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Negotium perambulans in tenebris. The old librarian rehearsed the formulae he had memorised, and clutched the paper containing the alternative one he had not memorised. He saw that his electric flashlight was in working order.

Armitage, having read the hideous diary, knew painfully well what kind of a manifestation to expect; but he did not add to the fright of the Dunwich people by giving any hints or clues.

He hoped that it might be conquered without any revelation to the world of the monstrous thing it had escaped. As the shadows gathered, the natives commenced to disperse homeward, anxious to bar themselves indoors despite the present evidence that all human locks and bolts were useless before a force that could bend trees and crush houses when it chose.

There were rumblings under the hills that night, and the whippoorwills piped threateningly. Once in a while a wind, sweeping up out of Cold Spring Glen, would bring a touch of ineffable foetor to the heavy night air; such a foetor as all three of the watchers had smelled once before, when they stood above a dying thing that had passed for fifteen years and a half as a human being.

But the looked-for terror did not appear. Whatever was down there in the glen was biding its time, and Armitage told his colleagues it would be suicidal to try to attack it in the dark. Morning came wanly, and the night-sounds ceased. It was a grey, bleak day, with now and then a drizzle of rain; and heavier and heavier clouds seemed to be piling themselves up beyond the hills to the northwest.

The men from Arkham were undecided what to do. Seeking shelter from the increasing rainfall beneath one of the few undestroyed Frye outbuildings, chapter 2: the dunwich horror they debated the wisdom of waiting, or of taking the aggressive and going down into the glen in quest of their nameless, monstrous quarry.

The downpour waxed in heaviness, and distant peals of thunder sounded from far horizons. Sheet lightning shimmered, and then a forky bolt flashed near at hand, as if descending into the accursed glen itself. The sky grew very dark, and the watchers hoped that the storm would prove a short, sharp one followed by clear weather.

It was still gruesomely dark when, not much over an hour later, a confused babel of voices sounded down the road. Another moment brought to view a frightened group of more than a dozen men, running, shouting, and even whimpering hysterically.

Someone in the lead began sobbing out words, and the Arkham men started violently when those words developed a coherent form.

Jest still-like. You men know that those Whateleys were wizards—well, this thing is a thing of wizardry, and must be put down by the same means. How about it? The sky was growing lighter, and there were signs that the storm had worn itself away. When Armitage inadvertently took a wrong direction, Joe Osborn warned him and walked ahead to shew the right one. Courage and confidence were mounting; though the twilight of the almost perpendicular wooded hill which lay toward the end of their short cut, and among whose fantastic ancient trees they had to scramble as if up a ladder, put these qualities to a severe test.

At length they emerged on a muddy road to find the sun coming out. They were a little beyond the Seth Bishop place, but bent trees and hideously unmistakable tracks shewed what had passed by. Only a few moments were consumed in surveying the ruins just around the bend. It was the Frye incident all over again, and nothing dead or living was found in either of the collapsed shells which had been the Bishop house and barn.

No one cared to remain there amidst the stench and tarry stickiness, but all turned instinctively to the line of horrible prints leading on toward the wrecked Whateley farmhouse and the altar-crowned slopes of Sentinel Hill. It was no joke tracking down something as big as a house that one could not see, but that had all the vicious malevolence of a daemon. Armitage produced a pocket telescope of considerable power and scanned the steep green side of the hill.

Then he handed the instrument to Morgan, whose sight was keener. After a moment of gazing Morgan cried out sharply, passing the glass to Earl Sawyer and indicating a certain spot on the slope with his finger.

It was one thing to chase the nameless entity, but quite another to find it. Voices began questioning Armitage about what he knew of the thing, and no reply seemed quite to satisfy.

Everyone seemed to feel himself in close proximity to phases of Nature and of being utterly forbidden, and wholly outside the sane experience of mankind.

In the end the three men from Arkham—old, white-bearded Dr. Armitage, stocky, iron-grey Professor Rice, and lean, youngish Dr. Morgan—ascended the mountain alone. After much patient instruction regarding its focussing and use, they left the telescope with the frightened group that remained in the road; and as they climbed they were watched closely by those among whom the glass was passed around. It was hard going, and Armitage had to be helped more than once.

High above the toiling group the great swath trembled as its hellish maker re-passed with snail-like deliberateness. Then it was obvious that the pursuers were gaining. Curtis Whateley—of the undecayed branch—was holding the telescope when the Arkham party detoured radically from the swath.

He told the crowd that the men were evidently trying to get to a subordinate peak which overlooked the swath at a point considerably ahead of where the shrubbery was now bending. This, indeed, proved to be true; and the party were seen to gain the minor elevation only a short time after the invisible blasphemy h a d passed it. The crowd stirred uneasily, recalling that this sprayer was expected to give the unseen horror a moment of visibility.

Two or three men shut their eyes, but Curtis Whateley snatched back the telescope and strained his vision to the utmost. Curtis, who had held the instrument, dropped it with a piercing shriek into the ankle-deep mud of the road. He reeled, and would have crumpled to the ground had not two or three others seized and steadied him. Curtis was past all coherence, and even isolated replies were almost too much for him. Fred Farr and Will Hutchins carried him to the roadside and laid him on the damp grass.

Henry Wheeler, trembling, turned the rescued telescope on the mountain to see what he might. Through the lenses were discernible three tiny figures, apparently running toward the summit as fast as the steep incline allowed. Only these—nothing more. Then everyone noticed a strangely unseasonable noise in the deep valley behind, and even in the underbrush of Sentinel Hill itself.

It was the piping of unnumbered whippoorwills, and in their shrill chorus there seemed to lurk a note of tense and evil expectancy. Earl Sawyer now took the telescope and reported the three figures as standing on the topmost ridge, virtually level with the altar-stone but at a considerable distance from it.

One figure, he said, seemed to be raising its hands above its head at rhythmic intervals; and as Sawyer mentioned the circumstance the crowd seemed to hear a faint, half-musical sound from the distance, as if a loud chant were accompanying the gestures.

The weird silhouette on that remote peak must have been a spectacle of infinite grotesqueness and impressiveness, but no observer was in a mood for aesthetic appreciation. The whippoorwills were piping wildly, and in a singularly curious irregular rhythm quite unlike that of the visible ritual. Suddenly the sunshine seemed to lessen without the intervention of any discernible cloud. It was a very peculiar phenomenon, and was plainly marked by all.

A rumbling sound seemed brewing beneath the hills, mixed strangely with a concordant rumbling which clearly came from the sky. Lightning flashed aloft, and the wondering crowd looked in vain for the portents of storm.

The chanting of the men from Arkham now became unmistakable, and Wheeler saw through the glass that they were all raising their arms in the rhythmic incantation. From some farmhouse far away came the frantic barking of dogs. The change in the quality of the daylight increased, and the crowd gazed about the horizon in wonder.

Then the lightning flashed again, somewhat brighter than before, and the crowd fancied that it had shewed a certain mistiness around the altar-stone on the distant height. No one, however, had been using the telescope at that instant. The whippoorwills continued their irregular pulsation, and the men of Dunwich braced themselves tensely against some imponderable menace with which the atmosphere seemed surcharged.

Without warning came those deep, cracked, raucous vocal sounds which will never leave the memory of the stricken group who heard them. Not from any human throat were they born, for the organs of man can yield no such acoustic perversions. Rather would one have said they came from the pit itself, had not their source been so unmistakably the altarstone on the peak.

It is almost erroneous to call them sounds at all, since so much of their ghastly, infra-bass timbre spoke to dim seats of consciousness and terror far subtler than the ear; yet one must do so, since their form was indisputably though vaguely that of half-articulate words.

They were loud—loud as the rumblings and the thunder above which they echoed—yet did they come from no visible being. Henry Wheeler strained his eye at the telescope, but saw only the three grotesquely silhouetted human figures on the peak, all moving their arms furiously in strange gestures as their incantation drew near its culmination. From what black wells of Acherontic fear or feeling, from what unplumbed gulfs of extra-cosmic consciousness or obscure, long-latent heredity, were those half-articulate thunder-croakings drawn?

Presently they began to gather renewed force and coherence as they grew in stark, utter, ultimate frenzy. The pallid group in the road, still reeling at the indisputably English syllables that had poured thickly and thunderously down from the frantic vacancy beside that shocking altar-stone, were never to hear such syllables again.

Instead, they jumped violently at the terrific report which seemed to rend the hills; the deafening, cataclysmic peal whose source, be it inner earth or sky, no hearer was ever able to place.

A single lightning-bolt shot from the purple zenith to the altar-stone, and a great tidal wave of viewless force and indescribable stench swept down from the hill to all the countryside.

Dogs howled from the distance, green grass and foliage wilted to a curious, sickly yellow-grey, and over field and forest were scattered the bodies of dead whippoorwills. The stench left quickly, but the vegetation never came right again. To this day there is something queer and unholy about the growths on and around that fearsome hill.

Curtis Whateley was only just regaining consciousness when the Arkham men came slowly down the mountain in the beams of a sunlight once more brilliant and untainted. They were grave and quiet, and seemed shaken by memories and reflections even more terrible than those which had reduced the group of natives to a state of cowed quivering.

In reply to a jumble of questions they only shook their heads and reaffirmed one vital fact. It was an impossibility in a normal world. Only the least fraction was really matter in any sense we know. It was like its father—and most of it has gone back to him in some vague realm or dimension outside our material universe; some vague abyss out of which only the most accursed rites of human blasphemy could ever have called him for a moment on the hills.

Memory seemed to pick itself up where it had left off, and the horror of the sight that had prostrated him burst in upon him again. Only old Zebulon Whateley, who wanderingly remembered ancient things but who had been silent heretofore, spoke aloud. We have no business calling in such things from outside, and only very wicked people and very wicked cults ever try to. There was some of it in Wilbur Whateley himself—enough to make a devil and a precocious monster of him, and to make his passing out a pretty terrible sight.

Things like that brought down the beings those Whateleys were so fond of—the beings they were going to let in tangibly to wipe out the human race and drag the earth off to some nameless place for some nameless purpose. It grew fast and big from the same reason that Wilbur grew fast and big—but it beat him because it had a greater share of the outsideness in it.

It was his twin brother, but it looked more like the father than he did. Working as a team, investigators can come from disparate backgrounds and be of varied occupations—each bringing certain expertise to the group.

Together, joined in comradeship and common purpose, you will stand steadfast against the coming darkness. This chapter provides the rules for creating investigator player characters.

A two-page spread that provides a handy summary for quick reference can be found on pages Before you begin rolling dice you should talk to the Keeper and ask for guidance on creating a suitable investigator for the scenario that you are going to play. The Keeper may stipulate strict guidelines, such as which professions you can chose from, or may leave it completely open to you.

The location or country in which the game is set. Does the Keeper recommend any occupations? Suggestions for how the investigators might know each other. The Keeper may tell you a great deal or very little about the scenario. Listen to what is said and ask any questions you may have. Once you have an idea for an investigator, run it past your Keeper for approval. This conversation can serve to stimulate imagination and create links between the investigators, helping to create a suitable mix of player characters.

If the Keeper says the investigators are going to be hired for an investigation, think about making an investigator who needs the money. When beginning a game of Call of Cthulhu, it is recommended that all the players “roll-up” their investigators together in the company of the person who will be taking on the role of Keeper— this ensures that everyone helps to form the group, with each investigator taking an agreed role, ensuring that a balance of skills and occupations is found.

If the premise asks that your investigator be part of an academic team attending a conference, perhaps your character could be one of the speakers. Giving your investigator more relevance to the story and making the “hook” stronger will make the game better.

Any connections that you create between your investigator and the plot are likely to hold greater emotional resonance for you than anything the Keeper supplies. If the Keeper is unable to give much of a premise you can still create some interesting facets to your investigator without knowing how they will come into play.

The Keeper may pick up on some of these facets and incorporate them into the scenario. Creating Your Investigator There is more than one approach to creating an investigator. Some people prefer to have an idea about the type of investigator they wish to create before rolling any dice, while others prefer to let the dice rolls guide their choices. What follows are the standard rules for creating investigators, with further options at the end of this chapter. In the game each characteristic represents an aspect of an investigator—intelligence, dexterity, and so on.

These identified quantities determine the relative capability of investigators and suggest ways for them to act and react during play. Characteristic values are generated randomly by rolling two or more six-sided dice. Rolling Characteristics Initially, write your results on a piece of scrap paper before writing them onto the investigator sheet as they may be modified by the age of your investigator. Enhancing Your Character’s Background The Keeper has presented an initial premise for the game, which involves an expedition team from the Miskatonic University traveling into the wilds in search of a missing colleague.

Amy asks if her investigator might work in the same department as the missing person. The Keeper agrees. Strength measures the muscle power of an investigator. The higher it is, the more the investigator can lift or tightly cling to something. This characteristic determines the damage an investigator inflicts in hand-to-hand combat.

Reduced to STR 0, an investigator is an invalid, unable to get out of bed. Constitution represents health, vigor, and vitality. Investigators with a high constitution often have more hit points—the better to resist injury and attack. Serious physical injury or magical attack might lower the statistic, and if Constitution reaches zero the investigator dies.

Introducing Harvey Walters To help illustrate the various rules of Call of Cthulhu, we are pleased to introduce you to Harvey Walters, the noted s New York journalist and investigator of the supernatural. We use Harvey to demonstrate how character creation works. To differentiate between the person playing Harvey and the actual character of Harvey, the investigator in the game, the player is female and her investigator is male.

For a walk-through of Harvey’s character creation see page Investigators with higher Dexterity scores are quicker, nimbler, and more physically flexible. A DEX roll might be made to grab a support to keep from falling, to move faster than an opponent, or to accomplish some delicate task.

An investigator with zero DEX is uncoordinated and unable to perform physical tasks. In combat, the character with the highest DEX acts first. Appearance measures both physical attractiveness and personality. A person with high APP is charming and likeable, but may lack conventional good looks.

An investigator with APP of 0 is appallingly ugly or someone with a wholly detestable demeanor, provoking comment and shock everywhere. APP may be useful in social encounters or when trying to make a good impression. Intelligence represents how well investigators learn, remember, analyze information, and solve complex puzzles. An investigator with zero INT is a babbling, drooling idiot. Size averages both height and weight into a single number.

To see over a wall, to squeeze through a small opening, or even to judge whose head might be sticking up out of the grass, use size. Size helps determine hit points, damage bonus, and build. Presumably if investigators lose all SIZ points they disappear—goodness knows to where! Often one or two low characteristic scores can help to bring the investigator “to life” and feel more real—as opposed to some incredible superhuman!

Rather than rejecting a low roll, try to incorporate it into the overall makeup of your investigator. Perhaps a low dexterity means that the investigator has suffered some form of leg or hand injury while in the armed forces, or a low education is the result of never attending school and being forced to grow up on the streets. INT also acts as the value for both Idea rolls and Intelligence rolls.

