3. Flow of AAF personnel returned from overseas by air through ports of aerial embarkation.. 4. Flow of AAF personnel returned from overseas. 98 99 8. Radius of aircraft turn required to blackout average pilot at various true air speeds. . . . . 269 9. Speed a plane must make to pull 2 to 8 G's on a flight path of 700-yard radius... 270 10. "G" force resulting from varying radius of turn with constant speed. 12. Malaria-annual admission rate per 1,000.. 13. Malaria-noneffective rate per 1,000... 270 620 909 910 14. Venereal diseases-annual admission rate per 1,000. 15. Venereal diseases-noneffective rate per 1,000... 16. Diarrheal diseases-annual admission rate per 1,000. 17. Diarrheal diseases-noneffective rate per 1,000.. 912 913 914 915 916 917 18. Common respiratory diseases-annual admission rate per 1,000. 19. Common respiratory diseases-noneffective rate per 1,000. Illustrations General of the Army Henry H. Arnold... Maj. Gen. David N. W. Grant (MC), The Air Surgeon. Brig. Gen. Theodore C. Lyster. Planning aviation medicine 1917, Theodore C. Lyster, W. H. Wilmer, I. H. Staff of medical research laboratory-Mineola, New York. Page 11 vi 9 10 12 65 .fold-in after 94 Main building, School of Aviation Medicine, Mitchel Field, New York.,... 146 147 152 One of the very first low-pressure chambers.. Low-pressure chamber-permanent type or fixed type.. Future flight surgeons work out in high-altitude chamber. 199 200 201 Maj. Gen. Harry G. Armstrong (MC). . Aircrew indoctrination in low-pressure chamber for high-altitude flight. The first building of the Aero Medical Laboratory. 202 232 233 235 A combat crewman wearing the Type A-10 Demand Oxygen Mask. 254 A combat crewman wearing the Type A-14 Demand Oxygen Mask. Simulating actual physical exertion of an airman in the sky. Page Four-motor bomber becomes mercy ship on return from bombing mission.. Nurses of an evacuation hospital unit of the Ninth Air Force. General Patton with casualties waiting to be evacuated by air Heated bag used for transportation and care of wounded bomber crews. Bed patient in traction using loom and wool to make a small rug. INTRODUCTION Medical care for the fighting forces was complicated in World War II because of the scale and rapid pace of mobilization and deployment of troops. In the Zone of Interior, young men and women were hurriedly drawn from civilian life and trained on a scale never envisaged in the pre-war days. The Army including the Army Air Forces was to expand from 93,000 to an authorized strength of 7,700,000. For every member, the military medical staff had to carry out physical examinations, to screen and classify him according to his mental ability and aptitudes. The medical profession was then called upon to provide nearly 8 million individuals with routine sick care at base level together with all required specialty care. Doctors, in cooperation with the base commander and the engineers, were moreover responsible for preventing the sudden outbreak of epidemics caused by the crowding of the new military population in makeshift facilities. Indeed, all medical resources were drawn upon to maintain fighting effectiveness, and newly inducted doctors found their professional skills suddenly mobilized to conserve the health of the forces. In the Army Air Forces alone personnel strength expanded by 1200 percent. Its projected strength of 2,340,000 was reached over a 2-year period. By 1 January 1944 the figure stood at 2,385,000 officers and Insofar as medical care for such a force was concerned, the Army Air Forces was in a favorable position as compared with the remainder of the Army, for it was given first priority in the nation's manpower pool and could maintain the highest physical standards besides requiring the highest educational and technical standards. In terms of human resources, its fighting effectiveness should therefore be greater than that of the remainder of the Army. This was to prove true, although there were other factors which entered into the picture. Army Air Forces personnel, like all other military personnel, enjoyed the benefits of the three great wartime advances in military medicine: the use of penicillin, the administration of whole blood on the battlefield, and the evacuation by air of the sick and wounded. In addition the Army Air Forces early violated traditional practice by propounding two theories which were later accepted by the medical profession and by the Army. The first encouraged the patient to become ambulatory shortly after surgery rather than remain immobile for many days. The second encouraged the patient to speed his own return to normal after his wounds had healed by turning his attention from his ailments to a program of education and physical rehabilitation. Yet another factor which made