It is advisable to use the data of forensic medicine to study the methods and better understand the processes of inflicting damage to the enemy's manpower. In this section, such as forensic traumatology and others, the mechanisms of damage formation that occur due to various influences are identified.

At the same time, we are interested primarily in the ways and means of inflicting damage that are possible in hand-to-hand combat. This allows us to identify new damaging factors of various types of weapons and ammunition, to develop ways to strengthen already known in forensic medicine.

Bodily injury or injury refers to a violation of the anatomical integrity or physiological functions of an organ (tissue) that occurred as a result of any environmental factor and resulted in a health disorder or death.

Damage caused by mechanical influences.

In medical practice, the most common injuries that occur as a result of various mechanical influences.

All means that can cause mechanical damage, it is customary to divide into weapons-products of special purpose-for attack and defense, tools (hammer, file, axe, kitchen knife) that have a domestic or industrial purpose, and items - all other means that do not have a direct purpose ( stick, stone, etc.).

All items (weapons, tools) that can cause mechanical damage, in forensic medicine, it is customary to divide, depending on the characteristics and mechanism of action, into crushing or blunt solid, sharp and firearms. In accordance with the mechanism of injury, there are injuries bruised, chopped, stab, cut, stab and gunshot origin.

In chemical and morphological terms, mechanical injuries are divided into bruises, abrasions, wounds, concussions and ruptures of organs, dislocations, fractures, kneading and dismemberment (dismemberment). This kind of damage is usually called anatomical.

Functional injuries are those in which anatomical disorders are absent or so minimal that they are detected only with the help of special studies, but the function of the organ is impaired. This can include a health disorder (blindness, deafness, paralysis of the limbs, etc.) and death by blows to the reflexogenic zones, concussion of the brain, physical pain.

Wounds are the result of a violation of the integrity of the skin, which is often accompanied by damage to the underlying soft tissues, nerve trunks, blood vessels, and when penetrating into the cavity of wounds - even internal organs. Depending on the type of weapon and object, as well as the mechanism of injury, there are wounds from the action of hard blunt objects - bruised (including torn and bitten), sharp objects - cut, stab, stab and chopped; firearms - bullet, shot, shrapnel.

Injuries to internal organs can occur as a result of direct impact directed at the projection of the organ (abdominal wall injury with liver damage, head blow in a fall and brain injury, etc.), or mediated by a General concussion of the body and be closed or form part of the wound channel. Internal injuries are accompanied by internal or external bleeding.

Dislocations are a displacement of the normal articular surfaces and are more often observed on the upper extremities.

A bone fracture-a violation of its anatomical integrity-is accompanied by damage to the surrounding soft tissues to a greater or lesser extent.

Kneading occurs due to the action of significant gravity.

Dismemberment of the body or dismemberment of individual parts is observed when explosives, firearms, chopping tools are used.

The causes of death from mechanical injuries are diverse, but the most common ones can be identified.

Injuries incompatible with life are associated with gross traumatization of the body: traumatic amputation of the head, kneading (crushing) of the head, separation of the trunk, extensive destruction of internal organs, destruction of the spinal cord in the neck, etc.

Blood loss-is plentiful and acute. With heavy blood loss, death occurs due to the expiration of a large amount of blood (40-50%). The bleeding is relatively slow, even within a few hours.

Acute blood loss is characterized by the outflow of blood from the main vessels, even in relatively small amounts (200 - 500 ml). At the same time, the intracardiac pressure drops sharply and acute anemia of the brain occurs. In such cases, the loss of 1 liter of blood is sufficient to cause death.

Bruising and concussion of the brain usually accompany a violation of the integrity of the bones of the skull, but can also be observed in the absence of its fractures or cracks. They are more common in blunt force trauma.

Concussion and contusion of heart with subsequent reflex stop to meet with strong blows with a blunt object in the reflex area( solar plexus, testicles, heart, etc.). Shaking heavily sometimes able to cause rupture of the heart muscle (usually the right ventricular wall, when the moment of impact coincides with the period of filling with blood), followed by filling with blood the cavity of the pericardium. With strong blows, even heart breaks are observed.

