The threat of chemical and biological weapons of mass destruction has intensified because of improved delivery systems and advances in chemistry, genetics, and other sciences. Possible US responses to this threat include deterrence, defenses, and/or disarmament, including a reaffirmation of the Biological and Toxin Weapons Convention of 1972, which is now in jeopardy. This article discusses the history of chemical and biological warfare, existing and potential weapons, the proliferation of weapons and delivery systems, ways to prevent the use of these weapons, and ways to protect populations from their effects.

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This study tests a previously published decision rule for identifying nonspecific abdominal pain (NSAP). The rule, developed for ambulatory male patients in two Veterans Administration (VA) facilities and a prepaid group practice, was studied in an additional 110 VA patients and in 77 patients (predominantly female) from a solo private practice. The group of 58 patients (33%) classified as "low-risk" rarely had abnormal laboratory tests or radiographs, except for upper gastrointestinal series; 15 of these patients had potentially serious disease. Peptic ulcer was the specific diagnosis most often misclassified as NSAP. The accuracy of the rule in our population is similar to the accuracy of the judgment of experienced clinicians.

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