Submarine Medicine Practice, NAVMED-P 5054, 1956, was prepared for the training and orientation of medical personnel to the unique problems associated with diving and submarine life. For this online version we have omitted the extensive first part dealing with deep sea and scuba diving. We have included only the second part on submarine medicine. This was done as an economy of effort as there are numerous other dive medicine references available, but little on submarine medicine. It provides a unique view into the conditions aboard US Diesel submarines.

The information in this manual represents the state of the understanding in 1956, it should not be used as a basis of clinical practice.

In this online version of the manual we have attempted to keep the flavor of the original layout while taking advantage of the Web's universal accessibility. Different browsers and fonts will cause the text to move, but the text will remain roughly where it is in the original manual. We have not attempted to correct any errors found in the original document. However, this text was captured by optical character recognition and then encoded for the Web which has added new errors we wish to correct.

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Our thanks to the US Naval History and Heritage Command for providing a copy of this manual.

Richard Pekelney
Webmaster

BUREAU OF MEDICINE AND SURGERY

UNITED STATES
GOVERNMENT PRINTING OFFICE
WASHINGTON : 1956

For sale by the Superintendent of Documents, U. S. Government Printing Office
Washington 25, D. C. - Price $2.00

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PREFACE

The purpose of this text is to present a comprehensive guide which can be utilized for training and indoctrinating regular and reserve Medical Department personnel with the many intricate problems connected with submarine medicine practice.

An attempt has been made to assemble in this volume the highlights of latest developments and the accumulated knowledge and experience resulting from years of research and investigations. Much has been accomplished in this respect since 1917, the year organized studies in the medical problems of undersea warfare were first initiated, but recent ventures and developments in underwater military operations demand an even greater surveillance of the medical problems involved. For the medical officer interested in the solution of these many unsolved problems, submarine (underwater) medicine practice offers a most challenging and fertile field. Increasing cruising range and prolonged submergence of modern submarines, penetration of greater depths by the deep sea diver, and the expanding practice of underwater swimming demand continued research effort and a promise of rich rewards for the individual investigator.

These discussions include personnel selection and assessment procedures, improvement of submarine habitability factors, solution of human engineering problems aboard submarines, submarine escape and rescue operations, and the medical aspects of all other undersea operational problems directed toward the improvement of the military effectiveness of the Submarine and Amphibious Forces.

This manual was prepared under the auspices of the Bureau of Medicine and Surgery for publication by the Bureau of Naval Personnel. However, credit for the actual accumulation of data and overall preparation involved should be given to the staffs of the U. S. Naval Medical Research Laboratory, U. S. Naval Submarine Base, New London, Conn.; and to the Experimental Diving Unit and the U. S. Naval School, Deep Sea Divers, Naval Gun Factory, Washington, D. C.

SPECIAL NOTE

The decimal system of indices used throughout this text, and the separate index with the table of contents which precedes each chapter are used primarily for purposes of simplification. This arrangement is designed for the convenience of the student, to simplify the process of locating the specific text required in resolving the problems presented in this course.

The first of three figures of a given reference indicates the number of the chapter. A second decimal digit denotes the primary proposition under discussion within the chapter. The third and last number refers to a further exposition of problems related to the same subject. For example, the "5" in the group of figures 5.1.2 refers to the overall material contained in chapter 5, "Helium-Oxygen Diving." The second and third figures refer to the sub-headings "General Considerations" and the "Development and Principles" of helium-oxygen diving.

References are frequently made to the Bureau of Ships Diving Manual, and to the Manual of the Medical Department which are indicated by the abbreviations DM or MMD. For example, DM-825 refers to Bureau of Ships Diving Manual, paragraph 825. Likewise, MMD-15-30 refers to chapter 15, article 30 of the Manual of the Medical Department.

Several of the chapters have a list of references to books and medical journal articles. When these are specifically mentioned in the text, numbers (such as 12b) are used. In this case, the reference would be "b" in the list at the end of chapter 12. Other book references are similarly cited.

CONTENTS

Part 1-Section 1

DEEP SEA DIVING AND UNDERWATER
MEDICINE PRACTICE

Part 1-Section 2

DIVING WITH SELF-CONTAINED UNDERWATER
BREATHING APPARATUS

Part 2

SUBMARINE MEDICINE PRACTICE

U. S. S. Nautilus.