■ ■ y =”-:s • \ •; • • - • 1 -V- ."iL.t V i - W:• “ v- L\ - . i L.. ■ L —i V.-1 - . - . *. 1 : : . VJ » 'i - - fcrf* * c' i ; ' _-C J V - C". . . '..v - L /.AS.; S > ;; y, ' r"_ \~j :% '% ■' ■ MAYO AERO MEDICAL UNIT STUDIES IN AVIATION MEDICINE Carried out with the assistance of the NATIONAL RESEARCH COUNCIL, DIVISION OF MEDICaL SCIENCES acting for the COMMITTEE ON MEDICaL RESEARCH of the OFFICE OF SCIENTIFIC RESEARCH AND DEVELOPMENT With the cooperation of the UNITED STATES hRmY AIR FORCES, MATERIEL COMMAND, WRIGHT FIELD. Responsible Investigatorsi Walter m# Boothby, E, J, Baldes and C. F, Code aided by many associates. In Six Volumes These reports, originally in "restricted" classification, have been declassified and all are now "open." VOLUME 6: FINAL REPORT Mayo Clinic and Mayo Foundation for Medical Education and Research, University of Minnesota Rochester, Minnesota 39aO - 19U5 COMMITTEE ON WAR MEDICINE, MAYO ASSOCIATES representing the MAYO CLINIC AND MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH Dr. D.C, Balfour, Dr. C.W, Mayo*, Dr. R.D. Mussey, Dr. A*R. Barnes and Mr. H.J. Harwick STAFF OF THE MAYO AERO MEDICAL UNIT Responsible Investigators High Altitude Laboratory; Walter M, Bocthby, Chairman* Member of the Subcommittee on Oxygen and Anoxia of the Committee on Aviation Medicine, National Research Council* Acceleration Laboratoryt** E,J, Baldes, Vice Chairman* Member of the Subcommittee on Acceleration of the Committee on Aviation Medicine, National Research Council. C,F, Code, Secretary. Member of the Subcommittee on Decompression Sickness of the Committee on Aviation Medicine, National Research Council. Investigators Staff of the Mayo Clinic and Mayo Foundation: (Full time) E.J, Baldes, J.B, Bateman, W.M, Boothby, A.H, Bulbulian, C.F. Code'. H.F, Helmholz, Jr., E,H, Lambert, W.R, Lovelace, II and E.H. Wood. (Part time) J.D, Akennan,*** J. Berkson, H,B, Burchell, P.L. Cusick, H.E. Essex, G,a# Hallenbeck, W.W, Heyerdale, H.C, H ins haw, J, Piccard,-*** M. Power, C, Sheard, J.H. Tillisch, M.N. Walsh and M.M.D. YJilliams. Fellows of the Mayo Foundation: R. Bratt, B.P, Cunningham, W.H, Bearing, E,W. Erickson, N, Erickson, J.H. Flinn, J.K# Xeeley, J, Pratt, F.J, Robinson, H.F, Rushmer, G.F, Schmidt, H.C, Shands, H.A. Smedal, A.R. Sweeney, A, Uihlein, R. Wilder, Jr., J. Wilson and K.G, Wilson. Officer assigned by the Air Transport Command of the Array Air Forces: K.R, Bailey, pilot* Officers assigned by Air Surgeon’s Office; 0,0. Benson, Jr., J.W, Brown, J.K. Bundy, D, Coats, E, Eagle, M.F. Green, J.H. Halbouty, R.B, Harding, J.P. Marbarger, M.M, Guest, O.C. Olson, C.M, Osborne, H. Parrack, N, Rakieten, J.A. Resch, H.A, Robinson, H.E, Savely, C.B. Taylor, L, Toth and J.W* Wilson. Officers assigned by the Navy; W, Davidson and D,W# Gressley, Officers sent by other governments; J.R. Delucchi, Argentina, and R.T, Prieto, Mexico. Other investigators: M. Burcham, C.J, Clark, M.A, Crispin, R.E . Jones, G, Knowlton, H, Lamport, C«A. Lindbergh, C.A. Maaske, G.L, Maison, A, Reed and R.E, Sturm, Technicians High Altitude Laboratory: Henrietta Cranston, Lucille Cronin, Ruth Knutson, Eleanor Larson and Rita Schraelzer; Margaret Jackson (from Wright Field). Acceleration Laboratory: L. Coffey, R. Engstrom, H. Haglund and A, Porter; Ruth Bingham, Velma Chapman, Marjorie Clark, Wanda Hampel and Marguerite Koelsch, Secretaries Evelyn Cassidy, Esther fyrand, Marian Jenkins and Ethel Leitzen. * Before going into military service. ** The major reports of the Acceleration Laboratory will be published shortly in the monograph entitled ’’Tie Effects of Acceleration and Their Amelioration,” edited by the Subcommittee on Acceleration of the Committee on Aviation Medicine of the National Research Council. *** From the Department of Aeronautical Engineering, University of Minnesota* NATIONAL RESEARCH COUNCIL, DIVISION OF MEDICAL SCIENCES acting for the COMMITTEE ON MEDICAL RESEARCH of th o Office of Scientific Research and Development COMMITTEE ON AVIATION MEDICINE OEMomr-129 OPEN Final Report Juno 15, 1946 THE MAYO AERO MEDICAL UNIT, ROCHESTER, MINNESOTA* FINAL REPORT INCLUDING A BRIEF HISTORY, SOME OF THE MORE IMPORTANT CHARTS CONTAINING DATA, AND COMPLETE BIBLIOGRAPHY FOR BOTH THE HIGH ALTITUDE AND ACCELERATION LABORATORIES, Responsible Investigators* W, M, Boothby, M«D«, E« J, Baldos, Ph,D, and C, F, Code, M,D, SUMMARY The final report of the Mayo Aero Medical Unit includes a list of our co-workers, a brief history of the development of the Unit and a very short account of the chief problems investigated. Charts illustrating the more important physiologic data contained in our various reports have boon arranged in eight subject groups to present a fairly comprehensive summary of the research carried out in the High Altitude Laboratory. The data of the Acceleration Laboratory is being presented later in a monograph form. Complete bibliography of both the High Altitude and Acceleration Laboratories is attached. NATIONAL RESEARCH COUNCILr DIVISION OF MEDICAL SCIENCES acting for the COMMITTEE ON MEDICAL RESEARCH of the Office of Scientific Research and Development COMMITTEE ON AVIATION MEDICINE Final Report Juno 15, 1946 OPEN THE MAYO AERO MEDICAL UNIT, ROCHESTER, MINNESOTA: FINAL REPORT INCLUDING A BRIEF HISTORY, SOME OF THE MORE IMPORTANT CHARTS CONTAINING DATA, AND COMPLETE BIBLIOGRAPHY FOR BOTH THE HIGH ALTITUDE AND ACCELERATION LABORATORIES. Responsible Investigators of the Mayo Aoro Medical Unit: High Altitude Laboratory: Walter M, Eoothby, Chairman, Member of the Subcommittee on Oxygon and Anoxia of the Committee on Aviation Medicine, National Research Council, Acceleration Laboratory: E, J. Baldos, Vice-Chairman, Member of the Subcommittee on Acceleration j»f the Committee on Aviation Medicine, National Research Council, C, F, Code, Secretary, Member of the Subcommittee on Booomprossion Sickness of the Committee on Aviation Medicine, National Research Council, Invo stigat^rs: (A) Full time staff for 1 year or tnoroi E, J, Baidas, J, B, Bateman, W» M. Boothby, A* H, Bulbulian, C, F, Coda, H, F, Helmholz, Jr,, E, H, Lambert, W, R, Lovelace, II, R, E, Sturm and E, H, Wood* (B) Part time: J, D, Akerman, J, Borkson, H, B, Burcholl, P, L* Cusiok, G, A, Hallonbook, W, W, Heyordalo, H, C, Hinshaw, R, E. Jonas, J, Piccard, M, H, Power, C, Sheard, J, H, Tillisoh, M, N, Walsh and M, M, D, Williams, Officer assigned by Air Transport Command of the Army Air Forces for acceleration studies: K, R, Bailey, pilot. Officers sent by Air Surgoon*3 Office for periods of 1 month to 1 year: 0, 0, Benson, Jr,, J, W, Brown, E, Eagle, M, F, Green, J. R. Halbouty, J, P, Marbargcr, M, M. Guest, 0, C, Olson, C. M, Osborne, H, Parrack, N, Rakieton, J, A, Resoh, H. A. Robinson, C, B. Taylor and L, Toth; also J, W. Wilson from Wright Field for joint acclimatiza- tion investigation at Colorado Springs, Officers sent by the Navy who wore assigned for an appreciable length of time: W, Davidson and D, W, Gressley# 2 Offioors sent by other governments! J, R. Deluoohi, Argentina, and R, T* Prieto, Mexico. Other investigators who did actual work! M, Buroham, C, J, Clark, M, A, Crispin , C a G Encwlton, II. Lamport, C, A, Lindbergh and Jjf Mai son. Assistant investigators I R. Bratt, B. P, Cunningham, N, E, Erickson, J, H, Flinn, J. Kf Keoloy, J. Pratt, F, J. Robinson, R. F. Rushmor, G. F, Schmidt, H. C, Shanda, H. A. Smedal, A. R. Sweeney, A. Uihloin, R. Wilder, Jr., J, Wilson and K. G, Wilson. High Altitude Laboratory technicians: Henrietta Cranston, Lucille Cronin, Ruth Knutson, Eleanor Larson and Rita Sohmolzor; Margaret Jackson (from Wright Field). Acceleration Laboratory technicians! L, Coffey, R. Engstrom, H. Haglund and A, Portorj Ruth Bingham, Velma Chapman, Marjorie Clark, Wanda Hampel and Marguerite Koolsoh. Secretaries! Evelyn Cassidy, Esther Fyrand, Marian Jenkins and Ethel Loitzon, Visitors: Our guest book contains the names of many noted Air Forces personnel and civilian investigators from our own country and from our Allies, As some came on what at the t;ime vroro confidential missions, it is best not to include any list, although each one contributed many very important and valuable suggestions which helped greatly-, The responsible investigators realize that any important or valuable results either scientific or military that Ka/ve emanated from the Mayo Aero Medical Unit are duo to complete whole-hearted cooperation on the part of all who were in any way connected with the Mayo Aero Medical Unit, This cooperation was extended to and reciprocated by all the governmental agencies, civilian and military, con- cerned with our efforts as well as with the staff of all the industrial groups who perfected our laboratory models to meet the needs of largo scale production for the Army and Navy Air Forces0 Of necessity our work was largely applied research and not an at temp 5 to advance pure science nor to obtain data for World War III, The atomic scientists had an unparalleled opportunity to "mass investigate" the funda- mental relationship between mass and energy because of tho tremendous power attainable if release was successful. Not so in aviation medicine - our duty (at least so it seemed to us) was immediately to use the scientific facts already known, or should wo say select the best established facts and theories and then retest and measure their applicability and efficiency, in the construction of practicable apparatus and procedures to increase tho safety of both civilian and military aviators. The serious effect of anoxia on the human organism in sickness and in health has boon long recognized. Its importance in military medicine and in aviation ■was investigated and emphasized especially by Haldane in World War I, Studios on anoxia and methods of oxygon administration have boon carried out in the Metabolism Laboratory of the Mayo Clinic and Foundation since 1918 by Dr, Boothby, The oxygen chambers installed in 1925 for clinical therapy proved very useful in the early studies in aviation medicine and -were used frequently by the addition of nitrogen to simulate altitude during 1938 and early 1939, As a result of this work the Board of Governors of the Mayo Clinic and Foundation, represented by Dr, C, W, Mayo, decided to expand the facilities and increase the personnel available for research in tho broad aspects of aviation medicine, Early in 1939 tho first low pressure chamber in a civilian laboratory in tho United States was installed and studios on high altitude physiology were intensified after tho full-time assignment of Dr, W, R, Lovelace, II, to the laboratory by the Mayo Foundation, Simultaneously oarly in 1939 Dr, A. H„ Bulbulian, in conjunction with Dr» Lovelace and Dr, Boothby, started to develop oxygon masks (B,L,B#) suitable for use both in clinical medicine and in aviation. At that time no accurate data wore available on how much oxygon was needed out of a cylinder to maintain an aviator in normal condition or to what altitudes an aviator could go and still function normally,, Therefore, studios not only on oxygen equipment but on the rates of flow needed at increasing altitudes had first to be carried out, theoretically, on the basis of a constant tracheal oxygon pressure for a respiratory volume of 10 liters (B,T,P,S,) per minute at rest and for moderate work at a respiratory volume of 20 and of 30 liters per minute and, second, to confirm such calculations by actual determination of the alveolar CO2 and O2 pressures at increasing altitudes. In conjunction with Dr, J, A. Hoidbrink, tho constant flow kinetic typo of flow motor was calibrated in a specially designed glass boll jar that could bo easily evacuated to desired pressure altitude for the appropriate flows of oxygon per minute (3,T,P,D,) needed to maintain aviators normal at rest and at work. By tho middle of 1939 tho administration of oxygen by moans of tho B,L,B, oxygon mask was being used extensively for oxygen therapy at the Mayo Clinic, The various clinical conditions which were found to bo helped by the use of high concentration of oxygen were rapidly widening. In the practical application and in a bettor understanding of tho underlying physiological mechanism of oxygon therapy wo were greatly aided by the visit of the nctod British scientists, Dr. Henry Tidy, Dr, J, Forest Smith and Prof, B, A, all from St, Thomas Hospital, London, Great Britain at that time was fearful of massive poison gas attacks on the civilian population from German airplanes should war develop, and the scientists wore sent by tho Royal Society to determine with utmost speed the practicability of olini-' oal administration of high oxygen concentration. They and our entire laboratory staff worked intensively on many problems of oxygen therapy and in making comparative tests of the various methods for administration. In conjunction with Prof. MoSwinoy a series of alveolar air determinations were obtained when using various modifications of masks and other types of apparatus on three subjects, small, medium and largo, at increasing rates of oxygon flow from 1 to 10 liters per minute. Tho methods of technic used in those experiments wore primarily planned for studying clinical oxygon therapy at ground level. However, tho same methods wore immediately found applicable in studying the effects of oxygen administration, both by a constant flow reservoir robroathing mask and by tho demand typo mask, to subjects at simulated high altitude in low pressure chambers. Thus was perfected a routine method by which the efficiency of various types of oxygon administration could bo positively and accurately determined on aviators. As a result it was possible to establish not only tho optimum oxygen requirement needed by aviators for all altitudes but also tho minimum specification permissible. It was found that so far as anoxia was concerned, tho desirable specification was the maintenance of tho same concentra- tion of oxygon in the "tracheal'* air as exists at or near sea level whore Tracheal pC>2 = (B-47) 0,21, A definite educational program was instituted so that aviators - flyers and manufacturers - would become acquainted with tho desirability of the uso of oxygon at altitudes in excess of 10,000 or 12,000 foot, and its absolute necessity for altitudes in excess of 15,000 feet if tho aviators wore to remain there for more than a few minutes. Several commercial airlines shortly began to install tho now typos of equipment as they became available for tho administration of oxygon, not only for tho pilot and co-pilot but also in some instances for passengers. Simultaneously studios wore initiated at tho Mayo Aero Medical Unit on how to protect aviators from developing bands such as wore known to bo common to divers upon ascending from considerable depths of water. Many experiments were carried out to determine the rate cat which the body nitrogen could bo eliminated at rest and at worke The experimental data when plotted {see attached chart) on semi—logarithmic paper showed curves both for the experiment at rest and at work which suggested an asymptote around 1200 to 1500 oo. However, when plotted on log-log paper tho indi- vidual experiment showed that tho data representing accumulated nitrogen elimination fell on perfectly straight linos within tho limits of 120 minutes,-. This log*log plot was very convenient because it could of course be directly transformed into a straight lino indicating rate of elimination in cubic centimeters per minute. In one experiment the rate of elimination when extrapolated passed very close to the rate of elimination directly determined on another day on tho same subject after breathing oxygon for eight hours. The straight their change in slope at rest and at work indicates that at least two major factors control the rate of nitrogen eliminations (l) the concentration of nitrogen in the body tissues and (2) the rate of circulation of the blood stream. Those important points were not at the time investigated in greater detail as to do so now apparatus had to be constructed* Tho beneficial effect of donitrogonation by breathing oxygon with and without exorcise was establishod in the laboratory in 1939 as a practical method of preventing tho bends. The value of donitrogenation in actual flight at high altitude was studied in conjunction with tho Experimental Flight Department of the Boeing Aircraft Company. The results of those studios, at that time "confidential,1* wore presented in a statistical report by Engineering Test Pilot Marvin Michael and by Dr* W, E, Russell to a closed session of the Aero Medical Association at Indianapolis, Indiana in September 1942. A photograph showing the method then in use as preliminary to flights between 30,000 and 40,000 feet appeared in Booing News, Yol, XI, No, 5, May 1941. These various investigations so briefly enumerated here also attracted the attention of other aircraft manufacturers who wore designing new high altitude aircraft and of the tost pilots who expected soon to be testing such airplanes; the latter appreciated efforts to reduce the hazard of their tests. Visits by these tost pilots to the laboratory for indoctrination increased their timely and pertinent suggestions the ability of the rapidly growing group of investigators at the Mayo Aero Medical Unit to direct their advice and research along practical lines for the safety of pilots at high altitudes. From them wo learned what procedures were possible for them to use and to recognize quickly what methods/ although able to bo carried out in the laboratory, were utterly impossible to do in the type of airplane they wore flying. The design engineers soon began to learn that they must provide spaoo for oxygen cylinders and other safety equipment. An inter- esting observation was made by us, namely, the design engineers of bombers or multiple seat airplanes learned more quickly the necessity for safety of the pilot because in those planes the engineers themselves had to share the dangers of the test flights. Today one can hardly think back and realize the efforts needed to overcome the preju- dices of World War I pilots, especially if they had become high executives, who believed that military airplanes need not bo provided with safety devices, and that "comfort" would "soften'* a fighter. In view of the general intorst in increasing the safety of civil aviation and the growing concern of the Army and Navy Air Forces over the military significance of high altitude flying, close cooperation on an informal basis was established with Colonel {later General) D, N, W, Grant, the Air Surgeon, •with Captain (later Colonel) H- G., Armstrong, Chief of the Aero Medical Laboratory at Wright Field, with Captain (later Commodore) J, C, Adams, Bureau of Medicine and Surgery, Division of Aviation Medicine, U.SCN,, and with the Assistant Secretary R, H, Hinckley of the Department of Commerce in charge of civil aviation* American aviators were fortunate indeed to have such able and far-seeing men in charge of providing and continually improving on a largo scale safety apparatus not only for civilian but also for military aviators. In 1939 and 1940 Colonel Grant assigned to the Mayo Aero Medical Unit for instruction and to conduct investigations Captains 0, 0, Benson, Jr,, J, A, Rosoh, J, R, Halbouty and Ja W, Brown, and from the Mayo Foundation were assigned for full time work Doctors H, F, Holmholz, Jr,, J, K, Kooloy, J, Pratt, R, F, Rushmer, G, F, Schmidt, II, A, Smedal, A, Uihloin and J, W, Wilson; in addition many others volun- tarily worked part time in the laboratory of whom wo mention only Dr, VI, W, Hoyerdalo* Professor Akorman arranged for Mr, N0 E, Erickson and Mr, R, Bratt, advanced students in the Department of Aeronautical Engineering at the University of Minnesota, to each spend a year in the laboratory. Many of these investigators, when war against the United States broke out, went into military or civilian service whore their early training in aviation medicine led to important assignments. Captain (later Colonel) Benson became Chief of the Aero Medical Laboratory at Wright Field and later Air Surgeon for the Mediterranean Theater* Dr» Lovelace entered the Army and as Major was assigned to the Office of the Air Surgeon and later as Colonel became Chief of the Aero Medical Laboratory at Wright Field* Dr, Smedal became Flight Surgeon on an aircraft carrier and later, as Commander, was in charge of the High Altitude Laboratory at Pensacola, Dr, Keelcy early entered the Army, was sent to the Philippines and became a prisoner of war; upon release ho returned to the Mayo Clinic fortunately in good health. Dr. Hoyordalc entered service and was sent to the South West Pacific Theater - he was killed on active duty in Now Caledonia, Dr, Rushmer, shortly after entering service, was assigned to the Research Laboratory of the School of Aviation Medicine, Randolph Field, Dr. Helmholz, Jr., inaugurated and became Chief of the High Altitude Laboratory, Flight Research Department of Consolidated Vultoe Aircraft Corporation at San Diego; ho also continued as Research Associate at the Mayo Aero Medical Unit and by alternating monthly between the two positions created a mutually beneficial and effective liaison. During this early period many papers were presented at medical mootings and wore published in medical journals on anoxia and oxygon administration, A mimeographed list of the papers by the staff, including titles and references are, for the convenience of readers, attached as an Appendix to this report. Copies can bc sbtainod on request, and those papers primarily oonoornod with aviation oan bo found under the name of the author in "A Bibliography of Aviation Medicine" compiled by E, C, Hoff and J, F. Fulton for the Committee on Aviation Medicine, National Research Council# Those early pre-war studios on high altitude physiology attracted much attention as evidenced by visits from Major (later Lt, General) Doolittlo> Major Lester Gardner, Miss Jacqueline Cochran and by the award at the White House of the Collier Trophy for 1939 by President Roosevelt to Drs. Walter M* Boothby and W» Randolph Lovelace, II, of the Mayo Foundation and to Capt, Harry G, M,C*, U.3.A,, currently Chief of the Aero Medical Laboratory at Wright Field* Tho studios and papers mentioned rendered possible and formed the basis for tho high altitude studies in physiology and oxygen equipment continued at the Mayo Aero Medical Unit under the auspices of the Committee on Aviation Modioino, Division of Medical Sciences, National Research Council, acting for tho Committee on Medical Research, Office of Scientific Research and Development, Washington, D, C# Studios on acceleration were initiated early in 1941 by tho design and construction at tho Institute of Experimental Medicine of a pilot model centrifuge by Dr# E. J# Baldos assisted by Ur. Adrien Porter, Various physiological studios, mostly on animals, were carried out by Dr, C, F, Code, Dr, G, A, Hallenbook and Capt, J. A, Rosoh, M.C., U,3,A.j also on this centrifuge the first moving pictures of blackout and unconsciousness of a human being were obtained in tho fall of 1941 on Capt, Rosch, who volunteered as a subject* it was a striking picture of rapid development of old ago, apparent death and complete rapid restoration* The data obtained on this pilot model demonstrated the importance of carrying out extensive studies on aoooloration, and the Mayo Properties Association authorized Dr* Baldos to design and construct a large human centrifuge* In the design and construction. Dr* Baldes received helpful suggestions from the engineers of the Sperry Gyroscope Company, and also of the Timken Roller Bearing Company* The superstructure of this centrifuge has an 18-foot radius* It is completely equipped with electronic and other types of recording instruments and is installed in a specially designed circular room of reinforced concrete with an elevated "control tower*" After the human centrifuge and its equipment became available. Dr, Code and Dr, Baldos, aided by Drs, G* A, Hallenbeok, E, H. Lambert, E, H, Wood, Mr, R, E, Sturm (electronic engineer) and Mr, L, Coffey (photographer), planned and devisod a groat variety of methods to study the effects of centrifugal force upon various measurable physiologic mechanisms. Dr, Code also emphasized the necessity and importance of objective methods for the bio-assay analysis of protective equipment. Many Army and Navy Air Force and medical officers and tost pilots cooperated in various specific problems of special military interest# The centrifuge, its electronic and other recording apparatus, a large low pressure chamber equipped with all types of oxygen apparatus, and a small low pressure chamber with refrigeration facilities to -70° F*, and necessary respiratory, blood gas and accessory apparatus were installed in a new specially designed laboratory building in the spring of 1942, Tho equipment and tho staff to man it were con- tributed and maintained by the Mayo Properties Association on behalf of the Mayo Clinio and Mayo Foundation for Medical Education and Rosoaroh as part of their war effort. In 1944 they also authorized the construction of a vertical centrifuge to aid in solving certain special problems of immediate importance on a new typo pursuit aircraft - the P-82, The Mayo Aero Medical Unit at the time of Pearl Harbor was thus ready both with apparatus and trained personnel immediately to play its part in the intensive research work in aviation medicine then being inaugurated in the various civilian laboratories under the auspices of the Office of Scientific Research and Development and simultaneously to continue-the cooperative research already under way with the Army and Navy Air Forces* On January 21, 1942 the Mayo Aero Medical Unit was visited by the Committee on Aviation Medicine of the National Research Council together with several liaison officers. The following were present: Prof, H, C, Bazott, Banting Institute, University of Toronto, Toronto, Canada; E, M, Landis, Professor of Medicine, Univer- sity of Virginia; L, E, Griffis, Lt, Col,, Air Surgeon’s Office, Washington, D, C,; Eric Liljonorantz, Comdr,, U,3,N,R,, Bureau of Medicine and Surgery, Navy Department, Washington, D, C6; E, C, Andrus, Technical Aide, Department of Medicine, Johns Hopkins University; T, C, MacDonald, Wing Commander, R„A,F,, Air Ministry, London; C, F, Schmidt, Prof, of Pharmacology, University of Pennsylvania; D, W, Bronk, Director, Johnson Foundation, University of Pennsylvania; W, R, Milos, Prof, of Psychology, Yale University School of Medicine, E, F, DuBois, Prof, of Medicine, Cornell Medical School; J, F, Pulton, Prof, of Physiology, Yale University School of Medicine, Shortly after this visit the activities of the Mayo Aero Medical Unit were formalized and the financial support by the Mayo Properties Association continued under their Committee on War Medicine consisting of Dr» D, C, Balfour, Dr, R. D, Hussey, Dr, A, R, Barnes and Mr. H, J, Harwich representing the Mayo Clinic and Mayo Foundation for Medical Education and Research, This Committee completed formal contracts with the officials of the Army Air Forces Materiel Command (Aero Medical Laboratory) at Wright the Office of Emergency Management through the Committee on Medical Research, National Research Council as follows* I. Contract No* W535-ac-25829 (issued 6 February 1942, signed 11 March 1942)? Contract Noe AG-25829 (1943) and Contract No, W( 33-038)ac-9166 (1945) with the Army Air Forces Materiel Command, II, Contract Ho, OEMomr-129 with the Committee on Medical Research of the Office of Scientific Research and Development, 20 March 1942, During the investigations, however, there was no attempt made to separate the studios made under these two contracts or that continued informally with the Navy or with various aircraft manufacturers. Nor could the early work under those contracts be separated from the basic studies briefly described above as carried out between 1939 and 1942, some of which had already been published. The studies after 1942 which were directly requested by the Armod Forces have been placed in the attached bibliography of our classified materials as AAF-CMR reports. Other studios wore sent in for publication as CAM reports and are listed by the CAM number assigned by that office* Because the three Responsible Investigators wore each a member of a separate Subcommittee some formal and informal reports wore made directly to the Subcommittee on Oxygen and Anoxia, to the Subcommittee on Acceleration, or to the Subcommittee on Decompression Sickness; the formal reports are appropriately indicated in the bibliography. Finally, as frequently the monthly or bimonthly progress reports contain preliminary data of considerable value ■we have also indexed the subjects as CMR-OSRD Progress Reports, Charts illustrating the more important physiologic data contained in these reports have been grouped together to form a fairly