The Dubious Quick Kill - Part I
By Maestro Frank Lurz

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. 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. 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. 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 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. 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.

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. The question arose on account of an accusation that the weapons used in the duel were "too heavy." 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. 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.

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. 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.

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. 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).

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 right and the left coronary arteries, each of which bifurcates into a series of subdivisions.

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.

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.

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. 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.

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, 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.

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, 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."

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. 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. 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.

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. 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.

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). 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; 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. 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.

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.

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. 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. 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.

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. 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.

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.

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.

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. 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. 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 thighbone, (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.

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. 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.

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.

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.

The Dubious Quick Kill - Part II

Because exsanguination is the most frequent cause of death in stabbing and incising wounds1, the first installment of this work covered the subject of wounds to the cardiovascular system. Anecdotes of duels fought with rapier, sabre, or smallsword, and forensic literature based upon present-day coroner's reports of homicides in which knives and other sharp instruments were used convincingly showed that mortal wounds to the major vessels and even to the heart itself do not always lead to instant incapacitation of the victim.

The veracity of these accounts is supported by a 1961 survey conducted by Spitz, Petty and Russell which found that of seven victims stabbed in various regions of the heart, none expired immediately. While two were quickly incapacitated, the remaining five were not, and of these one, despite a two-centimeter incision in the left ventricle, walked a full city block, armed himself with a broken beer bottle, and collapsed only after he returned to the scene of the crime to re-engage the individual who had stabbed him. This case in particular makes it clear that for the duelist, mortally wounding an adversary, even in the heart, may not necessarily be enough to place him hors de combat. This final installment will address other organ systems of the human body with an aim to further explore the question of instant incapacitation by thrust or cut.

The Respiratory System
To understand the mechanisms of incapacitation and death caused by sharp force injury to the respiratory system, a brief explanation of the anatomy and mechanical function of this system will be helpful. Air entering the nose and mouth is conducted to the lungs by way of the windpipe (trachea), a nearly cylindrical conduit passing down through the neck toward the chest cavity where it divides into the right and left bronchi. Each bronchus further bifurcates into a series of subdivisions within the lungs. In the chest, within the spaces (pleural cavities) found on either side of the heart, lie the lungs.

Divided into a number of lobes, these organs are exceptionally light, porous, highly vascularized, and elastic. The movement of air into the lungs is governed by a number of muscles which increase the volume of the chest, and hence, the volume of the pleural cavities within. As these cavities expand, a drop in intrathoracic pressure is produced. Provided the airway is clear, air rushes in along the pressure gradient to equilibrate the intrathoracic pressure with outside pressure, thereby inflating the lungs which expand as they fill the larger volume. Upon exhalation the process is reversed, generally through a passive mechanism produced by the elastic character of the lungs, chest wall, and abdomen.

Wounds to the Respiratory System
As long as the pleural cavities remain closed to the outside atmosphere, the mechanics of respiration function normally. If the chest wall is opened, however, intrathoracic pressure will equilibrate as outside air enters, not just into the lungs, but directly into the pleural cavity through the incision (pneumothorax), thereby causing the lung inside to collapse. A sabre stroke penetrating the intercostal muscles and opening the chest wall will produce a pneumothorax, resulting in the immediate loss of function of the lung. Of course to do so, the cut would either have to fall between and run parallel to the ribs, or be of sufficient force to cut through the bone. Since the right and left lungs are each isolated within their own pleural cavities however, a wound to only one side of the chest would leave the lung on the opposite side functional.

A point thrust inflicted by a smallsword or rapier may produce somewhat different results. While a penetrating wound inflicted with these weapons may appear on the surface to be much smaller than the incising wound produced by the stroke of a sabre, the track of a penetrating wound may extend completely through the body, damaging even the most deeply located structures. In addition, such a wound may be inflicted with little effort since the entire force of the thrust is delivered by a sharp point over an extremely small surface area. Depending upon the size of the blade, the hole in the chest wall may be small enough to close itself partially upon withdrawal of the blade, producing only a slow leak of air into the chest cavity. If the victim were well profiled when the thrust was delivered, the blade could enter one lung and easily pass through the chest to the opposite side, causing pneumothorax in both pleural cavities. In this case air would enter the pleural cavity not only through the hole in the chest wall, but also through the holes in the lungs themselves, with each respiratory cycle.