For example, an investigator with high EDU and low INT might be a pedantic teacher or a sideshow performer, someone who knows facts but not their meanings. Those with an EDU greater than 80 have most likely conducted graduate level work and have a degree, as expected of a person who has been to a university of some kind. W ay m page EDU is also used u yo e in practic d back-to-front, ee sp when making Know rolls.

Any adjustments are made to that value. Power indicates force of will: the higher the POW, the higher the aptitude for, and resistance to, magic. An investigator with zero POW is zombie-like and without purpose, as well as being unable to use magic.

Unless stated otherwise, POW that is lost during the game is lost permanently. Magic points are equal to one-fifth of POW. The POW of ordinary characters and investigators rarely changes. However, those adroit in the mysteries of the magic of the Cthulhu Mythos may be able to increase their personal POW.

Education is a measure of the formal and factual knowledge possessed by the investigator, as well as indicating the time the investigator has spent in full-time education. EDU measures retained information, not the intelligent application of that information see Intelligence. An investigator without EDU would be like a newborn baby or an amnesiac—without knowledge of the world, probably very curious and credulous. An EDU of 60 suggests the investigator is a high school graduate, while a score of around 70 indicates a person Luck: Roll 3D6 and Multiply by 5 When creating an investigator roll 3D6 and multiply by 5 for a Luck score.

Luck rolls are often called for by the Keeper when circumstances external to an investigator are in question, and when determining the fickle hand of fate. Age A player can choose any age between 15 and 90 for their investigator. If you wish to create an investigator outside this age range, it is up to the Keeper to adjudicate. Use the appropriate modifiers for your chosen age only they are not cumulative. Deduct 5 points from EDU. Roll twice to generate a Luck score and use the higher value.

Continued on page 48 45 investigator handbook What The Numbers Mean Strength 0 15 50 90 99 Enfeebled: unable to even stand up or lift a cup of tea.

Puny, weak. Average human strength. World-class Olympic weightlifter. Human maximum. Constitution 0 1 Dead. Sickly, prone to prolonged illness and probably unable to operate without assistance. Size 1 15 65 A baby 1 to 12 pounds. Note: Some humans may exceed SIZ Dexterity 0 15 Unable to move without assistance. Slow, clumsy with poor motor skills for fine manipulation. Olympic standard. Intelligence 0 15 50 90 99 No intellect, unable to comprehend the world around them.

Slow learner, able to undertake only the most basic math, or read beginner-level books. Average human intellect. Quick-witted, probably able to comprehend multiple languages or theorems.

Genius Einstein, Da Vinci, Tesla, etc. Power 0 Enfeebled mind, no willpower or drive, no magical potential. Note: Human POW can exceed , but this is exceptional. Education 0 15 60 70 80 90 96 99 A newborn baby. Completely uneducated in every way. High school graduate. College graduate Bachelor degree. Degree level graduate Master’s degree.

Doctorate, professor. World-class authority in their field of study. The player takes up a fresh investigator sheet and a pencil, and then she rolls some six-sided dice. This is abysmal. Harvey is exceptionally puny and weak, but the player is not dismayed—Call of Cthulhu is an unusual game and all kinds of investigators are needed. This is good, and Harvey will be fairly hardy. This may help make up for his low STR. His player wants Harvey to be 42 year old, with some experience under his belt.

She makes two experience checks for Education. Her first roll of 86 earns a reward of 4 points 1D Her second roll of 82 fails to earn any reward. With all of the characteristics done, his player can now write in the half and fifth values for each of them. He is 42 years of age, and so this is reduced by a further point to MOV 6. Harvey will not be winning many chases. It’s decided that Harvey will be a journalist, working for Enigma Magazine. Now he is at home in a language often encountered in Mythos researches.

As an investigative reporter, Harvey is well equipped to ask questions and get honest answers. Now occupation skill points remain. Now occupation points are left. While the Journalist occupation gives a Credit Rating range of 9—30, the player asks to invest more points as Harvey comes from a wealthy family—the Keeper agrees to this request. Harvey has good communication skills, useful for a reporter, and a Mythos-related skill, Archaeology.

These points can be spent as the player desires. With all of his points spent, his player writes down the half and fifth values for each of the skills on the investigator sheet.

Harvey’s player allocated 41 occupation skill points for Credit Rating, which means that he has an Average living standard. He may stay in moderately priced hotels, eat out economically , and take the occasional taxi. This seems to fit with Harvey; he is perhaps superstitious. Meaningful Locations is next. Harvey is a studious fellow, perhaps he enjoys sitting in his study as he ponders his writings.

Next, with a roll of 1, we have an item connected with his highest skill. This ties in with his uncle. While this has been attributed to dementia, perhaps there is another cause; perhaps there is something hidden among those old artifacts he collected that led him down the path of madness?

Once the percentage values for each characteristic have been determined, the next step is to write in the half and fifth values for each characteristic on the investigator sheet each characteristic has three boxes: a large box for the full value and two smaller ones for the half and fifth values.

Divide the percentage value by five, rounding down, and enter the “fifth” value after the half value. When a “characteristic value” is referred to in the text, this means the full value highest number. Where half or 48 believes he is more determined and of stronger mind than his uncle, and that he will triumph where his uncle failed.

This fits perfectly well; Harvey is a good-looking fellow. If he were to list a car among his starting gear, this would have to come out of his assets, as a car is not listed within the s Average Income bracket.

Harvey is now ready to begin his adventures! Half and fifth are the only fractions used in relation to characteristics and skills in the game and all the numbers are calculated up front so that play is not hindered by mental calculations. Larger and stronger creatures and humans do more physical damage than their lesser brethren. Each chapter 3: creating investigators range of results correlates with a die modifier or dice roll.

Build is determined using the same figures. Build is used in fighting maneuvers and also to give a sense of scale. Note: Damage bonus is not applied to firearms attacks. The investigator sheet is designed to help the player keep track of hit points and wounds. Other occupations are not those you would normally find in a Lovecraft story; however, they may interest particular players and be fun to play in a Call of Cthulhu game.

An occupation ties together a cluster of skills. Some occupations include no free choices; others may have two or more. Chapter 4: Occupations provides a wide range of possible investigator occupations. Most occupations can be applied to pretty much any historical setting in which games might take place. However, some occupations, like Hacker, exist only in specific settings, such as the modern-day.

You should choose only those skills appropriate to the time period in which your game is taking place. Once you have chosen the occupation for your investigator, write it down on the investigator sheet and then make a note of the occupational skills.

Skill definitions can be found in Chapter 5: Skills. Step Three: Decide Skills and Allocate Skill Points Occupation Skills After you have chosen an occupation, calculate your occupation skill points using the characteristics specified alongside the occupation. Points should also be allocated to Credit Rating within the range indicated for the occupation. Not all the skills need to have points allotted to them; however, points left undistributed are lost.

Note that each skill has a number in parenthesis next to it on the investigator sheet: this is the base chance of success in that skill, and any points allocated to that skill are added to this base number. The sheet also has space to write in the half and fifth values for each skill, allowing you to reference them quickly in the middle of a game.

It is advised that you allocate occupation skill points and then personal interest skill points before writing in the half and fifth values alongside the full value for each skill, as personal interest skill points can be used to bolster occupation skills, as well as other non-occupation skills see Personal Interests following.

Weapons and Firearm Skills Fighting and Firearms skills, and their various specializations, allow an investigator to use weapons. Personal interest or occupation skill points if applicable may be spent to raise any of these skills. When an occupation includes the skill of Fighting or Firearms, and no specialization is specified, it is up to the player to choose one or more specializations of that skill see Chapter 5: Skills.

In play, Credit Rating determines the amount of money a character has available. For example, criminal could be used as a profession for a poor lone pickpocket Credit Rating 09 or for a wealthy gang boss Credit Rating Any number of skill points can be invested in Credit Rating within the recommended limits for that profession.

There are six living standards: penniless, poor, average, wealthy, rich, and super rich. Each one determines the lifestyle, type of accommodation, travel, and expenses that a person can comfortably afford on a day-to-day basis.

See the box nearby for more information about the different living standard based upon Credit Rating. Step Four: Create a Backstory 50 Not one man who participated in that terrible raid could ever be induced to say a word concerning it, and every fragment of the vague data which survives comes from those outside the final fighting party.

There is something frightful Choosing an Occupation When choosing an occupation, there are some things to consider: Try to have a picture in your mind about who and what your investigator is—your character concept.

Look for occupations that suit this concept and add color to it. Remember, rolling up an investigator is all about building up a story of who you want to play in the game. Your characteristics, occupation, sex, and age all help to establish a fully-rounded, breathing investigator. Look through the skills associated with each occupation and see which of these you like the most. Certain skills are likely to appeal to you more. Perhaps you want your investigator to be a man or woman of action, leading you to choose an occupation with skills like Fighting, Climb, and Throw.

Alternatively you might decide to create a more studious investigator, with skill in Library Use, Spot Hidden, and Psychology. Creating a balance of occupations means that the group has a good mix of skills that will benefit everyone.

Depending on the style of game and scenario you will be playing, your Keeper might have certain occupations in mind for you to play; perhaps he or she mentioned this when they described the initial premise of the scenario.

Discuss your ideas with the other players in order to build the most appropriate group of investigators for your game. After all, it will be somewhat strange for everyone to turn up with musicians when the scenario is set in the Antarctic! It remains a good cooler at this price. When the Polar Bear is open, it stands erect like a grocery bag, providing easy access for loading and unloading. The cooler zips closed with two YKK 8 zippers YKK is the largest, and often considered the most reliable, zipper manufacturer in the world , and it folds down on either side, compressing into a rectangular brick.

This shape allows for all sides of the closed bag to have equal insulation coverage—a feature many cheaper soft coolers lack. The Polar Bear also held the most cans of any pack cooler we tested, carrying 24 cans and 6 pounds of ice all at one time. However, when fully loaded, this cooler can weigh 24 to 26 pounds. Better insulated and less expensive than the competition, this cooler keeps ice for a week. And its well-designed drain port makes the Coleman easier to clean.

So the hard cooler is a great pick for RVs, trailers, or boats. And it was completely leakproof in our tests. The Hydro Flask Wide Mouth 20 ounces is the most reliable, versatile water bottle for road trips that we found. An insulated stainless steel bottle with a plastic cap, this model kept water cool for our entire hour temperature test.

The mouth is wide enough that you can add ice cubes, and the Hydro Flask can adapt to many environments, including the car it fits in a cupholder and the gym you can add a sport cap or silicone bumper. Our pick comes with the flex cap a twist-off lid with a flexible carry handle , but we recommend picking up a straw lid.

Coffee and driving go hand in hand, and we think the Zojirushi SM-SA48 Stainless Steel Mug offers the best balance of heat or cold retention and versatility. Lighter and with a more-svelte lid design than that of its predecessor and the competition , this Zojirushi mug is more pleasant to drink from, yet it retains its impressive insulating abilities.

The ounce Zojirushi mug is at the higher end of the price spectrum. But its well-designed exterior, one-handed usability, and foolproof locking mechanism are well worth the price. It will never, ever spill, regardless of how rough the road gets.

Edward Abbey wrote an entire book about being alone in the desert , long before portable screens, streaming music, and the best and worst of what instant entertainment can bring.

He saw incredible things. But then again, Abbey wrote that book before he had kids. Being in close proximity on a road trip can bond families and friends. Of course, a packed car could also become a pressure cooker. Some games, toys, and electronics can provide welcome relief. Even more important, on our trip, every miles the scenery around us changed drastically, and being able to charge our cameras allowed us to capture some incredible personal moments.

Lots of newer cars have USB ports capable of charging plenty of smaller gadgets. After sending our three favorites, culled from a list of 18 top-rated inverters, to physicist Jim Shapiro for testing, we recommend the Bestek W Power Inverter for simple devices like water boilers. Shapiro examined this phenomenon using an oscilloscope. However, because many electronics, including laptop computers, use power supplies to convert AC back into DC before delivering the power to your device, a higher-quality power supply can make the arrangement work—as user reviews attest.

Shapiro was able to charge an iPad without any problems via the AC outlets on the inexpensive Bestek inverter. It now appears to be out of stock almost everywhere or discontinued. As an alternative, we recommend looking into a portable power station , which is basically a large battery in a protective box, with AC outlets and other ports built in. If you only need to power a laptop during your trip, we have several recommendations for portable laptop chargers.

It adheres to USB-C fast-charging standards and includes a quality cable. The Besign BK01 offers great sound quality for music and good sound quality for phone calls. It also lets you pair two phones and access your voice assistant with the click of an easy-to-find button. You can check out our full guide for all the options—including an FM transmitter and a speakerphone.

But the best and easiest way to add Bluetooth to most modern cars with a line-in jack is to get an aux kit. The Besign BK01 Bluetooth Car Kit provides good sound quality for music, clear-sounding voice audio for hands-free calls, and access to Siri or Google Assistant at the press of a button. Depending on the length of your trip and the temperament of your backseat passengers, you may need to find a way to keep them occupied.

Providing their favorite movies or TV shows on a tablet is an option. This model positions a tablet solidly between the front seats, for easy viewing by all backseat passengers. The Instax Square SQ6 provides quick snaps for physically embodied nostalgia.

With a smartphone, showing a photo to hundreds of your followers is as easy as pressing the share button and we have to admit that Instagram becomes oddly compelling on a road trip. But if you want to create something tangible, an instant-film camera can add a fun and welcome dose of analog charm to your digital world. Our new pick is the updated version of the Fujifilm Instax Mini 90, and it offers a better-quality photo on a slightly larger print.

After doing extensive research , we found the Fujifilm Instax Square SQ6 to be the best instant-film camera. This easy-to-use model takes better photos than most instant cameras, and if you want to put in more time and effort, the Instax has plenty of manual controls to fiddle around with, and it offers a built-in macro mode and additional exposure options. A tripod socket and self timer allow the photographer to join group shots, and everything is packed into a retro-cool body.

You know what kinds of games you like to play. I am, as a rule, generally wary of anything designed to prompt conversation.

But by day three of our trip, with 1, miles behind us and miles ahead, my then girlfriend now wife reached for Chat Pack and told me it was time. And that became an hour-long conversation. The feeling of camaraderie in the car was strong; we agreed that it was a dumb question. So get a Chat Pack. Your mileage may vary.

But this pack helped us pass the time, and it takes up barely any space. Make time in your trip for the detours. There will be times in the car when a sort of tunnel vision can set in, and the destination becomes all-consuming. We were alone, on an outcropping overlooking a shallow canyon. Someone had built an impromptu fire pit. You can find many ways to plan a trip. But once in a while, take a risk and make a left when all the maps and devices are telling you to go right.

Amazingly affordable with great optics, these binoculars offer comparable performance to many models that cost thousands more. Binoculars might not be a necessity. Yes they will. The waterproof and lightweight Athlon Optics Midas ED binoculars boast a rugged shock-absorbing exterior.

