DEFENSE AGAINST THE EFFECTS OF CHEMICAL AND BIOLOGICAL WARFARE AGENTS

672 Pages·1999·3.91 MB·English

Overview: Defense Against the Effects of Chemical and Biological Warfare Agents
Chapter 1
OVERVIEW: DEFENSE AGAINST THE
EFFECTS OF CHEMICAL AND
BIOLOGICAL WARFARE AGENTS
FREDERICK R. SIDELL, M.D.*; AND DAVID R. FRANZ, D.V.M., PH.D.†
INTRODUCTION
HISTORICAL PRECEDENTS
INTRODUCTION TO CHEMICAL AND BIOLOGICAL AGENTS
IMPLICATIONS FOR THE MILITARY MEDICAL DEPARTMENTS
*Formerly, Chief, Chemical Casualty Care Office, and Director, Medical Management of Chemical Casualties Course, U.S. Army Medical
Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland 21010-5425; currently, Chemical Casualty Consultant, 14
Brooks Road, Bel Air, Maryland 21014
†Colonel, Veterinary Corps, U.S. Army; Commander, U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick,
Maryland 21702-5011
1
Medical Aspects of Chemical and Biological Warfare
INTRODUCTION
“Gas! Gas!” This warning cry, so common in battlefield threats.
World War I, almost became real to U.S. forces again Two lessons were learned from this conflict,
as they prepared to liberate Kuwait in late 1990. The lessons that should never be forgotten by those
threat of chemical, and even biological, warfare was in the military. The first was that there are coun-
foremost in the minds of U.S. military personnel tries that have chemical and biological weapons,
during Operation Desert Shield, the preparation for and there are other countries that might obtain
the Persian Gulf War. Iraq was known to have a or produce them. The second was that the U.S.
large stockpile of chemical weapons and had dem- military medical departments must be prepared
onstrated during its conflict with Iran that it would at all times to treat both types of casualties. As
use them. It was not until after the Persian Gulf War long as potential adversaries exist, the U.S. mili-
that the U.N. Special Commission on Iraq confirmed tary might face a chemical or biological battle-
that Saddam Hussein also had biological agents field.
loaded in weapons. The chemical and biological Military medical personnel of the United States
threats were major concerns to those in the mili- have not treated a chemical casualty on the battle-
tary medical departments who would be called on field for nearly 8 decades, and they have never
to care for poisoned or infected casualties, possibly treated a biological casualty. Chemical agents have
in a chemically contaminated environment. Fortu- not been used as weapons in a major war or in any
nately the ground war of the Persian Gulf War military conflict in which the United States has
(Operation Desert Storm) was brief, and even more been involved since World War I. Despite the re-
fortunately, our adversary did not employ these cent dissolution of the Warsaw Pact, the breakup
weapons. of the Soviet Union, and other events that have
In the desert, during the fall and winter of seemingly reduced the conventional military threat
1990–1991, the threat of chemical warfare be- to the United States, a textbook for military medi-
came very real to our military medical personnel. cal personnel on the management of chemical and
The threat of biological warfare was no less feared. biological agent casualties is still urgently needed.
The military medical departments realized that The breakup of the Soviet Union, and the conse-
medical personnel were not prepared to pro- quent glut of biowarfare experts on the world em-
vide care to chemical or biological casualties ployment market, may have actually increased the
or to function in a contaminated environment. This threat of biological proliferation. In addition to the
textbook should help accelerate the assimilation recent experience in the Persian Gulf, a review of
of medical defense information in the next war; other events of the past 2 decades bears out this con-
in the past, such information has not been readi- clusion (Exhibit 1-1).
ly accessible. Two handbooks have also been pre-
pared: Medical Management of Chemical Casualties
Handbook, Chemical Casualty Care Office, Med-
ical Research Institute of Chemical Defense, Aber-
deen Proving Ground, Maryland (September 1994);
EXHIBIT 1-1
and Medical Management of Biological Casualties
Handbook, U.S. Army Medical Research Institute of RECENT TARGETS OF CHEMICAL OR
Infectious Diseases, Fort Detrick, Frederick, Mary- BIOLOGICAL AGENTS
land (March 1996).
