteries, each of which bifurcates into a series of subdivisions.14

Because the heart is a vital organ, it is generally thought that a serious injury to the heart will result in instant death. Consequently, it is not unreasonable to suppose that the duelist expected a thrust to his adversary's heart to disable him immediately. While swordplay done in earnest is now a thing of the past, a wealth of information regarding stab wounds to the heart has been accumulated in recent times by the practitioners of modern forensic medicine. Many of these wounds have been inflicted with instruments very much like the blades of rapiers, sabres, and smallswords and the means by which such wounds have been treated, combined with assessments of the injuries through the sophisticated discipline of forensic medicine, reveal some surprising truths with which many duelists most certainly had to deal.

While a stab wound to the heart is a grave matter, numerous instances of penetrating wounds to this organ have been documented in which victims have demonstrated a surprising ability to remain physically active. In 1896 a case was reported in which a twenty-four year old man was stabbed in the heart. Despite a wound to the left ventricle which severed a coronary artery, the victim not only remained conscious, but was also able to walk home.15 Much later, in 1936, a paper was presented to the American Association of Thoracic Surgery in which thirteen cases of stab wounds to the heart were cited. Of these, four victims were said to have collapsed immediately. Four others, although incapacitated, remained conscious and alert for from thirty minutes to several hours. The remaining five victims, thirty-eight per cent of the total, remained active: one walking approximately twenty-three meters and another running three blocks. Yet another victim remained active for approximately ten minutes after having been stabbed in the heart with an ice pick, and two managed to walk to a medical facility for help.16 In another instance a report cites an impressive case of a man stabbed in the left ventricle. Despite a wound 1.3 centimeters in length, the victim was able to continue routine activity for some time and lived a total of four days before expiring.17 In 1961, a survey conducted by Spitz, Petty and Russell included seven victims stabbed in various regions of the heart. While none of these people expired immediately, some were quickly incapacitated. Five were not, however, and one victim, despite a 2 centimeter slit-like "laceration" located in the left ventricle, managed to walk a full city block. After arming himself with a broken beer bottle, the victim finally collapsed while in the act of attempting to re-engage the individual who stabbed him.18

The amount of time elapsing between a stab wound to the heart and total incapacitation of the victim is dependent upon the nature of the wound and which structures of the heart are compromised. In the light of the cases cited in the preceding paragraphs, one may expect that a penetrating wound to the left ventricle, such as that which would be inflicted by a smallsword, may not necessarily bring a combat to a sudden conclusion. Blood in this chamber of the heart, at the end of ventricular contraction (end-systole), may reach pressures as high as one hundred twenty millimeters of mercury or more,19 especially during combat, and one might reasonably expect blood under such pressure to escape readily through a breach in the ventricular wall. The walls of this chamber are comprised almost entirely of muscle tissue, however, and are exceptionally thick. As a consequence, the left ventricular wall has the potential to seal itself partially through the contraction of the muscle tissue immediately surrounding the site of the wound. While the end-systolic pressure in the right ventricle normally amounts to only eighteen percent that of the left, wounds to the right ventricle are far more likely to be quickly fatal because the thickness of this ventricular wall is only a third that of the left ventricle and is, consequently, less able to close a wound.20

With respect to penetrating (stabbing) wounds to the heart the location, depth of penetration, blade width, and the presence or absence of cutting edges are important factors influencing a wounded duelist's ability to continue a combat. Large cuts that transect the heart may be expected to result in swift incapacitation due to rapid exsanguination,21 and immediate loss of pressure, but stab wounds, similar to those that might be inflicted by a thrust with a sword with a narrow, pointed blade may leave a mortally wounded victim capable of surprisingly athletic endeavors. Knight cites a case of one individual who, stabbed "through" the heart, was still able to run over 400 meters before he collapsed. Yet two more striking cases are also reported of victims who survived wounds to the heart, one of which is described as, "a through-and-through stab wound of the left ventricle that transfixed the heart from front to back."22

Wounds to the Major Thoracic Blood Vessels

The vital area located in the center of the chest is not occupied by the heart alone. The large thoracic blood vessels converge with the heart in such a way as to present an area nearly equal in size to that presented by the heart. Consequently, a sword-thrust that penetrates the chest but fails to find the heart may nevertheless pierce or incise one or more of these large vessels.