And it needs to be durable enough to survive beach trips, sightseeing, picnics, and museum tours. Packed up, it is very discreet: nearly the size of a keychain accessory. It has reinforced stitching at stress points, allowing the Ultra-Sil to carry more weight than you would expect.

That said, since this pack is made of such thin, light material, carrying large or awkwardly shaped loads is somewhat uncomfortable, especially when compared with our more structured picks. If lightness, waterproofing, comfort, or organization are more important to you, check out the alternative picks in our review of packable daypacks for travel.

Our favorite picnic blanket rolls easily and compactly, and it will keep you dry and comfortable, even on damp grass. We stopped dozens of times on our trip, and we were glad every time we were able to take a side road, pull out a blanket, and find a place to sit down and share some food. After considering 44 picnic blankets and testing 13 , we think the two-person Nemo Victory Blanket offers the best combination of comfort, durability, and compactness. With an acrylic flannel top and a padded waterproof polyurethane underlayer, the Victory is thick enough for you to lie on without feeling every stick and twig underneath you.

We even used the Victory Blanket as a tent pad for two nights. Because of supply-chain issues, the Victory Blanket has been difficult to find. After 60 hours of research and interviews, we recommend Coppertone SPF 70 sunscreen for everyday use. The one exception: your youngest passengers. Do not put sunscreen on an infant. The American Academy of Dermatology recommends keeping children who are younger than 6 months out of the sun entirely.

Even the most promising options suffer from having jumper cables that are too short, too thin, or both. On a desolate stretch of two-lane highway in northern Arizona, we were driving behind a rental camper van just as it had a rear-tire blowout after hitting a rumble strip.

And it gave us a great opportunity to put our emergency gear to the test! Basically, make sure your plan fits your needs. For example, if you live in a city, 3 miles of free towing may be enough. This kit is chock-full of bandages and cleaning supplies that are suitable for minor incidents. On the road, a first-aid kit is useful for keeping someone comfortable until people with real medical expertise can help. For an extensive list and comparison chart, see our full guide. This small shovel slices through icy snow and can be disassembled for car storage.

As of March , this shovel appears to be unavailable. As an alternative, you could try a non-telescoping version. If the telescoping feature is important to you, we recommend looking into the Black Diamond Transfer Snow Shovel. The tool, popular with ski patrols and people clearing backcountry trails, has a solid metal scoop and a two-piece handle that clicks together to form a sturdy shovel.

When not in use, the shovel breaks down into three pieces, which can be tucked neatly under a car seat or in the back. This is the favored tire gauge of all the professionals we interviewed. After our testing, which included road-tripping with the tool ourselves, the Accu-Gage has emerged as our favorite tire gauge for several years running.

The Accu-Gage is available in several different configurations , but the performance is largely the same. We prefer a version with a hose attached and a straight chuck, because that design makes it easier to hold the gauge and check the tire pressure at the same time.

The version we tested even comes with a removable rubber bumper in case you drop it. A digital display is more precise than analog, but the pros we interviewed all use analog gauges. If you prefer digital, get the Accutire MSB. The digital readout is easier to decipher than an analog dial though it rounds to the nearest 0. But you do need to factor in the periodic cost of two watch batteries ; according to owner reviews , they need replacing every six months.

Magazine reviewers say digital gauges are more precise than analog dial gauges—often showing one or two decimal points—but the professional mechanics we talked to all use analogs. This model can start larger V8 engines, and it has effective safety features and sturdy clamps. They can also recharge your phone, tablet, and other devices in a pinch. After researching 40 portable, lithium ion jump starters and testing 12 models, we recommend the PowerAll Deluxe PBJSR , which is our runner-up pick.

As of March , our top pick, the Weego Jump Starter 22s, appears to be discontinued. The redesigned model is the Jump Starter 44s , and we plan to compare it to its predecessor sometime soon. In our first round of testing, the PowerAll Deluxe had no problem starting our dead year-old Jeep Wrangler with a 4.

It provided amps to boost our battery, in line with the best of the jump starters we tested. The PowerAll Deluxe also performed well in our tests with the larger 5. When we connected the PowerAll Deluxe and hit the ignition, it delivered a little over amps, and the truck growled to life. Of the five jump starters we tested on that truck, it was one of only three that managed to revive it the other two models have since been discontinued or redesigned. When you start your car, the starter motor pulls a lot of power from your car battery for a short amount of time.

Once the internal combustion engine turns over, it sends power back to the depleted battery via the alternator. Aside from buying a new battery, generally you have two solutions to choose from. The first and arguably better option is to attach your battery to a trickle charger, which will safely and slowly charge your battery back up, typically over 12 hours or more. A portable jump starter is also easier to use than traditional jumper cables.

And if you hook it up incorrectly, the Weego safety features, like reverse protection and audible alarms and warning lights, will protect both you and your car. The clamps are sturdier than those on most other models, and they make a solid connection to a variety of battery-post shapes and sizes.

The battery pack and clamps fit in a handy carrying bag, which you can easily stow under your seat or in your glove box until you need it. This cable is long and durable enough for any situation, with a current rating that can handle SUVs.

As this image illustrates, these cables are long and thick enough for most situations, and their amp current rating means they can handle most vehicles even trucks and SUVs. They also come with a surprisingly sturdy and convenient mesh storage bag. One thing that sets the AAA cables apart from other cables we found on Amazon is that the 6-gauge description is accurate. For example, Capri sells a 4-gauge, foot cable that reviewers say is closer to 8-gauge.

But lest you forget, AAA includes a handy diagram in the bag. The important thing to keep in mind: Do not attach the black clamp to the black post of the dead battery. Instead, clamp it to an unpainted metal surface under the hood. The Petzl emits bright light with the highest beam quality. This is the perfect headlamp for backpacking trips. Its lumen light is the brightest of all our picks. Twice during our trip we pulled into our camping site late, and our headlamp was the first thing we reached for.

Right out of the box, the Petzl Actik Core was easy to use. It has just one button and three brightness options: low 6 lumens , medium lumens , and high lumens. If you hold down the button for several seconds, the color turns to red; double-clicking lets you access the Strobe setting. Compared with some other rechargeable headlamps, which require complicated clicking configurations to get to the desired setting, we found this one to be simpler, though we lamented its lack of a flood beam.

Crushproof and waterproof, this set of three beacons comes with magnets for car mounting. And these are much safer than traditional flares. We like the StonePoint set because, for the price of one high-intensity model like the PowerFlare , you get three separate lights that are all crushproof to 20, pounds, waterproof, magnetic, and easy to set up and turn on. The magnets are important because they let you mount the beacons on your car, which adds height; having a flare anywhere above the surface of the road greatly increases your visibility.

Traditional magnesium flares will almost always be brighter and more visible. But their hazards—both to your health and to the environment around you—are substantial read the health and environmental hazards section PDF for a breakdown of the risks and the potentially harmful chemicals involved. Combine that with the fact that you can mitigate any differences in visibility simply by elevating an electric flare, and you end up with a compelling argument against using traditional flares.

And the Smittybilt U. Only the StonePoint beacons were easy to fill with batteries and get onto the road exactly when we needed them. They also happened to be the brightest flare alternatives we had with us. I should take a moment here and repeat what the responding officer told us when he arrived on the scene. No emergency kit is complete without a multi-tool.

Most minor situations—such as a loose Phillips-head screw or needing to create a rag for checking your oil—are easily fixed as long as you have the right tool. Multi-tools are small enough to carry in a jeans pocket or to attach to a belt, so you can take a set of useful tools almost anywhere. The Skeletool stood out from the other 19 multi-tools we tested because it focuses on the functionality, ergonomics, and solid construction of a few essential tools, instead of cramming dozens of different tools into a single bulky body that makes it difficult to use.

This tape is super-strong and sticky, flexible enough to wrap around corners, and easy to tear in a clean, straight line. We tested the hell out of 10 rolls of duct tape and chose Duck Max Strength above the competition for its perfect blend of attributes: high material strength, a strong adhesive, and superior overall flexibility for easy wrapping around odd shapes and curved surfaces. Is it an absolute necessity on the road?

Duct tape is, as any MacGyver fan will tell you, a very useful tool. This water jug holds enough water for two people for two days, and it has a spill-proof screw-on vent cap. The general rule for water in an emergency is that one person needs one gallon of water for one day.

Four to five gallons is a good amount to throw into your trunk—enough to get you through being stranded, even with a passenger. You should increase that estimate if you plan to go out in the middle of nowhere, or if your travels take you to a desert region or some other dry place.

We found on our trip through the Southwest that we were refilling our water bottles a lot more than we were stopping for gas. After researching 16 different types of water jugs, we recommend the Reliance 4-Gallon Aqua-Tainer for most situations. Recently it has been found that the ozone layer is being destroyed, particularly over the poles, by earth’s pollutants. This may give rise to the increasing penetration of UV light causing an increase in skin cancer, cataracts and other health problems.

Ozone is a blue, unstable, toxic gas. The concentration at ground level is 0. Modern supersonic aircraft fly at altitudes where this can be a problem. In the human, acute exposure for two hours to between 0. Fortunately these effects are not permanent unless there is continual exposure. Ozone impairs night vision in man and in human cell cultures can induce chromatic breakages identical to those produced by x-rays. This temperature is reached by the Concorde’s air conditioning compressor circuit during climb and cruise, neutralizing what could otherwise be a significant problem.

Atmospheric pressure is the weight of the gases surrounding the earth. It is a function of height, density and the force of gravity.

At ground level it is recorded by meteorologists as Atmospheric pressure decreases with altitude and at 18, ft. It should be noted that the changes are small and gradual compared to the changes observed going down in water. Here atmospheric pressure doubles at 33 ft!

As will be noted later this is a point of importance when dealing with fliers who are also scuba divers. The properties of the standard atmosphere showing the variation in the height of the tropopause.

The atmosphere is affected by both galactic and solar ionizing radiation. The former is a predictable, low density flux of high energy particles from outside the solar system. Most of these are deflected by the earth’s magnetic field although the protection is greater in the equatorial regions than at the poles. There is also some protection by the solar interplanetary magnetic field and by the stratospheric absorption of low energy particles. Measurements of this type of radiation have been taken from high altitude aircraft.

Fortunately the annual dose is relatively low in constantly exposed air crew. Solar radiation is of lower energy but its production may be intense and is generally unpredictable although it appears to reach a peak about every 11 years.

The earth is well shielded by its atmosphere but the dose may be significant in prolonged high altitude or space flight. It’s most commonly observed effect is interference with radio and other forms of communication equipment at the time of solar flares. Space flight will lead to more precise measurements of its long term effects.

The hazards of high altitude became evident as soon as men set out in balloons, although the dangers had been suspected by missionaries in mountainous areas long before.

In the Jesuit Priest Acosta noted ” I am convinced that the element of the air is in this place so thin and so delicate that it is not proportioned to human breathing which requires extensive and more temperate air”. In Glaisher and Coxwell made an ascent by balloon to almost 29, ft. Fortunately one of them, his hands frozen, was able to raise his head sufficiently to grab the valve cord of the balloon in his teeth before passing out, thus releasing hydrogen and bringing the balloon back down.

Paul Bert in the late ‘s built an altitude chamber and reached the conclusion that, regardless of barometric pressure, air could not supply life when the partial pressure of oxygen reached 45 mm. Only one of the three survived, the other two dying of hypoxia. To maintain life, oxygen has to be inhaled, diffused across the alveolar-capillary membrane, carried by hemoglobin to the tissues and then transferred to the individual cells for aerobic metabolism. Dalton’s Law states that the partial pressure of a gas in a gas mixture is equal to the pressure which the gas would exert if it alone occupied the space taken up by the mixture.

Each of the gas components in the mixture therefore exerts pressure proportional to the fraction which it represents. Oxygen, being present as Hg in dry air at sea level.

However this changes when it is inspired. Water vapour pressure is 47 mm. In the trachea therefore the partial pressure of oxygen will be – 47 x 0.

Passing from the trachea to the alveolus, oxygen becomes mixed with carbon dioxide. It is also diffusing into the tissues from the respiratory bronchioles down, so by the time the alveolus is reached, the partial pressure of oxygen is much lower. The partial pressure of carbon dioxide is about 40 mm. Hg so the alveolar partial pressure of oxygen at ground level, when the respiratory quotient is taken into account, is mm.

Hg For those mathematically inclined relevant formulas are given at the end of this chapter. This steadily dropping partial pressure is known as the respiratory cascade. The diffusion of oxygen and of carbon dioxide in the opposite direction takes place at the level of the respiratory bronchioles and below. The majority of the diffusion takes place at the alveolus which is virtually surrounded by capillary blood. The area of the alveolar-capillary interface is astonishingly large, between 90 and sq.

If spread out the alveoli would cover a double tennis court. Diffusion at the alveolus takes place along the pressure gradient with most of the oxygen being picked up by hemoglobin for transfer to the tissues.

The rate of diffusion of a gas is proportional to its solubility and to the pressure gradient. Carbon dioxide, being more soluble than oxygen, diffuses at a faster rate.

In the tissues the pressure of oxygen falls with increasing distance from the capillary, with the lowest level being found midway between two capillaries. If the partial pressure of oxygen falls below 3 mm. Hg in the tissues anaerobic metabolism develops. Under normal conditions a rise in PC02 and the formation of tissue lactic acid causes capillaries to dilate. In muscle the number of open capillaries can increase by times but in the brain most of the capillaries are open, even at rest, so even in the face of imminent hypoxia the number of cerebral capillaries can increase only by a factor of four.

This is why hypoxia affects the brain first. Oxy-hemoglobin Hb02 dissociation describes an S-shaped curve See Figure 6 when saturation is plotted against oxygen partial pressures.

The characteristics of this curve are important. Down to a partial pressure of 60 mm. The sharp drop-off of the curve enables oxy-hemoglobin to unload rapidly in the relatively hypoxic tissues and equally allows reduced Hb to pick up oxygen rapidly at normal diffusion gradients.

Under hypoxic conditions lactic acid is formed in the tissues causing a relative acidosis which moves the curve to the right, increasing the uptake and release of oxygen. In alkalosis, as in hyperventilation, the curve moves left, lessening tissue availability. At 10, ft. Above this altitude significant tissue hypoxia develops and it is for this reason that oxygen is required while flying above 10, ft.

The critical level of 60 mm. This is referred to as an “equivalent oxygen level”. Hypoxia is an insidious killer. There is a tendency for euphoria to develop while motor skills and reasoning abilities deteriorate. The result is that in many cases the pilot may become seriously hypoxic without appreciating that there is a problem. To the observer tachypnea, cyanosis, mental confusion and loss of muscle coordination are obvious. To the pilot however, the only symptoms may be slight dyspnea, dizziness, fatigue, decreasing vision and finally loss of muscular control.