Rapid and intense teaching programs help-
Laos (mid to late 1970s; alleged)
ed prepare our medical healthcare providers, so
that by the onset of Operation Desert Storm, Kampuchea (late 1970s and early 1980s; alleged)
they were as ready as any military medical per-
Afghanistan (1980s; alleged)
sonnel might be to go to war. Hundreds of thou-
sands of troops were supplied with chemical
Iran (1980s; Iran–Iraq War; confirmed)
pretreatment and therapeutic agents and thou-
sands were immunized against anthrax and the Iraqi Kurds (1988; confirmed)
botulinum toxins, the two most likely biological
2
Overview: Defense Against the Effects of Chemical and Biological Warfare Agents
HISTORICAL PRECEDENTS
During the Arab–Israeli War (also called the Yom occurrence of internal hemorrhage and skin lesions
Kippur War) of 1973, chemical weapons were not could not be explained. Analysis of a leaf sample
used. While processing captured soldiers, however, collected in Kampuchea 24 hours after an attack
Israeli troops found that the Egyptians carried per- implicated trichothecene mycotoxins, a family of
sonal protective equipment, a decontamination kit toxins produced by fungi but having characteris-
containing items unfamiliar to U.S. personnel, and tics more like chemical than biological agents.
an antidote with which we were also unfamiliar. In August 1981, based on limited physical evi-
This evidence suggested that the Egyptians were dence, the U.S. government announced that
prepared for a chemical battlefield, and the com- trichothecene mycotoxins had been used—but the
ponents of the antidote suggested that they were findings were less than convincing to some in the
prepared for the use of the nerve agent soman. (The scientific community and the issue became ex-
antidote was a mixture of three compounds: atro- tremely contentious. This controversy was never
pine, benactyzine, and the oxime, TMB4.) The U.S. totally resolved, and the question of which, if any,
military soon issued the antidote to U.S. troops, only agents were used against civilians was not an-
to withdraw it about 5 years later. swered. If mycotoxins were, in fact, used it was the
In the mid to late 1970s, reports began to appear first recorded use of biological agents since before
that chemicals were being used against Hmong World War II, when the Japanese used them against
tribesmen in Laos. The Hmong had been loyal to the Chinese in the early 1940s.2
the United States and had served this country In the 1980s, Soviet troops battled Afghan rebels
in many ways during the Vietnam War; it was protesting the communist Afghan regime. During
suggested that chemicals were being used against this lengthy conflict, frequent allegations were
the Hmong in retaliation. Investigations were made of the use of chemical agents against the Af-
conducted by U.S. State Department personnel, ghans. One of these chemicals, known as Blue-X,
by a medical team sent by The U.S. Army Surgeon was said to cause instant immobilization, the vic-
General, and by international groups. Little defini- tim remaining in place for a number of hours be-
tive evidence was discovered, primarily because the fore recovering. The use of other, more lethal agents
alleged attacks took place deep in Laos. The was also alleged, but again no definitive evidence
victims took weeks to travel to Thailand to be was found.
examined, and outsiders could not enter Laos to The most widespread and most open use of
examine the attack sites. The Hmong who reached chemical weapons on a battlefield in recent decades
Thailand provided graphic accounts of attacks was by Iraq in its conflict with Iran. This time the
by sprays and bombs from airplanes and how these evidence of chemical use was conclusive. Undeto-
“smokes,” which were of all colors, killed many nated shells were sampled and their contents were
in their villages. One member of the medical team analyzed by several laboratories in Europe. A vesi-
brought back a sample of a yellow substance on cant or blister agent (mustard) and a nerve agent
the outer (barklike) layers of a bamboo culm (ie, (tabun) were identified. About 100 Iranian soldiers
stalk); the sample had been given to him by a with chemical wounds were sent to European hos-
Hmong, who claimed that the material had killed pitals for care; their wounds were consistent with
many of his fellow villagers. This yellow substance, vesicant (mustard) injury. A team appointed by the
along with samples from many other locations, later U.N. secretariat went to Iranian battlefields and
became known as “yellow rain” (see Chapter 34, hospitals and found chemical shells and patients
Trichothecene Mycotoxins, which discusses yellow with chemical injuries. The public outcry at the use
rain in greater detail). of these weapons was less than overwhelming. Ig-
Moreover, in the late 1970s and early 1980s, alle- noring protests from the world community, Iraq
gations were made of chemical agent use against continued to use these agents.
