The word ‘napalm’ is derived from the two
words ‘naphthene’ and
‘palmitate’. Napalm itself is a jelly obtained from
the salts of
aluminium, palmitic or other fatty acids, and naphthenic acids.
These acids give a viscous consistency to gasoline so that an
incendiary jelly results. We have developed the habit of calling
‘napalm’, not only the napalm itself, but also the
material
resulting when it is mixed with gasoline to form the incendiary
weapon.
The generic precursors of this weapon
go back
to the flame-throwers first used in the First World War. These
flame-throwers had a limited effective range because of the
fluidity of the liquids. Therefore an attempt was made to diminish
fluidity and render the liquids more adherent. An example of
primitive success in this area is the early Molotov cocktail in
which a simple fragment of cotton was added to adhere to a tank and
to render the combustion of the gasoline more effective.
The first napalm was developed by
American
technicians of the Chemical Corps during the Second World War. They
observed that latex mixed with gasoline took on a viscous
consistency which gave good results. But as the sources of latex
were blocked after Pearl Harbor, they had to find a synthetic. They
sought a jelly which could be prepared at low temperatures, which
was easily handled, stable and not too costly. A soap-like
aluminium mixture - aluminium salts with fatty acids - met these
requirements, especially the acids having from ten to sixteen
carbons, like palmitic acid and oleic and other unsaturated acids.
Napalm comes in the form of a grey-white powder resembling soap
powder; it can be made effective by mixing it with gasoline on the
battlefield.
The use of fire as a weapon by soldiers
is very
ancient, but the {191} technology in modern terms really began, in
a rudimentary way, during the First World War and became
generalized during the Second World War. Napalm conferred on a
flammable substance the properties necessary for extended use and
the aeroplane furnished an efficient delivery system.
Until the beginning of the Second World
War,
magnesium was the incendiary substance most frequently employed by
all belligerents. But from 1942 on, it was recognized that
magnesium was expensive and in too short supply for massive use.
Therefore, as napalm was developed, it became the prime material in
the manufacture of incendiary bombs. The first model in service,
the M-69 bomb weighing six and a half pounds, was used in great
quantities against Japan. The models which followed were developed
too late to use against Japan, but they were used during the Korean
War and then by the French in Indochina and Algeria.
To utilize napalm effectively, large
target
areas are preferable. Flame-throwing aircraft have proved
ineffective because conventional aircraft fly too fast to be
accurate. On the other hand, excellent results are obtained by
dropping fire bombs made from launchable drums filled with gasoline
jellied with napalm. The napalm drums have exterior ignition
devices consisting of small incendiary bombs or phosphorous
grenades.
There are a number of different
containers for
napalm. Those most frequently used contain nearly 500 litres of
gasoline, jellied by an addition of napalm varying from six to
thirteen per cent - six per cent seems more often used. Such a bomb
will cover with flames a surface 75 feet wide by 270 feet long. To
obtain the best results, the bomb should fall as rapidly as
possible, giving, by momentum, a greater length to the surface
covered. Therefore the best means of delivery is not to drop the
bomb vertically, but to launch it from low altitude - about 100
feet - from a ‘hedge-hopping’ aircraft.
The Americans use two types of napalm
and
several different means of delivery. The two napalms are
‘ordinary’, which produces a temperature of
800-1,200°C
[1,472-2,152°F] and ‘super-napalm’,
enriched with polystyrene,
sodium, magnesium or phosphorus, with which the temperatures reach
1,500-2,000°C [2,732-3,632°F]. These two napalms are
principally
used in {192} drums of from 60 to 630 litres capacity and in bombs
weighing from 100 to 200 kilos [220-440 lbs.]; the US 7th Fleet
also uses napalm missiles.
Since napalm is essentially an
incendiary
product, it sets fire to any combustible matter with which it comes
in contact. A human being in the open cannot protect himself
against it. Napalm acts not only by burning but has an equally
devastating effect which consists of a complicated process whereby
shock, absorption of oxygen from the air [deoxygenation], smoke and
noxious gases become lethal. The Surgeon-General of the French Army
has described the massive poisoning by carbon monoxide after a
napalm attack and points out that none of those burned in the
central strike area survives because of this phenomenon. Only those
who have been on the periphery of the strike zone can survive the
massive deoxygenation.
