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relief; and, as the report remarks, the issue of a alwar might turn on its success. In the British Medical isJournal last week a surgeon wrote of the sense of ai

futility and bitterness with which he viewed the task tlthat seemed to lie before him a few weeks ago ; he w

saw it as an unending effort-useless from a military ir

standpoint-to repair damage wrought by bombs on b-civilians who should not have been in London at all. ir

Only those civilians should remain in the front line, slhe said, whose presence is essential; and in present fcircumstances all will agree with him. But according Sl

to current plans at least half or two-thirds will v

remain, including most of the wives of workers and n

many of their young children. The question arises n

whether much more elaborate provision for the safety w

of all these people should not be made. A.R.P. ri

policy hitherto has been directed chiefly against bthe menace of gas, because protection against gas is dmuch simpler than protection against high-explosive Ibombs. The main purpose, it is clear, has been to 2.take enough precautions to prevent panic ; for it isbelieved that guns, balloon barrages, and fighteraeroplanes would suffice to prevent any terrificdestruction of life and that the real danger from air

C9raids is not so much material loss as a collapse of tcivilian morale. Prof. J. B. S. Haldane, F.R.S., targues against this policy on various grounds, the Ichief of which is that protection against bigh explo- 1sives has proved vitally necessary in Spanish cities,and is even more applicable to this country. His

l

book 2 puts forward a scheme by which brick-lined (

tunnels would be built at a safe depth (in Londonabout 60 feet) below the towns in such a way thatno dwelling would be more than 400 yards from anentrance and the entire population could take secure

f

shelter when a warning is given. The scheme may Isound fantastic ; but he estimates that, by engagingunemployed miners, tunnels holding tbree-quarters Jof the population could be soon prepared at a cost :

of something like JE400 million-" about one quarterof the sum which the Government proposes to

spend on rearmament during the next few years."As compared with other means of defence, such asaeroplanes, the tunnels would have the advantage ofbeing a permanent investment. They would threatennobody and they would remove any hope of victoryover this country by a knock-out blow.

In the House of Commons six years ago LordBaldwin, then Prime Minister, said:

" I think it is well for the man in the street torealise that there is no power on earth that canprotect him from being bombed. Whatever peoplemay tell him, the bomber will always get through....The only defence is in offence, which means you haveto kill more women and children quickly if you wantto save yourselves."Prof. Haldane’s book challenges these statements onthe ground that the offensive defence is technicallyas well as morally wrong. Writing from experienceof contemporary warfare in Spain, he pleads for thevariety of defence which does not concentrate on

destroying the enemy’s women and children, andwhich accordingly rates the subterranean tunnel higherthan the bombing plane. In so doing he recognises apsychological difficulty. During countless genera-tions the soldier has been given a prestige and glorygreater than the miner, though his work is seldommore dangerous and his courage in emergency no

greater. Hence an expenditure of E400 million onarmy, navy, and air force does not seem excessive,whereas expenditure of the same sum on digging

2 A.R.P. By J. B. S. Haldane, F.R.S. London : VictorGollancz. 1938. Pp. 296. 7s. 6d.

appears rather absurd. A second difficulty, he believes,is that military men are taught how to win battlesand campaigns but not how to win wars ; whereasthe manoeuvring of troops and the use of offensiveweapons are not necessarily any longer the mostimportant part of war. A third obstacle encounteredby supporters of passive defence is that manyindustrialists are interested in the production of guns,ships, and aeroplanes ; and even the concrete manu-facturers are beginning to see the possibility of

superficial street shelters ; whereas no powerful orvocal interest would profit by setting unemployedminers to dig in the London clay-especially as

most of the money would go direct to the miners inwages. Against this, if Prof. Haldane were provedright about the feasibility of building such tunnels,his proposals would have the goodwill of all whodeplore the policy of ordeal and reprisal that LordBaldwin unwillingly held to be inevitable. Sir JohnAnderson will have much to think about.

PENTOTHAL ACID

THE latest barbituric narcotic of which we havean account, Pentothal acid, ethyl (1-methyl butyl).thiobarbituric acid, appears to be a useful additionto the drugs that can safely be used to procure somno-lence before the administration of the main anms-thetic. In the October issue of the British Journalof Ancesthesia, Dr. J. S. Horsley describes the resultof three years’ clinical and laboratory research withpentothal sodium which resulted in his trial of

pentothal acid. The main chemical differencebetween the acid and the salt is in the much greatersolubility of the latter so that the acid is relativelystable. It is supplied as a purified powder of a,

lemon-yellow colour which must be kept in tightlystoppered bottles, or else as tablets each containing4 grains. Small doses are sedative, medium doseshypnotic, and large doses anaesthetic. Respirationis lessened by full ansesthetic doses but almostunaffected by doses recommended for basal anoes-

thesia. The drowsiness following anaesthesia frompentothal acid is less often associated with rest-lessness than is that after the other barbiturates.The chief practical advantage offered by this newbasal narcotic appears to be its certainty of actionwhen given by the mouth. Nembutal, for example,although valuable and much used orally, has thedrawback that it cannot be relied on with the samecertainty as when injected into a vein. Pentothalacid has been given by the mouth in a series of500 patients. The dosage, however, needs carefularrangement, and after various amounts had beentried the conclusion was reached that the best resultsare achieved by giving 8 grains three hours beforeoperation, repeating this dose at intervals of an hour,either once or twice according to the effect. Doses.of gr. 8 given three and two hours before opera-

I tion gave consistently better results than a singledose of gr. 16 ; this, in may be, is another exampleof that cumulative action of drugs which led to the

r conception of synergism.L

Pentothal acid is one of the rapidly eliminated

-

barbiturates. It certainly appears that a good caser

has been made out for its administration, withoutother drugs, as a basal narcotic.

1 ON Tuesday and Thursday, Nov. 8th and lOth, at, 5 P.M., Dr. Harold Scott will deliver the FitzPatrick lectures at the Royal College of Physicians of- London. His subject will be the conquest of diseaser in the tropics.