Night vision can be impaired at as low as ft. Tolerance to hypoxia varies from individual to individual and from time to time. Tolerance can be increased by continual exposure to high altitudes and varies with the level of the hemoglobin and the oxygen carrying capacity of the blood. It is decreased by fatigue, cold and poor physical conditioning. Even at 5, ft. Hypoxic hypoxia is due to a decrease in the oxygen available to the body such as typically occurs with altitude.

Hypemic hypoxia is caused by a reduction in the oxygen carrying capacity of the blood for any reason. It also occurs when hemoglobin is saturated by gases for which it has a higher affinity, the most common of which is carbon monoxide. This is not only produced by exhaust leaks into the cockpit but also by cigarette smoking.

Stagnant hypoxia is a less common problem caused by a reduction in total cardiac output, pooling of the blood or restriction of blood flow. Heart failure, shock, continuous positive pressure breathing and Gforces in flight can create stagnant hypoxia. Local stagnant hypoxia can occur with tight and restrictive clothing or, in the cerebral circulation, in association with vasoconstriction due to respiratory alkalosis provoked by hyperventilation.

Histotoxic hypoxia refers to poisoning of the respiratory cytochrome system by chemicals such as cyanide or carbon monoxide but it can also be caused by the effects of alcohol.

Needless to say a pilot in poor physical condition, recovering from a hangover and smoking while in flight can quickly become an unfortunate statistic! In the seated position the lungs, due to the pull of gravity, are stretched at the apices and condensed at the bases. At the same time, the blood supply is least at the apices and greatest at the bases. Thus in the area where the alveolar ventilation is best, perfusion is least and at the bases the opposite is true.

Only in the mid section of the lung is there an ideal ventilation – perfusion ratio. Under positive G, the situation is exaggerated and if it is of long duration in crews breathing oxygen, rapid absorption from the alveoli tends to cause basilar atelectasis.

Hyperventilation may be described as a respiratory rate excessive for the body’s oxygen requirements. It may be voluntary or involuntary and can occur in relation to many different activities. In the pilot the most common precipitating causes are anxiety, fear, excessive concentration on a flight procedure and as a reaction to pain or illness. Hyperventilation may be obvious, as in the case of children preparing to compete in underwater swimming, or it may be covert as for example when the respiratory rate increases from a required 12 per minute to an excessive 15 per minute and remains elevated for a prolonged time.

Whatever the cause the results are the same. Carbon dioxide, the most potent stimulus to respiration, is blown off in excessive amounts. The PACO2 falls and respiratory alkalosis develops. The cerebral vessels become constricted and subjectively the pilot often notices a feeling of dizziness, a coldness and tingling around the lips and a feeling as though there was a band around the head.

Nausea may be present. Peripherally there is vasodilatation and stimulation of sensory nerves causing a sensation of pins and needles in the hands and in the feet. If hyperventilation continues carpopedal spasm develops and the subject may become unconscious and develop frank tetany.

With the breath held the carbon dioxide levels build up once more and the symptoms disappear in reverse order. Obviously such a chain of events can lead to an accident.

This has been documented in some incidents in young fighter pilots or untrained private pilots who have inadvertently flown into bad weather and have kept the microphone button depressed, broadcasting their breath patterns up to their final moment.

Hyperventilation is often suspected in unexplained accidents. If one considers the symptoms of hypoxia and hyperventilation it will be seen that they are very similar.

Although it is usually in military pilots that problems arise with hypoxia at levels above 30, ft. The Concorde, for example, cruises above 60, ft. Cabin pressurization in these aircraft ensures that the partial pressure of oxygen is adequate and it is rare for the cabin pressure to be above 7, ft.

See Fig. However, it is wise to remember that passengers with chronic lung diseases or serious anemia, particularly those who are smokers, may be significantly hypoxic even at this altitude. More dangerous however is the situation which develops when cabin pressure suddenly fails, usually due to the loss of a window or door. The result is rapid decompression with a sudden increase in the cabin altitude to match the ambient altitude.

In aircraft such as the Concorde the windows have been made particularly small to lessen this effect but in older aircraft more serious problems have occurred. The immediate effect of decompression is a loud noise, condensation of water vapour causing a mist and a shower of dust and small particles.

The temperature falls dramatically. The resultant cabin pressure may actually fall below that of the ambient pressure due to “aerodynamic suck”. This refers to the Venturi effect created by the speed of the aircraft through the air. The initial hazard to aircraft safety is hypoxia. The crew are unlikely to be wearing oxygen masks at the time of the incident and, if the final cabin altitude is high, the time of useful consciousness may be very short see Figure 8.

It may actually be lower than would be anticipated because of the sudden escape of expanding gas from the lungs due to the reduced ambient pressure. This causes reversal of the oxygen diffusion gradient across the alveolar membrane and oxygen passes back into the lung from the blood. At 35, ft. Airlines make provision for this eventually by providing pilots with “quick-donning” oxygen masks, which can be donned in 5 seconds or less.

At sea level this is – 47 x 0. The respiratory quotient R on a pure carbohydrate diet is 1. On a balanced diet of carbohydrate, protein and fat, R is generally about 0. We have already commented on the decrease in atmospheric pressure which occurs with altitude. Boyle’s Law states that, at constant temperature, the volume of a gas varies inversely with the pressure. If the pressure of gas is halved, its volume is doubled.

Application of this simple law to the closed body cavities quickly indicates where problems are likely to occur. By far the most common problems are with the middle ear. It resembles a box, closed by a flexible diaphram at one end and drained by the Eustachian tube narrow tube at the other. The eustachian tube however is not rigid or symmetrical throughout its length and becomes slit-like at its outlet in the nasopharnyx. On ascent expanding trapped air usually escapes easily and the only thing noticed is a periodic “popping” due to movements of the drum as pressure equalizes.

On descent however equalization of pressure through the slit-like outlet is much more difficult and a negative pressure can build up in the middle ear. This leads to a decrease in hearing and to pain. The ear can be cleared by opening and closing the mouth, thus activating the tensor tympani muscle and dilating the tube, or by inflation by a Valsalva maneuver.

In an U. The pressure in the middle ear on descent may then become so low relative to the outside pressure that exudation and hemorrhage may take place and ultimately the eardrum may burst. Excessive valsalva maneuvers however may force bacteria into the middle ear, leading to infection. When an ear blocks and cannot be cleared by the usual maneuvers, the best way to deal with the situation is to reascend and start a slower descent.

This is not always possible. During World War II the pilots of vertical diving Stukas had constant ear problems and their flight surgeons solved these by periodically incising the drums! Nowadays this is not recommended! A particular problem occurs when pilots flying at high altitude on oxygen retire to sleep soon after landing.

The middle ear is full of soluble oxygen rather than inert introgen which is absorbed during sleep. On awakening they have earache due to the indrawn drums. This is called “oxygen ear”.

Other air spaces are equally affected. The nasal sinuses are a common source of pain as may be poorly filled teeth if the filling has not been carefully inserted and a gas space remains below it. These various symptoms are referred to as “barotraumas” and toothache of this type is known as “barodontalgia”. The best approach to these conditions is knowledge and prevention. Fortunately most professional pilots are well aware of the problems and avoid flying when they are congested.

A common irritating, embarrassing and potentially serious problem is gas in the bowel. This expands rapidly as might be expected and, if it cannot be passed, may lead to severe pain. Chewing gum, air swallowing, carbonated drinks and beer in the passenger all add to the gas, as do various gas producing foods. Passengers with ostomy bags or various types of bowel obstruction are particularly likely to have problems. Boyle’s Law must be kept in mind if you are involved in the transport by air of patients requiring cuffed tubes of any type or if casts or pneumatic dressings are being used.

Cuffs should be inflated with saline or water rather than air before the trip. The “Bends” or “Caisson disease” has been recognized since in association with “hard hat” divers or men working under pressurized conditions.

By the end of WWI the possibility of decompression sickness in aviators was predicted and once high altitude balloon flights were undertaken the prediction was fulfilled.

The cause of decompression sickness is the formation of gas bubbles in the body and the physical law was described by Henry. Henry’s Law states that the quantity of gas that goes into solution at a given temperature is dependent upon its solubility characteristics and is proportional to the partial pressure of that gas over the surface of the liquid. Hence as the pressure falls, the amount of gas which can be held in solution is reduced.

The dominant gas in the atmosphere we breathe is nitrogen. It is inert and the body is saturated with it at ground level. During rapid ascent the reduction of barometric pressure creates a condition whereby the inert gas tension in the tissues is greater than the external barometric pressure.

This condition is called super-saturation. At this point, in association with bubble nuclei produced by muscle shear forces or turbulent blood flow, bubbles of nitrogen can be formed in the tissues and in the body fluids.

It is these bubbles which give rise to decompression sickness. The symptoms of decompression sickness are described as the four “C’s”. These are Creeps, Cramps, Chokes and Collapse”. This “formication” is believed to be caused by the formation of tiny bubbles. Smaller joints may be affected and it is not uncommon to first notice the symptoms in joints which have previously been injured.

The pain is deep and aching in character and varies from mild to severe. It is made worse by movement of the joints and is sometimes improved by pressure on the area. It is a much more serious disorder caused by multiple pulmonary gas emboli. The subject complains of substernal chest pain, dyspnea and a dry, non-productive cough. If altitude is maintained “Collapse” will inevitably occur. The treatment is immediate descent which is generally effective. Neurological decompression sickness is the most dangerous form and often has a very serious prognosis.

It may be responsible for permanent neurological deficits particularly if hyperbaric treatment is not immediately available. In the aviator brain injuries, although uncommon, are most frequent. In divers the spinal cord type is most frequent. The reason for this variance is not known. In the brain type visual disturbances scotoma, tunnel vision, diplopia etc. Physical signs are spotty and diffuse, both motor and sensory.

The signs may be thought to be hysterical but collapse may occur. In the spinal cord the most common onset is of numbness or paraesthesia in the feet. A complete transverse spinal cord lesion may occur as bubbles obstruct the blood supply and infarct the cord. Fortunately serious decompression sickness is uncommon in commercial aviation. Generally the altitude threshold is above 18, ft. Above 26, ft. It is much more often seen therefore in high altitude military pilots whose cockpit pressurization profiles are lower than those in commercial aircraft.

There are various factors which affect it. The incidence increases with age, there being a threefold increase between the year old and the year old age groups.

Nitrogen is well dissolved in fat, so obesity is a factor. It is probably more common in women than men. It is more common with exercise at altitude, with rapid ascents, with re-exposure to altitude at frequent intervals and at low temperatures. The after effects of alcohol and intercurrent infection both increase the susceptibility.

It is important to keep in mind the relationship between SCUBA diving and decompression sickness in aviators. SCUBA divers use compressed air in their tanks and are often exposed to two or more atmospheres of pressure, supersaturating the tissues. If they fly within twelve hours of emerging from diving at standard depths, decompression sickness has been recorded at altitudes as low as 10, ft.

Where they have been diving at depths which require decompression stops on the way to the surface, they should not fly for a minimum of 48 hours. Although serious problems are uncommon, it is necessary to be aware of the danger to recognize it, particularly with neurological symptoms. Occasionally a medical emergency results when a diver ascends to the surface too rapidly, causing a bubble formation. In such cases the diver must be reexposed to a greater pressure as quickly as possible and then brought back to the surface.

Sometimes the diver is too ill to undertake another dive and must be transported to a hyperbaric chamber for treatment as quickly as possible. Pilots transporting such individuals should be cautioned that increases in altitude will worsen the patient’s condition.

If pressurized aircraft are not available, flights should be made at the lowest safe altitude. Recompression treatment tables are outlined in textbooks of Diving medicine. Doctors often feel that an understanding of acceleration G and the effects of gravity g are only of importance to aerobatic or high performance aircraft pilots.

This is a mistake. Because we are normally terrestrial creatures, bonding to the earth has taught us that gravity exerts a downward pull. In an aircraft however, G-forces are often upward or outward and as they are associated with changes in both acceleration and direction, what is experienced is a resultant force. It is these forces and their effects on the vestibular organs which give rise to our recognition of position in space.

In the review of orientation the importance of this will be explained. Speed is the rate of movement of a body while velocity is a vectorial quantity made up of both speed and direction. Acceleration G is a change in velocity either in direction or in magnitude.

It is described in three axes in relation to the body, x, y and z. Considerable confusion can arise if a clear distinction is not made between the applied acceleration and the resultant inertial force as these, by definition, always act in diametrically opposite directions. The physiological effects of G vary with its magnitude, duration and axis of application and are modified by the area over which it is applied and the site.

Tolerance to acceleration varies from day to day and is modified by body build, muscular tone and experience. It is decreased by poor health or conditioning, fatigue, hypoxia and alcohol. It can be increased by continued exposure and education. Pilots exposed to heavy G loads soon learn to use a modified Valsalva manoeuvre with controlled breathing and muscle contraction to increase their tolerance the M1 manoeuvre. G-suits mechanically increase resistance to positive Gz by exerting pressure on the lower limbs and the abdomen to prevent pooling of blood.

Unfortunately there is no mechanical device to counteract negative Gz. Positive Gz forces the pilot into the seat, draining the blood towards the lower part of the body. A lb. This interferes with muscular movement, aircraft control and the ability to change position or to escape in an emergency. As G comes on and blood is drained from the head, the first symptom is visual. This leads to “grey-out”, a condition in which peripheral vision is progressively lost and central vision begins to lose its acuity.

As the G load increases the retinal arterial flow is further reduced until “black-out” occurs. At this point, although vision is absent, the cerebral blood flow is often maintained and the pilot may remain conscious. At G however most pilots become unconscious unless they are protected. This is referred to as G-LOC. G-Loss of consciousness. When the G load is reduced, consciousness will be regained although there is often a brief period of confusion before full awareness is reached.

This has been determined as the cause of several accidents in high performance aircraft. Negative Gz, acting from the foot to the head, is poorly tolerated by the body and in most cases the threshold is below -5 Gz.

As might be expected the visual symptom is “red-out” as blood is forced towards the head and into the retinal arterioles. Excessive -Gz leads to hemorrhages into the conjunctiva and ultimately into the brain.

A special form of G is known as “jolt”. Jolt is the rate of change of acceleration. It is descriptively used in relation to short, sharp accelerations. This type of shock can give rise to serious spinal injuries and must be minimized in the design of ejection seats. Brief alternating positive and negative Gz forces are experienced in turbulence and may be a serious problem when flying light aircraft in hot weather or flying high speed aircraft at low levels.

G-forces not only interfere with precise flying but are also a potent source of fatigue. Tolerance to transverse G Gx is much higher. It is for this reason that the astronauts in the early vehicles were placed in a recumbent position during lift-off.

Gy is not of great enough amplitude to cause problems in consciousness and is not a problem with modern day aircraft. At present, head restraint is the only problem experienced with Gy.

