Aviation medicine is not purposed for people with diseases, but contingencies have been developed to allow people to go into low pressure environments, which in itself is a large medical challenge.
Paul Bert (1833–1886) of France is known as the Father of Aviation Medicine, the first to research effects of air-pressure on health and oxygen toxicity; he worked with the French meteorologist Gaston Tissandier. The first fatalities from aviation hypoxia occurred on 15 April 1875 in France, when the balloon Zenith reached 28,200 ft.[1]
Early research on altitude sickness
Chimborazo in July 2014
Alexander von Humboldt in 1802 climbed 19,286 feet up Chimborazo, setting a record, but suffered oxygen starvation in the blood. This was described as 'mountain sickness', or altitude sickness. Denis Jourdanet, of France, later described this as 'anoxemia'.
The summit of Chimborazo, in Ecuador, is the furthest place away from the centre of the Earth, due to the Earth being flatter at the poles.
Italy was the first country to develop research into aviation medicine in World War I, followed by France. Britain was the first country to look at the effects of atmospheric pressure on pilots. By 1917, Britain and America were collaborating on research into aviation medicine, with a combined report in March 1918 started by Brigadier GeneralTheodore C. Lyster (1875–1933), who helped to form the United States Army Air School of Aviation Medicine in 1918.
The Royal Flying Corps (RFC) did not believe in issuing any of their World War I pilots with parachutes, as the 'stiff upper lip' British believed that parachutes could 'impair the fighting spirit of pilots'. But other air forces, instead, issued their World War I pilots with parachutes.
Interwar era
In the interwar era, techniques in aviation medicine mainly started; aircraft were gradually becoming more advanced. The United States passed its Air Commerce Act on 20 May 1926, which laid down medical regulations for commercial pilots. In 1931, the Swiss physicist Auguste Piccard made important investigations of atmospheric pressure of the upper atmosphere (mesosphere).
The first textbook on aviation medicine was written in 1919 by Henry Graeme Anderson (1882-1925), in the UK. He was a surgeon at the Royal Air Force Central Hospital. It included work by Martin William Flack and Oliver Horsley Gotch (1889-1974), published by Hodder & Stoughton; his grandfather John Callcott Horsley had designed the world's first Christmas card in 1843; his father was the neuroscientist Francis Gotch.[3]
An early 'catapulted cockpit' was developed by Romanian Anastase Dragomir, and first tested by Lucien Bossoutrot, on 28 August 1929, in France.
High altitude enclosed ballooning
On November 4 1927 Hawthorn Charles Gray, of the US, is claimed to have reached around 12,950m in a US Army balloon. He had died of hypoxia, when the balloon descended.
So Auguste Piccard designed an aluminium balloon, made by Georges L'Hoir of Liège of Belgium. The breathing apparatus was by Hermann Stelzner (1884-1942) of Dräger (company) in Lübeck. The balloon was made by August Riedinger of Augsburg. It flew in 1931 and 1932.
In only a few years, the Soviet balloon USSR-1 on September 30 1933 reached 18,482m. On January 30 1934 the Soviet balloon Osoaviakhim-1 reached 21,978m, but crashed.
August 1933 picture showing the curvature of the Earth
In May 1934 meteorologists Martin Schrenk and Victor Masuch at Bitterfeld in eastern Germany, died of hypoxia. The balloon landed at Sebezh in Pskov Oblast in Russia, with no-one aboard. The balloon was 'Bartsch von Sigsfeld', named after the German balloonist Hans Bartsch von Sigsfeld (1861-1902). On 31 August 1933 this balloon had reached a height of 11,300m, which is the highest altitude that an unenclosed balloon has ever reached, piloted by Alexander Dahl.
In France, Air Minister Pierre Cot would not fund any work on pressurised aircraft from the early 1930s. Early pressurised aircraft included the Farman F.1000 and a version of the Farman F.220, from the Farman Aviation Works of France. The Renard R.35 of Alfred Renard of Belgium, first flew on April 1 1938, but crashed, killing the pilot Georges Van Damme.
At the Mayo Clinic in Albuquerque, Arthur H. Bulbulian developed the A-14 oxygen mask.
World War II
By 1941–42, some production military aircraft were pressurised for the first time.
From 1940-51 much work was conducted by John Farquhar Fulton at a university aeromedical unit. At this centre, Samuel Gelfan, Leslie F. Nims, and Robert Burr Livingston looked at explosive decompression. M Laurent, M Richou and Paul Garsaux looked at decompression in France.
Research in the war for the RAF was conducted by Roland Henry Winfield DFC (20 December 1910 - 1 November 1970), who flew on twenty bombing missions, from August 1941 to July 1942, to look at the effect of amphetamine (benzedrine).
A few reconnaissance high-altitude versions of the Mosquito had a pressurised cabin from around 1944, but nothing else did. But it was British civil engineer Sir Ernest William Moir who had developed the first air-lock and recompression chamber, in 1889.
