Contents
Chapter
INTRODUCTION 1
I. ORIGINS OF AN AIR FORCE MEDICAL SERVICE 6
Evolution of a Physical Examination for Flyers 6
Establishment of Medical Research Laboratory 11
Medical Support of Combat Mission in World War 1 13
The Interim Years 20
Transition from Peace to War 24
II. THE WAR MISSION 45
The Issues Emerge: 1942 50
The Issues Are Clarified: 1943 67
The Mounting Crisis: 1944 83
The Issues Are Partially Resolved: 1944. . . . 91
Mission Accomplished: 1945 114
III. SCHOOL OF AVIATION MEDICINE AND RELATED PROGRAMS. 144
The School of Aviation Medicine 145
The War Curriculum: SAM 159
Advanced Study for Altitude Training 196
Implementing the Altitude Training Program in the AAF 210
Air-Sea Rescue Training 218
Medical Service Training School 219
IV. RESEARCH AND DEVELOPMENT 230
Anthropology 238
High Altitude Studies 253
Acceleration 283
Medical Logistics 295
Medical Instrumentation 303
Clinical Aspects of Aviation Medicine 305
Among the Heroes 340
V. AIR EVACUATION MISSION 35Z
The 349th Air Evacuation Group 366
The Flight Nurse 368
AAF School of Air Evacuation 371
Air Evacuation to Zone of Interior 383
Contribution to Military Medicine 410
VI. MEDICAL SUPPORT OF AIR COMBAT IN NORTH AFRICA AND
THE MEDITERRANEAN 419
Twelfth Air Force and TORCH 419
The Tactical Situation 424
Case History: 434th Bombardment Squadron 430
Establishment of Army Air Forces, Mediterranean Theater of Operations . 438
Personnel 448
Hospitalization 455
Air Evacuation 473
Special Problems of Aviation Medicine: Twelfth and Fifteenth Air Forces . 493
Health and Fighting Effectiveness .... 508
VII. MEDICAL SUPPORT OF AIR COMBAT IN EUROPE 528
The Early Period 529
The Eighth Air Force 534
First Echelon Medical Service for Air Combat Crews 543
Eighth Air Force Central Medical Establishment 547
Medical Support of the Early Combined Bomber Offensive 555
Medical Support of United States Strategic Air Forces in Europe 559
Hospitalization Crisis: Spring 1944 563
Medical Staffing 571
Air Support of Ground Forces: Ninth Air Force 588
Air Evacuation 598
VIII. SPECIAL PROBLEMS OF AVIATION MEDICINE IN EUROPE. . . 617
Protective Armor 617
Cold Injuries 635
Anoxia 647
Aero-otitis 655
Stress 660
Disposition 670
Health and Fighting Effectiveness 680
Injuries and Wounds 692
AAF Aero Medical Center 708
United States Strategic Bombing Survey in Germany 710
IX. MEDICAL SUPPORT OF AIR COMBAT IN THE PACIFIC 725
Hospitalization 736
The Central Medical Establishment 751
Convalescence and Rehabilitation 756
Medical Supply 760
Air Evacuation 766
AAF Dental Program: Case History 789
Health and Fighting Effectiveness 793
Sanitation 822
Terrain Factors 827
Native Population Factor 828
Special Problems in Aviation Medicine 830
Nutrition as a Health Factor 838
Stress 847
Disposition 856
X. MEDICAL SUPPORT OF AIR COMBAT IN CHINA-BURMA-INDIA . 875
The Early Period 876
Tenth Air Force 886
India-Burma Theater 898
Health and Fighting Effectiveness: Tenth Air Force and AAF India- Burma Theater 900
Fourteenth Air Force and AAF China Theater 902
Health and Fighting Effectiveness: AAF China Theater 907
XI. MEDICAL SUPPORT OF THE VERY LONG RANGE (VH) BOMBER PROGRAM 92
Organising the Medical Service of the XX Bomber Command 926
XX Bomber Command Moves to India 929
China Bases 932
Air Evacuation and Rescue 935
Health and Fighting Effectiveness: China-Burma-India 944
Withdrawal to the Pacific 947
XXI Bomber Command 949
Special Problems of Aviation Medicine 955
Health and Fighting Effectiveness: Marianas 958
The Final Days 964
U. S. Strategic Bombing Survey in Japan 965
POSTSCRIPT 971
GLOSSARY 977
INDEX 981
Tables
1. Procurement of Medical Corps Officers for Duty With the Army Air Forces from August 1942-December 1942 56
2. Procurement of Medical Corps Officers for Duty With the Army Air Forces from December 1942 Through December 1943 59
3. Nurses Assigned by the Nursing Section, Office of the Air Surgeon 60