Normally, blood pressure in the major arteries located in the chest (thorax) averages approximately one hundred millimeters of mercury, with a maximum pressure of some one hundred twenty millimeters at end-systole. Subdivisions of the aorta greater than three millimeters in diameter offer little vascular resistance. Consequently, the average blood pressure in these vessels is nearly the same.23 Since the thoracic arteries confine blood under considerable pressure, and because the walls of these vessels are relatively thin, compared to the walls of the ventricles, punctures or cuts in these vessels may allow blood to escape quite rapidly, depending on the size of the opening. The major thoracic arteries then, are more vulnerable to stabbing wounds than are the ventricles of the heart.24 While a good deal smaller in diameter, a puncture or severing of the coronary arteries, because they supply blood to the walls of the heart's ventricles, may also result in rapid incapacitation of a duelist. Forensic pathologists Dominick and Vincent Di Maio point out that especially vulnerable is the left anterior descending coronary artery which supplies the anterior wall of the left ventricle. Stabbing wounds which transect this small vessel may be expected to result in sudden death.25

Nevertheless, cases have been reported in which stabbing victims, whose thoracic arteries were penetrated, remained physically active for a surprisingly long period of time. An example may be found in the case of a twenty-three year old man who was stabbed in the chest with a kitchen knife.26 At autopsy a wound tract was disclosed that penetrated both the aorta and the left ventricle. Blood issuing from these wounds into the chest cavity amounted to a volume of two liters. Despite the serious nature of his wounds, the victim nevertheless managed to walk more than 100 meters before collapsing and remained alive until shortly after he had been taken to the hospital. Another example is that of a twenty-five year old man whose subclavian artery and vein were severed by a thrust delivered by a kitchen knife. Losing a total of three liters of blood, he was able to run a distance of four city blocks before finally collapsing.27

Wounds to the Major Blood Vessels of the Neck

The aortic arch branches into arteries that service the upper body, including the head. Of these, the left and right common carotid arteries are of significant interest with regard to dueling practice because these vessels supply the larger share of blood to the brain and because they extend unprotected, in the neck, on either side of the windpipe(trachea).28 While these arteries are not externally visible, one can understand why a stroke delivered to the neck with an edged weapon such as a sabre, or thrust with an edged smallsword or rapier, would seem to be an effective means of incapacitating an adversary. Certainly, the severing of a common carotid artery will immediately terminate a large portion of the blood supply to the brain. Nevertheless, the victim of such a wound may remain conscious for from fifteen to as many as thirty seconds;29 a more than ample amount of time for a dying swordsman to execute a number of cuts, thrusts and parries.

In addition to the carotid arteries, the neck also encompasses the jugular veins, which return blood from the brain, face, and neck to the heart.30 While the escape of blood under high pressure is a concern for wounds to the vessels of the arterial system, wounds to the jugular veins pose a different problem. By the time blood reaches these vessels, its pressure is nearly zero.31 In fact, during the inspiratory phase of the respiratory cycle, when contraction of the diaphragm and intercostal muscles creates a negative pressure within the thorax, pressure in the jugular veins also falls below zero. As a consequence, an opening in the jugular vein which communicates with the external environment may allow small bubbles of air to be entrained into the vessel. As the air enters, a bloody froth can be produced which, when drawn into the heart, may render the pumping action inoperative (valve lock). Whereas a severed vein is not usually considered to be as serious an injury as a severed artery, air embolism due to a cut jugular vein may cause a victim, after one or two gasps, to collapse immediately.32

As the neck encompasses the cervical spine, carotid arteries, trachea, and jugular veins in a relatively small space, a sword-thrust to this area would seem very likely to sever or impale a vital structure and disable an adversary almost immediately. And so it was, during the reign of Louis XIII, for one Bussy D'Ambrose who was run through the throat while acting as a second for the Marquis de Beuvron.33 The chance of combat, however, is a fickle companion to the duelist, as Sir Hatton Cheek discovered in 1609 in his duel with Sir Thomas Dutton.34 Each, armed with rapier and dagger, met the other on the sands of Calais. On the first pass Cheek directed a dagger thrust to Dutton's throat, close to the trachea, and ran him through. One may imagine with what surprise Cheek found that the wound proved to be entirely ineffective. In fact, despite the seemingly serious nature of his injury, it was Dutton who concluded the combat by running Cheek through the body with his rapier, and then stabbing him in the back with his dagger. If we are surprised at Dutton's ability to continue the combat, it is with horror that we find that Cheek, after having been so grievously wounded, not only failed to drop to the ground, but continued on with the combat, gathering enough strength to rush yet again upon his adversary. The conflict continued until Dutton, noticing that Cheek began to droop on account of massive blood loss, wisely adopted a defensive strategy, keeping his distance until Cheek finally collapsed from loss of blood.