Death caused solely by pneumothorax is generally a slow process, occurring as much as several hours after the wound is inflicted. However, because lung tissue is so heavily vascularized, a blade penetrating not only the chest wall but the lung as well will also cause hemorrhaging into the pleural cavity (hemothorax); the amount of blood and the rate of its flow being dependent upon the dimensions of the wound, blood pressure, vascular structures compromised, and clotting factors.

While blood loss alone may produce incapacitation and death, it is important to consider that, in the case of stab wounds to the chest, most of the blood lost usually remains confined within the pleural cavity because the elastic nature of the tissues around the site of entry tends to at least partially close the wound. Consequently, as the cavity fills with blood, the lung becomes increasingly compressed and less able to function, contributing to the cause of death. Today, most fatalities due solely to stab wounds which penetrate the lungs are caused by hemothorax, with pneumothorax sometimes also present.

As is the case with pneumothorax, neither death nor incapacitation by hemothorax is rapid. Spitz reports a typical case of a twenty-nine year old man stabbed in the chest. Immediately after the stabbing the victim ran across the street to ask for help. He eventually collapsed, but remained alive for one and a quarter hours before expiring. Autopsy revealed a 2.5 centimeter wound track in the lung and a volume of blood in the pleural cavity in excess of two liters.8

Consistent with the findings of Spitz and other present-day investigators, numerous examples taken from dueling anecdotes indicate that sword-thrusts to the lungs were not always effective in immediately placing a determined duelist out of the combat. The duel fought in 1613 between the Earl of Dorset and Lord Edward Bruce is a typical example. According to the account, the Earl received a rapier thrust, which entered the right nipple and passed "level through my body, and almost to my back."

It seems certain that a blade introduced in this fashion would penetrate some part of a lung. Nevertheless, Dorset remained engaged for a considerable period of time and ultimately ran his adversary through with two separate thrusts. Dorset's wound was, indeed, serious for his complete incapacitation followed immediately afterward; as is evidenced by the necessity of one of his seconds to intervene to defend him as one of Lord Bruce's friends, in a moment of uncontrolled temper, attempted to dispatch Dorset where he lay.

This duel almost seems a copy of the duel described by Deerhurst in which a mortally wounded combatant received a through-and-through rapier thrust just above the nipple. With the blade still protruding from his back, the dying man remained upright and fully engaged, repeatedly attempting to drive his own blade into his adversary's throat. Losing a number of fingers while attempting to parry away the thrusts with his hand, the ill-fated defender was eventually impaled. Each transfixed upon the blade of the other, both men remained upright and locked in a death grip for some time before collapsing.

Another example may be found in the duel between Sawyer and Wrey, in which the latter was initially stabbed in the left chest. As Wrey failed to collapse on the spot, Sawyer quickly launched another attack, this time wounding him in the left arm. Despite his chest wound, Wrey nevertheless remained an active, capable, and dangerous adversary. Upon the increasingly confidant Sawyer's third attack, Wrey reversed the fortunes of his as yet unscathed opponent and ran him through.

Given the typically sketchy character of dueling anecdotes, it is often difficult to ascertain satisfactorily the precise nature of the wounds involved since duelists who survived their wounds were not examined at autopsy. However, the account of a duel fought in 1765 between Lord Kilmaurs and an unnamed French officer is an uncommonly illuminating one. The likelihood that a lung was penetrated through-and-through seems, in this case, to be well supported by the details of the anecdotal evidence. According to the account, after one or two attacks, the Frenchman delivered a thrust, which entered the "pit" of Kilmaurs' "stomach" and exited through his right shoulder.

It seems probable that, given the sites of entry and exit, the blade of the officer's weapon would have had to pass through some portion of a lung. In support of this probability, the account goes on to state that subsequent to the termination of the combat, Kilmaurs was nearly "stifled with his own blood." The sign of blood in the airway, combined with the description of the manner in which the blade entered and exited the victim's body, strongly suggests that a lung had been pierced.

It is impossible to know how this affair would have ended since, after the wound had been delivered, the duel was immediately interrupted by spectators. In fact, despite the horrific nature of his wound, Lord Kilmaurs was reported to have seemed hardly aware that anything was amiss. Consequently, assuming that this account is reasonably accurate, Kilmaurs appears to have been, for some time, capable of continuing the combat, potentially reversing the fortunes of his adversary.

