03 May 2018

United Nations Secretary General

His Excellency, António Guterres,


Regarding a scientific reflection of the Douma incident, our country’s scientists at the Academy of Medical Sciences of the Islamic Republic of Iran have scrutinized the many ambiguities connected to the declared Douma incident on April 7, 2018.  A summary of the items discussed is being sent to you for your attention in advance of the final consideration given to the assessment of this incident by UN certified centres.

The first reports of the incident were made by twoforeign funded Syrian opposition groups; the Syrian American Medical Society (SAMS) and the Syrian Civil Defense (White Helmets). In these two reports released on April 8, 2018, which were very similar to each other, a group of over 500 chemical victimsin an area controlled by Jaysh al-Islam (Army of Islam)is documented as presenting clinical symptoms indicative of exposure to a chemical agent.1-2 In the reports, a female victim is recorded as convulsive and having pinpoint pupils. Apart from this, another 43 cases of people allegedly found dead in their homes showing cyanosis, excessive oral foaming, and corneal burns have been reported. These symptoms are more likely consistent with exposure to organophosphate compounds. Subsequently, many news agencies reported these symptoms quoting the two reports,3-5 and others cited similar symptoms quoting unidentifiable sources including a local news agency as well as local paramedic and relief forces.6 

A - Regarding the clinical symptoms 

One of the signs mentioned in these reports which is also very important for the diagnosis of nerve gas poisoning are pinpoint pupils (extremely constricted pupils). The points below should be observed regarding this matter: 

1 - In the Syrian cases mentioned, very little photographic evidence exists showing pinpoint pupils and the degree of pupil constriction is much less than expected in cases of nerve gas poisoning. 

2 - One of the signs mentioned in the more than 500 cases are corneal burns, which means examinations were carried out on the eyes of the victims. How is it possible that in such a large group, only one instance of pinpoint pupils, and only in a suspected severe case of exposure, has been observed?  

3 - Due to our extensive experience gained during the time of Iraq’s chemical warfare, pinpoint pupil has no relation to the severity of poisoning and is normally apparent even in mild poisoning and will remain for one to two days after the exposure.  Therefore, in the presumption of a nerve gas attack, there should be many mild cases showing eye symptoms, but no evidence has been reported in this regard. Four photographs showing cases of pinpoint pupils related to nerve gas used during Iraq’s chemical attacks on Iran (1980-1988) are attached for comparison to those from the suspected Douma incident. In the alleged chemical attack on Douma, there should be many patients like the Iranian victims of nerve gases with clear symptoms of pinpoint pupils, but such photographic evidence in the case of Douma patients do not exist. The only photographic evidence released has been of a single alleged case, and these do not show any definitive sign of pinpoint pupils. Also attached is a link to a short video of the light reflex of a nerve gas victim (March 17, 1984 - the first ever nerve gas attack in history*) who was moved from the war zone to an infirmary in Ahvaz, Iran. The patient is in relatively good general condition a day after poisoning and standing beside a healthy nurse.

We suggest that the videos and pictures that were used by the US, UK, and France to pass judgement, be made available to the public and handed over to the OPCW for precise diagnosis. 

B- Regarding the biological samples 

The U.S. State Department said on April 8, 2018 there were reports of mass casualties from an alleged chemical weapons attack in Douma. It added, “These reports, if confirmed, are horrifying and demand an immediate response by the international community,”.7 Following this, The U.S. President began his threatening tweets.8  On April 10, the White House spokesperson was asked during a press briefing  that  “the British government said they’re still looking for confirmation that Assad used chemical weapons last weekend. Is the President still looking for confirmation of that?” Her reply was:  “I can’t get into specific classified information.”9The fact that pictures of victims had already been published in the media, well before the conclusion of any UN report regarding the incident would appear to suggest that these cannot be the classified information referred to in the response of the White House spokesperson.  What then was the information that was waiting for confirmation and is still classified? The only information that would clear all ambiguities can be nothing less than the biological samples that only the U.S. appears to possess,but refrains from making public.

