He became Americas leading authority on gunshot wounds and is credited as the United States first civilian trauma surgeon.Mid-nineteenth-century handguns such as the Colt revolvers used during the American Civil War had muzzle velocities of just 230–260 m/s and their powder and ball predecessors had velocities of 167 m/s or less. Unlike todays high-velocity bullets, nineteenth-century balls produced almost little or no cavitation and, being slower moving, they were liable to lodge in unusual locations at odds with their trajectory.Wilhelm Röntgens discovery of X-rays in 1895 led to the use of radiographs to locate bullets in wounded soldiers.Survival rates for gunshot wounds improved among US military personnel during the Korean and Vietnam Wars, due in part to helicopter evacuation, along with improvements in resuscitation and battlefield medicine. Similar improvements were seen in US trauma practices during the Iraq War. Some military trauma care practices are disseminated by citizen soldiers who return to civilian practice. One such practice is to transfer major trauma cases to an operating theater as soon as possible, to stop internal bleeding. Within the United States, the survival rate for gunshot wounds has increased, leading to apparent declines in the gun death rate in states that have stable rates of gunshot hospitalizations. Research
Research into gunshot wounds in the USA is hampered by lack of funding. Federal-funded research into firearm injury, epidemiology, violence, and prevention is minimal. See also
Blast injury, an injury that may present similar dangers to a gunshot wound.
The majority of all homicides and suicides are firearm-related, and the majority of firearm-related deaths are the result of murder and suicide. When sorted by GDP, however, the United States has a much higher violent gun death rate compared to other developed countries, with over 10 times the number of firearms assault deaths than the next four highest GDP countries combined. Gunshot violence is the third most costly cause of injury and the fourth most expensive form of hospitalization in the United States. History
Until the 1880s, the standard practice for treating a gunshot wound called for physicians to insert their unsterilized fingers into the wound to probe and locate the path of the bullet. Standard surgical theory such as opening abdominal cavities to repair gunshot wounds, germ theory, and Joseph Listers technique for antiseptic surgery using diluted carbolic acid, had not yet been accepted as standard practice. For example, sixteen doctors attended to President James A. Garfield after he was shot in 1881, and most probed the wound with their fingers or dirty instruments. Historians agree that massive infection was a significant factor in Garfields death.At almost the same time, in Tombstone, Arizona Territory, on 13 July 1881, George E. Goodfellow performed the first laparotomy to treat an abdominal gunshot wound. : M-9  Goodfellow pioneered the use of sterile techniques in treating gunshot wounds, washing the persons wound and his hands with lye soap or whisky, and his patient, unlike the President, recovered.