The account goes on to say that His Lordship eventually became speechless and demonstrated every sign of impending death for several hours. Incredibly, after just a few days, Lord Kilmaurs' condition improved and over time the gentleman ultimately recovered. Curiously, the Earl of Dorset also recovered from his chest wound and lived an additional thirty-nine years.

As an historical aside, given the current forensic literature one may accept that a swordsman grievously wounded in the lung may nevertheless remain a dangerous adversary for a considerable period. However, one may yet wonder why Dorset and Kilmaurs did not eventually succumb due to pneumothorax or hemothorax. Of course, without medical records or any other information one can only speculate as to why these men survived.

Aside from almost impossibly good luck, their survival may be explained by the fact that because tuberculosis was more prevalent during those times, each of these men may have been previously afflicted with this disease. If so, the scarring of lung tissue may have left portions of their lungs poorly vascularized and slow to hemorrhage. While the evidence of blood in the airway strongly indicates that a lung of Lord Kilmaurs was penetrated, it may be that the rate of blood flowing from scarred lung tissues was low enough to allow clotting to take place before His Lordship bled to death.

Sword-thrusts to the lungs are certainly a serious matter as far as the question of long-term survival is concerned, but it is clear that wounds of this type offer no guarantee that an opponent will immediately be rendered helpless. A thrust or cut to the throat, on the other hand, is a very different matter. As everyone knows, the inadvertent aspiration of even a small amount of fluid into the airway can instantly produce powerful coughing and choking reflexes and acute respiratory distress. Stab wounds or cuts to the neck, which penetrate or transect the trachea or larynx will allow blood to flow directly into the airway, quickly causing incapacitation and death by asphyxiation.

On May 12, 1627 Bussy D'Amboise, while acting as a second in the duel between Francois de Montmorency and the Marquis De Beuvron, was reported to have received such a wound. Immediately disabled, D'Amboise was said to have "just had time to cross himself and die." The evidence for the neck as a choice target for quick kill seems compelling, but by no means should it be taken as a guarantee. In the 1609 duel between Sir Hatton Cheek and Sir Thomas Dutton, Cheek plunged a dagger into Dutton's throat, "close to the windpipe." With so many vital structures compactly situated in the area, it is hard to imagine how Dutton could have survived. Nevertheless, the blade seems to have narrowly missed the trachea, neatly avoiding the common carotid and vertebral arteries and the internal jugular vein as well. As luck would have it, Dutton survived both the wound and the affair, killing Cheek with a rapier thrust through the body, and a dagger thrust to the back as well.

The Musculature
In order to effect locomotion, the human body is invested with an ingeniously designed array of contractile tissues; the voluntary, or skeletal muscles. These muscles are composed of numerous, relatively long muscle fibers gathered together in parallel to form bundles (fasciculi) which, in turn, are bundled together to form individual muscle organs, e.g., the deltoid, biceps or calf muscles with which most of us are familiar. To effect locomotion, muscles must span the joints of bones and attach directly to them at some point by means of masses of strong connective tissues called tendons and aponeuroses16. Upon contraction, the tension between the attached muscle ends pulls one bone toward the other with the joint acting as a pivot or hinge.

The fibers which compose a muscle are generally aligned in a parallel fashion, much like the hairs in a horse's tail. Consequently, a penetrating wound delivered by a narrow blade may have little immediate effect upon the functionality of a muscle since all it does is separate slightly the fibers which compose the muscle as a whole. Similarly, a cutting stroke from an edged weapon which results in an incision running parallel to the fibers of a muscle may not necessarily render an adversary immediately helpless. On the other hand, a cut which incises a muscle at right angles to the longitudinal axis of its fibers can be expected to compromise the function of that muscle to a degree commensurate with the severity of the cut. The same may be said for cuts, which sever the tendons. Should a muscle, a group of muscles, or their tendons be severed, voluntary movement of the body part serviced by that muscle or muscle group will be immediately terminated.

