Many real and potential hazards will face astronauts* during operations in space. Some of these hazards might be of little medical significance; others might produce serious medical problems. This book is an initial attempt to describe the characteristics and suggest the management of possible medical problems which might arise from hazards of space operations. Attention is not given here to the so-called 'naturally occurring' diseases. Writing is oriented to future interplanetary missions during which, due primarily to the time required to return to earth, the diagnosis and definitive or interim treatment of medical problems will have to be carried out in space. It is therefore assumed that suitable diagnostic and treatment facilities and medically trained personnel will be available on advanced spacecraft, in which large, multidisciplined crews will be living in a comfortable, 'shirt-sleeves' environment. To lay the groundwork of Space Clinical Medicine, a field in which very little has been written and essentially no experience gained to date, it was found necessary to consider clinical manifestations, diagnosis, and treatment of possible medical problems in space. Wherever necessary, various hazards of space operations are defined and analysed in order to determine their possible medical effects. The patho physiologic characteristics of medical problems are discussed, frequently in detail, to provide the rationale for their prevention and treatment."

This book is a collection of scientific papers presented at the XVIII International Congress of Aviation and Space Medicine held in Amsterdam, The Netherlands, from 15-18 September 1969. It is dedicated to General E. de Vries and Dr. K. Vaan drager, President and Vice-President of the Congress, who wished that this unsur passed exchange of scientific information by distinguished authorities of the inter national aerospace medical community be made readily available to all as a valuable source of information. I am deeply grateful to the Congress Committee for honoring me with this editorship, to the authors for submitting generally excellent manuscripts and to the publisher for compiling a book of such high quality. This book contains both Main Theme papers, given by invited lecturers, and selected Free Communications at the Congress. Main Themes were 'physiology of atmospheric pressure' (papers by Ernsting, Meijne, Sluijter, Behnke), 'vestibular problems in aviation medicine' (papers by Melvill Jones, Benson, Oosterveld, Groen, Guedry and Benson, Brandt, Henriksson and Nilsson), 'aviation and cardiology' (papers by Blackburn, Wood) and 'space medicine' (paper by Berry). The Free Communications herein focus on many areas of continuing and timely interest to clinicians and investigators in aerospace medicine. Selection and health maintenance of pilots, medical problems in airline passengers, use of the centrifuge as a therapeutic device, and circadian rhythm effects on man's psychophysiological state receive particular attention."