To the earth bound individual, orientation means being aware of one’s body position relative to the earth. Gravity acts towards the centre of the earth and is recognized as down. The aviator however lives in a different world, a world in which proprioceptive senses may give rise to false information.

At the top of a loop for example, where centrifugal force replaces gravity, down appears to be up and up appears to be down! Disorientation, in the pilot’s sense, sometimes described as “vertigo” is to be unable to locate oneself in space and can be one of the most terrifying and lethal of experiences.

We orient ourselves by vision, the vestibular system and by proprioceptive nerve data. The mental images of orientation that we derive from these impulses are learned from birth and relate to our terrestrial habitat.

So strong are these sensations that it is possible to produce nausea by placing us in an environment where what we see is different to what we feel. This is the theoretical basis of motion sickness and will be described later.

Vision is the strongest orienting sense, and the one to which we turn when other senses fail. It is functionally divided into two parts. One, employing central foveal vision and sharp focus, is concerned with object recognition and is used together with learned conditioned reflexes in instrument flight.

The other, ambient orientation, is peripheral, less acute and is directly connected to vestibular function. That the two parts of vision are independent can be observed in a driver who reads a map and follows the road at the same time.

Although we can orient ourselves and function normally when the vestibular apparatus is absent or ablated, without vision orientation is much more difficult. However vision can also give rise to illusions both of location and of movement.

The vestibular system has three functions. It acts to stabilize vision via the oculo-vestibular reflexes, to orient the body in relation to movement in the environment and to give a perception of motion.

These functions are performed by two 1. Each vestibule see Fig. Each canal lies in a separate plane of space: one is horizontal, one vertical and one lateral. The canals sense angular accelerations in the planes of yaw, pitch and roll respectively. They are connected at each end to the utricle, a dilated central area in which are the ampullae.

In the ampullae delicate hair cells topped by a gelatinous cupola project into the endolymph and move with it like river bottom plants in a current. The utricle is connected to the saccule and in the floor of these chambers are the macula sacculi. The macula in the utricle lies in the horizontal plane and that in the saccule lies in the vertical plane. The maculae consist of hair cells projecting into the endolymph and covered by a gelatinous membrane containing tiny calcium carbonate crystals.

They are referred to as otoliths and act as linear accelerometers. The vestibular apparatus has connections to the visual cortex, to the innervation of the extra-ocular muscles and to the vestibular nuclei in the cerebrum. Try holding your hand up in front of your face and then moving it from side to side. The movement does not have to be fast before focused vision of the fingers is lost. Holding the hand still however and moving the head from side to side allows sharp focus to be maintained at much greater rates.

Occulovestibular reflexes make this possible. Proprioception is of only secondary importance to vision on the ground, but is much less reliable in the air.

While flying, centripetal and centrifugal forces compete with gravity and proprioception may be confused. Although proprioception enables the pilot to stabilize his body in the cockpit and gives valuable clues to changing directions and attitudes in visual flying conditions, in instrument conditions “flying by the seat of the pants” can rapidly become lethal.

All crashed within seconds! These may be foveal or vectional, that is concerned with central vision or orientation vision. The former type is often associated with landing approaches and is most common where visual clues are reduced or unfamiliar. Apilot approaching an unfamiliar runway with a minor uphill slope, for example, may feel that he is too high and may fall below the normal glide slope.

If the fields runs down hill, he may land long. Pilots inexperienced in the Arctic may miscalculate their height on final approach because the trees they use for unconscious reference are shorter than trees in the South.

 
 

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That upstairs more ahead of me than I had thought it would be, and is not like to have much earth brain. Grandfather kept me saying the Dho formula last night, and I think I chapter 2: the dunwich horror saw the inner city at the 2 magnetic poles.

They from the air told me at Sabbat that it will be years before I can clear off the earth, and I guess grandfather will be dead then, so I shall have to learn all the angles of the planes and all the formulas between the Yr and the Nhhngr. They from outside will help, but they cannot take body without human blood.

That upstairs looks it will have the right cast. I can see it a little when I make the Voorish sign or blow the powder of Ibn Ghazi at it, and it is near like them at May-Eve on the Hill. The other face may wear off some. I wonder how I shall look when the earth is cleared and there are no earth beings on it. He that came with the Aklo Sabaoth said I may be transfigured, there being much of outside to work on.

Armitage in a cold sweat of terror and a frenzy of wakeful concentration. He had not left the manuscript all night, but sat at his table under the electric light turning page after page with shaking hands as fast as he could decipher the cryptic text. He had nervously telephoned his wife he would not be home, and when she brought him a breakfast from the house he could scarcely dispose of a mouthful.

All that day he read on, now and then halted maddeningly as a reapplication of the complex key became necessary. Lunch and dinner were brought him, but he ate only the smallest fraction of either. On the morning of September 4th Professor Rice and Dr.

Morgan insisted on seeing him for a while, and departed trembling and ashen-grey. That evening he went to bed, but slept only fitfully. Wednesday—the next day—he was back at the manuscript, and began to take copious notes both from the current sections and from those he had already deciphered. In the small hours of that night he slept a little in an easy-chair in his office, but was at the manuscript again before dawn.

Some time before noon his physician, Dr. Hartwell, called to see him and insisted that he cease work. He refused; intimating that it was of the most vital importance for him to complete the reading of the diary, and promising an explanation in due course of time. That evening, just as twilight fell, he finished his terrible perusal and sank back exhausted. His wife, bringing his dinner, found him in a half-comatose state; but he was conscious enough to warn her off with a sharp cry when he saw her eyes wander toward the notes he had taken.

Weakly rising, he gathered up the scribbled papers and sealed them all in a great envelope, which he immediately placed in his inside coat pocket. He had sufficient strength to get home, but was so clearly in need of medical aid that Dr. Hartwell was summoned at once. Armitage slept, but was partly delirious the next day. He made no explanations to Hartwell, but in his calmer moments spoke of the imperative need of a long conference with Rice and Morgan.

His wilder wanderings were very startling indeed, including frantic appeals that something in a boarded-up farmhouse be destroyed, and fantastic references to some plan for the extirpation of the entire human race and all animal and vegetable life from the earth by some terrible elder race of beings from another dimension. He would shout that the world was in danger, since the Elder Things wished to strip it and drag it away from the solar system and cosmos of matter into some other plane or phase of entity from which it had once fallen, vigintillions of aeons ago.

At other times he would call for the dreaded Necronomicon and the Daemonolatreia of Remigius, in which he seemed hopeful of finding some formula to check the peril he conjured up. He woke late Friday, clear of head, though sober with a gnawing fear and tremendous sense of responsibility.

Saturday afternoon he felt able to go over to the library and summon Rice and Morgan for a conference, and the rest of that day and evening the three men tortured their brains in the wildest speculation and the most desperate debate. Strange and terrible books were drawn voluminously from the stack shelves and from secure places of storage; and diagrams and formulae were copied with feverish haste and in bewildering abundance. Of scepticism there was none. Opinions were divided as to notifying the Massachusetts State Police, and the negative finally won.

There were things involved which simply could not be believed by those who had not seen a sample, as indeed was made clear during certain subsequent investigations. Late at night the conference disbanded without having developed a definite plan, but all day Sunday Armitage was busy comparing formulae and mixing chemicals obtained from the college laboratory.

The more he reflected on the hellish diary, the more he was inclined to doubt the efficacy of any material agent in stamping out the entity which Wilbur Whateley had left behind him—the earth-threatening entity which, unknown to him, was to burst forth in a few hours and become the memorable Dunwich horror. Monday was a repetition of Sunday with Dr. Armitage, for the task in hand required an infinity of research and experiment.

Further consultations of the monstrous diary brought about various changes of plan, and he knew that even in the end a large amount of uncertainty must remain. Then, on Wednesday, the great shock came. Tucked obscurely away in a corner of the Arkham Advertiser was a facetious little item from the Associated Press, telling what a record-breaking monster the bootleg whiskey of Dunwich had raised up. Armitage, half stunned, could only telephone for Rice and Morgan. Far into the night they discussed, and the next day was a whirlwind of preparation on the part of them all.

Armitage knew he would be meddling with terrible powers, yet saw that there was no other way to annul the deeper and more malign meddling which others had done before him. The day was pleasant, but even in the brightest sunlight a kind of quiet dread and portent seemed to hover about the strangely domed hills and the deep, shadowy ravines of the stricken region. Now and then on some mountain-top a gaunt circle of stones could be glimpsed against the sky.

Throughout that afternoon they rode around Dunwich; questioning the natives concerning all that had occurred, and seeing for themselves with rising pangs of horror the drear Frye ruins with their lingering traces of the tarry stickiness, the blasphemous tracks in the Frye yard, the wounded Seth Bishop cattle, and the enormous swaths of disturbed vegetation in various places. The trail up and down Sentinel Hill seemed to Armitage of almost cataclysmic significance, and he looked long at the sinister altar-like stone on the summit.

At length the visitors, apprised of a party of State Police which had come from Aylesbury that morning in response to the first telephone reports of the Frye tragedy, decided to seek out the officers and compare notes as far as practicable. This, however, they found more easily planned than performed; since no sign of the party could be found in any direction. There had been five of them in a car, but now the car stood empty near the ruins in the Frye yard. The natives, all of whom had talked with the policemen, seemed at first as perplexed as Armitage and his companions.

Then old Sam Hutchins thought of something and turned pale, nudging Fred Farr and pointing to the dank, deep hollow that yawned close by. Armitage, now that he had actually come upon the horror and its monstrous work, trembled with the responsibility he felt to be his.

Night would soon fall, and it was then that the mountainous blasphemy lumbered upon its eldritch course. Negotium perambulans in tenebris. The old librarian rehearsed the formulae he had memorised, and clutched the paper containing the alternative one he had not memorised.

He saw that his electric flashlight was in working order. Armitage, having read the hideous diary, knew painfully well what kind of a manifestation to expect; but he did not add to the fright of the Dunwich people by giving any hints or clues.

He hoped that it might be conquered without any revelation to the world of the monstrous thing it had escaped. As the shadows gathered, the natives commenced to disperse homeward, anxious to bar themselves indoors despite the present evidence that all human locks and bolts were useless before a force that could bend trees and crush houses when it chose.

There were rumblings under the hills that night, and the whippoorwills piped threateningly. Once in a while a wind, sweeping up out of Cold Spring Glen, would bring a touch of ineffable foetor to the heavy night air; such a foetor as all three of the watchers had smelled once before, when they stood above a dying thing that had passed for fifteen years and a half as a human being. But the looked-for terror did not appear.

Whatever was down there in the glen was biding its time, and Armitage told his colleagues it would be suicidal to try to attack it in the dark. Morning came wanly, and the night-sounds ceased. It was a grey, bleak day, with now and then a drizzle of rain; and heavier and heavier clouds seemed to be piling themselves up beyond the hills to the northwest. The men from Arkham were undecided what to do.

Seeking shelter from the increasing rainfall beneath one of the few undestroyed Frye outbuildings, chapter 2: the dunwich horror they debated the wisdom of waiting, or of taking the aggressive and going down into the glen in quest of their nameless, monstrous quarry. The downpour waxed in heaviness, and distant peals of thunder sounded from far horizons. Sheet lightning shimmered, and then a forky bolt flashed near at hand, as if descending into the accursed glen itself.

The sky grew very dark, and the watchers hoped that the storm would prove a short, sharp one followed by clear weather. It was still gruesomely dark when, not much over an hour later, a confused babel of voices sounded down the road.

Another moment brought to view a frightened group of more than a dozen men, running, shouting, and even whimpering hysterically. Someone in the lead began sobbing out words, and the Arkham men started violently when those words developed a coherent form.

Jest still-like. You men know that those Whateleys were wizards—well, this thing is a thing of wizardry, and must be put down by the same means. How about it? The sky was growing lighter, and there were signs that the storm had worn itself away. When Armitage inadvertently took a wrong direction, Joe Osborn warned him and walked ahead to shew the right one. Courage and confidence were mounting; though the twilight of the almost perpendicular wooded hill which lay toward the end of their short cut, and among whose fantastic ancient trees they had to scramble as if up a ladder, put these qualities to a severe test.

At length they emerged on a muddy road to find the sun coming out. They were a little beyond the Seth Bishop place, but bent trees and hideously unmistakable tracks shewed what had passed by. Only a few moments were consumed in surveying the ruins just around the bend. It was the Frye incident all over again, and nothing dead or living was found in either of the collapsed shells which had been the Bishop house and barn.

No one cared to remain there amidst the stench and tarry stickiness, but all turned instinctively to the line of horrible prints leading on toward the wrecked Whateley farmhouse and the altar-crowned slopes of Sentinel Hill.

It was no joke tracking down something as big as a house that one could not see, but that had all the vicious malevolence of a daemon. Armitage produced a pocket telescope of considerable power and scanned the steep green side of the hill. Then he handed the instrument to Morgan, whose sight was keener. After a moment of gazing Morgan cried out sharply, passing the glass to Earl Sawyer and indicating a certain spot on the slope with his finger.

It was one thing to chase the nameless entity, but quite another to find it. Voices began questioning Armitage about what he knew of the thing, and no reply seemed quite to satisfy. Everyone seemed to feel himself in close proximity to phases of Nature and of being utterly forbidden, and wholly outside the sane experience of mankind.

In the end the three men from Arkham—old, white-bearded Dr. Armitage, stocky, iron-grey Professor Rice, and lean, youngish Dr. Morgan—ascended the mountain alone. After much patient instruction regarding its focussing and use, they left the telescope with the frightened group that remained in the road; and as they climbed they were watched closely by those among whom the glass was passed around.

It was hard going, and Armitage had to be helped more than once. High above the toiling group the great swath trembled as its hellish maker re-passed with snail-like deliberateness. Then it was obvious that the pursuers were gaining.

Curtis Whateley—of the undecayed branch—was holding the telescope when the Arkham party detoured radically from the swath. He told the crowd that the men were evidently trying to get to a subordinate peak which overlooked the swath at a point considerably ahead of where the shrubbery was now bending. This, indeed, proved to be true; and the party were seen to gain the minor elevation only a short time after the invisible blasphemy h a d passed it.

The crowd stirred uneasily, recalling that this sprayer was expected to give the unseen horror a moment of visibility. Two or three men shut their eyes, but Curtis Whateley snatched back the telescope and strained his vision to the utmost. Curtis, who had held the instrument, dropped it with a piercing shriek into the ankle-deep mud of the road.

He reeled, and would have crumpled to the ground had not two or three others seized and steadied him. Curtis was past all coherence, and even isolated replies were almost too much for him. Fred Farr and Will Hutchins carried him to the roadside and laid him on the damp grass. Henry Wheeler, trembling, turned the rescued telescope on the mountain to see what he might. Through the lenses were discernible three tiny figures, apparently running toward the summit as fast as the steep incline allowed.

