Black Medicine Anthology

by N. Mashiro

  e. Knee joint (strike anywhere on the front and sides)

  f. Deep peroneal nerve (shin)

  g. Arch of the foot (right against the shin)

  h. Lateral plantar nerve

  Figure 36

  The rear view of the leg.

  a. Coccyx

  b. Sciatic nerve (within or just below the told of the buttocks)

  c. Hamstrings

  d. Popliteal fossa

  e. Gastrocnemius and Soleus muscles

  f. Achilles tendon

  g. Lateral malleolus

  h. Tibial nerve and artery

  Rectus femoris:... are both areas where a kick or club blow to the belly of the muscle will cause temporary paralysis and cramping, making it difficult for the opponent to maneuver and impossible for him to use foot techniques, (Figure 35).

  Back of the thigh (the hamstrings): The biceps femoris, the semitendinosus, and the semimembranosus are three specialized muscles of the back of the thigh which collectively are known as the hamstrings. Although they are located in the thigh, these three muscles actually are attached to the bones of the pelvis and the lower leg, and do not attach to the femur at all. For this reason the hamstrings are able to both straighten the hip and also bend the knee. These are the muscles which athletes spend so much time trying to lengthen, because when the hip if fully flexed, as when attempting a high kick, the hamstrings are normally too short to allow full straightening of the knee at the same time. A blow to the bellies of these muscles will partially paralyze them, temporarily weakening the leg. Beneath these muscles lies the sciatic nerve which may also be affected by a blow to this area. Under rare conditions, the hamstrings may be presented as a knife or bayonet target. Severing them produces immediate collapse of the leg and permanent crippling, (Figures 36 and 37).

  Patella or Kneecap: The patella is a small piece of bone which carries a tendon across the knee joint from the rectus femoris to the tibia. When the leg is extended fully and relaxed, the patella can be grasped and manipulated from side to side and up and down over the surface of the knee joint. This looseness makes the patella vulnerable to dislocation by a skillful kick which catches the lower edge of the bone at either side and drives it upward at a forty-five degree angle across the face of the knee joint. Once dislocated, the patella requires surgery before it can be relocated, and permanent injury to the mobility of the leg may result, (Figures 35 and 38).

  Front or side of the knee: The knee is a very weak joint since it is held together by a number of small ligaments and little else. In addition, the knee joint connects two of the longest bones in the body, the femur and the tibia, which makes it vulnerable to blows falling anywhere in the central third of the leg. When the knee is bent it can be broken by a kick against either side of the joint, and when the knee is completely straight in toward the patella. The knee is particularly vulnerable because in most fighting stances this is the part of the body closest to the opponent.

  Figure 37

  The photo shows an attack on the sciatic nerve and hamstring muscles intended to insure that a temporarily downed opponent stays down. In this position such a kick might easily break the femur as well.

  Broken knees have a reputation of not healing very well at all, and for this reason most karate instructors refrain from allowing their students to direct practice attacks at each other's knees. This is a target where a slight error can cause severe injury and permanent disability. Needless to say, in an emergency a kick to the knee will immobilize an opponent, effectively putting him out of the fight, (Figure 35).

  Back of the knee (popliteal fossa): The popliteal fossa is the indentation at the back of the knee, bordered on either side by the tendons of the hamstrings. A light kick to this point will almost invariably bend the knee, abruptly bringing the opponent to a kneeling position. The tibial nerve is vulnerable at this point as well, (Figure 36).

  Deep peroneal nerve: This nerve lies exposed on the surface of the tibia from a point about seven inches below the knee all the way down to the front of the ankle. Also known as the anterior tibial nerve, this nerve is vulnerable to any kicking or raking action against the front of the tibia. An unusually sharp pain results, which in addition to weakening the whole leg, also paralyzes the muscles which flex the foot and toes upward. This makes it impossible for the opponent to perform tricks involving the ball, front, or side of the foot. Severe trauma to this nerve will produce "footdrop," a condition where the toes drag on the ground with every forward step, greatly reducing the opponent's mobility, (Figure 35).