it possible for the AAF to maintain the highest rate of fighting effectiveness was in the area of management and was in itself a command problem. Because of the sudden and unprecedented expansion of the military forces, it had been necessary to revise Army management policies and procedures along the lines of "big business." At the same time it remained a basic military principle that the major force commander must control all resources, including human resources, placed under his command to carry out the combat mission. And while the total Army Air Forces strength stood at 2 million, fighting effectiveness must initially be measured in terms of the individual. Every day an individual was absent from his post of duty because of illness represented a man-day lost to the Air Forces. This fact took on new significance in terms of the limited number of highly trained pilots, bombardiers and gunners. Within the broad area of administration, therefore, it was necessary to maintain constant vigilance to make sure that personnel excused from duty because of illness were not actually absent because of cumbersome and obsolete procedures of hospital administration or unnecessarily distant travel from hospital to place of duty. Whatever the cause, each man-day lost lessened to that degree the total effectiveness of the fighting machine. As the air offensive over Europe increased in intensity each man-day lost took on new significance. The Army Air Forces, however, had a primary medical mission which extended beyond that of maintaining combat effectiveness in peace and war. As does any combat force, it had also the responsibility of planning for war. This included the provision of proper organic medical support. Because the nature of the air combat mission itself had not yet been clearly defined and accepted among line officers, the nature of an effective medical service to support these forces could not yet be determined. Many officers viewed military aviation in terms of the dog-fights over France in World War I and had not yet comprehended the newer lessons of aerial warfare in Europe. For that reason there were often clashes among ground and air officers and among combat and noncombat officers each of whom was trying in a troublous time to meet the imponderables of global war. As a result, it was too often an easy observation among the less knowledgeable that there were "personality clashes" among responsible leaders. In that heat of the moment it was easy to forget the heavy burdens borne by those who ultimately had to make the command decision. At the TRIDENT Conference in May 1943 the Army Air Forces mobilization strength was fixed at 273 combat groups. This number comprised 5 very heavy bombardment (B-29's and 32's), 96 heavy bombardment (Flying Fortresses and Liberators), 26 medium bombardment, 8 light bombardment, 87 fighters, 27 troops carrier and 24 reconnaissance groups. The dependence in combat upon human resources is apparent in the fact that every B-29 that flew over Japan required the efforts of 12 officers and 73 men in the combat area alone. The Air Staff, recognizing the need for harboring its human strength, was to be concerned throughout the war with the problem of how best to maintain fighting effectiveness in the combat areas. To meet that need, the rate of pilot production was about 75,000 per year not including glider, liaison, and observation pilots.* The First, Second, Third, and Fourth Continental Air Forces born of the old GHQ Air Force, tactical element of the prewar air arm, became the training ground for overseas air forces. These forces were eventually to go to every part of the globe, and in the combat areas not one trainee was expendable. To maintain combat effectiveness it was necessary that each individual be able to attend his duties, and it fell to the Surgeon to circumvent his being absent because of preventable sickness and to assure his return to duty within as few hours as possible. If his illness were prolonged, he must be replaced as quickly as possible. Only in this manner could the precarious balance between available skilled flying personnel and the combat requirements be maintained. During World War II, the professional aspects of military medicine were rendered yet more complex by the changing mode of war. As the techniques of waging surface warfare were modified by new *This was in contrast to the total of less than 7,000 pilots who had been training in the 19-year period prior to 1941. In the 20-year period prior to 1 July 1941, there had been less than 15,000 graduates from Air Corps technical training schools to provide ground crews; but in the succeeding two year months over 625,000 men completed prescribed courses in specialties which had increased from 30 to 90 specialties. |