Wounds to the Major Abdominal Blood Vessels

Within the abdominal cavity are found the abdominal aorta and its two major branches, the common iliac arteries; and their venous counterparts, the inferior vena cava and the common iliac veins. These vessels are large, relatively speaking, and they confine blood under end-systolic pressures similar to those found in the major thoracic arteries. All of these vessels are located in close proximity to the spinal column and lie behind the bulk of the abdominal viscera.35

In the present-day United States, wounds delivered by thrusts or cuts from a sword are almost entirely unheard of; knives are by far the most common weapon involved in stabbings.36 Obviously, the depth to which a knife may penetrate the abdominal cavity is less that that for the blade of a sword. It is important to bear this point in mind with respect to a finding that less than half of all stab wounds do any serious injury to the abdominal viscera. Longer blades might well increase the morbidity and mortality of such injuries.

Wounds to the abdomen which do prove fatal usually involve the large blood vessels and/or the liver, which is a highly vascular organ itself.37 The rate of blood loss from even a grievously wounded liver is not likely to be sufficient to cause sudden cardiac collapse, however, since the vascular resistance within this organ is very high. Complete transection of the abdominal aorta could be expected to incapacitate a duelist relatively quickly, but some degree of good fortune would be required to introduce the blade in such a way as to impale this relatively narrow structure within the bulk of the abdomen, or draw the blade's edge along the artery's wall to transect it.

A sabre stroke would certainly be an effective means of severing the major abdominal arteries and veins, but because they are located against the vertebral column, the stroke would have to be made with considerable violence in order to pass the blade through the skin, the underlying abdominal muscles, and the viscera situated in front of the vessels. Were such a stroke delivered, violating the integrity of the large vessels would be a moot point in any case since the sudden loss of intra-abdominal pressure and the attendant cardiac return would induce immediate cardiac collapse.38 For a cutting action to do so much damage the type of sabre would be an important consideration. While a heavy cavalry sabre with a curved blade would have sufficient mass and dynamics to yield the necessary force, a cut delivered to the abdominal wall by the lighter and shorter dueling sabre with a straight rather than a curved edge would likely prove inadequate to the task and could leave the adversary still capable of posing a serious threat.

Wounds to the Blood Vessels of the Upper Limbs

Although relatively far removed from the heart, the arteries of the arms are still of sufficiently low vascular resistance to carry blood under pressures similar to those found in the greater thoracic arteries. Of the major arteries of the arm, the brachial artery is the largest and lies along the medial surface of the bone of the upper arm (humerus). As it descends, it progressively courses anteriorly to the crook of the arm, where it is well exposed to a sword-thrust or cut. From the crook of the elbow it divides into the ulnar and radial arteries.39 Wounds to any of these vessels can be extremely life-threatening, especially if the vessel is only partly severed, since the muscular walls of a completely transected artery will naturally retract and impair the rate of hemorrhage.40 Incisions in the radial artery are a well-recognized cause of death in suicide victims. Nevertheless, because of their relatively smaller diameters, immediate incapacitation due to blood loss from the severing of these arteries cannot be expected.

The veins of the arm are far more numerous than the major arteries. They are significantly more narrow and intravenous pressures are normally less than ten millimeters of mercury.41 As a consequence, incisions or even complete transections of these vessels can be expected to result in no immediately serious consequences.

Wounds to the Blood Vessels of the Lower Limbs

Much like the arms, the legs each are serviced by one large artery which divides into two major branches. The femoral artery lies in front of the hip joint and descends along the medial surface of the thigh bone, (femur). Unlike the brachial artery, however, the mid and distal portion of the femoral artery is not altogether vulnerable to the blade of the duelist. As it approximates the knee joint it spirals around the femur and passes directly behind the knee in the form of the popliteal artery, which subsequently bifurcates to become the anterior and posterior tibial arteries.42

Like the arm, the leg is laced with a complex network of veins. Most of these are relatively narrow and deep and the pressure of blood confined within these vessels is low. The rate of blood flow through these vessels is relatively slow and wounds severing one or more of them cannot be expected to result in consequences of any interest to the duelist.