Wounds to Musculature of the Forearm
Incising wounds, delivered with the cutting edges of a sabre or rapier, which transect tendons or muscle groups servicing the sword arm or hand may be expected to serve as an effective means of immediately terminating an adversary's ability to pose a menace. In a duel with the fencing master of the Chasseurs de Vintimille, Marshal Ney, the Duke of Elchingen is said to have wounded his adversary in this fashion. Surgical techniques being as crude as they were in those days, the wound left the victim permanently crippled. The dorsal surface of the forearm of a sabreur in the guard of second is particularly exposed. An examination of the anatomy of the forearm, however, suggests that a single cut to this area may not necessarily succeed in severing a sufficient number of the muscles at this site before the bones around which they are so elaborately entwined prevent the blade from transecting the entire muscle mass.

Cuts transecting the palmar surface of the forearm can sever muscles and tendons required to flex the fingers as they effect a grip on the weapon, and to flex the wrist. An incising wound delivered to this region may incapacitate an adversary more effectively, especially if the cut is placed across the wrist itself because the tendons of so many muscles pass over this site. The palmar surface of the wrist is not well exposed, however, by the sabreur maintaining guards of second, third, or fourth. In rapier play, guards or invitations of second or third suppinate the hand and displace the arm in such a way as to leave the palmar surface of the wrist more vulnerable, but the protection afforded by rapier hilts, whether swept or cup, makes such a cut not so easy a thing to accomplish.

Wounds inflicted by point thrusts through the muscles of the forearm most certainly do not guarantee the immediate disability of an adversary. In the account given by Deerhurst, one of the two combatants received a rapier thrust which entered the inside of the sword arm and exited at the outside of the elbow.18 This description indicates that the track of the wound, rather than transecting the muscles of the arm, ran a course more or less parallel to them and likely did relatively little damage. In fact, after springing back and dislodging the hostile blade from his arm, the combatant was still able to wield his weapon with dexterity sufficient to enable him to run his adversary through.

In the duel between the Earl of Dorset and Lord Edward Bruce, Dorset also received a "great" wound to the arm. Nevertheless, subsequent to the injury, Dorset was able to deliver not one, but two thrusts, each of which passed through his adversary's body. The affair between Sawyer and Wrey, is yet another example. According to this account, Captain Wrey is reported to have received two wounds, one to the left chest and one to the left arm. Because both injuries are located on the same side of the body, it is likely that Wrey was left-handed. If so, it was his sword arm which, though wounded, nevertheless remained serviceable enough to dispatch his antagonist on his third attack.

Wounds to Musculature of the Leg and Thigh As in the case for the forearm, attempts to immediately incapacitate an adversary by directing thrusts or cuts to leg muscles may not have been particularly effective. In the first place, the leading leg of a swordsman in the guard position faces forward to present a fairly heavy bone, the tibia (shin bone), situated just beneath the skin, on the leg's anterior and medial surfaces. Unless a stroke is delivered with enough force to part the bone, a cut placed across this region of the leg is not likely to transect a great deal of muscle. Although considerably more muscle lies on the lateral side of the leg, a stroke to this region would have to be delivered across the target from right to left (in the case of two right-hand swordsmen) with the tibia once again affording some measure of protection.

Regarding the thigh, in the guard position a duelist presents the leading thigh forward in such a way as to expose the femoral muscle group, the quadriceps femoris. This group is composed of four muscles of relatively massive proportions which lie in front and on either side of the thigh bone (femur). All four of these muscles cooperate in extending the leg. The posterior femoral muscles, commonly known as the hamstrings, work together to flex the leg. Because the individual muscles in these groups are massive, and because the individual muscles of each group share common functions, a single cut or thrust to either muscle group may not do enough damage to cripple a leg instantly.

One example illustrating this point may be found in the sabre duel between St. Aulaire and Pierrebourg in which St. Aulaire, quickly seizing what appeared to be an opportunity, delivered a cut to his adversary's knee. While the massive tendons of the quadriceps extend over this site, the account makes no mention of Pierrebourg being either seriously wounded or incapacitated. In fact, the stroke proved to be a costly one for St. Aulaire in that, upon delivering the cut, St. Aulaire exposed his upper body. Seeing the opening, Pierrebourg took advantage and gave point to his opponent's chest. St. Aulaire expired a few minutes later.

Another example of the damage a leg may sustain without loss of function may be found in the duel in 1712 between the Duke of Hamilton and Lord Mouhn, in which Hamilton had been mortally wounded. After he had expired an examination of the body revealed numerous wounds, including one that penetrated his right leg to a depth of eighteen centimeters as well as another wound on the left. Despite these injuries, the Duke was able to inflict three wounds to his adversary, including one to the groin and another, which penetrated the right side of the body, clear through to the hilt.

