Treatment of Gas Casualties

Useful in the plants where phosgene was manufactured was the discovery that hexamethylenetetramine (HMT) was an effective prophylactic against phosgene poisoning. The compound rapidly combined with phos- 

For detailed studies of phosgene therapy, see chapter by Ralph W. Gerard, Recent Research on Respiratory Irritants, Advances in Military Medicine, II. pp. 565-87. 

Mustard, the most important of the blister gases, is a disabling rather than a killing agent, its action painless and undetected since it is rapidly absorbed by the skin. The liquid, spray, and vapor produce severe eye injury, blisters on the body, and injury to the lining of the respiratory tract exposing it to infection. In World War I the bronchopneumonia that followed inhalation of mustard gas was responsible for most deaths from this agent. 

The antimustard preparation, M5 protective ointment, while not the final answer to mustard decontamination and prevention of mustard effects on the skin, was the most satisfactory preparation devised during the war for this purpose. Researchers found no clear-cut superiority for any therapeutic agent in the treatment of mustard burns of the skin, but they concluded that the use on third degree burns of sulfadiazine ointment and petrolatum containing silver nitrate was the best treatment for the burnlike injury. As for contamination of the eyes by liquid mustard gas, nothing proved much more effective in preventing the rapid and destruc- 

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Postel, S. and Swift, M. 1945. Evaluation of the bleeding-transfusion treatment of phosgene poisoning. In Fasciculus on chemical warfare medicine v. II, respiratory tract. Washington, DC National Research Council, Committee on Treatment of Gas Casualties pp. 664-690. (Cited in EPA 1986)... 

Hughes, W.F. Importance of mustard burns of the eye as judged by WW I statistics and recent accidents. IN National Research Council, Division of Medical Sciences, Committee on Treatment of Gas Casualties. Fasciculus on Chemical Warfare Medicine, Volume I Eye. Prepared for the Committee on Medical Research of the Office of Scientific Research and Development. 

War Office, "Manual of Treatment of Gas Casualties", HMSO, London, 1930. 

An improved version of the World War I orchard sprayer decontamination apparatus was fielded to provide ground and equipment decontamination. It could also be used for plain water showers for soldiers (Figure 2-39). For treatment of gas casualties, the CWS standardized the M5 Protective Ointment Kit. This kit came in a small, waterproof container and held four tubes of M5 Protective Ointment wrapped in cheesecloth and a tube of BAL (British anti-Lewisite) Eye Ointment. The protective ointment was used to liberate chlorine to neutralize vesicant agents on the skin. The BAL ointment neutralized Lewisite in and around the eye by changing it to a nontoxic compound. Over 25 million of the kits were procured for the army.26 35 105 Biological Warfare Program... 

Bunting H. Clinical findings in acute chlorine poisoning. In Respiratory Tract. Vol 2. In Fasciculus on Chemical Warfare Medicine. Washington, DC Committee on Treatment of Gas Casualties, National Research Council 1945 51-60. 

For a decade and a half following World War I there had been a Medical Division in OC CWS. But in 1932 General Gilchrist had eliminated this division, and thereafter CWS and the Medical Department maintained co-ordination solely through the medical research group at Edgewood Arsenal. Just prior to World War II, increased emphasis began to be placed on the medical aspects of gas warfare, and a Committee on the Treatment of Gas Casualties was set up within the National Research Council. Later, when the Office of Scientific Research and Development (OSRD) was activated, the work was also carried on by its various committees and subcommittees. The chemical warfare functions of the National Research... 

Lewisite, discovered too late for use in World War I, received its share of attention from researchers. In the winter of 1940-41, a group working under R. A. Peters at Oxford University experimented with a compound called DTH (dithioglycerol) or BAL (British antilewisite) which was quite effective in preventing arsenical poisoning by lewisite. Under the direction of the Committee on the Treatment of Gas Casualties, extensive studies of the new substance were undertaken in CMR and NDRC contract agencies, as well as at the Edgewood laboratories. 

Chief of the Special Assignments Branch, Office of the Chief of the Chemical Warfare Service Committee on the Treatment of Gas Casualties Chemical Warfare Board... 

Dr. Leo P. Brophy wrote all of the chapters and sections of chapters dealing with procurement and distribution. He was assisted in the research and writing of Chapters XIV and XVI by Mr. Sherman L. Davis of the Historical Staff, Chemical Corps. Dr. Wyndham D. Miles wrote all of the chapters on research and development except the section of Chapter IV dealing with the treatment of gas casualties and Chapter V. The latter were researched and put in draft form by Dr. Rexmond C. Cochrane. Dr. Brooks E. Kleber and Mr. Dale Birdsell reviewed the chapters and offered helpful comments. 

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