Cuts or thrusts to the major arteries of the legs can be serious enough to cause death. Nevertheless, an adversary seriously wounded in a femoral artery ought still to be considered an extremely dangerous adversary because blood loss is unlikely to be so rapid as to result in immediate collapse. In the last of the judicial duels fought in France in 1547 between Francois de Vivonne, Lord of Chastaigneraye and Guy de Chabot, the oldest son of the Lord of Jarnac, Chastaigneraye was wounded by cuts to the back of the knee of both legs.43 Hamstrung, Chastaigneraye lay helpless on the ground while a lengthy exchange of words followed between him and his adversary. Jarnac offered to spare Chastaigneraye if he would admit that his accusations, over which the trial took place, were in error, but Chastaigneraye refused to recant and Jarnac, loth to take his opponents life, pleaded with the attending monarch, Henry II, to intervene and save Chastaigneraye's life. Initially, the king refused to interfere, however. Hemorrhaging uncontrollably from at least one artery, Chastaigneraye remained upon the ground while Jarnac continued to plead back and forth with both Chastaigneraye and the king to end the combat. After Jarnac's third appeal, the king finally interceded, but Chastaigneraye's pride had been mortally wounded. Refusing to allow his wounds to be treated, he finally succumbed after "a little time" from loss of blood.44

It is important to note that Chastaigneraye was considered to have been a swordsman of extraordinary skill as well as an excellent wrestler. Following the cutting stroke to his leg, the extended period during which he lay hemorrhaging to death was certainly of sufficient length to have afforded him a number of thrusts, strokes and parries. Had the slash to the backside of his right leg not crippled him, Chastaigneraye might well have been the victor in this combat, severed artery notwithstanding.

SUMMARY

In conclusion, fencing tempo is a vital element of swordsmanship, but clearly for the duelist hitting before being hit is not at all the same thing as hitting without being hit. Exsanguination is the principal mechanism of death caused by stabbing and incising wounds and death by this means is seldom instantaneous. Although stab wounds to the heart are generally imagined to be instantly incapacitating, numerous modern medical case histories indicate that while victims of such wounds may immediately collapse upon being wounded, rapid disability from this type of wound is by no means certain. Many present-day victims of penetrating wounds involving the lungs and the great vessels of the thorax have also demonstrated a remarkable ability to remain physically active minutes to hours after their wounds were inflicted. These cases are consistent with reports of duelists who, subsequent to having been grievously or even mortally wounded through the chest, neck, or abdomen, nevertheless remained actively engaged upon the terrain and fully able to continue long enough to dispatch those who had wounded them.