comprehensive report of research carried out in the High Altitude Laboratory of the Mayo Aero Medical Unit, Oxygon Masks — The first B,L,B, oxygon mask was made by Dr, A, H, Bulbulian in February, 1939 and may be regarded as a forerunner of all subsequent oxygen masks developed at the Mayo Aero Medical Unit, The trial models were made by him in the fully equipped laboratory of the Mayo Foundation Museum of Hygiene and Medicine by the liquid latex or "anode" deposition technic, the method long used by Dr, Bulbulian in making artificial ears, noses, et cetera for patients who had lost them from accident or disease and in making reproductions of interesting and instructive anatomical modols0 The "anode" method is also used in largo scale production of many commercial articles of intricate design. The great advantage of this method lies in the fact that for a comparatively small cost many experimental forms can bo made in the laboratory from plaster of paris, low fusing metal, or aluminum. Many now and sometime:; radical designs can bo constructed, tried out, and either entirely abandoned or repeatedly modified until found suitable and the fit accurate and comfortableo After laboratory and field tests, the final stop is then delegated to the manufacturers for the construction of steel molds for large scale production. The A~3, and A-8-B (Army Air Forces designation) continuous flow oxygon oro-nasal masks, although an adaptation of the B,L,B, clinical masks, were progressively improved for military aviation in collaboration with Capt, (later Colonel) Rudolf Fink, who was at that time in charge of oxygon equipment at Wright Field, Those constant flow masks were used by the Air Forces until safe air-oxygon demand valves and masks were developed. There wore a number of intermediate masks developed here which intervened between the A-8-B and the A—14, Typo 12 was a continuous flow oxygen mask with chin bag. Typo 16 was a clinical mask and the so-called Universal Mask was a typo which could be easily converted from the continuous flow to the demand type. The typo 17 and 19 had some of the features of the A-8-B and A-14, While none of these masks were used widely, the face fitting features developed in those masks were later in part incorporated in the A-14 demand typo mask. The progressive alterations found necessary to prevent freezing and to meet the strict! military requirements were made by personal consultation with the members of the Oxygen Equipment Section of the Aero Medical Laboratory, Army Air Forces, Wright Field, The A-14 mask during its developmental stages wont through a series of modifications too numerous to mention. From 1941 to 1943 nearly a hundred experi- mental soft metal forms were made in the laboratory, and from those forms more than a thousand experimental masks were produced before the final stool production forma were made. Over one million of those masks were produced for the Army and Navy, One of the last In the scries of masks developed at the Mayo Aero Medical Unit,, in collaboration with Wright Field, is the A-15 pressure demand oxygen mask, which had finally been perfected and was in tbo process of going into largo scale, production in the last months of the war. Some of the basic principles utilized in 9 the design of the A-15 were described in the Memorandum Report, dated 23 October 1542, to Col, W. R, Lovelace and Col. A. P, Gagge, Aero Medical Laboratory, Wright Field, submitted by Dr. A. H, Bulbulian, Our early laboratory designation for this mask was Type 21 and the Army Air Forces experimental designation was XA-15, A Memorandum Report by Dr. A. H, Bulbulian dated 9 November 1943 on the detail of design and method of molding of the mask is on file. A Memorandum Report submitted by Dr. Bulbulian on 23 March 1945 presents the contemplated changes in the continuous flow A-8-B mask to make it more useful for certain special purposes desired by Wright Field. In the development of the whole series of oxygen masks at the Mayo Aero Medical Unit great credit is due to Mr. Allan Russell of the Ohio Chemical and Manufacturing Company and to Dr. J. A, Heidbrink and Mr, R, H. MoElrath of the Heidbrink Division. Likewise, the officers and production engineers of the American Anode Company deserve much credit for their continued effort in maintaining a high rate of production in spite of frequent changes and improvements in the forms. Much of the success of the work carried out in the Mayo Acceleration Laboratory under the direction of Dr, Baldes and Dr, Code has been due to the early establishment of adequate procedures and recording techniques for studying man's reactions to positive acceleration. The importance of the duration of exposure as a factor affecting man’s response to acceleration was one of the first problems studied. As a result of these studies a standard acceleration-time exposure pattern was established. In this so-called standard run the acceleration is increased at a rate of approximately 2 g per second and the maximal g level is maintained for 15 seconds. This type of exposure pattern allows the full develop- ment of symptoms in man and has given the most complete picture of the effects of positive acceleration as the aviator may experience them. Using the standard run it was shown that the increased weight of the blood, which occurs as a consequence of the exposure to centrifugal force, initiates a definite sequence of physiologic changes in man. These fall sharply into two distinct periods — a period of progressive failure followed by a period of compensation. During the period of progressive failure the blood pressure at the level of the head falls, the heart rate increases, the blood content of the ear decreases, the amplitude of the ear pulse is reduced or lost and finally changes in vision or consciousness, if they are to occur, become evident. The period of progressive failure is terminated as a rule by a compensatory reaction which becomes effective about seven seconds after the onset of the force. During the period of compensation the blood pressure rises, the ear pulse improves, the amount of blood in the ear increases and the heart rate slows. If compensation is sufficient, recovery from symptoms will occur. This sequence of events has been observed to occur in each of more than 300 subjects who have been studied in this laboratory. The maintenance of certain standard conditions under which the tests were performed was also stressed* Early in 1944 an air-conditioning system was provided which made it possible to maintain a constant temperature in the centrifuge room. The effects of warm and cool environmental temperatures on g tolerance were studied, but for routine tests a temperature of approximately 72° F (60 per cent relative humidity) was maintained. Subjects on the centrifuge were asked to main- tain a comfortable sitting posture and not to "fight the g." They were requested to put their heads back on a head rest rather than to support them during exposure to acceleration. Every effort was made to determine the subject’s "basal” g tolerance When tests are performed in the manner described, trained subjects on the Mayo centrifuge on the average experience dimming of vision at approximately 3 g, loss of peripheral vision at 3,5 g, complete loss of vision at 4,0 g and unconscious- ness at accelerations of 4.5 g or more. The standard deviation of the average g tolerance of individuals (inter-individual difference) is 0,6 g, while the standard deviation of the g tolerance of one individual (intra-individual difference) is C.4 to 0.5 g. Study of the details and inter-relations of the symptoms and physiologic changes which occur during exposure to positive acceleration was facilitated by a recording system which allowed the continuous and simultaneous registration of more than 12 variables (time, acceleration, arterial pressure measured by arterial puncture or by an indirect method, venous pressure, ear pulse, ear opacity, electrocardiogram, heart rate, respiration, intra-reotal pressure, the subject's reaction time to light signals in his peripheral and central fields of vision, motion pictures or still photographs of the subject, anti-blackout suit pressures and others). Using these techniques observations were made on over 300 subjects (laboratory personnel and civilian and Army volunteers) in over 10,000 exposures to acceleration under standard conditions and with various protective devices and procedure s• The recognition of the sequence of physiologic changes which occur in man during exposure to positive acceleration and the regularity of their occurrence allowed an orderly and quantitative approach to the problem of protecting the aviator. Upon the basis of these changes a hio-assay procedure was developed which allowed accurate determination of man's g tolerance and the protective value of any device or procedure designed to offset the deleterious effects of positive acceleration. The assay procedure was based upon the recognition and determination of the g level at which various subjective symptoms occur (dimming of vision, loss of peripheral vision and complete loss of vision) and upon the measurement of certain objective changes in the subject (loss of blood from the ear, reduction or loss of the blood pulsations in the ear, degree of pulse rate increase and magnitude of blood pressure changes) during exposure to various amounts of accele- ration with and without the protective device or procedure (Figure l). The study of methods whereby the ability of aviators to withstand positive acceleration oouid be increased was divided into three categoriest (l) limitation of duration of force, (2) changing the position of the pilot to reduce the hydro- static distances between the heart and head, and (3) increasing arterial pressure. Limitation of the duration of the for&e and other changes in the aooelor- ation-time curve which might allow the aviator to experience high accelerations without symptoms were studied but were not considered a practical solution to the problem of blackout because of the limitation they imposed on the combat maneuvers which the pilot could perform. Studies were carried out on the protective value of the crouch and prone positions and of tilting seats. These procedures, while effective, restricted the activity of the pilot in his cockpit and were likewise not accepted as a practical solution for the immediate emergency. It ’became evident that the most practical anti-blackout procedure for pilots in World War II would be one which would require no attention on the part of the pilot and would allow him full freedom of activity in the normal sitting position, A very effective straining maneuver (M-l) was developed which increased arterial pressure and enabled pilots to maintain accelerations up to 8 or 9 g in the sitting position. While this was effective, the procedure was considered only a stop-gap or emergency procedure and not a satisfactory solution to the blackout problem because it increased the pilot’s fatigue and required his con- centrated attention. In 1942 efforts wore directed to the development of anti-blackout suits. Also comparative tests were made on suits which were being developed elsewhere at that time, particularly the Navy Gradient Pressure Suit and the Canadian Frank's Flying Suit. Mr, F, Moller, Mr. I. R. Versoy and Mr, S, M, Berger of the Berger Brothers Company cooperated in some of the tests on the Gradient Pressure Suit (Navy GPS or Army G-l), The GPS and FFS were designed to prevent pooling of venous blood below the heart during exposure to positive acceleration. How- ever, our records of the cardiovascular changes which occurred during exposure to positive acceleration on the centrifuge did not confirm the concept that pooling of venous blood was the dominant or chief factor limiting man’s g tolerance. After several seconds' exposure to acceleration, arterial pressure rose and recovery from symptoms occurred even though acceleration was continued. We realised that this compensation could not have occurred if pooling of blood were the critical factor. Attention was then directed to the development of anti-blackout suits designed primarily to increase arterial pressure. Dr. E. H, Wood was most closely associated with the development of anti-blackout suits carried out in the Mayo Acceleration Laboratory, although the other members of the laboratory participated from time to time. In the construction of the anti-blackout suits collaboration with Mr. David Clark of the David Clark Company, Worcester, Massachusetts had been underway since April, 1942, Mr. Clark had been working on the construction of anti-blackout suits independently up to that time. By the spring of 1943 two suits had been constructed which by applying arterial occlusive pressures to the extremities and pressure to the abdomen increased the blood pressure at heart level and directed cardiac output towards the head during the critical periods of exposure to centrifugal force. The Progressive Arterial Occlusion Suit (PAO, Mayo Models 1 and 2) was tested on the centrifuge in November, 1942, and the Simple Arterial Occlusion Suit (AOS, Mayo Models 3 to 9) was first tested fn the centrifuge in February, 1943. These suits were found capable of increasing the g tolerance of centrifuge subjects by as much as 3 g. They are still the most effective anti-blackout suits which have been developed. The AOS was extensively tested by the Army Air Forces (Dr. Vfood assisted in many of these tests), but were not accepted for use because the pilots objected to the discomfort caused hy the high pressure to which the suits were inflated in order to obtain a 3 g protection. Late in 1943 it became evident from observations mado by the Navy and Army on the use of anti-blackout suits in field trials and in combat that pilots needed only a moderate increase in their g tolerance to avoid blackout in the aircraft in use in World War II and that pilot acceptance particularly from the standpoint of comfort was a most important requirement for an anti-blackout suit. Basic information which had been obtained up to this time from studies on the centrifuge using the GPS, FFS and AOS made it possible to outline the factors which are important in the protection afforded by anti-blackout suits. As a result in January, 1944 a simple bladder system was constructed by Mr. Clark and Dr* Wood that could be put into any type garment which would allow transmission of pressure by the bladder system to the important parts of the body. Numerous modifications of the outer garment (M-10 to M-22, the nylon bladder suits) were tested on the centrifuge. All of these contained the simple basic bladder system and all were effective anti-blackout suits. The principle of the simple bladder system was accepted by both the Army and the Navy and was employed in garments designed to fulfill the particular requirements of their pilots in different war theaters. The Navy in collaboration with the David Clark Company developed a coverall garment (Navy 2-1 and 2-2 suits. Army G-4) while the Army in collaboration with the Berger Brothers Company, New Haven, Connecticut and the David Clark Company developed the cutaway or skeleton suit (Army G-3, Navy 2-3). These suits increase the g tolerance of centrifuge subjects by 1 to 1,5 g. The protection against blackout which they afford has been shown by experiments carried out in the Mayo Acceleration Laboratory to be due to the Increase in blood pressure which they produce* The development of inflating valves for the anti-blackout suits was carried out simultaneously with the development of the suits themselves. Early models were developed in collaboration with the Heald Valve Company, Worcester, Massachusetts (particularly for the AOS) and the Cornelius Company, Minneapolis, Minnesota, In the spring of 1944 Mr. Richard Cornelius designed, built and submitted for test the antecedent of the present C-C-l valve. With little modification this valve was accepted as their standard valve by the Navy and as an alternate standard by the Army, A large amount of work was done in the Mayo Acceleration Laboratory to establish the performance characteristics of Inflation systems under all flight conditions and to set down the requirements for adequate anti-blackout suit inflation. In June, 1944 the Mayo Acceleration Laboratory extended its studios of blackout to include controlled observations made in aircraft, under the direction of Dr, E, H. Lambert, in order to determine in detail the applicability of human centrifuge observations to the pilot in flight. An RA-24 A (SBD-4) Douglas dive bomber was assigned to the Mayo Aero Medical Unit by the Army Air Forces at the request of the Aero Medical Laboratory at Wright Field. Recording equipment in part' supplied by the National Research Council (OSRD) was installed for making physiologic studies of pilots and passengers in flight (Figure 2), The plane was stationed at the Rochester Airport (Minnesota). Lt, Kenneth R. Bailey, engineering 13 offioer of the Air Transport Command Station at the Rochester Airport, volunteered to assist in these tests, and his participation as pilot of the plane and as supervisor of its maintenance was made possible hy Brigadier General Boh E, Nowland, Commanding General of the berrying Division, In the fall of 1945 a second plane (SBD-6) was assigned to the laboratory by the U,S, Navy through the Aero Medical Laboratory at Wright Field to replace the then obsolete A-24, This plane was also equipped for recording physiologic events during acceleration and at the end of the war was returned to Wright Field for continuation of these studies by the Army Aero Medical Laboratory. The studies carried out in the airplane fully substantiated the funda- mental results which were obtained on the human centrifuge. Pilots performing maneuvers which produced an acceleration-time curve similar to that used on the centrifuge experienced visual symptoms and showed the changes in the ear pulse, blood content of the ear and pulse rate which were the same as those observed in subjects on the human centrifuge. The principal difference between men piloting the airplane and subjects on the centrifuge was in their g tolerance* Pilots on the average experienced dimming of vision, loss of peripheral vision and blackout at 4.7, 5,1 and 5,5 g, respectively, and lost the ear pulse at 5,3 g. This was on the average 0,7 g higher than the g tolerance of airplane passengers and 1.4 g higher than the g tolerance of subjects on the Mayo centrifuge. Among the factors contributing to the higher g tolerance of the pilots were: (l) the "excitement of flying", (2) the crouching position when piloting, (3) the effort of pulling the control stick to execute the high g maneuver, and (4) the colder temperatures in the airplane. Despite the higher control g tolerance of pilots without protedtlcn, the increase in g tolerance which they were afforded by anti-blackout suits was the same as that afforded subjects on the centrifuge. This observation corrected an impression based on poorly controlled field trials that the standard anti-blackout suits provided 2 or 3 g or oven unlimited protection against blackout, when in fact they afforded only 1 to 1,5 g protection. The suits were nonetheless satis- factory in the fighter planes of World War II, At the higher accelerations which were reached with the suits on, the majority of pilots did not or could not sustain the peak accelerations of combat maneuvers long enough to produce definite visual symptoms. Straining on the part of the pilot probably further increased the apparent effectiveness of the suits. These controlled observations made in the airplane effectively rounded out the program of the Mayo Acceleration Laboratory by demonstrating that the fundamental information obtained from centrifuge experimentation could be applied with confidence to the conditions of actual flight. From time to time aspects of the problem of acceleration other than those dealing with the effects of positive acceleration were studied in the Mayo Acceleration Laboratory, The ability of man to move and to don a parachute when exposed to accelerations of up to 2 to 3 g was studied on the centrifuge. These studies illustrated the difficulty experienced by aviators attempting to escape from spinning aircraft. Experiments were performed on a vertical centrifuge to study man’s reactions to unusual accelerations which, it was anticipated, might be encountered in certain types of aircraft then in the stages of development. 14 A more complete description of the procedures and recording techniques used and of the physiologic studies and anti-blaokout suit development which were carried out in the Mayo Acceleration Laboratory is being prepared for the monograph on acceleration to be published by the Subcommittee on Acceleration, A review which covers many of the principle contributions during the war of all the acceleration laboratories of the United States, Great Britain, Canada and Australia was prepared by the Mayo Acceleration Laboratory for a symposium on "Soineyf&ontri- butions to the Solution of War Problems” which was presented before the American Physiological Society in 1946. Several extramural projects of considerable magnitude were carried out by the staff of the Mayo Aero Medical Unit with the approval of the Mayo Properties Association in conjunction with the Army Air Forces and the Subcommittee on Acceleration of the National Research Council, Dr, E. J, Baldes was appointed in 1941 as Special Consultant to the Air Technical Service Command at Wright Field and spent considerable time throughout the war on special tnissions connected with acceleration and deceleration, the chief of which are listed below. For this work he was awarded on August 31, 1945 at Wright Field by Brigadier General L. C« Craigie on behalf of the Secretary of War the following citation: War Department Commendation for Exceptional Civilian Service To Whom It May Concern: Edward J. Baldes has received official commendation and praise for exceptional performance of duty Citation: In recognition of his outstanding service to the Army Air Forces and the nation’s war effort in the design of special centrifugal devices. His exceptional ability and untiring efforts have contributed immeasurably to the flying safety of American aviators and have provided the Army Air Forces with the finest scientific knowledge available. Henry L. Stimeon Secretary of War Shortly after Major Lovelace made, on June 24, 1943, his epoch making parachute jump from 40,200 feet for which he was awarded the Distinguished Flying Cross, studies on deceleration forces involved in parachute jumps at high altitudes were initiated by him at the Air Technical Service Command of the Army Air Forces at Wright Field. Dr, Baldes was requested to undertake this inves- tigation. As no recording instruments were available the first problem was to design, in conjunction with Professor J. J. Ryan and Dr. B. Lindquist of the University of Minnesota, an appropriate recording tensiometer. As soon as recording 15 instruments were available extensive data were quiokly obtained by parachute experiments at Muroo, California in cooperation with Captain Hallenbeok and other officers from Wright Field, These studies later were correlated with the Sub- committee on Deceleration of the National Research Council and finally resulted in an entire revision of the heretofore accepted assumptions in regard to the magnitude of the forces involved. In the fall of 1944 Dr, E. J. Baldes as Special Consultant of the Air Technical Service Command was sent on a special mission to the Southwest Pacific Theater to assist in the indoctrination of Air Force Squadrons in the use of anti-g suits in part developed at the Mayo Aero Medical Unit and also to obtain suggestions from the fighter pilots as to their possible improvement. The trip was extended on behalf of the National Research Council to Australia to consult with the scientists and officers of the acceleration group of the Royal Australian Air Force. Dr, Baldes also worked on problems connected with deceleration as a member of a special Subcommittee of the Committee on Medical Research in conjunction with the Aero Medical Laboratory at Wright Field, The solution of the problems of deceleration has a wide application not only in aviation but also in transportation in general. Therefore, it is hoped that these studies will be continued. At the request of the Array Air Forces and the National Research Council Dr, E, J. Baldes was sent on a special mission to the European Theater shortly after the Germans surrendered to assist in obtaining the reports of the inves- tigations of the various German civilian and military research laboratories on the problems of acceleration and to obtain full details of the German ejection seat, A large number of German reports were brought back by him and by Colonel Lovelace, and many of these were translated at the Mayo Aero Medical Unit under the super- vision of Dr, Bateman. In the spring of 1946 Dr, Baldes was requested by the Army Air Forces to proceed again to the European Theater to obtain still more from the German research laboratories and the German scientists. On this trip he was accompanied by Dr, E, H, Wood of the Mayo Aero Medical Unit who was also made a "Special Consultant.” 16 LEGENDS Figure lr An example of records obtained in routine studies on the human centri- fuge. The records shown are taken from an assay of the protective value of the G-2 suit inflated with a pressure approximately 1,0 p.s.i, per g. To determine the protective value of any suit or device against the effects of acceleration, tests are conducted in the manner of a bio- assay using man as the test object. Exposures to acceleration with inflation of the anti-blackout suit are preceded and followed by runs without the suit. A subjective estimation of the effectiveness of the suit is obtained using visual symptoms as an end point, while the decrease in amplitude of the ear pulse, the decrease in blood content of the ear (E.O.) and the increase in pulse rate are used for objective measurement of protection. In the run shown the subjective symptoms we re as follows ; Control runs s Run 2AAD- 1: 2,5 g for 15 seoends, Vision clear. Run 2AAD-16*. 4 g for 15 seconds. Peripheral lights lost from 5,5 to 11,5 seconds. Center light lost from 8 to 12 seconds (blackout). Protected runs, single pressure suit Run 2AAD- 8j 4 g for 15 seconds. Vision clear. Run 2AAD- 7; 6 g for 15 seconds. Peripheral lights lost from 6 to 17 seconds. Center light lost fr*m 8.5 to 17,5 seconds (blaokov't' In the entire series of 16 runs in this assay on Subject 2, protection against visual symptoms was about 1,3 g, against a decrease in blood content of the ear 1,7 g, and against a decrease in amplitude of the ear pulse 2,4 g. Figure 2: An example of the records obtained from studies carried *ut in the A-24 airplane. This composite shows the effect of 5,0 g positive acceleration on a passenger in the airplane. The photographs are enlargements from a 16 mm, motion picture film. The middle tracing was obtained from the oscillographic unit recording the ear opacity, ear pulse, etc. The lower record shows the g-time pattern recorded by the R.S, recording accelerometer. The black lines synchronize the notion pictures with the other records. The subject stated that he blacked out in this run. He was apparently disoriented for several seconds after the run. Note the failure to respond to the light signals. Note that the ear pulse is almost lost. Legend: RESP. ; Respirotton tMA : Electrocardiogram, leads placed over each mppl*. E.P. Ear opacity puis* E.O, Ear opacity, downward deflection caused by e decrease m «or opacity. 