SummaryAirway management is primarily designed to avoid hypoxia, yet hypoxia remains the main ultimate cause of anaesthetic‐related death and morbidity. Understanding some of the physiology of hypoxia is therefore essential as part of a ‘holistic’ approach to airway management. Furthermore, it is strategically important that national specialist societies dedicated to airway management do not only focus upon the technical aspects of airway management, but also embrace some of the relevant scientific questions. There has been a great deal of research into causation of hypoxia and the body’s natural protective mechanisms and responses to it. This enables us to think of ways in which we might manipulate the cellular and molecular responses to confer greater protection against hypoxia‐induced tissue injury. This article reviews some of those aspects.

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treated with neutrons and photons.2 Results were significantly better, however, for neutron than photon treatment in node positive patients, but worse in node negative patients with the suggestion that these were caused by inadequate planning because of the fixed neutron beams. No opposition was expressed to continued trials now under way. The discontinuation of funding suggested by Dr Tobias refers to that of new cyclotrons rather than of existing units.The arguments against neutrons have been well rehearsed. We still do not have clear cut answers. The proposed unit at St Thomas's would be for not only neutron therapy but also particle treatment of eye tumours and nuclide production for positron emission tomography. Cancer therapy depends on adequate planning of treatment obtainable only with the newer high energy neutrons. The earlier work at Hammersmith using fixed horizontal beams was a remarkable achievement, whatever the final value of neutron therapy.The

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