Iranian Veterans Suffer Chemical Warfare’s Chilling Effects : Poison gas: Afflicted by burns, blisters and blood disorders, hundreds exposed to Iraq’s arsenal now seek treatment in Germany.

A young man lies in a hospital bed beneath a pale yellow blanket. His hands are sheathed in silvery scales. He has blood poisoning, and his breathing passages are pocked with abscesses from exposure to chemical weapons during the Iran-Iraq War.

He was a 19-year-old Iranian volunteer in Kurdistan in 1987. Gas rained from the sky as his unit slept. Now he shares a hospital room here with two other former soldiers, one of whom has come down recently with a blood cancer believed traceable to his exposure to poison gas.

The men are among some 400 Iranian victims of Iraqi chemical warfare who have been treated here over the past seven years by Dr. Nosraf Firusian, an Iranian-born specialist who has devoted much of his practice since 1984 to treating the effects of exposure to poison gas.

The damage Firusian has seen is chilling--from burned and blistered skin to abscesses deep in young men’s lungs. There are innumerable blood disorders, recurrent depression and ominous changes in pulmonary tissue that Firusian fears may later prove to be a harbinger of cancer.

About 7% of Firusian’s patients have died--in part, he believes, because of delays in receiving treatment after exposure. While American troops are generally far better protected against chemical weapons than Iranian soldiers were, Firusian’s observations nonetheless present a cautionary tale should Iraq use its chemical arsenal in the Gulf War.

“It is very important to start treatment immediately after injury,” Firusian said in an interview in his office at Elisabeth Hospital here this week. “ . . . Even for those without evidence of lesions, you must consider every (exposed person) as involved.”

Firusian’s patients were exposed to the very weapons that some military officials fear may be used by Saddam Hussein and the Iraqi army in the Gulf War.

Chemical weapons, which include poison gases such as cyanide and chlorine, nerve gases and so-called blistering agents like mustard gas, are widely reported to have been used repeatedly by the Iraqis against Iranian civilians as well as soldiers during their eight-year war.

Several nerve gases, like sarin and tabun, are lethal in minute amounts. Exposure to poison gases, like phosgene and cyanide, can in some cases be survived. Judging by the condition of his patients, Firusian believes the main component in Iraqi gas attacks has been mustard gas.

Nearly all of his patients have permanently scarred skin, particularly in sensitive areas of their bodies, including their face and crotch. Those areas were severely blistered, but Firusian believes the skin problems are “nothing, nothing” compared to burning internal lesions.

For many of his patients, the gas seared their throat, larynx, trachea and bronchial tree. Later came repeated bouts of bronchitis and pneumonia. The worst cases developed severe respiratory distress, narrowing of the airways and a condition Firusian calls acute shrinking lung.

In addition, Firusian has found a wide range of blood disorders in his patients--dramatic drops in white blood cells or red blood cells or platelets. Some have had bleeding problems as a result. Others have had septicemia, or blood poisoning, from infections spreading throughout their body.

Firusian, 55, was raised in Iran. He attended German medical schools and became a specialist in blood disorders and cancer. In 1982, he started a department at Elisabeth Hospital, a rambling complex of brick buildings in a labyrinth of residential streets in this industrial Ruhr Valley town.

Two years later, Firusian saw his first gas patients. They were sent by the Iranian government, which, according to Firusian, had begun looking for doctors in Western Europe, fluent in Farsi, who might provide specialized care for Iranians badly injured in the war.

Seven years later, they continue to come. The average hospital stay is four to five weeks, costing about $8,000. The treatment relies heavily on the use of a flexible, fiber-optic bronchoscope to explore the patient’s bronchi and a repeated washing of the bronchial system in an amino acid solution.

A few patients have required laser surgery to widen or replace parts of the bronchial system that have become narrowed or tightened by proliferating tissue. And in many of his patients, Firusian said, he sees worrisome changes in cells in the pulmonary system.

“That’s, for me, the threatening component--in connection with the later development of lung cancer,” Firusian said. He said there are suggestions in medical literature that victims of World War I gas attacks faced up to triple the normal risk of lung cancer.

For now, many of Firusian’s patients return for follow-up every two years. Some, he said, are doing well. But most are plagued with respiratory problems that inhibit their ability to do hard work and that make it impossible for them ever to participate in sports.

On a recent afternoon, an American reporter visited the three men currently in Firusian’s care. Gaunt and intense, they spoke quietly in Farsi as Firusian ran his fingers gently over the scars on one man’s hands and the permanently altered pigmentation at the nape of another’s neck.

As Firusian and the reporter got up to leave, one man asked the physician to pass on an observation to the reporter--an observation informed by his beliefs about the U.S. role in supporting Saddam Hussein and Iraq in the war against Iran under the Ayatollah Ruhollah Khomeini.

“American people are very lovely,” the man said, as Firusian translated. “But they are the most responsible for our being here.”