Michael Courtney
Member
Earlier posts described the physics of the ballistic pressure wave and provided a definition of stopping power that can be used to investigate possible pressure wave contributions to incapacitation.
It is generally agreed upon that bullet design plays at least as important a role in bullet effectiveness as the cartridge from which it is fired. However, it is still widely debated whether the only contributing factors to the effectiveness of different designs are the volume of crushed tissue and penetration depth. Crushed tissue volume and penetration clearly contribute to bullet effectiveness through the physiological consequences of blood loss. Over the years, a variety of other mechanisms such as hydrostatic shock, energy dump, hydraulic reaction, and the temporary stretch cavity have been suggested. Authors who suggest these mechanisms usually have something in mind more or less related to a ballistic pressure wave. However, these suggested mechanisms have eluded both clear definitions and unambiguous evidence.
The view that the crushed tissue volume (the permanent cavity) is the only reliable contributor to incapacitation (for handgun bullet placements which do not hit the central nervous system or supporting bone structure) relies strongly on the unproven presupposition that easily detectable wounding (see footnote 1) is necessary for an effect to contribute to incapacitation.
Even though it has been shown that most handgun bullets do not produce a temporary stretch cavity (the volume of tissue temporarily pushed out of the way by a passing bullet) large enough to stretch most vital tissue beyond the elastic limit, it remains an unproven presupposition that exceeding the elastic limit is necessary for correlating increased incapacitation with parameters determined from ballistic gelatin.
footnote 1
By this we mean wounding that would typically be detected by a trauma surgeon or medical examiner.
Handgun bullet effectiveness should be studied without depending on the unproven presupposition that the only significant contributors to incapacitation result in wounding that is easily observable to the trauma surgeon or medical examiner. One way to do this is to separate the issue of incapacitation from wounding by directly considering incapacitation and attempting to correlate observed metrics of incapacitation with potential causal agents. Previous work considering wounding or wound trauma as a valid incapacitation metric depends strongly on the unproven presupposition that only easily detectable wounding contributes to rapid incapacitation.
When considering the handgun loads that produce relatively large pressure waves, there is no published data showing that observed measures of rapid incapacitation are correlated only with the volume of crushed tissue or observed wounding. The conclusion that incapacitation is only caused by volume of crushed tissue or observed wounding is not founded upon repeatable experiments or carefully compiled data, but relies only on expert opinion (see footnote 2) and efforts to discredit data suggesting other causal agents.
footnote 2
We agree with Fackler, MacPherson, Roberts, Dodson, etc. on many points, especially their correlations of bullet parameters and gelatin measurements with observed wounding. MacPherson's book is nearly flawless for the ranges of bullet parameters considered. Our scientific disagreement with their work is whether wounding alone is well correlated with rapid incapacitation. To the extent that they don't claim that it is, we are not saying that they are wrong as much as their work is incomplete. (Their claim is that wounding is well correlated with reliable eventual incapacitation. Our concern is rapid incapacitation.) In areas where Fackler, MacPherson, Roberts, Dodson, etc. make assertions based on published data, we agree with almost every assertion they have made. We disagree only with an untested hypothesis for which they offer no data. Such is science. Disagreeing with expert opinion that is not backed up with published data is how scientific progress is made. We kept asking, "Where's the published data correlating rapid incapacitation only to observable wounding?" There isn’t any.
One step in the formation of the pressure wave hypothesis is the fact that most wound ballistics experts agree that a strongly energy-dependent factor such as the temporary stretch cavity plays a vital role in incapacitation via rifle bullets. It is not obvious that this energy dependent disappears as the energy-dependent parameter is lowered from rifle levels to handgun levels. The most powerful service caliber loads only have 20-30% less impact energy than the .223 Remington. (see footnote 3) In addition, some service caliber handgun loads have peak pressure wave magnitudes that are larger than some of the more deeply penetrating rifle bullets.
A second step in the formation of the pressure wave hypothesis is our repeated observations from sport hunting that one only needs a handgun bullet which expands to 0.6” or 0.7” to incapacitate a deer as quickly (with a shot to the center of the chest) as a archery broadhead of 1-3/8” to 1-1/2” cutting diameter. If the only important parameter was the amount of major blood vessels severed to create gradual blood loss, then it stands to reason that a bullet would have to expand to a diameter comparable to that of the broadhead to have a comparable effect.
footnote 3
The most energetic 10mm loads provide over 750 ft-lbs of energy. In an M4, the SS109 round provides 1026 ft-lbs at 50 yards and only 686 ft-lbs at 200 yards. Consequently, studying how incapacitation depends on pressure wave magnitude (related to energy) is also relevant for understanding decreasing .223 effectiveness as range is increased or barrel length is shortened.
