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

History of the Medical Management of Chemical Casualtiestinations via the bathhouse. There, chemical casualtieswere treated or bathed with alkaline soap and solution.Otherwise they were bathed in the ward. Retained patientswere furnished with pajamas; evacuated patientsand those returned to duty were given fresh clothingand sent to the evacuation ward. 48Base and Gas HospitalsThe organization of gas teams at base hospitals wasauthorized by the AEF’s chief surgeon on June 2, 1918.Each team consisted of an officer, two nurses, and twoenlisted soldiers. A course on degassing instructionwas provided at the central laboratory at Dijon for officersdesignated to perform degassing service. 50 Thegas team’s mission was established as an additionalduty. If the hospital received chemical casualties, degassingteams (usually three soldiers) were organizedunder the chief of the medical service but were underthe direct supervision of another officer. Degassingteams were relatively permanent and functioned likereceiving and evacuating departments. 51Gas hospitals had to support special treatment forchemical casualties. They were located near a watersource because persistent and even nonpersistentagents clung to clothing, hair, and skin. The 2nd Division’sgas hospital bath house had a portable heaterand six shower heads. After admission to a hospital,soldiers stripped off their clothing and showered.Casualties with serious symptoms were bathed whilestill on litters. When soldiers left the showers, medicssprayed their eyes, noses, and throats with bicarbonateof soda. Depending on the diagnosis, patients mightbe given a special treatment of alkaline, oxygen, and,if necessary, venesection to counteract the effects ofinhaled gas. Doctors prescribed olive or castor oil tocoat the irritated stomach linings of soldiers who hadingested food or water contaminated by gas. Whentreatment failed to allow free breathing or whenpatients developed additional symptoms, medicsimmediately evacuated them to a base gas hospital. 24Because of the shortage of medical personnel, ambulancepersonnel were often temporarily used to relieveoverworked and understaffed gas hospitals. 52Division Field HospitalsWhen possible, division field hospitals were locatedin the same general area as base and gas hospitals,with one hospital officially designated to handlechemical casualties. Soldiers were placed into one ofthe following categories: severely gassed (immediateor expectant); fit for duty, immediate return to unit(minimal); fit for duty in 24 hours, return to unit (delayed);or evacuate to an Army hospital. Exhaustedsoldiers who complained of gas symptoms but whoshowed no outward signs of having been gassed wereheld in the division rear for rest, food, and observation.If medics verified their claims of gas poisoning,they were evacuated. 32 In open warfare, field hospitalswere usually located from 4.8 to 9.6 km (3 to 6 miles)from the front. This site was often determined on thebasis of the routes of ingress and egress. Because inopen warfare field hospitals had a paucity of fixedstructures, they often operated out of tents. In manydivisions, field hospitals were so near the front thatthey were easy targets for enemy shells. 53Although by design field hospitals were specialized,they were expected to care for casualties outsidespecializations, as seen in the May 16 report of FieldHospital No. 2, which was managing 3 sick and 189chemical casualties (98%). Field Hospital No. 3 reportedlymanaged 123 sick and wounded and 159 chemicalcasualties (56%), Field Hospital No. 12 managed 24 sickand wounded and 43 chemical casualties (64%), andField Hospital No. 13 managed 37 sick and woundedand 37 chemical casualties (50%). 54Casualties began arriving at division field hospitalsshortly after the onset of the Aisne-Marne offensive inJuly 1918. From July 22 to August 11, one ambulancecompany evacuated 1,860 casualties, including medicalpersonnel, of which four were chemical casualties.The field hospital at Ville Chamblon received chemicalcasualties of the 3rd Division, but only a few of thesewere severely affected; most of the chemical casualtiesthat initially arrived were sneezing or vomitingfrom gas intoxication (riot control agents). Phosgenecasualties presented later. Mustard casualties began toappear after German counterattacks. 55During the summer and fall of 1918, the SecondCorps fought with the British in Flanders in two phases.The corps made its medical personnel familiar withconditions in the British section of the western front,providing lectures and practical demonstrations thatcovered the medical management of chemical casualties,methods employed for transporting the wounded,the selection and operation of lines of evacuation,the treatment of water for drinking purposes, andrelated topics. 56 By September 1918 the field hospitalsof the 2nd Division had become specialized, and thepermanent triage station carried portable baths withboth tubs and showers, gas soap, soda, and extra pajamasand underwear for reissue. The remaining fieldhospital was equipped to medically manage chemicalcasualties. 57With the reduction of the Saint Mihiel salient, thefront became so vast and the objectives so diverse thata single army could no longer manage alone, so the95