Because exsanguination is the most frequent cause of death in stabbing and incising wounds1, the first installment of this work covered the subject of wounds to the cardiovascular system. Anecdotes of duels fought with rapier, sabre, or smallsword, and forensic literature based upon present-day coroner's reports of homicides in which knives and other sharp instruments were used convincingly showed that mortal wounds to the major vessels and even to the heart itself do not always lead to instant incapacitation of the victim.

The veracity of these accounts is supported by a 1961 survey conducted by Spitz, Petty and Russell, which found that of seven victims stabbed in various regions of the heart, none expired immediately. While two were quickly incapacitated, the remaining five were not, and of these one, despite a two-centimeter incision in the left ventricle, walked a full city block, armed himself with a broken beer bottle, and collapsed only after he returned to the scene of the crime to re-engage the individual who had stabbed him.2 This case in particular makes it clear that for the duelist, mortally wounding an adversary, even in the heart, may not necessarily be enough to place him hors de combat. This final installment will address other organ systems of the human body with an aim to further explore the question of instant incapacitation by thrust or cut.

Wounds to the Skeletal System
With the exceptions of the enamel and dentin of the teeth, bone composes the hardest structures in the human body. Durable and slightly elastic, it is capable of sustaining considerable force. Although violent strokes delivered by massive weapons such as cavalry sabres can produce forces sufficient to divide bone, cuts or thrusts by the duelist's rapier, sabre or epee may fail to have any immediate incapacitating effect. In fact, some duelists who delivered cuts or thrusts which met with their antagonist's bones were sometimes left at a serious disadvantage. A classic example may be found in the duel fought with rapier and dagger between Lagarde and Bazanez in which a stroke was delivered by the former to his adversary's head. No doubt to Lagarde's surprise, the stroke proved to be ineffective, as the steel merely bounced off his adversary's skull, leaving the blade inconveniently bent.

In the encounter between Baron de Mittaud and Baron de Vitaux, a thrust to the chest by Vitaux also resulted in a disfigured blade. It had been argued that it was a flesh-colored cuirass, concealed beneath the Baron's shirt, that had caused the steel to bend, but tricks of this sort were not unknown, and in fact, both Vitaux and Mittaud had been properly examined by seconds before the duel began. No doubt for this reason it had also been suggested that it was the impact of the point on one of Mittaud's ribs that had bent the blade; a suggestion which may lead one to conclude that such occurrences may have been witnessed before or since. In any case, Vitaux was left with nothing to do but hack away at his adversary until, after "four well-applied cuts," Mittaud finally ran him through.

Yet another example may be found in the 1777 affair between Captain Stoney and a Reverend Mr. Bate. In this combat a thrust delivered by Bate is said to have struck the captain's breastbone. The Reverend's weapon was left so badly bent that his chivalrous opponent felt obliged to pause in order to allow his adversary an opportunity to restore his blade to its proper alignment.

Wounds to the Peripheral Nervous System
Because they lie close to and often between the bones, the larger nerves of the peripheral nervous system are generally not well exposed to the blade. As they extend farther away from the central nervous system, both motor and sensory nerves repeatedly subdivide, ultimately forming a complex network of individual fibers.35 By virtue of its wide distribution this network, as a whole, is capable of sustaining a localized cutting or penetrating wound with little effect to the overall motor function of the body in most cases. Severed pain fibers, of course, are still capable of relaying sensory information, which the brain interprets as pain. The deeply distressing sensation of a cut from a sharp kitchen knife is an experience with which nearly everyone is familiar.

It is not unreasonable, therefore, for one to anticipate that the pain resulting from a sabre or rapier blade drawn across the flesh or passing through the chest, abdomen, or a limb would be severe enough to be immediately disabling. The dueling accounts cited in this essay, however, suggest that even in the case of mortal wounds, pain may not reach levels of magnitude sufficient to incapacitate a determined swordsman. Considering the great emotional stress under which these combats were fought, the adrenaline-mediated "fight or flight" response undoubtedly played a significant role in attenuating the pain of many wounds.