An examination of some of the methods
of
execution practised during the Middle Ages sheds some light on
these effects. In executions by burning at the stake, when large
fires were used, the victim died rapidly from carbon monoxide
poisoning before being actually burned by the flames; when small
fires were used, a longer and much crueller death by flame
resulted. (From this has come the popular French expression for
being on tenterhooks: brûler à petit feu,
to roast over a
slow fire.)
During the Second World War, troops
found
Japanese shelters which had been struck by napalm bombs in which
all the occupants were dead without having been burned at all.
These soldiers had died, apparently without pain, and with an
expression of fright and surprise frozen on to their faces; they
had been instantaneously and massively poisoned by carbon monoxide.
The only way to escape the asphyxiating effects of napalm is to
flee into the open air - where the direct destruction by burning
from flaming splashes is greatest. In a strike zone it is almost
impossible to escape the effects of napalm by taking shelter, for
one cannot hold one’s breath for the time it takes napalm to
burn
off. The carbon monoxide poisoning itself paralyses the will and
robs the victim of the ability to move.
From the above it can be seen that a
napalm
bombardment has two principal effects: fire and asphyxiation. When
napalm strikes human beings the resulting burns are distinguishable
from ordinary {193} burns by the fact that they are covered with a
viscous black magma resembling tar. The depth of the burn is always
considerable. The extensive fires caused by the combustion of
flammable structures in contact with napalm prolong the effect of
the primary burning.
The asphyxiating effect of napalm is
due to the
incomplete combustion of the compound, which produces carbon
monoxide. This phenomenon has been reported in areas ravaged by the
fire storms caused by bombardment of cities with conventional bombs
during the Second World War. The lethality of carbon monoxide is
well known and it was tried by the Nazis as a destructive gas for
the mass execution of civilians. The source of this gas was the
exhaust of diesel motors which was either directed into an
enclosure built on to a truck or into a gas chamber. The method was
too primitive and was abandoned in favour of cyanide
derivatives.
We now turn to the poison -and-burn
pathology of
napalm. Carbon monoxide poisoning is most effective. Carbon
monoxide dissolves rapidly into blood plasmas. Combined with
haemoglobin, it imparts to the red corpuscles a very stable
combination of carboxy-haemoglobin, which is more stable than the
combination with oxygen. The combining with haemoglobin is powerful
and rapid, occurring within a few hundredths of a second. It is 250
times more rapid and powerful than the reaction with oxygen. The
elimination of carbon monoxide, on the other hand, is much more
slow and difficult. Once combined with haemoglobin, carbon monoxide
suppresses the oxygen-carrying capacity of the blood pigment,
thereby inhibiting the function of haemoglobin in supplying oxygen
to the tissues. Carbon monoxide also seems to have an effect on the
iron-containing cells and combines readily with the respiratory
enzymes, bringing about direct disturbances of cellular respiration
in addition to those caused by the lack of oxygen.
The chemical effects of carbon monoxide
depend
on its concentration in the surrounding air. With as little as one
per cent, it is toxic. With higher concentrations, ideation is
disturbed and there are hallucinations. Concurrently there occur
motor disturbances and paralysis which prevent walking and all
desire to escape. Beginning with a saturation of fifteen to forty
per cent of {194} the haemoglobin, encephalic disturbances,
cardio-respiratory failure and fatal coma appear. Survivors of
poisoning who have received emergency treatment exhibit permanent
neurological after-effects which range from mild to very severe.
Prognosis for coma depends in large part on the therapeutic
facilities. The immediate use of oxygen therapy is called for since
the symptoms are reversible with a forced intake of oxygen. Modern
resuscitation equipment is imperative. One can imagine the
unavailability of such equipment in a target area in Vietnam.