Only these—nothing more. Then everyone noticed a strangely unseasonable noise in the deep valley behind, and even in the underbrush of Sentinel Hill itself. It was the piping of unnumbered whippoorwills, and in their shrill chorus there seemed to lurk a note of tense and evil expectancy. Earl Sawyer now took the telescope and reported the three figures as standing on the topmost ridge, virtually level with the altar-stone but at a considerable distance from it.

One figure, he said, seemed to be raising its hands above its head at rhythmic intervals; and as Sawyer mentioned the circumstance the crowd seemed to hear a faint, half-musical sound from the distance, as if a loud chant were accompanying the gestures. The weird silhouette on that remote peak must have been a spectacle of infinite grotesqueness and impressiveness, but no observer was in a mood for aesthetic appreciation. The whippoorwills were piping wildly, and in a singularly curious irregular rhythm quite unlike that of the visible ritual.

Suddenly the sunshine seemed to lessen without the intervention of any discernible cloud. It was a very peculiar phenomenon, and was plainly marked by all.

A rumbling sound seemed brewing beneath the hills, mixed strangely with a concordant rumbling which clearly came from the sky. Lightning flashed aloft, and the wondering crowd looked in vain for the portents of storm. The chanting of the men from Arkham now became unmistakable, and Wheeler saw through the glass that they were all raising their arms in the rhythmic incantation.

From some farmhouse far away came the frantic barking of dogs. The change in the quality of the daylight increased, and the crowd gazed about the horizon in wonder. Then the lightning flashed again, somewhat brighter than before, and the crowd fancied that it had shewed a certain mistiness around the altar-stone on the distant height. No one, however, had been using the telescope at that instant.

The whippoorwills continued their irregular pulsation, and the men of Dunwich braced themselves tensely against some imponderable menace with which the atmosphere seemed surcharged. Without warning came those deep, cracked, raucous vocal sounds which will never leave the memory of the stricken group who heard them. Not from any human throat were they born, for the organs of man can yield no such acoustic perversions.

Rather would one have said they came from the pit itself, had not their source been so unmistakably the altarstone on the peak. It is almost erroneous to call them sounds at all, since so much of their ghastly, infra-bass timbre spoke to dim seats of consciousness and terror far subtler than the ear; yet one must do so, since their form was indisputably though vaguely that of half-articulate words.

They were loud—loud as the rumblings and the thunder above which they echoed—yet did they come from no visible being. Henry Wheeler strained his eye at the telescope, but saw only the three grotesquely silhouetted human figures on the peak, all moving their arms furiously in strange gestures as their incantation drew near its culmination. From what black wells of Acherontic fear or feeling, from what unplumbed gulfs of extra-cosmic consciousness or obscure, long-latent heredity, were those half-articulate thunder-croakings drawn?

Presently they began to gather renewed force and coherence as they grew in stark, utter, ultimate frenzy. The pallid group in the road, still reeling at the indisputably English syllables that had poured thickly and thunderously down from the frantic vacancy beside that shocking altar-stone, were never to hear such syllables again.

Instead, they jumped violently at the terrific report which seemed to rend the hills; the deafening, cataclysmic peal whose source, be it inner earth or sky, no hearer was ever able to place. A single lightning-bolt shot from the purple zenith to the altar-stone, and a great tidal wave of viewless force and indescribable stench swept down from the hill to all the countryside. Dogs howled from the distance, green grass and foliage wilted to a curious, sickly yellow-grey, and over field and forest were scattered the bodies of dead whippoorwills.

The stench left quickly, but the vegetation never came right again. To this day there is something queer and unholy about the growths on and around that fearsome hill. Curtis Whateley was only just regaining consciousness when the Arkham men came slowly down the mountain in the beams of a sunlight once more brilliant and untainted.

They were grave and quiet, and seemed shaken by memories and reflections even more terrible than those which had reduced the group of natives to a state of cowed quivering. In reply to a jumble of questions they only shook their heads and reaffirmed one vital fact.

It was an impossibility in a normal world. Only the least fraction was really matter in any sense we know. It was like its father—and most of it has gone back to him in some vague realm or dimension outside our material universe; some vague abyss out of which only the most accursed rites of human blasphemy could ever have called him for a moment on the hills. Memory seemed to pick itself up where it had left off, and the horror of the sight that had prostrated him burst in upon him again.

Only old Zebulon Whateley, who wanderingly remembered ancient things but who had been silent heretofore, spoke aloud. We have no business calling in such things from outside, and only very wicked people and very wicked cults ever try to.

There was some of it in Wilbur Whateley himself—enough to make a devil and a precocious monster of him, and to make his passing out a pretty terrible sight.

Things like that brought down the beings those Whateleys were so fond of—the beings they were going to let in tangibly to wipe out the human race and drag the earth off to some nameless place for some nameless purpose.

It grew fast and big from the same reason that Wilbur grew fast and big—but it beat him because it had a greater share of the outsideness in it. It was his twin brother, but it looked more like the father than he did.

Working as a team, investigators can come from disparate backgrounds and be of varied occupations—each bringing certain expertise to the group. Together, joined in comradeship and common purpose, you will stand steadfast against the coming darkness.

This chapter provides the rules for creating investigator player characters. A two-page spread that provides a handy summary for quick reference can be found on pages Before you begin rolling dice you should talk to the Keeper and ask for guidance on creating a suitable investigator for the scenario that you are going to play. The Keeper may stipulate strict guidelines, such as which professions you can chose from, or may leave it completely open to you.

The location or country in which the game is set. Does the Keeper recommend any occupations? Suggestions for how the investigators might know each other. The Keeper may tell you a great deal or very little about the scenario. Listen to what is said and ask any questions you may have. Once you have an idea for an investigator, run it past your Keeper for approval.

This conversation can serve to stimulate imagination and create links between the investigators, helping to create a suitable mix of player characters. If the Keeper says the investigators are going to be hired for an investigation, think about making an investigator who needs the money. When beginning a game of Call of Cthulhu, it is recommended that all the players “roll-up” their investigators together in the company of the person who will be taking on the role of Keeper— this ensures that everyone helps to form the group, with each investigator taking an agreed role, ensuring that a balance of skills and occupations is found.

If the premise asks that your investigator be part of an academic team attending a conference, perhaps your character could be one of the speakers. Giving your investigator more relevance to the story and making the “hook” stronger will make the game better. Any connections that you create between your investigator and the plot are likely to hold greater emotional resonance for you than anything the Keeper supplies. If the Keeper is unable to give much of a premise you can still create some interesting facets to your investigator without knowing how they will come into play.

The Keeper may pick up on some of these facets and incorporate them into the scenario. Creating Your Investigator There is more than one approach to creating an investigator. Some people prefer to have an idea about the type of investigator they wish to create before rolling any dice, while others prefer to let the dice rolls guide their choices.

What follows are the standard rules for creating investigators, with further options at the end of this chapter. In the game each characteristic represents an aspect of an investigator—intelligence, dexterity, and so on. These identified quantities determine the relative capability of investigators and suggest ways for them to act and react during play. Characteristic values are generated randomly by rolling two or more six-sided dice. Rolling Characteristics Initially, write your results on a piece of scrap paper before writing them onto the investigator sheet as they may be modified by the age of your investigator.

Enhancing Your Character’s Background The Keeper has presented an initial premise for the game, which involves an expedition team from the Miskatonic University traveling into the wilds in search of a missing colleague. Amy asks if her investigator might work in the same department as the missing person. The Keeper agrees. Strength measures the muscle power of an investigator. The higher it is, the more the investigator can lift or tightly cling to something.

This characteristic determines the damage an investigator inflicts in hand-to-hand combat. Reduced to STR 0, an investigator is an invalid, unable to get out of bed. Constitution represents health, vigor, and vitality.

Investigators with a high constitution often have more hit points—the better to resist injury and attack. Serious physical injury or magical attack might lower the statistic, and if Constitution reaches zero the investigator dies. Introducing Harvey Walters To help illustrate the various rules of Call of Cthulhu, we are pleased to introduce you to Harvey Walters, the noted s New York journalist and investigator of the supernatural.

We use Harvey to demonstrate how character creation works. To differentiate between the person playing Harvey and the actual character of Harvey, the investigator in the game, the player is female and her investigator is male. For a walk-through of Harvey’s character creation see page Investigators with higher Dexterity scores are quicker, nimbler, and more physically flexible. A DEX roll might be made to grab a support to keep from falling, to move faster than an opponent, or to accomplish some delicate task.

An investigator with zero DEX is uncoordinated and unable to perform physical tasks. In combat, the character with the highest DEX acts first.

Appearance measures both physical attractiveness and personality. A person with high APP is charming and likeable, but may lack conventional good looks. An investigator with APP of 0 is appallingly ugly or someone with a wholly detestable demeanor, provoking comment and shock everywhere. APP may be useful in social encounters or when trying to make a good impression.

Intelligence represents how well investigators learn, remember, analyze information, and solve complex puzzles. An investigator with zero INT is a babbling, drooling idiot.

Size averages both height and weight into a single number. To see over a wall, to squeeze through a small opening, or even to judge whose head might be sticking up out of the grass, use size.

Size helps determine hit points, damage bonus, and build. Presumably if investigators lose all SIZ points they disappear—goodness knows to where! Often one or two low characteristic scores can help to bring the investigator “to life” and feel more real—as opposed to some incredible superhuman!

Rather than rejecting a low roll, try to incorporate it into the overall makeup of your investigator. Perhaps a low dexterity means that the investigator has suffered some form of leg or hand injury while in the armed forces, or a low education is the result of never attending school and being forced to grow up on the streets. INT also acts as the value for both Idea rolls and Intelligence rolls. For example, an investigator with high EDU and low INT might be a pedantic teacher or a sideshow performer, someone who knows facts but not their meanings.

Those with an EDU greater than 80 have most likely conducted graduate level work and have a degree, as expected of a person who has been to a university of some kind. W ay m page EDU is also used u yo e in practic d back-to-front, ee sp when making Know rolls.

Any adjustments are made to that value. Power indicates force of will: the higher the POW, the higher the aptitude for, and resistance to, magic. An investigator with zero POW is zombie-like and without purpose, as well as being unable to use magic. Unless stated otherwise, POW that is lost during the game is lost permanently. Magic points are equal to one-fifth of POW. The POW of ordinary characters and investigators rarely changes. However, those adroit in the mysteries of the magic of the Cthulhu Mythos may be able to increase their personal POW.

Education is a measure of the formal and factual knowledge possessed by the investigator, as well as indicating the time the investigator has spent in full-time education.

EDU measures retained information, not the intelligent application of that information see Intelligence. An investigator without EDU would be like a newborn baby or an amnesiac—without knowledge of the world, probably very curious and credulous. An EDU of 60 suggests the investigator is a high school graduate, while a score of around 70 indicates a person Luck: Roll 3D6 and Multiply by 5 When creating an investigator roll 3D6 and multiply by 5 for a Luck score.

Luck rolls are often called for by the Keeper when circumstances external to an investigator are in question, and when determining the fickle hand of fate. Age A player can choose any age between 15 and 90 for their investigator. If you wish to create an investigator outside this age range, it is up to the Keeper to adjudicate. Use the appropriate modifiers for your chosen age only they are not cumulative.

Deduct 5 points from EDU. Roll twice to generate a Luck score and use the higher value. Continued on page 48 45 investigator handbook What The Numbers Mean Strength 0 15 50 90 99 Enfeebled: unable to even stand up or lift a cup of tea. Puny, weak. Average human strength. World-class Olympic weightlifter. Human maximum. Constitution 0 1 Dead. Sickly, prone to prolonged illness and probably unable to operate without assistance.

Size 1 15 65 A baby 1 to 12 pounds. Note: Some humans may exceed SIZ Dexterity 0 15 Unable to move without assistance. Slow, clumsy with poor motor skills for fine manipulation. Olympic standard. Intelligence 0 15 50 90 99 No intellect, unable to comprehend the world around them. Slow learner, able to undertake only the most basic math, or read beginner-level books.

Average human intellect. Quick-witted, probably able to comprehend multiple languages or theorems. Genius Einstein, Da Vinci, Tesla, etc. Power 0 Enfeebled mind, no willpower or drive, no magical potential. Note: Human POW can exceed , but this is exceptional. Education 0 15 60 70 80 90 96 99 A newborn baby. Completely uneducated in every way. High school graduate. College graduate Bachelor degree. Degree level graduate Master’s degree.

Doctorate, professor. World-class authority in their field of study. The player takes up a fresh investigator sheet and a pencil, and then she rolls some six-sided dice. This is abysmal.

Harvey is exceptionally puny and weak, but the player is not dismayed—Call of Cthulhu is an unusual game and all kinds of investigators are needed. This is good, and Harvey will be fairly hardy.

This may help make up for his low STR. His player wants Harvey to be 42 year old, with some experience under his belt. She makes two experience checks for Education. Her first roll of 86 earns a reward of 4 points 1D Her second roll of 82 fails to earn any reward. With all of the characteristics done, his player can now write in the half and fifth values for each of them. He is 42 years of age, and so this is reduced by a further point to MOV 6. Harvey will not be winning many chases.

It’s decided that Harvey will be a journalist, working for Enigma Magazine. Now he is at home in a language often encountered in Mythos researches. As an investigative reporter, Harvey is well equipped to ask questions and get honest answers. Now occupation skill points remain. Now occupation points are left. While the Journalist occupation gives a Credit Rating range of 9—30, the player asks to invest more points as Harvey comes from a wealthy family—the Keeper agrees to this request.

Harvey has good communication skills, useful for a reporter, and a Mythos-related skill, Archaeology. These points can be spent as the player desires. With all of his points spent, his player writes down the half and fifth values for each of the skills on the investigator sheet. But during my trip there were a few afternoons when I had completely forgotten I was even wearing the Maui Jims—despite five-plus hours of driving with them on.

The clarity of the lenses was also a surprise. As far as specific model recommendations go, I suggest scanning the offerings on the Maui Jim website and reading the fit descriptions to find something that matches your aesthetic sensibilities.

Unlike companies that go by lens size only, Maui Jim lists face shape as part of its fit guidelines. Just keep in mind that bigger lenses tend to be better because they offer more coverage. Maui Jim glasses come with a two-year warranty. After checking with the company, we confirmed that it fulfills warranties on its sunglasses no matter where you buy them. You can tell whether the pair you have is genuine and not a knockoff by confirming that the Maui Jim logo is etched, not just painted onto the lens.

But in reality, for many drivers, a phone is the source for navigation, information, messages, music, and of course phone calls. However, if you hold the phone in your hand as you drive—or look down at it in a cupholder or center-console bin—it can be a major distraction and safety risk.

I enjoy the simplicity of my phone with no accessories, so I like that the iOttie iTap Magnetic 2 mounts offer an attractively easy way to mount and unmount my phone with one hand.

To use the magnetic mount, you have to attach a small metal plate to the back of your phone or to the case. But the plate could interfere with your ability to wirelessly charge your phone.