9 : R.P.M. of the centrifuge converted to 9 unite. P.LR.; Reaction time to light* in the pertpherol wieual field, etgnoi magnet deflects upward when light* are turned on. CL-R.: Reaction ttma to a light at lha fixation point, signal magnet deflects upward when center light is turned on. Vertical black lines indicate the rote af each heart boot. Verttaol whtta hnet delineate five second intervals. SUBJECT 26, UNPROTECTED, PASSENGER IN A-24 AIRPLANE 5.0 g (Symptoms; “Blackout" , Disorientation) G - UNITS EAR OPACITY „ PERIPHERAL LIGHTS^ CENTER LIGHT ACCELERATION EAR PULSE , SECONDS PERIPHERAL LIGHTS, ACCELERATION. CENTER LIGHT FIRST TESTING OF BLB MAST XTT LOW PRESSURE CHAMBER USING RATES OF OXYGEN FLOW CALCULATED TO MAINTAIN NORMAL ALVEOLAR p02 (Preliminary Deniion) April 11, 1938 Wright Field Aero Medical Laboratory Low Pressure Chamber Captain Harry Armstrong, Chief; Dr, Heim, Scientific Associate Object of the pressure chamber flight is to test the efficiency of the BLB nasal mask with 500 cc, reservoir bag with metal connector containing 4 holes which could be closed or opened by a revolving sleeve* The floows of oxygen which were used at the various altitudes- were considered by Boot hby and Lovelace to be theoretically sufficient to maintain a normal alveolar air* Such low rates of flow had never before been tried except once in a nitrogen chamber. Dr* Hein in the absence of Capt# Armstrong was in charge of the low pressure chamber and extended to Dr. Boothby and Dr, Lovelace every courtesy and assistance* Dr, Lovelace was the subject of the experiment, Dr. Boothby was outside the chamber to regulate the oxygen flow so that the desired amount would be obtained. For this purpose the oxygon was passed through a 10 liter gas motor at room temperature and ground barometric pressure to give tho desired rate of flow after correction to STPD, The oxygon flowed into the chamber through a special valve inserted for the purpose of preventing suction on tho gas meter# A few days previous to this experiment Dr, Hein had collapsed and became paralyzed for a short tine on a flight in tho low pressure chamber at about 30,000 foot# After discussion of the various factors that might cause collapse it was concluded that aero-embolism was a possible if not probable explanation# To avoid such a complication as aero-embolism from obscuring the results of tho main object of the experiment Dr, Lovelace breathed pure oxygen for approximately one half hour during the preliminary preparations for the flight to reduce tho body nitrogen especially as during the flight he was to breathe an air-oxygon mixture of a composition calculated to maintain only a normal tracheal pO^* Accompanying Dr, Lovelace in the flight was Private Whitney who received throughout approximately 10 liters of oxygon per minute (STPD) and wore the ordinary laboratory mask which he had worn on previous chamber flights. He used the same equipment as ho did on the flight when Dr. Heim had collapsed; and as ho had had no difficulty during that or other flights ho did not de- nitrogeniae for this flight. Furthermore, the ascent was to be relatively slow and ho was to be supplied with a large excess of oxygon so that he would bo breathing approximately pure oxygen from the ground up. Throughout the experiment Dr, Lovelace appeared perfectly normal and showed no cyanosis or other evidence of anoxia although ho was fairly active inside the chamber especially when attempting to obtain alveolar air samples unaided. Both the CO2 and O2 pressures were slightly below normal. The alveolar air sample obtained at 20,000 feet indicated the subject had an alveolar oxygen pressure which wo now know to be equivalent to about 7,500 feet without oxygen. The alveolar air obtained at 27,000 foot was slightly higher and equivalent to about 6,000 foot without oxygen. The CO2 pressure indicated a slight degree of hyperventilation not sufficient to cause any symptoms of acapnia but comparable to what might be expected on a "first time," At no time was there the slightest evidence indicating bonds in cither subject. (Tho above report has been somewhat amplified from the original notes#) (o ve r) April, II, 1930, Experiment in low pressure chamber at Wright Field, Dayton, 0, Time Minutes Elevation Foot Oxygon flow Litara/tnin*' STPD Alveolar Air Pressure Amount dosirod Amount actually delivered 1 PC02 (ntn. Hg) p0? (mm. Hg) 10.40 Ground 1.0 0.9 10.50 10,000 1.0 0,9 11.16 20,000 1.0 0,9 11.20 20,000 1.0 0.9 (1) 31 (2) 31 70 (2) 71 11,35 20 ,000 1,5 1.4 11.38 21,000 1.5 1.4 (1) 31 (2) 29 (1) 76 (2) 74 11.41 22,000 1.5 1.5 11,47 27,000 1.5 1.5 (1) 31 (2) 29 (1) 76 (2) 74 12.04 28,000 1.5 1.5 12,11 30,000 1.5 !.4 12.28 33,000 1.5 1.5 t 12.39 Started down because Dr, Hein did not wish to have the subject &o higher on account of the recent accident possibly to aeroembolism 1 # It) Ground Temperature of meter average 77° F, Barometer 747,3 Dr. Lf.velace deni tro genated for approximately 1/2 hour previous to ascent. TESTING BLB MASKS aND OXYGEN SUPPLY EQUIPMENT IN COMMERCIAL AIRPLANES Northwest Airlines was the first commerical line to install efficient oxygen equipment. Date *. July 28, 1938. Reference: San Francisco Examiner July 3Q 1938. Airplane Northwest Airlines, Lockheed Sky Zephyr. Destination .o... Minneapolis via Billings to Los Angeles - 1900 miles. Mask BLB, nasal mask of light brown rubber, with metal valve on connector to reservoir bag. Chief pilot ..... Mai Freeburg.. Co-pilots; Mel Swanson and B.E. Richie. Passengers W,H, Lovelace and six NWA engineer personnel. Altitude .......* 20,000 feet for greater portion of flight. Object of trip .. To test new oxygen equipment for use by pilots and passengers and new type reducing valve which feeds correct amount of oxygen to maintain a normal tracheal p©2 regardless of number of persons whose oxygen masks are connected to oxygen supply. Date August 5, 1938*. Reference; . Minneapolis Tribune, Airplane ........ Northwest airlines, Lockheed Sky Zephyr. Destination Los Angeles to Minneapolis in 7 hours and U0 minutes. Mask BLB, nasal mask of light brown rubber, with metal valve on connector to reservoir bag. Chief pilot Mai Freeburg, Co-pilot; Mel Swanson and B.E. Richie, Passengers ....... W.R, Lovelace and two NWA personnel. Altitude l/3 of flight at 30,000 feet; maximum 31,UOO feet. Object of trip ..To test new oxygen equipment for use by pilots and passengers and new type reducing valve at high altitudes. Date August 20, 1938. Reference; St. Louis Post Dispatch. Airplane Howard Hughes - Lockheed lU monoplane. Destination Glendale, Calif, to Floyd Bennett Field, N.Y« Mask ...... BLB, nasal mask of light brown rubber, with metal valve on connector to reservoir bag. Chief pilot ...., Howard Hughes• Passengers ...... Three companions. Altitude Average elevation 17,000 feet and maximum elevation 20,000 feet. Object of trip .. Record for speed - average of 238 miles per hour in 10 hours and 32 minutes. This record is over Tommy Tomlinson (11 hours, 5 minutes) 1* years ago. Date October 27, 1938, Reference: Rochester Post Bulletin, Airplane ........ Vanderbilt's Lockheed Zephyr, Destination ...... One and one half hour flight over Rochester and vicinity. Mask BLB, nasal mask of light brown rubber, with metal valve on come etc to reservoir bag. Chief pilot Russel Thsw„ Passengers W,M. Boothby, W,R. Lovelace, A. Uihlein, Ruth Knutson and 3 other personnel. Altitude Maximum altitude 15>,U50 feet. Object of trip The oxygen distribution equipment was installed at the Lockheed factory in Los Angeles, The Rochester flight was made to test the installation of the oxygen equipment. 2 Date• February 20, 1939♦ Reference: Minneapolis Journal. Airplane .••••••« Northwest Airlines - Lockheed Sky Zephyr. Destination ..... Minneapolis to Little Falls, Mask' .., BLB, nasal mask of black rubber, with metal valve on connector to reservoir bag-, Chief pilot ..... Mol Swanson. Co-pilot: Tom Chastain Passengers ...... W.R. Lovelace and 5 other NWA personnel. Altitude 15,000 to 20,200 feet. Object of trip •. * To test the new BLB oxygen mask and oxygen distribution equipment that will be installed on all Northwest Airlines planes for use of pilots and passengers when necessary. Date .. March 10, 1939* Reference: Boston Evening Transcript, Airplane ........ Northwest Airlines - Lockheed Sky Zephyr. Destination ..... Minneapolis to Boston, Washington, Indianapolis and back to Minneapolis. ' .... Mask BLB, nasal mask of black rubber, with metal valve on connector to reservoir bag. ..... Chief pilot •••*• Mai Freeburg. Co-pilot: Eric Jaselk* Passengers ...... W.M. Boothby, W.R. Lovelace, A. Uihlein, A. Bulbulian and six ■ other passengers* • Altitude ..•..••• 15,000 feet to 23,000 feet. ' 4 ‘ Object of trip .. To demonstrate the efficacy of the BLB oxygen mask and oxygen equipment as installed in a commercial airliner' to special meeting 'on Aviation Medicine at the Harvard University Fatigue Laboratory. It was the first public demonstration of an oxygen equipped commer- cial passenger plane intended'for regular passenger1service. The equipment was inspected at Boston, New York* and Washington by various officials concerned with the safety of‘the crews and passengers in prolonged flights at the higher altitudes. SCIENTIFIC MEETINGS AND DEMONSTRATIONS Poo. 28. 1939 - Columbia, Ohio. The American Association for the Advancement of Science, W, M, Boothby, W, R, Lovelaoo, II and 0. 0, Benson, Jr, (Science Service, for release Deo, 29, and A.P, in Minneapolis Tribune Deo, 29,1939) At this meeting first public discussion was made of the value of prelim- inary denitrogenation both with and without exercise before high chamber flights. Jan, 8, 1940 - Toronto University, R.C.A.F, Research Group, Prof. G. E. Hall, Cbr, Discussions by W, M, Boothby, W, R, Lovelace, II and 0, 0, Benson, Jr. (l) on value and advisability of preliminary denitrogenation for high flights, (2) on rates oxygen flow needed with BLB mask and reservoir bag to maintain normal tracheal PO2 at rest breathing 10 liters per minute and at light and moderate work when breathing 20 to 30 liters per minute. Following the demonstration at Toronto Prof. Hall and Major Tice, R.C.A.F*,visited our laboratory on Jan, 15 to 17, 1940, They made several flights (Nos, 50, 51 and 52) to 40,000 feet in the low pressure chamber with and without denitrogonation; electrocardiographic records and alveolar air studios wore made. Mar. 15. 1940 - New Orleans, Scientific Exhibit of the Federated Biological Societies. W, M, Boothby, W, R, Lovelace, II and 0, 0. Benson, Jr, demonstrated methods of denitrogenation, of bail-out bottle and of charts illustrating rates of flow needed with BLB apparatus at rest and at light work calculated to maintain normal tracheal p02» April 24, 1940 - Mayo Aero Medical Unit special demonstration for Major (later Lt, Gen,)Doolittlo and Major Lester 0, Gardner (retired) Institute Aeronautical Sciences. (Minneapolis Tribune April 24, 1940) Preliminary denitrogonation with ascent to 40,000 feet made by Major Doolittle and Captain Benson, Jr.; the latter made a simulated parachute jump with recently devised bail-out bottle (Flight No, 82), Mav 15. 1940 - University of Western Ontario, Canada. (Toronto Globe May 16, 1940) Lecture by W, M. Boothby on "The clinical uses of oxygen and its application to aviators," in which preliminary denitrogenation and the bail-out bottle were discussed. May 27. 1940 - Mayo Aero Medical Unit. The first experiments to determine with greater exactness the rate of nitrogen elimination were made by W, M, Boothby, W, R, Lovelace, II and 0, 0, Benson, Jr. with subject (O.O.B.) at sitting rest and at work (walking on the treadmill at 3 miles per hour). The average results of the series of experiments were first published in "Physiology of Flight," Wright Field, 1940-42, page 27, The graph in this publication was made on semi-log paper to indicate the probable asymptote; the data 6f the individual experiments when plotted on log-log papor lie in nearly all instances on a straight line over periods of 2 to 3 hours. June 22. 23, 1940 - Seattle, University of Washington, Branch meeting of the American Association for the Advancement of Science and at Booing Aircraft Corporation. During lecture by W. M. Boothby in high altitude physiology W. R. Lovelace, II demonstrated method of preliminary denitrogonation, then ascended to 40,000 feet in a small portable low pressure chamber using BLB mask, reservoir bag and recom- mended rotes of oxygen flow; descent was very rapid (not explosive) from 40,000 foot to ground level in 40 seconds. 2 Juno 26, 1940 - Pasadena, California, California Institu-te of Technology» (Looture and demonstration of June 22 repoateA,) Sept. 26, 1940 - Washington, D,C,, National Aeronautical Association at the WillarA Hotel. A complete exhibit and demonstration of all phases of the high altitude studios carried out at the Mayo Aero Medical Unit wore made to the members of the Collier Trophy Committee and other officers of the National Aeronautical Association, Miss Jacqueline Cochran, who was one of the members of the Collier Trophy Committee, made all the arrangements for this demonstration after she visited the Mayo Aero Medical Unit in August 1940, Deo, 4, 1940 - Washington, D, C,, White House, President Roosevelt personally presented the Collier Trophy on behalf of the National Aeronautical Association at noon on Tuesday, December 17, 1940 with the following award* "The NATIONAL AERONAUTIC ASSOCIATION awards herewith the COLLIER TROPHY, aviation’s highest civil honor, for the year 1939 to the AIRLINES OF THE UNITED STATES for their high record of safety in air travel, with special recognition to DOCTOR WALTER M. BOOTHBY DOCTOR WILLIAM RANDOLPH LOVELACE II of the Mayo Foundation for Medical Research and Education, and to CAPTAIN HARRY C, ARMSTRONG of the U,S, Army Medical Corps at Wright Field, for their contribution to this safety record through their work in aviation medicine in general and pilot fatigue in particular. Done at Washington, D. C, on the seventeenth day of December, Nineteen hundred and forty, Gilo Rosh Wilson G, do Forest Lamer President Secretary" Dec, 1940 - Mayo Aero Medical Unit, X-rays of Joints, During this month several series of x-rays wore taken at 40,000 feet of various painful joints of Dr. Harold Smedal. Definite indication of air in the wrist joint was obtained. One set of experiments are reproduced in Fig, 14a and 14b, page 26 of "Physiology of Flight," Aero Medical Research Laboratory, Wright Field, 1940-42, Jan, 29, 1941 - Columbia University, Annual meeting of the Institute of Aeronautical Sciences, (Reported in New York Tines Jan, 29, 1941) W, M, Boothby and W, R, Lovelace, II showed a motion picture of some of their activities in working to overcome anoxemia and aeroembolism. Sent . 1942 ~ Indianapolis, Ind, Closed session of the Aero Medical Association* First statistical study of which wo wore aware of the value of denitrogenation as recommended by Mayo Aero Medical Unit in actual flight was presented by Dr, Russell and Mr# Michael of the Booing Aircraft Company, Part of this presentation, with additional data, was included in a mimmeographod and confidential report on "High Altitude Flying" at the Boeing Aircraft Company, Method of denitrogenation used with exercise shown by pictures in Booing Nows of May, 1941, Vol, XI, Ho, 5* MAYO AERO MEDICAL UNIT EARLY FLIGHTS IN LOW PRESSURE CHAMBER Flight 1, May 26. 1939 The first run in the low pressure chamber of the Mayo Aoro Medical Unit was a slow ascent (l hour 23. minutes) to 15,500 foot (S.O.F.)* ' *“ Flight 2. May 29. 1939 Asoont to 20,000 foot (S.O.F.) - no symptoms reported , Flight 3, .Tune 5. 1939 .. . . . ; , Ascent to 30,000 feet (S.O.F.) - no symptoms reported Flight 4, Juno 6, 1939 • , ., Ascent to 30,000 feet (S.O.F. ) - no symptoms reported Flight 5, Juno 7. 1939 Ascent to 30,000 feet (S.O.F.) L.C, reported a smarting of eyes after passing 20,000 foot; note was made , that the smarting and gritty sensation was considered .7 as possibly a manifestation of bonds duo to small superficial corneal bubbles. Flight 6, June 9, 193 9 Ascent to< 30,000 feet (S.O.F.) and no symptoms reported . . ,, .... Flight 7, Juno 12, 1939 Ascent to 30,000 feet (S.O.F.) and no symptoms reported Flight 8. Juno 13, 1939 Ascent to 30,000 foot (S,0,F.) L.C., reported itching of skin and N.D* smarting of eyes at 30,000 feet. Flight 9. Juno 14, 1939 Ascent to 30,000 feet (S.O.F.) and no symptoms reported Flight 10, Juno 15, 1939 L.C, reported "light headedness" at 35,000 foot (S.O.F.) (bonds was considered, no anoxia) Flight 11, Juno 19, 1939 Denitrogonatod. First preliminary denitrogonation by breathing 100$ oxygon at sitting rest for approximately 1 hour followed by ascont to 33,000 foot (S.O.F.); notes in log.; "oyos, skin o.k., moderate gas pains, no fatigue and sleopy," This marks the beginning of the nearly routine use of denitrogonation before chamber flights on which the intention was to go above 30,000 feot; later if tho flight was to bo short some runs wore made without denitrogonation. At the Mayo Aero Medical Unit subjects wore scarce and we felt it safer to prevent the extra fatiguo which our subjects noted if they did not denitrogenate; we never had sufficient subjects to determine statistically the frequency of bends. Wo also began to recommend preliminary denitrogenation to tost pilots of the various aircraft manufacturers who were testing tho new high altitude aircrafts. S.O.F. = Standard Oxygon Flowt Those flows based upon maintaining a normal tracheal p©2 were later recommended by Boothby, Lovelace and Benson, Chart 1-1* Mayo Aero Medical Unit; also J, Aeronaut, Soi,, 7: 465, Sept, 1940, 2 Flight 12, Juno 20, 1939 Denitrogenated, Denitrogenatod for 1 hour on 100% oxygon at sitting rest* On ascent to 33,000 feet (S,0,F,) slight gas pains (bend symptoms mentioned). Flight 13, Juno 21, 1939 Denitrogonatod, Donitrogcnatod for 56 minutes on 100% oxygen at sitting rest. On ascent to 35,000 feet (S,0,F.) no significant symptoms. Flight 35, Nov, 28, 1939 Donitrogonatod. Denitrogonat od for 1 hour on 100% oxygon at sitting rest. Ascent to 40,000 feet (S.0,F„) and exorcise. Cyanotic and coughing and pain in joints at 40,000 feet (S.O.F,), Pain disappeared on descent to 33,000 feet. From 35,000 feet to 40,000 feet for 2 hours. Had difficulty with intestinal gas since 15,000 feet was attained. Some gas in stomach or transverse colon with slight upper abdominal cramps. Better when sitting upright. After 1 hour and 27 minutes above 35,000 feet abdominal discomfort gone. Fl.lgV-t 37, Dec, 5, 1939 Donitrogonatod with exercise, Denitrogenatod by walking on troadnill at rate of 4 miles per hour•breathing 100% oxygen for 25 minutes. This is the first time exercise was taken while denitro- genating on 100% oxygen. Because of slight symptoms of bends in Flight 35 after 1 hour denitrogenation at sitting rest it seemed advisable to tost the value of exercise in order to shorten the time needed to eliminate sufficient nitrogen to prevent bonds* MAYC AERO MEDICAL UNIT ASCENTS IN LOW PRESSURE CHAMBER A few geleoted experiments which at the tine done were considered Record Events 7-27-39 Rochester Experimental Subjects ..... W.R.Lcvelace and pilot from Northwest Airlines* Denitrogaiation ....... 40 minutes on 100$ oxygen at sitting rest. Ascent •••••. From 1,000 ft. to 40,000 ft. ( at 40,000 ft. for 2 minutes ). 11-28-39 Rochester Experimental Subjects ..... W*R#Lovelaoe and 0,0,Benson. Penitrogeaation 1 hour on 100$ oxygen at sitting rest* Ascent 1,000 ft, to 40,000 ft. (at 40,000 ft. for 3 minutes)■ ■ 1-14-40 Rochester Experimental Subjects .... .Prof* CoEsHall, Toronto and Lovelace, Benitregonfttion 25 minutes on 100$ oxygen - Treadmill 2 miles per hour. Ascent • • • • . 1,000 ft. to 40,000 ft. (at 40,000 ft> for 10 minutes)« 6-12-40 Seattle Experimental Subject ..... W.R.Lovelace Denitrogormtion 30 minutes on 100$ oxygen. Ascent sea level to 33,000 ft. in 11 minutes. Meeting, Seattle Branch, Institute of Aeronautical Sciences, 6-26-40 Pasadena Experimental Subject ..... .W.R,Lovelace Denitrogonation. ....... On 100$ oxygen preliminary to flight. Ascent . From sea level to 40,000 ft. in 8 minutes and 58 seconds. Meeting at Caltech of Institute of Aeronautical Sciences. 8-31-40 Rochester Experimental Subject W.R,Lovelace Denitr^genation ... On 100$ oxygen preliminary to flight. Assent ............ 1,000 ft* to 41,000 ft. Special demonstration for Mr. Robert Hinckley, Assistant Secretary of Commerce for Aviation and Pr. Brimhall, Director of Research, Civil Aeronautics Authority* 9—22—41 Rochester Experimental Subjects. .... D.B.Bill, Wright Field and J.Wilson. Denitrogenation. ....... 30 minutes on 100$ oxygen - Treadmill 3 miles per hour* Ascent 1,000 ft. to 40,000 f t»(at 40,000 ft* for 25 minutes.) 10-3-41 Roche ster Experimental Subjects. • . • . A.P.Gagge and H*Cranston* Denttrogenation. 36 minutes on 100$ oxygen - Treadmill 3 miles per hour. Ascent 1,000 ft* to 42.2QQ ft, (40-42,200 ft. for 1 hour.) ASCENTS IN LOW PRESSURE CHAMBER (Continued) 10-21-41 Rochester Experimental Subjects «... D.B.Dill, Wright Field and J.Resch. Dentrogonation 31 minutes on 100$ oxygen - Treadmill 3 miles per hour. Ascent 1,000 ft. to 41,900 ft. (at 40-41,900 ft. for 2 hours and 40 minutes). 12-6-41 Roche ster Experimental Subjects .... F.B.Vose, Sperry Gyro and Capt. Halbouty Denitrogonation ....... 30 minutes on 100$ oxygen - Treadmill 3 miles per hour. Ascent 1,000 ft. to 45,000 ft. (at 40-45,000 ft for 9 minutes) 1-15-42 Rochester Experimental Subjedts .... J.W.Brnrrn and L.A.Bullard - Denitrogonation ....... 30 minutes on 100$ oxygen - Treadmill 3 miles per hour® Ascent 1,000 ft. to 45,000 ft. (at 40-45,000 ft. Tor 10 minutes ). 3—31-42 Rochester Experimental Subjects • • • • L. Cronin and Lt. Gressley. Denitrg'g.anation 20 minutes on 100$ oxygen - Treajlmill 3 miles per hour. Ascent 1,000 ft. to 45,000 ft. (at 40-45,000 ft. for 57 minutes). MAYO AERO MEDICAL UNIT RAPID DESCENTS IN LOW PRESSURE CHAMBER DATE HIGHEST ELEVATION TIME IN MINUTES AND SECONDS 10-3—42 C,A, Lindbergh L, Cronin 40,000 ft, to ground 36 seconds 1-7-43 J,P, Marbargor 45,000 ft. to ground 1 minute 10 seoo nd s 1-8-43 J,P, Marbargor 50,608 ft, to ground 1 minute 15 seconds MAYO AERO MEDICAL UNIT SIMULATED PARACHUTE JUMPS TESTING VALUE OF BAIL-OUT BOTTLE A few selected experiments which at the time done wore considered Record Events 4-5-40 W,R, Lovelace and 0*0, Benson denitrogonizod for 33 minutes on 100$ oxygon -walking on treadmill and ascended to 35,000 ft, Lovelace simulated parachute jump from 35,000 ft, on hail-out bottle. 4-19-40 0,0, Benson and J,H, Doolittle denitrogenized for 35 minutes on 100$ oxygon -walking on treadmill and ascended to 40*000 ft, Benson simulated parachute jump from 35,000 ft, on bail-out bottle. 10-18-40 Milo Buroham, tost pilot for Lockheed, Capt, Diso-way and H, Smodal donitrogenizod for 31 minutes on 100$ oxygon -walking on treadmill and ascended to 40,000 ft, Buroham simulated parachute jump from 35,000 ft, on bail-out bottle. 10-20-40 Milo Buroham and W*R* Lovelace denitrogonized for 59 minutes on 100$ oxygen walking on treadmill and ascended to 35,000 ft. Violent exercise on bail-out bottle for 1 minute to imitate struggle to abandon plane, Buroham simulated parachute jump from 35,000 ft. Became unconscious at about 25,000 ft. Mask with oxygen applied by Lovelace, 12-17-42 A,R, Loomis, Willow Run and H, Cranston (movies) donitrogenized for 20 minutes on 100$ oxygen walking on treadmill and ascended to 40,000 ft, Loomis simulated parachute jump from 40,000 ft, on bail-out bottle. 4-29-43 Murray Hawley, Willow Ruu, wearing old positive pressure vest and Hcidbrink anesthesia mask, and J, P, Marbarger, wearing positive pressure vest and mask, denitrogcnized for 15 minutes on 100$ oxygon walking on treadmill and ascended to 50,000 ft, (at 40,000-50,000 ft, for 22 minutes)* Hawley simulated parachute jump from 40,000 ft, on bail-out bottle. MAYO AERO MEDICAL UNIT RECORD ASCENTS IN LOW PRESSURE CHAMBER WITH POSITIVE PRESSURE 1-3-42 Norvin Erickson end Bill McFarland -wearing Akerman positive pressure suit donitregonized for 1 hour and 12 minutes on 100$ oxygen walking on treadmill. Ascended to 44,000 ft, anrf stayed at 40,000-44,000 ft, for 10 minutes, 10-23-42 WV,R, Lovelace wearing positive pressure mask without counter-pressure denitrogenized on 100$ oxygen from ground up, Above 45,000 ft, for 7 minutes. Upon reaching 51,440 ft,, suddenly became extremely cyanotic, collapsed and had convulsions Rapid descent to about 35,000 ft, when L, Cronin entered chamber from air look, Lovelace rootvorod, L, Cronin on positive pressure apparatus with weighted spirometer, no counter-pressure. She had denitrogeni zt;d on 100$ oxygon intermittently for 16 hours., She ascended to 46,200 ft, and stayed there 11 mlnutosfthon wont into air lock which was lowered somewhat and changed to standard oxygon mask to observe W,R, Lovelace as ho ascended to 51,440 ft. When he collapsed yho entered main chamber upon oquilization of pressures around 35,000 ft, 3- J,P, Marbargcr and C,B, Taylor wearing pressure mask and a counter- pressure vest (laboratory model) using closed circuit principle with absorption of CG2 Arterial puncture made at 50,000 ft. Movie to show the technic and coordination of operator (16 minutes at ft.) Upon reaching 50,000 ft, arterial puncture easily and quickly made by Marbargcr into the femoral artery of Taylor lying on cot. Throe blood samples wore taken after 1, 5 and 16 minutes at altitude. Movies taken almost continuously throughout stay at 50,000 ft, show operator perfectly coordinated and able to make the arterial puncture and move about in the chamber. The subject indicated condition throughout as excellent by regularly lifting right arm, 4- W, Burrows using Wright Field positive pressure regulator and J,P, Marbargor wearing positive pressure vest and mask donitrogenized for 20 minutes on 100$ oxygon walking on treadmill. Ascended to 46,000 ft, and remained there for 27 minutes, 5- J,P, Marbargcr wearing positive pressure mask connected to positive pressure regulator and Prof. Akerman*3 pressure suit and helmet (Navy) lbs, pressure,. Ascended to 56,964 ft, and stayed there for 10 minutes, above 50,000 ft, for 16 min tos, 5-7-43 Ray Moore wearing Prof. Akorman*s positive pressure suit and helmet with chin type mask. Ascended to 53,861 ft, and stayed above 52,000 ft, for 27 minutes, 5-0-43 Harley Thorson wearing Akerman suit and helmet denitrogenized on on 100$ oxygon. Ascended to 57,165 ft, and stayed above 50,000 ft, for 35 minutes, 8- Capt, Dawbarn from Wright Field wearing Goodrich pressure suit. No denitrtgonation because pressure maintained subject at low level. Ascended to 67,471 ft, and stayed for 5 minutes, 9- Phil Gilmore from Republic and H, F, Helmholz, Jr,, wearing pressure mask with counter-pressure vest. Ascended to 47,473 ft, and stayed above 45,000 ft, for 4 minutes. MAY# AERO MEDICAL UNIT DATA FROM HIGH ALTITUDE LABORATORY The data obtained by the research -workers in the High Altitude Laboratory were usually best presented in charts# The majority of these charts were Incorporated in the various reprints or papers listed in the bibliography# It is time consuming to search through papers for the specific data they contain and as most of this data is valuable it seemed best for the convenience of any one reviewing the subject to have as much data as possible conveniently availhble# The graphs are self explanatory and are arranged in the following subject groups#. Group I Alveolar air data Group II (a) Effect of altitude on oxygen pressure in the lungj (b) oxygen requirement at altitude# Group III Percent saturation hemoglobin determined by (a) Van Slyke blood gas analysis (b) oximeter (o) from alveolar pOg Group IV Vital capacity# Group V Voluntary hyperventilation* Group VI Nitrogen elimination and effect of preoxygenation# Group VII Effusion time of gases and their flow characteristics through single orifices and through sponge rubber disks# Group VIII Miscellaneous# MAYO AERO MEDICAL UNIT DATA FROM HIGH ALTITUDE LABORATORY Group I ALVEOLAR AIR DATA (l) II-l August 1939, W.M.Boothby, B.A.McSwiney and A.Uihlein. Alveolar pC2 resulting from increasing rate of oxygen flow using a BLB mask on a small, medium and large individual at ground level. (2) II—2 November 1940, W.M.Boothby, J.Pratt and H.Smedal. Alveolar oxygen and C02 pressures as affected by varying (l) size of reservoir bag of BLB mask and (2) rate of oxygen flow at ground level. (3} II—3 v August 1940 and W*R*Lovelaoe Alveolar oxygen pressures as effected by different rates of oxygen flow using different methods of administration at ground level. (4) X—1 September 1940, W.M.Boothby, W.R,Lovelace and O.O.Bonson Jr. Alveolar 02 pressures at increasing altitude (a) while breathing air and (b) while adding oxygen at indicated rates of flow per minute as re- commended to maintain normal tracheal p02* (5) 1—2 September 1940, W.M.Boothby, W.R,Lovelace and 0.0,Benson Jr. Alveolar 02 and C02 pressures at various altitudes breathing air in low pressure chamber compared with data obtained by McFarland in nitrogen chamber (method of calculating altitude not known) (6) 1—3 November 1940, W.M.Boothby, N. Erickson, H. Snedal and J.Pratt. No significant difference in the alveolar 02 and C02 pressures at various altitudes found on subjects with and without breakfast. (7) 1-4 September 1940, W.M.Boothby and W.B.Dublin. Effect of regulated hyperventilation on alveolar 02 and C02 pressures at various altitudes. (8) I-5a 1940 revised 1943 by W.M.Boothby. Alveolar 02 and C02 pressures while breathing oxygen at stipulated rates of flow using BLB mask at elevations up to 42,000 feet. (9) I-6b October 1943, W.M.Boothby 1313 alveolar p02 and pC02 individual observations and their averages at various altitudes in low pressure chamber. (10) 1-7 September 1943, W.M.Boothby The same alveolar oxygen pressure is attained by simulating altitude by addition of nitrogen as found in previous experiments in low- pressure chamber. (11) I-6b-o August 1944, J.W.Wilson and W.M.Boothby Alveolar air data on subjects acclimatized to 6,X90 feet at Peterson Field Colorado Springs Colorado. Cooperative study Wright Field Aero Medical laboratory and Mayo Aero Medical Unit. Alveolar Air Data (continued) (12) I—6b—1 August 1944* J.W*Wilaon and W.M.Boothby, Alveolar air data on game four subjects (a) At Rochester, altitude 1,000 feet* (b) After 2 or 3 days at Colorado Springs, altitude 6,180 feet, (o) After 2 -weeks at Colorado Springs, (13) I-6E February 1944, W,M,Boothby. Comparison alveolar air data in males and females at various altitudes, (14) I—10a Maroh 1942, W,M,Boothby* Alveolar p02 and pC02 and alveolar pressure ratios as affected by duration of stay at 15,000 feet* (Stabilization within 15 minutes after removal normal oxygen,) (15) I-10b July 1943, W,M,Boothby and H.F.Helmholz Jr* Alveolar p02, pC02 and APR as affected by duration of stay at 10,000 feet (immediate stabilization.) (16) I-lOo June 1944, W,M,Boothby and J.B.Bateman* Alveolar p02, pC02 and APR as affected by duration of stay at 15,000 feet (no oxygen during ascent 3 minutes). (17) XII-7a May 1942, W.M.Boothby, 240 observations on p02, pC02 at various atmospheric pressures from 270 mn, to 350 nn^ (18) I-lla June 1944, J.BoBateman and W.M.Boothby Comparison of respiratory quotients calculated from analyses of alveolar and total expired air, (19) I-llb June 1944, J.B, Bateman* Time course of change of true respiratory quotient and alveolar respira- tory quotient after a meal of rice at ground level of 1,000 ft, (20) I-llo June 1944, J,B,Bateman, Sane as (19) except experiment done at 12,000 ft, (21) I-lle June 1944, J,B,Bateman, Comparison of observed changes in partial pressures with those calculated from changes in respiratory quotient occurring after meal of rice, (22) I-6d-b June 1944, W,M*Boothby Comparison of inspired, tracheal and alveolar air pressure between . ' . low altitudes breathing air and high altitudes breathing oxygen* (chart available in large size for indoctrination), (23) I—6d-c June 1944, W*M*Boothby, H.F.Helmholz Jr„ and.