Medical Aspects of Chemical Warfare (2008) - The Black Vault

History of the Medical Management of Chemical Casualtiesa chemical attack. As 1914 drew near, chemicals usedon the battlefields were primarily irritants. In the earlyyears of World War I, the Germans employed nontoxic“ni-shells” and “T-shells,” containg xylyl bromide (seeChapter 2). 6 Because these chemicals were nontoxic andtheir employment as weapons was tactically unsound,the combatant armies established no real medical supportorganization or protocol to respond—organized managementof chemical casualties was not necessary becauseno elevated influx of chemical patients occurred.World War IWorld War I heralded several battlefield discoveriesthat changed the face of warfare and the futurechemical threat. In addition to causing large numbersof casualties, gas was an effective and versatile weaponbecause it placed an additional strain on every aspectof combat. According to British Major General CharlesH Foulkes, the “appearance of gas on the battlefield .. . changed the whole character of warfare.” 7(p345) Gaspermeated clothing, food, and water. It corroded humanskin, internal organs, and even steel weapons. Itssmell lingered in the air. Not only did soldiers haveto train constantly in emerging chemical warfare, butan entire logistical network had to be established foroffensive and defensive gas equipment. As a result, anew branch of the US Army came into existence, andnew units, such as decontamination squads, mobiledegassing units, and special gas troops, were created(Figure 3-1). Combat arms officers became gas officersin divisions, regiments, and battalions, reducing thenumber of combat arms personnel. The impact of gason the Medical Department also posed tremendousproblems for casualty treatment. The number of gaswounded became so great that one field hospital outof four per division was dedicated solely to the treatmentof gas casualties (Table 3-1). 7Prewar Intelligence and the Second Battle of YpresThe failure to plan for chemical warfare in WorldWar I was a strategic error on the part of the Allies becausethey had sufficient intelligence to warrant preparation.In the time leading up to the first gas attack atYpres, intelligence of chemical weaponry mounted.Trepidation existed on both sides of the trenches,however. According to the official German World WarI military history, Der Weltkrieg, constant reports by theforeign press appeared in the early weeks of the warabout new inventions and secret weapons that mightTable 3-1Fig. 3-1. The mobile decontamination facility was an essentialpart of the degassing station, and plans called for twoper division. As events transpired, only one experimentalmobile decontamination facility was actually constructed,and it was never used in combat. Its objective was “to givehot baths and clean clothing to those subjected to the fumesof mustard gas at the nearest possible points to where gasbombardments take place.” 1 Given what is now known aboutthe speed with which mustard injury develops, attempting toslow the progression of mustard injury by this regimen wasmost likely ineffective. Nevertheless, by providing a showerand clean clothing, the degassing station would have playedan important role in improving the general sanitation andmorale of combat troops.(1) Gilchrist HL. Field arrangements for gas defense and thecare of gas casualties. In: Weed FM, ed. Medical Aspects of GasWarfare. Vol 14. In: Ireland MW, ed. The Medical Departmentof the United States Army in the World War. Washington, DC:Government Printing Office; 1926: Chap 4: 61.Photograph: Courtesy of Chemical and Biological DefenseCommand Historical Research and Response Team, AberdeenProving Ground, Md.Chemical Casualties in World War ICountryNonfatalChemicalCasualtiesChemicalFatalitiesPercentageFatalGermany 191,000 9,000 4.5France 182,000 8,000 4.2British Empire 180,597 8,109 4.3United States 71,345 1,462 2.0Russia* 419,340 56,000 11.8*The data from which these figures were derived have apparentlybeen lost to history. However, the Russians themselves analyzedtheir casualty statistics from World War I. The Narkomzdrav Commissionfound the figures for nonfatal and fatal gas casualties to beonly about one tenth as great as AM Prentiss’s values, which arethe ones commonly accepted in the West (total gassed casualties:40,000–65,000; total gas fatalities: 6,340).Data sources: (1) Prentiss AM. Chemicals in War: A Treatise on ChemicalWarfare. New York, NY: McGraw-Hill; 1937: 653. (2) Kohn S. The Costof the War to Russia. New York, NY: Howard Fertig; 1973: 136.79