Manual of Surgery volume First:

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[Illustration: FIG.  62. --Radiogram showing Pellets embedded in Arm.
(Mr. J.  W.  Dowden's case. )] A charge of small shot is much more destructive to blood vessels, tendons, and ligaments than a single bullet, which in many cases pushessuch structures aside without dividing them. In the abdomen and chest, also, the damage done by a full charge of shot is much more extensivethan that inflicted by a single bullet, the deflection of the pelletsleading to a greater number of perforations of the i
...ntestine and morewidespread laceration of solid viscera.
When the charge impinges on one of the extremities at close range, weoften have the opportunity of observing that the exit wound is larger, more ragged than that of entrance, and that its edges are everted; theextensive tearing and bruising of all the tissues, including the bones, and the marked tendency to early and progressive septic infection, render amputation compulsory in the majority of such cases.
At a range of from twenty to thirty feet, although the scatter iscomplete, the pellets are still close together, so that if theyencounter the shaft of a long bone, even the femur, they fracture thebone across, often along with some longitudinal splintering.


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