The stress of modern warfare has also provided numerous present-day examples of similar cases in which combat soldiers who, despite extremely serious and even mortal wounds, were surprisingly unaware of their injuries until the engagement was concluded or they noticed blood. Some of these men were reported capable of amazing physical feats and collapsed only when the sequelae of their injuries made further action physically impossible.

Wounds to the Central Nervous System
The central nervous system is well protected by the vertebral column and by the skull. Because of the thinness of bone in the orbits and at the site of the temples however, a point thrust may penetrate these areas with relative ease. Other vulnerable areas of the skull are also found in the frontal, maxillary, and nasal sinuses. The vulnerability of the face was clearly appreciated early in the history of rapier-play.

In Vincentio Saviolo's treatise, "His Practice in Two Books," published in 1595, the master makes it plain that he advocates actions directed to the adversary's face, especially time thrusts. Also, a generous number of illustrations of various fencing actions, described in the treatises published by Capo Ferro and Alfieri in the first half of the 17th century, depict rapier thrusts entering the forward area of the head. In England, fencing master John Turner was reported to have developed considerable skill in dispatching adversaries with thrusts to the eye. In one case Turner is reported to have delivered a thrust to the eye of a combatant "so far in the brain at the eye that he presently fell down stone dead."

That one would instantly fall down "stone dead" as a consequence of a stabbing which penetrates the brain through a breach in the skull may seem an outcome to be reasonably expected. Modern medical case reports, however, show that stab wounds of the skull and brain are, in general, not immediately fatal. In fact, victims have frequently been reported to have walked, and in some cases run away from their attackers. In some instances, victims may not even realize that they have been wounded.

A report by Adam describes a case very much analogous to a sword thrust penetrating the frontal sinus of the skull. According to the report, the victim sustained a wound from a blade eleven centimeters in length which passed through the frontal bone in the region of the frontal sinus and penetrated deeply into the brain. The patient was found to be conscious and coherent upon admission, and after forty days, recovered completely. In another incident, a young man was accidentally shot through the head with an arrow which penetrated to a depth of twenty to twenty-five centimeters. The patient remained conscious, and while being transported to the hospital, attempted to extricate the projectile himself. The arrow, which entered through the face, was finally withdrawn through the back of his skull.

Summary and Conclusions
Early American motion pictures have frequently misrepresented virtually every aspect of authentic swordplay. This seems to have been especially true of the industry's depiction of the manner in which swordsmen fell before the blades of their opponents. While anecdotes of duels may have been biased by politics or personal vanity, modern forensic medicine provides ample evidence to support historical accounts of gravely wounded duelists continuing in combats for surprising lengths of time, sometimes killing those who had killed them.

In the first installment of this essay modern forensic evidence indicated that exsanguination is the principal mechanism of death caused by stabbing and incising wounds, but that death by this means is seldom instantaneous; victims frequently capable of continued physical activity, even after being stabbed in the heart. Similarly, victims of sharp force injuries to the lungs are not infrequently able to carry on for protracted periods of time. Wounds, which result in the introduction of blood into the upper airway, on the other hand, are likely to incapacitate and kill an adversary quite rapidly.

Duels featuring penetrating wounds to the muscles of the sword arm appear in some cases to have left duelists fully capable of manipulating their weapons. Thrusts to the thigh and leg may have been even less efficacious. Strokes with the cutting edges of swords to the limbs may result in more serious wounds to the musculature than the penetrating variety, but historical accounts of duels demonstrate that immediate incapacitation of an adversary stricken with such wounds was by no means guaranteed. Incising wounds, which sever tendons, however, can be expected to immediately incapacitate the muscles from which they arise. Recent medical reports of sharp force injuries to the brain suggest that even a sword-thrust penetrating the skull ought not to have been expected always to disable an opponent instantaneously.

While severe pain is usually incapacitating, the stress of combat may mask the pain of gravely serious wounds, enabling the determined duelist to remain on the ground for a considerable length of time. The immediate consequences to a duelist of wounds inflicted by thrusts or cuts from the rapier, dueling sabre or smallsword were unpredictable. While historical anecdotes of affairs of honor and twentieth century medical reports show that many stabbing victims collapsed immediately upon being wounded, others did not. While a swordsman certainly gained no advantage for having been wounded, it cannot be said that an unscathed adversary, after having delivered a fatal thrust or cut, had no further concern for his safety. Duelists receiving serious and even mortal wounds were sometimes able to