Reviewed by Enoch Callaway, MD, Professor of Psychiatry Emeritus, University of California San Francisco

“Chemical Warfare Secrets Almost Forgotten”

James S. Ketchum, MD, COL USARMC (ret.)

ChemBook Inc., December 2006
(available at www.forgottensecrets.net)
ISBN: 978-1-4243-0080-8

This is a fascinating book, perhaps best reviewed as a combination of books: (1) an autobiography of a scientist-physician studying chemical warfare agents from 1961 to 1971,  (2) a collection of vignettes of fellow scientists he encountered, (3) a polemic against the aversion of politicians and the public to all chemical weapons, and, (4) a reference book on more than a dozen low lethality belladonnoids (atropine-like drugs such as BZ) and their antidotes (such as physostigmine), as well as valuable data on other mind-altering substances such as LSD-25, cannabinoids (marijuana-like drugs), butyrophenones (antipsychotic drugs) and even the most common disabling agent: alcohol.
His vignettes of fellow scientists also bring back memories of many departed friends and colleagues and a few (Alexander “Sasha” Shulgin, for example) that seem indestructible. 

Ketchum’s selective defense of certain forms of chemical warfare strikes a sympathetic chord.  While I was at Edgewood, we were preoccupied with the lethal nerve gas variously known as diisopropyl flurophosphonate, sarin or GB.  From what I learned, I believed that death from nerve gas would be preferable to being incinerated by napalm or taking a phosphorus bullet in the gut.  Of course, the newer low lethality agents seem even more humane.  The book’s prologue, “Hot Night in Fallujah,” creates a compelling scenario involving a carefully planned attack with sufentanil, one of the more recent agents, a highly potent analogue of fentanyl and a relative of morphine.  Not only is its disabling dose considerably lower than the lethal dose, but an effective antidote (naloxone) is available to reverse its effects.

Fascinating as Dr. Ketchum’s stories of his adventures in the Army Chemical Corps may be, and as important his defense of the military use of the “gentler” incapacitating chemical agents, I suspect that the most lasting value of this book will lie in the details of the actual studies done with these pharmacological substances.  The experiments with Army volunteers were remarkable for the care with which they were designed and carried out.  The last 80 pages of the close to 400-page volume are set aside as a technical appendix, containing many details of the actual studies and summary graphs and tables of the extensive data gathered.  But it is the verbatim record of the responses of numerous volunteers, while intoxicated with various psychochemical agents, and which are scattered throughout the earlier informal narrative chapters of his historical chronicle, that will be particularly invaluable if similar research with chemical warfare agents is ever revived.

Finally, this variegated volume will correct some of the many errors, misconceptions and outright lies that have grown up around the Edgewood Arsenal research program.  A combination of a sensation seeking press, compensation seeking litigators and mawkish anti-military “bleeding hearts” has resulted in massive misinformation.  One can only hope that this persuasive book will set some of the record straight.

Personal Notes

I personally found the lively descriptions of his adventures a delight, as they brought back my own memories of Edgewood Arsenal during the Korean War, from 1950 to 1952.  I was a Naval Reserve Medical Officer, called to active duty because the Army had lost so many medical officers in combat.  At first, I was ordered to don my Navy lieutenant’s uniform and report to Fort Sam Houston, where I was trained as a battalion surgeon in anticipation of going to the front in Korea.  Needless to say, I did not object when, because of my work at the University of Maryland, I was assigned to the Medical Research Laboratories at Edgewood Arsenal, rather than to an Infantry unit in Korea.  As a Naval Officer on loan to the Army, my position was odd, and if anything, I believe some of my experiences were even more bizarre than those described by Dr. Ketchum.

I particularly remember the first case of major intoxication with a belladonnoid drug that I ever saw.  A chemical warfare officer at Dugway Proving Grounds in Utah, who was working with GB (sarin) while wearing an exposure suit, began to convulse.  It was immediately assumed that he had been exposed to the gas and he was immediately treated with atropine, a belladonna antidote for nerve agents.  He received multiple injections before it was recognized that his disability did not result from GB exposure, but rather to an intemperate “night on the town” followed by a day in the desert heat while enclosed in a chemical warfare exposure suit.  The unfortunate officer was flown back to Edgewood Arsenal where I, as psychiatrist in residence, was sent to examine him.  I remember that during his atropine-induced delirium, he saw tiny paratroopers coming through the ceiling with gaily colored parachutes.  Later I found that micropsia (seeing things as smaller than they really are) often accompanies atropine overdosage.  I did think it odd, however, that apparently no other belladonnoids were described as producing such Lilliputian hallucinations.  Dr. Ketchum, however, noted that this feature was common to all of the more than a dozen atropine-like drugs (including BZ) that he studied.

About the reviewer

Dr. Callaway was born in LaGrange, GA, and graduated from Columbia College and College of Physicians and Surgeons.  He also studied at Grady Hospital (Emory University), Worcester State Hospital, University of Maryland, Johns Hopkins University, the Baltimore Psychoanalytic Institute and the US Naval Hospital, Bethesda, Maryland. During the Korean War he served as Lieutenant (s.g.) US Naval Reserve at Edgewood Army Chemical Center, Bethesda Naval Hospital and the Naval Medical Research Institute.  He moved from the University of California, San Francisco, in 1958 and is now Emeritus Professor of Psychiatry.

In addition to clinical work and teaching, Dr. Calloway has done research in psychopharmacology and brain electrical activity and is the author of over 100 edited papers and a monograph. He has edited several volumes and served as editor and review for numerous scientific journals, as well as serving as board member and officer in various scientific societies.