Prepared by CDR Turley/OUSN/Ll April 1963

Prepared by CDR Turley/OUSN/ll April 1963 . c

Frcm: Chief of Naval Personnel To: Secretazy o? the Navy Subs: Experimantal studies of a Eedical nature involving persons in the Naval Bstablishment; request for consideration and recon- nendation on 1. Forwarded, recamending disapproval, concurring in the comnents of the endorsement of tho Chief, Bureau of Xedicine and Surgery. I' . I 8 .. a- c #21* . .-

'Bw-73:JffSt 6420. 1 File: 6500 29 March 1963

FOUBTH 011 Mdtcal Officer, USS SAM HOUSTOX SSB(N)=609 (BLUB) ltr of 19 Feb 1963

From: Chief, Bureau of Medicine and Surgery To: Secretary of the Navy Via: Chief of Naval Personnel

Subj: Experimental studies of a medical nature involving persons in the Naval Establishment; request for consideration mad recoxmendation on 1. Forwarded, readdressed.

2. This Bureau concurs with Conrrpaader Submine Force, U. S. Atlantic Fleet, in reconmending disapproval.

3. This Bureau feels that inves' igatioa la this area is warranted and UDR Thoma N. &NN, Mc, US=, shoul be complhnted for his suggestiom, fnwost, (Lpd willingness to attempt the $udy. It is felt that this iZlVeStig8ttoo should be uadertakon fa 8 laboratory, utilizing anhds rather then hupun sub jeCt8.

!-. i .I5 *. C, 8. GALWIWf Assistant Chief for Research and Military Medical Specialties

copy to: MO USS SAM HOUSTON CO USS SAM HOUSTON CWUBRON FOULTEEN DSPCOMSiuSM CCMSUBLANX c

FF4-12 6000 ser DEP 20/ 1787

THIRD ENDORSEMENT on Kedical Officer, USS SAM HOUSPON (SSBN609) (BLUE) ltr of 19 Febrcary 1963 From: Commander Submarine Force, U.S. At2antic Fleet To: Secretary of the Navy _. Via: Chief, aureau of Xedicine and Surgery Subj: Experimental studies of a Medical nature involving persons in the Naval 2stablishment; request for consideration and recommendation on 1. Forwarded, not recommending approval, for the following reasons:

a. No significant evidence exists which would support a hypothesis of delayed vourd healing in submarine personnel. b. As noted in enclosure (l), "Histologic studies are very valuable but they are extremely difficult to interpret."

copy to: CCMSUBRON FOURTEEN CO, US SAM HOUSTON (SsBN609)(BLUE) mmBLAsT

e . ,. FCSS14/6000 ( WHP :P j w 1 Ser 43/RI? 9 UR2 1964 SECOND ENDORSEMENT on Medica1 Officer, USS SAM HOUSTON (SSBN609)(BLUE) ItP af 19 Feb 63 morn: CarPmander Submarine Squadron fOUR3EEN .. .. Tot Secretary of the l!avy Via: (1) Deputy Cormnander Subaarine Force, U4S4 Atlanric Fleet (2) Chief, Bureau of Medicine adSurgery

Subj: Experimental of a medical involving the studies nature persons in Naval I EstabLfrhaIent ; request for consideratioA and recanmendation oA 1. Forwarded, recommending approval. #*h By direction

copy to: COS USS SAM HOUSTON (SSBN609)(BLUE)

8 3678

3 .

USS Sal IIOUSTON jSS&UGCiS) %Fleet Post Office -- Now York, New York - 19 FEB-1963

From: Medical Officer, USS SAM IIOUSTON (SSIWG09j(BLUE) To: Secretary of the Navy Via: (1) Commanding Officer, USS SAM NOUSTON (SSRN609j (BLUE) (2) Commandor Submarinc Squadron lp Fta,'.reax'?.x2"? (3) Deputy Commander Submarine Force, U.S. ~tlanticFleet (4) Chief, Bureau of Medicine and Surgery Subj: Experimental studies of a medical nature involving persons in the Naval Establishment; request for consideratron and rocommendation on Ref: (a) Manual of the Medical Department, U.S.' Navy, Chap- ter lDArticle 11

