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War! What Is It Good For? Mustard Gas Medicine

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War! What Is It Good For? Mustard Gas Medicine HUMANITIES | MEDICINE AND SOCIETY War! What is it good for? Mustard gas medicine n Cite as: CMAJ 2017 February 27;189:E321-2. doi: 10.1503/cmaj.161032 ustard gas, which was named ready to deploy gas weapons and defend agent experiments involving patients with for its yellow-brown colour and against them if necessary.5,6 cancer, who hoped for relief and maybe mustard smell, has been in the During World War II, medical scientists even a cure. Military and civilian scientific Mnews lately because of its use in the Mid- developed cancer chemotherapy from research were deeply intertwined.5,7 dle East, including against civilians in mustard agents because these were the In the early 1940s, doctors associated Syria and Iraq. Many North Americans poisons they knew best. Dr. Cornelius with Yale University, the University of Chi- would be shocked, however, to learn of Rhoads, for example, was the head of the cago and Memorial Hospital conducted the deep connection between mustard Medical Division of the US Chemical War- the first therapeutic experiments with the gas, a chemical weapon, and medical fare Service and also director of the Sloan – intravenous use of mustard agents by ad- research. Kettering Institute for Cancer Research of ministering sulfur mustard and nitrogen Mustard agents have a long history in Memorial Hospital in New York City. Cancer mustard into the veins of cancer patients. American medical research, beginning researchers built on their own research Although some patients did benefit tem- with the work of Dr. Edward and Helen experience into chemical warfare. Wartime porarily, especially those with Hodgkin Krumbhaar during World War I.1 By World scientific research involved both medical disease and lymphosarcoma, problems War II, at least two dozen medical re- research for military purposes through with chemoresistance and chemotoxicity searchers transformed mustard agents mustard gas experiments involving sol- emerged.2,8 Several drugs derived from into cancer chemotherapy. In the 1940s, diers, many of whom were enticed or mustard agents are still used today to sulfur mustard, commonly called mustard ordered to volunteer, and medical applica- treat cancer, including one known as gas, and nitrogen mustard, a derivative of tions of military research through mustard Mustargen (mechlorethamine). mustard gas, became a new form of can- cer treatment.2 The search for medical ap- plications of mustard compounds contin- ued into the 1970s. For example, in 1972, Dr. Rudolf L. Baer, a renowned dermatol- ogist, published the results of a study in which he used nitrogen mustard to treat psoriasis in nine patients.3 Baer, who was on the faculty at New York University School of Medicine for more than 50 years, was part of the World War II generation of physician-researchers who spent a great deal of time studying the effects of mustard agents. In the 1940s, he and hundreds of physicians and scien- tists from a number of fields, including bio- chemistry, pathology, pharmacology, physiology, hematology and dermatology, conducted military medical research on dozens of chemical warfare agents, partic- ularly mustard gas.2–4 Medical scientists in Canada, the United States, the United Kingdom and Australia conducted toxicity studies as part of Allied preparation for chemical warfare. After the terrifying ex- periences of gas warfare during World Library and Archives Canada War I, the Allied nations wanted to be Canadian soldier in France during World War I. © 2017 Joule Inc. or its licensors CMAJ | FEBRUARY 27, 2017 | VOLUME 189 | ISSUE 8 E321 The connection between chemical The creation of cancer chemotherapy References weapons and cancer treatment may seem depended on the contributions of service- 1. Krumbhaar EB, Krumbhaar HD. The blood and surprising, even disturbing, to us. However, men and people with cancer who partici- bone marrow in yellow cross gas (mustard gas) poisoning: changes produced in the bone marrow for the physician-researchers and medical pated in experiments with mustard agents. of fatal cases. J Med Res 1919;40: 497-508. scientists at the time, it was the logical out- Soldiers, including those at Suffield Experi- 2. Moulton FR, editor. Approaches to tumor chemo- come of their wartime research on mustard mental Station in Alberta, took part in therapy. Washington (DC): American Association for the Advancement of Science; 1947. gas. They learned about the medical effects chemical warfare experiments as part of HUMANITIES 3. Baer RL, Michaelides P, Prestia AE. Failure to induce from toxic exposures of servicemen, both their wartime military service. They faced immune tolerance to nitrogen mustard. Intravenous the unintentional from a wartime disaster toxicity studies with mustard gas that administration preceding topical use in patients with psoriasis. J Invest Dermatol 1972; 58:1-4. in Bari, Italy, and the intentional in the included drop tests, field tests and even 4. Sulzberger MB, Baer RL, Kanof A, et al. Skin sen- 6 mustard gas experiments conducted at mil- tests in gas chambers. In later years, many sitization to vesicant agents of chemical warfare. itary and civilian facilities, including medi- of these young, healthy enlisted men faced J Invest Dermatol 1947;8:365-93. 5. Smith SL. Toxic exposures: mustard gas and the health cal schools. Their interdisciplinary research long-term health consequences from those consequences of World War II in the United States. produced an enormous amount of data on toxic exposures. People with cancer took New Brunswick (NJ): Rutgers University Press; 2017. the health effects of mustard agents on ani- part in therapeutic experiments with mus- 6. Avery D. The science of war: Canadian scientists and allied military technology during the Second World mals and humans. However, the military tard agents in hopes of finding some bene- War. Toronto: University of Toronto Press; 1998. heritage of cancer chemotherapy is not fits, even if only for a short time. Together, 7. Kutcher G. Contested medicine: cancer research common knowledge because of long- researchers and research participants and the military. Chicago: University of Chicago Press; 2009. standing government secrecy regarding transformed mustard agents from chemi- 8. Karnofsky DA, Craver LF, Rhoads CP, et al. An eval- 5 5 chemical weapons research. cal weapons into medical treatments. uation of methyl-bis (β-chloroethyl) amine hydro- To be clear, it was not war itself that Medical oncology, which seeks to con- chloride and tris (β-chloroethyl) amine hydrochloride 9 (nitrogen mustards) in the treatment of lympho- advanced medicine. The development of a trol cancer through chemotherapy, origi- mas, leukemia, and allied diseases. In: Moulton FR, new form of cancer control in the 1940s was nated in the science of war and Allied editor. Approaches to tumor chemotherapy. Wash- due to the determination of physicians and preparation for gas warfare during World ington (DC): American Association for the Advancement of Science; 1947:319-37. scientists who deliberately tried to extract War II. It grew out of medical research for 9. Cooter R, Sturdy S. Of war, medicine and moder- health care dividends from weapons of war. military benefits. Today, governments nity: introduction. In: Cooter R, Harrison M, Sturdy The mobilization for war provided the con- need to support medical research for its S, editors. War, medicine and modernity. Stroud text for the kind of political will, govern- own sake and not to serve other agendas. (UK): Sutton Publishing; 1999:1-21. 10. Pickstone JV. Contested cumulations: configura- ment resources and human suffering that As the history of chemotherapy reminds tions of cancer treatments through the twentieth scientists drew on to expand medical us, it was science, not war, that was good century. Bull Hist Med 2007;81:164-96. knowledge. Medical researchers tapped for medicine. Funding: This project was funded by a grant from into the available government resources, the Social Sciences and Humanities Research and during World War II, a major area of tar- Susan L. Smith PhD Council. The funding had no direct impact on the geted funding was for the investigation of Department of History and Classics, author’s research or conclusions. chemical warfare agents, particularly mus- Faculty of Arts, University of Alberta, This article was solicited and has been peer tard gas and the nitrogen mustards.5,10 Edmonton, Alta. reviewed. E322 CMAJ | FEBRUARY 27, 2017 | VOLUME 189 | ISSUE 8 .
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