Yet with full broadside penetration near the center of the chest, hunting handgun bullets that reliably expand to only 0.6” or 0.7” in the typical deer hunting cartridges will reliably incapacitate deer at least as quickly (on average) as a hunting broad head of 1-3/8” to 1-1/2” cutting diameter. If handgun bullets produce an effect in deer that provides for more rapid incapacitation than bleeding effects alone, it stands to reason that this effect may be present in similarly-sized mammals such as humans.
A third step in the formation of the pressure wave hypothesis is the idea that blood pressure drop due to internal bleeding takes about 5 seconds to have its effect in a best case scenario. Newgard describes this idea well (Ref i):
For an average 70 kg (155 lb.) male the cardiac output will be 5.5 liters (~1.4 gallons) per minute. His blood volume will be 60 ml per kg (0.92 fl. oz. per lb.) or 4200 ml (~1.1 gallons). Assuming his cardiac output can double under stress (as his heart beats faster and with greater force), his aortic blood flow can reach 11 liters (~2.8 gallons) per minute. If one assumes a wound that totally severs the thoracic aorta, then it would take 4.6 seconds to lose 20% of his blood volume from one point of injury. This is the minimum time in which a person could lose 20% of his blood volume.
We agree with this assertion, and the theoretical ideas are confirmed by many observations of deer almost always taking 5-10 seconds to fall with any broadside archery shot hit through the center of the chest. In contrast, we have observed numerous deer drop in under 5 seconds when hit by handgun bullets creating pressure waves at the larger end of the spectrum. Likewise, events of apparently involuntary incapacitation in under 5 seconds are repeatedly reported in humans for handgun shots which fail to hit the CNS or supporting bone structure.
The Strasbourg Tests (Ref ii) employed a pressure sensor inserted into the carotid artery of live unanaesthetized goats. These tests directly suggest that an internal pressure wave created by the interaction of the bullet and tissue can contribute to rapid incapacitation and can incapacitate more quickly than the crush cavity/blood loss mechanism alone:
In a substantial number of cases, the subject was incapacitated almost instantly. Each time this occurred, between two and five pressure spike tracings of high amplitude and short duration were found which immediately preceded and matched corresponding, diffused, or flattened lines (EEG tracings). Normally, the time lag between the first pressure spike and the beginning of slowed or flattened lines was between 30 and 40 milliseconds (although there were several cases where this delay lasted as long as 80 milliseconds)…The taller pressure spike tracings always preceded the slowed or flat line tracing…The initial spikes had to be of a certain height in order for the animal to collapse immediately.
However, the anonymity of the experimenters and has resulted in ongoing doubt about the findings.
In contrast to the Strasbourg result, there have been some arguments against the pressure wave hypothesis. Claims to disprove the hypothesis of pressure wave incapacitation effects usually contain one or more of the following flaws:
1. Considering velocity ranges rather than pressure wave magnitude ranges. There is no velocity threshold where the pressure wave effects begin to turn on. There is a pressure wave magnitude threshold.
2. Considering observable wounding rather than a measure of incapacitation. It is important to consider the possibility of incapacitation mechanisms that might not produce wounding that is easily detectable to a trauma surgeon or medical examiner. Consequently, to disprove the pressure wave hypothesis, one would have to observe and measure incapacitation directly rather than simply observing wounding after the fact. To our knowledge, there is no published data that fails to show a pressure wave contribution to incapacitation over the full range of peak pressure magnitudes produced by handgun loads.
3. Showing that the pressure wave does not make a significant contribution to incapacitation in a pressure wave regime considerably smaller than some available handgun loads. To compare different handgun loads, we consider the peak pressure on the edge of a 1" diameter circle centered on the axis of the wound channel. Handgun loads that produce 500 PSI at this point have pressure wave incapacitation effects that are difficult to discern (require a very large number of data points) with shots to the thoracic cavity. Handgun loads that produce over 1000 PSI at this point and penetrate at least 10" have pressure wave contributions that are relatively easy to discern (don't require as many data points.)