If you want to be able to continue to use that function, consider the following options from our guide to wireless charging phone mounts. This model delivered some of the quickest charging speeds and earned top results for stability. This is the sturdiest vent-mounted model we tested, with fast charging speeds, a firm grip, and a quick way to attach and remove your phone. The iOttie Easy One Touch Wireless 2—available as a dash and windshield mount or a vent and CD player mount —offers a convenient way to charge your phone in the car while also giving you easy access to audio controls, directions, messages, and more.

In our tests , both models were among the quickest at charging our phones. The spring-loaded tension arms made attaching or removing a phone of any size very simple, and they held the phone steady while we drove.

And both models offer a wide range of adjustability for positioning your phone where you can readily see it, regardless of the vehicle. Rain and snow add stress to a road trip, and they also decrease your visibility and your reaction time in an emergency.

Along with wipers, rain-repellent windshield coatings can help keep your windshield clear. If you want the most effective rain repellent, pick up the classic Rain-X spray bottle and commit to applying it once a month. If you simply want to give your windshield a boost, Aquapel is almost as effective and can last six times longer between applications—but it is very expensive.

This affordable hydrophobic spray offers effective protection, but it wears off after a couple of weeks. Most auto-supply shops offer a huge variety of Rain-X products, including wiper blades, gels, and washer-fluid additives, but you should stick to the original formula in the ounce spray bottle because it has the most reliably positive user reviews.

Once applied, Rain-X forms a hydrophobic coating that causes water to bead up and quickly slide off your windshield. Most who have used Rain-X agree that it needs to be reapplied about once a month to maintain effectiveness.

Aquapel bonds to your windshield for up to half a year, but it costs more than twice as much as Rain-X. Instead of coating your windshield, it bonds to the glass chemically , and it should last for three to six months before you need to pull out another one-time-use sponge and reapply. YouTube user jwardell posted a day comparison video that shows how Rain-X is more effective initially, but after a month Aquapel still works even after the Rain-X has all but worn off.

For either repellent, proper application is the key to getting the maximum benefit. Then clean it again just to be sure. Both of these repellents dry best in warm weather, out of direct sun. Even when perfectly applied, however, these substances have potential drawbacks. Some who have used them complain that the repellents cause noticeable haziness at night.

Efficient at clearing ice and sweeping snow, this scraper works on vehicles of all sizes. But no other contender offers such a complete scraping-and-sweeping package with so few weaknesses. With the advent of GPS units and smartphone navigation apps both of which we recommend over the onboard navigation systems that might come with a car , the age of the paper road atlas would seem to be over.

A road atlas is the heart of every road trip. Planning a road trip starts with imagining the places you could be next weekend, if you threw a few granola bars and some clothes into the backseat and left everything else behind. Or you could pull out a physical map and highlight a route.

And regardless of electronic-device failures, you will always have a map in hand. For use in the car, we like the classic Rand McNally Road Atlas —just make sure to get an updated edition. The Rand McNally was simple, functional, and easy to follow. Most important, it was fun to use. For most shorter trips, a smartphone can provide all the navigation assistance you need. But should your journey take you off the beaten path and out of your coverage area , we suggest the Garmin DriveSmart Like the best GPS models, the DriveSmart 55 can also connect to a smartphone via Bluetooth, which lets you send destinations to the device, get incoming messages onscreen, and receive extra trip and traffic info.

Similar to a smartphone, the DriveSmart 55 allows multi-touch gestures, such as pinching or spreading for easier zooming on a map. This feature is a clear step up from the resistive displays of less-expensive units, which allow only single-finger gestures and require you to tap on the plus and minus buttons to zoom in or out. The DriveSmart 55 also provides helpful traffic info in many metro areas. Not quite a shower but pretty darn close, these wipes are amazing after a sweaty day in the desert.

Road-trip and backpacking veterans know just how much better a shower can make an adventure after three days and a lot of smelly clothes. When taking a shower is not an option, or even if you just want to tidy up a bit after a long drive, body wipes can provide some much-needed relief. We considered 22 brands and tested nine different body wipes, including some that were popular on Amazon and others that were recommended on the blogs of seasoned outdoorspeople.

Cheap, portable, and durable, the Sea to Summit Wilderness Wipes were the clear winners. The wipes come in a resealable package, which helps keep them fresher for longer. You can find them in two sizes, XL 8 by 12 inches, in a pack of eight and Compact 6 by 8 inches, in a pack of On our trip, we preferred the XL wipes for their extra coverage and longer cleaning power.

The fully compostable Wilderness Wipes were among the most lightly scented ones we tested, and the lack of alcohol left our skin feeling clean and moist. Effective, EPA-approved, and usually easy to find, these pre-soaked wipes need only four minutes of contact time to neutralize the coronavirus. Most disinfecting wipes are the same. These wipes can eliminate the coronavirus on hard surfaces—countertops, door handles, and bathroom fixtures—in your home, vehicle, or motel room, but not on fabric or other soft materials.

Instead of bleach, which can damage car interiors, Lysol Disinfectant Mist uses quaternary ammonium. The spray eliminates the coronavirus on hard surfaces in 10 minutes, but on soft surfaces it only sanitizes kills most but not all pathogens. Most mask mandates have been rescinded, but the rules can change or vary depending on where you are. Based on our research and testing, we have a few recommendations for adjustable masks that should cover most faces comfortably and work well when worn properly.

We consulted a range of authorities to zero in on the small but crucial design details that have an outsize impact on how a mask fits and feels. We then commissioned independent lab tests to assess the filtration efficiency and breathability of a variety of cloth masks and filters, including our picks. If you want to read more about selecting your own mask, check our full review here.

Our panel testers liked wearing the lightweight, filter-incorporated Enro Tech Mask formerly called the Enro Face Mask more than any other model as did our junior panelists, who tested pint-size versions for our guide to cloth face masks for kids.

This mask tents up over the nose and mouth more than any other one we tested. The drawback: It has to be hand-washed.

Long a recommendation in our guide to the best face masks for kids, the Happy Masks Pro is now also an adult pick. You must hand-wash and air-dry it, though. Due to supply issues, the mask is currently available via waitlist only. A new design, called the Happy Masks Ultra , is machine-washable.

We plan on testing it soon. This stylish mask has good clearance off the nose and mouth and—thanks to a sewn-in filter—decent filtration efficiency. You can choose between adjustable headbands and ear loops, both of which provide a good fit. However, the material feels thicker and less breathable than that of the filter-incorporated Enro and Happy Masks Pro.

With the sold-separately filter stuffed in its pocket, this mask with adjustable ear loops fit all of our testers and struck the best balance of filtration and breathability in independent lab testing.

The nose-bridge wire on the Graf Lantz Zenbu Organic Cotton Face Mask hits a nice balance between sturdy and pliable—making for a great seal.

Used with its separately sold filter, the mask balances breathability with solid filtration, assuming good fit. We wish the filter would cover the entire mask to maximize its filtration potential, though. I met my own inevitable conclusion outside an In-N-Out Burger on the last leg of our trip. We tested them against other instant spot removers and assorted DIY methods to see how they handled wine, coffee, lipstick, and mustard stains. In our tests, the Shout wipes easily outperformed the popular Tide to Go pen , and the Shout option was the only stain remover that erased almost all traces of lipstick on the collar of a shirt.

These wipes also did pretty well on the ketchup I spilled. You might find yourself washing your hands a lot on the road, which can result in cracked and dry skin. Aveeno Daily Moisturizing Lotion is thick enough to stay neat in your hand and thin enough to spread quickly and smoothly onto your skin. And unlike its competitors , this moisturizing lotion dries nicely without leaving a greasy film in its wake.

Can a long road trip be comfortable? Long hours of sitting in one position, nights spent camping or sleeping in cheap motel beds, and breaks for indigestible fast food are a terrible combination. With a little planning and a few small luxuries, you can keep the enthusiasm of your trip alive.

Skip the fast food, and instead pack your own snacks and water. And stop for as long as you need. It also now has a sewn-in cable that you can cinch down to make the pillow firmer.

A good travel pillow is hard to find. During the day, it can fold in on itself a loop-and-toggle closure holds it tight , which makes it easy to stow in a backpack or to toss into the backseat. At night, the pillow unrolls and expands into a decent bed pillow, though side-sleepers with larger frames may say it has too little padding.

But this is a travel pillow, of course, so it will never feel like your home pillow, which is all part of the fun somehow. In spring , Therm-A-Rest released a slightly redesigned version of the pillow. The pillow also has a cord sewn in a loop into its back; you can tighten the cord and cinch it securely to make the pillow firmer.

This liner is a lightweight, moisture-wicking, easy-packing fix for scratchy motel sheets. Not all motels are created equal. Some are fantastic, with their bright neon signs truthfully advertising a cheap, clean, and convenient place to stay.

Not every bedroom on the road is as dark as some people would like. Although the mask is adjustable, with Velcro straps, restless sleepers may want to consider other options here.

This blanket offers the greatest warmth and durability for the lowest relative weight, price, and size. It also stuffs away very well when not in use. It helps you to stay warm longer, inside or outside. So far in our testing, the Rumpl has survived four rounds in the washing machine without a snag and it dried within an hour. And it was notably stain-resistant after encountering dirt, dew, and even coffee. The Hest takes up about the space of a small cot mattress 78 by 25 inches.

Half of the mattress consists of a dense foam layer, and the other half is a high-pressure inflatable base that needs a pump system to inflate. One of the longest and widest of all the single-piece reusable funnels Nancy tested , the Tinkle Belle makes less mess and is easy to use. The more coverage a funnel has, the lower the risk of leakage or spills.

You also get a matching case for your funnel. We like the A1 Windshield Sun Shade , which we found to have the best combination of low cost, decent coverage, and ease of setup. Its pop-up design made it much simpler to install and stow than the accordion—style shades we tested. But the A1 offers several sizing options, ranging from 59 by 19 inches to 69 by 36 inches when fully expanded. Each of these size options can be compressed down to fit into a circular carrying case, which you can easily store on the door or underneath the seat.

Amazon reviewers mention that the build quality is solid and that the metallic finish does a good job against the sun, particularly in hot Southern states like Florida and Texas. Several reviewers also recommend that you buy a size smaller than you think you need, however, to avoid excessive overhang.

Even with the choice in sizes, you still might have difficulty arranging the two plastic circles which provide rigidity within the A1 into a shape that hugs both edges of the front window and that balances off the rear-view mirror.

Gaps, loose corners, or overhangs are almost unavoidable. This custom-fitted shade will ensure no sun gets in, even in the sunniest climates. If maximum temperature reduction is your goal, invest in a custom-fitted WeatherTech SunShade. Thicker than the A1, the SunShade completely blacks out the windshield when you install it. This shade sticks easily to your windows and provides great sun protection for passengers. We researched 14 shade models and tested two finalists before determining that the Britax EZ-Cling Window Shade is the best around.

The Mylar on the back provides some protection against UV rays, and it acts like a large sheet of cling film that seems drawn to your windows once you pull the shades out of the box; the black mesh on the inner surface blocks a good amount of sunlight while still allowing you to see through the shade. We like the EZ-Cling better than film-only shades because the EZ-Cling has a support ring of firmer material around its perimeter that makes it easier to install without getting wrinkles and bubbles.

So he brought two EZ-Cling pairs for testing on a four-day road trip with his family. We also removed them and reapplied them many times as our position relative to the sun changed, and it was easy to do so. Quick tip: Be sure to wipe your EZ-Clings with water when you first get them. A thin film protects the Mylar sheets during production, and it can leave a waxy residue on your car windows if you use the shades right out of the box without first wiping them down.

This extending shade attaches to a variety of vehicles, whether you have a roof rack or not, and whether you attach it to metal or a composite material such as a pickup-truck bed cover. Although it works best on SUVs and trucks, the MoonShade is lightweight and adaptable enough to work with smaller vehicles. When deployed, the MoonShade covers 9 by 7 feet, and its height adjusts from 78 inches to 96 inches. The shade mounts in three ways: directly to a roof rack, with very strong magnets, or with surprisingly robust suction cups for composite materials.

We found that all three methods are secure enough for most situations, though as you might imagine, the suction cups are somewhat less stable than a direct mount on a rack. The MoonShade weighs 8 pounds and stows away into a carrying case that measures 28 by 6 inches, which is small enough to fit in the trunk of most cars.

The MoonShade is great if you like to pull over in the middle of the day and set up a lunch, or if you tend to do activities outdoors in predominantly shadeless areas, as you find in the Southwest.

You could cross America with no plan at all and survive solely on fast food as your nourishment—without ever having to leave your car. Packing your own snacks and bringing your own water is not only healthier but also safer—you never know when you might be stranded somewhere along the way.

We got stranded on our second day of driving, somewhere east of Joshua Tree, California, when we pulled off the side of the road onto a soft, sandy shoulder we were new in this part of the country.

As we waited, I was thankful that Caleigh and I both had full water bottles, more water in the trunk, and plenty of food. A highway patrol officer drove up, gave us a little lesson about sand, and pushed us out with no trouble. So things turned out fine. The beauty of a road trip is in the unexpected moments. You can be prepared for most of them by having a little food and water on hand. This cooler is lightweight, sturdy, and easy to pack. With enough ice, it will keep contents cold for more than 24 hours without leaking or sweating.

Its details, including stitching and superior insulating foam, set it apart from its competitors. After several mile days on the road, having a chilled container filled with cold drinks and body wipes is an incredible gift. It remains a good cooler at this price.

When the Polar Bear is open, it stands erect like a grocery bag, providing easy access for loading and unloading. The cooler zips closed with two YKK 8 zippers YKK is the largest, and often considered the most reliable, zipper manufacturer in the world , and it folds down on either side, compressing into a rectangular brick.

This shape allows for all sides of the closed bag to have equal insulation coverage—a feature many cheaper soft coolers lack. The Polar Bear also held the most cans of any pack cooler we tested, carrying 24 cans and 6 pounds of ice all at one time. However, when fully loaded, this cooler can weigh 24 to 26 pounds. Better insulated and less expensive than the competition, this cooler keeps ice for a week.

And its well-designed drain port makes the Coleman easier to clean. The eye, in the absence of other clues, tends to place the two lighted areas on the same elevation which may lead to premature ground contact. There is a special problem at night with small light sources, such as stars or distant ground lights. When watched intently they will appear to move and may be mistaken for other aircraft.

This movement of stationary objects is known as autokinesis and has been responsible for accidents. Where the light source is bright or large this illusion is uncommon.

The commonest type of vectional movement illusion is that experienced sitting in a car at a traffic light when the adjoining car creeps forward. This causes a sensation of backward movement and often reflex braking. In the rotational plane similar illusions occur. In a darknened chamber where light from a rotating source is reflected on the walls, the movement of the light on the walls is soon replaced by a sensation of body rotation, the walls appearing fixed.