refugees fleeing the barbaric conditions that existed Evacuating wounded soldiers to Europe not only
in Kampuchea at that time.1 The clinical response lessened the burden on the medical facilities in Iran
of the exposed humans did not fit what we under- (although the number sent was a small fraction of
stood about the effects of classic chemical agents. the total) and provided soldiers with good medical
Tearing and itching looked like the effects of tear care, but it also provided the rest of the world with
gas. Convulsions suggested nerve agents. But the evidence that Iraq was using these weapons. In gen-
3
Medical Aspects of Chemical and Biological Warfare
eral, the casualties were sent privately, not through Soviet Union had signed the Biological Weapons
governmental connections. Physicians in Europe Convention.
accepted the patients and assumed responsibility In addition to their being used on the battlefield,
for their care, usually in private hospitals (a situa- chemical and biological agents might also be used
tion that made a retrospective analysis of the care in terrorist attacks. The nerve agent sarin was twice
rendered and the effectiveness of different treat- used in Japan. The first incident, in Matsumoto in
ment regimens difficult). June 1994, produced more than 200 casualties in-
A similar situation enabled three physicians from cluding 7 fatalities. In the second incident—in the
the U.S. Army medical community to examine sev- Tokyo subway system on 20 March 1995—5,510
eral casualties from Iraq’s use of chemical weap- people were taken to medical facilities or sought
ons. On March 19, 1988, Iraqi airplanes bombed the medical assistance. About 20% of these were hos-
village of Halabja, in Iraq. The inhabitants were pitalized, and 12 died. The cult that was accused of
Kurdish Iraqi citizens, a tribespeople who live in both attacks was found to have a large facility for
the region where the borders of Turkey, Iran, and manufacturing both chemical and biological agents.
Iraq meet. The casualties from this raid received In the face of overwhelming evidence, the Soviet
worldwide media attention. The chemical weapons Union continued to officially deny having an offen-
allegedly used were nerve agents, cyanide, and sive biological weapons program until 1992, when
mustard. The casualties were cared for by Iran, and Russian President Boris Yeltsin admitted publicly
five of them (a man, a woman, and three young to having maintained a program until March of that
children, all unrelated) were sent to the United year. Since then, visits by teams from the United
States for care by an Iranian physician living here. States and the United Kingdom to former biologi-
On examination by three authors of chapters in this cal warfare facilities under the Joint United States/
textbook, the casualties were found to have skin United Kingdom/Russia Trilateral Statement on
lesions and pulmonary pathological changes (as Biological Weapons have clearly documented the
determined by radiograph) consistent with mustard capabilities to produce biological warfare agents in
exposure. massive quantities.
Other items in the news over the past decade Verification of compliance with agreements such
have suggested that the proliferation of chemical as the Trilateral and with the chemical and biologi-
and biological agents is greater than we might hope. cal weapons conventions are plagued by the “dual-
For example, numerous accounts claimed that Libya use” nature of the facilities in which these agents
had built a facility capable of chemical agent pro- are developed and produced. A legitimate chemi-
duction at Rabta—Libya’s protestation that this fa- cal facility can be converted fairly easily for the
cility was a pharmaceutical plant notwithstanding. manufacture of chemical agents. On threat of in-
One report even noted that monthly production was spection by an international group, the facility can
about 30 tons of mustard. readily be converted back to a legitimate use. The
In 1979, an accident at a previously undetected dual-use nature of production facilities is even more
biological weapons plant in Sverdlovsk, Russia, sur- applicable to the production of biological agents.
prised even the intelligence community.3 At least Partly for this reason, chemical and biological weap-
66 humans living or working downwind of the plant ons have been called “the poor man’s atom bomb.”
died of pulmonary anthrax. Soviet troops quickly It has also been said that agents can be made in a
attempted to decontaminate the facility and the city bathtub, which may be true to a limited extent for a
following airborne release of anthrax spores, and skilled microbiologist or chemist. Production of
medical teams instituted preventive therapy, but the even tactical quantities of these agents and their
message was clear. The Soviet biological warfare deployment on the battlefield, however, is not a
program was thriving, more than 6 years after the trivial undertaking.