  Gastrocnemius and Soleus muscles: These are the muscles of the back of the lower leg which extend the foot and which support the weight of the body when one stands on one's toes. It is interesting to note that the gastrocnemius is another of the unusual leg muscles which spans two joints, in this case the knee and the ankle joints. A kick to the back of the calf will tend to weaken and paralyze these muscles, and the tibial nerve may be injured as well, (Figure 36).

  Achilles' tendon (tendo calcaneous): Any kind of stomping or raking kick to the Achilles' tendon is tantamount to a blow to the gastrocnemius and soleus muscles, since it is through this tendon that these muscles act upon the foot. Stretching of the tendon stimulates injury-sensing nerves which misinterpret the situation and inhibit the calf muscles. An attack upon the opponent's Achilles' tendon will produce pain and weakness in the opponent's legs. A knife slash here will sever the tendon and bring the opponent - permanently - to his knees, (Figure 36).

  Figure 38

  When embraced from behind it is very easy to attack the opponent's knees, shins and feet. Here a difficult dislocation of the kneecap is being attempted.

  Lateral malleolus: This target area is the hard bony lump on the outside of the ankle, and the side of the fibula for a few inches up the leg from the ankle. The superficial peroneal nerve runs through the skin over the bone in this area, and a raking blow down the fibula will damage it. This will inhibit the muscles which control the ankle. This makes it very difficult to maintain one-point balance on the injured foot, (Figure 36).

  Tibial nerve and posterior tibial artery: Immediately below the medial malleolus, which is the hard bony lump on the inside of the ankle, the tibial artery and nerve are exposed to attack where they cross the side of the first tarsal bone (the talus) on their way down into the sole of the foot. Trauma to this area produces pain in the entire leg and hip and paralyzes the posterior calf muscles, making it impossible to flex the foot downward. This is turn makes it very difficult for the opponent to support his weight on the injured foot, (Figure 36).

  Arch of the foot: The target point is the instep of the foot at the base of the first and second metatarsals, where the shin meets the foot. Trauma to the arch of the foot at this point will also injure portions of the medial plantar nerve, the deep peroneal nerve and the superficial peroneal nerve. The net result is loss of coordination in the entire leg plus secondary pain in the leg and abdomen, (Figure 35).

  Lateral plantar nerve: The striking point is about two inches from the point described above, at the level of the fourth and fifth metatarsals. Dislocation or fracture of these bones results in trauma to the lateral plantar nerve, another of the branches of the posteriortibial nerves, producing severe pain and partial paralysis of the lower leg, (Figure 35).

  Toes: The toes, like the fingers, are easily sprained by nearly any blow which brushes across the end of the foot, such as any of a variety of blocks which might be used to nullify an opponent's kick. An untrained individual could be sufficiently distracted by this injury that he might glance downward momentarily or in some other way lose his concentration and make himself vulnerable to a more serious attack.

  Why should a manual of vital points include a section on pistol shooting? There is a very good reason illustrated by the following story.

  In their classic combat text, Shooting to Live, W. E. Fairbairn and E. A. Sykes related the tale of a sergeant of police who interrupted a Chinese robber
as he was holding up a rice shop in Shanghai.

  The Chinese immediately opened fire on the sergeant with an automatic pistol at about six yards, firing several shots until his pistol jammed. Fortunately, none of the shots took effect, and meanwhile the sergeant returned the fire swiftly and effectively with a .45 Colt automatic, commencing at about ten feet and firing his sixth and last shot at three feet as he rapidly closed in on his opponent. Later, it was found that of those six shots, four had struck fleshy parts of the body, passing clean through, while one bullet remained in the shoulder and another had lodged near the heart. Yet, in spite of all this, the robber was still on his feet and was knocked unconscious by the butt of the sergeant's pistol as he was attempting to escape by climbing over the counter.