^BjrBatenan Effect of anoxia on alveolar air pressure* A simplified form of (22) for indoctrination* W.M.Boothby Alveolar air data(continued.) (24) I—6d—«. August 1940, WuMtBoothby, H, p,. Helnholz J*, &nd J*B%Ea-t enan Atmospheric Triangles* Another simple form of (22) for indoctrination* (25) I-6b-2 December 1945 , J.Helmholz and WeM,Boothby Changes in APR and ARQ, (l) after ascending to 18,000 feet for 1 hour and (2) after descending to ground for 1 hour. Alveolar oxygen pressures with various rates of flow of oxygen using B.L.B, mask small subject Mouth op Al_ Alveolar Ox-ygcn Pressures as effected, by different Rates and diff oront ITlotKodL of Flow MODIFIED FROM CLAIRBOIS Experiments of Clairbois Curve 1. Simple Bullona nasal apparatus. 2. Same nith 3 cm. nasal tube. 3. Same nith 10 cm. nasal tube. 4. Nasal catheter. 5. Dautrebande mask nith 1 meter long reservoir tube. 6. B.L.B. inhalation apparatus on large man. 7. B.L.B. inhalation apparatus on small and on a medium sized man. TTIAYO AERO mEDIGAE 'LL TUT Liters of oxqdcn flow per minute 1 I I I Alveolar H20 pressure Alveolar C0% pressure Alveolar oxygen pnessane - mm. of Hg. [ubject: High altitude effect on human body lublished: J. Aeronaut. Sc. 7* U65, Sept. 19U0. EQUIVALENT ALTITUDES ALVEOLAR Oa PRESSURES - MM. OF HG. ' WHILE BREATHING AIR AND WHILE BREATHING OXYGEN AT STIPULATED RATES OF FLOW Oz flow —liters per minute S.T P D. 0.5 0.7 1.0 1.3 1.7 2.1 24 Ban-S.T-Dry 0.73 1.24 2.18 3.51 5.78 8.93 12.94 Bar -37°C-Dry 0.63 1.41 2.49 4.00 6.59 10.18 14.75 Bar-37°C-5at. 0.91 1.58 2.68 4.60 8.30 13.64 22.13 Used and recommended by Boothby, Lovelace and Benson for constant flow with reservoir ' bag, Mayo Aero Medical Unit 1939* calculations of flow made for an assumed venm-nation rate of 10 L per min. at B, 37° C, sat. Aviators sitting res.t. J* Aeronaut* Sc* Sept* 19U0. yuveoJar* U& pr>e - mm. of' fid. Boothby- Benson (Calculated) air R.Q. 1.0 B-Breathing RQ. 1.0 •-Experimental determinations x = Hyperventilation (breathing air) x-l Barometric pressure - cm. of Hd Altitude - thousands of feet Formula [(B.-VP)xOa%] - —R Q* mm =P0a e$ [(760-47) * .2093] .2093-49.64 [(760-47) *.2093] - = B * .2093-59.64 [(760-47) * 1.00] - •= B- 67.00 ALVEOLAR Oz AND C02 PRESSURES AT VARIOUS ALTITUDES - BREATHING AIR 0a carves A-Boothby-Benson (calculated R.Q. 1.0) B-Boothby average (low pressure chamber) C - McFarland average (nitrogen chamber) D-Boothby-Benson (calculated R.Q. 0.6) , Altitude - thousands of feet Barometric pressure - cm. of Hd. C0a curves C-McFarland average B-Boothby average Boothbv lovelace and benson c\2 i H Alveolar pressure - mm. of Na. ALVEOLAR Oz AND COa KKLbbUKLb AT VARIOUS ALTITUDES - BREATHING AIR - BEFORE AND AFTER BREAKFAST Theoretical uncompensated curves calculated according to formula of Boothby and Benson P02= [(B-47) 0.£093]- J— A = R.Q. of 1.0 B = R.Q. of 0.6 Barometric pressures in cm.1 of Hd. With breakfast I Altitude in thousands of feet Without breakfast Erickson Smedal Pratt I DO I H Alveolar* pressures in mm. of Np. THE EFFECT OF HYPERVENTILATION ON ALVEOLAR 02 AND C02 PRESSURES AT VARIOUS ALTITUDES - BREATHING AIR i i A - With hyperventilation B - Boothbu - Benson (calculated R.Q. 1.0) C-Normal respiration Altitude. — .thousands of feet Barometric preslsure - cm. of Ho. I 0Z curves C0a curves BOQTHBy AND DUBLIN Alveolar pressure — mm. of Ng. ALVEOLAR 02 AND C02 PRESSURES - MM. OF HG. WHILE BREATHING OXYGEN AT STIPULATED RATES OF FLOW (average for each individual and average for all individuals) Walter M. Boothby 0Z flow - liters per minute (s.t.rd.) Altitude - thousands of feet Barometric pressure-cm. of H£. AVERAGES ON 10 INDIVIDUALS OF 258 OBSERVATIONS (Original) AVERAGES on ALL INDIVIDUALS I (Original) NEW INDIVIDUAL OBSERVATIONS = 209 at 30,000 to 42,000 feet MEAN OF NEW DATA REVISED AUGUST 1943 L- 5a Alveolar pressure - mm. of Ng. ALVEOLAR 0? and CO? PRESSURES and ALVEOLAR RATIOS at VARIOUS ALTITUDES WHILE BREATHING AIR MAYO AERO MEDICAL UNIT ALTITUN-THOUSANDS OF_FEET SUBJECTS ACCLIMATIZED TO A GROUND ALTITUDE OF 1,Q00 FEET Averafee: HaIdane-Prie*tly Method at Rest O 45 observation* or aore O 37 observation* or less 209*1 9*28 9*8 2 Z 000*92 692*I O'ZC 0*92 I 000**2 681*1 0*08 0*62 1 000*82 880*1 6*2 2*08 2*2 1*82 9* 000*22 818*0 0*0C 8**2 9 000'IT ►90*1 9** 8 *9C 9*2 ►‘Of 18 000*0Z C86 * 0 9*98 **62 ll 000*61 900*1 8*8 6*28 9*2 8'IC 99 000*81 288*0 1*88 i*OC 28 000*11 668 0 8 * 8C 8*88 6 000*91 616*0 1*9 Z'VY 8*2 6 * 28 9*1 000*91 ►68*0 0‘yy 9*98 9Z 000*91 198*0 6*99 9*98 91 000*C1 198*0 >*9 L * 09 2*8 8*98 19 000*21 228*0 8*89 8*98 21 000*11 826 * 0 9*9 6*09 9*2 8*9C 26 000*01 628*0 9*9 2*19 2*C 9*98 09 000*6 098*0 8*99 9*28 01 000*8 128*0 0*29 0*0* 8 000*2 2C8*0 2*9 2*92 1*C 2*98 99 000*9 268*0 9*9 9*18 8*2 9*9€ 29 000*7 206*0 8 * y9 9*88 8 000 / 088 * 0 2*9 2*68 6*2 2*98 9* 000*8 268*0 9*96 1*88 8 000*2 688*0 9*9 8*201 2*2 2*98 981 punas? o»»W uof*»TA»Q ■■ oof»»|A»a «■ fnQU»AJ»*qo uj •11*8 j*|o»aty “»»W pj»pu**s »»®H I® J»q*"N "®U»a»|3 Alveolar COj Alveolar Oj INDIVIDUAL OBSERVATIONS Total number • 1313 ALVEOLAR 02 PRESSURE mm. Sign riunbtr I'othod CenUUoa * ■ 102*! H* 1 l»n e-Pr 1 • 111 y Raat 22 Raliano—Prtaatly Raft (Work Serial) X 65 Haldano—Prlaatly Hark O, 106 Ra<-Rokraathlaf Raat ff 40 Paj-Rabraathlng Raat (Work Sarlaa) 55 Ba*-Robroathin£ Work Chart Include* all data obtained v*tw*en 12-Jl-Jb and 3-19-43. Both the COj and Oj content of all alveolar air sample* wore - metrically In calibrated Haldane ga* analyser. description or curves CUHVI A - EXPERIMENTAL ALVEOLAR 02 PRESSURE (Ap02) CURVE C - EXPERIMENTAL ALTUCLAR C02 PRESSURE (ApCOj) CURVE t - EXPERIMENTAL ALVEOLAR PRESSURE RATIO (APR) A, C and E are smoothed curve* representing the experimental data. Beth the carve* and the Individual value* are related a* felle»*i fcJ>R _ Af C02 (B—47) or . ApCQ2 If02 (B—47) - Af02 (B—47) ° IpOj - Ap02 Ap02 - If02 (B—4/) - or ApOj - 0.2094 (B-4/) - where D Indicate* barootetrlo pressure, p Indicate* partial preaaur* of fa*, f Indicate* volumetric fraction of dry 2a», A Indicate* alveolar air, I Indicate* Inspired air, 47 1* the vapor pr***ur* water at 37° C., and 0.2094 1* the fraction of 02 la pure dry CURVE B - THECRBTICAL ALVEOLAR 02 PRESSURE. It 1* assumed that there 1* no compensation by the body to the anoxia resulting from tho decree** la partial pressure of oxygen in Inaplred air at Increasing altitude*. CURVE D - THEORETICAL ALVEOLAR C02 PRESSURES. (No compensation fop anoxia.) CURVE T • THEORETICAL ALVEOLAR RATIO. (No compensation for anoxia.) ALVEOLAR C02 PRESSURE mm ALVEOLAR PRESSURE RATIO I- 6b BAROMETRIC PRESSURE - mm. Hg. Walter M Boothby October 1943 Based on comparison of tracheal nitrogen Corresponds to comparison of tracheal as opposed to alveolar oxygen ALVEOLAR 02 and C02 PRESSURES at ALTITUDES—SIMULATED by adding NITROGEN to CHAMBER AIR Mayo Aero Medical Unit SUBJECTS ACCLIMATIZED TO A GROUND LEVEL OF 1.000 FEET ALVEOLAR AIR BY HALDANE - PRIESTLEY METHOD SUBJECTS AT SITTING REST • 272 Observotions : C02 leu than l%(7mm.)in chamber air o 74 Observation! : C02 more than 1% (7mm) in chamber Oir CALIBRATED HALDANE APPARATUS FOR AIR ANALYSIS USED CALCULATION OF ELEVATION USING NITROGEN TO CALCULATE THE SIMULATED BAROMETRIC PRESSURE THE FOLLOWING FORMULA WAS USED (Bq- 47)X fO, , _ Ba * 0.2094 +47 Where Ba ■ Barometric pressure of the simulated gltitude Bg * Barometric pressure at experimental ground level f02 * Volumetric fraction of oxygen in the chamber air (dry) after nitrogen has been added 47 > Pressure of water vapor in the saturated air, at body temperature of 37*C ALVEOLAR 02 PRESSURE COMPARISON pO, PRESSURE OBTAINED BY ACTUAL DECREASE IN BAROMETRIC PRESSURE ond SIMULATED ALTITUDE BY ADDING NITROGEN THE 3 SUPERIMPOSED CURVES A,B and C REPRESENT DATA IN THE LOW PRESSURE CHAMBER (DECREASE IN BAROMETRIC PRESSURE) PRESENTED IN CHART Z-6a THE p 02 DATA OBTAINED BY BOTH METHODS INDICATES EXCELLENT CORRELATION CURVE A = EXPERIMENTAL ALVEOLAR 02 PRESSURE CURVE B • THEORETICAL ALVEOLAR 02 PRESSURE WITHOUT HYPERVENTILATION CURVE C • MEAN OF THE EXPERIMENTAL ALVEOLAR CO, PRESSURE ALVEOLAR C02 PRESSURE Chart I - 7 SIMULATED BAROMETRIC PRESSURE mm. Hg Walter M. Boothby September 1943 CALCULATION ELEVATION USING NITROGEN I* The partial pressure* of oxygen in the tracheal air** at any altitude is obtained from the following equation* (P02)tt “ (Ba - 47) * 0.2093 Where {?q2)& m partial pressure of oxygen in the tracheal air at any altitude# B » total barometric pressure at the altitude 9b 47 water vapor pressure of saturated air at 37°C# 0*2093 » volumetric fraction of oxygen in atmospheric air (dry) II. When it is impossible to go to the desired altitude or to simulate the altitude in a low pressure chamber, another method of studying effects of altitude on the avia- tor is available, namely, that of reducing in a chamber the partial pressure of oxygen by the addition of nitrogen* The altitude resulting thereby can be determined as follows t (p02) g “ (Bg - 47) * *02 Where (po2)g * partial pressure in ram* of Hg* of oxygen in tracheal air obtained at ground level by simulating altitude by addition of nitrogen* Bg « total barometric pressure at ground level. 47 “ water vapor pressure of saturated air at 37°C* *02 ** volumetric fraction of oxygen in the chamber air (dry) after nitrogen has been added* III* In order to compare the results obtained between an altitude simulated by nitro- gen with those actually obtained by altitude or by utilizing a negative pressure cham- ber, the two expressions may be equated and then solved for Ba which would be the actual barometric pressure for an altitude corresponding to the nitrogen added* Equat- ing the two equations I (Ba - 47) * 0.2093 - 47) tQZ solving for Ba (Bg - 47) x fo2 B - -H47 a 0.2093 It is to be noted specifically that this method in both instances deals properly and simply with the partial pressure of water vapor which is constant at 47 mm* of Hg* in the lungs under all conditions* Prom barometric pressure thus obtained one looks up in the "Altitude-Pressure Tables Based on the United States Standard Atmosphere" the corresponding4Altitude in feet* •All pressures expressed in millimeters of mercury* ••The term "tracheal air1* is used arbitrarily to indicate atmospheric air saturated with moisture at body temperature which is the actual condition of the air as it enters the alveoli before any exchange with blood gases has occurred* This is, of course, an arbitrary division because gas exchange proceeds more or less simultane- ously with saturation* The word "trachea** does not have an anatomical limitation but, as mentioned above, is used arbitrarily# ALVEOLAR Og AND COgPRESSURES AND ALVEOLAR RATIOS AT VARIOUS ALTITUDES WHILE BREATHING AIR A Cooperative Study carried out at Peterson Field, Colorado Springs, Colorado by WRIGHT FIELD AERO MEDICAL LABORATORY AND MAYO AERO MEDICAL UNIT SUBJECTS ACCLIMATIZED TO 6,180 FEET • 542 Observations on 32 Subjects by Haldane - Priestley Method — o Averaged Alveolar Air Data on Subjects Acclimatized to 6.178 feet Altitude Av. No. Carbon Dioxide Oxygen Nitrogen Thous. Ft Bor. Obs. Mean ± SEm I S.D I C.V. ~Meon ± S.eJ S O CV Mean 1 S EM S.D C.V. 6r. 6 2 610 173 32.3 ± 0.2 2,9 9.0 815 ±0.4 4.8 5.9 449.3 ± 0.2 2.8 0 6 9.0 541 8 31.8 ± 1.5 43 13.5 64.2 ±2.1 5,8 9.0 397.9 ±1.0 2.8 0.7 12.0 484 65 31.0 ±0.4 2.8 9.0 56.8 ±0.6 4.4 7.7 349.3 ± 0.3 2.6 0.7 *T 15.0 430 62 29.7 + 0.3 2.5 8.4 46.4 ±0.5 3.7 80 3088 ±0.3 2,1 0.7 t8.0 382 63 27.9 ± 0.4 2.9 10.4 38.5 ±0.5 3.8 9.9 2687 ± 0.2 1,8 0.7 . 200 351 62 25.7 ± 0.4 2.8 10.9 34.6 ±0.5 3.7 10.7 243.8 ± 0.2 2,0 0.8 220 323 53 23.4 t 03 2.4 10.3 31.1 ±0,4 3.1 10.0 22l.7±0.2 1.7 0.8 24.0 296 39 21.9 ± 0.3 2.1 9.6 27.6±0.4 2.5 91 I99,6±0.2 1.5 0.8 260 273 II 18.8 ± 0.6 2.0 10.6 26.4 ±0.5 1.8 6.8 180,9+0.5 1.6 0.9 ” 27.0 261 4 18.8 24.3 170.9 280 2491 2 | 18.7 22.1 I 61.2 Experimental Work directed by Captain John W. Wilson Sn. C The Low Frees ure Chamber of Peterson Field woe used- ALVEOL/Ir 02 PRESSURE mrm j ! .111,11 111 I ' I I M I i I I. DESCRIPTION OF CURVES SUBJECTS ACCLIMATIZED TO GROUND LEVEL OF 6,178 FEET Curve Ag Experimental Alveolar Oxygen Pressures Curve Cg Experimental Alveolar Carbon Dioxide Pressures Curve Eg Experimental Alveolar Pressure Ratio Theoretical curves Bs and Ds are constructed assuming there is no compensation by body to anoxia resulting from decrease in partial pressure of oxygen in inspired air at increasing altitudes Difference between uncompensated and experimental curves indicates magnitude of the compensation produced by the ANOXIC DRIVE. SUBJECTS ACCLIMATIZED TO GROUND LEVEL OF 1,000 FEET Experimental curves A| ,C| and Ej and theoretical curves B| and D| taken from Moyo Aero Medical Unit chart X—6b are added for comparison. These curves based on over 1.000 observations. I jAlWotAR i C02 PRESSURE mm. i ALVEOLAR j PRESSURE_RATjp j BAROMETRIC PRESSURE mm. Ha. CHART I-6b-C.Mayo Aero Medical Unit W9lter M. Boofhby August 1944 ALTITUDE - THOUSANDS OF FEET Mayo Amo Nodical Unit ALVEOLAR 0, AND CO, PRESSURES AND ALVEOLAR R.Q. BREATHING AIR Data obtained at Colorado Springs (6, ISO fast) Data obtained previously at Rochtsltr. Mtanssota (1,000 foot) X Shortly aftsr arrival ( I flight) a Avsrags of tavaral flitfrts 0 Aftsr two wests (I flight) _ MJmI 1.6, at 6«l«vu« IptUft, Mwim flals* (1 fll«t t) 4t tro ♦ * 0.7B to m tt 0. BO tt it> to n rti ♦ 3 O.Bt 14 m IB ii too ♦ S O.Bt If rn 17 »• 1B0 ♦ z At 1, OOO fHt, A*«A**t*f, H&XHNtl Avirtft •< 4 fllfhta. • 1 71) 1) 10) 990 ♦ • 0.74 ) 6B1 )1 B4 909 ♦ • 0.7B B BOB 11 7B 49t ♦ • 0.79 B 94) 11 •9 400 ♦ • 0.76 It 443 )0 191 ♦ • 0 . BO 11 44* I) IIB ♦ • 0.77 19 4tB IB 47 )06 ♦ 4 0.B9 17 )B9 tB IB 2 BO ♦ * 0.B1 Cot* fta *Urt Mt C»|i, J.M. C*l*r*4* IkUHi Mtriu Kill, lltnllM 1,110 faot. CO, o» «, «1~. K/. A.1.8 fl *o# 79 78 44# 0.84 » 91# 19 82 199 0.82 I* 47# 19 4# 14# 0.80 19 4)1 92 41 lie 0.82 19 181 90 >8 270 0.82 »0 14? 28 94 241 0.89 22 m 29 12 UV 14 itn it ,180 fMt. 8 (l • «n 98 79 499 0.81 • 941 97 9# 1## 0.7# 12 441 97 48 791 0.82 IS 49? 19 40 91C 0.81 18 182 12 79 28# 0.87 20 1S2 28 91 249 0.87 22 929 27 28 222 0.87 24 2*4 21 27 19# o.#o U 272 20 a 180 It 1,000 It. kHlM •• , Hluuiti. i ni|M. • l 728 97 101 949 0.88 8 808 97 79 891 0.81 1C 922 97 981 0.82 19 490 40 >08 0.82 18 180 >0 19 288 0.89 1 I •Urt Mk IttjMt 1.1. CtlwUt lprli|i, M«mi run* IlmtUa 1,110 ft* WO •il or oc Ml it WO w fir IC TTT ex *••0 tcc t« Cl •9* ex M*0 IK on re Tri X • 'Will T in *"* •w 000* t IT wo 009 IT n u*0 *u M u uc a u*o rr» TC u rrc or WO OM • ( M ooc ox u*o iOl c» U LZ* ex *••0 irf N TC oor n 0i*0 0*1 n Cl or« 0 91*0 ox CC ex# • («»' ml c W 001 •# »» •i«» fit w5 ?r- ri OT wo rxr •« M TOC ox WO etc rr U ter fit wo VM w u Mr XT wo ro oe m u*o Ttr 00 oc *ot • *»TT •ATX* h *0 Too {WWI tl k HJ «r» »« I tvbjMt K. 0. CtUrilo tyrlili, Mmim field. ( 1 flight) i-ltl 1 M jt Biff. .0, °2 ■2 • •Oft >9 490 ♦ ft 0.82 ft >4 ft) 402 ♦ • 0.7ft II *« >4 40 799 ♦ ft 0,7ft 19 4)1 H )12 ♦ ft )*2 2ft )4 272 ♦ 7 0.7ft 20 ML. rr • •1) 99 7* 492 ♦ 9 C.29 ft 940 J1 ft) J*ft ♦ • 0.7) 12 4ftc )) 91 no 19 427 12 42 907 ♦ 7 O.ftI 11 ->*a. .31 -U JH. ♦ 9 iJS. SSWf ChartX-Cb-l Meyo A$ro Medical Uni\ .COMPARISON .PE MAI F& aH|D HfMAI FS. ALVEOLAR 0 1 CO,, AND ftLVEOLAR RATIO ?RE$SUFiES AT VARIOUS ALT IT JOES WHILE BREATIflNG AR AVi:RAG|E Off MA.ES X AVERAGE FEMALES 0 ALT4TLDE T-HCO&Af IOS-(TF FfeET ALVEOLAR AIR DATA USING HALDANE - PRIESTLEY METHOD SUBJECTS AT SITTING REST ACCLIMATIZED TO GK ’ - ' LIE Of 1,000 ET. « ° o r* o o O r-i o o m o* SR? Is* $ o O cn £ °i »< 3 4 a o o d O o o O O o o o o t-i O r-i •5 n »n in CM o o O' * m »-< 4» ID o JO JO CD t-i H o ® E V a <3 o o o o o o o O o O o o r-i O .H • a o * o m S § o rH O* o f' o r-' 2 o CNJ m r-i m ? 2 ¥ o* ? 37 38 H r-i m cn o ■* f* r* o m o o r-i in o o * H o o i s 33 CD 33 !n M O' O* r*- in * in cn * o CM «o r-i cn m * •H O' O' ¥ O' ¥ o « H as s ¥ s S O a s o o o o O o o o O o o o o o o o O O 4» O' r-i m in O' * M ** ¥ * I r\j s 00 * rH r In in s s O ? * Sr CO m m jo jr r-i - r-i rH m in o n o * r* * o CD * ® ® r-i m H o o I s 37 | •o In 9 In JO JO In in 37 In s 33 r-i s z a 3 z m -O O 148 CD 31 CO 09 40 m 10 34 ® 10 in * ii 18 116 O' S 43 9 68 o O 9 9 9 9 o O g o o o o § o 9 o o § § ® © 6 o 6 6 6 6 6 6 6 6 6. o 6 6 o 6 o 6 6 o M r-i m *■ m o r- CO o r-i >-i r-i n t-i r-i S 17 s S8| ALVEOLAR OXYGEN PRESSURE mm. I Average Experimental Alveolar Curves for Males and Females Curve A — Alveolar Oa Pressure (ApOa) Curve C— Alveolar COgPressure (ApCOa) Curve E—Alveolar Pressure Ratio(APR) These Curves token from Chart I *- 6 b based on 1025 Observations by HaldanePriestley Method at SjttThg ’ Rest ? f I [ T 1 ALVEOLAR C02 PRESSURE mm I I ALVEOLAR PRESSURE RATIO Chari 1-6 E ALTITUDE - THOUSANDS OF FEET W. M. BOOTH BY FEB '944 Alveolar 02and 002 Pressures and Alveolar Pressure Ratios as affected by Duration of Stay at 15,000 feet MAYO AERO MEDICAL UNIT Five subject were taken to 15,000 feet on "normal " oxygen, about 10 minutes at altitude mask was removed and alveolar airs obtained at intervals up to 90 minutes _Ap_D2 ApQQg N2 Dif f. Alv.N2- Insp .Ng APR Previous Ground Chortl-lOo Time in Minutes after Reaching 15,000 feet WM. Booth by Mar. 194 2 .Mayo Aero Medical Unit Alveolar O2 and CO2 Pressures and Alveolar Pressure Ratios as affected by Duration of Stay at 10,000 feet Five subjects were taken to 10,000 feet without oxygen. Alveolar airs were obtained at intervals up to 120 minutes W.M.Boothby and Fred Helmholz July 1943 Time in Minutes after Reaching 10,000 feet Preliminary Ground Chart X — 10 b Alveolar Og and COg Pressures and Alveolar Pressure Ratios as affected by Duration of Stay at 15,000 feet Mayo Aero Medical Unit Six subjects went to 15,000 feet without Oxygen. Alveolar airs were obtained at intervals up to 90 minutes Preliminary Ground Chart X -10 c June 194 4 Time in Minutes after Reaching 15,000 feet W. M. Boothby J. B. Bateman Alveolar pressures for various total atmospheric pressures Barometric pressure-mm. Hg. Means (total 240 observations) \^\eon . pi2.(B-47)h2093-— Mean pcoz (tor < 550 mnn.) = 37.0 mm fV-een—A.R. (for B < 550 mm.) - 0.778 Alveolar Oxuqen Pressure- Alveolar CO2 pressure^ Alveolar ratio COMPARISON OF RESPIRATORY QUOTIENTS CALCULATED FROM ANALYSES OF ALVEOLAR AND TOTAL EXPIRED Al R HC LC RS MC HALDANE TOTAL Mayo Aero Medical Unit Chart I- 11 a Total Expired Air J.B.Bateman and W.M.Boothby June 1944 GROUND 12,000 FEET Fig. I TIME COURSE OF CHANGE OF TRUE RESPIRATORY QUOTIENT AND ALVEOLAR RESPIRATORY QUOTIENT AFTER A MEAL OF RICE DATA OBTAINED AT GROUND LEVEL (1,000 FEET) Upper section of each quadrant contains points for true respiratory quotient Q'" • and for alveolar respiratory quotient Q“ 0 Lower sections show ventilation rate in liters per minute (atmospheric pressure, 37° C, 47mm. water vapor), • and oxygen consumption incc. per minute at 760 mm., 0° C, dry Abscissa : time in minutes. Zero is time at which meal of rice was finished. RICE 517 g. RICE 949 g. RS LC RICE 675 g. d* 2 C0 UJ o cc HC MC Mayo Aero Medical Unit Chart!-lib June 1944 TIME J.B Bateman W.M. Boothby Fig. 2 TIME COURSE OF CHANGE OF TRUE RESPIRATORY QUOTIENT AND ALVEOLAR RESPIRATORY QUOTIENT AFTER A MEAL OF RICE DATA OBTAINED AT 12,000 FEET SIMULATED ALTITUDE Upper section of each quadrant contains points for true respiratory quotient, O'", and for alveolar respiratory quotient,Q“ Lower sections show ventilation rote in liters per minute ( ambient pressure, 37°C, 47mm. water vapor) , and oxygen consumption in cc. per minute at 760 mm., 0°C, dry Abscissa: Time in minutes. Zero is time al which meal of rice was finished. Dotted line on left of each qradrant shows point of ascent to 12,000 feet. 12,000 FEET RICE 552 g. RICE 326 g GROUND GROUND 12,000 FEET RS LC 12,000 FEET RICE 720 g. 12,000 FEET RICE 916 g GROUND GROUND HC MC Moyo Aero Medical Unit Chart I- lie June 1944 J.B. Bateman W.M.Boothby Fig. 3 COMPARISON OF OBSERVED CHANGES IN PARTIAL PRESSURES WITH THOSE CALCULATED FROM CHANGES IN RESPIRATORY QUOTIENT OCCURRING AFTER A MEAL OF RICE Abscissa: Calculated change, ApC" + ApO" . Ordinate: Measured change, ApC" + Ap0" Units : Millimeters of mercury. 0 Ground level, 1,000 feet, • 12,000 feet. Points representing measured changes smaller than those calculated must all fall within sectors AOB and COD. The pairs of lines parallel to AOD represent the average discrepancy between calculated and measured values. Fig. 5 Mayo Aero Medical Unit ChartX-lle June 1944 J.B. Bate mar W.M. Boothby AVIATOR BREATHING OXYGEN As the inspired tracheal air contains only oxygen and water vapor any decrease in volume of the alveolar air cannot decrease the olveotar oiygen pressure. The APR is always 1.0. The dlveolar oxygen pressure can be determined directly by subtracting the otveotor COj pressure from the tracheal oxygen pressure PARTIAL PRESSURE OF INSPIRED, TRACHEAL AND ALVEOLAR AIR ALTITUDE o o 0, Nt HfcO Vop. feet mm mm. mm mm mm . Chomber 35,000 178 9 37.0 A 1 True 88 7 6 0 47.0 35,71 6 172 9 B ( Chomber 40,000 140 7 339 56 0 38 47 0 True 40,560 136 9 Chomber 42,000 12 7 9 45 7 C True 31 3 38 470 42,652 124 0 The elicit tracet of nitrogen pretent in the alveolar air tonjplet can be eotily allowed for by tubtrocting the nitrogen preteere from the chamber pretture I hut obtaining the true or phytiotogtcol altitude of the subject. MAYO AERO MEDICAL UMT COMPARISON BETWEEN LOW ALTITUDES BREATHING AIR AND HIGH ALTITUDES BREATHING OXYGEN based on over 1400 determination* of the alveolar olr by the Haldane - Priestley method on subjects acclimatized to ground level of 1000 feet HokJane-Priestley Alveolar Airs at High Altitudes COMPARISON ILLUSTRATED BY THE A SERIES AI ■ Eiptrimtntol olvaolor 0* on osyg«n ot 39,716 feat A2 ■ Intpirfd t roc tool Of on oxygen A3 > lAfpirod troctool Ot on oir equal to A 2 A4 » Alveolar 0*on oir equal to Al oeturmng APR *1.0 A9 « Alveolar Of on oir equal to AI but with actual experimental APR of 0.89 illuftroting the effect of N* of air in lowering the ceiling whenever the APR it lets than i 0 A6 ■ Alveolar Ot on air it 9mm lower than A4 due to increote of Ns in alveolar air when breathing oir,when APR *0.89 for the tome altitude at A 3 A2 to Al • Alveolar CO*') gidentical ot equivalent altitude* A3 to A4 > Alveolar COfJ A3 toA6 ■Alveolar COf-t- increote in alveolar Nz A4 to A5 * Lott in altitude due to increote in alveolar Nf A4, A9, A6 : the trianglulor area indicotet the probable error due to variation* in APR when the anoxia of the aviator ot high altitude breathing oxygen it com- pared to a comparable degree of anoxia ot altitude! breathing air Alv. pOt » Troch. pOc — (aIv. pCOt — (Alv. pNt - Trocb pO‘» pO' -fpC"— (pN* - pN j) ww*# 004 prim* ' • trot Poo! Mr port two prior** " • ohmotor olr AVIATOR BREATHING AIR As the inspired tracheal air contains nitrogen in addition to oiygen and water vapor any decrease in volume of the alveolar air increases the pressure of nitrogen because there is no net change in the number of nitrogen molecules Thus, there is less available oxygen and, there- fore. a decrease in the alveolar oxygen pressure In the absence of hyperventilation the APR is decreased. Both the alveolar COt and the increase in nitrogen pressure mutt be sub- tracted from the tracheal oxygen to obtain the alveolar oxygen pressure. Low Altitude Breathma Air See Chart I-6b for complete data Ground level-l.OOOft. • 733 mm. Inspired Troch Air Alveolar air(H-P) COe • 0.2 mm COt 36 7 mm Ot ■ 143.6 mm 0« *102 3mm N* • 5 42.1 mm Ns =547 Omm HeO » 47.0mm HiO* 47 0mm fliv pCO, 36.7 Intp. troflh. Alv.p Og 143 6 — 102 3 Mayo Aero Medical Unit EFFECT OF ANOXIA ON ALVEOLAR AIR PRESSURES AVIATOR BREATHING AIR AT VARIOUS ALTITUDES The pressures of O2, CO2 and N2 in the inspired tracheal air are characteristically altered during the respiratory cycle In the “Steady State" these respiratory changes are based upon the character of food eaten which alters not only the partial pressures but also the total volume of the alveolar air from the inspired’air. Altitude anoxia, dependent upon its intensity and duration, superimposes in the " Semi - Steady State" definite additional changes in the alveolar nitrogen, oxygen and carbon dioxide pressures and consequently upon the various ratios or quotients that can be calculated therefrom. The alveolar oxygen pressure can be calculated by the following formula; pO" = pO' - [pC" +(pN" - pN')] One prime' - Tracheal air: Two primes" • Alveolar air Curves based on the averages obtained from over 1,000 HALDANE - PRIESTLEY alveolar air determinations most of which were obtained on 10 males and 5 tamales : See chart X-6 b Chart X- 6 dc ALTITUDE - THOUSANDS OF FEET Boothby, Helmholz and Batemon June 1944 MAYO AERO MEDICAL UNIT ATMOSPHERIC TRIANGLE EXPLANATION OF UPPER SERIES OF SCALES X Altitude 1,000 feet IT Barometric Pressure XT Partial Pressure of Nitrogen in Dry Air; ( B x 0.7903) XZ Partial Pressure of Nitrogen in " Tracheal" Air after Saturation with 47 mm. Water Vapor, Body Temperature 37°C (BT. PS) •( B - 47) 0.7903 1C Partial Pressure of Nitrogen in Alveolar Air: (B-47)AfNz Partial Pressure of Carbon Dioxide in Alveolar Air: (B—47) AfCOz All Pressures in mm. Hg The Portiol Pressure of Alveolar Gases must equal Barometric Pressure Unless A.R.Q, is Unity there is a change in the Lung of the Volume of the Respiratory Gases As many Molecules Nitrogen are exhaled as are inhaled Therefore a nJumge in Nitrogen Pressure con be used to calculate the change in Volume and to obtain the A.R.Q NITROGEN p » partial pressure of gas At. '"Atmospheric" air dry T «" Tracheal" air ( BTRS) A 'Alveolar air (SIRS) OXYGEN OXYGEN BREA THING AIR ALVEOLAR RESPIRATORY QUOTIENT No Nitrogen available so A R.Q. cannot be calculated J.B.Bateman and W.M.Boothby Aug. 1944 If) Q >. -Q .c o o m 2 3= ■O e o M O XL e « X •o ® u. k_ 3 O x: k_ __ 3 w. £ O O w o - W. •*- >■ Q o O o t z O < §< C Qs -jjf O < £L o XJ x iSl || Sen S ?z? go S fS « g g! u ° 8§ J QJ TJ < •” 5 »- • < a> <= S < oJ CJ I -Q u> I H h OC < I o MAYO AERO MEDICAL UNIT DATA FROM HIGH ALTITUDE LABORATORY Group II EFFECT Or ALTITUDE ON OXYGEN PRESSURE IN THE LUNG AND OXYGEN REQUIREMENT (1) XII-4 May 1942, J.Berkson and W.M.Boothby Change of alveolar oxygen pressure with altitude. (2) XII-5 May 1942, J, Borkson and W.M.Boothby > Change of alveolar oxygen pressure with altitude and its effect on (a) dry atmospheric inspired air and (b) air saturated with nositure at 97°C ( irhchbal’airy id) XII-6 May 1942, J.Berkson and W.M.Boothby Liters of oxygen necessary to maintain at altitude oxygen pressure normal (149 inn) in tracheal air per liter of ventilation measured at BTPS. (4) XII-13 August 1943, W.M.Boothby Oxygen and air added to inspired mixture required to maintain at various altitudes the pressure of oxygen existing in tracheal air at the sea level equivalent of 149 nn. expressed volunetrically and by weight# (5) XII-11 June 1943 H.F.Helnholz Jr. Effect of temperature change, water vapor and pressure change in reducing a constant ventilation rate of 10 liters per minute P.T.P.S. L SkT.PiD* (6) V—la 1940, W.M.Boothby Comparative rates of oxygen flow expressed at STPD needed by I Constant flow (a) Manual control (b) Automatic aneroid II Demand Method (?) V-2a Same as (6) but expressed BTPS (8) XII-14 December 1944, Swann modified by Boothby Rates of oxygen flow per minute compared with oximeter data obtained by Capt. Swann at Wright Field. (9) 2c Maroh 1942, W.M.Boothby Oxygen requirement for aviators 2gii- August 1943, W.M.Boothby Table showing oxygen and air added to It L (BTPS) inspired air required to maintain at various altitudes the pressure of oxygen existing in tracheal air of sea level equivalent of 149.3 mn. Data for chart XII-13 No. 4 in this series. MAYO AERO MEDICAL UNIT DATA FROM HIGH ALTITUDE LABORATORY EFFECT OF ALTITUDE ON OXYGEN PRESSURE IN THE LUNG AND OXYGEN REQUIREMENT. (11) 2G(a) August 1943, W,M,Boothby (a) Pressure and percent oxygen needed in Inspired Air Dry to maintain tracheal air at 149.3 mm. « Sea Level Equivalent (b) Amount of oxygen used from cylinders, subject breathing at rate 10, 20, and 3F L/min* (12) 2G)b) August 1943, W.M.Boothby Sane as 10 but for 122,5 ran. « 5.000 ft, equivalent (13) 2g(o) August 1943, W.M.Boothby Sane as (lO) for 117,7 ran. “ 6,000 ft, equivalent (14) 2G(d) August 1943, W.M.Boothby Method of calculation (lO), (ll), (12), and (14) (15) 2G(jp August 1943, W.M.Boothby Sane as (10) for 143,6 mm, = 1,000 ft, equivalent (Rochester) (16) XVIII-tla July 1J43, W.M.Boothby Amount of oxygen saved by using Diluter on Demand Valve, (17) XVIII-lb July 1943, W.M.Boothby Further saving of oxygon by using both "Diluter*’ and "Economizer Bag" ■with Demand Valve, CHANGE OF ALVEOLAR OXYGEN PRESSURE WITH ALTITUDE - 1 II-OXYGEN PRESSURE, ATMOSPHERIC] AIR DRV - ATMOSPHERIC PRESSURE - B XII-4 SATURATED III - FACTOR FOR SATURATION DRY CHANGE OF ALVEOLAR OXYGEN PRESSURE WITH ALTITUDE - 2 II - OXYGEN PRESSURE ATMOSPHERIC AIR DRY (Bx.209) IV - OXYGEN PRESSURE:” TRACHEAL AIR (:i X III) ALTITUDE - THOUSANDS OF FEET BY SAT URATION R E DU C TTON OF PRESSURE EXCHANGE (lV-4Cl PRESSURE AFTER -III - FACTOR FO V -V - ALVEOLAR OXYGEN XII—5 IV, V-LITERS OF 02 ADDED III-PER CENT O2 -ITERS OF OXYGEN ADDED PER LITER OF VENTILATION (TRACHEAL A r) XII-6 Mayo Aero Medical Unit OXYGEN and AIR ADDED to INSPIRED MIXTURE REQUIRED to MAINTAIN at VARIOUS ALTITUDES the PRESSURE of OXYGEN EXISTING in TRACHEAL AIR at the SEA LEVEL EQUIVALENT of 149.3 Meosured Volumetrically at B, 37* C, sat. Measured Volumetrically at B, 0° C, dry Measured Volumetrically at 760, 0° C, dry (STPD) . . ...... =1.429 grams per liter Measured by Weight < ' (Air =1.293 grams per liter Hatching1 Instrumental Tolerance at STPD THE SAME DATA EXPRESSED IN 4 WAYS AS FOLLOWS ro X EFFECT OF TEMPERATURE CHANGE, WATER VAPOR. AND PRESSURE CHANGE IN REDUCING A CONSTANT VENTILATION RATE, 10 L. PER MIN..TO S. T. R D. MAYO AERO MEDICAL UNIT A I ti t u de thousand ft. Bar ome trie pre s sure mm. H g, XII -II Comparative: Pates oe Oxygen Plow by O/EFERENT MeTHOOS I T. Constant flow Method A. Manual Control B. Automat/c Control JA. Oemaa/e> Me thoo (3.TPO.) 2rl A CoAXRA RA T/YE Ft A TES OR Oxygen Flow by D/rrereht Methods : I.’ Constant Flow Methods A. Manual Control S. Automate Control H. Demand Method Mayo Aero Medical Unit Volume or Oxygen Flow /a/ L/ters rer M/nute at Bar -3T’°C.~3at (Sar-JZV-3atM 3T-2A Altitude /n Thousands or Feet MAYO AERO MEDICALAL UNIT Walter M. Boothby COMPARISON OF THE OXIMETER DATA OBTAINED BY Copt. H.G.Swann TSEAL3- 696-42 H Dec. 30. 194 4 With other pertinent observations Chart XII-14 LEGEND OHART XII-14 3TPD « Standard temperature and pressure, dry* 760 mm#, 0°C,dry NTPD *• Normal temperature and pressure, dry* 760 cm. 70°F, dry BTPS Body temperature and ambient pressure, saturated with moistures Bar.37°C, Sat3 Swann*s data for curves 1, 2 and 3 are indicated by a large solid circle for the average of 3 determinations and the upper and lower of these determ- inations are indicated by the oblong block expressed at NTPD. Curve 1 - Oxygen flow required for subject at sitting rest* Curve fitted to data by method of least squares. The average ventilation rate of sAna subjects under similar conditions was found to be 8.9 L/min., BTPS. Curve la - Similar to curve 1 but calculated for the standard resting ventila- tion rate at sitting rest of 10.0 L/min., BTPS. (This allows easy compar- ison with other data the majority of which is calculated for a standard resting ventilation rate of 10.0 L/min., BTPS.) Curve 2 - Subjects on a bicycle ergometer doing work equivalent to 2400 ft. . Ibs./min. The same subjects when doing similar experiments at ground level had an average ventilation rate of 26.4 L/mln., BTPS. Curve 3 - Subjects doing work equivalent to 4200 ft. Ibs./min. In similar experiments on same subjects at ground level the average ventilation rate was 40.7 L/nin., BTPS. Curve 4 - "5,000 foot" standard oxygen requirement for the demand regulator. The curve represents the liters of oxygen, STPD, needed to maintain tracheal p02 =• 123 mm. with subject breathing 10 L/min., BTPS. Curve 4* - SAtle as curve 4 but oxygen floVf expressed? at NTPD. Curve 4a — "Sea level" standard for demand regulator. Liters oxygen, STPL, needed to maintain tracheal p02 » 149 mm. with subject breathing 1* L/min., BTPS. Curve 4a1 - Same as curve 5 except oxygen flow expressed at NTPD. Curve 5 - Liters oxygen, STP1, recommended by Boothby, Lovelace and Benson for use with constant flow BLB mask (750 oo. reservoir). Their recommend- ation corresponds approximately to a "4,000 foot" standard to 20,000 feet and increasing to "sea level" standard at 30,000 feet. Above this altitude oxygen flows increased to 2,4 L STPD to give an excess at 40,000 feet for Safety. Note In attached chart that-these oxygen flows maintained an essentially normal alveolar p02 up to 40,000 feet on a large number of subjects at sitting rest. Curve 5* - Same as curve 5 except oxygen flow expressed at NTPD. Comment on paper by Captain H.G.Swann* "Oxygen Requirements with Constant Flow Equipment•" OXYGEN REQUIREMENT FOR AVIATORS Oxygen requirement for aviators at various altitudes per liter of ventilation: The ventilation is always measured at ambient barometer, 37° C« and saturated. The oxygon is measured at (l) ambient barometer, 37° C, saturated and at (2) S.T.P.D, Requirement I: The amount of oxygen needed per liter of ventilation to keep the tracheal air and therefore the alveolar air normal as at sea level up to 33,000 foot whore pure oxygen must bo used. To maintain the alveolar air normal, the oxygen pressure in the tracheal air must be kept at 149 mm. Requirement lit The amount of oxygon needed per liter of ventilation to maintain the tracheal and therefore the alveolar air as though the aviator wore at an elevation of 6000 up to 37,000 feet (36,800 ft,) whore pure oxygen must be used. To maintain the alveolar air equivalent to 6000 feet, the oxygen pressure in the tracheal air must be kept at 117 mm. Altitude in thousand s of foot Baro- meter A. Requirement I. Sea level tracheal O2 = 149 mm. Amount ©2 needed per liter of ventilation at Bar,37° C, Sat, Requirement II, 6000 ft, tracheal Og = 117 mm. Amount O2 needed per liter ventilation at Bar,37° Ce Sat, c. B,L,B, Recommendation per liter ventilation at Bar, 37° C, Sat, Oxygon measured at Oxygen measured at Oxygen measured at Bar, 37° C, Sat, S. T.P.D. Bar, 37° C, Sat, 3.T.P.D. Bar* 3?o C,Sa-U I S.T.P.D, 5 632 0,06 0,04 — MW WM 10 523 0.13 0.07 0.05 0.03 0.09 0,05 15 429 0.23 0.10 0.12 0.05 0.18 0.08 20 349 0.36* 0,13 0,23 0,08 0.28 0.10 25 282 0,54 0.15 0,37 0.10 0.51 0.14 30 226 0.79 0.16 0.56 0,12 f'' CD • O 0.18 33 196 1.00 0.17 0,73 0.12 35 179 1.00 0,15 0.80 0.12 1,45** 0.22 37 164 1,00 0,13 • O O 0.13 40 141 1,00 0,11 1,00 0,11 2,69** 0,25 Table 2 c Harch 1941 •• Note the safety factor as the result of the excess flow at high alti tudos« • For example, for each liter inspired the mixture is composed of 0.36 liters oxygen taken from the tank and 0.64 liters taken from the atmosphere, both measured at Bar, 37° C, Sat, The value 0.36 liters is reduced to 0.13 liters •when measured at S.T.P.D, which is the convenient expression for the supply officer to calculate the amount available in his tanks as the oxygen in the tanks is dry. I II III IV Measured at Measured at Measured at Weighed at Eleva- Bar. E. 37° C, *at-. B, Oo C. Dry 760, 0° C. Dry 1 760, 0° C. Dry tion Press, 02 Air vt. 02 Air Vt. i 02 i Air -11 L 02 Air Vt. Feet — inra. Liters liters Liters [} Liters Liters Liters ] Liters i Liters j biters Grams Grams Grams 0 1' 760 10.0 10.0 !i 0 8.26 8 c 26 1 0 ! 8 *-26 2 8.26 0 10.683 10.683 5,000 632 0,58 9.1*2 10,0 0.1*7 7.68 8,15 0.393 : 6.385 6.78 | 0,562 8.256 8.818 10,000 “^23 lo32 — 10.0 1.06 6*96 6toi 0.72:1 ! 1*-78y 5..51 ! IcOUO" 6,190 7-230 15^,000 1*2 9 1 2.29 7.71 10.0 1 1.80 6.05 7.81* i.oii* : 3.1*12 J*4*3 J 1. .1*1*9 U-U.2 5.861 20,060 3l*9 t 3-60 6.I4O 10.0 2.7 i* I*.88 7.62 r 1.260 t 202UO 3.50 1 1.801 2.896 1 U.697 25^000 282 i 5.39 u.61 10.0 3.96 3.38 7.31* lMj.68 I 1,255 .2,72 „ j 2-°98 I 1.623 3.721 30,000 ■-225" “ j 7.90 2.10 10.0 5.51 i.y> 5,97 1.633 | 0,136 2.07 2.3U1 0,561* 2.905 33,000 196 I 10.02 0 10,0 6.66 0 6.69 1.730 ! 0 1.73 ! 2.1*72 0 2.1*72 ~T±1— (.2) rrSrn U) ' ~W "TtT" hTsr ~T9) I (10) ntil ! (12) (13) (lit) O2 Coinr Aviate*? • Cols. £ >, 7 and 8 are Cols. 9, 10 and 11 are jl Col. Col® Col. { from = 10 L, quiet Cols, 3, U and 5 Cols„ 3, h and 5 12 - 13 *■ lh ' j Table - Col.j Vt. = t multiplied by factor multiplied by factor Col. Col. Col. 2 G a 10 L, B-U7, 273 B-li? .. 273 j 1 9 x 10 x 9 + 1 1 B 273 + 37 755" 273 + 37 1 1.1*29 1.293 Cob 10 (1) It is suggested that the overall instrumental tolerance of the demand valve at ary altitude should not exceed 0.5 Liters, STPD ( + 0.25> liters from mean) on basis of 10 L./min* ventilation msasured at B„ 370 C. sat. However, if Dossible, the tolerance should be limited to 0,3 liters, STPD (+ 0.l5 liters from mean). (2) At lower altitudes the initial proportions of oxygen may vary between the sea level (or possibly the 2,5>00 foot Level) and the 5,000 or possibly 6,000 foot level. (3) On the lower limit of tolerance the air inlet must always completely close at 33,000 feet to give 100$ oxygen. This is necessary to maintain a normal sea level concentration of 1U9.3 mm. oxygen in the inspired air, saturated vith moisture at 37° 0, (U) On the upper limit of tolerance the air inlet must close at 29,000 feet; preferably it should close at 30,000 Dr 31,000 feet. (5) On chart XII-13 tl e vertical hatched areas along the oxygen and air requirements when measured volumetrically at ?60, 0° C., dry, indicate the extreme limits of tolerance. The values for other methods of expression, of course, can be readily calculi ted. Table 2 G e August 19U3 Walter k« Bcothby IIAYQ AERO RED ICAL UNIT OXYGEN AND AIR ADDED TO INSPIRED FIXTURE REQUIRED TO MAINTAIN AT VARIOUS ALTITUDES THE PRESSURE OB' OXYGEN EXISTING IN TRACHEAL aIR OF THE SEA LEVEL EQUIVALENT OF 1U9.3 m. WITH a SUGGESTED LLalT OF TOLERANCE FOR THE Altitude Total ©2 in Insp* Mix., Dry, to maintain in Tracheal Air,Sat* p02 = 149,3 nn. O2 added per Liter Insp, Mix, Both measured at B. 37° C. Sat. . O2 Used by Aviator from Tank The Og measured at 760, 0° C, Dry The respiration measured at B, 37° C, Sat, For each dui ot Wo rking Elev- ation Bar* Pros. liter resp. Breathing 10 L,/nin, Breathing 20 L,/nin, Breathing 30 L,/min, Foot inn* nn* Per cent Liters \ Per cent Liters Liters Liters Liters 0 " 760 159,1 20.93 0 0 0 0 0 0 5,000 632 161.3 25,52 0.058 5.8 0,0393 0*4 0.8 1.2 10,000 523 164.6 31.36 0.132 13.2 0.0728 0,7 1.4 2.1 15,000 429 167.7 39.09 0.229 22.9 0.1014 1.0 2.0 3.0 20,000 349 172.6 49,46 0,360 36*0 ’ 0,1260 1.3 2.6 3.9 25,000 232 179.2 63.55 0.539 53,9 0.1468 1.5 3.0 4.5 30,000 226 188.6 83*45 0,790 79.0 0.1638 1.6 3.2 4.8 32,934 197 196.0 99*49 0.994 99.4 0,1728 1.7 3.4 5.1 33', 000 196 196.3 100.20 1,002 100.2 0,1730 1.7 3.4 5.1 Above this altitude an oxygen pressure of 149.3 mm. cannot be maintained in the inspired air because total barometric pressure i s insufficient as there is 47 nn. pressure of water vapor at 37° C. 35,000 179 ! 100 1.0 (. 100 0.1530 1.5 3.0 4.5 40,000 141 j 100 1.0 100 0.1090 1.1 2.2 3.3 42,000 128 L — 100 1.0 100 0,0939 0.9 - 1.9 2.8 Table 2 G (a) August 1943 OXYGEN REQUIRED TO MAINTAIN IN INSPIRED AIR B. 37° C, SAT. THE EQUIVALENT PRESSURE EXISTING AT SEA LEVEL. OF 149.3 MM. Mayo Aoro Medical Unit Rochester, Minnesota Altitude Elev- Bar. ation Proa. Total O2 in Insp. Mix,, Dry, to maintain in Tracheal Air,Sat. pO? = 122,5 mm. O2 added per Liter Insp, Mix. Both measured at B, 37° C, Sat, ©2 Used by Aviator from Tank Tho O2 measured at 760, 0° C. Dry, The respiration measured at B. 37° C. Sat* For each liter ,T2L.gP» Ouiot Working Breathing 10 L./min. Breathing 20 L./min. Breathing 30 L./min, Feet mm. mm. Per cent I j Liters Per cent Liters Liters Liters Liters 0 760 1 ~ — — — — — • — 5,000 632 132,3 20.93 0 0 0 0 0 0 10,000 523 134.6 25.74 0,061 . 6.1 0.0336 0.3 0.6 0.9 15,000 429 137.6 32,07 0.141 14.1 0.0624 0.6 1.2 1.8 20,000 349 141.6 40.57 0,248 24,8 0.0868 0.9 1.8 2.7 25,000 282 147.0 52.13 0.394 39,4 0,1073 1.1 2.2 3.3 30,000 226 154.7 68,45 0,601 60,1 0.1246 1.2 2.4 3.6 33,000 196 161,1 82.19 1 0.775 77,5 0.1338 1.3 2.6 3.9 35,000 179 166.1 92,79 0.909 90.9 0.1391 1.4 2.8 4.2 .36,000 170 169.3 99.59 0,995 99.5 0.1418 1.4 2.8 4.2 36,170 169 1 169.7 100.41 1.005 100,5 0,1420 1.4 2.8 4.2 Above this altitude an oxygon pressure of 122, 5 nn. cannot be maintained in tho inspired air because total barometric pressure is insufficient as there is 47 mm pressure of ■water vapor at 370 C, 37,000 162 100 1.0 100 0.1332 1.3 2.6 3,9 40,000 141 100 1.0 100 0.1090 1.1 2,2 3.3 42,000 128 100 1.0 100 0.0939 0.9 1.9 2.8 Table 2 G (b} August J.943 OXYGEN REQUIRED TO MAINTAIN IN INSPIRED AIR B. 37c C. «AT, THE EQUIVALENT PRESSURE EXISTING AT 5/000 FEET OF 122,5 MM, Mayo Aero Medical Unit Rochester, Minn, 1 O2 Used by Aviator from Tank Total O2 in Insp, Mix*, Dry, O2 added per The Og measured at 760, 0° C, Dry, The respiration measured at B, 37° C. Sat, Alti tude to maintain in Liter Insp, Mix, For each Cluiot Working Elev- ation Bar* Pres. Trachea pO? = 1 Air,Sat, 117,7 mm, ! Both measured at B, 370 C, Sat. liter resp, Breathi ng 10 L,/min, Breathing 20 L,/min, Breathing 30 L./min, Feet m. nn, 1 Per cent ] Liters 1 Per cent Li tors Liters Liters Liters 0 760 — — — ~ ... 1 —— 6,000 609 127 o 5 20,94 0 0 0 0 0 0 10,000 523 129,3 24.72 0.048 4.8 0.0265 0.3 0,6 0,9 15,000 429 132.2 30.82 0.125 12,5 0.0553 0,6 1.2 1.8 20,000 349 136.1 39,00 0.228 22,8 0,0798 0.8 1,6 2,4 25,000 282 141* 2 50,07 0,369 36,9 0.1005 1.0 2.0 3,0 30,000 226 148,7 65.80 0.567 56.7 * 0*1176 1.2 2.4 3,6 33,000 196 154.8 78,98 0.734 73,4 0.1268 1.3 2.6 3,9 35,000 179 159,6 89,16 0.863 86.3 0.1320 1.3 2.6 3.9 36,000 170 162,7 95*71 0,945 94,5 0,1347 1.4 2.8 4,2 36,651 165 164,5 99.70 0.997 99.7 0,1364 1.4 2.8 4.2 36,799 164 , 165.0 100.61 1.007 100.7 0,1364 1.4 2.8 i 4.2 37,000 162 Abo nal i s ve this alt: ntained in i insufficion 100 Ltudo an the inspi fc as then 1 1.0 1 oxygon press red air bee. e is 47 mm. 1 100 sure of 117,7 ’.use total ba pressure of lj 0,1332 mm, cannot b romotric pres vrater vapor a 1.3 e sure t 37° C, 2.6 1 3,9 40.000 42.000 141 128 100 100 1.0 1.0 100 100 | 0,1090 • 0.0939 1 1 1.1 0.9 2.2 1.9 3.3 2,8 Table 2 G (o) August 1943 OXYGEN REQUIRED TO 1.IAXNTAIN IN I1TSP RED AIR B. 37° C. SAT. TEE EQUIVALENT PRESSURE EXISTING AT 6,000 FEET OF 117.7 MH. Mayo Aero Medical Unit Rochester, Minnesota EXAMPLE OF CALCULATION 3oa Leva I Requirement Mayo Aero Medical Unit STPD = Standard temperature, 0° C,, and pressure, 760 mm,, dry, 760 mm, = Barometric pressure at sea level, 47 mm, =* Pressure of water vapor in saturated air at body temperature of 37° C, Sat, =* Air saturated with water vapor, B = Ambient barometric pressure, 0,2094 = Per cent oxygen in air, dry, 0,7906 = Per cent nitrogen and other gases in air, dry, T = Tracheal air = Inspired mixture at B, 37° C,, sat, » condition of gases in body, VT = Volume inspired nixturo measured at B, 37° C, sat. TP02 = Pressure of oxygen desired in tracheal air* For soa level equivalent = (760-47) 0,2094 = 149,3 mm, • 5,000 ft. " = (632-47) 0,2094 = 122,5 mm. " 6,000 ft. " = (609-47) 0.2094 = 117.7 mm, A VO 2 =* Volume oxygen measured at B, 37° C, sat, added to inspired mixture, AV02stpd = Vo‘Luno °*ygon, STPD, added to inspired mixture. For soa level equivalent* AVO? = 149.3 - 0,2094 (B-47) y 0.7906 (B-47) 1 149.3 0.2094 (B-47) , t „ , ,.A AV0? sa 2 - ~~z \ .1. x 1 -where Vm = 1 liter, c 0,7906 (B-47) 0.7906 (B-47) ' T AVOo « - 265 2 B-47 Therefore at 15,000 feet* AVO2 = 8,265 = 0.229 L, added per liter ventilation = 22.9$ as both measured at B, 37° C. sat. AV02STPD = 0,229 x x ■ 7L,,. « 0.1014 L. oxygen, 760, 0° C. dry, /OvJ 273 + 37 VT = 10 L, per minute when the aviator is sitting quietly (B, 37° C. sat,), s 20 L, " " n " " ■ doing light work " • * " = 30 L, " " »n it i»h fairly heavy work (B,37o C.sat.), lOg =* Amount of oxygen in inspired nixturo dry consisting of (a) the oxygen in air, and (b) the oxygen added necessary to maintain the desired oxygon equivalent* PI02 = 149.3 x — = 167,7 nun, 429-47 %102 = i|Z|Z x 100 « 39,09$, Table 2 G (d) August 1943 A3 titude Total 0g in Insp, Mix., Dry, to maintain in Tracheal Air, Sat. p0o = 143,5 mm- O2 added per Liter Insp, Mix, Both measured at B. 37° C, Sat. j O2 Used by Aviator from Tank The O2 measured at 760, 0U 0, Dry The respiration measured at Bt 37° C« Sat, For each liter rasp , Quiet Working Elev- ation Bar, Pros • Breathing 10 L./min, Breathing 20 L,/min. Breathing 30 Lft/min, Feet nn, mm. | Per cent Liters Par cent Liters Liters Liters Li tars o~ 760 153 04 20 c 94 0 0 0 0 0 5,000 632 155., 1 24.51 0.045 4,5 0.0349 0.3 0.6 0,9 10,000 523 157 c 8 30 a 19 0,117 11.7 0,645 0,6 1.2 1.8 15,000 429 161 .3 37.61 0 0 211 21.1 0,934 0,9 1.8 2.7 20,000 349 165.- 9 47 c 53 0.336 33.6 0,1176 1,2 2, 4 3.6 25,000 282 172.3 61,33 0-508 50,8 0 a1383 1.4 2,8 4,2 30,000 226 181.4 80*41 0 j 752 75.2 I 0.1556 1,6 3,2 4,8 32,000 206 136.1 90 c 43 0., 939 93,9 0„1728 1.7 3,4 5.1 33,000 196 | 188,8 95,12 0.951 95,1 0,1647 1.7 3.4 5.1 33,650 191 1 190,5 100c00 1.000 100.0 0.1664 1.7 3.4 5.1 i r 1 1 Above this altitude an oxygon pressure of 143.6 mm. cannot be maintained in the inspired air because total barometric pressure is insufficient as there is 47 mm, pressure of water vapor at 37° c. 1 U-— — 35,000 179 100.0 1.00 100.0 0.1530 40,000 141 100.0 1.00 100,0 0.1089 42.000 128 — 100,0 1.00 100.0 0,0939 Table 2 G (f) January 1944 OXYGEN REQUIRED TO MAINTAIN IN INSPIRED UR B. 37° C, SAT* • THE EQUIVALENT PRESSURE EXISTING AT 1,000 FEET OF 143.6 MM* Mayo Aero Moiioai Unit Rochester, Minnesota rO >. 3 “3 Based on data obtained in a low pressure chamber Series of 9 experiments on 6 subjects computed on a basis of a ventilation rate of 10 liters per minute lung condition or, at sea level, 8.3 liters per minute S.T.P.D. ARO Regulator No 4902 DILUTER DILUTER SAVING OF OXYGEN BY USING DILUTER MAYO AERO MEDICAL UNIT DILUTER DILUTER DILUTE R OFF XVIII- I A July 1943 DILUTER SAVING Of OX YG E N. B_Y USING DILUTER AND ECONOMIZER BAG ARO REGULATOR NO. 4902 DILUTER MAYO AERO MEDICAL UNIT DILUTER DILUTER BLACK INDICATES OXYGEN WASTED WITHOUT BAG XVIII- IB Liters per minute of oxygen used S.T. P.D. MAYO AERO MEDICAL UNIT DATA FROM HIGH ALTITUDE LABORATORY Group III PERCENT SATURATION HEMOGLOBIN DETERMINED BY V (a) Van Slyko blood gas analysis, (b) oxineter and (o) alveolar p02 (1) III-10f March 1943, W#M,Boothby and R«F*Rushner# (a) Calibration oxineter, (b) Comparison of oxineter reading and alveolar p02 when oxineter set at 100$ on oxygen it is found henoglobin is 97$ saturated, when subject is breathing air, (2) III-10g March 1943, W,M,Boothby and F,J.Robinson# Sane as in (l) except conditions of experiment slightly different# (3) III~10h May 1943, replotted July 1945, W.M.Boothby, The data of (l) and (2) replotted to show direct correlation percent saturation by oxineter against barometric pressure# (4) III-10k May 1943 data replotted April 1946, W#M#Boothby# The averages of data in (3) are plotted together with data fron Naval Medical Research Institute, Bethesda# (5) Ill-Boa February 1943 replotted April 1, 1943 and again July 1946# M H*Powor, J,P.Marbarger and 0,B,Taylor# Arterial henoglobin saturation by blood gas oonpared with oxineter at high altitudes with and without positive pressure# (S) III-80 February 1943, replotted July, 1946# M#H,Power, J,P,Marbarger and C#B,Taylor# Mayo Aero Medical Data and Wright Field data with and without positive pres sure# ALVIOLdR OXYCIH PRESSURE ts OXIMETER READING In this ohart ars plotted tho individual obsorratlons as averaged for altitude in prsosodlng chart III-10d. O * Oximeter sat at 95* with subject breathing air at ground laral X ■ Oximeter sot at 100* with subject breathing oxygen at ground level. All subjects »t sitting rest. The oxyhemoglobin curves for whole blood are those reported by Major Dill and have boon redrawn from PHYSIOLOGY Of FLIGHT, Bright field, 1940-42, page 15. Boothby and Robinson March 1949 ' s This ohart mows tha ootre Lation of tha ' oximeter ratings (oxlmote' set at 100* / subjects braat ling oxygon at [round lowel) / and the par oo it saturation o hemoglobin calon .ated from the ilreclar oxygen pressure, TOT£ 10-' rlcatly mai (ST This lata same aa th it shown by oro isea in ohart Ill-DB. dll sub J ec is at sitting Tint. Calculations if psr osnt sat iration fro. al 'solar oxygon prsssnra worn based on tha s yhaaaglohln d s.oolstlon onrra of Uajs ■ bill for whsl > blood, pi 7.4 PIYSICLOGT 0> FLIGHT, Bright Maid, 1940-4Z page 15 / Mayo Aero Medical Unit COMPARISON OF OXIMETER READINGS AND ALVEOLAR OXYGEN PRESSURES toirtlti Hoy. Oxiaotor Ho. of Oximotor A1t.02 root «.t on Obsorr. Readings Pt.m, 1,000 Air 21 99 99 [ground) Onr<«» . 12 97 no 3,000 Air 34 94 89 Oxytfen e 95 90 0,000 Air 33 91 74 Onrion 10 93 75 9,000 Air 32 68 61 8 90 84 12,000 Air 36 63 50 Oxrtmn 10 87 54 15,000 Air 33 78 42 OXYfOIl 7 80 46 17,000 Air 13 79 39 Oxygon 2 74 12 Humber of observations • 259. Observations averaged for each altitude. Alveolar air, Haldane-Priestly methodi O • Oximeter set at 95* with subject breathing air at ground level. * - Oximeter ,»t at 100* with subject br.athlpg oxygon nt ground Isrsl. The Individual observation* comprising the averages are shown in chart III-10B. All subject* at sitting rest. The oxyhemoglobin dissociation curve* for whole blood are these reported by Major Dill and have been redrawn from PHYSIOLOGY OP PLIGHT, Hright Field, 1940-42, page 15. III-10A Boothby and Robinson March, 1943. ■hi* ohart shows tho calibration data on tho oximeter usad in this aboratory (Coleman Modal 17, 5769) obtained by analysis of tha mygan oapaolty and content of tha artarlal blood by tha manom.trlo aohnlo of Van Slyka and Heill. Subjects at lying rest. A1 _a,_ Boothby and Robinson March, 1943. (1) Beat - fitting In ohalr. Wort - stepping onto 5 Inch atool 1« tines per minute with metronome aet at 80 to obtain S beats to alternate legs used for eleeatlon. (2) Alveolar air methods! (a) Haldane-Priestly. (b) Rebreathing method with single expiration rebreethed 3 tinea. Oximeter set at 100* with subject breathing oxygen at ground level. The oxygen dissociation curves for whole blood are these reported by Major Bill and have been redrawn from PHYSIO LOGY OP PLIGHT, Wright Pleld, 1940-4Z, page 15. Boothby and Inblnaon Marok 1943 The observations ere averaged according to method of obtaining alveolar »lr at both root and at work for each altitude. /®1#T• iOtlT- Air. Air Ho. of Oximeter - Air. ©2 Foot Method(21 ObsorT. Reading Press. 1,000 Re.t 0 Halds.no 20 96 105 (dround) R««t A Robroatb- 20 96 102 Work x Haldane 27 95 97 Work ♦ Robroatb. 30 96 89 10,000 Rost O Haldano 6 86 60 *«■* A Robroatb. 6 89 59 Work X Haldano 11 85 57 Work -t Robroatb- 12 83 SI 12,000 Root O Haldano e 86 54 Rost Ck Robroatb 6 86 53 Work x Haldano 15 82 50 Work Robroatb. 11 82 <5 14,000 Rest O Haldano 6 85 50 R..t A Robroatb- 6 84 47 Work x Haldano 10 80 49 Work ■¥ Robroatb- 11 Bf rtlllTitlMI * Z07. 78 42 C ;— / This chart she :a the correla- / ° tion of oxlmet r readings / (oxlr.otar set at 100}' wl ;h subjects breathing oxygen at grou id level) and the per cent eituretlon of heniglobin calcu- lated from alveolar oxygen pressures. —/■ tlv-oelaP 'alf-Hj-mbPoathitg methcri / 0 • maximum exilratlcn rcbrea'ted 3 times. / X e maximum orilratlon rebre-tked 4 times. This date a as a aa that ahowi by circles andlcrosaea In chart III-101 . All subject, at sitting raaR. Calculations or per cent sett ration from aleeolar oxygen pres cure were >aaad on the o: yhomoglobln dll sedation ourv< cl Major Bin 'or whole hloo, , pH 7.4, PHYSIOLOGY OP / PLIGHT, bright Plaid, 1940-4! page 15. / OXIMETER READINGS IE PER CENT OXYHEMOGLOBIN Mayo Aero Medical Unit COMPARISON OF OXIMETER READINGS AND ALVEOLAR OXYGEN PRESSURES P2R CENT OXYHEMOGLOBIN CALCULATE? PROM ALVEOLAR OXYGEN PRESSURE OXIKfTXR READINGS IN P1R CENT OXYHOIOCLOBIN III-10* In tkla chart are platted the Individual observations whloh were averaged for altitude In proceeding ohart I1I-10C. Alveolar air by robreathlng method! O e maximum expiration rebreathod 3 times. X - maximum expiration rebreathod 4 times. Oximeter set at 100)1 with subject breathing oxygen at ground level. All subjects at sitting rest. The oxyhemoglobin dissociation ourvos for whole blood are those reported by Major Dill and have been redrawn from PHYSIOLOGY OP PLIGHT, Wright Pleld, 1940-42, page 15. I1*T. Vo. of Vo. of Oxla*tor ▲It.02 1,000 3 xo 98 96 (tfround' « • 9« 10« 3,000 3 10 95 85 * e w 85 6,000 3 10 92 n 4 8 s* 71 9,000 3 10 88 59 4 e 89 59 12,000 3 10 83 47 4 8 83 47 15,000 3 8 77 40 4 8 77 40 Obaorvntlcno averogod for each altitude. Number of observations • 100. Oximeter aet at 100)1 with subject breathing oxygen at ground level. The Individual observations comprising the averages are shown in chart III-10D. All subjects at sitting rest. The oxyhemoglobin dissociation curves for whole blood are those reported by Major Dill and have been redrawn from PHYSIOLOGY OP PLIGHT, Wright Pleld, 1940-42, page 15. Bootbly and Robinson Usrch 1943 JH-lo G Alveolar air by rebreathing method! A - maximum expiration rebraatbed 3 times. Q - maximum expiration rebreotbed 4 tlaiett. III-IOC III-10D KieOaOOHSHAXO IMO Mid KI OKIdTlH MlilNIXO PERCENT SATURATION HEMOGLOBIN PLOTTED AGAINST BAROMETRIC PRESSURE x AVERAGE INCREASED 2 5 TO OBTAIN APPROXIMATE CORRECTION FOR ORIGINAL SETTING AT 95% INSTEAD OF 97% OR 98% Smoothed curves obtained by reading ; First the average alveolar oxygen ‘ pressure read from smooth curve A on chart X- 6b, Mayo Aero Medical Unit (some as chart A-I in Handbook of Respiration on Data m Aviation prepared by Subcommittee on Oxygen and Anoxia of CAM for CMR , OSR D.) Second the corresponding percent saturation Hemoglobin read fr®m Dills Oxygen Dissociation Curve, pH 7.4 (Fig. 9 Physiology of Flight 1940-1942. Wright Field. A AF) W.M.Boothby, July 1945 AT BEGINNING OF RUN OXIMETER SET AT 95% SATURATION WITH SUBJECT BREATHING AIR AT GROUND LEVEL, 1000 FT. Work accomplished by subject stepping up on 5 inch step 16 times per minute in time with a metronome set at 80 times per minute to obtain 5 beats to alternate legs used for elevation by introducing an extra non-elevating step on the floor SUBJECT AT REST Breathing air at ground level SUBJECT AT WORK Breathing air at ground level ALTITUDE - THOUSANDS OF FEET Replotting data of Boothby and Robinson, CAM Report No 163, June 1943 AVERAGE OF ACTUAL OXIMETER OBSERVATIONS AT EACH ALTITUDE INDIVIDUAL OBSERVATIONS AND UNCORRECTED AT BEGINNING OF RUN OXIMETER SET AT 100% SATURATION WITH SUBJECT BREATHING OXYGEN AT GROUND LEVEL, 1000 FT SUBJECT AT REST Breathing oxygen at ground level SUBJECT AT WORK Breathing oxygen at ground level CHART HE -10H MAYO AERO MEDICAL UNIT AVERAGE PERCENT SATURATION HEMOGLOBIN - OXIMETER Data from the Mayo Aero Medical Unit - 1943 Oximeter set at 100# - Subject breathing oxygen Or Not over 10 minutes a1 progressively increasing altitudes Oximeter set at 95# — Subject breathing air J irve A; Obtained by reading: First the average alveolar oxygen pressure read from smooth curve A, chart A-l, handbook of Respiration, Subcommittee on Oxygen and Anoxia N.R.C, Second the corresponding percent saturation hemoglobin from Dill's dissociation curve, pH 7.4, Fig, 9 Physiology of Flight 1940-1942, Wright Field,AAF, Data fror. the Naval Medical Research Institute. Bethesda ® Less than 10 minutes at progressively increasing altitudes • More than 15 minutes at progressively increasing altituds (not over 30 minutes) Curve 3s chart B—4 in Handbook of Respiratory Data in Aviation, Subcommittee on Oxygen and Anoxia, N.R.C, Chart III—10k W, M, Boothby, April, 1946 ALTITUDE - THOUSANDS OF FEET AVERAGE OF 154 DETERMINATIONS ON 5 MALES AVERAGE OF 209 DETERMINATIONS ON 9 MALES AND 3 FEMALE OXIMETER READING PERCENTAGE SATURATION HEMOGLOBIN MAYO AERO MEDICAL UNIT ARTERIAL BLOOD OXYGEN CONTENT DETERMINATION VS OXIMETER READINGS COLEMAN OXIMETER-MODEL 17, NO. 5769 ARTERIAL BLOOD OXYGEN (PERCENT CONTENT SATURATION) OXIMETER OXYGEN PERCENT SATURATION HI- 8 Ca Power, Toy lor , Marbarger March 1943 No pressure 20 cm. water pressure 40-46 cm. water pressure MARCH . 