Compression of organs with spilled blood or air occurs, as a rule, with injuries to the cranial or thoracic cavity, less often-the spinal cord in the cervical Department.

Intracranial hemorrhages of traumatic origin, even with the volume of blood spilled in 70-120 ml, sharply increase intracranial pressure, causing compression (compression) of the brain and dislocation (displacement) of its stem part.

Compression of the heart's blood during hemorrhage into the cavity of the pericardial SAC (tamponade) occurs due to damage to the vessels or even the walls of the Atria and ventricle , as well as hollow veins, which stops the flow of blood into the heart cavity.

Compression of the lungs with blood that has poured into the pleural cavity is less dangerous, since the lungs are very elastic, and the volume of the pleural cavities is significant. More often, death occurs from compression of the lungs with blood and air (hemopneumothorax). Usually fatal bilateral pneumothorax, and of the unilateral most life-threatening is the right-sided (especially valvular).

Pneumothorax can occur not only as a result of wounds to the chest cavity, but also when the chest is closed and the lung tissue is damaged by fragments of the ribs.

Shock of the 3rd and 4th degree can be the main cause of death, when the injuries themselves do not lead to death, but cause overexcitation of the Central nervous system, with subsequent disorders of nervous regulation. Primary shock causes reflex cardiac arrest when the so-called reflexogenic zones are traumatized (the larynx, genitals, nail phalanges, etc.).

Death due to mechanical damage can also occur due to complications, which are very diverse.

One of the most frequent and dangerous complications is acute renal failure, which develops as a result of traumatic shock, acute blood loss, extensive soft tissue kneading. Trauma combined with pain factor and toxemia causes spasm of the kidney vessels, which leads to a decrease in blood flow in their cortical layer with impaired microcirculation and microthrombosis.

Injuries that occur as a result of compression or impact of any, even a small, area of the object, it is customary to designate as bruised, i.e., arising from the action of a blunt object. Blunt objects are those that do not have sharp ends or sharp corners and have a specific mechanism of action (impact, compression, stretching, friction) when causing damage. At the heart of such injuries is a General mechanism by which the anatomical integrity of the organ tissue or its function is violated. Both in impact and compression, blunt objects (more or less sharply) produce a compressive effect due to their surface. Usually, the tissues do not separate, and if this happens, then the already mashed tissues are separated.

The direction of external impact, the properties of the surface of the traumatic object and the amount of kinetic energy are factors that largely determine the morphological features of the injury. Among the numerous objects that are considered damaged by a blunt hard object, there are various objects that have a flat or uneven surface (a stone, a stick), as well as parts of the human body: a fist, a leg, a head, etc.The action of a damaging object at an angle of 900 to the surface of the human body, depending on the kinetic energy and the striking plane, can cause various injuries. The larger the impact surface, the less (all other things being equal) expressed trauma at the point of impact. The phenomena of body concussion come to the fore. There are ruptures of parenchymal organs such as the heart, lungs, and their displacement.

As the area of the damaging object decreases (at the point of impact), the damage increases as kinetic energy is concentrated on a small surface. Depending on the properties of the striking part of the object, damage occurs (bruises, wounds, fractures) of one form or another.

Falling from a height and resulting injuries in forensic medicine are considered as a type of impact of solid blunt objects. In this case, a free-falling body hits a stationary surface (plane). The scale of damage consists of the kinetic energy of a free-falling body and the nature of the surface on which the body falls.

In forensic medical practice, there are often cases of falling on a flight of stairs, and the resulting damage depends not only on the height of the fall, but also on the additional speed communicated to the body, such as when pushing a stranger's hand.

Injuries caused by human body parts are assessed as a type of blunt force trauma and are not uncommon in forensic practice. They can occur as a result of a blow with a fist, palm, nails, shod feet, head, or teeth. When a fist is struck, bruises and even bruised wounds occur (especially in places where the bone lies close to the skin). Possible fractures (for example, the bones of the nose, jaw, ribs), bruises and concussions of the brain. There are cases of reflex cardiac arrest when a blow is made to the area of the fifth intercostal space on the left, the epigastric region, and the anterolateral surface of the neck.

