Shvartsman first suggested that matter accreting onto a neutron star w
ould produce observable gamma-ray spectral features, thus providing a
measure of the gravitational redshift of the neutron star. We reconsid
er the prevalent gamma-ray production channel: emission of 2.2 MeV pho
tons from neutron-proton recombination. Nuclear spallation of a large
fraction of the accreting helium (and heavier elements) liberates neut
rons throughout the upper atmosphere. The eventual recombination of th
e neutrons with atmospheric protons produces 2.2 MeV photons throughou
t the atmosphere, a fraction of which escape unscattered. We have calc
ulated the 2.2 MeV gamma-ray line flux and Compton-scattered continuum
from this process. The flux of gravitationally redshifted 2.2 MeV pho
tons from the brightest accreting X-ray source Scorpius X-1 is F2.2 al
most-equal-to 10(-6)gamma cm-2 s-1, a factor of 20 below the sensitivi
ties of the Compton Gamma-Ray Observatory. The next generation of gamm
a-ray telescopes might observe this gravitationally redshifted spectra
l feature if Scorpius X-1 is accreting matter rich in helium. The dest
ruction of accreted He-4 leads to appreciable abundances of lighter el
ements (D, H-3, He-3) in the upper atmosphere, which we determine. The
destroyed He-4 is reformed through fusion reactions a few scale heigh
ts beneath the photosphere, and thus presents no difficulties for X-ra
y bursts. Our detailed discussion of the He-4-initiated nuclear spalla
tion cascades and neutron diffusion effects may also be relevant to so
lar flares, where the same nuclear processes occur.