4. Confusing the concepts of unproven and disproven. The fact that some previous studies make a weak case for the pressure wave mechanism, means that the effect has not yet been proven in the published literature. This does not mean it has been disproven.
5. Considering kinetic energy ranges rather than pressure wave ranges. It is not sufficient to show the absence of a pressure wave contribution to incapacitation with loads that produce a certain amount of kinetic energy. Disproving the pressure wave hypothesis requires showing the absence of a pressure wave contribution to incapacitation with loads that produce 1500 PSI on the edge of a 1" diameter circle centered at the wound channel.
6. Considering only the "sonic pressure wave" rather than the complete pressure wave (defined as the force per unit area that would be measured by a high-speed pressure transducer).
Consequently, since there has been no convincing experimental disproof of the pressure wave hypothesis, we should consider that the hypothesis of a pressure wave contribution to rapid incapacitation has substantial anecdotal support, and is well supported by an anonymous experiment of questioned veracity (the Strasbourg Tests).
There are also a number of papers in the peer-reviewed journals discussing ballistic pressure wave effects on wounding and incapacitation (Ref iii). These papers are mainly concerned with velocities of rifle bullets, but the energy and pressures produced are within the regime of pistol bullets.
Suneson et al. report that peripheral high-energy missile hits cause pressure changes and damage to the nervous system. This experimental study on pigs found that test subjects shot in the left thigh (516 ft-lbs of energy transferred) experienced pressure waves in the brain on the order of 18 PSI. Apneic periods were observed during the first few seconds after the shot, and both blood-brain and blood-nerve barrier damage were found. They concluded that “distant effects, likely to be caused by the oscillating high-frequency pressure waves, appear in the central nervous system after a high-energy missile extremity impact.”
Martin Fackler published a reply in both the Journal of Trauma and Wound Ballistics Review (Ref iv), asserting that “Shock Wave” is a myth:
In ascribing “local, regional, and distant injuries” to the sonic pressure wave, Suneson et al. have overlooked the effect of transmitted tissue movement from temporary cavitation. Since two distinct mechanisms are acting in the Suneson et. al experiment, one cannot arbitrarily assign any effects observed to only one of them.
Fackler’s replies have several major flaws:
Fackler continues:
Recently, eleven adult human-sized swine (90 kg) were shot in the proximal part of the hind leg with a projectile producing the damage profile of the Russian AK-74 Assault rifle bullet. This same projectile was used in another study in which five 90 kg swine were shot through the abdomen …No indication of any sort of “distant” damage was seen in the pigs’ behavior and no “distant” injuries were found at autopsy.
The methodology of Fackler’s pig experiments is significantly different from Suneson et al., who report that the neural damage is not easily observable, but rather depends upon examination with light and electron microscopy. The effects that Suneson et al. report “were evident a few minutes after the trauma and persisted even 48 hr after the extremity injury.” In Fackler’s experiments, autopsies were not performed until weeks or months later. With such great differences in experimental methodology, it is unfounded to assert that Fackler’s swine experiments contradict the conclusions of Suneson et al.
Fackler continues:
A review of 1400 rifle wounds from Vietnam (wound Data and Munitions Effectiveness Team) should lay to rest the myth of “distant” injuries. In that study, there were no cases of bones being broken, or major vessels torn, that were not hit by the penetrating bullet.
It strains that boundaries of credulity that someone would refute modern observations (using new methods) of microscopic damage to nerve cells by referring to the absence of observations of broken bones or torn blood vessels in a Vietnam-era observations from trauma surgeons. The Vietnam-era study was not looking for distant nerve damage, and they did not employ the methods used by Suneson et al.
The results of Suneson et al. also find substantial agreement with later experiments in dogs conducted by an independent research group using a substantially similar methodology (Ref v).
There are a number of additional papers in the peer-reviewed journals studying the damage to the central nervous system caused by pressure wave effects. Since their focus is on long-term effects, this research does not reach definitive conclusions regarding whether these pressure wave effects contribute to rapid incapacitation of humans. However, there is a growing body of evidence that pressure waves near 30 PSI can cause CNS damage that would usually be undetected by a trauma surgeon or medical examiner, but can be quantified with advanced neurological techniques.