4. Number of Medical Department Officers on Duty With the Army Air Forces Whose Separations Orders Had Been Received by the Office of the Air Surgeon from V-E Day to 29 January 1946 134
5. Course Hours Schedule 148
6. The School of Aviation Medicine Graduates 153
7. Instruction Surgical Subjects, AAFSAM 1936-1946. 173
8. AME Students From Overseas 187
9. Medical Examiner Ratings 189
10. Aviation Medical Examiner Graduates, August 1940-September 1945. . . . 190
11. Failures AME Course in Fiscal Year; 1941-1945 191
12. Didactic Grades by 3- Year Age Groups 191
13. Extension Course Fiscal Years 1941-1945 194
14. Unit Oxygen Officer Graduates 208
15. Altitude Chamber Flights 216
16. Major Surveys of the Army Air Forces Anthropological Projects 243
17. Medical Technicians Graduated from the Course at the School of Aviation Medicine from November 1944 to October 1945 381
18. Number of Patients Evacuated Within the United States from October 1944 Through May 1946 382
19. Distribution of 1,172,648 Air Evacuees by Theater With Death Rates in Flight per 100,000 Patients (January 1943-May 1945) 399
20. Hospitals Attached to Twelfth Air Force 471
21. Evacuation in the Tunisian Campaign Ending 23 May 1943 480
22. MTO Air Evacuation, September 1943-December 1943 486
23. Patients Evacuated by Month in the Mediterranean Theather of Operations, 1944 487
24. Percentages of Patients Evacuated by Category in the Mediterranean Theater of Operations, 1944 488
25- Patients Evacuated by Months in the Mediterranean Theater of Operations, 1945 489
26. Percentages of Patients Evacuated by Category in the Mediterranean Theater of Operations, 1945 490
27. Check Points in Effect in the Twelfth Air Force, 1943 500
28. Probabilities of Survival in the Twelfth Air Force, 1944 500
29. Cases Appearing Before the Medical Disposition Board of the Twelfth Air Force 501
30. Fifteenth Air Force Medical Disposition Board Cases, 1944 501
31. Evaluation of Diets Issued as Rations in the Theater 507
32. Fifteenth Air Force, Monthly and Annual Rates for Important Causes of Noneffectiveness, 1944 510
33. Fifteenth Air Force, Important Causes of Noneffectiveness by Months and Total for Year 1944 511
34. Incidence of Infectious Hepatitis by Squadrons, 19 August-29 December 1944 513
35- Comparative Attack Rates in Personnel Over 30 Years of Age and Personnel Under 30 Years by Various Categories 514
36. Disorders Due to Flying, Twelfth Air Force, November 1943-May 1944. . 515
37. Total Casualties, Flying Personnel, Fifteenth Air Force, November 1943 to May 1945 516
38. Killed in Action, Flying Personnel, Fifteenth Air Force, November 1943 to May 1945 517
39. Wounded in Action, Flying Personnel, Fifteenth Air Force, November 1943 to May 1945 517
40. Ratio of Medical Department Personnel in 1944 to the Total Strength of the Eighth Air Force 576
41. Gain and Losses in Medical Department Officer Personnel During 1944. . . 577
42. Dental Officer: Personnel Status During 1944 579
43. Distribution of Medical Department Personnel Within U. S. Strategic Air Forces in Europe 580
44. Flight Surgeons and Aviation Medical Examiners to Units of U. S. Strategic Air Forces in Europe at Close of Period Covered by Report 582
45. Distribution of Medical Department Personnel Within U. S. Strategic Air Forces in Europe 583
46. Flight Surgeons and Aviation Medical Examiners Assigned to Units of U. S. Strategic Air Forces in Europe at Close of Period Covered by Report 585
47. Distribution of Medical Department Personnel Within U. S. Strategic Air Forces in Europe 586
48. Flight Surgeons and Aviation Medical Examiners Assigned to Units of U. S. Strategic Air Forces in Europe at Close of Period Covered by Report 588
49. Air Evacuation : 609
50. Patients Evacuated to United States 610
51. Incidence of Body Injuries 645
