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THE NITROGEN MUSTARDS (β-CHLOROETHYL AMINES)

JAMA. 1947;135(2):98-99. doi:10.1001/jama.1947.02890020028010.
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At the conclusion of World War I the theory was accepted that mustard gas exerts its vesicant action by releasing hydrochloric acid intracellularly. Studies undertaken at the beginning of World War II have revealed1 a type of action of the sulfur and nitrogen mustards which is unlike that of any other chemical agent and which resembles in many ways that of x-rays. The principal systemic action of the nitrogen and sulfur mustards is that which causes the death of cells. The cellular susceptibility is related to proliferative activity; thus the formed elements of the blood and the mucosa of the gastrointestinal tract first reflect the cytotoxic action of the mustards. The action of the mustards on the blood forming organs as reflected in the peripheral blood of both experimental animals and man results in lymphopenia, granulocytopenia, thrombocytopenia and moderate anemia. Although diverse systemic effects can be elicited in the

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