The second and most evident effect of
napalm is
the burn. The explosion of a 200-litre napalm incendiary bomb
precipitates massive destruction by flames in a circle about 240
feet in diameter. In that zone the heat is from 1,800-3,600°F
and
the carbon monoxide release is massive; within this zone, there
will be no survivors. Outside this zone unsheltered individuals
will suffer burns from flaming splashes of napalm of a gravity in
proportion to the amount of cutaneous surface affected. Parts not
protected by clothing - face, hands, often the upper and lower
members will be burned. The fire affects the clothing also, which
can contribute to localized burning, rendering the effect
worse.
After bombardment of a group of people
by
napalm, the wounded - in need of immediate treatment if they are to
survive - will be found around the periphery of the strike zone.
The possibility of treatment is a function of the gravity of the
burn. Besides the extent and depth of burning, age is a determining
factor since the effects are more severe on children and the old.
Also, burns on the face and neck are more serious for a child than
for an adult. Gravity is expressed in terms of percentage of the
body surface affected. Any adult burned on more than ten per cent
of the body, or any child burned on more than eight per cent, is
considered critically burned.
Doctors also distinguish between
superficial
burns - first and second degree burns where the thermal lesion
involves only the epidermis - and third degree burns, where the
destruction of all skin, epidermis and dermis, renders any
spontaneous healing impossible. Burning which goes as deep as the
tissues (third degree) develops scabs which, when they fall off,
leave an open wound susceptible to infection. A third-degree burn
will never heal aseptically. Because of napalm’s adhesive
quality,
the burns it {195} causes are almost always of the third degree. It
is estimated that a napalm burn affecting as little as five per
cent of the body surface is grave.
A serious burn progresses through
successive
stages: first of shock and poisoning; second of infection; and
third of healing. Any grave burn becomes a generalized illness due
to the loss of body fluid and the breakdown of the body’s
mechanism
for fluid balance. Immediately after burning there is shock due to
pain and fear. Towards the sixth hour and for three or four days
thereafter, true physiological shock due to the leakage of liquid
plasma from the burned areas sets m. The amount of this fluid loss
is proportional to the amount of burned surface. Some loss occurs
at the exterior but mostly in the subcutaneous tissues, causing
oedema which is sometimes considerable. The direct consequence of
the plasma leakage is a haemoconcentration from diminution of the
blood mass. The diminution of the blood mass leads to a circulatory
slowing and often to cardiovascular collapse, which in turn
compromise the oxygenation of the tissues and cause multiple
metabolic disturbances.
Beginning with the third and fourth
days, a
reverse phenomenon of reabsorption of the exuded liquids takes
place. The tissues and red corpuscles release their liquids into
the circulatory system bringing about a haemodilution causing
anaemia and hypertension with crises of cerebral and pulmonary
oedema. Also around the third day, the consequences of liver and
kidney damage appear. This is an anoxia of the tissues due to the
build-up of toxic products coming from the reabsorption into the
blood stream of the destroyed tissues. Later, nutritional
disturbances appear which are a result of the nitrogen loss
following nitrogen destruction. Thus within ten days such a burned
person loses about eleven pounds from fluid loss alone.
In addition every profound burn is a
wound that
is susceptible to infection. This is especially true since the
initial inadequacy of general resistance facilitates the
multiplication of microbes. Once established, this infection
further inhibits nutrition and blocks healing. Thus a vicious,
often irreversible circle is created which is responsible for more
than fifty per cent of the secondary deaths from burns. Such deaths
can often appear months after the trauma.
Finally, the healing process develops
with
elimination of the {196} necrotic tissues. A second-degree burn
heals in a few weeks. By contrast, in a deep burn, the
epidermatization [growth of new skin] can only start from the
periphery of the wound, if one has been unable to make a graft, to
build a fragile scar tissue. This tendency to heal from the
periphery causes granular, sclerotic tissue to form on the wound,
further inhibiting healing.
In napalm burns, a final element is of
great
importance; this is the gravity of facial burning. Eye burns can
lead to loss of one or both eyes. Nasal and ear passages involved
develop extended suppuration and necrosis which abscess with
unbearable pain to the patient. The face becomes hideous with
psychological trauma of formidable proportions. There are other
lingering damages: lesions of the bone, which do not show up on
X-rays, and appearance of cysts of certain joints and bones of the
hand - for instance, the metacarpus - which persist for many years
after the initial burning.