There is also well-established evidence that pressure waves near 30 PSI applied to the brain causes immediate incapacitation of laboratory animals (Ref vi). In a study applying a pressure wave directly to the brain via the lateral fluid percussion technique, Toth et al. report both instantaneous incapacitation and cellular damage:
The delivery of the pressure pulse was associated with brief (<120-200 sec), transient traumatic unconsciousness (as assessed by the duration of suppression of the righting reflex).
One reasonably wonders what relevance these live animal experiments using the lateral fluid percussion technique to induce a pressure wave injury in laboratory animals have for understanding neurological pressure wave effects in humans. A 15 year review and evaluation of this question concluded (Ref vii):
We conclude that the lateral fluid percussion brain injury model is an appropriate tool to study the cellular and mechanistic aspects of human traumatic brain injury…
Consequently, there is significant support for the hypothesis of a pressure wave contribution to incapacitation not only in anecdotal observations and an anonymous experiment on goats, but also in well-established results of neurological experiments.
As of January 2006, there are published results showing that a pressure wave can cause rapid neurological incapacitation and/or damage in goats, dogs (Ref viii), swine, several species of laboratory rats, and even in whales (Ref ix). In many of these cases, detecting wounding requires advanced techniques such as electron microscopy, cellular analysis, EEG monitoring, and sophisticated chemical analysis. Consequently, the hypothesis that incapacitation only occurs from wounding that is easily detectable to the trauma surgeon or medical examiner has been disproven. This opens the door to consider support for pressure wave contributions to incapacitation by experiments observing incapacitation directly without concern for easily detectable wounding.
Michael Courtney
It is generally agreed upon that bullet design plays at least as important a role in bullet effectiveness as the cartridge from which it is fired. However, it is still widely debated whether the only contributing factors to the effectiveness of different designs are the volume of crushed tissue and penetration depth. Crushed tissue volume and penetration clearly contribute to bullet effectiveness through the physiological consequences of blood loss. Over the years, a variety of other mechanisms such as hydrostatic shock, energy dump, hydraulic reaction, and the temporary stretch cavity have been suggested. Authors who suggest these mechanisms usually have something in mind more or less related to a ballistic pressure wave. However, these suggested mechanisms have eluded both clear definitions and unambiguous evidence.
The view that the crushed tissue volume (the permanent cavity) is the only reliable contributor to incapacitation (for handgun bullet placements which do not hit the central nervous system or supporting bone structure) relies strongly on the unproven presupposition that easily detectable wounding (see footnote 1) is necessary for an effect to contribute to incapacitation.
Even though it has been shown that most handgun bullets do not produce a temporary stretch cavity (the volume of tissue temporarily pushed out of the way by a passing bullet) large enough to stretch most vital tissue beyond the elastic limit, it remains an unproven presupposition that exceeding the elastic limit is necessary for correlating increased incapacitation with parameters determined from ballistic gelatin.
footnote 1
By this we mean wounding that would typically be detected by a trauma surgeon or medical examiner.
Handgun bullet effectiveness should be studied without depending on the unproven presupposition that the only significant contributors to incapacitation result in wounding that is easily observable to the trauma surgeon or medical examiner. One way to do this is to separate the issue of incapacitation from wounding by directly considering incapacitation and attempting to correlate observed metrics of incapacitation with potential causal agents. Previous work considering wounding or wound trauma as a valid incapacitation metric depends strongly on the unproven presupposition that only easily detectable wounding contributes to rapid incapacitation.
When considering the handgun loads that produce relatively large pressure waves, there is no published data showing that observed measures of rapid incapacitation are correlated only with the volume of crushed tissue or observed wounding. The conclusion that incapacitation is only caused by volume of crushed tissue or observed wounding is not founded upon repeatable experiments or carefully compiled data, but relies only on expert opinion (see footnote 2) and efforts to discredit data suggesting other causal agents.
footnote 2
We agree with Fackler, MacPherson, Roberts, Dodson, etc. on many points, especially their correlations of bullet parameters and gelatin measurements with observed wounding. MacPherson's book is nearly flawless for the ranges of bullet parameters considered. Our scientific disagreement with their work is whether wounding alone is well correlated with rapid incapacitation. To the extent that they don't claim that it is, we are not saying that they are wrong as much as their work is incomplete. (Their claim is that wounding is well correlated with reliable eventual incapacitation. Our concern is rapid incapacitation.) In areas where Fackler, MacPherson, Roberts, Dodson, etc. make assertions based on published data, we agree with almost every assertion they have made. We disagree only with an untested hypothesis for which they offer no data. Such is science. Disagreeing with expert opinion that is not backed up with published data is how scientific progress is made. We kept asking, "Where's the published data correlating rapid incapacitation only to observable wounding?" There isn’t any.