A blow with the edge of the palm on the anterolateral surface of the neck can cause a fracture of the laryngeal cartilage, trauma to the neurovascular bundle and associated reflex cardiac arrest.

When kicking an opponent, especially if he is in a supine position, injuries, including in the abdomen, lead to ruptures of internal organs, fractures of the ribs, sternum, other bones of the skeleton, to a closed craniocerebral injury.

Thus, strikes by an unarmed person can be life-threatening and cause death if they are inflicted in reflexogenic zones. Sometimes blows can be applied to two reflexogenic zones in rapid succession, causing a combined injury.

Immediately after exposure to the reflexogenic zone, clinical manifestations occur, which either instantly or quickly lead to death or helplessness of the victim. After a blow, the victim often screams, or utters one or two words, holds his breath, wheezes, turns sharply pale, grabs the injured area, sometimes foam is released from the mouth, loses consciousness, slowly settles or falls as if knocked down. With perineal trauma, acute pain is accompanied by vomiting, nausea, dizziness, sharp loss of consciousness and less often leads to reflex cardiac arrest. It should be noted that when the reflexogenic area is injured, conscious actions and insignificant movement are not excluded.

When hitting the reflexogenic zones, various injuries can occur. On the skin in the area of blunt force trauma (including fist, hand or foot, head, etc.) can be bruising, abrasion, less a flesh wound. In the area to be injured, hemorrhage, tissue tears, fractures of the ribs and sternum are detected. When you hit the heart area, there are hemorrhages in the heart muscles, external and internal ruptures: pericardium, septum and heart valves. With abdominal trauma, hemorrhage is found in the abdominal muscles, diaphragm, pancreas, a blow to the neck leads to hemorrhages along the vagus and lingual nerves, along the carotid artery, to damage to the hyoid bone, thyroid cartilage, and epiglottis.

A blow to the perineum can lead to a superficial wound and hemorrhage in the scrotum, bruising, rupture or rupture of the testicles.

Damage caused by sharp objects.

Sharp are objects, tools, and weapons that have a sharp end or sharp edge, or both.

Sharp objects (depending on their purpose, features of mechanisms of damaging action) are divided into chopping, cutting, stabbing, stabbing, sawing. Differentiating feature for objects, determining the morphological features of the damage is slashing and cutting objects with sharp edges (blade), have piercing-cutting – sharp edge (or edges) and the sharp end, the sharp – pointed end.

Chopping tools in cross-section have the form of a wedge, a more or less sharp blade and a significant mass (axe, mowers, checkers, sabers, broadswords, etc.). Chopped damage can also be caused by a shovel, hoe, etc. Characteristic signs of chopped injuries are their significant depth and dissection of the underlying bone tissue.

Cutting objects have a sharp blade (razor, table knives, edge of glass, etc.). when the blade of the cutting object is pressed on a part of the body and simultaneously stretched, cut wounds are formed.

Cutting objects can be submerged not only when the blade slides, but also when plunging into the body of the sharp end. In such cases, it is customary to talk about stab injuries, and the objects themselves are called stabbing. These include: knives, daggers, shears, etc. Immersion of the pointed blade in the depth of the body is accompanied by separation of tissues-a cut.

Rod-shaped objects with a cross section of a wide variety of shapes that do not have a cutting edge, but only have a sharp end, cause damage when it is immersed in the body. Such items are designated as stabbing, and damage from them-stabbed. Such items include: the rapier, espadron, awl, chisel, chisel, folded the jaws of the scissors, etc. Saws and similar tools can be referred to as saws.

Damage caused by throwing devices.

Projectile devices such as spearfishing rifles are the precursors of firearms ("shoot" - to release an arrow). Such throwing weapons currently have the character of sports (crossbows, bows, spearfishing guns). As damaging objects (wounding projectiles) are various designs of arrows, Darts, harpoons, the kinetic energy of the flight of which is created by the elastic properties of the structure itself (bow), or its parts (rubber at the gun for spearfishing). Injuries that occur when exposed to arrows and harpoons are stab wounds. The wound channels are mostly blind. In some cases, when an arrow (harpoon) is extracted, the tip may remain in the depth of the wound. Damage can be significant, capturing not only soft tissue, but even flat bones.

