Infection/blood loss. Even the wild west super dooper gunfighter died from the infection or blood loss which ensued not from the wound inflicted by the bullet. These people did not die instantly.
An example is the US Civil War photos from Matthew Brady. Discheveled clothing wasn't because these folks were sloppy. They lived beyond the bullet entry and knew that if they were able to extract the bullet their chance of survival increased substantialy.
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