One step in the formation of the pressure wave hypothesis is the fact that most wound ballistics experts agree that a strongly energy-dependent factor such as the temporary stretch cavity plays a vital role in incapacitation via rifle bullets. It is not obvious that this energy dependent disappears as the energy-dependent parameter is lowered from rifle levels to handgun levels. The most powerful service caliber loads only have 20-30% less impact energy than the .223 Remington. (see footnote 3) In addition, some service caliber handgun loads have peak pressure wave magnitudes that are larger than some of the more deeply penetrating rifle bullets.
A second step in the formation of the pressure wave hypothesis is our repeated observations from sport hunting that one only needs a handgun bullet which expands to 0.6” or 0.7” to incapacitate a deer as quickly (with a shot to the center of the chest) as a archery broadhead of 1-3/8” to 1-1/2” cutting diameter. If the only important parameter was the amount of major blood vessels severed to create gradual blood loss, then it stands to reason that a bullet would have to expand to a diameter comparable to that of the broadhead to have a comparable effect.
footnote 3
The most energetic 10mm loads provide over 750 ft-lbs of energy. In an M4, the SS109 round provides 1026 ft-lbs at 50 yards and only 686 ft-lbs at 200 yards. Consequently, studying how incapacitation depends on pressure wave magnitude (related to energy) is also relevant for understanding decreasing .223 effectiveness as range is increased or barrel length is shortened.
Yet with full broadside penetration near the center of the chest, hunting handgun bullets that reliably expand to only 0.6” or 0.7” in the typical deer hunting cartridges will reliably incapacitate deer at least as quickly (on average) as a hunting broad head of 1-3/8” to 1-1/2” cutting diameter. If handgun bullets produce an effect in deer that provides for more rapid incapacitation than bleeding effects alone, it stands to reason that this effect may be present in similarly-sized mammals such as humans.
A third step in the formation of the pressure wave hypothesis is the idea that blood pressure drop due to internal bleeding takes about 5 seconds to have its effect in a best case scenario. Newgard describes this idea well (Ref i):
For an average 70 kg (155 lb.) male the cardiac output will be 5.5 liters (~1.4 gallons) per minute. His blood volume will be 60 ml per kg (0.92 fl. oz. per lb.) or 4200 ml (~1.1 gallons). Assuming his cardiac output can double under stress (as his heart beats faster and with greater force), his aortic blood flow can reach 11 liters (~2.8 gallons) per minute. If one assumes a wound that totally severs the thoracic aorta, then it would take 4.6 seconds to lose 20% of his blood volume from one point of injury. This is the minimum time in which a person could lose 20% of his blood volume.
We agree with this assertion, and the theoretical ideas are confirmed by many observations of deer almost always taking 5-10 seconds to fall with any broadside archery shot hit through the center of the chest. In contrast, we have observed numerous deer drop in under 5 seconds when hit by handgun bullets creating pressure waves at the larger end of the spectrum. Likewise, events of apparently involuntary incapacitation in under 5 seconds are repeatedly reported in humans for handgun shots which fail to hit the CNS or supporting bone structure.
The Strasbourg Tests (Ref ii) employed a pressure sensor inserted into the carotid artery of live unanaesthetized goats. These tests directly suggest that an internal pressure wave created by the interaction of the bullet and tissue can contribute to rapid incapacitation and can incapacitate more quickly than the crush cavity/blood loss mechanism alone:
In a substantial number of cases, the subject was incapacitated almost instantly. Each time this occurred, between two and five pressure spike tracings of high amplitude and short duration were found which immediately preceded and matched corresponding, diffused, or flattened lines (EEG tracings). Normally, the time lag between the first pressure spike and the beginning of slowed or flattened lines was between 30 and 40 milliseconds (although there were several cases where this delay lasted as long as 80 milliseconds)…The taller pressure spike tracings always preceded the slowed or flat line tracing…The initial spikes had to be of a certain height in order for the animal to collapse immediately.
However, the anonymity of the experimenters and has resulted in ongoing doubt about the findings.