  The point of the story is that it is quite possible to shoot an attacker full of holes with a pistol and yet not stop him! Although there are many confounding factors to take into account, it turns out that the "stopping power" of a pistol bullet depends mainly on what part of the body is hit. In other words, there are a certain number of vital areas of the body which when hit by a pistol bullet will produce instant incapacitation. If these areas are missed though, there is no guarantee that any bullet wounds inflicted will slow the man down at all. Contrary to popular opinion, variations in bullet diameter, weight, speed and energy have much less effect on the stopping power of pistol bullets than the placement of the shot.

  The previous statement calls for some justification. According to the Army Medical Department's Wound Ballistics, bullets of roughly the size used in modern small arms require a minimum velocity of 120 feet per second in order to penetrate human skin. Another 200 feet per second of speed is used up in penetrating a layer of bone, such as a rib, the breastbone or the braincase. Allowing a little more to account for damage to internal structures after penetration we can make the generalization that just about any kind of small arms bullet traveling faster than 400 feet per second represents a potentially lethal projectile. That pistol bullets in general are potentially lethal with standard velocities in excess of 700 feet per second is not in question. Even the lowly BB-cap traveling at 400 f.p.s. has been known to kill.

  For most pistol calibers the maximum velocity of the bullet does not exceed 1200 f.p.s. At speeds between 400 and 1200 f.p.s. the bullet has a tendency to bore a hole through the body, creating a wound channel that is about the same diameter as the bullet. Damage is confined to this channel. At velocities higher than 1200 f.p.s. the bullet carries enough energy that under special circumstances much more severe wounds can result, but generally the bullet simply passes through the body. It is only after the bullet has been accelerated above 2400 f.p.s. that the high-velocity "explosive" wound becomes typical, in which a wide zone of tissue around the wound track is pulped by the passage of the bullet. No defensive handgun approaches this level.

  The most complete and comprehensive investigation of the effect of various pistol calibers and bullet designs on the human body was conducted by John T. Thompson and Louis A. LaGarde over seventy years ago on behalf of the War Department. (Note that pistol and bullet designs have changed very little since then). It was their ghoulish task to fire handguns at human cadavers under controlled circumstances in search of a pistol load that would prove more effective in combat than the .38 caliber sidearm the Army was using at that time. There was some thought that when an enemy soldier is swinging a machete at your head it would be nice if your pistol would kill him instantly rather than just puncture him.

  Thompson and LaGarde tested a variety of pistols and bullet designs on the cadavers and carefully evaluated the wounds produced. Their conclusions, confined to a discussion of handguns, contradicted some of the more macho inclinica- tions of shooters then and today.

  According to Thompson and LaGarde, the vital points of pistol combat shooting consists of the brain, spinal cord, and the long bones of the legs, (Figure 40). No other part of the body can be wounded by a pistol bullet in such a way as to guarantee that the victim will collapse immediately. Shots through the heart or major blood vessels can very quickly prove fatal, but collapse may not come quickly enough to prevent injury or death to the shooter.

  Figure 39

  In combat pistol shooting, the brain is the primary target for maximum stopping power.

  Pistol wounds through the lungs, although commonly regarded as fatal, cannot be depended upon to drop a man in his tracks. This is true also of wounds in other fleshy parts of the body. To test for "shock" effects due to multiple wounds, which the cadavers didn't show very well, Thompson and LaGarde fired rapid bursts of shots into the chests of living cattle. The idea was to determine what effect multiple shots through the lungs had on "stopping power" as measured by the number of shots it took to make a steer collapse. They found that ten .30 caliber Luger bullets (93 gr., 1420 f.p.s.) through the lungs did not upset the steers at all. The animals turned their heads to see what had caused all the noise, but showed no sign of distress. (This says something about the effectiveness of small caliber sidearms and also about how stupid a steer is). .45 caliber and larger bullets should drop the steers, but it usually took four or five shots.