INTRODUCTION TO CHEMICAL AND BIOLOGICAL AGENTS
Chemical and biological agents differ in several peptides) that can be produced by living organisms.
important ways. Chemical agents are typically man- Some of the nonreplicating biological agents can
made through the use of industrial chemical pro- also be produced through either chemical synthe-
cesses. Biological agents are either replicating sis, solid-phase protein synthesis, or recombinant
agents (bacteria or viruses) or nonreplicating ma- expression methods. Almost none of the biological
terials (toxins or physiologically active proteins or agents are dermally active (the mycotoxins are a
4
Overview: Defense Against the Effects of Chemical and Biological Warfare Agents
rare exception) and none are volatile. On the other to advance. A persistent agent might be used to con-
hand, most of the chemical agents are dermally ac- taminate terrain, supplies, and equipment, deny-
tive, volatile, or both. ing the enemy their use.
Therefore, while many of the dermally active or Biological weapons may contain either replicat-
volatile chemical agents can be disseminated as liq- ing or nonreplicating agents. Although hundreds
uids or aerosols, and the biological agents must be of naturally occurring bacteria, viruses, and toxins,
dispersed as respirable aerosols (particles approxi- as well as “designer compounds,” could potentially
mately 1–10 µm in diameter). Dispersing a respirable be considered agents by an aggressor, a finite num-
aerosol on a battlefield requires a high-energy gen- ber of these are actually useful as area weapons on
erating system to produce the small particle size, the battlefield. The agents’ utility is limited by ease
appropriate weather conditions to assure that the of production, stability, and infectivity (bacteria and
aerosol cloud stays near the ground, and adequate viruses), or toxicity/effectivity (toxins and other
infectivity or toxicity of the agent to produce the physiologically active materials). Bacillus anthracis,
desired effect. Except for infectivity, these are all for example, is often touted as the best of bacterial
important practical requirements for the field use agents. Stability of the spore form and ease of pro-
of chemical, as well as biological, warfare agents. duction are its greatest strengths as weapons mate-
In World War I, the use of chemical agents began rial. Among viral agents, Venezuelan equine en-
with the small-scale use of irritants (known today cephalitis virus is easily grown to extremely high
as riot control agents). Chlorine, the first agent used titers, making it a potential incapacitating agent.
on a large scale, and phosgene caused large num- The bacterial agents that cause tularemia, Q fever,
bers of deaths. Cyanide was introduced in midwar, and brucellosis are infective at extremely low doses
but the agent that caused the greatest number of (1–10 organisms per person). Finally, the extraordi-
casualties was the vesicant mustard, which was in- nary toxicity (1,000- to 10,000-fold more toxic than
troduced late in the war. Cyanide, phosgene, and the classic nerve agents) of the staphylococcal en-
mustard are still potential chemical weapons today. terotoxins as incapacitants and the botulinum tox-
In the period before World War II, German sci- ins as lethal agents makes them candidates for
entists synthesized the first nerve agents; during the weaponization.
war, Germany had thousands of tons of nerve Most of the chemical compounds noted above
agents stockpiled in munitions. The United States have characteristics that make them uniquely suited
and the Soviet Union captured the stockpiles and to warfare. Closely related chemical substances,
manufacturing facilities late in the war, and they however, and some of the threat agents, are found
began to manufacture and stockpile these agents. throughout the civilian community. Unlike the
Nerve agents are 15- to 100-fold more potent than chemical warfare agents, which are not found in
the chemical agents used in World War I. In the nature, essentially all of the biological agents de-
1950s, the United States put the incapacitating com- scribed are found in nature and cause the same or
pound BZ into munitions (which have been de- very similar disease syndromes. Military medical
stroyed); late in that decade, the currently used riot personnel might encounter persons exposed to the
control agent CS was introduced for military use. organisms as endemic disease agents on remote
Military chemical agents are classified as “per- battlefields.
