The thought of chemical and biological
warfare terrifies us. What is it in the human psyche that makes being attacked
with conventional weaponsóthat kill and maimómore acceptable than being
attacked with molecules that alter the body chemistry or with organisms that
cause disease? For some, the wearing of chemical protective clothing seems to
exemplify our fear of an unknown agent that we cannot see, do not understand,
and think must be immoral.
World events have conspired to increase the threat
of the use of chemical and biological weapons. The end of the Cold War brought
not only the hoped-for change of swords into plowshares but also political and
economic turbulence in the former Soviet Union, unemployed and disenchanted
weapons specialists and scientists, the rise of religious fundamentalism in
southwest Asia, state-sponsored terrorism, and blurring of the lines between
terrorism and traditional warfare.
In addition, the nature of war is changing.
We no longer expect a war to last years, as World War II did, but rather days,
as we saw with the Persian Gulf War. Worse, the weapons of war have also
changed. Many countries do or could possess chemical and biological
agentsóbypassing the tremendous financial outlay required to acquire
Until this decade, our military forces had not
faced chemical and biological weapons since World War I, and the prevailing
attitude has been "out of sight, out of mind." The Persian Gulf War
changed all that. Just the threat that such weapons would be used was
itself an effective weapon, as it required us to expend tremendous logistical
resources to supply our troops in the desert. Now we know that we must master
all relevant aspects of defense against chemical and biological warfare. The
Biological Weapons Convention, ratified in 1975, did not slow the massive Soviet
program, which continued until early 1992, nor did it prevent the buildup in
Iraq between 1985 and 1990. At this time, experts are severely questioning
whether verification of compliance with the treaty can be certain. Similar
concerns delayed ratification of the Chemical Weapons Convention by the U.S.
Senate; nevertheless, the senate ratified the treaty on 24 April 1997.
A primary value of the Textbook of
Military Medicine series is to preserve the lessons of past wars and, by so
doing, demonstrate how current doctrine is built on knowledge that was gained at
so high a cost. Medical officers should read this volume, Medical Aspects of
Chemical and Biological Warfare, and learn its lessons well. Civilians
expect that we in the military will know how to manage chemical and biological
casualties. Indeed, if we do not, then who will? The nation expects us to be
prepared to defend against all attacks and will be unforgiving of any incapacity
on our part.
Lieutenant General Ronald R. Blanck
The Surgeon General
Washington, D. C.