  As for "knock down," there is probably no greater area of misinformation in the whole subject of stopping power. According to Newton's third law, the detonation of the powder charge in a pistol must push the pistol backward as forcefully as it pushes the bullet forward. Therefore, if the recoil transmitted to the shooter's body from the gun is not enough to knock him off his feet, then it follows that the energy absorbed by the victim's body when struck by the bullet will not be enough for a "knock down" either. In his Textbook of Pistols and Revolvers, Julian S. Hatcher demonstrated this point with a series of calculations showing that a standard military .45 ACP bullet carries only enough energy to knock a man backward at a rate of a little less than two inches per second. This is next to nothing. Fairbairn and Sykes, authors of Shooting to Live, related their attempts to examine the "knock down" potential of pistol bullets by allowing themselves to be shot at while holding a bullet-proof shield. They reported that in all cases the force transmitted to them through the shield was negligible. The ability of modern kevlar body armor to stop .44 magnum bullets at point-blank range without knocking the wearer off his feet is further proof of this point, if any is needed.

  Thompson and LaGarde concluded that any pistol load in general use could penetrate the brain case and produce an instantly lethal wound of the brain. It was also found that although some of the higher velocity bullets (comparable to today's magnums) could produce explosive brain wounds there was no need for the added destruction. A.22 bullet in the brain will stop a man just as quickly as blowing his skull apart. Much the same conclusion was applied to the case of explosive wounds of the long bones of the legs, caused by high-velocity pistol bullets. Less energetic bullets were capable of fracturing these bones and producing instant incapacitation, and the explosive effect contributed little. In fact, the researchers tried actual exploding bullets, filled with black.powder and a primer, but concluded that the wounds produced were not very different from those produced by high-velocity bullets, and therefore did not contribute much to stopping power.

  The researchers found that larger pistol bullets in general produced more dangerous wounds since the wound channel was large in diameter and did not close easily when the various layers of skin and muscle re-arranged themselves after wounding. This promoted greater bleeding in wounds caused by large diameter bullets.

  Pistol bullets of all types including soft lead, hollow point, and dum-dum completely failed to expand regardless of velocity unless they hit bone or solid cartilage. Soft lead bullets in a flat-point (wadcutter or semi-wadcutter) shape were judged fractionally more effective in producing wounds because they tended to catch on bones and cut into arteries in circumstances where jacketed or round-nosed bullets would glance off.

  In general, Thompson and LaGarde concluded that the available pistol ammunition they te
sted did not differ much in terms of stopping power, although there were significant differences in penetration and general killing power. Wounds in the brain, spinal cord, and long bones of the legs would reliably stop a man regardless of the bullet employed, but for non-vital areas they somewhat facetiously suggested that a three-inch diameter bullet would be necessary for reliable stopping power.

  Figure 40

  This diagram illustrates the vital areas of combat pistol shooting as defined by Thompson and LaGarde. For absolute "stopping power" only the brain, spinal cord and the long bones of the legs can be wounded in such a way as to guarantee that the victim will drop immediately to the ground. The heart and associated major blood vessels present another vital target, but some individuals will be able to stay on their feet for several seconds after being wounded in these organs. For the situation in which all resistance must be extinguished immediately, the brain is both the most effective target and the largest.

  The reader should bear in mind that in a gun fight when time is the critical factor the old rule of firing into the center of the body is still good advice. These vital areas are for occasions when the shooter has that extra split-second in which to take aim.

  FIGURE 40

  One aspect of pistol combat at close quarters that may have been overlooked is the destructive power of the muzzle blast, which can produce a more serious wound than the bullet itself if the pistol is fired in contact with the victim's body. That is a tricky business, admittedly, since there is always the possibility that the pistol will suffer a ruptured barrel if fired with the muzzle against flesh. Still, after contemplating some of the ghastly photographs in LaGarde's Gunshot Injuries, it is a possibility that cannot be lightly dismissed. One photo, for instance, is of a man who put the muzzle of a .30-'06 rifle in his mouth and committed suicide. It is a picture of a headless man.