Poison Gas Lungs Study Reveals Lessons from World War I for Modern Medical Care of Chemical Warfare Victims

By Lauren Bigge
NMHM Public Affairs Coordinator

Poison gas was a signature weapon during World War I, but chemical weapons remain a potent threat on the battlefield and are a major concern for modern military medicine, Australian pathologist Robin Cooke told the Medical Museum Science Café audience at the National Museum of Health and Medicine (NMHM) on Aug. 22.

NMHM invited Dr. Cooke to speak about World War I and poison gas as part of the museum's ongoing commemoration of the centennial of World War I. Dr. Cooke visited NMHM previously in 2015, to survey the museum's collections regarding poison gas victims, said Brian Spatola, NMHM's curator of Anatomical Collections.

Cooke explained that he was able to study poison gas pathology from World War I because the various nations' medical services collected data about clinical and pathological illnesses and information on how chemical injuries were treated. In addition to NMHM's own collection, he visited museums in Vienna, Munich, London, and Edinburgh to examine lungs and other anatomical specimens with gas damage. The professor discovered abnormalities in the air passages when an individual's lungs had been exposed to poison gas.

Soldiers exposed to mustard gas experienced intense itching and skin irritation. Over time, large blisters formed and filled with yellow fluid wherever the chemical agent had touched the skin. This also happened inside the lungs.

"If you make microscopic sections on these 100-year-old specimens, a veritable wonderland of changes comes to light," Dr. Cooke said.

He explained that German pathologist Walter Koch likened the respiratory tracts of soldiers exposed to gas during World War I to those of people who had suffered from diphtheria, a common disease at that time.

An examination of lung tissue from workers who died after an explosion in a German mustard gas factory in 1930 revealed the rapid destruction of the lining in respiratory air passages, exposing the tissue to infection such as quick and fatal pneumonia.

He mostly saw anatomical specimens with mustard gas damage, but some had chlorine gas damage. The specimens showed evidence of emphysema, necrosis, bronchitis, bronchopneumonia, peribronchial fibrosis, pneumonia, oedema, and pulmonary fibrosis. Lessons learned from microscopic examinations of tissues from the World War I era may help physicians treat chemical warfare casualties in the future.

"Modern military physicians are already dealing with victims of gas attacks," Dr. Cooke said. "This is the original human experiment. That's why it's important. It's something that will never be repeated."

The timing of Dr. Cooke's research has been important to NMHM. "We've recently re-identified many of the museum's World War I "wet tissue" anatomical specimens," Spatola said. "We've established a World War I collection. We recognized that the World War I material needs to be separated and highlighted and referenced on its own, which coincides with Dr. Cooke's interest. It's also good collections management." NMHM's historical and archival collections also include artifacts related to American military medicine's response to World War I.

NMHM's Medical Museum Science Cafes are a regular series of informal talks that connect the mission of the Department of Defense museum with the public. NMHM was founded as the Army Medical Museum in 1862 and moved to its current location in Silver Spring, Maryland, in 2012. NMHM is an element of the Defense Health Agency. For information on upcoming events, please call 301-319-3303 or visit www.medicalmuseum.mil.

 
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	Caption: Prof. Robin Cooke, Australian pathologist, speaks about lung specimens he has studied, during the Medical Museum Science Café, "100 Years Later: The Pathology of Poison Gas," on Aug. 22, 2017 at the National Museum of Health and Medicine in Silver Spring, Md. (National Museum of Health and Medicine photo by Matthew Breitbart / Released)
	Caption: Prof. Robin Cooke, Australian pathologist, speaks about the effects of chemical warfare on lungs during the Medical Museum Science Café, "100 Years Later: The Pathology of Poison Gas," on Aug. 22, 2017 at the National Museum of Health and Medicine in Silver Spring, Md. (National Museum of Health and Medicine photo by Matthew Breitbart / Released)
	Caption: The audience listens as Prof. Robin Cooke, Australian pathologist, speaks about microscopic examinations of lung specimens during the Medical Museum Science Café, "100 Years Later: The Pathology of Poison Gas," on Aug. 22, 2017 at the National Museum of Health and Medicine in Silver Spring, Md. (National Museum of Health and Medicine photo by Matthew Breitbart / Released)