It’s a widely held misconception that an “unarmed” person – someone with only their hands, without tools (gun, knife, baseball bat, hammer, 2×4, etc.) – is not dangerous, is not harmful.

Robert A. Margulies, MD, MPH, FACEP speaks with the ACLDN about blunt force trauma lethality.

A blow to the temple area where the skull is relatively thin can actually cause a fracture in that area and tear the underlying artery. This can produce permanent disability, and can cause death.

A blow to the back of the neck can dislocate the spine and cause paralysis or death. These are things that one does not really have to be a trained martial artist to do. Blows to the nose, to the back of the neck, to the throat are examples of “empty hands” that can produce disability or death.

Head and face trauma has an interesting aspect to it. It is not just that somebody has been hit in the face, but bleeding and swelling of tissues can also lead to airway blockages. Bleeding in the mouth can lead to swallowed blood, which is very irritating and can cause vomiting which puts somebody at a disadvantage, but also leads to the risk of aspiration. That is, the vomit is trying to come up and out, and you’re trying to breath in, and you suck some of this stuff down into your lungs. All of these things can become fatal, even though this was just a broken jaw and a little bleeding.

A blow to the ribs can cause injury to the liver or the spleen, both of which, in the vernacular, bleed like stink. Surgery is extremely difficult because the liver and the spleen are not like muscle where you can isolate a blood vessel and get control, they’re spongy and trying to suture is like trying to sew gelatin—it is difficult! It requires a highly trained team to be able to salvage somebody who has a shattered liver or spleen. Spleens can be removed and the patient can survive. Humans do not do well without a liver.

Dr. Margulies continues:

Unequivocally not. I consider hands and feet, knees, elbows and shoulders, to be deadly weapons. Once that first blow is delivered and once you go to the ground, the kick to the head, the knees in the chest, may produce permanent injuries and fatalities. I’m going to give you a reference to an article in the Journal of Head and Face Medicine, published in October 2005 (see http://www.head-face-med.com/content/1/1/7 – B10). One of the comments in it is that as of 2005, we in developed countries have a level of facial injuries caused by interpersonal violence exceeding those from motor vehicle crashes. This is not a new concept or a new problem.

I won’t question the fact that tools enable us to do things more efficiently, more effectively – that’s why we humans are tool creators and tool users. However, the lack of tools does not preclude a human from inflicting deadly harm upon another.

Please understand this.