In contrast to the Strasbourg result, there have been some arguments against the pressure wave hypothesis. Claims to disprove the hypothesis of pressure wave incapacitation effects usually contain one or more of the following flaws:
1. Considering velocity ranges rather than pressure wave magnitude ranges. There is no velocity threshold where the pressure wave effects begin to turn on. There is a pressure wave magnitude threshold.
2. Considering observable wounding rather than a measure of incapacitation. It is important to consider the possibility of incapacitation mechanisms that might not produce wounding that is easily detectable to a trauma surgeon or medical examiner. Consequently, to disprove the pressure wave hypothesis, one would have to observe and measure incapacitation directly rather than simply observing wounding after the fact. To our knowledge, there is no published data that fails to show a pressure wave contribution to incapacitation over the full range of peak pressure magnitudes produced by handgun loads.
3. Showing that the pressure wave does not make a significant contribution to incapacitation in a pressure wave regime considerably smaller than some available handgun loads. To compare different handgun loads, we consider the peak pressure on the edge of a 1" diameter circle centered on the axis of the wound channel. Handgun loads that produce 500 PSI at this point have pressure wave incapacitation effects that are difficult to discern (require a very large number of data points) with shots to the thoracic cavity. Handgun loads that produce over 1000 PSI at this point and penetrate at least 10" have pressure wave contributions that are relatively easy to discern (don't require as many data points.)
4. Confusing the concepts of unproven and disproven. The fact that some previous studies make a weak case for the pressure wave mechanism, means that the effect has not yet been proven in the published literature. This does not mean it has been disproven.
5. Considering kinetic energy ranges rather than pressure wave ranges. It is not sufficient to show the absence of a pressure wave contribution to incapacitation with loads that produce a certain amount of kinetic energy. Disproving the pressure wave hypothesis requires showing the absence of a pressure wave contribution to incapacitation with loads that produce 1500 PSI on the edge of a 1" diameter circle centered at the wound channel.
6. Considering only the "sonic pressure wave" rather than the complete pressure wave (defined as the force per unit area that would be measured by a high-speed pressure transducer).
Consequently, since there has been no convincing experimental disproof of the pressure wave hypothesis, we should consider that the hypothesis of a pressure wave contribution to rapid incapacitation has substantial anecdotal support, and is well supported by an anonymous experiment of questioned veracity (the Strasbourg Tests).
There are also a number of papers in the peer-reviewed journals discussing ballistic pressure wave effects on wounding and incapacitation (Ref iii). These papers are mainly concerned with velocities of rifle bullets, but the energy and pressures produced are within the regime of pistol bullets.
Suneson et al. report that peripheral high-energy missile hits cause pressure changes and damage to the nervous system. This experimental study on pigs found that test subjects shot in the left thigh (516 ft-lbs of energy transferred) experienced pressure waves in the brain on the order of 18 PSI. Apneic periods were observed during the first few seconds after the shot, and both blood-brain and blood-nerve barrier damage were found. They concluded that “distant effects, likely to be caused by the oscillating high-frequency pressure waves, appear in the central nervous system after a high-energy missile extremity impact.”
Martin Fackler published a reply in both the Journal of Trauma and Wound Ballistics Review (Ref iv), asserting that “Shock Wave” is a myth:
In ascribing “local, regional, and distant injuries” to the sonic pressure wave, Suneson et al. have overlooked the effect of transmitted tissue movement from temporary cavitation. Since two distinct mechanisms are acting in the Suneson et. al experiment, one cannot arbitrarily assign any effects observed to only one of them.
Fackler’s replies have several major flaws:
- Fackler employs the straw man fallacy by referring to the pressure wave studied by Suneson et al. as “the sonic pressure wave.” The authors studied a “shock” wave and clearly stated that the wave includes both sub-sonic and super-sonic frequency components up to 250 kHz. By definition, sonic waves only include frequencies from 20 Hz - 20 kHz. The pressure wave under study has both sonic and super-sonic components. In addition, Fackler considers the “sonic pressure wave” to be limited to a very short (several microseconds) pulse that preceeds temporary cavitation. Suneson et al. are describing effects of pressure waves with a much longer duration.