The treatment of the burned is directed
at
those symptoms we have just enumerated. It is simple and generic,
but requires that treatment be undertaken immediately, that it
should be prolonged and attentive and that it should be given by a
very advanced medical organization. At the bombardment site,
extreme care must be taken not to increase the risk of infection.
The patient should be wrapped in a sheet and given pain-killing
injections, and antibiotic injections and anti-tetanus serum to
combat infection. If possible, an infusion of glucose or saline
solution should be given and the victim evacuated immediately to a
medical facility of the ‘general hospital’ level.
Every burn victim
should be treated as an incipient shock case and should receive
emergency treatment without delay. This is of extreme urgency; if
shock is not prevented it will establish itself and become
irreversible. If so treated, the burned person will pass the crisis
in from six to ten days. It can be seen that in countries with good
medical organization it is possible to reduce the mortality from
severe burning. In underdeveloped areas, or during great cataclysms
such as war, this is another matter.
In medical summation, then, treatment
consists
of compensation for liquid loss by blood transfusion, plasma,
substitutes, saline solutions (especially at the time of
haemodilution), prevention of infection by antibiotics, oxygenation
under pressure {197} and high-calorie intake. After these emergency
treatments follow long-term care, dressing, antiseptic cleaning of
the wounds, excision of necrotic tissue and, if possible, grafting.
Grafting requires good general health, clean wounds and the
availability of skin from unburned parts of the body. The present
state of medical science does not allow us to take grafts from any
donor other than the recipient himself. It is evident that the
treatment of a burn victim is difficult, even with specialized
personnel and the most modern equipment. Even with this, the
suffering of the patient is intense and onerous.
It is obvious that under repeated
bombardments
which destroy structures which might be used for evacuation - when
medical personnel are overworked and subject to lethal attacks
themselves - these ideal conditions we have described are
impossible. There is no resemblance between conditions prevailing
when treating accident victims during peacetime and victims of
deliberate attacks. The emergency treatment of a mass of burn
victims in areas remote from medical centres and without adequate
means of evacuation presents insuperable problems. It is therefore
inadvisable in such conditions to try to save the worst case, who
will, no matter what is done, die within a week. One ought to
concentrate efforts upon the less gravely burned with between ten
and twenty per cent of the body surface affected and without
impairment of the digestive tract.
In Vietnam, a limited number of gravely
burned
persons can be treated in a general hospital, especially those in
Hanoi, but the majority of victims are treated in the village
maternity infirmaries and the district hospitals where skin
grafting is not possible. Instead of grafting, wounds are left to
heal by slow skin extension from the wound periphery.
I do not have definitive statistics,
but it
seems that only about thirty per cent of those wounded by napalm
and not killed outright can be saved. If the victim does survive,
the dermatological consequences of napalm burns are especially
serious. After the surgery there is a great risk of
superinfections. Poor grafting also leaves serious after-effects.
Retractile skin and contraction of scars form huge welts which will
need further treatment. Keloid and hypertrophic scars will form to
limit and inhibit the normal elasticity of the skin, which in turn
inhibits the normal movement {198} of the member. These scars are
prone to pyodermic and microdermic infections. The new skin is
extremely fragile, and scleroatrophied skin will always be
susceptible to minor infections that a normal skin would easily
combat.
Lastly, concerning the medical effects
of
napalm recovery, there is the spectre of secondary cancers. Old
burn scars show a frequency of skin cancer out of proportion to
such appearance in normal skin. This cancer consists of a
spino-cellular epithelioma with a negative prognosis because of the
rapid invasion by the malignant cells of the related ganglion
areas.
Napalm, to conclude, whether it is used
strategically on the battlefield or in the bombardment of urban
areas or village collectives, is a means of extensive
undiscriminating destruction. It affects primarily human beings,
livestock, crops and light inflammable structures such as houses.
Its use in heavily populated areas will produce immense loss of
life from burning and asphyxiation. In survivors, corporal injuries
of the greatest gravity with functional sequels which prevent the
resumption of normal life are the rule.
Though some of the victims may
partially
recuperate after long and costly treatment, nothing much can be
done for the majority of napalm-burned persons.
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