Air Disease

Captain Harry George Armstrong, a salty ex-Marine doctor, is director of the Army's efficient Aero-Medical Research Laboratory at Wright Field, Dayton, Ohio. Ten years ago Dr. Armstrong made his first parachute jump from an altitude of 2,200 feet, then published a cold, detailed medical report on his "free fall in space."

"The period of free fall," he wrote, "was remarkably free from abnormal physical sensations. . . . Consciousness was unclouded, and ideation [thought] was rapid, precise, penetrating and clear."

Last week Dr. Armstrong officially opened a new branch of medical science with a weighty tome, Aviation Medicine

(Williams & Wilkins, $6.50), first book of its kind to appear in 13 years. Crammed with technical advice to physicians, pilots, passengers, airlines, the Army, the aviation industry, the book is especially significant for its lengthy discussions of aviators' diseases.

Ears and Stomach. "Pilots suffer more frequently from occupational diseases of . . . [the ear] than from all other occupational diseases combined." Conditions of flight damaging the ear: 1) "changes of atmospheric pressure during ascent and descent"; 2) harsh, monotonous propeller and exhaust noises, which airplane manufacturers are unable to muffle. A common aeronautical affliction is "aero-otitis media." This is a "chronic inflammation of the middle ear caused by a pressure difference between the air in the [ear] cavity and that of the surrounding atmosphere. It ... occurs during changes of altitude," starts as a "hissing, roaring, crackling, or snapping," soon leads to warm pain and vertigo, often deafness. Yawning, shouting or singing may help to equalize the pressure. Treatment is the same as for ordinary earache: dry heat and a cotton plug.

Droning noises may not only destroy the auditory nerve, but also reduce the flow of saliva and gastric juices. Noise, fear, and changing atmospheric pressure (lowered pressure expands intestinal gases, may cause violent cramps) all add up to a second major occupational disease of fliers: "gastric disturbances."

Air and Altitude Sickness. Identical with seasickness, airsickness is "one of the most important unsolved problems in aviation medicine." Dr. Armstrong believes that it occurs mainly among neurotics who have an unconscious fear of falling. Far more serious is "acute altitude sickness," caused by decrease in the pressure of the oxygen breathed at high altitudes. Altitude sickness, says Dr. Armstrong, is a tough problem. Few people ever feel its painful symptoms while aloft, even though its serious effects may begin at altitudes as low as 9,000 feet. Reason: as the amount and pressure of oxygen breathed is decreased, the senses are dulled, so that bodily changes which would normally cause pain are not felt. Above altitudes of 12,000 feet, a man who does not take oxygen will become sleepy and depressed, or hilarious and pugnacious. At 25,000 feet, he may droop into a pleasant, possibly fatal coma. A pilot flying at 15,000 to 18,000 feet for four or five hours may feel well enough to ignore his cumbersome oxygen mask. But when he lands he may collapse with violent headache, dizziness, nausea, muscular weakness, mental confusion. Chronic altitude sickness may ground a flier for over a month. Only pressure cabins or oxygen masks will forestall the disease. And even with these precautions, warns Dr. Armstrong, "it cannot be considered a safe practice to fly over 20,000 feet where the safety of the flight depends upon the inhalation of oxygen."

Aeroembolism. After rapid ascent to high altitudes a pilot may be attacked by sickness similar to the dread staggers, bends, or caisson disease of divers. Cause of "aeroembolism" is formation of nitrogen bubbles in the blood and spinal fluid. Symptoms are neuritis, joint pains, a heavy red rash, burning and stabbing pain in the lungs, a weird tingling "like a small compact colony of ants rushing madly over the surface of the body." For aeroembolism, only thing to do is come down in a hurry.

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