1943 NUMBERS = MINUTES BEFORE SAMPLING AT ALTITUDE. MAYO AERO MEDICAL UNIT ARTERIAL BLOOD OXYGEN CONTENT BREATHING OXYGEN WITH AND WITHOUT PRESSURE ALTITUDE - THOUSANDS OF FEET No pressure - Physiology of Flight Wright Field , 1940 - 42, Fig. 8 nr- 8 - c POWER, TAYLOR AND MARBARGER ARTERIAL OXYGEN PERCENT OF CAPACITY MAYO AERO MEDICAL UNIT DATA FROM HIGH ALTITUDE LABORATORY Group IV VITAL CAPACITY (1) XIX-2b September 1943, H,A,Robinson and r*J*Reblnson Method of measurement - Error produced by absorption of C02 (2) XIX-2a September 1943, A,Robinson and 3T*J*Robinson Method to determine effect of positive pressure breathing* (3) XIX-2c September 1943, H*A*Robinson and y,J,Robinson Effect of positive pressure breathing on relation of oomplinental and reserve air* (4) XIX-2d September 1943, H*A*Robinson and I**J*Robinson Error in vital capacity by absorption of C02 - Greater the higher the altitude. yASSUMPTION - RBSP/PATORY R* 0R£ArHIAj 6 S*7AZK J. WATER MANO M £. T£R MAYO AERO MEDICAL UNU APPEMD/X E/G. I JiA '2. d MAJ. H A. ROBINS ON,MC SEPfWZm F.J. ROBINSON, M.D. Mayo Aero Medical Unit EFFECTS OF POSITIVE PRESSURE BREATHING ON I RELATION OF COMPLEMENTAL AND RESERVE AIR IN PERCENT OF VITAL CAPACITY AT ALTITUDES VARIATION IN LEVEL TIDAL AIR A - 'NORMAL CpNTRQL D = RETURN NORMAL CONTROL B •..POSITIVE PRESSURE BREATHING[ - 20 Cm. HzO i J WITH CORRESPONDING COUNTER PRESSURE C = Positive PRESSURE BREATHING-EO cm. NzO NO COUNTER PRESSURE APPENDIX FIG. HI r J t rH - - COMPLE MENTAL AIR \fM % OF VITAL CAPACITY- RESERVE AIR __ in % of vital Capacity !ii i X1Z- C MAJ. HA. ROBINSON, MC SEPT. 1043 F O. ROBINSON, wa Mayo Amo M&^jaLMmL ir/TAl $A PA CiTV ~\—Q 37°\c XAT~ APPEND FIG. I(LrALSAPAQ/.Ty| - WiTM AND i/JTUQUT SODA LIME IN SYSTEM NEAR L£L XJBJF PK. _L -u>_U-4-j- 4- WITHOUT SODA LIME /* SYSTEM S~ w\tn limb in system HZ- Zd MAYO AERO MEDICAL UNIT DATA FROM HIGH ALTITUDE LABORATORY Group V VOLUNTARY HYPERVENTILATION (1) X-12(a,b,c,d#) November 1941, Redrawn 1944, W#M,Boothby, R.F.Rushmer and J, Wilson# Graphic representation of data on 4 subjects. Ventilation rate. Respiration Rate, °xygen Consumption, Alveolar and Expired Air R#CL,, Alveolar p02, Alveolar pC02 and C02 deficit© (2) X*l0 November 1941, Redrawn 1944, R,F#Rushmer, J,Wilson and W#M,Boothby, Variation of alveolar pC02 with ventilation rate© (3) X-ll November 1941, Redrawn 1944, R.F.Rushmer, J#Wilson and W,M#Boothby- Variation of alveolar pC02 with body deficit C02, (4) X-13a October 1941, W.M.Boothby# Respiratory curves on subject R#T,P, with notes* (5) X-13b October 1941, W.M.Boothby, Respiratory curves on subject H• Vf• B• with notes# (6) X-I3d October 1941, W»M*Boothby, Respiratory curves on subject J„W.W, with notes# VOLUNTARY HYPERVENTILATION Graphic representation;on four subjects MAYO AERO MEDICAL UNIT Oort No. X- 12 a TIME IN MINUTES Moyo A#ro Modicol Unrt Chart no X -12 b TIME IN MINUTES Booth by , Ruth mar and Wilton Chort no- X - 12 - d Mayo Atro Modicol Unit TIME IN MINUTES Chart no. X-I2(a,b,c,d) Mayo Aero Medical Unit Chart no. X - 12 c ° Mayo Aero Medical Unit TIME IN MINUTES Boothby, Ruehmer and Wilton Nov 194-4 VOLUNTARY HYPERVENTILATION VARIATION OF ALVEOLAR C02 WITH VENTILATION RATE SUBJECTS R FR JWW RIP RWB NORMAL BREATHING VENTILATION RATE MAYO AERO MEDICAL UNIT CHART NO. X- 10 Rushmer,Wilson and Boothby OCT. 1944 VOLUNTARY HYPERVENTILATION 1 \ VARIATION OF ALVEOLAR C02 WITH BODY DEFICIT C02 SUBJECTS R F R J W W RTF R W B ALVEOLAR CO2 mm. Hg. DEFICIT BODY CO2 IN LITERS STPD MAYO AERO MEDICAL UNIT CHART NO. X-ll Rushmer, Wilson and Boothby Oct. 1944 mayo aero medical unit VOLUNTARY HYPERVENTILATION Subject RTF SirSRIMKNT B Sept. 18, 1941 EXPSRlUKNT A Normal Breathing Oot. 9, 1941 Normal Breathing Hyperventilation Car 17.3 mlnutea. Ventilation rate: 2.5 timer normal. Reaplratlon rate: 2,0 times normal. Hyperventilation for 17,3 minutes. Ventilation rate: 2.0 tiaea normal. Besplratlon rate: eeeentlally normal. lat. Period let* Period (Upward trend due to leak around neck of subject as he was breathing Inside coffin.) 2nd. Period 2nd. Period 3rd. Period 3rd. Period Recovery le*. Period Recovery 2nd. Period Mo subjective symptoms noted. On stopping hyperventilation irregular breathing for 1 minute, quickly becoming normal. No subjective symptoms produced and breathing vaa essentially normal after stopping hyperventilation. KXFBRBfXNT C Oot. 22, 1941 SXPKRIMENT D Oot. 4, 1941 Hyperventilation for 17.9 mlnutea. Ventilation rate: 3.0 times normal. Respiration rate: essentially normal. Hyperventilation Tor 9 .ft minutes. ▼••tuition rate; 3.6 times normal. Respiration rate: essentially normal. let. Period Ut. Period 2nd. Period 3rd. Period Sad. Period Recovery lot. Period T°.«ra. «nd of 2nd. hyparrantllatlon p«rlod the sublet no tad nun.bo.gs of f*o. ul flngars; oarpopsdal spasm was marled. Subjaot b.oam. wary weak and .ip«lm«it was dl.oontlnu.d. It was impossible to obtain tracing of the respiration during recovery. 2nd. Period No special subjective symptoms recorded, but following the voluntary hyperventilation the subject continued to breathe somewhat deeper, although more slowly than normal for l£ min., followed by the developnent of a rather typical Choyne-Stokos• rhythm for about 5 min.; respiration then continued shallow with less marked rhythm. (Downward trend of curve due to leak around neck of subject as he was breathing inside coffin.) Chart no.X - 13 a MAYO AERO MEDICAL UNIT VOLUNTARY HYPERVENTILATION Subject RWB EXPERIMENT A Normal Breathing Oct. 8, 1941 EXPERIMENT B Normal Breathing Oct. 14, 1941 Hyperventilation fbr 4.0 minutes. Ventilation rate: 7.1 times normal. Respiration rate: 1.7 to 5.0 times normal. Hyperrentilatlon for 17.7 minutes. Ventilation rate: 2.6 times normal Respiration rate: 2.3 times normal. let. Period let. Period After 3 minutes of maximal voluntary hyperventilation the subject passed into stage of Involuntary hyperventilation of a panting character which continued a minute or more, ending finally in complete apnea. An alveolar air sample was obtained with difficulty towards end of period of involuntary hyperventilation. 2n' Period Racorery 3rd. Period The apnea was complete for more than 1 minute followed by shallow and irregular breathing with sereral short periods of apnea for about 3 minutes. The respi- ration remained irregular and shallow for the next 8 minutes, gradually becoming more normal. Although tracing for first 13 minutes of recovery was obtained, it was impossible to collect the expired air for the metabolian determination. Racorery No symptoms noted. After hyperrentilatlon ceased the respirations remained irregular for ebout 2 minutes, followed by one minute of rery shallow respi- ration amounting almost to an apnea. Breathing then tended to become normal. EXPEH IMEi .T C Normal Breathing Sept. 18, 1941 Normal Breathing EXPERIMENT D Sept. 30, 1941 Hyperventilation for 19.0 minutes. Ventilation rate: 2.0 times normal. Respiration rate: essentially normal. Hyperventilation for 16.3 minutes. Ventilation rate: 2.8 times normal. Respiration rate: essentially nc-rmal. let. Period 1st. Period 2nd. Period 2nd. Period 3rd. Period 3rd. Period Recovery Reo orary During the hyperventilation the respirations were maintained deep and regular throughout. In the 15th. minute he became dizzy and on stopping hyperventilation he continued breathing deeply for £ minute; the respirations were then shallow and irregular for 1 minute, after which breathing tanded to became normal. Sood deep and regular breathing during hyperventilation. Following last alveolar air still automatically continued to breathe deeply for nearly a minute, then shallow breathing for 2 minutes, and axcer that the respirations were normal. Chart no. X - 13 b Dec. 1944 MAYO AERO MEDICAL UNIT VOLUNTARY HYPERVENTILATION Subject JWW. SXPEhlME.T k Normal Breathing Oct. 13, 1541 EXPERIMENT B Normal Breathing 3ept. 17. 1941 Hyperrentilation for 18.0 minutes. Ventilation rcte: 2.1 times normal. Respiration rate: 2.1 times normal. Hyper-rentllatlon for 10.3 minutes. Ventilation rate: 2.3 times normal. Respiration rate; essentially normal. let. Period During the byparrac- tuation period the subject breathed rhythmically, es- pecially during the first and third periods. 1st. Period 2nd. Period 3rd. Period 2nd. Period Reoorery 3rd. Period No subjectire symptoms were noted. Following the hyper-rent Hat I on the respirations sere irregular and shallow for a short time but were definitely rhythmical. Recorepy No subjectire symptoms noted. On cessation of hyperrentilation the respirations were rery shallow and irragular for 3 to 4 minutes with occasional short periods of apnea. Following this the respirations showed a tendency to be rhythmical. EXPERIMENT C Normal Breathing Sept. 26. 1941 EXPERIMENT D Normal Breathing „0ot. 8, 1941 Hyperrenti1st!on for 11.4 minutes. Ventiletion rate: 7.S times nomal. Respiration rate: 1.7 times normal. Hyperrentilation for 18.5 minutes. Ventilation rate: 2.8 times normal. Respiration rate: essentially normal. 1st. Period 1st., 2nd., 3rd.! Periods 2nd. Period Towards the latter part of the forced breathing the respiration was slightly less deep but more rapid. IXirlng last minute of hyperrentilation the subject began to hare the following symptoms with- increasing sererlty: (1) numbness of face (2) srasm of masseter muscles interfering with oral breathing (3) carpal spasm lasted 4 minutes (4) twitching arms and forearm (5) nystagmus greater on the right eye than on the left 3rd. Period Recovery 1st. Period Following hyperrentllation the subject went into practically complete apnea lasting about 25 minutes. Symptoms so bad that recorery gasometer period was not started until subject started to breathe, and about 1 minute before end of carpal spasm the relaxation of the mnsseter muscles so that mouth pleca could be introduced. Reoorery No ambjeotire symptoms noted. Following hyperrentilation the respirations for 2 minutes were shallow and irregular, with short periods of apnea. The respi- rations then became rhythmic for sereral minutes before becoming essentially nomal. 2nd Pariod Mot until 7 minutes after hyperrentilation stopped did the auhj.ot' beTln to feel nomal, during which time breathing was Irregular and somewhat rhythmic. 3rd. Period Chart no. X- 13d Dec. 1944 MAYO AERO MEDICAL UNIT DATa FROM HIGH ALTITUDE LABORATORY Group VI NITROGEN ELIMINATION AND EFFECT OF PREOXYGENATION (1) VI-1 October 1941, J.Piocard modified by W.M.Boothby. Relative size of the air bubbles and the water volume from which the molecules must cone, (2) VII-1 October 1940, W,M,Boothby, W.R,Lovelace and 0,0,Benson, The rate of nitrogen elimination (plotted on semi-log paper). (3) Vll-la October 1940, W,M,Boothby, W.R.Lovelaoe and 0,0,Benson* The rate of nitrogen elimination (plotted on log-log paper), (4) VII-2 November 1942, F,J.Robinson, H,C«Shands and E.Larson® Comparison of (l) Gaseous nitrogen eliminated from the lungs (accumulated) while breathing oxygen and (2)'Venous (antecubital) blood nitrogen content• (5) VII-3 September 1942, F.J,Robins on. Comparison of nitrogen eliminated by heavy and light subjects (a) body weight (b) transposed proportionally for weight of 70 kgs, (6) VII-8b August 1944, J,B,Bateman® Effect of preoxygenation on degree of immunity from symptoms of bends, (7) VII-80 August 1944, J,B,Bateman® Effects of prolonged inhalation of gas mixture compared with effects of preoxygenation, (8) VII—8e August 1944, J,B,Bateman, Comparison nitrogen elimination curves from data of Behnke and Willmon with data of Lovelace and Benson, (Semi-log paper plotting fraction of normal dissolved nitrogen remaining after oxygen inhalation). (9) VII-8d September 1944, J,B,Bateman, Principle of equilibration method in study of decompression sickness (10) VII—8g August 1944, J,B,Bateman, Scores obtained after ’’equilibration” with gas mixtures, (11) VII-8f-2 September 1944, J,B,Bateman. Course of elimination of symptom-producing nitrogen. Modified from ?T<(f. Piooard CASE II Pressure Reduced from 1 Atmosphere to l/5 Atmosphere AIR BUBBLE AND WATER VOLUME Radius 1*82/* Volume 25.7/** No* Molecules Air 690 x 106 Minimum amount of water containing these air molecules Radius 7.15/ Volume 1538/r RELATIVE SIZE OF THE AIR BUBBLES AND THE WATER VOLUME FROM WHICH THE MOLECULES MUST COME / Micron ~ 0,00/ Mi///meter i - Minimum Water Volume Required To Form Bubble- Air Bubble- AIR BUBBLE AND WATER VOLUME Radius 0*365/* Volume 0*205//* , No* Molecules Air 27*6 x 10° Minimum amount of water containing these air molecules Radius 1.43/* Volume 12*2tyu3 CASE I Pressure Reduced from 5 Atmospheres to 1 Atmosphere n-i Data published in Physiology of Flight, page 27 Wright Field, 1940-1 942 Boothby, Lovelace and Benson , Oct . 1940 A Walking 3 miles per hour @ B Sitting in chair Q AVERAGES OF 133 DETERMINATIONS OBTAINED ON 17 RUNS ON 2 MALE SUBJECTS MAYO AERO MEDICAL UNIT THE RATE OF NITROGEN ELIMINATION Subject Age Ht. cm Wt. kg N.E. 23 178 71 N.D 2 1 176 73 Chart TZH- I W M.Boothbv Mav 1946 T o> H •O • 0) U B « -H ja to o +* •H O O o «n • • K, B « B 3 O +> O o -n O « .B -HO e cO "-3 O H c rO OQ O I* »w 0 o, *h e « rrj (J Li a « a o o <3 O O *> rH >-l o «0 ® -H t« T* E o e H O *9 -h b • rH +» *1 S * CO >H O U iO {e (1 V js (U rH O O O ► S n << m o MAYO ASRO MEDICAL UNIT THE RATE OF NITROGEN ELIMINATION Subject h&l cm. Wt• kgm N.fi. 23 178 71 N.D. 21 176 73 Log — log plotting of semi-log chart Physiology of Flight p. 27 Wright Field, 1940-42 Chart 231-1 a zVfAK XO sAoaso - M/TOACXKC. CSas/T C>*- * /V> Gs*\&£10CS!S A//7~/*OG>£TAS £L//vr/AjA\re:4D tt/o/vt t csa/cs rv/r/L.£ /3/?/ox\ r a. v/v&rxy/tjr~ie G/ao4 Go Ac/ .* >SS»crr7 cAs <**s /=>£/R. /V/ t Atooer/v /a/ /3t~000 13/ooc/ A/'tryzxy&si A// froa&rt /T/zm/natec/ s5t//^ec/s x -a B /VCnS ® c/=~c: YLT-a r\ T~/A*e: /as As//a/c/tj£& S Oorft* Commerce/ fo q Sod? kVerpk/ a/ 7TO k/Zas) Le&mno/ /V/? Coas/=w/?/*so/v or A//7~roG£r/v sy /-/£r\yy mo L/ght sSo&orct~*s Arf*yo A£&o-A4£D/c*/~ C/as/t~ Legend EffW (9/ k//on) (E3 k//oo) f Oo/o C/noorrecfvd for /Body J k//frogen E/fnv'nafeJ /n c.c (LxZ/PD.) m-j EFFECTS OF PREOXYGENATION DEGREE OF IMMUNITY (ARBITRARY UNITS) DURATION OF INHALATION OF OXYGEN Mayo Aero Medical Unit Chart No UTL-S b (MINUTES) JB.Bateman Aug. 1944 EFFECTS OF PROLONGED INHALATION OF GAS MIXTURES COMPARED WITH EFFECTS OF PREOXYGENATION DEGREE OF IMMUNITY (ARBITRARY UNITS) FOR SIX HOURS CD tr < FOR SIX HOURS D 5 5 FOR SIX HOURS FOR SIX HOURS DURATION OF INHALATION OF OXYGEN (MINUTES) Mayo Aero Medical Unit Chart No. m- 8 c J.B. Bateman Aug. 1944 NITROGEN ELIMINATION CURVES FRACTION OF NORMAL DISSOLVED NITROGEN REMAINING AFTER OXYGEN INHALATION FROM DATA OF BEHNKE AND W1LLMON FROM DATA OF BOOTHBY, LOVELACE AND BENSON DURATION OF OXYGEN INHALATION Mayo Aero Medical Unit Chart No. 1ZIL- 8 e J.B.Boteman Aug. 1944 PRINCIPLE OF EQUILIBRATION METHOD IN STUDY OF DECOMPRESSION SICKNESS J.Bfioteman Sept. 1944 i ■" ~~ I i ”» TIME Mayo Aero Medical Unit Chart 3ZH 8 d PERCENT INITIAL NITROGEN SCORES OBTAINED AFTER " EQUILIBRATION" WITH GAS MIXTURES SCORE LC JB RS RH FRACTION OF NORMAL DISSOLVED NITROGEN Mayo Aero Medical Unit chart yrr — ft g j g Bateman Aug. 1944 COURSE OF ELIMINATION OF SYMPTOM-PRODUCING NITROGEN FRACTION OF BODY'S INITIAL DISSOLVED NITROGEN REMAINING AFTER DESATURATION RS RH LC JB MAYO AERO MEDICAL UNIT Chart TZE- 8f- 2 DURATION OF INHALATION OF OXYGEN J.B.Bateman Sept. 1944 MAYO AERO MEDICAL UNIT DATA FROM HIGH ALTITUDE LABORATORY Group VII SITUSZQ5 TIME OF GASES AND THEIR FLOW CHARACTERISTICS THROUGH SINGLE ORIFICES AND THROUGH SPONGE RUBBER DISKS. (1) XX—1 January 1939, W.M.Boothby and H.O.Brvwn Effusion tine of gases through 0*005 inch orifice at various pressures* (2) V—3 February 1945, W.M.Boothby Repetition of experiments of Boothby, Lovelace and Benson in 1940 on flow characteristics of sponge rubber disks* (3) V—4 February 1945, H.F.Helnholz Jr. Flow characteristics of l/2" and 5/l6w orifice and 2 standard sponge rubber disks* (4) V-5 February 1945, H*F*Helnholz and W.M.Boothby Conparison of resistance characteristics at ground level and at 28,000 ft. to increase gas flows (l) l/4" orifice (2) Two dry sponge rubber disks (3} Two wet sponge rubber disks. (5) V—6 May 1945, W.M.Boothby Flovr characteristics of air, argon and helium using adjustable low re- sistance flow neter with varying number of sponge rubber disks. (6) V-7 May 1945 W.M.Boothby Sane as (5) with conparison of ground and 30,000 ft, (7) V-8 March 1946, W.M.Boothby Flovr characteristics of Oxygen using adjustable sponge rubber resistor with 1 to 6 disks* (8) V—9 March 1946, W.M.Boothby Sane as (7) for Argon. (9) V-10 March 1946 W.M.Boothby Sane as (?) for Heliun Jan. 1939 E £ E E E e e e e e 0 o o o o ro r-- o o o r- oo cvj cd ■I H ii ii H (/) -r- W H in in O in — m « O J) 3 j) □I >. Q_ 00 CL 3 — 73 — .2 z O ® a ~ v o o -p 0) I— 3 C C O Q> 1 II | I i5 * | S 1! a> jd c q. Q- E o x o UJ 3 W. M.Boothby and H.0-Brown Graham’s Law Effusion Time of Gases through 0.005 inch Orifice at Various Pressures MAYO AERO MEDICAL UNIT ■ 6 .8 1.0 1.2 \A 1.6 1.8 0 .2 .4 .6 Required for Gas to Effuse out of Bulb under Several Constant Differential Pressures Chart XX - | FLOW CHARACTERISTICS Same method as used in 1940 by Boothby , Lovelace and Benson CENTIMETERS OF WATER (PRESSURE) PRESSURE DIFFERENTIALS PRODUCED BY INDICATED VOLUME FLOW OF OXYGEN (B = 730 mm., T= 25° C, DRY) EXPRESSED AT STPD. MAYO AERO MEDICAL UNIT CHART NO. V - 3 LITERS/ MIN. STRD W.M. BOOTHBY FEB. 1945 FLOW CHARACTERISTICS VOLUME FLOW OF AIR (B = 735 mm., T* 25° C, SAT.) EXPRESSED AT STPD., AT INDICATED PRESSURE DIFFERENTIALS cr LU H < £ Ll_ O cn cn LU LU 2 H Z LU O LU OC -D (f) (/) LU LT CL MAYO AERO MEDICAL UNIT CHART NO V - 4 LITERS/MIN. STRD FRED HELMHOLZ FEB. 1945 VV T F. HELMHOLZ and WM.BOOTHBT FEB. 1945 COMPARISON OF RESISTANCE CHARACTERISTICS TO INCREASING GAS FLOWS DIFFERENTIAL FLOWMETER: LITERS PER MINUTE (AMBIENT) GROUND - 1.000 feet. B = 728 mm..T = 25°C EXP. I-a 1/4 inch ORIFICE EXP. 3-4 TWO DRY SPONGE RUBBER DISKS EXP 9-10 TWO WET SPONGE RUBBER DISKS ELEVATION 28.000 feet , B = 249 mm.. T = 25°C EXP. 5-6 1/4 inch ORIFICE EXP 7-8 TWO DRY SPONGE RUBBER DISKS MAYO AERO MEDICAL UNIT CHART NO 1C- 5 GLASS SPOON RECORDE: PRESSURE IN CENTIMETERS WATER W. M Boothby May I 945 Calibration made by constant flow of air or gas from a weighted spirometer which produced the indicated differential pressure on the two sides of the sponge rubber disks. The results are expressed at the ambient pressure and temper - ature saturated with moisture which corresponds to the de- crease per minute in the actual volume of the weighted spirometer The sponge rubber disks used in this calibration were coarser than the A- 8-B standard disk. i i i i i i i i i CALIBRATION FOR I AND 3 SPONGE RUBBER DISKS (I ) AIR AT GROUND • (2) ARGON ® (3) HELIUM 80% OXYGEN 20% Q MAYO AERO MEDICAL UNIT ADJUSTABLE LOW RESISTANCE FLOW METER LITERS PER MINUTE AMBIENT APPROXIMATE RATIO OF RATE OF FLOW WHEN USING I AND 3 SPONGE RUBBER DISKS Air I; 3.1 He 80% Oz 20 %- 1: 3.2 ARGON 1 : 3.5 CHART 3ZT - 6 DIFFERENTIAL PRESSURE' MILLIMETERS OF WATER FOR I AND 3 SPONGE RUBBER DISKS II) AIR AT GROUND • (2) AIR AT 30,000 FEET O Goiibrotion mode by const on* flow of oir or gos from o weighted spirometer which produced the indicated differential pressure on the two sides of the sponge rubber disks The results ore expressed at the ambient pressure and temper- ature saturated with moisture which corresponds to the de- crease per minute m the actual volume of the weighted spirometer The sponge rubber disks used in this calibration were coarser than the A-0~B standard disk W M Boothby May 1*43 MAYO AERO MEDICAL UNIT ADJUSTABLE LOW RESISTANCE FLOW METER ID IS 90 VT AO AS fo CO CC -rr\ 7C on nc rut nc .rv/t /APPROXIMATE RATIO OF RATE OF FLOW WHEN USING I AND 3 SPONGE RUBBER DISKS Air ol Ground 1:5 I . Air ol 30,000 ft 12 8 / Chart 3T- 7 W.M.Boothby 3-14-1946 OXYGEN AT BAROMETER = 733 m.m TEMPERATURE = 25°C. “ WATER VAPOR =24 m.m.: CALIBRATION OF SPONGE RUBBER RESISTOR LITERS PER MINUTE - OXYGEN MAYO AERO MEDICAL UNIT chart 3Z: - PRESSURE WATER W.M.BOOTHBY 3-21-46 ARGON BAROMETER =733 mm TEMPERATURE =25° C WATER VAPOR =24 mm CALIBRATION OF SPONGE RUBBER RESISTOR LITERS PER MINUTE - ARGON MAYO AERO MEDICAL UNIT CHART 1-9 HELIUM BAROMETER = 733 m.m. - TEMPERATURE = 25° C - WATER VAPOR =24 m.m. ~ W.M, BOOTHBY 3-21-46 CALIBRATION OF SPONGE RUBBER RESISTOR MAYO AERO MEDICAL UNIT CHART 3T - 10 MAYO AERO MEDICAL UNIT DATA FROM HIGH ALTITUDE LABORATORY Group VIII MISCELLANEOUS (1) Xa>6 November 1939, H,0 Brown and W.M.Boothby Respiratory curves produced by (a) Deoreas ng oxygen concentration and (b) increasing carbon dioxide concentration. (2) XIY-1 January 1940,. W.M.Boothby and 0.0.Benson,Jr, Oxygen consumption and ventilation rate per minute at various altitudes while breathing oxygen, (3) III-5A June 1942, Lt, I!,Mason Guest, Wright Field, Oxygen dissociation curves for human blood. Curves based on data of Major Dill Wright Field Aero Medical Unit, (4) IX-7 August 1944, H,F#Helmholz Jr,, J,B#Bateman and W*M,Boothby, Increased circulation rate with anoxia, (5) III—12a November 1944 H, F.Helmholz Jr* Oxygen carrying capacity of the blood. The effect of altitude with and without the addition of oxygen. Arterial hemoglobin saturation calculated from experimental alveolar air data by means of Henderson's nomogram, (0) III—12b November 1944, H.F.Helmholz Jr, Effect of decreasing barometric pressure on oxygen transport by the blood increase in circulation# (7) III-12o November 1944, H.F0Helnholz Jr. Oxygen carrying capacity of the blood. Effect of pressure breathing, (8) IV—2 July 1940, W,R.Lovelace, CompardUive volumes of gases (saturated at 37°C) inside the body at various altitudes. MAYO AERO MEDICAL UNIT RESPIRATORY CURVES DECREASING OXYGEN CONCENTRATION INCREASING CARBON DIOXIDE CONCENTRATION CHART NO. XT - 6 Subject H.O.B. 11-29-39 MAYO AERO MEDICAL UNIT OXYGEN CONSUMPTION AND VENTILATION RATE PER MINUTE AT VARIOUS ALTITUDES WHILE BREATHING OXYGEN GROUND BAR.: 733 10,000 FT. BAR.: 523 20,000 FT. BAR.: 349 30,000 FT, BAR.: 226 35,000 FT. BAR.: 179 40,000 FT. BAR.: 141 02 CON- ALT I- SUMPTION VENTILATION RATE TUDE S.T.P.D. S.T.P.D. B-37w-D. B-37°-S IN FT. c • c • Liters Liters Liters 1,000 244 6.79 7.93 oo . *4 10,000 264 5.37 8.86 9.74 20,000 256 3.01 7.45 8.61 30,000 255 1.68 6.42 8.10 35,000 259 1.50 7.23 9.81 40,000 273 1.39 8.51 12.77 Chart No. XIV - 1 Subject 0.0.B. 1-29-40 “ °/A pO^nmtlg _ Saturation pttffi pHU 2 1.7 2.1 2.6 4 3JO 3.8 4.6 6 4.4 5.5 6.6 10 65 8.2 10.5 ~ 15 8.7 10.9 13.5 T 20 10.7 13.4 16.5 ~ 50 14.2 17.9 22.1 — 40 17.5 22.0 27.1 - 50 20.9 26.3 32-5 - - 60 24.7 31.1 38.2 — 70 28.7 36.1 44.3 _ 80 36.3 45.7 56.2 _ 85 41.1 51.7 63.6 90 48.7 61.4 77.2 94 59.5 75.0 92.1 96 69.7 87.7 106.0 98 89.8 113.0 139.0 " OAYGLN DISSOCIATION CURVES: TOR HUMAN BLOOD — ~ Curves based on data of Major Dill ~~ Wriaht Held Awo-np.diml Unit. HT-5A _ flayo Aero-Medical Unit L+. M. Mason Guest 6*9-42, C02pressures for various pH values have, been ....equation % using a value, of .6JO. .and. assuming a constant hi cod bicarbonate content (nwi.q) INCREASED CIRCULATION RATE WITH ANOXIA MAYO AERO MEDICAL UNIT ALVEOLAR A R PRESSURE from ito.AMU Chart X-Sb ARTERIAL HEMOGLOBIN SATURATION VENOUS OXYGEN PRESSURE COMPENSATORY INCREASE CIRCULATION RATE ALVEOLAR RESPIRATORY QUOTIENT Alt. 1,000‘sft.lO Chart TXT-7 Helmholz, Bateman and Boothby Aug 1944 OXYGEN CARRYING CAPACITY OF THE BLOOD The effect of altitude with and without the addition of oxygen Arterial hemoglobin saturation calculated from experimental alveolar air data by means of Henderson's nomogram HEMOGLOBIN - % SATURATION VOLUMES % BAROMETRIC PRESSURE (Hg. mrrO ALTITUDE (1,000 feet ) Chart no. HT- 12-a Mayo Aero Medical Unit F red Helmholz Nov. 194 4 EFFECT OF DECREASING BAROMETRIC PRESSURE ON OXYGEN TRANSPORT BY THE BLOOD INCREASE IN CIRCULATION HEMOGLOBIN % SATURATION VOLUMES % BAROMETRIC PRESSURE (mm.Hg.) ALTITUDE (1.000 feet) Chart no HE- 12-b Mayo Aero Medical Unit Fred Helmholz Nov. 1944. OXYGEN CARRYING CAPACITY OF THE BUOOD EFFECT OF PRESSURE BREATHING HEMOGLOBIN % SATURATION VOLUMES % Alveolar pOz with increasing Mask Pressure 35 mm.( Experimental development only) "Above 45 M"-22mm. Hg (12 in. HzO ). I | 45 M"- 15mm. Hg( 8 in. Hz 0 ) |- 43 M"- I I mm.Hgl 6 in. HzO) 41 M"- B mm.Hg (4 in. H2O ) ‘Safety" - 2 mm.Hgjl in. HzO) (Prevents mask leak) ALTITUDE (1,000 feet) BAROMETRIC PRESSURE (mm. Hg.) Chart No. HE- 12-c Mayo Aero Medical Unit Fred Helmholz Nov. 1944 Comparative volumes of puses (saturated, at 37° C*) inside the body at various altitudes „ . . , \ 760-47 Vol.(m body) = ' Vol. (outside body)=-g~ - Relative volume of 0us Mayc Aero Medical Unit W. R, Lovelace, II Barometric pressure - mm. of Hp. W-8008, AF * Pressure of aqueous vapor at 37°C is 47 mm. of mercury Bibliography MAYO AERO MEDICAL UNIT Soecial Reoorts to National Research Council and to Army Air Forces, Wright Field I . High Altitude Laboratory II. Acceleration Laboratory Appendix For the convenience of readers the bibliography of papers previously published on Anoxia and Oxygen in Aviation Medicine and in Clinical Medicine by various members of the Mayo Clinic and Mayo Foundation are presented in an Appendix. MAYO AERO MEDICAL UNIT HIGH ALTITUDE LABORATORY Bibliography A = Oxygon and Anoxia B = Decompression Sickness C = Pressure Breathing D = Oxygen Equipment E « Miscellaneous A, OXYGEN AND ANOXIA A-l Oxygon and air proaAUJM .at various altitudes as they influence the efficient functioning ..of- the aviator. Part I, Effect of water vapor. "Tracheal air" [ as^8 *or comparing altitudes when breathing air, oxygen or mixtures using nitrogen to simulate altitude. Part II, The rele played by combustion or respiratory quotient, hyperventilation and diffusion of gases in the final gaseous equilibrium in the pulmonary alveeli resulting in alveolar ratio. By Walter M, Beothby, JLug. 1942, CMR Special Report No, 9 text obtainable on ■ ' ;■ ' request) Oct, 1944, Abstract! CAM Report No, 340, A-2 Indoctrination of 21 crews of 307th Bombardment Group, By Walter M, Boothby, Oct, 1942, AAF-CMR Reports Series A, No, 2, A—3 Xndootr5.nation of 21 crews of 307th Bombardment Group (abstract), Py Walter M. Beothby, Dec, 1942, CMR-OSRD Progress Report No, 6, A- 4 Comparison of alveolar oxygen pressures, oximeter readings and percentage satura— tion-of hemoglobin, N*4*mal arterial saturation approximately 97 per cent. By Walter M, Boothby and F, J, Robinson, Apr, 1943, NRC (Cen, Oxygen & Anoxia) Report No, 2, A-5 Comparison of alveolar oxygen pressures, oximeter readings and percentage satura- tion of hemoglobin. By Walter M, Boothby and F, J, Robinton* June 1943, CAM Report No. 163, Above replotted and combined with data from Naval Medical Research Institute, Bethesda, Maryland, By Walter M, Boothby. Aug, 1945, CMR-OSRD Progress Report No, 16, A-6 Discussion of alveolar air data (sea level versus 5000 foot standard) by Boothby, Helmholz and Robinson. By Walter M, Boothby, July 1943, CMR-OSRD Progress Report No, 7. A-7 "Tracheal" versus "alveolar" aln A review of the methods of selecting certain physiological data bearing on the design of oxygen supply system for aviators. By J, B, Bateman and Walter M, Boothby, Deo, 1943, CAM Report No, 222. A-8 Comparison of alveolar air data en men and women at various altitudes. Chart I-6e with tabulated data. By Walter M, Bsothby. Apr, 1944, CMR-OSRD Progress Report No, 9, A-*9 Tracheal oxygen pressure r(B—47)f02 1 • Best ptlnt of reference for comparison of a.i4 i C'1do, L J By vur M. Boothby, Jan, 1944, CMR-OSRD Progress Report No, 8, 1/*10 Cor.parl ,:on between low altitudes breathing air and high altitudes breathing oxygen on bo h the tracheal and alveolar air basis! 