52. Incidence of High Altitude Cold Injury, Eighth Air Force 646
53. Trend of Anoxia Accidents in the Eighth Air Force Heavy Bombardment October 1943-November 1944 655
54- Permanent Removals from Flying 680
55. Mean Strengths 680
56. Admissions to Sick Report July 1942 to June 1945 681
57. Admissions, All Causes, Diseases, and Nonbattle Injury, Air Forces in Western Europe, July 1942-June 1945 682
58. Admissions, Common Respiratory Diseases, Air Forces in Western Europe, July 1942 Through June 1945 683
59. Common Respiratory Diseases, July 1942-June 1945, Air Forces in Western Europe, Monthly Incidence 684
60. Admissions, Pneumonia, Air Forces in Western Europe, July 1942 Through June 1945 685
61. Admissions, Influenza, Air Forces in Western Europe, July 1942 Through June 1945 685
62. Venereal Diseases by Type, White and Colored Personnel, Air Forces in Western Europe, July 1942 Through June 1945 686
63. Admissions, Venereal Diseases, Air Forces in Western Europe, by Period, July 1942 Through June 1945 687
64. Admissions, Gonorrhea, Syphilis, and Other Venereal Diseases, White Personnel, by Period 688
65. Admissions, Gonorrhea, Syphilis, and Other Venereal Diseases, Colored Personnel, by Period 688
66. Venereal Disease Rate by Commands, January Through June 1945 689
67. Admissions, Diarrhea and Dysentery, Air Forces in Western Europe, July 1942-June 1945 690
68. Number of Cases of Malaria and Admission Rate, July 1942-June 1945, Western European Theater 691
69. Admissions, Communicable Diseases, July 1943-June 1945, Air Forces in Western Europe 691
70. Principal Causes of Death, Disease and Injury, Air Forces in Western Europe, July 1942 Through June 1945 692
71. Cause of Wounds (1 November 1942-31 December 1943) 692
72. Body Area of Wounds (1 November 1942-31 December 1943) 693
73. Single and Multiple Area Wounds (1 November 1942-31 December 1943). - 693
74. Types of Wounds (1 November 1942-31 December 1943) 694
75. Wounds of the Extremities (1 November 1942-31 December 1943) 695
76. Fatality Rate by Area of Body Struck (1 November 1942-31 December 1943) 695
77. Incidence of Wounds by Crew Position (1 November 1942-31 December 1943) - 696
78. Mean Strength of Air Force Personnel, European Theater of Operations (January-June 1944) 698
79. Air Force Battle Casualties, European Theater of Operations, Number, by Type of Aircraft, and Category (January-June 1944) 699
80. Air Force Battle Casualties, European Theater of Operation, Rate per 1,000 per Annum (January-Tune 1944) nnn
84. iNumDer t^uiea ana Missing in Action 705
85. ' 'Life Table" for Group of 1,000 Bombers Starting Sorties, Lost at Specified Rates in Successive Missions, and Completing Tour at End of 25 Missions 706
86. Air Force Casualties in All Theaters (December 1941-August 1945) . . . 707
87. Dental Classification, September 1944 to February 1945 791
88. Morbidity Rate, First Air Commando Force, 1 February 1944-30 April 1944 892
89. Injuries 893
90. Missing in Action 895
91. Killed in Action 895
92. First Air Commando Force 896
93. Percentage of Combat and Noncombat Injuries, March 1943-June 1945- . . 920
94. Medical Statistical Summary 942
95. Direct Cause of Wounds in Forty-eight Wound Cases 945
96. Wounds Classified as to Crew Position 946
97. Severity of Wounds Tabulated as to Cause 947
Charts
No, Page
1. War Department, Headquarters of the Army Air Forces, Washington — Organization of the Air Surgeon's Office, 25 April 1942 39
2. Organizational chart for the Medical Service with the Army Air Forces, 27 May 1942 fold-in after 38
3. Flow of AAF personnel returned from overseas by air through ports of aerial embarkation 98
4. Flow of AAF personnel returned from overseas 99
5. Human factors in aircraft design 234
6. Aero medical aspects of cabin pressumation 268
7. Pressure cabin 269
8. Radius of aircraft turn required to blackout average pilot at various true air speeds 269
