The Remington was just powerful enough to bring into the wound the lead bullet. dirt from unwashed skin, bacteria and all sorts of other nasties. Blood poisoning is why men were afraid of the Derringer.
Elmer Keith said that an old barber taught him about the Derringer. The pistol would make a pop and the bullet would barely enter the floorboards of the shop.
Holt Bodinson wrote a recent article (basically a reprise of his 1990 Gun Digest piece, but who hasn’t mined past stuff?) about the .41 Rimfire cartridge and it apparently has a bit more get and go that most folks think.