3 charts No, I—6d-b, I-6d-c and r»Cd'<« ie charts are obtainable in large size for use in class and pressure c h t■ do j 1 n ••tru c ')i o a « Py Walter M, Bo.thby, Juno 1944, CMR-OSRD Progress Report No, 10, A-ll Alve >lar respiratory quotients: an experimental study of the difference betvroen true an 1 a’5vo-*Iar respiratory quotients, with a discussion of the assumptions vei ir tie calculation of alveolar respiratory quotients and a brief review cf experimental evidence relating to these assumptions, By Jo Pj Bateman and Walter M, Boothby, June 1944, CAM Report No, 341, A~12 Comments on Study of Hyperventilation as a Means of Gaining Altitude and Voluntary fro 3sure Breathing" by L.E. Chadwick, A,B, Otis, H, Rahn, M,A, Epstein an I J Oo Fern* CAM Report No, 302, May 22, 1944, made at the request of Chief, memo Moll cal Laboratory, Engineering Division, Wright Field, Ohio, By Jo Ba Bateman July 1944, AAF-CMR Report: Series A, No, 8 (Wright Field), A-13 The effects of altitude anoxia on the respiratory processes, "Tracheal" and "alveolar" reference points in regard to comparable altitudes} steady and semi** tteady states, Ey K, Fj Holmholz, Jr., J. B. Bateman and Walter M, Boothby, Aug, 1944, CAM Report No, 360, A-14 The redaction of alveolar carbon dioxide pressure during pressure breathing and its relation to hyperventilation, together with a now method of representing the effects of hyperventilation. By J, £0 Bateman and Walter M, Boothby, Sept, 1944, CAM Report No, 381, i - •. Af-\5 To study the effect of acclimatization of individuals to 6,200 feet altitude upon the alveolar air. Joint study of Wright Field and Mayo Aero Medical Unit made at Peterson Field, Colorado Springs, Py Capt« J, W. Wilson (and Walter M, Boothby), Sept, 1944, AAF-CMR Serial No, Eng, 49-696-42 F, 3- A—16 Sea level alveolar pC(>2 and pC>2 carried out at San Diego in cooperation with t: o iligh Altitude Laboratory of Consolidated Vultea Aircraft Corporation, By ilt F, Helmholz, Jr, June 1944, Progress Report No, 10, A-17 Alveolar respiratory quotients: an experimental study of differences between tr'au expired dip and alveolar respiratory quotients. By Jr B. Bateman and Walter M, Boothby. Oct, 1944, CMR-OSRD Progress Report No. 11, A«18 Effects of altitude anoxia on respiratory processes by Helmholz, Bateman and Boothby, Preliminary notes. By V'alter M. Boothby, Dot, 1944, CMR-OSRD Progress Report No, 11, A-19 Comments on "The Calculation of Equivalent Altitude" by J,S, Gray, prepared at reques- of Chief, Aero Medical Laboratory, Engineering Division, Wright Field, By Jm B, Bateman, Oct, 1944, AAF-CMR Report: Series A, No, 9 (Wright Field), hr 20 Study of residual air and lung emptying time. By H, F, Helroholz, Jr, and J,B, Bateman, Oct, 1945, CMR-OSRD Progress Report No, 17, A-21 Unequal pulmonary ventilation, residual air and "average* alveolar air. By J, B, Bateman, Fob, 1945, CMR-OSRD Progress Report No, 13, A-22 Unequal pulmonary ventilation, residual air stressing errors due to nitrogen elimination. By J, B, Bateman, July 1945, CMR-OSRD Progress Report No, 15, A-23 Effect on ceiling attainable and on the alveolar air data of 3 individuals originally acclimatized to low levels (1,000 feet, Rochester, Minnesota) on going til the higher levels around Colorado Springs (6,200 feet). By Walter M, Boothby, Mayo Aero Medical Unit and J', W, Wilson, Wright Field, Aug, 1944, AAF-CMH Report: Series A, No. 8a, A-24 Dark adaptation, I, Apparatus and methods, II, Effects of anoxia, * III, Effects of fasting and ef high carbohydrate meals on the courses and threshtld values of dark adaptation obtained at ground levels, using air and oxygon. By C, Shoard, J, W, Brown and K, G, Wilson, Juno 1942, AAF-CMR Report: Series B, No, 1. B. DECOMPRESSION SICKNESS. B-l Accumulated nitrogen elimination. By Walter M, Boothby, W, Randolph Lovelace and Otis 0, Benson, AAF-CMR Report, Wright Field, Abstracted in Physiology of Flight, 1940-42, page 27, Fig, 15, B-2 Demonstrating air bubbles in wrist joint by roentgenogram while at 35,000 feet. By Walter M, Boothby, Otis 0, Bonson and Harold A, Smcdal, AAF-CMR Report by Wright Field, Reproduced in Physiology of Flight, 1940-42, page 26, Fig, 14a and 14 b, B-3 lononpros si on symptoms developing during indoctrination of 21 crows of 307th Bombardment Group, By Walter M, Boothby, Oot, 1942, AAF-CMR Report* Series A, No, 2, B-4 Nitrogen elimination illustrated by throe charts* Chart VII-1, accumulated nitrogen eliminated at royt and at work; Chart VII-2, comparison (l) gaseous nitrogen eliminated While breathing oxygen and (2) venous blood nitrogen content* Chart VII-3, comparison of nitrogen elimination by heavy and light subjects. By Walter M, Boothby and C, F, Code, Sept, 1942, CMR-OSRD Progress Report No, 5, Also detailed report by Code to Subcommittee on Decompression ioknoss. B-5 Aero-embolism, Preliminary report on the protective effect of prolonged inhalation of air oxygen mixture by Bateman, By Walter M, Boothby, Apr, 1944, CMR-OSRD Progress Report No, 9, B-6 Aoro-ombolism. Further data on protective effect prolonged inhalation air-oxygon mixtures by Bateman, By Walter M. Bsothby, Juno 1944, CMR-OSRD Progress Report No, 10, B-7 Susceptibility to decompression sickness* the effects of prolonged inhalation of certain nitrogen-oxygon mixtures compared with those of exposure to pure oxygen. By J, B. Bateman, Sept, 1944, CAM Repsrt No, 364, B-8 To study the effect of acclimatization of individuals to 6,200 foot altitude up#n alveolar air, (joint study by Wright Field and Mayo -*oro Medical Unit carried out at Peterson Field, Colorado Springs.) By Capt, J, W, Wilson, Wright Field, Sept, 1944, AAF-CMR Repert No, Eng, 49-696-42 F, 3-9 Susceptibility to decompression sickness* Notes on the effects of prolonged inhalation of certain nitrogen—oxygen mixtures compared with those of exposure to pure oxygen. By J, B. Bateman and Walter H, Boothby, Oct, 1944, CMR-OSRD Progress Report No, 11, B-10 Now mathematical analysis of factors involved in explosive decompression, Ey H, Fs Holmholz, Jr, July 3, 1945, CMR-OSRD Progress Report No, 15, B-ll A tentative physical formulation of the susceptibility of divers and aviators to decompression sickness and a review of the various effects of inhaling oxygen upon iuecoptibillty* By J. B, Bateman, Chapter in book on Decompression Sickness edited by J, F. Fult-r for the Subcommittee on Decompression Sickness, N«R,C, C. PRESSURE! BREATHING C-l The development of a laboratory model of a positive pressure jacket for use during positive pressure breathing, closed circuit typo using shell natron to absorb COg, Flights up to 50,000 foot with physiologic observations. By C, B, Taylor and J, P, Marbarger, Feb* 1943, AAF-CMR Report* Series A, No, 4 (Wright Field), C-2 A study on the effect of positive pressure breathing on the arterial blood pressure, venous blood pressure and the ocrcbro-spinal fluid pressure in the dog. By C, B, Taylor and J, P, Marbarger, Feb, 1943, AAF-CMR Report* Series A, No, 4a (Wright Field), C-3 Studios with photographic records of the effect of positive pressure breathing on the appearance of the retinal vessels on the intra-ocular pressure in man and in the dog. By C, B, Taylor and J, P, Marbarger, Fob, 1943, AAF-CMR Report* Series A, No, 4b (Wright Field), C—4 The effect of breathing against 30-35 mm, Hg on the cardiac output (Roentgen kymograph), By W, S, Erickson, C, B, Taylor and J, P, Marbarger, Feb, 1943, AAF-CMR Report* Series A, No, 4o (Wright Field), C-5 Preliminary report on arterial puncture studios up to altitudes of 50,000 foot breathing against positive pressure with counter pressure by the positive pressure jacket. By C* B, Taylor, J, P, Marbarger and M. H, Power, Mar, 1943, AAF-CMR Report* Series A, No, 4d (Wright Field). C-6 Arterial blood studios at altitudes up to 50,000 foot, breathing under positive pressure in the positive pressure jaokot. Movie to show technic and coordina- tion of operation at 50,000 feet. By M, H, Power, C, B, Taylor and J, P, Marbarger, Mar, 1943, AAF-CMR Report* Series A, No, 4e (Wright Field) with movie, C-7 Eleotro-onoophalographio and electrocardiographic studios at ground level with positive pressure jacket. By C, B, Taylor and J, P, Marbarger, Mar, 1943, AAF-CMR Report* Series A, No, 4f (Wright Field), .7. C-8 Roertgen kymograph etudies on the effect of breathing against positive pressure Cijirg the positive pressure rebreather bag. Increase in rate with apparent decrease in stroke volume. By Co B. Taylor and J. P# Marbarger. Mar. 1943, A*if-CMR Report* Series A, No, 4g (bright Field), 1-9 Revert on (a) -arterial punctures at 44,000 and 46,000 feet with electrocardiograms. Positive pressure breathing with new vest of Marbarger and Taylor, (b) Flight with pressure breathing and vest to 50,000 feet by Lt, Marbarger, (o) Flight by Lt. Marbarger in Prof, Akerman’s pressure suit with 2~g lbs, pressure plus positive pressure regulator using differential pressure of 7 inches water to 56,964 feet corrected (above 50,000 feet for 15 min,) By C, B. Taylor and J, P, Marbarger, May 1943, AAF-CMR Report* Series A, No, 4h (Wright Field), C-IC Arterial blood studies at altitude of 44,000 and 46,000 feet breathing under vc itive pressure with Wright Field using positive pressure mask and regulator > foloped by Major m., P. Gagge, and his group, By I., H, Power, C,B, Taylor and J.P, Marbarger, May 1943, AAF-OLR Report* Series No. 4j (Wright Field), C -11 7omo preliminary observations on the partition of the total respiratory volume clc-ing positive pressure breathing with and without the counter-support of a pressure jacket. By C, B, Taylor, M, H, Power and J. P, Marbarger, May 1943, Report* Series No. 4k (bright Field). I * C-.12 "ummary of the development of positive pressure closed circuit jacket to be used to attain as high as 50,000 feet. By Walter M, Boothby, ' •' . Apr, 1943, NRC (Com, Oxygen & Report No, 3, C—1? The vital capacity, oomplemental and reserve air, in positive oressure breathing, with and without corresponding counter pressure, attention directed to errors to absorption of Ctg by soda lime. By H, A. Robinson, F, J, Robinson and Walter M, Boothby, Sept. 1943, *w,r-QMR Report* Series A, No, 5 (Wright Field), C-14 Tests on various constant flow reducing valves and regulators with and without economizer bag. Normal and positive pressure regulators. By Walter M. Boothby, Jan, 1943, NRC (Com. Oxygen & -anoxia) Report No, 1, C-15 Visual adaptation and pressure breathing. By C, Sheard, , . „ Apr, 194$,_ CMR-OSRD Progress Report No# 9# C-X6 Difference in effect on alveolar pCOg by hyperventilation and pressure breathing. By Walter M, Boothby and J, B, Bateman, Juno 1944, CMR-OSRD Progress Report No, 10, 0— lit to on the reduction of alveolar carbon dioxide during pressure breathing and its relation to hyperventilation, together with a now method of representing the effect of hyperventilation by Bateman, By Walter M, Boothby, Oct, 1944, CMR-OSRD Progress Report No, 11, C 1J Improved design of counter-pressure vest. By Walter M, Boothby, Oct, 1944, CMR-OSRD Progress Report No, 11, 1— The reduction of alveolar carbon dioxide pressure during pressure breathing and ils relation to hyperventilation, together with a now method of representing the effects of hyperventilation. By J. B. Bateman, Sept, 1944, CAM Report No, 331, C-20 Comments on nA Study of Hyperventilation as a Means of Gaining Altitude and Voluntary Pressure Breathing” by L,E, Chadwick, A,B, Otis, H, Rahn, M,A, Epstein and W,0, Penn (CAM Report No, 302, May 22, 1944) made at the request of Chief, Aero Medical Laboratory, Engineering Division, Wright Field, By J, B, Bateman, July 1944, AAF-CMR Report* Series A, No• 8 (Wright Field), C-21 Report on positive pressure breathing (a) constant pressure (b) pulsating pressure (chest compression up to 4 cm, Hg for short periods 3 to 4 times during expiration). By Walter M, Boothby and C, A, Lindbergh, Oct, 1944, AAF-CMR Report* Series A, No, la, C—22 The effect of pressure breathing upon the skin temperatures of the extremities. By J, B, Bateman and Charles Sheard, May 1945, CAM Report No, 428, C-23 Effects of increased intrapulmonary pressure on dark adaptation. By C, Sheard, May 1945, AAF-CMR Report* Scries A, No. 12 C-24 Motion picture showing Jfocntgen kymographic studios of cardiac and respiratory movements (with and without positive pressure at ground level and at high altitude. May 1944), By Walter M, Boothby and H, F, Helmholz, Jr, Dec, 1944, CMR-OSRD Progress Report No, 12, Federation Proc,, Vol, 5, No, 1, page 3, 1946, •8a« C-25 Further studios on the effect of positive pressure breathing on the appearance of +ho retinal vessels in nan, A supplement to Serial Report, Series A, No, 4b, By C, B, Taylor and J. P, Marbargor. Apr, 1943, AAF-CMR Report* Series A, No, 4 b-2 (Wright Field), C—26 Partial pressures of oxygon and carbon dioxide of blood sampd.es taken at simulated aDtitudos up to 50,000 feet, breathing under positive pressure in the positive pressure jacket. By M, H, Power- C, B. Taylor and J, P. Marbarger. May 1943, AAF-CMR Report* Series A, No, 4 1 (Wright Field). C-2"7 A comparison of per cent saturation of arterial blood by chemical determination* to por cont saturation of arterial blood as determined by the oxim»*or. By F, ,T. Robinson, C, B, Taylor, M, H, Power and J, P, Marbargor. June 1943, AAF-CMR Report* Series A, No, 4m (Wright Field), 9 D, OXYGEN EftUIPMENT 5-1 The advantages of both and constant flow system of oxygen administration are combined by the utilization of a small reservoir or economizer bag with the demand type mask# By Walter M, Boo’thby* Aug# 1942, CMR Special Report No, 1, D-2 Development of oxygen equipment. Physiological criteria to be considered by engineers. Requirements at rest and at work. Eight charts. Written in response to request by Lt, Comdr. L, D. Carson, (MC) USN, transmitted through Dr, L, B, Flexner, NRC. By Walter M, Boothby, Aug, 1942, CMR Special Report No, 3, D-3 Observations, experiences, recommendations and equipment related to bailing oat at high altitudes. By Walter k. Boothby, K,G. Wilson, Mayo Aero Medical Unit, and C,a, Lindbergh and C, J, Clark, Ford Willow Run Bomber Plant, Oct, 1942, aAF—CMR Report; Series a, No, 1 (Wright Field), Bail-out* Observations, experiences and recommendations related to bailing cat at high altitudes. Abstract aAF-CMK Report No, 1, Dec, 1942, by W. M, Boothby and C, A. Lindbergh, By Walter M. Boothby, Oct, 1942, CMR-OSRD Progress Report No, 6, D-5 Conservation of oxygen effected by the use of economizer bag on corrugated tube of demand regulator; with and without the use of the automix. By Walter M, Boothby, C, B, Taylor, J,P, Marbarger, B,P, Cunningham, F,J, Robinson and A,R, Sweeney, Nov, 1942, AAF-CMR Report* Series A, No, 3 (Wright Field), D-6 Conservation of oxygen effected by economizer bag in conjunction with demand regulator, abstract AAF-CMR Report No, 3, Dec. 1942, By Walter M, Boothby, Deo. 1942, CMR-OSRD Progress Report No, 6, D--7 Reducing valves, regulators and economizer bags. Administration of oxygen to aviators. By Walter M, Boothby, Jan, 1943, NRC (Com, Oxygen & anoxia) Report No, 1, 10. 1-0 Burns pneumatic balance resusoitator, Report of studies made at Mayo Aero Medical Unit., By 0, C, Olson, Wright Field, ■' Deo, 1944, CMR-OSRD Progress Report No, 12, D-9 Comments requested by Chief, uro Medical Lcaboratory, Engineering Division, Wright Field, on (l) "Adequacy of Reservoir Delivery Oxygen Systems," by Squadron Leader J.K.W, Ferguson, (2) "Optimum Sizes Of Reservoirs for the Breathing of Oxygen," by Squadron Leader J.K.W, Ferguson, (3) "Evaluation of Constant Flow Reservoir Oxygen Mask System for Use in Navy Transport Planes," Report No, 2, Naval Medical Research Institute Research Project X-391, By Walter M, Boothby, Deo. 1944, AAF-CMR Report* Series a. No, 10 (Wright Field), *»-10 Oxygen requirements with constant flow equipment and comments on paper by Capt, H, G, Swann, 3-696-42 H, By Walter k, Boothby, Feb, 1945, iM-F-CMR Report* Series No, 11, D-ll Properties of sponge rubber disks used in constant flow oxygen masks. By Walter M. Boothby and H, F, Helmholz, Jr, Feb, 1945, CMR-OSRD Progress Report No, 13, D-12 Use of sponge rubber disks as resistance unit in a gas flow meter. By Walter li. Boothby and H, F, Helmholz, Jr, Apr, 1945, CMR-OSRD Progress Report No, 14, D-13 Cold chambers and small low pressure chamber and new large low pressure chamber. By Walter M. Boothby, May 1942, CMR-OSRD Progress Report No, 1, D-14 York refrigeration apparatus and new large low pressure chamber. By Walter M, Boothby, June 1942, CMR-OSRD Progress Report No, 2, D-15 Oxygen requirements in the design and in the production of air-oxygon demand regulators. By Walter M, Boothby, H.F, Helmholz, Jr,, and F. J, Robinson, July 1943, CMR-OSRD Progress Report No, 7, D-16 Comparison of the properties of the sponge rubber disks used in the constant flow oxygen equipment with those of single orifices offering approximately the same resistance to flow. By Walter M. Boothby, Feb, 1945, CMR-OSRD Progress Report No, 13, 11 £, MISCELLANEOUS E—1 Outlines and lectures for beginning and advanced air corps personnel* First edition prepared by Capt, M« Robert Halbouty, M.C., USa and Capt, Joseph A* Reach, M.C, , US/i, while assigned to the Mayo -*ero Medical Unit. Jan* 1942, First edition* Aug* 1942, Second edition. E-2 First meeting of the Subcommittee on Oxygen and ..noxia in Washington, Visit to Naval Air Station, Jacksonville and Pensacola. By Walter k. Boothby. July 1942, CMR-OSRD Progress Report No, 3, E-3 Comparative effects of toxic doses of digitalis and of prolonged deprivation of oxygen on the electrocardiogram, heart and brain* By Walter M. Boothby, ft. B. Bearing, a. R. Barnes and H. £, Essex. <.ug, 1942, CMR Special Report No. 2. £-4 Protection of the Mayo acto Medical Unit, By A, G, Berens. Aug, 1942, CMR Special Report No, 4, E-5 A laboratory aid. By M, R, Halbouty, J. a* Reach and R. F. Ruehmer, Aug. 1942 (2nd ed,) AAF-CMR Report No. la. E~6 Brief statement of experiments underway. By Walter M, Boothby, AUg, 1942, CMR-OSRD Progress Report No. 4, E-7 Summary of data on the volumetric analysis of pure atmospheric air* By Walter M, Boothby, Wot# 1943, AAF-CMR Report* Series a, No. 6 (Wright Field), 1-8 Review of Study of Cerebral Physiology at High Altitude,* by Melvin W, Thorner, Major, M,C, Report No* 2, Project No, 60, frem the j-rmy Air Forces school of Aviation Medicine, Randolph Field, made at the request of Chief, .*»ro Medical Laboratory, Engineering Division, Wright Field, By Walter M. Boothby. Apr, 1944, AAF-CMR Report* Series A, No, 7 (Wright Field), S-9 New data on visual adaptation by Sheard* By Walter M. Boethby* Apr, 1944, CMR-OSRD Progress Report No. 9, 12. E-13 Motion picture showing reentgen kymographio studios of cardiac and respiratory movements (with and without positive pressure at ground and at high altitude. May 1944). By Walter M, Boothby and H, F, Helmholz, Jr, Deo, 1944, CMR-OSRD Progress Report No, 12, Federation Proo,, Vol, 5, No, 1, page 3, 1946, B--11 Recording movements of ballistooardiograph using microprojector. By J, B, Batoman. Oct, 1945, CMR-OSRD Progress Report No, 17, E-12 Summary of recent work on respiration. By J, B. Bateman, Mar, 1945, NRC (Com. Oxygen & Anoxia) Report No, 4, 3-13 On tan transmission of radiant energy (visible and ultraviolet) by materials submitted, By C, Shoard, Sept, 1944, AAF-CMR Report* Series B, No. 2. E-14 Accumulated nitrogen elimination at rest and at work. By Walter M, Boothby, W, Randolph Lovelace and 0, 0, Benson, Nov, 1940, AAF-CMR Report, E-15 X-ray photographs demonstrating air bubbles in wrist joint at 35,000 feet. By Walter M. Boothby, 0, 0, Benson and H, A, Smedal, Doc, 1940, AAF-CMR Report, MAYO AERO MEDICAL UNIT ACCELERATION LABORATORY Bib11ography A — The Construction and Operation of the Human Centrifuge B — Studies on the Effects of Positive Acceleration on Dogs Carried Out on ■fie Animal Centrifuge at the Institute for Experimental Medicine of the Mayo Foundation. C — Studies on the Physiologic Mechanisms Involved in the Production of Blackout and Unconsciousness as These Occur under Accelerative Forces D — Reports Dealing with the Quantitative Determination of the Protection Afforded by Anti-Blackout Procedures and Devices E — Studies on the Effect of Posture on G Tolerance F — Studies on Self-Protective Straining Maneuve rs G — Reports Dealing with the Development and Testing of Anti-Blackout Suits H — Reports Dealing with the Development and Testing of Inflation Systems for Anti-Blackout Suits I — Studies in Aircraft J — Other Reports on the Effects of Aooelerat i on 1 BIBLIOGRAPHY 0* THE ACCELERATION LABORATORY OF "HE MAYO AERO MEDICAL UNIT A* Construction and Operation of the Human Centrifuge A—1 Note on the first testa of the human centrifuge. Sept. 1942, CMR-OSRD Progress Report No, 5. A-2 Relation of centrifuge carriage r.p.m. to initial flywheel r.p.m, on the human centrifuge of the Mayo Acceleration Laboratory, By E. H. Wood. Feb. 1945, Wright Field Report. A-3 Human centrifuge for use in studies of man's reaction to acceleration. By E, J, Baldes and A. N, Porter. Mar. 1945, Federation Proceedings, 4*4, A--4 Human centrifuge operation (motion picture). By E. J. Baldes and A. N. Porter, Mar, 1945, Abstract published in Federation Proceedings, 4j3-4, B, Studies on the Effects of Positive Acceleration on Dogs Carried Out on the Animal Centrifuge at the Institute for Experimental Medicine of the Mayo Foundation B—1 Protection afforded animals by immersion in water to neck (motion picture). By E. J. Baldes, C, F. E, W. Erickson and Major J, A, Resoh. Aug. 1942. B~2 The response of normal dogs to prolonged exposure to centrifugal force. By G. A. Hallenbeok. Mar. 1944, CAM Report No. 279. B-3 The effect of immersion in water on the tolerance of dogs to centrifugal force. By G, A. Hallenbeok, E. J. Baldes and C, F. Code, Mar. 1944, CAM Report No. 278. C, Studies on the Physiologic Mechanisms Involved in the Production of Blackout and Unconsciousness as These Occur under Accelerative Forces G-l Some of the medical problems in modern aviation. By C. F. Code, Deo. 1942, presented before the Sydenham Society, Minneapolis, Minnes ota. C~2 Effect of breathing oxygen under positive pressure on the g tolerance. By Lt. S, C, Allen, E. J. Baldes, Lt, J, P. Marbarger and C. F. Code. April, 1943, Wright Field Report. C-3 Are the intervertebral disks compressed or displaced during positive aocelerati on? By M.M.D. Williams, E. J* Baldes, R. K. Ghormley and C. F. Code. Feb. 1944, CAM Report No, 255, C-4 Changes in the oireulation of the ear and in the heart, rate of human beings during positive aco-eleration. Presented by C. F, Code before Subcommittee on Acceleration of the National Research Council. Feb. 1944. C-5 The time of occurrence of visual symptoms during positive acceleration. Presented by E. H. Lambert before Subcommittee on Acceleration of the National Research Council. Feb. 1944. C-6 Blood pressure in man during exposure to high accelerations on the centrifuge. Presented by E. H. Wood before Subcommittee on Acoelerrtion of the National Research Council. Feb. 1944. C-7 The site of origin of visual symptoms in positive acceleration. Presented by E. H. Lambert before Subcommittee on Acceleration of the National Research Council. Feb, 1944, (also see notes on the effects of positive and negative eyeball pressure in CMR-OSRD Progress Report No. 9, April, 1944). C-8 Systolic blood pressure in man during exposure to high accelerations on the centrifuge (indirect method). By E. H. Wood, E, H, Lambert and R, E, Sturm. Aug. 1944, CAM Report No. 338. C-9 Studies on the physiology of acceleration. By C. F. Code, E, H. Wood, E. H. Lambert and E. J, Baldes. Sept. 1944, presented by C, F, Code at Aero Medical Association Meeting, St, Louis, Missouri. C-10 An instantaneously recording oardiotaohometer—applicable to the study of heart rate changes in human beings during exposures to acceleration. By R, E. Sturm and E, H. Wood Sept. 1944, CAM Report No. 371, (abstract published in Federation Proceedings, 5;102, February, 1946), C-ll The sequence of physiologic events in man during exposure to positive acceleration. By C. F. Code, E, H. Wood, R. E, Sturm, E, H, Lambert and E, J. Baldes* Mar, 1945, Federation Proceedings, 4;14-15, C-12 Determinations of man's blood pressure on the human centrifuge during positive acceleration (indirect method). By R. E, Sturm, E, H. Wood, E, H. Lambert Mar. 1945, Federation Proceedings, 4:69. C-13 The physiologic basis of "blackout" as it occurs in aviators. By E. H. Lambert. Mar. 1945, Federation Proceedings, 4;43. C-14 The symptoms vhioh oooar- in ma,.n_.durin.g. tiv-e acce-le rat Lon. (motion picture). By E. H. Lambert, G, A. Hallenbeok, E. J. Baldes, E. H. Wood and C. F. Code. Mar. 1945, Federation Proceedings, 4_?43, C-15 Changes in the external appearance of the human being during positive accelerati on. By E, H, Wood, E, J. Baldes and C. F. Code. CAM Report No. 391. Oct, 1944, (Published in Air Surgeon's Bulletin, 2jll7, April, 1945; Technical Data Digest, 1_1:59, August, 1945). C-16 Human centrifuge and studies of blackout. By E,J . Baldes, G, F.-Code, Er-H. Lambert and Et H. Wood. Deo. 1945, Journal of Physiology, volume 104. C-17 The effect of environmental temperature upon man's g tolerance. By C. F. Code, E. J. Baldes, E. H. Wood and E, H. Lambert. Feb. 1946, Federation Proceedings, (Presented by C. F. Code before Subcommittee on Acceleration of the National Research Council, April, 1945). C—10 Direct determination of man's blood pressure on the human centrifuge duriig positive acceleration. By E. H. Lambert and E, H, Wood Feb. 1946, Federation Proceedings, ?5;59, C-19 Comparison of effects of positive g on subjects studied at both the Mayo and Air Technical Service Command centrifuges. By G, A. Hallenbeok, E. H. Wood, E. H, Lambert and S, C, Allen. Feb. 1946, Federation Proceedings, 5:40-41, (Wright Field Report in preparation). C-20 The problem of blackout and unconsciousness in aviators. By Ef H. Lambert and E. H, Wood. 1946 (in press) Medical Clinics of North America. C-21 Some physiologic contributions to the solution of war problems; effects of acceleration in relation to aviation. By E. H. Wood, E, H. Lambert, E. J. Baldes and C# F. Code, 1946 (in press) Federation Proceedings, Presented by E. H. Wood at the American Physiological Society Symposium on Aviation Medicine at Atlantic City, March 15, 1946. D, Reports Dealing with the Quantitative Determination of the Protection Afforded by Anti-Blackout Procedures and Devices D-l The quantitative determination of the protection afforded by anti MgH Device s, Presented by Cf F. Code before the Subcommittee on Acceleration of the National Research Council, Sept. 1943. D-2 Methods of protection against the effects of acceleration. Presented by C. F, Code before the Subcommittee on Acceleration of the National Research Council. Feb. 1944. Also see the following reports: (1) Discussion by C. F. Code, E. H. Wood and E. J, Baldes in CAM Report No. 187 and listed as Report G-4 in this bibliography. (2) See report listed as G-5 in this bibliography. E. Studies on the Effect of Posture on G Tolerance E-l Notes concerning the effect on g tolerance of tilting the back of the seat backward to 30° with the horizontal, Deo. 1942, CHR-OSRD Progress Report No. 6. E-2 Is protection afforded against the effects of acceleration by tilting the back of the seat backwards to an angle of 45°? By C. F. Code, E. H. Wood and E. J, Baldes. Mar. 1943, Wright Field Report. E-3 Protection against the effects of acceleration afforded the human by assumption of the prone position. By E. H. Wood, C, F. Code and E, J. Baldes. Mar, 1943, CAM Report No, 158, E-4 Man's ability to withstand transverse acceleration when in the sitting position (preliminary report). By E, H. Lambert, E, H. Wood and E, J, Baldes, Mar. 1945, CAM Report No. 418. F. Studies on Self-Protective Straining Maneuvers F-l je If-p'roteotive maneuvers against positive acceleration, maneuver M-l (motion picture). By E. H. Wood, C, F. Code, G, A, Hallenbeck and E, J. Baldes. Feb. 1943, presented before Subcommittee on Acceleration of the National Research Council in March, 1943, (abstract published in Federation Proceedings, 4;78-79, March, 1945). F-2 SeIf-protective maneuvers against positive acceleration, maneuver M-2 (motion picture). By E. H, Wood, C, F, Code, E. J. Baldes June, 1943. F-3 The protection against the effects of acceleration afforded by pulling against a weighted control stick and the influence of this on the effect- iveness of pneumatic anti-blackout suits. By E. H. Lambert, E. H. Wood and E. J, Baldes. Feb, 1944, CAM Report No. 265. F-4 SeIf-protective maneuvers combined with anti-blackout suits. Presented by E. H, Lambert before the Subcommittee on Acceleration of the National Research Council. Feb. 1944. See note in CMR-OSRD Progress Report No. 9, Apr. 1944. G. Reports Dealing with the Development and Testing of Anti-Blackout Suits G-l Mechanical devices designed to increase the tolerance of humans to positive acceleration; the progressive arterial occlusion suit (motion picture). By E. H. Wood, E. J. Baldes and C. F, Code. Feb, 1943. G-2 Mechanical devices designed to increase the tolerance of humans to positive acceleration—the F.F.S. (motion picture). By G. , Code, E. J, Baldes and E, H, Wood. June, 1943. G-3 The protection afforded the human by hydrostatic as compared to pneumatic anti g devices , By E. H. Wood, C. F, Code and E, J. Baldes, Presented by E. H. Wood before the Subcommittee on Acceleration of the National Research Council, September, 1943. Nov. 1943, CAM Report No. 207. G-4 Tests of protection against the effects of acceleration afforded the human by the use of the latest model of the gradient pressure suit (GPS) when inflated by three different,pres sure arrangements. By H. Lamport, E. C. Hoff, E. J. Baldes, A. R, Sweeney, C, F, Code and E. H. Wood. Aug. 1943, CAM Report No. 187. G-5 The protection against the effects of acceleration afforded the human by immersion in water and by a water filled suit (the F.F.S.). By C, F. Code, E, H. Wood and E. J, Baldes. Aug. 1943, Wright Field Report. G-6 The F.F.S, with pneumatic pressurization as an anti g device. By E. H. Lambert, C. F. Code, E, J. Baldes and E. H. Wood. Jan. 1944, CAM Report No. 248. G—7 Note on the development of the Clark Nylon Bladder Suit. Apr. 1944, CMR-OSRD Progress Report No. 9. G-8 Comparison of protection against the effects of positive acceleration afforded by the standard gradient pressure suit (G.P.S.) and a simplified single pressure suit. By E. H. Lambert, E. H. Wood, E, J. Baldes and C. F, Code. June, 1944, CAM Report No. 308. 