- Fackler creates a false dichotomy to divide effects beyond the permanent crush cavity into only the temporary cavity and the “sonic” pressure wave. Ballistic pressure waves have components both at frequencies below the sonic range (< 20 Hz), and at frequencies above the sonic range (> 20 kHz). The pressure wave consists of every force per unit area that can be detected by a high-speed pressure sensor.
- Movement of tissue by cavitation is not distinct from the ballistic pressure wave. (One can consider temporary cavitation an effect of the inertial component of the pressure wave.) Consequently, ascribing the local neural injuries to the pressure wave is not unreasonable, though Fackler is correct to point out that in the local region, the pressure wave effects cannot be distinguished from temporary cavitation effects.
- Suneson et al. also report regional and distant effects beyond the reach of the temporary cavity. Nerve damage is observed as far as 0.5m away from the wound channel. These regional and distant effects cannot be ascribed to temporary cavitation.
Fackler continues:
Recently, eleven adult human-sized swine (90 kg) were shot in the proximal part of the hind leg with a projectile producing the damage profile of the Russian AK-74 Assault rifle bullet. This same projectile was used in another study in which five 90 kg swine were shot through the abdomen …No indication of any sort of “distant” damage was seen in the pigs’ behavior and no “distant” injuries were found at autopsy.
The methodology of Fackler’s pig experiments is significantly different from Suneson et al., who report that the neural damage is not easily observable, but rather depends upon examination with light and electron microscopy. The effects that Suneson et al. report “were evident a few minutes after the trauma and persisted even 48 hr after the extremity injury.” In Fackler’s experiments, autopsies were not performed until weeks or months later. With such great differences in experimental methodology, it is unfounded to assert that Fackler’s swine experiments contradict the conclusions of Suneson et al.
Fackler continues:
A review of 1400 rifle wounds from Vietnam (wound Data and Munitions Effectiveness Team) should lay to rest the myth of “distant” injuries. In that study, there were no cases of bones being broken, or major vessels torn, that were not hit by the penetrating bullet.
It strains that boundaries of credulity that someone would refute modern observations (using new methods) of microscopic damage to nerve cells by referring to the absence of observations of broken bones or torn blood vessels in a Vietnam-era observations from trauma surgeons. The Vietnam-era study was not looking for distant nerve damage, and they did not employ the methods used by Suneson et al.
The results of Suneson et al. also find substantial agreement with later experiments in dogs conducted by an independent research group using a substantially similar methodology (Ref v).
There are a number of additional papers in the peer-reviewed journals studying the damage to the central nervous system caused by pressure wave effects. Since their focus is on long-term effects, this research does not reach definitive conclusions regarding whether these pressure wave effects contribute to rapid incapacitation of humans. However, there is a growing body of evidence that pressure waves near 30 PSI can cause CNS damage that would usually be undetected by a trauma surgeon or medical examiner, but can be quantified with advanced neurological techniques.
There is also well-established evidence that pressure waves near 30 PSI applied to the brain causes immediate incapacitation of laboratory animals (Ref vi). In a study applying a pressure wave directly to the brain via the lateral fluid percussion technique, Toth et al. report both instantaneous incapacitation and cellular damage:
The delivery of the pressure pulse was associated with brief (<120-200 sec), transient traumatic unconsciousness (as assessed by the duration of suppression of the righting reflex).
One reasonably wonders what relevance these live animal experiments using the lateral fluid percussion technique to induce a pressure wave injury in laboratory animals have for understanding neurological pressure wave effects in humans. A 15 year review and evaluation of this question concluded (Ref vii):
We conclude that the lateral fluid percussion brain injury model is an appropriate tool to study the cellular and mechanistic aspects of human traumatic brain injury…
Consequently, there is significant support for the hypothesis of a pressure wave contribution to incapacitation not only in anecdotal observations and an anonymous experiment on goats, but also in well-established results of neurological experiments.
As of January 2006, there are published results showing that a pressure wave can cause rapid neurological incapacitation and/or damage in goats, dogs (Ref viii), swine, several species of laboratory rats, and even in whales (Ref ix). In many of these cases, detecting wounding requires advanced techniques such as electron microscopy, cellular analysis, EEG monitoring, and sophisticated chemical analysis. Consequently, the hypothesis that incapacitation only occurs from wounding that is easily detectable to the trauma surgeon or medical examiner has been disproven. This opens the door to consider support for pressure wave contributions to incapacitation by experiments observing incapacitation directly without concern for easily detectable wounding.
Michael Courtney