Aerospace Medicine at 100 Years!

January 25, 2018

Aerospace Medicine at 100 Years!

Jeffrey C. Sventek, M.S., CAsP, FAsMA, FRAeS
Executive Director, Aerospace Medical Association

  • 1917: U.S. Army Lt. Col. Theodore C. Lyster (1875–1933) serves as first Chief Surgeon of the Army Signal Corps as America enters World War I. That December he observed medical support of aviation units at the front lines.
  • 19 Jan. 1918: The U.S. Army Air Service establishes its “Medical Research Laboratory and School for Flight Surgeons” at Hazelhurst Field, Long Island, NY.
  • 11 Mar. 1918: The term “flight surgeon” is officially adopted by the U.S. Army Air Service Medical Research Laboratory.
  • 8 May 1918: Capt. Robert J. Hunter, M.D., and three other physicians are ordered to report to an aviation school. Capt. Hunter reported to duty on 13 May 1918, 2 days before his colleagues. He was the first American flight surgeon.

   The history of Aerospace Medicine closely follows the development of aviation and space operations. From the beginnings of aviation via balloons to aviation experimenters Hiram Maxim, Clément Ader, Karl Jatho, Augustus Moore Herring, Alberto Santos-Dumont, Gustave Whitehead, and, of course, the Wright Brothers, to modern aviation and eventually to space, human physiology has presented significant limitations. Aviation and space operations expose human beings to a variety of environmental situations that the human body has little to no natural ability to counter. In this way, as aeronautical science and engineering slowly evolved, an understanding of human physiological response and the development of life support equipment to counter human physiology limitations remained one small step behind. The specialty of Aerospace Medicine developed a few years following the Wright Brothers’ success in North Carolina and has developed into a highly specialized and fascinating medical discipline that ensures the health, safety, and performance of those engaged in aviation and space operations.

The Father of Aviation Medicine
Paul BertPaul Bert (1833–1886; pictured to the left) was a French physiologist with doctorates in medicine and science, acquired in the 1860s. Dr. Bert was very interested in the effects of altitude on human physiology and conducted hundreds of experiments to research his hypotheses. Not content with experimenting solely with balloonists, he developed the first hypobaric chamber, which was able to simulate altitudes up to 36,000 ft. He experimented with animals to determine the minimum required partial pressure of oxygen in circulating blood. Using the results from these experiments, he came to the conclusion that the use of supplemental oxygen in high altitude balloon travel was necessary, and fervently urged operators to do so. He also discovered oxygen toxicity. His research entered vast amounts of scientific information into the new field of flight physiology. Ultimately, Dr. Bert compiled all of his research into a simple book titled “La Pression Barometrique” (“Barometric Pressure”), published in 1878. His book would form much of the early foundation for the new discipline of Aviation Medicine, resulting in his designation as the “Father of Aviation Medicine.”

Pilots & Fitness to Fly
It wasn’t long after the first manned powered airplane flight at Kitty Hawk in December 1903 that the U.S. War Department (predecessor to the U.S. Department of Defense) became interested in aviation for purposes of national security and military operations. As infantry soldiers and sailors transformed themselves into pilots of flying machines, European militaries led the way in setting medical standards for aircrew. The Germans were the first to develop a minimal set of aeromedical standards in 1910, which were soon imitated by the Italians, the British, and the French. The United States followed this trend, publishing instructions for aviation physical examinations in 1912 and then actual aeromedical standards in 1916. Much of the medical operations in early military aviation was guided by then Lt. Col. (later ret. Brig. Gen.) Theodore Lyster (1875–1933; pictured to the left). The book “Air Service Medical” published by the War Department in 1919 was likely written by Dr. Lyster and his colleagues Dr. Isaac H. Jones and Dr. Eugene R. Lewis. This book served as the earliest military aviation medicine textbook.
   In addition to his efforts behind “Air Service Medical,” Dr. Lyster served as Chief Surgeon of the Army’s Aviation Section during World War I, emphasized the importance of medical standards for pilots as a significant factor affecting flight safety, and created the role of flight surgeon in military flying units. Although he may not have been the first to coin the term “flight surgeon,” it was Lyster who really developed the concept. He assigned these military physicians to individual flying units and deployed them with their units rather than the larger medical teams. Brig. Gen. Lyster also established the Air Service Medical Research Laboratory on Long Island, NY. This facility allowed the military to considerably increase medical research studies in pilots, which were later catalogued in “Air Service Medical.” Later, after retiring to civilian life, Dr. Lyster would serve as the medical examiner for the Federal Aviation Administration’s predecessor, the U.S. Department of Commerce. In this role, he also organized the first issuing of licenses to civilian commercial aviators.
   Dr. Lyster chose otologists Isaac H. Jones and Eugene R. Lewis to assist in the expansion of aviation medicine and the opening of medical examination centers for pilots. Both doctors were adamant that these new aviation medical specialists fly regularly to better understand the physiological consequences of flight. Jones was an especially strong advocate of the mission of the flight surgeon in keeping pilots fit to continue flying duties. He constantly campaigned against the commonly held belief among pilots at that time that flight surgeons only wished to take their wings.

The First Flight Surgeon
It is uncertain who first created the term “flight surgeon.” Less contentious among military historians is who was the first flight surgeon. Capt. Robert J. Hunter, M.D., was ordered, along with three other physicians, to report to an aviation school on 8 May 1918. Their orders did not originally contain the words “flight surgeon,” but were later revised to include verbiage stating “amended so as to have the officers report in person to the Commanding Officers at the places specified for duties as Flight Surgeons.” In this role, these four physicians were tasked to ensure that military personnel selected as aircrew maintained fitness to fly. As they developed the roles and responsibilities of the flight surgeon, they also provided early insights into accident prevention, safety improvements, and investigated aircraft crashes. Capt. Hunter reported to duty on 13 May 1918, 2 days before his colleagues. He was the first American flight surgeon.

Celebrating 100 Years of Aerospace Medicine
The Aerospace Medical Association has a unique opportunity during our upcoming 89th Annual Scientific Meeting in Dallas, TX, to celebrate the first 100 years of Aerospace Medicine as a medical discipline. We are planning an evening reception to celebrate 100 years of Aerospace Medicine that will include entertainment, food, and fun. The “Reception to Celebrate 100 Years of Aerospace Medicine” is scheduled for 8 May 2018 … 100 years to the day that the U.S. Army ordered the first four physicians to an aviation school to become the first U.S. flight surgeons!
   Tickets for this reception event can be purchased during your meeting registration. Tickets for the reception are priced at $10 per person and will help defray some of the costs for the reception. I encourage all planning to attend the 89th Annual Scientific Meeting to consider spending Tuesday evening with us to celebrate Aerospace Medicine at 100 Years.