sistent” and “nonpersistent.” Persistent agents are Similarly, civilians as well as military personnel
those with low volatility or which evaporate slowly. could be exposed during peacetime to commercial
Since they do not readily evaporate, they stay on chemicals closely related to chemical warfare
terrain, materiel, or equipment for days, weeks, or agents. Thousands of tons of cyanide, for example,
months, depending on the weather. Chief among are manufactured annually for industrial use and
the persistent agents are the vesicant mustard and are shipped to users by truck and train throughout
the nerve agent VX. Nonpersistent agents are those the country. Phosgene is also manufactured in large
that are volatile and hence evaporate quickly; they amounts and shipped cross-country. The nerve
are not expected to be present for more than sev- agents are not available outside the military, but
eral hours. The nonpersistent agents are phosgene, they are closely related to most pesticides or insec-
cyanide, and the G series of nerve agents. Each type ticides that are sprayed on orchards or used by the
has military advantages. Advancing troops might backyard rose gardener. The effects of these agri-
disperse a nonpersistent agent ahead of their attack cultural compounds are nearly identical to those of
to have the advantage of its effects on the enemy nerve agents, and medical therapy is the same. The
and later to have uncontaminated terrain into which incapacitating agent BZ (3-quinuclidinyl benzilate)
5
Medical Aspects of Chemical and Biological Warfare
is used in small amounts in research pharmacology tively unprotected troops. With well-trained troops
(where it is known as QNB). Also, BZ is pharmaco- and well-prepared medical personnel, these figures
logically related to anticholinergic drugs, which are will be lower. For the chemical agents, real-time
present in many over-the-counter preparations, detectors allow exploitation of the excellent indi-
such as sleeping medications. vidual physical protective mask, effective pretreat-
Unlike the chemical warfare agents, essentially ment, and therapy.
all of the biological agents described cause syn- These countermeasures, in conjunction with
dromes that mimic or are identical to naturally oc- training of our forces, can make an enormous dif-
curring diseases. Outbreaks of disease caused by ference and actually serve as a deterrent to chemi-
bacteria or viruses or isolated intoxications caused cal agent use. A chemical attack on a battlefield will
by toxins may result in syndromes similar to those not be the devastating event that some military
seen in biological warfare attacks. In the case of medical personnel fear. Soldiers will survive and
these agents, the route of exposure—universally via return to duty. For the biological agents, field detec-
the airways on the battlefield—may cause slightly tors are still not responsive enough to allow timely
or significantly different clinical presentations. Gen- warning of a cloud moving across the battlefield. Al-
eral principles of prophylaxis and therapy pre- though the mask is protective, adequate warning may
sented in this text, however, often apply. Although still be a problem. Knowledge of the meteorological
the reader may initially think that the information conditions necessary for effective deployment of bio-
presented in this textbook is needed only in war- logical and chemical agents can at least limit the time
time, much of the contents will also be useful to the during which a force must be on highest alert. In
physician in a busy emergency room. addition, effective medical countermeasures (vac-
On the battlefield, knowledge of the chemical or cines, drugs, and diagnostics) are available for many
biological agent threat and its medical and physi- of the agents of greatest concern. An integrated sys-
cal countermeasures can actually reduce the threat. tem of countermeasures for the chemical and bio-
In World War I, the death rate for chemical casual- logical agents can significantly reduce the threat by
ties was about 3%. Data are not available for the raising the cost/benefit ratio for the would-be ag-
Iran–Iraq War, but informal reports indicate that the gressor. If the agents are used, appropriate medical
death rate for those chemical casualties who reached care from well-informed medical care providers that
medical care was probably less than 5%, despite the enables soldiers to survive could be the factor de-
use of the highly toxic nerve agents against rela- termining whether a battle is won or lost.
