This document presents information on vesicants, chemical agents that produce vesicles or blisters.
There have been a number of recorded and suspected incidents of mustard use, culminating with the Iran-Iraq War in the 1980's. The threat of an enemy's using chemical weapons against United States' forces is ever present. Although mustard is the most important vesicant militarily, the vesicant category includes other agents, such as Lewisite and phosgene oxime. Mustard sulfide is one of the two most important known chemical agents (the group of nerve agents is the other). Despite 75 years of research, there is still no antidote for mustard. Probably at least a dozen countries have mustard in their arsenals today. The organs most commonly affected by mustard are the skin, eyes, and airways: the organs with which mustard comes in direct contact. Nausea and vomiting are common within the first few hours after mustard exposure, beginning at about the time initial lesions become apparent. Although the effects are not usually prominent clinically, mustard affects the central nervous system with symptoms of apathy, depression, intellectual dullness, and languor. Most casualties die of massive pulmonary damage complicated by infection and sepsis. There is no specific laboratory test for mustard exposure. Decontamination within one or two minutes after exposure is the only effective means of preventing or decreasing tissue damage from mustard. Lewisite is similar to mustard in that it damages the skin, eyes, and airways; however, it differs from mustard because its clinical effects appear within seconds of exposure. An antidote can ameliorate the effects of Lewisite if used soon after exposure. Phosgene oxime has been called a corrosive agent because it causes extensive tissue damage. Its lesions have been compared with those caused by nettle stings. There is not antidote for phosgene oxime, nor is there a recommended therapeutic regimen. 111 references