Encl:' (1) Repfoduction of a personal letter dated 7'FeD i963 and received from Doctor J. EngZebert DunDhv, Pro- fessor and Head of the Department of Surg y, Uni- versity of Oregon Medical School. 'r' /'4 1. This imestigatqr requests permission to study wound healing rates amng ton-vo unteer submariners in accordance,with reference (a) . ?! '? 2. In conjunction with Doczor $LA. Ilayas, an academically oriented surgeon at the Grace New Haven 1Iosni tal Now Ilaven ConTrecticut, an investigarive scheme was developed. 'I=. . , - tally, the crinical inquiry involves the following? a. Ilistorical investigations and pnysical examinations of ten volunzeers from a Fleet Ballistic Missile Sub- marine Crew will be conducted to eliminate those gross factors that may aitcr zhc healing process.

b. During .rho fir'th week of patrol under a sterilt set- up and utilizing local field block anesthesia, 3 srngie two centimeter long incision will be made on the volar surface of the forearm of each of the ten men. Each of these incisions will then be sutured with 4-0 sill, ..~r: natcrfo :. .* . c. Every other day for the next trdenty days one of the men will have this healing sutured incision excised. The residual dliptocal defect will then be primarily closed leaving as the maximum anticipated tissue alteration, a scar apyroximatcly one inch in length. Photographs and .-- 8 .- . : a

'9 . . 9 *.

recording of gross clinical observations will also be done as an integral part of this clinical invcstigarion. On return from patrol the fixed tissue specihons will bo histologically assessed.

4, A similar grwp [similar in body habitus, blood type, age, and raring) of volunteers is anticipated from the personnel based on the surface craft irS the Holy Loch. Procedures of an identical nature and done on the exact same date as those aboard the submarine will be under- taken by regiopal U.S. Navy physicians. 3. This protocol has been reviewed by Doctor J. Englobert hrnphy relative to its technical validity and his comments may be noted in enclosure (1).

4. A reply within tho next fror weeks is rewrestad in order to meet the PBM extendec ozerating schedzle. 5 =der to ne& this schedule advance copies are provided aaaressa in wuer to provide time for formulation of endorsements.

From: Commanding Officer, USS SAEf HOUSTON (SSBN609) (BLUE) To: Secretary of the Navy Via: (1) Commander Submarine Squadron 14 RE';,-~+=-Z~%:.:. 'e, (2) Deputy Commander Submarine Force, U.S. Atlanric Fleet (3) Chief, Bureau of Medicine and Surgery Subj: Experimental studies of a medical nature involving persons in the Naval Establishment; request for consideration and reconnnendarion on s . 1. Forwarded recommending approval.

W. Po WILLISo Jr, . .. 0.- 84 e.' University of Oregon Medichi'Sihool 76 . . .' ,' / a . - v 3181 S. W. Sam Jacbn Park Road Portland I, Oregon DEPARTMENT OF SURGERY

Lt, Thmas N. Gynn, MC. USNR 6 Hayes Street Waterford, Connecticut I Dear Doctor Gynn:

? &XI d, interested in theqmssibility that subm8rir.e crews have delayed wound healing,' Of course, the most import- 8rrt pmhlen here is to make certain that on pr~~~0U8runs there was an adequate diet, particularly with reference to Vitamin C. It would be extraordinary if defective wound healing occurred under these circumstances on c definitely adequate diet. I think your proposed project is well designed to detect the first issue, namely io there or is there not a significant interference with wound healing in suhnarine personnel. The only additional suggestion that I would have would be the possibility of including sane tensile strength studies. Some pears ago, Professor Philip Sandblun in Sweden devised a sllnpl e tecslometer for separating superficial skin wounds In pat!cnt~. Ymi w:ll find the reference ir; Acta Chirurgica Scand- inzviaa, 'Jo'?. 105. ?. 1-4, 1953. 1 am afraid that the instnment my Se t tiay bit too difficult to fit into a suharine but I tkirk ft would be worth your while to have a look at the article. This would be a sinpler procedure than the biopsy excisions which you pian to do, and I tt3r.k might be equally effective in de- tcrxining whether or not tkere was defective re_oalr. Histologic studies 8re very valuable but thq are extremely dlfflcslt to interpret end there is great v8rlrbility in the * histologic appearance from various areas in the same wound. I congratulate you on the efforts you are making to come to the root of this problem, and 1 will bo mort intererted in your f?s,dit?gSo

With beet wishes. Siacsruly,yortrs,