IMPLICATIONS FOR THE MILITARY MEDICAL DEPARTMENTS
From 18 January to 28 February 1991, 39 Iraqi- gas will be employed in future wars is a matter of
modified SCUD missiles reached Israel.4 Although conjecture. But the effect is so deadly to the unpre-
many were off target or malfunctioned, some of pared that we can never afford to neglect the
them landed in and around Tel Aviv. Approximately question.”5(p623)
1,000 people were treated as a result of missile attacks, The experience in the Persian Gulf War reinforced
but only 2 died. Anxiety was listed as the reason for General Pershing’s warning. Despite the improve-
admitting 544 patients and atropine overdose for hos- ment in relations between the East and the West,
pitalization of 230 patients. Clearly, these convention- potential adversaries still exist—and potential ad-
ally armed SCUDs were not effective mass casualty versaries have chemical and biological agents.
weapons, yet they caused significant disruption to the These agents have been used in recent years, and
population of Tel Aviv. Approximately 75% of the ca- probably will be used again on the battlefield or in
sualties resulted from inappropriate actions or reac- small, regional conflicts. They might also be used
tions on the part of the victims. Had one of the war- in acts of terrorism within the United States, in
heads contained a chemical or biological agent that which case, by authority of Presidential Decision
killed or intoxicated a few people, the “terror ef- Directive 39 (1995), the military will assist civilian
fect” would have been even greater. authorities and medical personnel.
The likelihood of such a weapon causing panic Fortunately, U.S. troops and medical personnel
among military personnel decreases, however, have not been involved in these attacks; it is hoped
when the leaders and troops become better edu- that they never will be. We must be prepared, how-
cated regarding these agents. As General John J. ever. The purpose of this textbook is to assist in that
Pershing wrote after World War I: “Whether or not preparation.
6
Overview: Defense Against the Effects of Chemical and Biological Warfare Agents
REFERENCES
1. McDermott J. The Killing Winds. New York, NY: Arbor House; 1987: 49–60.
2. Williams P, Wallace D. Unit 731: Japan’s Secret Biological Warfare in World War II. New York, NY: The Free Press
(Macmillan); 1989: 65–70.
3. Meselson M, Guillemin J, Hugh-Jones M, et al. The Sverdlovsk anthrax outbreak of 1979. Science. 1994;266:1202–
1208.
4. Karsenty E, Shemer J, Alshech I, et al. Medical aspects of the Iraqi missile attacks on Israel. Isr J Med Sci.
1991;27:603–607.
5. Pershing JJ. Final report of General John J. Pershing. Annual Report. Vol 1, Part 1; 1919. Quoted by: Brown FJ.
Chemical Warfare. A Study in Restraints. Princeton, NJ: Princeton University Press; 1968: 623.
7
History of Chemical and Biological Warfare: An American Perspective
Chapter 2
HISTORY OF CHEMICAL AND BIOLOGICAL
WARFARE: AN AMERICAN PERSPECTIVE
JEFFERY K. SMART, M.A.*
INTRODUCTION
PRE–WORLD WAR I DEVELOPMENTS
WORLD WAR I
THE 1920S: THE LEAN YEARS
THE 1930S: THE GROWING THREAT OF CHEMICAL AND BIOLOGICAL
WARFARE
THE 1940S: WORLD WAR II AND THE NUCLEAR AGE
THE 1950S: HEYDAY OF THE CHEMICAL CORPS
THE 1960S: DECADE OF TURMOIL
THE 1970S: THE NEAR END OF THE CHEMICAL CORPS
THE 1980S: THE RETURN OF THE CHEMICAL CORPS
THE 1990S: THE THREAT MATERIALIZES
SUMMARY
*Command Historian, U.S. Army Chemical and Biological Defense Command, Aberdeen Proving Ground, Maryland 21010-5423
9
Medical Aspects of Chemical and Biological Warfare
INTRODUCTION
Webster’s Ninth New Collegiate Dictionary defines or biological warfare went virtually unnoticed by
the term “chemical warfare,” first used in 1917, the U.S. Army. By the end of World War I, the situ-
as “tactical warfare using incendiary mixtures, ation had drastically changed. Chemical warfare
smokes, or irritant, burning, poisonous, or asphyx- had been used against and by American soldiers
iating gases.” A working definition of a chem- on the battlefield. Biological warfare had been used
ical agent is “a chemical which is intended for covertly on several fronts. In an effort to determine
use in military operations to kill, seriously injure, what had gone wrong with their planning and train-
or incapacitate man because of its physiological ing, U.S. Army officers prepared a history of chemi-
effects. Excluded from consideration are riot con- cal and biological warfare. To their surprise, they
trol agents, chemical herbicides and smoke found numerous documented cases of chemical and
and flame materials.”1(p1-1) Chemical agents were biological agents having been used or proposed to
usually divided into five categories: nerve agents, influence the outcome of a battle or campaign. In
vesicants, choking agents, blood agents, and addition, they discovered that the technology to
incapacitants. protect against chemical and biological agents al-
Webster’s dictionary likewise defines “biological ready existed, and, in some cases, was superior to
warfare” as “warfare involving the use of living the equipment used during the war. In hindsight,
organisms (as disease germs) or their toxic prod- these officers realized that the army had failed to
ucts against men, animals, or plants.” A working recognize and prepare for these two already exist-
definition of a biological agent is “a microorgan- ing types of warfare.
