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

History of the Medical Management of Chemical CasualtiesI am not sure they made the right decision. I am notsure that the six months’ advantage might not havebeen worth to them the terrific shellacking theywould have gotten from our gas. It was a difficult decision.They decided not to use it. I am sure the onlyreason they decided not to use it was because theyknew we were ready, and could retaliate heavily andeffectively. 75The Bari DisasterShortly after the 1943 disaster at Bari, Italy (seeChapter 2), Lieutenant Colonel Stewart Alexander ofthe US Army Medical Corps, the chemical warfareconsultant on General Eisenhower’s staff, was sentto Bari, where he made the diagnosis of mustard poisoning.He reported 6l7 cases in troops and merchantmarine seamen, with a 14% fatality rate. This highfatality rate was nearly 3-fold that of the mustard fatalityrate in World War I, largely because the merchantmarine seamen had been thrown into the sea, wherethey either swallowed mustard in the water or werebadly burned. 68,76 Dr Cornelius P Rhoads, anotherphysician involved in diagnosing and treating thecasualties, observed chemically induced leucopeniaamong the locals.close-quartering, and all were physically, mentally, andemotionally exhausted from atrocious working and livingconditions. Diseases such as typhus, tuberculosis,and dysentery were evidenced. The US military medicalorganization faced a multifaceted presentation forwhich it had no organizational adaptations.Chemicals in Korea and VietnamAfter World War II the management of chemicalcasualties shifted back to research and training. TheKorean War did not produce any documented chemicalcasualties. The organization for medically managingchemical casualties during the Vietnam era wassimilarly untried, though the United States did usechemical defoliants in Vietnam for canopy clearingand crop destruction. It also used tear gas for clearingtunnels and bunkers (Figure 3-18). 78 “Tunnel rats”were often Chemical Corps personnel assigned to useo-chlorobenzylidene malononitrile agent (known as“CS,” a riot control agent) when searching for enemyChemical Agents in Concentration CampsBiological and chemical casualties and fatalitiesfrom Germany’s experimental testing of chemical andbiological warfare agents, including cyanide, mustard,lewisite, and nerve agents, were found at Dachauand Buchenwald. Camp Natzweiller-Struthof, theonly concentration camp in France, used phosgeneand mustard on inmates. Sachsenhausen Camp atOranienburg, just north of Berlin, used mustard inexperimentation on inmates, and Spandau Universityin Berlin was believed to have used nerve agentsfor experimentation. At the camp in Neuengamme,mustard was given to inmates to drink. The details ofthis kind of chemical agent use were explored by theUnited States in the Nuremburg and British war trials.After the defeat of the Nazi forces along the easternfront, the Soviet Army uncovered Auschwitz-Berkinauand saw how Zyklon B, a rat poison, had been used inspecially constructed gas chambers for the purpose ofmass human extermination. Before settling on ZyklonB, the Nazis had experimented with specially adaptedcarbon monoxide gas vans to induce mass killing atthe Russian front. 77No clearly structured chemical casualty managementwas established for camp inmates after liberation.All camp inmates had baseline clinical presentationconsistent with food deprivation, malnutrition, andFig. 3-18. Tear gas was used extensively by US forces in theVietnam War, especially in clearing enemy tunnel complexes.However, the US government did not consider tear gas tobe a chemical weapon and therefore did not consider its useto be banned by international law. Many others outside ofgovernment disagreed, using as evidence the fact that thosewho used tear gas wore protective masks. The soldiers shownhere are wearing the little-known M28 protective mask. Thislightweight (and perhaps more comfortable) mask was designedto be worn in situations in which the threat was notfrom nerve agents, and the heavy-duty protection offeredby the standard masks was not necessary.Photograph: Courtesy of Chemical and Biological DefenseCommand Historical Research and Response Team, AberdeenProving Ground, Md.105