End Notes

1 L. Sabine, Notes on Duels and Dueling (Boston: 1855) 70-71.
2 Baldick, The Duel (New York: 1965) 52-53.
3 J. Millingen, The History of Dueling, 2 vols. (London: 1841) II 18-21.
4 W. Spitz and R. Fisher, Medicolegal Investigation of Death (Springfield: 1980) 99.
5 W. Spitz, C. Petty and R. Fisher, "Physical Activity Until Collapse Following Fatal Injury by Firearms and Sharp Pointed Weapons," Journal of Forensic Science 6, no. 3 (1961): 290-300.
6 C. Thimm, A Complete Bibliography of Fencing and Duelling (New York: 1992) 487.
7 Supra, 497-498.
8 B. Knight, Forensic Pathology (New York: 1991) 146-147.
9 Thimm (Supra n. 6), 463.
10 C. Polson, D. Gee and B. Knight, The Essentials of Forensic Medicine (Oxford: 1985)125.
11 Knight (Supra n. 8), 147.
12 Supra, 133.
13 Supra, 140.
14 H. Gray, Anatomy of the Human Body (Philadelphia: 1967) 543.
15 Spitz (Supra n. 4) 291.
16 D. Elkin, "Wounds of the Heart Report of 13 Cases," Journal of Thoracic Surgery 5 (1936): 1936.
17 Spitz (Supra n 4) 292.
18 Supra, 297.
19 A. Guyton, Textbook of Medical Physiology (Philadelphia:1971) 220.; A. Vander, J. Sherman and D. Luciano, Human Physiology: The Mechanisms of Body Function (New York: 1970) 256.
20 Knight (Supra n. 8) 154.
21 D. Di Maio and V. Di Maio, Forensic Pathology (New York: 1989) 185.
22 Knight (Supra n. 8) 154.
23 Guyton (Supra n. 19) 219.
24 Knight (Supra n. 8) 154.
25 DiMaio (Supra n. 21) 184.
26 Spitz (Supra n. 4) 297.
27 Guyton (Supra n. 19) 219.
28 Gray (Supra n. 14) 581-583.
29 Mitchel Morey and Lindsey Thomas, personal communication of 4/9/96.
30 Gray (Supra n. 14) 698, 700
31 Guyton (Supra n. 19)
32 Knight (Supra n. 8), 154, and also Spitz (Supra n. 4), 199.
33 L. Sabine, Notes on Duels and Dueling (Boston: 1855) 70-71, and also Millingen (Supra n. 3), I: 149.
34 Millingen (Supra n. 3), II: 12.
35 Gray (Supra n. 14), 631-632, 645-646, 710.
36 Di Maio (Supra n. 21), 187, and also Knight (Supra n. 8), 141.
37 Di Maio (Supra n. 21), 185.
38 Supra, 187.
39 Gray (Supra n. 14), 618-621.
40 Supra n. 63.
41 Gray (Supra n. 14), 704, and also Guyton (Supra n. 19), 219.
42 Gray (Supra n. 19), 657-665.
43 A. Hutton, The Sword and the Centuries (New York: 1995), 46-52; Baldick (Supra n. 2), 29-31; and also Millingen (Supra n. 3), I: 50-54.
44 Millingen (Supra n. 3), I: 53.


Select Bibliography

Adam, J.C. "Stab Wound of the Brain," British Medical Journal, 2 (1925): 546.
Albuquerque Journal. May 6, 1993. cited in Stockel, H. The Lightning Stick (Reno: University of Nevada Press, 1995)
Alfieri, Francesco. La Scherma (Padova: 1640).
Amberger, J. "The Coup de Jarnac in 150 A.D.!," Hammerterz Forum, 2, no.1 (1995): 12-14.
Aylward,J.D. The English Master of Arms (London: Routledge and K. Paul, 1956).
Baldick, Robert. The Duel (New York: Clarkson N. Potter, Inc.1965).
Capo Ferro, Ridolfo. Gran simulacro dell' arte e dell' uso della scherma (Siena:1610).
Di Maio, Dominick and Vincent Di Maio. Forensic Pathology (New York: Elsevier, 989).
Evangelista, Nick. The Encyclopedia of the Sword (Greenwood: Greenwood Press 1995).
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Gray, Henry. Anatomy of the Human Body, 28th ed.(Philadelphia: Lea and Febiger, 1967) 543.
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Thimm, Carl. A Complete Bibliography of Fencing and Duelling (New York: 1992).
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Vander, Arthur, James Sherman, and Dorothy Luciano. Human Physiology: The Mechanisms of Body Function (New York: McGraw-Hill Book Company, 1970).

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Saddle, Lance and Stirrup: The Irish/Roman Connection
The Naked Truth | If I Had a Hammer
The Sabre's Edge | Swordfight at the OK Corral
How to Defend a Monopoly | A Propos d'un Accident
The Dubious Quick Kill part 1 | The Dubious Quick Kill part 2
Review and Commentary | Duels with the Sword | Starting with Foil
Liancour's Tercentenary | The Manuel d'escrime of 1877 | The Military Masters Fencing Program
Analysis of the Patton Fencing Manual | The Red Court Fencing's Royal Connection
| The Practical Saviolo part 1 | Saddle, Lance and Stirrup
Demystification of the Spanish School 1 | Demystification of the Spanish School 2
Demystification of the Spanish School 3
| A Brief Look at Joseph Swetnam
| Ithacan Retains Title | Third Time's a Charm
Cross-Training Not Cross-Purposes | Riposte Direct | Use of the Word "Sparring"
Chivalry Makes a Come-back | Teachings of Marozzo |

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