ism (or a toxin derived from it) which causes dis- [This chapter focuses primarily on the develop-
ease in man, plants or animals or causes deteriora- ment of chemical and biological weapons and coun-
tion of material.”2(p1-1) Biological warfare agents termeasures to them, thus setting the stage for
were normally divided into three categories: anti- Chapter 3, Historical Aspects of Medical Defense
personnel, antianimal, and antiplant. Against Chemical Warfare, which concentrates on
Prior to World War I, the United States had little medical aspects of chemical warfare. To avoid ex-
knowledge about the potential of chemical and bio- cessive duplication of material, protective equip-
logical warfare. Particularly in terms of preparing ment of the modern era is illustrated in Chapter 16,
soldiers for future wars, the possibility of chemical Chemical Defense Equipment.—Eds.]
PRE–WORLD WAR I DEVELOPMENTS
The chemical agents first used in combat during China as early as 1122 BC. Yellow fever was first
World War I were, for the most part, not recent dis- described in the 1600s. Carlos Finlay, a Cuban
coveries. Most were 18th- and 19th-century discov- biologist, identified mosquitoes as the primary
eries. For example, Carl Scheele, a Swedish chem- carrier of yellow fever in 1881, while Walter Reed,
ist, was credited with the discovery of chlorine in a U.S. Army physician, proved the agent to be a vi-
1774. He also determined the properties and com- rus. Casimir-Joseph Davaine isolated the causative
position of hydrogen cyanide in 1782. Comte organism of anthrax in 1863, followed by Robert
Claude Louis Berthollet, a French chemist, synthe- Koch, a German scientist, who obtained a pure cul-
sized cyanogen chloride in 1802. Sir Humphry ture of anthrax in 1876. Koch also discovered the
Davy, a British chemist, synthesized phosgene in causative agent for cholera in 1883. Rocky Moun-
1812. Dichloroethylsulfide (commonly known as tain spotted fever was first recognized in 1873;
mustard agent) was synthesized in 1822, again in Howard T. Ricketts, an American pathologist,
1854, and finally fully identified by Victor Meyer discovered the causative agent in 1907. Ricketts
in 1886. John Stenhouse, a Scotch chemist and in- also identified the causative organism of typhus in
ventor, synthesized chloropicrin in 1848.3 1909. F. Loffler and W. Schutz identified glanders
Many biological agents were naturally occurring in 1882. Sir David Bruce, a British pathologist, dis-
diseases thousands of years old. Others were gen- covered the causative organism of brucellosis (it
erally discovered or recognized in the 19th and 20th was named after him) in 1887. Ricin toxin was iden-
centuries. For example, plague was recognized tified in 1889. Tularemia was first described in
about 3,000 years ago. Smallpox was known in Tulare County, California (after which it was
10
History of Chemical and Biological Warfare: An American Perspective
named), in 1911, and the causative agent was iden- If the shell should explode over the heads of the
tified the next year.3 enemy, the gas would, by its great specific gravity,
rapidly fall to the ground: the men could not dodge
it, and their first intimation of its presence would
Early Chemical Weaponization Proposals and Usage
be by its inhalation, which would most effectually
disqualify every man for service that was within
There are numerous examples of chemical weap- the circle of its influence; rendering the disarming
ons used or proposed during the course of a cam- and capturing of them as certain as though both
paign or battle. The Chinese used arsenical smokes their legs were broken.5(p27)
as early as 1000 BC. Solon of Athens put hellebore
roots in the drinking water of Kirrha in 600 BC. In As to the moral question of using chemical weap-
429 and 424 BC, the Spartans and their allies used ons, he echoed the sentiments of Lyon Playfair a
noxious smoke and flame against Athenian-allied decade earlier:
