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

Medical Aspects of Chemical Warfarewere dead. Everything, even the insects were dead.We started counting the casualties. This operationwas so much bigger than we had ever imagined. Thatnight we guessed over 20,000 French soldiers, andeven more town people had died. The infantry followedus but when they couldn’t find any French tofight, they stopped. All of us went back to our campsand quarters wondering what we had done. Whatwas next? We knew what happened that day had tochange things. 13The number of French and Algerian soldiers killedthat day is estimated to be about 10,000. The numberof civilians and animals killed is undetermined. Evenas the chemical casualties from the attack began filteringinto rear areas, the response was generally denial.When the word of a chemical attack reached HarveyCushing, an American physician working with theFrench at Compiegne, he responded with disbelief(Exhibit 3-1):It was soon whispered about that this lot had comefrom Ypres and that they had all suffered greatlyfrom some German gaz asphyxiant [sic]; but I hardlybelieved the tale, or thought I had misunderstood,until this evening’s communiqué bears it out. Manyof them were coughing; but then, as I’ve said, most ofthe wounded still come in with a bronchitis. We haveheard rumors for some days of a movement of Germantroops in the direction of Ypres, and this attackis apparently the result.When we got back to the Ambulance, the air was fullof tales of the asphyxiating gas which the Germanshad turned loose on Thursday—but it is difficult toget a straight story. A huge, low-lying greenish cloudof smoke with a yellowish top began to roll downfrom the German trenches, fanned by a steady easterlywind. At the same time there was a terrificallyheavy bombardment. The smoke was suffocating andsmelled to some like ether and sulphur, to anotherlike a thousand sulphur matches, to still another likeburning rosin. One man said that there were about athousand Zouaves of the Bataillon d’Afrique in thelines and only sixty got back either suffocated or shotas they clambered out of the trenches to escape. Anotherof the men was en repos five kilometres [sic]away and says he could smell the gas there. He withhis fellows was among those of the reserves whowere called on to support the line, but by the timethey got up the Germans were across the canal, havingeffectively followed up their smudge. They seemto have been driven out later, or at least the seamenthought they had been. We’ll have to await the officialcommuniqués, and perhaps not know even then.In any event, there’s devil’s work going on aroundYpres, and the heralded “spring drive” seems to havebeen initiated by the Germans. . . .Then we saw many of the severely “gassed” menwho had come in this morning—a terrible business—one man, blue as a sailor’s serge, simply pouring outwith every cough a thick albuminous secretion, andtoo busy fighting for air to bother much about anythingelse—a most horrible form of death for a strongman. 14(p69)Initial ResponsesEXHIBIT 3-1Dr Harvey CushingDr Harvey Cushing experienced the western front inthe French and British sectors of occupation beforethe American Expeditionary Forces deployed medicalsupport. His first duty was in the early springof 1915, when he served with a Harvard unit in theAmerican Ambulance at Neuilly, France. At thattime he became familiar with the French Service deSanté. From Paris he visited the British Royal ArmyMedical Corps in Flanders. He managed chemicalcasualties during the battles for the Messines andPasschendaele ridges in Flanders at the time ofthe Third Battle for Ypres. His observations as anAmerican physician gave insight into how Americanwartime medical management of chemical casualtiescompared to international standards.Data source: Cushing H. From a Surgeon’s Journal, 1915–1918.Boston, Mass: Little, Brown and Company; 1936.The deliberate use of tactical chemicals on anunprepared enemy created a marked change in thenature of the casualty. It was quickly learned thatchemical agents had a debilitating effect on soldiers:not only did the chemicals physically injure soldiers,but they also added a psychological element thatcommon artillery could not match. During a chemicalattack, soldiers felt that other than masking, theyhad no real defense. This resulted in a “gas-fright”syndrome hallmarked by psychological depressionand war weariness. Untrained physicians were unsympatheticto those suffering from “gas poisoning”and the battle fatigue it caused, often accusing soldiersof malingering. Unfortunately, few physiciansknew how to medically manage a chemical casualtyat the onset of the war (Table 3-2). In the absence of aremedy, soldiers were given bed rest with the hopethat the body’s intrinsic healing abilities would beadequately facilitated.On a chemical battlefield, normal medical opera-82