World War I and the beginnings of aviation medicine Published Sept. 21, 2017 By Judith Taylor AFMS History Office United States involvement in World War I began April 6, 1917. For the U.S. military, aviation medicine began in May 1917 when the U.S. Army appointed Lt. Col. (Dr.) Theodore C. Lyster, often called the father of aviation medicine, as the first service member dedicated to aviation-related medicine. Lyster’s assignment was to take charge of aviation work in the Surgeon General's Office. Lyster was officially named Chief Surgeon, Aviation Section of the Signal Corps in September 1917. Under his leadership, aviation medics, few as there were, continued to conduct investigations into the causes of extremely high losses of flying personnel. Their efforts created a new medical specialty, flight medicine, which ultimately led to the Air Force Medical Service. Lyster began his aviation career in 1916, when the Army appointed him and two Signal Corps officers to a board to determine the fitness of persons applying for the Army’s Aviation Section. The new board replaced an earlier examination program, which had a checkered history of success. The board based initial selection criteria on standard physiology texts of the day, and existing regulations for United States military personnel. Soon after the original test’s introduction, the Chief Signal Officer returned and asked to lower the standards—no one had passed the new test. The Army granted the request, but by 1916 concluded it must replace the inadequate selection assessment. Lyster, with the help of other Army physicians, developed a number of improved screening tests. By July 1918, 67 testing centers had screened 38,777 applicants. Just over 50 percent met the physical standards, putting qualified candidates in the skies. In the course of his investigations, Lyster also recognized that medical officers of the day did not understand unique physiological issues affecting pilots. He recommended creating a research board to investigate the causes contributing to extraordinary pilot loss. The Army established the Medical Research Laboratory at Hazelhurst Field, in Mineola, New York, in 1918, to study flight effects on the human body. Researchers at the lab began operations on January 19, and soon initiated the first aviation medicine education program for physicians. In 1922, the laboratory was renamed the School of Aviation Medicine, and later became the United States School of Aerospace Medicine. Laboratory personnel adopted the term “flight surgeon” to refer to physicians who specialized in care for flyers and began training physicians in the unique specialty of aviation medicine. With nothing to base training on, laboratory personnel improvised educational courses. The first three students graduated in May 1918. The first was Capt. Robert J. Hunter, who arrived at his station on May 8, 1918, becoming the first U.S. flight surgeon. In July 1917, Lyster set up an office in Washington, D.C., which consisted of Lyster, an enlisted man, and a stenographer. In their 1954 work, Medical Support for the Army Air Forces in World War II, Link and Coleman credit Lyster’s appointment as chief surgeon in September 1917, as the source of authority for the establishment of a separate medical service for the Aviation Section (later the Army Air Corps). They stated, “On September 17, 1917, the Air Division of the Signal Corps was organized into six sections, of which one was the ‘Medical Department.’ The authorizing directive defined the duties of the chief surgeon of the new medical department as being synonymous with those outlined for department surgeons and chief surgeons of field armies." During World War I, U.S. Army aviation units enjoyed a certain autonomy over their medical services. The Aviation Section supervised medical activities at 61 air stations, operated 45 hospitals with over 3,600 beds, and employed over 3.300 medics. In addition, they established 77 medical boards that completed more than 50,000 aircrew examinations. With the return of peace however, the medical organizational component returned to the command control of the Surgeon General of the Army. Harry Armstrong, a researcher and later Air Force Surgeon General, described the post-war situation. “For 10 years following the end of World War I, Aviation Medicine almost ceased to exist as a living science and was kept from utter decay only by the efforts of a few individuals who had the foresight to realize that aviation and aviation medicine were more than a transient necessity of World War I." Fortunately for the U.S., these extraordinary individuals stepped forward to continue their investigations into human factors in flight and helped usher in air travel and flight medicine as we know it today.