cities during the Peloponnesian War. About 200 BC,
the Carthaginians used Mandrake root left in wine As to the moral question involved in its introduc-
tion, I have, after watching the progress of events
to sedate the enemy. The Chinese designed stink
during the last eight months with reference to it,
bombs of poisonous smoke and shrapnel, along
arrived at the somewhat paradoxical conclusion,
with a chemical mortar that fired cast-iron stink
that its introduction would very much lessen the
shells. Toxic smoke projectiles were designed and
sanguinary character of the battlefield, and at the
used during the Thirty Years War. Leonardo da Vinci same time render conflicts more decisive in their
proposed a powder of sulfide of arsenic and verdi- results.5(p33)
gris in the 15th century.3
During the Crimean War, there were several pro- Doughty’s plan was apparently never acted
posals to initiate chemical warfare to assist the Al- on, as it was probably presented to Brigadier Gen-
lies, particularly to solve the stalemate during the eral James W. Ripley, Chief of Ordnance, who
siege of Sevastopol. In 1854, Lyon Playfair, a Brit- was described as being congenitally immune to
ish chemist, proposed a cacodyl cyanide artillery new ideas.5 A less-practical concept, proposed the
shell for use primarily against enemy ships. The same year by Joseph Lott, was to fill a hand-pumped
British Ordnance Department rejected the proposal fire engine with chloroform to spray on enemy
as “bad a mode of warfare as poisoning the wells troops.6
of the enemy.”4(p22) Playfair’s response outlined a The 1864 siege of Petersburg, Virginia, generated
different concept, which was used to justify chemi- several chemical warfare proposals. Forrest Shep-
cal warfare into the next century: herd proposed mixing hydrochloric and sulfuric
acids to create a toxic cloud to defeat the Confeder-
There was no sense in this objection. It is consid- ates defending Petersburg.5 Lieutenant Colonel
ered a legitimate mode of warfare to fill shells with William W. Blackford, a Confederate engineer, de-
molten metal which scatters among the enemy, and signed a sulfur cartridge for use as a counter-
produced the most frightful modes of death. Why tunnelling device.7 The Confederates also consid-
a poisonous vapor which would kill men without ered using Chinese stink bombs against the Union
suffering is to be considered illegitimate warfare
troops. Elsewhere, the same year, Union Army Cap-
is incomprehensible. War is destruction, and the
tain E. C. Boynton proposed using a cacodyl glass
more destructive it can be made with the least suf-
grenade for ship-to-ship fighting.5 Other than pos-
fering the sooner will be ended that barbarous
sibly Blackford’s cartridge, none of the proposals
method of protecting national rights. No doubt in
time chemistry will be used to lessen the suffering were used on the battlefield.
of combatants, and even of criminals condemned Two wars at the turn of the century also saw lim-
to death.4(pp22–23) ited use of chemical weapons. During the Boer War,
British troops fired picric acid–filled shells, al-
There were other proposals for chemical warfare though to little effect.8 During the Russo–Japanese
during the Crimean War, but none were approved. War, which was closely observed by those who
During the American Civil War, John Doughty, a would plan World War I, Japanese soldiers threw
New York City school teacher, was one of the first arsenal rag torches into Russian trenches.3
to propose the use of chlorine as a chemical warfare In 1887, the Germans apparently considered us-
agent. He envisioned a 10-in. artillery shell filled with ing lacrimators (tear agents) for military purposes.
2 to 3 qt of liquid chlorine that, when released, would The French also began a rudimentary chemical war-
produce many cubic feet of chlorine gas. fare program with the development of a tear gas
11