6 G—9 The Clark nylon bladder suits (models 10 to 21), Presented by E. H. Lambert before the Subcommittee on Acceleration of the National Research Council, June, 1944. G-10 Factors involved in the protection afforded by pneumatic anti-blackout suits. By E. H, Wood, E, H. Lambert, C. F. Code and E. J. Baldes. Presented by E. H. Wood with first demonstration of Clark nylon bladder suit (M-10) before Subcommittee on Acceleration of the National Research Council, Feb. 1944 Aug. 1944, CAM Report No. 351. G-ll The Eglin Field tests of the Clark nylon bladder anti-blackout suits (June 23 to July 10, 1944). By E. H. Wood Aug. 1944, Wright Field and Eglin Field Reports. G-12 A report on the introduction of anti ngM equipment to FEAR and a survey of aero-medical problems in SWPA including continental Australia, By E. J. Baldes and C. A. Maaske. Feb. 24, 1945, Army Air Forces Memorandum Report, TSEAL-696-51H, G-13 Concerning the qualifications and standards of anti-blackout suits: I. General consideration, I_I. Recommendations concerning anti-blackout suits at present in use by the Air Forces of the United States, III. Recommendations concerning likely courses of action towards developing more effective and still practical anti-blackout suits. By E. H. Wood. Mar, 1945, Wright Field Report, G-14 Hydrostatic anti-blackout protection; the protection afforded man against the effects of positive acceleration by immersion in water (motion picture). By C. F, Code, E. H, Wood and E, J. Baldes. Mar. 1945, abstract published in Federation Proceedings, 4:15, G-15 An analysis of factors involved in the protection afforded man by pneumatic anti-blackout suits. By E. H, Wood, D, M. Clark and E. H, Lambert, Mar. 1945, Federation Proceedings, 4:79, G-16 Factors influencing the efficacy of anti-g equipment at present in use. By E, H. Wood and E, H. Lambert. Presented by E. H. Wood before Sub- committee on Acceleration of the National Research Council, January, 1945, June, 1945, CAM Report No. 442. G-17 Note on endurance tests of the nylon bladder suits, July, 1945, CMR-OSRD Progress Report No. 15. G-18 Study of the eperation of the Z-3 suit with and without an electrically heated flying suit. By E. H. Wood. Oct. 1945, CMR-OSRD Progress Report No. 17. G—19 The effect of anti—blackout suits on blood pressure changes produced on the human centrifuge. By E, H. Wood and E, H. Lambert Feb. 1946, Federation Proceedings, 5:115-116. H. Re ports Dealing with the Development and Testing of Inflation Systems for Anti-Blackout Suits H-l Pump-valve assembly tests at altitude (particularly the Berger valve). By E, H. Wood (first report). Apr, 1944, Wright Field Report. H-2 Pump-valve assembly tests at altitude (particularly the Berger valve). By E. H. Wood (second report). May, 1944, Wright Field Report, H-3 Performance of the instrument pump suit-tank valve assembly used in the F6F5, By E, H. Wood. Oct. 1944, Wright Field Report. H-4 Input pressure at the instrument pumps in various planes and effect on pump output. By E. H. Wood Oct. 1944, Wright Field Report. H-5 Operation, adjustment and maintenance of Cornelius suit-tank valve. By E. H. Wood Nov. 1944, Wright Field Report, H-6 Altitude performance (comparison) of B-3 and B-ll pumps. By E. H. Wood. Dec. 1944, Wright Field Report, H-7 Centrifuge and static tests of the General Electric suit control valve, model P-321-11. By H, Haglund, R, Engstrom, E, H, Wood and R. J, Sertl, Jan. 1945, Wright Field Report, H-8 Intake suction generated by Cornelius compressor. By E. H, Lambert. Feb, 1945, Wright Field Report, H-9 Input suction at instrument pump. By Ryan Aeronautical Company and E. H. Wood, Mar. 1945, Wright Field Report. H-10 Performance of 2-valve assemblies for jet planes. By E. H. Wood. K«r. 1945, Wright Field Report. H-ll Flight tests of adjustable valve. By Ryan Aeronautical Company and E. H. W*>od. Apr, 1945, Wright Field Report, H-12 Flight tests of suit inflation time at altitude. By Ryan Aeronautical Company and E. H. Wood. Apr. 1945, Wright Field Report. H—13 The effect of simulated altitude on the time required by the B-2 and B-3 instrument pumps to inflate the Z—1 suit when these pumps are run without input suction (i.e., with the vacuum instrument suction regulator removed). By E. H. Wood, R, L, Engstrom and H. J. Haglund. May, 1945, Wright Field Report. H-14 The effect of the type of oil separator used on the effective output of the B-2 instrument pump at simulated altitudes. By E, H. Wood with technical assistance of R. L, Engstrom and H, J. Haglund. Hay, 1945, CAM Report No. 461. H-15 The effect of simulated altitude on the performance of the B-2 and B-3 instrument pump. By E. H. Wood with technical assistance of R, L. Engstrom and H. J. Hagliind. June, 1945, CAM Report No, 462. H-16 Notes on the adaptation of the G-C-l valve for use in jet propulsion a ircra f t. July, 1945, CMR-OSRD Progress Report No. 15. H—17 Notes on the development of an adjustable valve for anti-blackout suit inflation, Feb., Apr. and Oct. — CMR-OSRD Progress Reports No. 13, No, 14 and No. 17. I. Studies in Aircraft 1-1 The importance of studying accelerations in connection with parachute jumps. Presented by E, J. Baldes before Subcommittee on Acceleration of the National Research Council. Sept, 1943. 1-2 The use from June 26 to July 29, 1944 of the A-24 airplane assigned to the Acceleration Laboratory of the Mayo Aero Medical Unit, By E. H. Lambert. Aug. 1944, Wright Field Report. 1-3 A comparison of man's g tolerance in the airplane and on the centrifuge. Presented by E. H. Lambert before Subcommittee on Acceleration of the National Research Council. Jan. 194 5. 1-4 G tolerance in fighter aircraft. Presented by E. H. Wood before Suboommitt-er-e’ -cn Xcxsoof the National Research Council. Apr. 1945, abstract published in Technical Data Digest, 11j58, August, 1945. 1-5 Physiologic studies of g tolerance and anti-blackout protection on pilots in flight. Presented by E. H. Lambert before Subcommittee on Acceleration of the National Research Council. Apr. 1945. 1-6 Comparison of the physiologic effects of positive acceleration on subjects on the Mayo centrifuge and in an A-24 airplane. By E. H. Lambert. Sept. 1945, CAM Report No. 467, Mayo Serial B No. 1 Wright Field Report. 1-7 Comparison of the protective value of an anti-blackout suit on subjects in an A-24 airplane and on the Mayo centrifuge. By E. H. Lambert. Oct. 1945, CAM Report No. 487, Mayo Serial B No, 2 Wright Field Report. 1-8 Man's g tolerance in aircraft (motion picture). By E. H. Lambert, 1945. 1-9 Physiologic studies of man's g tolerance in aircraft (motion picture) By E. H. Lambert, Feb, 1946, abstract published in Federation Proceedings, 5:59. 1-10 Physiologic studies on the effects of positive acceleration on pilots in flight. By E. H. Lambert. Mayo Serial B, No, 3 Wright Field Report. 1-11 Comparison of the protection afforded by an anti-blackout suit to airplane pilots and centrifuge subjects. By E, H, Lambert. Mayo Serial B, No. 4 Wright Field Report. 1-12 Notes on the development of a new oscillographic unit for physiologic studies of g tolerance in aircraft. By E. H. Lambert and E, H, Wood. Oct. 1945, CMR—OSRD Progress Report No. 17. (This equipment is now in use at the Aero Medical Laboratory, Wright Field), io J. Other Reports on the Effects of Acceleration J-l Brief description of the vertical centrifuge. April, 1944, CMR-QSRD Progress Rep-ort No. 9. J-2 Vertical centrifuge (motion picture). Presented by E. J. Baldes before Subcommittee on Acceleration of the National Research Council. June, 1944. J-3 Demonstration of the effects of the "invisible force" which restricts man’s escape from spinning aircraft (motion picture). By E. H, Wood, E. K. Lambert and C. F. Code. Nov. 1944. J-4 The limiting effect of centripetal acceleration on man’s ability to move (an appraisal of some of the difficulties which may be encountered when attempting escape from a spinning aircraft). By C, F. Code, E, H. Wood, E, H. Lambert with technical assistance of R. L. Engstrom and H, J, Haglund. June, 1945, CAM Report No. 436. MAYO CLINIC AND MAYO FOUNDATION MAYO AERO MEDICAL UNIT Bibliography* (1) Anoxia and oxygen in aviation and in clinical medicine, (2) Miscellaneous subjects in high altitude physiology. Not included are the confidential and other reports which wore made by the Mayo Aero Medical Unit to the Committee on Aviation Medicine, National Research Council, and to the Aero Medical Laboratory, Army Air Forces, Wright Field, 1927 1, Oxygen therapy. By W, M, Boothby and S, F, Haines, Trans, Amer, Ass, Physiol,, 1927, 42*287-299* Clin, Bull., 1927, 2*124-125, J, Amer, Med, Ass,, 1928, 90*372-376, Collected Papers Mayo Clin,, 1927, 19*990-1000, 2, The value of oxygen following bronchoscopy in children. By H, J, Moersch and W, M, Boothby, Arch, Otolaryng., 1927, 6*542-545, 1928 3, The value of oxygen treatment after thyroidectomy. By S, F, Haines and W, M, Boothby# Prcc, Mayo Clin,, 1928, 3*189-190, Amor, J, Surg,, 1929, 6*1-6, 4, Oxygen therapy with special reference to its value after thyroidectomy. By W, M, Boothby and S, F, Haines, Sv, Lakf-3iSllsk,-Forhandl, 1928, Oct, 245-259, (Read before the Medical Society, Sweden, Oct, 1928, at Uppsula, Lund and Stockholm,) 1929 5, Treatment with oxygon* With special reference to treatment of conditions complicating goiter. By 3, F. Haines, Discussion by W, M. Boothby, Prcc. Mayo Clin,, 1929, 4*116-117, 6, Oxygon treatment with special reference to treatment of complications incident to goiter. By S, F, Haines and W, M, Boothby, Amer, J, Surg,, 1929, 7*174-180, 7, Note on treatment by oxygen. By W, M, Boothby, Proo, Mayo Clin,, 1929, 4:366, 1930 8, Oxygen therapy. By W, M, Boothby* Lecture at Peoria, 111,, 1930, Jan, (Not published), 1931 9, Oxygen therapy* By W, M, Boothby, Chapter for Sajou*s Encyclopedia of Medicine, F, A« Davis Co,, Phil., Pa., 1931, 816-826. 1932 10, Oxygon therapy. By YT, M. Boothby, J. Amcr, Mod, Ass,, for the Council of Physical Therapy, 1932, 99*2026-2033 and 2106-2112. Collected Paper? Mayo Clin,, 1932, 24*993-1021, 1933 11, Oxygen therapy* History, administration and nursing aspects. By Lyla Olson, (R,N«), Amor, J. Nurs,, 1933, 33*107-196, 12, Oxygon thorapy* Method of analyzing for carbon dioxide and oxygen when using an oxygon tent. By W, M, Boothby, Amor, J, Nurs,, 1933, 33*341-347, Collected Papers Mayo Clin,, 1933, 25*1056-1066, 1934 13, Miniature oxygen chamber for infants* A modification of Hess incubator. By W, M, Boothby, Proo, Mayo Clin,, 1934, 9*129-131, 14, Oxygon thorapy. By W# M, Boothby, Principles and Practice ")f Physical Therapy, Editors, Pemberton and Coulton, W, F, Prior Co,, 1934, Oct, 193 5 15, Oxygen therapy. By Yf, M, Boothby, Cyclopedia of Medicine (Piorsol), F,A, Davis Co,, Phil,, Pa., 1935, 9*473-480, 16, The use of helium and oxygen in the treatment of severe intractable asthma. By C,K, Haytum, L, E. Priokman and W. M, Boothby, Proo, Mayo Clin,, 1935, 10*788^790, 17, Practical considerations of oxygon therapy. By V/, M, Boothby, Hospital Year Book, The Modern Hoa$ital Publishing Co,, Chicago, 1935, 122-127, 1936 13, Some interesting ophthalmologioal factors in selection of the military aviator. By J. M, Hargreaves, J, Aviat, Mod,, 1936, 7*9-11. 2- •3 19* Changes in the oxygen content of venous blood as the result of fever therapy with and without the administration of oxygon. By Mildred Adams and W, M, Boothby, Proc, Amor, Soc, Biol, Chem,, 1936, 8:-3, 1938 *20; Oxygen administration! The value of high concentration of oxygen for therapy. By TT, M, Boothby,, Pro Or Mayo Clin,, 1938, 13*641-645, *21,, Oxygen therapy and ati on» An apparatus for the administration of oxygen or oxygen and helium hy inhalations By iT, R, Lovelace, II. Proc. Mayo Clin,, 1938, 13!646-653, *22, Design and construction of the masks for the oxygon inhalation apparatus. By A* H, 5ulbulian3 Proc, Mayo Clin,, 1938, 13:654-656, 23j A protection against night blindness. By J; M, Hargreaves. Flight Surg, Top,, 1938, 2, (3):151, 24, Editorial! Recent development in use and administration of oxygen in aviation and therapeutics. By W. M. Boothby; Ann, Intern, Med,, 1938, 12:560-563, 25„ Helium and oxygen treatment of intractable asthma. By C, I.. Proc, Mayo Clin., 1938, 13:783-789, 26, Technic of treatment with helium and oxygen using B.L.B, inhalation apparatus. By W. R, Lovelace, IIe Proc, Mayo Clin., 1938, 13?79D—791, 27, Oxygen in aviation: The necessity for the use of oxygen and practical apparatus for its administration to both pilots and passengers. By W, M, Boothby and W, R, Lovelace, II, J, Aviat. Mod., 1938, 9:172-198, Collected Papers Mayo Clin,, 1938, 30:907-914, 1939 28c Oxygon in aviation and therapeutics. By W, R, Lovelace, II#. Minn« Med., 1939, 22:117-119, 29, Aero-otitis media: Its alleviation or prevention by the inhalation of helium and oxygon. By W, R, Lovelace, XI, C, W, Mayo and W, M, Boothby, Proc, Mayo Clin,, 1939, 14:91-96, •Discussion by C, W, Mayo, Proc. Mayo Clin,, 1938, 13:656, 30c Oxygon therapy and its practical use -with troops on active service. By Lt, Col, C, K; Berio* M.C,, USA and W, R, Lovelace, II, Int* Congr, Milit, Med,, 1939, 1:321-363, Collected Papers Mayo Cline, 1939, 31:932-935, 31, Amaurosis fugax: Effect of centrifugal force in flying, ty Re Bj Phillips and C* Shcard, Poor!- Mayo Clin,, 1939, 14:612-618, 32, Photometric no aaur erne nt a on visual adaptation in normal adults on diots deficient in vitamin A- . - By -hi I, Steffens, H; L® Bair and C, Shoard, ProCc Mayo Clin,, 1939, 14j698-704, 33r The testing of hearing with the audiometer. By J, M. Hargreaves, Flight Surg, Top,, 1939, 3 (3):185, 34, New treatment for migraine. By W, C, Alvarez, Proc, Mayo Clin., 1939, 14*173-174. 35, Oxygen and oxygon and helium therapy: Recent advances. By W, M, Boothby, C, W« Mayo and W, R, Lovelace, II* Mod, Clin* N. Amor,, 1939, 23:977-1005. i 36, The necessity for the use of oxygen in flying at high altitudes* By W, R, Lovelace, II, Photo gramme trio Engineering, 1939 (July-Aug.-Sopt*) 111-122, 37, Determination of the velocity of sound in a gas: Application to analysis £f mix- of oxygen, helium and nitrogen. By W, B, Dublin, W, M. Boothby and M. M, D, Williams, Proo, Mayo Clin., 1939, 14:588-592, Correction in Proc, Mayo Clin,, 1939, 14:635, 38, Determination of the velocity of sound in a gas: Application to analysis of mixtures of oxygen, helium and nitrogen. By W, B<* Dublin, W. M, Boothby and M, M, D, Williams, Science, 1939, 90:399-400® 39p Oxygen: Importance of oxygen to the Navy in aviation and in therapeutics. By W. Mtf Boothby, W, R, Lovelace, II, and H, H, Carroll, Nav. Med, Bull,, 1939, 37:640-656, 40, The B,L.B, inhalation apparatus for flying at high altitudes. By W, R, Lovelace, II, Inter Avia Sooicte Anonymo Aeronautiquos Internationales. 1939, May 12, No, 643. 41, One hundred per cent oxygen: Indications for its use and methods of the admin- istration. By Wo M. Boothby, C, W, Mayo and W, R, Lovelace, II, J, Amor, Mod, Ass,, 1939, 113=477-482, Collected Papers Mayo Clin,, 1939, 31:922-930, 1940 42, Oxygon therapy. By W, M, Boothby, Chap tor in Cyclopedia of Medicine tPiorsol), F, A, Davis Co,, Phil,, Pa,, 1940, 82-91, 43, Dark adaptation and dietary vitamin A deficiency. By C, Shcard, H, L, Bair and L, F, Steffens, Amer, J, Physiol,, 1940, 129x461-462, 44, Value of high concentrations of oxygon in surgery. By C, W, Mayo, Proc, Mayo Clin,, 1940, 15x193-194, 45, The B,L.B. oxygen inhalation apparatus, (l) Improvements in design and (2) Effi- ciency as determined by studios on oxygen percentage in alveolar air. By W, M, Boothby, W, R, Lovelace, II, and A, Uihloin, Proc, Mayo Clin,, 1940, 15x194-206, 46, Effect of anoxia of high concentrations of oxygen on the retinal vessels* Preliminary report. By P, L, Cusiok, 0, 0, Benson and W, M, Boothby# Proc# Mayo Clin,, 1940, 15*501-502, 47# The use of oxygon and oxygon-helium, with special reference to surgery* By W, M, Boothby, C, W, Mayo and W, R, Lovelace, II, Surg, Clin# N, Amor,, 1940, 20*1107-1108, 48# Emergency oxygon unit for use in parachute escape or in case of failure of regular oxygon supply at high altitude, ' By W, M,Boothby, 0, 0, Benson and W, R, Lovelace, II, J, Aviat, Med,, 1940, 11*59-66. 49, High altitude and its effect on the human body# By W, M, Boothby, W, R, Lovelace, II, and 0, 0, Benson# J, Aeronaut, Soi,, 1940, 7*461-468 and 524-530, 50, Oxygon therapy, now fields opened up by ability to administer high concentrations of oxygen* economically, efficiently and comfortably. By W, M, Boothby, C, W, Mayo and W, R, Lovelace, II, Trans, Ass, Amer, Phys,, 1940, 55*261-269# 51, The value of oxygon and of helium-oxygen mixtures before and after thyroidectomy. By W, M. Boothby.and S# F, Haines, West# J, Surg,, Obstet, and Gyneo,, 1940, 48*662-669* 52# Voice changes with mixture of helium and oxygon. By W# B, Dublin, E. J, Baldcs and M, M, D, Williams, Proc# Mayo Clin,, 1940, 15*586-588, 53# Analysis of mixtures of helium, oxygon and nitrogen by moans of determinations of the velocity of sound* Further observations# By W, B, Dublin, W, M, Boothby, H, 0, Brown and M, M# D, Williams Proc, Mayo Clin,, 1940, 15*412-416, 54, Oxygon administration — indications,methods and typos, of apparatus. By F. R, Fraser, R* V, Christie and B, A. MoSwiney, Emergency Medical Services Memorandum No, 5, London, 1940, 1-7, 55, The B,L,B, mask for administering oxygon. By W, I, Card, J, F. Smith, W, J. Griffiths, B, A, McSwinoy and B, Savage, The Lancet, 1940, Mar, 2, pe 398, 56, The effect of decreased barometric pressure on the electrocardiogram. By 0, 0, Benson, J. Aviat, Mod,, 1940, 11:67-74, 1941 57, Physiologic effects of reduced barometric pressure on man: Thesis, By W, R, Lovelace, II, March 21, 1940 in partial fulfillment of requirement for the degree of M,S, in Surgery, Mayo Foundation, University of Minnesota, Collected Papers Mayo Clin,, 1941, 33:1-34. 58, The importance of the "nervous energy reserve” in aviation. By M, N, Walsh, Proc. Mayo Clin,, 1941, 16:707-714, Collected Papers Mayo Clin,, 1941, 33:34-41, 59, Airplane transportation of patients. By W, R, Lovelace, II, Surg., Gynoo. and Obstct,, 1941, 73:396-397, 60, Aviation deafness - acute and chronic. By P, A, Campbell and J, Hargreaves, Arch, Otolaryng,, 1940, 32:417-428, Abstr.: J. Aviat, Mod,, 1941, 12:267, 61, Necessity of emergency oxygen unit for use in parachute escape at high altitudes. By W, M, Boothby, W, R, Lovelace, II# and H, Burchell, J. Aviat, Mod., 1941, 12:126-130, 62, Ophthalmology with special reference to aviation tests. By P, L. Cusiok, Collected Papers Mayo Clin,, 1941, 33:61-65, 63, Rod and cone dark adaptation: Surveys of normal subjects, and applications to clinical problems. By C, Sheard, J, Opt, Soc, Amor,, 1941, 31:757, *64, Hemorrhage from duodenal ulcer in a pilot while flying: report of case. By J, H, Tilli sch, Proc. Mayo Clin., 1941, 16:209-211, Collected Papers Mayo Clin,, 1941, 33:42-43, *65, The syndrome of hyperventilation: Its importance in aviation. By H, C, Hinshaw and W, M, Boothby, Proc, Mayo Clin., 1941, 16:211-213. •Published in Symposium on Aviation and Medicine, Proc, Mayo Clin,, 1941, 16:209-227, *66. Hearing among experienced aviators. By P. N, Pastoro, Proc, Mayn Clin,, 1941, 16:214-217, Collected Papers Mayo Clin., 1941, 33:43-47, *67r Aviation medicine: A survey. By F* So McDonough. Proc. Mayo Clin,, 1941, 16:217-219, Collected Papers Mayo Clin,, 1941, 33:47-49, *68, Changes in intracranial volume on ascent to high altitudes and descent as in diving By M, N, Walsh, Proc, Mayo Clin,, 1941, 16*220-221, *69, Transportation of patients by airplane. By W, R, Lovelace. II0 Proc, Mayo Clin,, 1941, 16ii221-223, *70o The demonstration of air bubbles in the spinal fluid under atmospheric pressures, produced in a low pressure chamber, approximating those obtained during rapid ascents in airplanes. By M, N, Walsh and W„ M, Boothby* Proc* Mayn Clin,, 194.1, 16:225-227., Abstr,: J, Aviat. Med,, 1941, 12:2620 71, The hazards of aerial transportation to patients with pneumothorax. By W, R, Lovelace, II, and H, C. Hinshaw-, Prooe Mayo Clin,, 1941, 16:40, 72, Aeroembolism: A medical problem in aviation at high altitude. By W, R, Lovelace, II, Wc M, Boothby and 0, 0, Benson, Soi* Mon,, 1941, 53:30-37., 73* Medical problems in aviation. By K, C, Hinshaw and W, M, Boothby, Quart, Bull,, Inde Univ, Medical Center, 1941, 3:123-131, Collected Papers Mayo Clin,, 1941, 33:50-61, 74, Aoro-omphyscma and the birth of gas bubbles. By Jean Piccard,-. Prof, in .doronautical Engineering Proc, Mayo Clin,, 1941, 16:700-704, 75, Some effects of hyperventilation with special reference to aviation medicine. By R, F. Rushmer, W. M, and H, C* Hinshaw* Procc Mayo Clin,, 1941, 16:801-808^ Collected Papers Mayo Clin,, 1941, 33:66-73, 76, The physical maintenance of transport pilots. By J, H, Tillisoh and W„ R., Love lace, t II., Collected Papers Mayo Clin*, 1941, 33:78-86, J, Aviat, Mod*, 1942, 13;121-1290 77, The hyperventilation syndrome and its importance in aviation. By H, C, Hinshaw, R„ F„ Rushmer and W, M, Boothby* Collected Papers Mayo Clin*, 1941, 33:73-78, J, Aviat, Med,, 1943, 14:100-104, •Published in Symposium on Aviation and Medicine, Proc. Mayo Clin,, 1941, 16:209-227, 1942 78,. Dangers of aerial *tran»p-«r%ft-ti«n to persons with pneumothorax, Roa-ntgenographio demonstration of the effect of deoroasod barometric (b-igh altitude) and of increased barometric pressure. By W, R, Lovelace, II- and H, C. Hinshaw, J, Amer. Med. Ass., 1942, 116:1275-1278. 79, Transportation of patients by airplane. By W. R, Lovelace, II, and J. Hargreaves, J0 Aviat- Mod,, 1942, 13:2-25, 80, A practical method of pilot selection. By M, N, Walsh, Proo, Mayo Clin,, 1942, 17:65-69, 81, Aerial transportation of patients; with special reference to traumatic pneumothorax, diaphragmatic hernia and mediastinal emphysema. By W, R, Lovelace r II,-. and H„ C, Hinshaw, War Med,, 1942, 2:580-585* Collected Papers Mayo Clin,, 1942, 34:759-764, 82, Chronic exhaustion state in test pilots. By J, H, Tillisch and H, Nc Walsh, War Med., 1942, 2:917-922. 83, Hyperventilation: Its occurrence among passengers on airplane. By A, Uihloin and W, M, Boothby, Proc, Mayo Clin,, 1942, 17:417-419, 84, Study of the effects of airplane transportation of 200 patients. By J, H, Tillisch, J, F, Stotlcr and W, R, Lovelace, II, Collected Papers Mayo Clin,, 1942, 34:936-943, J. Avlat, Med,, 1943, 14:162-172, 1943 85, Chronic exhaustion state in tost pilots. By M, N, Walsh, (Letter to editor) War Med., 1943, 3:560^*561, 86, Neuropsyohiatrio aspects of aviation medicine. By M, N. Walsh, Arch, Neurol, Psychiat,, 1943, 49:147-149, 87, Medical activities in military aviation. By 0, 0, Benson, D, B, Dill and W, R, Lovelace, II, J0 Aeronaut, Sci,, 1944, 11:21-25. Collected Papers Mayo Clin,, 1943, 35:820-826, 88, Flight testing of items of medical equipment used by military pilots and their crews. By W, R, Lovelace, II, and J, A-, Rosch0 Collected Papers Mayo Clin,, 1943, 35:826-831, 89, Physiology of anoxia. The basis of inhalation therapy, (Scenario for movie), fty A, h. Oarach, V, M. Bpothby, A, B, Luckhardt, C. P, Schmidt and R. M, Waters, The Lindo Air.Products Co«> 1943* 99. The D.t.B, Jnask anti the nask, By M, I, Rat-arson, (R,N,) An*r, J *. Nurs., 1944, 44{1060—1062, 91. The effects of altitude anoxia on the respiratory processes. By H, F.Helmholz, Jr,* J* B, Bateman and We M, Boothby, J- Aviat, Med*, 1944, 15:366-380. 92* Dark adaptationc Tone physical, physiological, clinical and aoromedioal consid- er a';ion? - By G-, ChcarcU J0 OptiCj Soc* America, 1944, 34:464-508, 1945 93* Oxygon therapy.- By W, M, Booth')*/ end H* FP Helmholz, Jr* Cyclopedia of Medicine (Piersol), F, A. Davis Co,, Phil., Pa, 1945, V 0 x a 11* 94, Effects of high altitudes on the composition of alveolar air* Introductory remarks. By We M, Boothb3*o Proc, Mayo Clin,, 1945, 20: (June) 209-213, 95, Effect of altitude, added oxygen and pressure breathing on transportation of oxygon by the blood. By H, F. Helmholz, Jr, i’roo» Mayo Clin,, 1945, 20* (June) 224-229, 96, Factors influencing the composition of alveolar air in normal persons. By J, B, Bateman. Proc, Mayo Clin,, 1945, 20?(June) 214—224, 97, Effects of anoxia, oxygen and increased intrapulmonary pressure on dark adapta- tion. By C, Sheard, Proof Mayo Clin., 1945, 20: (June) 230-236, 98s Experience with photography in aviation codioino. By L, A, Coffey, J, Biol, Photographic Sec,, 1945, (June) (in print), 99, Two physical methods for the quantitative determination of one component of a mixture of gases. By M. M, D, Williams, H, 0, Brown, W, B, Dublin and W, M, Boothby, Presented at meeting of Minnesota Academy of Scinece, Apr, 21, 1945, Proc, Minn, Acad, Sci, (in preparation) , 100, Flatulence at altitude in presence of cardiospasm. Report of a case* By C, B, Taylor and F, J, Robinson, J. Aviat. Med., 1945, 16:272-274. 101, Safety advantage of rearward seating. By K, G, Wilson and H, F, Helmholz, Jr, (Consolidated Vultoo Aircraft Corporation, San Diego, Calif,), The Air Surgeons Bulletin, 1945, 2:455, 10- 102, Notes on a modified op-erw-oirouit method for the moasurecvcn-t- erf residual air. By J, B. Bateman, Proc. Mayo Clin,, 1945, 20:(Doc.) 482-485, 103, Large molecules; their physicochemical properties and their architectural and functional significance in living matter. Section II in Physical Chemistry of Cells and Tissues edited by R, Hoobor, By J. B. Batoman. Philadelphia, Blakiston, 1945, 93—216, 1946 104, .Roentgen kymographic studios of cardiac and respiratory movements (motion picture). By W, M, Boothby and H, F. Holmholz, Jr. (by invitation)e Federation Proc., 1946, Part II, 5:10, 105o The measurement of intrapulnonary mixing and pulmonary midcapacity ("functional rosidual air”), By J, B, Bateman, Proc. Mayo Clin., 1946, 21:(Mar.) 112-120, 11 INDEX OT AITTK0R5 Adana, M, ...... * 19 Alvarox, W, C. • • • i 34 Bair, H. L. f . . . * 32, 43 Baidas, E. J. . . « * * 2 Baraoh, A, L, ..... . 89 Batenan, J. B, ...» 91, 96, 102, 103, 105 Benson, 0* 0. .... * 46, 48, 49, 56, 72, 87 Bcrla, C. E* .... * 30 Boothbv, W. M, ... * 1, 2, 3, 4, 5, 6, 7, 8, lO, 12, 13, 14, 15, 16, 17, 19, 20, 24, 27, 29, 35, 37, 38, 39, 41, 42, 45. 46, 47, 48,49, 50, 51, 53, 61, 65, 70, 72, 73, 75, 77, 83, 89, 91, 93, 94, 99, 104 Brown, H, 0, • • • « • 53, 99 Bulbulian, A. H. . . .. 22 Burchell, H, « • . « . 61 Campbell, P. A. . • » 60 Card, W, I, . » . « • • 55 Carroll, H, H, • * . • 39 Christy, R, V, • « • • 54 Coffey, L. A. . • . . . 98 Cusick, F. L* • • 46, 62 Dill, D, B. * , * * . . 87 Dublin, W, 37, 38, 52, 53, 99 Fraser, F* R, • • • • ♦ 54 Griffiths, W. J* • . . 55 Haines, S, F* . • * • 1, 3, 4, 5, 6, 51 Hargreaves, J. H, • • - 18, 23, 33, 60, 79 Helnholz, H. F,, Jr, • 91, 92, 94, 101, 104 Hinshaw, H. C* • « • • 65, 71, 73, 75, 77, 78, 81 Lovelace, W, R., XX * . 21, 26, 27, 28, 29, 30, 35, 36, 39, 40, 41, 45, 47, 48, 49, 50, 57, 59, 61, 69, 71, 72, 76, 78, 79, 81, 84, 87, 88 Luokhardt, A, B* . . .. 89 Mayo, C. W. , . * . . . 29, 35, 41, 44, 47, 50 Maytun, C* K, » • . . * 16, 25 McDonough, F, E, . • • 67 MoSwiney, B. A, , , . 54, 55 Moersch, H, J. • . • 2 Olson, L, ••••*»• 11 Pastore, P. N, . » • • 66 Piccard, J, • • ... 74 Peterson, M. I, • • . • 90 Phillips, R, B. • • • • 31 Prioknan, L, E. . . . • 16 Rosch, J. A, . • . . • 88 Robinson, F, J* • • • . 100 Rushner, R. F, • « • • 75, 77 SftVTigo, 6. •«..«. 55 Schnidt, C, F* • • • • 89 Sheard, C. . . • . . . 31, 32, 43, 63, 92, 97 12 Smith, J, F, , , » • • 55 Stoffons, L, F, • • • 32, 43 Stotler, J, I* • • • 84 Taylor, C, B, , . , • 100 Tillisoh, J„ H, , « • 64, 76, 82, 84 TJihlain, A, o « . . , 45, 83 Walsh, M, N3 58, 68, 70, 80, 82, 85, 86 Viators, Rv M, • 0 • . 89 Williams, Me M. D. , , 37, 38, 52, 53, 99 Wilson, K- G3 • • • • 101