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 cancer 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 scientists 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 HUMANITIES E322 tard gasandthenitrogenmustards. chemical warfareagents,particularlymus- geted fundingwasfortheinvestigationof and duringWorldWarII,amajorareaoftar- into theavailablegovernmentresources, knowledge. Medicalresearcherstapped scientists drewontoexpandmedical ment resourcesandhumansufferingthat text forthekindofpoliticalwill,govern- The mobilizationforwarprovidedthecon- health caredividendsfromweaponsofwar. scientists whodeliberatelytriedtoextract due tothedeterminationofphysiciansand new formofcancercontrolinthe1940swas advanced medicine. chemical weaponsresearch. standing governmentsecrecyregarding common knowledge because of long- heritage ofcancerchemotherapyisnot mals andhumans.However,themilitary the healtheffectsofmustardagentsonani- produced anenormousamountofdataon cal schools.Theirinterdisciplinaryresearch itary andcivilianfacilities,includingmedi- mustard gasexperimentsconductedatmil- in Bari,Italy,andtheintentional the unintentionalfromawartimedisaster from toxicexposuresofservicemen,both gas. Theylearnedaboutthemedicaleffects come oftheirwartimeresearchonmustard scientists at the time, it was the logical out- for thephysician-researchersandmedical surprising, evendisturbing,tous.However, weapons andcancertreatmentmayseem To beclear,itwasnotwaritselfthat The connection between chemical 9 The development of a Thedevelopmentofa 5 5,10 CMAJ cal weaponsintomedicaltreatments. transformed mustardagentsfromchemi- researchers andresearchparticipants fits, evenifonlyforashorttime.Together, tard agents in hopes of finding some bene- part intherapeuticexperimentswithmus- toxic exposures.Peoplewithcancertook long-term healthconsequencesfromthose of theseyoung,healthyenlistedmenfaced tests in gas chambers. included droptests,fieldtestsandeven toxicity studieswithmustardgasthat their wartimemilitaryservice.Theyfaced chemical warfareexperimentsaspartof mental StationinAlberta,tookpart Soldiers, includingthoseatSuffieldExperi- pated inexperimentswithmustardagents. men andpeoplewithcancerwhopartici- depended onthecontributionsofservice- Edmonton, Alta. Faculty ofArts,UniversityAlberta, Department ofHistoryandClassics, Susan L.SmithPhD for medicine. us, itwasscience,notwar,thatgood As thehistoryofchemotherapyreminds own sakeandnottoserveotheragendas. need tosupportmedicalresearchforits military benefits.Today,governments War II.Itgrewoutofmedicalresearchfor preparation forgaswarfareduringWorld nated inthescienceofwarandAllied trol cancerthroughchemotherapy,origi- | FEBRUARY 27, 2017 The creationofcancerchemotherapy Medical oncology,whichseekstocon-

6 In later years, many In later years, many | VOLUME 189 5 | ISSUE 8

10. reviewed. This articlewassolicitedandhasbeenpeer author’s researchorconclusions. Council. Thefundinghadnodirectimpactonthe the SocialSciencesandHumanitiesResearch Funding: Thisprojectwasfundedbyagrantfrom

References

5 3 6 7 8 1 9. 4. 2...... Kutcher War. Toronto:UniversityofTorontoPress; allied militarytechnologyduringtheSecondWorld Karnofsky Press; and themilitary.Chicago:UniversityofChicago chloride andtris(β uation ofmethyl-bis(β Advancement ofScience; ington (DC):AmericanAssociationforthe editor. mas, leukemia,andallieddiseases.In:MoultonFR, (nitrogen mustards)inthetreatmentoflympho- New consequences ofWorldWarIIintheUnitedStates. Cooter Smith J InvestDermatol1947;8:365-93. sitization tovesicantagentsofchemicalwarfare. Pickstone (UK): SuttonPublishing;1999:1-21. S, editors.War,medicineandmodernity.Stroud nity: introduction.In:CooterR,HarrisonM,Sturdy century. BullHistMed2007;81:164-96. tions ofcancertreatmentsthroughthetwentieth Avery Sulzberger Moulton FR, of fatalcases. poisoning: changesproducedinthebonemarrow bone marrow in yellow cross gas (mustard gas) Krumbhaar with psoriasis. administration preceding topical use in patients immune tolerancetonitrogenmustard.Intravenous Baer for theAdvancementofScience;1947. therapy. Washington(DC):AmericanAssociation Brunswick (NJ):RutgersUniversityPress; RL, D SL. 2009.

Approaches totumorchemotherapy.Wash- . R The science of war: Canadian scientists and The scienceofwar:Canadianscientistsand Michaelides , G Toxic exposures: mustard gas and the health Toxic exposures:mustardgasandthehealth Sturdy DA, . JV. MB, Contested medicine:cancerresearch EB, editor. J MedRes J InvestDermatol Contested cumulations:configura- Craver Baer Krumbhaar

-chloroethyl) aminehydrochloride S . Of war, medicine and moder P Approaches totumorchemo- LF, RL, , Prestia -chloroethyl) aminehydro- 1919; Rhoads 1947: Kanof 40: HD. AE. 1972; 319- A, 497- CP, Failure to induce Failure toinduce The bloodand et al. 37. 58: 508. et al. 1 - 4 Skin sen- 1998. . An eval- 2017. -