And it is conceivable that they may have the further anguish of seeing an effectual chemical remedy made the basis of a fiendish weapon. Clearly all this poses problems to the medical profession very different from those entailed by the development of "conventional" weapons from the knobkerrie to the high-explosive bomb. A doctor did not have to understand the structure of a shell or the composition of an explosive to treat the wounded successfully.58

Any genuine step in the direction of one or more of the above approaches on the part of Congress and the United States might constitute a promising beginning from which more effective solutions could emerge. Experience has shown that new restraints, legal or otherwise, tend to reinforce existing restraints and that they all tend to reinforce each other.59

"Ethics and Biological Warfare" (editorial), British Medical Journal, June 8, 1968 (pp. 571-572). Op. cit., Brown (summary and conclusions).

SUMMARY OF APPROACHES

In summary, the suggested approaches to solution of the threat and danger of CBW are as follows:

Hearings might be conducted to coincide with the July 1969 release of the United Nations' report on the effects of chemical and biological warfare.

A group of Senators and Representatives might call upon President Nixon to look into the status of CB weapon systems of the United States and to reconsider U.S. plans and policies with respect to their further development and use.

Legislation could be introduced similar to an amendment proposed by Senator Clark in 1968 requiring the Secretary of Defense to prepare semiannual reports on CBW money expenditures and submit such reports to appropriate committees of the House and Senate.

A Senate resolution might be introduced at once, endorsing recent CBW resolutions in the United Nations for which the United States delegation has voted. This includes the December 5, 1966 resolution cosponsored by the United States calling for strict observance of the principles and objectives of the Geneva Protocol, as well as the November 1968 resolution calling for the Secretary General to prepare a report on the effects of CB weapons.

Authorization and appropriation committees, by means of money control, might move the Army and Navy in the direction of emphasis on the development and procurement of early CB warning systems. It has been suggested that rapid and reliable detection might justify later consideration of a CB test ban treaty.

The United States Arms Control and Disarmement Agency could be encouraged, by means of increased appropriation for the purpose, to study more intensively the feasibility of detection of CB weapons production and field trials.

Through appropriate channels, the United States Arms Control and Disarmament Agency and the U.S. Ambassador to the United Nations might be requested to examine and consider some proposals put forth by D. E. Viney in his 1968 paper on "International Law on Chemical Warfare: The Scope for Reform." One of Mr. Viney's proposals is that consideration be given to an unqualified nonuse law for biological weapons (not chemical weapons) to include an agreed abrogation of retaliatory rights. The removal of the right of reciprocity might offer a "hopeful road for discouragement of the proliferation of BW capabilities and procurement decisions."

Should resistance develop to the separate treatment of biological warfare (above) as against chemical-biological warfare as a whole, other areas which might be amenable to agreement are: the continued emphasis on all existing restraints; a tacit reciprocal agreement among major powers not to supply or trade in weapons of the CB class; and the definition and declaration of "free-zones" wherein CB weapons would not be allowed to exist in any form.

By means of appropriate legislation it may be possible for the United States to dispose of the concept of food crop-destroying agents and hope that this step would be emulated around the world. Expressions of concern might be placed with the Departments of Defense and State over the level and degree of official secrecy controls in CB research. There are some who feel that the open publication of more (not all) research results from DOD sponsored research would in itself serve as a valuable safeguard. In addition, it has been agreed that more physicians need to know the methods by which CW weapons would "do their deadly work" in order that proper remedies may be applied to those casualties which would result if CB agents were ever used.

Experience has shown that new restraints, legal or otherwise, tend to reinforce existing restraints and that they all tend to reinforce each other.

APPENDIX A.-EFFECTS OF CHEMICAL AGENTS1

IRRITATING AGENTS

These gases usually apply to riot control but have been employed in combat. Effects include conjunctival irritation, lacrimation, cough, dyspnea, nausea and vomiting. Examples of these weapons are as follows: DM (diphenylaminochloroarsine), a pepper-like agent that incapacitates for periods of half an hour to 2 hours; CN (chloroacetophenone), a form of "tear gas" that may also irritate the skin and incapacitates for about 3 minutes; and CS (O-chlorobenzalmalononitrile), a more recently developed lacrimatory and nausea-inducing agent that incapacitates for 5 to 10 minutes. Specific first aid against these agents requires the victim to avoid rubbing his eyes and to face into a wind free of the agent.

Weapons of this type, according to Secretary of Defense Robert S. McNamara, have been used "only two or three times" in Vietnam, "most recently on January 27 [1965] after Communist guerrillas took refuge in a village in Phuyen Province." 2

VESICANT AGENTS

Agents of the blistering type used in World War I included sulfur mustard ("mustard gas" or H), which caused about 25 percent of the casualties in the American Expeditionary Force, and lewisite (L), an arsenical. A new distilled mustard (HD) and two kinds of nitrogen mustards (HN-1 and HN-3) are available for military use. Low concentrations of sulfur mustard will irritate conjunctivas severely and the skin mildly. Moderate concentrations will burn the eyes and will produce skin blisters, which can be deep and may require weeks or months of healing. High concentrations will have systemic effects such as nausea and vomiting, cardiac arrhythmia, and shock. The victim who survives the initial effects may later show aplasia of the bone marrow, dissolution of lymphoid tissue, and ulceration of the gastrointestinal tract. The nitrogen mustards, used for their cytotoxic effects in patients, are nitrogen analogues of sulfur mustard.

The vesicant agents in their gaseous phase are more insidious than the irritants, because their effects may not be noted for several hours; the victims will unknowingly remain in the atmosphere until severe damage is done. Furthermore, liquid mustard-the "gas" is a liquid at room temperature-penetrates leather, clothing, plastics and other materials. Since the liquid material may evaporate very slowly it can cause casualties several weeks later. First-aid measures include blotting

1 From "Chemical and Biologic Weapons-A Primer," by Victor W. Sidel, M.D., and Robert M. Goldwyn, M.D., in the New England Journal of Medicine, Jan. 6, 1966, pp. 21-27.

The New York Times (Oct. 11, 1965, p. 59) reports the following developments since this paper was submitted: "On Sept. 25 Gen. William C. Westmoreland, U.S. commander in Vietnam, announced that there would be no disciplinary action against a marine officer who chose to use tear gas rather than lethal flame throwers or grenades to remove women and children from a series of Vietcong tunnels. On Oct. 8 U.S. paratroopers used tear gas in combat under specific authorization from General Westmoreland and officials said the tactic would be repeated in 'selected circumstances'."