9. Speed a plane must make to pull 2 to 8 G's on a flight path of 700-yard radius 270
10. "G" force resulting from varying radius of turn with constant speed 270
11. Organizational chart, functional, Medical Section, Headquarters U. S. Strategic Air Forces in Europe 620
12. Malaria — annual admission rate per 1,000. 909
13. Malaria— noneffective rate per 1,000 910
14. Venereal diseases — annual admission rate per 1,000 912
15. Venereal diseases — noneffective rate per 1,000 913
16. Diarrheal diseases — annual admission rate per 1,000 914
17. Diarrheal diseases — noneffective rate per 1,000 915
18. Common respiratory diseases — annual admission rate per 1,000 916
19- Common respiratory diseases — noneffective rate per 1,000 917
Illustrations
General of the Army Henry H. Arnold ii
Maj. Gen. David N. W. Grant (MC), The Air Surgeon Brig. Gen. Theodore C. Lyster 9
Planning aviation medicine 1917, Theodore C. Lyster, W. H. Wilmer, I. H. Jones, and E. R. Lewis 10
Staff of medical research laboratory — Mineola, New York 12
First anniversary celebration of Convalescent Training Center 65
Service commands — general hospitals — AAF regional station hospitals, AAF convalescent hospitals fold-in after 94
Main building, School of Aviation Medicine, Mitchel Field, New York ..... 146
The School of Aviation Medicine, Brooks Field, Texas, November 1929 147
The School of Aviation Medicine, Randolph Field, Texas . 152
One of the very first low-pressure chambers 199
Low-pressure chamber — permanent type or fixed type 200
Future flight surgeons work out in high-altitude chamber 201
Aircrew indoctrination in low-pressure chamber for high-altitude flight 202
Maj. Gen. Malcolm C. Grow (MC) 232
Maj. Gen. Harry G. Armstrong (MC) 233
The first building of the Aero Medical Laboratory 235
A combat crewman wearing the Type A-10 Demand Oxygen Mask 254
A combat crewman wearing the Type A-14 Demand Oxygen Mask 254
Simulating actual physical exertion of an airman in the sky. 255
Diagram of oxygen mask 256
Lt. Col. Randolph Lovelace II (MC) 280
Pressure suits 284
Lt. Col. Melbourne W. Boynton (MC) 342
Early air evacuation planes 353
Interior of Douglas C-54 plane showing web strapping litter 362
Four-motor bomber becomes mercy ship on return from bombing mission . . 363
Evacuating the wounded at La Guardia Field, New York 364
Interior of plane showing four tiers of litters 365
Members of the first class of air evacuation nurses graduated from Training
School at Bowman Field 379
Evacuation of wounded in North Africa, near Tunisan field of operations .... 474
Wounded on way to hospital 475
The return of an Air Evacuation Unit whose plane was forced down 492
Strecker visit to England in March 1944 569
Nurses of an evacuation hospital unit of the Ninth Air Force 589
General Patton with casualties waiting to be evacuated by air 602
England. Personnel of a USAAF air evacuation hospital unit 603
One of the " Grow Escadrille" 608
Armored suit — familiarly called Flak Suit" — developed personally by General Grow 619
Helmet and face protector 625
Life raft exhibit 626
High-altitude frostbite fold-in after 626
Stanbridge Earls, the first rest home in England for the Eighth Air Force officers 627
Electrically-heated muff 629
Heated bag used for transportation and care of wounded bomber crews 630
Bed patient in traction using loom and wool to make a small rug 757
Native stretcher bearers in New Guinea 767
Natives carrying wounded along Peep Trail to be evacuated by transport plane, New Guinea 768
Flight nurse secures a casualty of Okinawa into his stretcher on a huge transport plane 769
Patients being loaded by the 804th Medical Air Evacuation Transport Squadron 770
Patients of the 41st Infantry Division being evacuated from Dobadura, New Guinea 771
Mindanao, Philippine Islands, 12 May 1945 772

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