“The Dubious Quick Kill, Part 1⁄2: Sword Wounds and the Circulatory System”, 2006 ():
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.
…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 20th 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 continue effectively in the combat long enough to take the lives of those who had taken theirs…For the duelist, however, another form of tempo had to be considered. In the early history of affairs of honor, this “dueling tempo” spanned the period extending from the moment that a wound was inflicted until the instant that the adversary was no longer able to continue effectively. This span of time was unpredictable in length and could be expressed in terms ranging from a fraction of a second to minutes. Considering the number and severity of wounds that were sustained by combatants in the early days of the duel, it would not be surprising to find that many duelists of latter days secretly breathed a sigh of relief when interrupted by seconds rushing in to terminate affairs of honor immediately upon the delivery of a well placed cut or thrust.