Gunshot wounds.

Due to the fact that shooting from short distances (based on the experience of the great Patriotic war and local conflicts after it) is an integral part of hand-to-hand combat, it is advisable to study the use of firearms in hand-to-hand combat, as well as damage resulting from its use.

In case of firearm injuries, the main damaging factor is a bullet, shot, or other projectile that causes a strong blow to the body. In a small area, this leads to a rupture or dislocation of the skin, compression of them and the transfer of waves towards the wound channel. In a hollow organ or filled with a liquid, a shock wave leads to a hydrodynamic effect, due to which the organ is completely destroyed. Hitting the bone, the projectile (bullet) can lead to a crushing action. Losing energy at the exit, and sometimes at the entrance, the bullet has a wedge-shaped effect, spreading the tissue like a piercing weapon.
The mechanisms of formation of injuries caused by firearms (bullets) are very diverse and largely depend on the kinetic energy of the wounding projectile (bullet). A bullet with a flight speed higher than 230 m / s has a breakdown effect. At a flight speed of less than 150 m/s, the bullet acts wedge-shaped, forming, as a rule, blind wounds.

To defeat (wound) a person, the bullet must have an energy of at least 10 KGM (100 j). A bullet with a lower kinetic energy ("on the fly", after passing through an obstacle, after a ricochet, etc.) can only cause a concussion effect.

At the moment of impact of a bullet in the soft tissues of a person there is a shock head wave that propagates in the direction of the bullet movement at a speed of about 2000 m/s-in the soft tissues there are phenomena of shock concussion of the environment. A "molecular concussion zone" is being created. In the area bordering the wound canal, a shock head wave can cause significant damage.

It is established that at the speed of a bullet about 800 m\s, fatal injuries to the head and chest are always found, without damage to large vessels or vital organs by the bullet itself. With the passage of the bullet through the soft tissue close to the bone there is a fracture.

The striking effect of small arms bullets can increase after breaking through various obstacles and ricochets. At the moment of destruction of the barrier by the bullet, its fragments are formed, which have kinetic energy sufficient for destruction. In addition, the bullet itself can be destroyed (fragmented) or change its shape, thereby increasing the area of damage.

The piercing effect of the bullet and the striking effect behind the barrier depends on its speed and energy, the thickness and strength of the obstacle material.

According to the mechanism of damage caused, shell fragments (grenades, mines) and secondary shells can be equated to bullets. If the muzzle of the barrel is pressed tightly against the body, this is usually denoted as a shot at point-blank range. In such conditions, the pre-zero air causes damage earlier than the bullet, which flies into the already formed wound. Following the bullet, gases and components accompanying the shot burst into the wound channel. They not only cause the rupture of the skin wound, which acquires a cruciform shape, but also have a destructive effect on the course of the wound channel.

Gunshot wounds can be through, blind, and tangent.

A through-wound is a wound that has an inlet and outlet connected by a wound channel, which is usually straight. Sometimes when the internal rebound or displacement of organs, the wound channel is a broken line, and when the bullet passes through different organs, it can be intermittent.

A blind wound is a wound that has an entrance hole and a wound channel, at the end of which there is a firearm shell.

A tangent is called a wound if the bullet does not penetrate the skin, passing through it, but forms an open elongated superficial wound channel. It is noteworthy that often death occurs from wounds to the heart and large vessels, but at the same time, such injured people are able to run, walk, scream, etc. Similar cases are described with through-stab wounds of the heart, numerous injuries to the ventricles and Atria of the heart and blood vessels.

There are cases of injuries when a firearm is fired with through wounds to the heart, lungs, and aorta, when after each of these fatal injuries, the person continued to shoot accurately.

It should be emphasized that the functional capabilities of a person with fatal injuries of vital organs are great. A stressful situation mobilizes the body's forces, which lead to unexpected actions.