Most revolutionary new Luftwaffe aircraft were tested at Müritz Airpark at Rechlin in north-east Germany. During the war, Junkers produced the Junkers Ju 188, Junkers Ju 288 and Junkers Ju 388 for high-altitude flight, although only the Ju 388 was designed with a pressurised cabin from the outset. The Germans never produced a high-altitude fighter aircraft, with the closest being the Blohm & Voss BV 155, and the prototype Focke-Wulf Ta 152 and the Focke-Wulf Ta 153 design. Hermann Tietze at Draeger developed a pressure suit by the end of the war, which would have been worn by pilots of the proposed manned-rocket Bachem Ba 349 Natter.
The Germans were the first to develop ejection seats from 1939, and in January 1942 Helmut Schenck was the first to eject, out of a turbojet Heinkel He 280, developed by Ulf Weiß-Vogtmann (1900-89).
The Heinkel He 219 Uhu nightfighter was the first production aircraft to have an ejection seat fitted, as standard equipment. On 11 April 1944, at 11.08pm, a Heinkel He 219, of 2./NJG 1, was shot down by a Mosquito of 239 Sqn at RAF West Raynham, over Weert in the south-east of the Netherlands, and Unteroffizier Herter ejected.[5]
Over 60 Luftwaffe pilots made ejections in the course of the war, from April 1944.
In the post-war era, jet aircraft were now commonplace. Jet engines allowed aircraft to reach much higher altitudes; an aircraft has a maximum height it can reach known as its ceiling.
Wilbur R. Franks looked at centrifugal effects in Canada, and invented the G suit, and similar work was conducted in Australia by Professor Frank Cotton, who invented another G-suit.
Hugh DeHaven conducted much research into surviving accidents in the US.[7]
Around August 1947, ejection seats were tested by a Gloster Meteor III, [8] piloted by John Ernest Dudley Scott (May 10 1908 - April 23 2002), known as Jack Scott.[9] Later tests were by Sqn Ldr John Stewart Fifield DFC, in a Meteor VII.[10] In October 1955, he ejected at 40,000ft.[11] Fifield had flown with nightfighter Mosquitos with 169 Sqn in Norfolk.
On Wednesday April 9 1958 the record for the highest ejection was set over Monyash in Derbyshire, at 56,000 ft. The previous highest ejection was 45,200 ft in 1954, by a USAF pilot.[13] Pilot Flt Lt (John) Peter Fane de Salis, aged 29 of Hythe, Hampshire and navigator Fl Off Patrick Henry George Lowe, aged 23 of Potters Bar in Hertfordshire, ejected from Canberra B6 'WT207', which had a booster Napier Double Scorpion rocket attached, to reach high altitude, where the Canberra of 76 Sqn, which took off from RAF Hemswell at 3pm, had climbed from 45,000 ft, to 60,000 ft, in 4 minutes. The Canberra had earlier flown from RAF Cranfield, but the Bedfordshire airfield was closed.[14][15][16][17]
Ejecting at that height could be fatal, as the temperatures at 56,000ft is -93 C, and air pressure is 1.2 pounds per square inch; a minimum of 2.7 pounds per square inch is needed to get oxygen into the blood. At that altitude, you would expect to live for 15 seconds.
Both pilots freefalled for around nine miles, before the parachutes opened at 10,000ft. On landing, blood was coming from their eyes, nose and ears. Parts of their body, and face, had greatly swollen in the life-threatening low pressure conditions. Both were taken to Bakewell Cottage Hospital, then Chesterfield Royal Hospital, when none had broken bones. Later taken to Princess Mary's Royal Air Force Hospital Halton. Their eyes stopped bleeding after two days. Their sinuses were full of blood.[18] This is the highest ever ejection from an aircraft.[19][20]
Pat Lowe later became an air traffic controller in west London, and died in February 2014.
Rocket ejection
The first rocket ejection seat was tested in Gloster Meteor VII 'WA634' mid-March 1962 with 36-year-old Sqn Ldr Peter Howard (December 15 1925 - October 21 2007), of Church Crookham in Hampshire, in a Martin-Baker Mk 4 seat, at 288mph.[22][23] For this he was awarded the Richard Fox-Linton Memorial Prize in March 1964.[24] He was an RAF doctor, who was head of the RAF Institute of Aviation Medicine from 1975-88, later becoming Air Vice-Marshal.[25] This type of seat entered service as the Martin-Baker Mk.6.
During the Vietnam War was the highest number of ejections, in Martin-Baker seats, in one day - 11 on November 22 1969.
The Russian Kamov Ka-50 is the first helicopter to fit an ejection seat; not many others have followed. The experimental Sikorsky S-72 had an ejection system in 1976, but this was not a production aircraft.
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