MEDICAL ASPECTS OF CHEMICAL AND BIOLOGICAL WARFARE
Image 01
The Coat of Arms
1818
Medical Department of the Army

A 1976 etching by Vassil Ekimov of an original color print that appeared in The Military Surgeon,
Vol XLI, No 2, 1917



The first line of medical defense in wartime is the combat medic. Although in ancient times medics carried the caduceus into battle to signify the neutral, humanitarian nature of their tasks, they have never been immune to the perils of war. They have made the highest sacrifices to save the lives of others, and their dedication to the wounded soldier is the foundation of military medical care.


Textbook of Military Medicine


Published by the

Office of The Surgeon General
Department of the Army, United States of America

Editor in Chief
Brigadier General Russ Zajtchuk, MC, U.S. Army

Director, Borden Institute
Commanding General
U.S. Army Medical Research and Materiel Command
Professor of Surgery
F. Edward Hébert School of Medicine
Uniformed Services University of the Health Sciences
Bethesda, Maryland

Managing Editor
Ronald F. Bellamy, M.D.

Colonel, MC, U.S. Army (Retired)
Borden Institute
Associate Professor of Military Medicine
Associate Professor of Surgery
F. Edward Hébert School of Medicine
Uniformed Services University of the Health Sciences
Bethesda, Maryland




The TMM Series

Part I. Warfare, Weaponry, and the Casualty
Medical Consequences of Nuclear Warfare (1989)
Conventional Warfare: Ballistic, Blast, and Burn Injuries (1991)
Military Psychiatry: Preparing in Peace for War (1994)
War Psychiatry (1995)
Medical Aspects of Chemical and Biological Warfare (1997)
Military Medical Ethics
Part II. Principles of Medical Command and Support Military Medicine in Peace and War
Part III. Disease and the Environment

Occupational Health: The Soldier and the Industrial Base (1993)
Military Dermatology (1994)
Military Preventive Medicine: Mobilization and Deployment
Medical Aspects of Deployment to Harsh Environments
Part IV. Surgical Combat Casualty Care

Anesthesia and Perioperative Care of the Combat Casualty (1995)
Rehabilitation of the Injured Soldier Military Surgery



Image 02


....
Gas! GAS! Quick, boys!— An ecstasy of fumbling,
Fitting the clumsy helmets just in time;
But someone still was yelling out and stumbling
And flound. ring like a man in fire or lime . . .
Dim, through the misty panes and thick green light,
As under a green sea, I saw him drowning.

In all my dreams, before my helpless sight,
He plunges at me, guttering, choking, drowning.1
....

— Wilfred Owen

The poetry, excerpted from Dulce et Decorum Est, was written by Lieutenant Wilfred Owen of the Royal Army, who was killed in action in France on 4 November 1918. . Gassed,. the frontispiece painting, shows the horror of chemical warfare in World War I as perceived by the artist, Gilbert Rogers.2 As Keegan and Darracott observed, . Rogers was an officer of the Royal Army Medical Corps commissioned to record medical work during the First World War. The subtitle to this painting, . In Arduis Fidelis. (Faithful in Hardships), suggests the subject is a stretcher-bearer who has succumbed to gas while transporting wounded..3

1. Excerpted from Wilfred Owen. Dulce et decorum est. In: The Collected Poems of Wilfred Owen. Copyright © 1963 by Chatto & Windus, Ltd. Reprinted by permission of New Directions Publishing: New York, NY.
2. Painting: Printed with permission from Imperial War Museum, London, England.
3. Keegan J, Darracott J. The Nature of War. New York, NY: Holt, Rinehart and Winston; 1981: 222.



MEDICAL ASPECTS OF CHEMICAL
AND
BIOLOGICAL WARFARE


Specialty Editors

FREDERICK R. SIDELL , M.D.
Chemical Casualty Consultant

ERNEST T. TAKAFUJI, M.D., M.P.H.
Colonel, Medical Corps, U.S. Army

DAVID R. FRANZ, D.V.M, PH.D. Colonel, Veterinary Corps, U.S. Army




Borden Institute
Walter Reed Army Medical Center
Washington, D. C.

Office of The Surgeon General
United States Army
Falls Church, Virginia

United States Army Medical Department Center and School
Fort Sam Houston, Texas

United States Army Medical Research and Materiel Command
Fort Detrick, Frederick, Maryland

Uniformed Services University of the Health Sciences
Bethesda, Maryland

1997



Editorial Staff: Lorraine B. Davis
Senior Editor
Colleen Mathews Quick
Associate Editor/Writer



This volume was prepared for military medical educational use. The focus of the information is to foster discussion that may form the basis of doctrine and policy. The volume does not constitute official policy of the United States Department of Defense.

Dosage Selection:
The authors and publisher have made every effort to ensure the accuracy of dosages cited herein. However, it is the responsibility of every practitioner to consult appropriate information sources to ascertain correct dosages for each clinical situation, especially for new or unfamiliar drugs and procedures. The authors, editors, publisher, and the Department of Defense cannot be held responsible for any errors found in this book.

Use of Trade or Brand Names:
Use of trade or brand names in this publication is for illustrative purposes only and does not imply endorsement by the Department of Defense.

Neutral Language:
Unless this publication states otherwise, masculine nouns and pronouns do not refer exclusively to men.



CERTAIN PARTS OF THIS PUBLICATION PERTAIN TO COPYRIGHT RESTRICTIONS.
ALL RIGHTS RESERVED.

NO COPYRIGHTED PARTS OF THIS PUBLICATION MAY BE REPRODUCED OR TRANSMITTED IN ANY FORM OR BY ANY MEANS, ELECTRONIC OR MECHANICAL(INCLUDING PHOTOCOPY, RECORDING, OR ANY INFORMATION STORAGE AND RETRIEVAL SYSTEM), WITHOUT PERMISSION IN WRITING FROM THE PUBLISHER OR COPYRIGHT OWNER


Published by the Office of The Surgeon General at TMM Publications Borden Institute
Walter Reed Army Medical Center
Washington, DC 20307-5001

Library of Congress Cataloging. in. Publication Data
Medical aspects of chemical and biological warfare / specialty
     editors, Frederick R. Sidell, Ernest T. Takafuji, David R. Franz.
          p.    cm. . (TMM series. Part I, Warfare, weaponry, and the casualty)
          Includes bibliographical references and index.
1. Medicine, Military.
2. Chemical warfare.
3. Biological warfare.

I. Sidell, Frederick R.
II. Takafuji, Ernest T.
III. Franz, David R., D.V.M.
IV. Series: Textbook of military medicine. Part 1, Warfare, weaponry, and the casualty ; [v. 3].

[DNLM: 1. Chemical Warfare. 2. Biological Warfare. 3. Military Medicine. methods.
UH 390 T355 pt. 1 1997 v. 3]
RC971.T48 1989 vol 3
616.9 . 8023 s. dc21
[616.9. 8023]
DNLM/DLC

for Library of Congress               97-22242
                                                            CIP

PRINTED IN THE UNITED STATES OF AMERICA

07, 06, 05, 04, 03, 02, 01, 00, 99, 98      5 4 3 2 1



Interested readers can also find up-to-date information on the medical aspects of chemical and biological warfare at the following internet locations:
The Medical NBC Information Server
Medical Research and Materiel Command
Medical Chemical and Biological Defense
Medical Research Institute of Chemical Defense
Medical Research Institute of Infectious Diseases
http://www.nbc-med.org
http://mrmc-www.army.mil
http://mrmc-www.army.mil/researchAreas/index.htm
http://chemdef.apgea.army.mil
http://www.usamriid.army.mil