Eventually on April 12, U.S. officials made reference to what they declared was evidence, saying  “The U.S. now has  blood and urine samples from last Saturday's deadly attack in Syria that have tested  positive for chemical weapons . . . suggested the presence of both chlorine gas and an unnamed nerve agent.”10-11 Then on April 13, CNN claimed, “the substance used in the attack was a mixture of Chlorine, Sarin and possibly other chemicals”, and on the same day the U.S. ambassador to the UN told reporters with confidence that a chemical weapons attack happened and that the U.S., France and UK have all confirmed it.13 Finally, during the early hours of the morning on the following day, the missile attack of those three countries against Syria was carried out based on this “evidence”, the most important of which are the biological samples.  If we were to accept the authenticity of the sampling claimed by the U.S., there are a few obscurities that must be explained:

1 - How many samples were there and how many were positive? Were there control samples? Were these samples analyzed in only one laboratory in the United States or analyzed in France, the UK and other laboratories as well, and were the results compared? Were they internationally recognized laboratories? How were the samples obtained and what was the chain of custody?

2 - Did the samples include those from living patients as well as those who allegedly lost their lives? 

3 - Have there been any cases in which both Chlorine and nerve gas was observed in the same single sample?

4 - Has chlorine poisoning been confirmed from biological samples? What was the method used? Until now there has not been any known scientific source that supports the claim that this can be determined by biological fluid sampling.

I suggest that these samples, which have formed the basis of the justification for the U.S., France and the UK to carry out a military attack on Syria,immediately be handed over to the OPCW and made public to obtain a definitive understanding about the test results. 

Yours sincerely, 

Seyed Alireza Marandi, M.D.


Academy of Medical Sciences 

Islamic Republic of Iran



1- A Statement about the Chemical Attack on Eastern Ghouta. Syria Civil Defense, 8 April 2018.


2- SAMS, Syria Civil Defense Condemn Chemical Attack on Douma. Syrian American Medical Society Foundation, 8 April 2018.


3- Dozens Reported Killed in Suspected Syria Chemical Attack. NBC News, 8 April 2018.


4- Syrian Government Accused of Using Nerve Agents as Death Toll from Douma chemical Weapons Attack Rises. The Independent, 8 April 2018.


5- Dozens killed in apparent chemical weapons attack on civilians in Syria, rescue workers say. Washington Post, 8 April 2018.


6- Dozens Killed in Suspected Chemical Attack on Syrian Rebel Enclave. The Guardian, 8 April 2018.


7-U.S. Says Reports of Chemical Attack in Syria ‘horrifying’ if confirmed, calls for response. Reuters, 8 April 2018.



-8 Syrian Government Accused of Using Nerve Agents as Death Toll from Douma chemical Weapons Attack Rises.The Independent, 8 April 2018


9- Press Briefing by Press Secretary Sarah Sanders. The White House, 10 April 2018.


10- U.S. Officials: Blood Samples Show Nerve Agent in Syria Gas Attack. NBC News, 12 April 2018.


11- White House: No Final Decision on Syria Action. NBC News, 12 April 2018.


12- Official: Biological Samples from Syria Attack Site Test Positive for Chlorine and Nerve Agent. CNN, 13 April 2018.


13- Haley Slams Russia over Syria Chemical Attack. CNN, 13 April 2018.


Nerve gases were produced by the Germans during wwII in industrial scale but were never used therefore the first use of at least three types of nerve gases (including Tabun, sarin and cyclosarin) was by Iraq
against Iran and Iranian physicians diagnosed and treated these patients for the first time in history




Pinpoint pupils in four patients of different chemical attacks by Iraq on Iran (1980-1988)

Notice that around one day after treatment and in complete consciousness, the pinpoint pupils is still visible.           


The light reflex of a victim of the first nerve gas attacks on Iran (1984)

On the right, healthy nurse ,  on the left, nerve gas victim

Video link:



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