Before the advent of dueling pistols, affairs of honor were fought with swords. Fortune favored the more skilled and agile swordsman, but even a bad swordsman could by chance land a crippling or lethal blow.
Pistols were a great equalizer in the matter of duels, as they were to later become on the battlefield or in man-to-man encounters of the Old West. It took much less time to master the skills of firing a pistol than to become proficient at fencing. While marksmanship was, of course, important for success in pistol dueling, skill was of less importance with pistols at twenty paces than it was in an up-close-and-personal combat with swords, and speed mattered not at all, as combatants either fired pre-primed and loaded pistols in turn, or together at an agreed signal.
Once pistols became the weapon of choice in most duels, fatalities declined accordingly, though many injuries were still inflicted. By the time the duel actually took place, tempers had often cooled enough that only 'token shots'--not intended to strike their targets--were exchanged and honor was satisfied without bloodshed.
Famous duelers include the Duke of Wellington, while he was Prime Minister of England; and the United States' 7th President, Andrew Jackson--a hot-tempered individual with a marriage to a divorced woman that scandalized the nation--fought at least a dozen duels.
Perhaps the most famous American duel was between sitting Vice President Aaron Burr and Secretary of the Treasury, Alexander Hamilton. That duel literally changed the course of history by its effects on two of the fledgling United States' most brilliant and capable Founding Fathers.