Other problems are confusion between ground lights and the stars when flying over prairie areas or pilots orienting the aircraft to sloping cloud decks or to the Northern Lights rather than to the true horizon. These may arise from the otoliths, the semicircular canals or from a combination of the two. They are among the most serious of the illusions and the most likely to cause lethal accidents.

At rest or in constant motion gravity is the only force acting on the otolithic membrane. We are used to interpreting gravity as a force pointing to the centre of the earth and, when our plane of movement is changed, falsely interpret sensations according to this precept.

A pilot accelerating down the runway and rotating to lift-off is exposed to an acceleration which pushes him back in the seat, together with the force of gravity acting downwards. The resultant is interpreted as a single force acting upwards and backwards. Because the brain interprets the force of gravity as being vertical, the sensation is of pitch-up and the pilot may instinctively make a forward stick movement for control.

This can complicate the situation because causing negative G stimulates an oculo-vestibular reflex movement of the eyes which gives rise to the sensation that the instrument panel is moving upwards, heightening the illusion. This is the known as the oculogravic illusion. With deceleration, such as that experienced on descent when the flaps are deployed, a pitch down sensation may be felt.

These sensations are normal and of no great importance if the pilot is experienced or visual flight is maintained. At night however, particularly taking off from a lighted runway into a dark featureless area, and accident can occur due to inappropriate control movements performed in the transition from visual to instrument flight. Even an experienced pilot can take as long as 7 seconds to adjust. A common form of disorientation is a sensation of incorrect rotation or absence of rotation caused by the semicircular canals.

The cupola in its neutral position is upright. When the head rotates, the bony canals move but there is inertia in the endolymph. The cupola is therefore deflected leading to a sensation of rotation. Our sensitivity to rotation however is not perfect and can be diminished by any form of distraction. Rotation in the vertical axis of per second may not be perceived. If a pilot, flying straight and level, gradually drops the left wing by 15 degrees whilst otherwise occupied and suddenly becomes aware from the instruments of this attitude and corrects it at a much faster rate, only the correction will be sensed.

The pilot then feels as though the aircraft has rolled 15 degrees towards the right and will lean towards the left to maintain balance. This is called “the leans” and is extremely common.

A different problem arises with prolonged turns at a constant rate, such as those encountered in a holding pattern at a busy airport. On entering a turn the cupola is deflected by the inertia of the endolymph see Fig. As the turn continues the endolymph will begin to move until it is in equilibrium with the bony canal and at this point the cupola will return to its central position. Depending on the steepness of the turn this may occur in seconds. When the turn is terminated the bony canal will cease to rotate immediately but the endolymph, due to inertia, will continue to swirl thus moving the cupola in the opposite direction.

This gives rise to the impression that a turn in the opposite direction has been entered and the tendency will be to correct this and so to reenter the original turn.

Although this is a minor distraction under most circumstances, in instrument meterological conditions it can be extremely serious and lead to a “graveyard spiral”. Here the inexperienced pilot, having inadvertently entered a steep descending turn under instrument conditions, makes the correct stick movements to control the aircraft but experiencing the sensation of entering a turn in the other direction may re-enter the spiral.

As the aircraft is also descending, pulling back on the stick to stop the loss of altitude, although giving rise to a comforting feeling of gravitational pull in the seat, actually steepens the spiral, ultimately driving the aircraft into the ground.

The most extreme form of vestibular disorientation is due to the Coreolis phenomenon. This is thought to be caused when two different semi-circular canals are stimulated at the same time.

As an example, a pilot taking off from an airport in instrument conditions, banks towards the left while climbing. So far there is stimulation of the otolith and of one canal.

In order to reach a switch or see a gauge however the pilot turns the head quickly downwards and towards the right. Two different canals have now been stimulated and, as all are connected, a movement of endolymph takes place in the third canal.

The result is a sensation of tumbling which may be extreme and worsened by visual problems due to oculo-vestibular reflexes.

Even if control of the aircraft can be maintained under these very trying circumstances, the pilot may still be subject to the leans or other abnormal sensations until able to obtain a visual reference. Distinction is sometimes made between two different type of disorientation.

Type I is unrecognized and Type II recognized. Obviously a Type I illusion is more likely to lead to an accident or incident. Illusions are also divided into oculo-gyral somatogyral or oculogravic somato-gravic. An oculogyral illusion is defined as the apparent movement of an object in the visual field resulting from stimulation of the semi-circular canals by angular acceleration. An oculo-gravic illusion is the false perception of tilt induced by stimulation of the otolith by linear accelerations.

The terms somato-gyral and somatogravic refer to the resulting body sensations. The relationship between this condition and orientation is striking.

The causes of motion sickness are both visual and mechanical, the latter arising from stimulation of the vestibular system. Animals in whom the vestibular system has been ablated or people born with non-functioning labryinths cannot be made motion sick. The cause of motion sickness has never been completely clarified but it is felt that it results from sensory conflicts, the difference between what is seen or felt and previous orientational experience.

Motion sickness, for example, can occur in aircraft simulators and is more common amongst pilots experienced on the type of aircraft being simulated than it is in an inexperienced crew. Motion sickness increases in frequency up to puberty and then decreases. Women are more subject than men and it is more common in passengers than in aircrew. Motion sickness may be provoked by anxiety, fear or orientational insecurity. Unfortunately it can become a conditioned reflex.

A trainee pilot, having been motion sick during flight, may become ill on the ground approaching an aircraft. It can be overcome by repeated exposure or adaptation and is rarely experienced by the person in charge of the aircraft or automobile who is aware, and braced for, changes in attitude or direction. Up to one third of military flight trainees become air sick at some point in their training and about 1 in 5 suffer severe air sickness. Adaptation depends upon gradually increasing stimulation.

In trainee pilots who develop severe problems, desensitization programs have been successfully employed. Motion sickness can be much reduced by the use of Scopolamine and nowadays transcutaneous administration of this medication is used in sea sickness. The drug however creates drowsiness and cholinergic effects and is not suitable for pilots.

Small doses of the drug may be used in the initial phases of training when an instructor is in the aircraft but this must be discontinued before solo flight is undertaken. There is no place for prolonged drug therapy in aircrew.

A continuing challenge for those involved in the aeromedical certification process is in making decisions which take into consideration both the rights of the individual and the safety of the public.

This is not always an easy task. One of the areas that has been most challenging is neurology and neurosurgery. Making predictions about the likelihood of subtle or sudden incapacitation is at best an imprecise science. However, modern neurological diagnostic imaging techniques and prospective studies are making outcome predictions more reliable.

These guidelines have been prepared to assist practicing physicians determine whether or not their pilot patients may meet the neurological requirements for the aviation environment. The guidelines are the result of an analysis of the proceedings of a 2 day workshop on neurological disorders and aeromedical certification held in Ottawa, June 3rd and 4th Physicians are reminded that this document should be used as a guide only and should not be confused with the medical standards for aviation personnel published by Transport Canada, Aviation TP Specific questions should be directed to the nearest regional aviation medical office, Civil Aviation Medicine Division, Health Canada.

To all the panel members who participated in the workshop with such enthusiasm, and who gave so generously their expertise and precious time in the development of these guidelines I extend to each of you my sincere and respectful gratitude.

To Dr. James M. Wallace, Senior Consultant, Operations Policy and Standards who shouldered the responsibility of writing and editing this document, I thank you for your dedication. Takahashi, M. George Y. Wallace Sr. Clinical Prof. University of Ottawa Co-Chairman. Henery J. Professor, University of Ottawa. Stephen V. Blizzard Sr. The Canadian Charter of Rights and Freedoms which was enacted in has a number of human rights provisions, one of which states that “no person shall be discriminated against on the basis of disability”.

Given this constitutional background there have been an increasing number of challenges in the Courts and Human Rights Tribunals on refusals to medically certify applicants with neurological disorders. Aeromedical “unfit” assessments must therefore be based on current scientific “state of the art” knowledge.

In the aviation environment neurological disease is a recurring concern for those involved in aeromedical certification. The mode of presentation may vary from full-blown grand mal seizures or massive stroke to the insidious onset of cognitive impairment in conditions such as multiple sclerosis and Alzheimer’s disease. The prevalence and marked variability in severity of migraine has caused difficulty in objectively deciding where the line should be drawn between “fit” and “unfit” assessments.

The person who has sustained a significant head injury is subject to the dual dilemma of risk of posttraumatic seizures and also of cognitive impairment. In in the United States, the Federal Aviation Administration solicited a proposal from the American Medical Association AMA to produce an authoritative report on neurological disorders and aviation safety.

The AMA in conjunction with the American Academy of Neurology and the American Association of Neurological Surgeons convened a series of meetings with experts in the field which resulted in the publication in of a special issue of the Archives of Neurology, entitled “Neurological and Neurosurgical Conditions Associated with Aviation Safety”. This document served as one of the primary resources for Canadian aeromedical certification decisions on neurological disorders throughout the ‘s.

Advances in diagnostic imaging and the management of neurological and neurosurgical disorders over the intervening years indicated that more current references were required. It should be pointed out that this document is only guidance material and that each decision will be based on the individual circumstances of the case.

There are two major concerns following head trauma resulting in loss of consciousness. One is the neuropsychological consequences of the trauma in patients who have not had any focal deficits. The other is the possibility of seizure secondary to the trauma. Because of the anatomy involved, these forces cause their greatest focal damage to the orbital, frontal and anterior temporal areas of the brain.

Associated with the cortical damage there is diffuse white matter damage. The result of this is dysfunction in a number of functional executive activities of the brain. These frequently are, 1 slowing of reaction time, impaired memory and deficient ability to perform constantly at a high level over time, particularly in settings of complex activities and choices.

Other problems include attention, initiation and proper sequencing of tasks, difficulty in planning and anticipating the future, and difficulty establishing automatic responses to a trigger. The affected individual may not notice or care that the task is being poorly performed. Problems are exacerbated by stress, fatigue and pain and the handling of simultaneous emergency tasks is particularly affected.

Although the problems may be severe, routine IQ and mental status testing may be within normal limits. Fortunately there is a natural tendency for deficits to improve. Sufficient data to accurately predict the outcome of most types of head injury is unfortunately unavailable. There are a number of ways to predict the outcome of head injury and the most commonly used to date has been the duration of post-traumatic amnesia PTA.

Most individuals who have had a PTAof less than 30 minutes are likely to be fit within three months. A person with PTA lasting more than 30 minutes but less than 24 hours will likely be fit from a neuropsychological point of view after a longer time, probably one year. Those with focal neurological deficits, those who have focal abnormalities on CT scanning or a more prolonged PTA require neuropsychological assessment with particular attention to frontal lobe functioning before medical certification.

Flight simulator testing may be useful. Magnetic resonance imaging MRI is more sensitive than CT scanning in defining areas of frontal lobe and white matter abnormality and is therefore an important diagnostic adjunct in those who have had brain injuries. These people clearly require a more prolonged period off work than those with simple concussion.

The probability of epilepsy is greater in those with penetrating skull injuries. Even with full physical and neuropsychological recovery there is an increased probability of seizures for over ten years. The probability of seizures has been correlated with CT scan findings as illustrated in Table 1.

These can occur at any age, though they are more common in the older age group. Individuals frequently are unaware of significant head trauma. Stroke is the third most common cause of death and a leading cause of disability in Canada. The risk of a recurrent stroke following an initial TIA or stroke has been looked at in a number of trials of various antiplatelet medications.

The probability of recurrence does depend on the number of risk factors present and the degree of carotid artery stenosis. Blood pressure control, cholesterol control, antiplatelet medications and cessation of smoking have made significance inroads into reducing the risk of stroke. Surgery has been particularly successful in patients who have significant carotid stenosis. Nevertheless, despite these management techniques, the risk of recurrent stroke remains high.

Therefore, the vast majority of applicants who have had a stroke, will remain permanently unfit. All applicants with stroke secondary to an intracerebal hemorrhage are permanently unfit. The applicant who has a TIA must be evaluated carefully as some will in reality be migraine without headache, seizures, vestibular dysfunction, failure of ocular fusion, multiple sclerosis, brain tumors, subdural hematoma, hypoglycemia or syncope.

Risk factors have to be carefully evaluated including possible cardiac sources of embolus. Applicants with negative imaging of brain, neck and heart and with minimal other risk factors can be considered for medical certification at three years after the event. These are a specific symptom complex with an appropriate abnormality on neuroimaging ascribed to a lacune.

The majority are secondary to small vessel occlusion, others may be secondary to an embolus of various possible origins. They pose two problems one is the risk of recurrent infarct which is significant and the second is the accumulation of lacunes without obvious symptomatology but leading to the insidious onset of dementia The majority of applicants with lacunar infarcts are therefore unfit.

Occasional individuals who never had significant deficits and who fully recovered may be considered on an individual basis. These individuals require extensive work-up, including carotid Doppler studies and echocardiography.

They need an MRI to show if there is evidence of significant lacunar disease. If the above investigations do not show significant pathology, the risk factors are controlled and if after four years, the MRI does not show any increase of lacunar disease, the applicant could be considered on an individual basis for medical certification.

Applicants with multiple lacunes are a concern, as they may be developing dementia and are unfit. A patent foramen ovale should not be considered a risk factor for stroke according to recent trials, unless associated with an atrial septal aneurysm. If there is no evidence of an ongoing or recurrent risk, if there has been no evidence of epilepsy and if the person has no significant sequelae from the thrombosis, they can be considered medically fit two years after the event.

During pregnancy and puerperium the risk of stroke is 44 per , The cause for this type of stroke must to be sought as often multiple factors predispose towards such strokes. One has to look particularly for thrombophilia, anti-phospholipid antibodies, dehydration, cardiac disease and dissection. In those individuals where there has been no significant sequelae, particularly no cognitive difficulties or history of epilepsy and if the etiology of their stroke is not going to be a recurrent or ongoing problem, then they could be considered fit two years after the event.

They are unfit. An endarterectomy will not resolve this problem, as they probably have other arteries significantly involved.

Arterial dissections are one of the most common causes of stroke in the young. Applicants who have had a good recovery, in which imaging does not show any evidence of cerebral infarction, who have had no evidence of epileptic seizures, can be considered for medical certification after two years.

They need imaging to show good restitution of flow, with no evidence of aneurysm. There should be no evidence of having had a subarachnoid hemorrhage. There should be no predisposition to further dissections. The majority of applicants who have had a subarachnoid hemorrhage are permanently unfit. There are occasional people who have been successfully treated, who had excellent recovery, and who have never had seizures.

Those individuals in which repeated angiography shows that the treatment has been successful can be considered for medical certification at two years.

If they had an endovascular approach, an angiogram should be repeated yearly for two further years, to show that successful repair has been maintained. An EEG at two years should not show significant abnormalities and particularly no potentially epileptiform discharges.

Those who have perimesencephalic bleeds with normal angiography, could be considered fit at one year if they have had an excellent recovery, as is usually the case. Those with asymptomatic intracranial aneurysms less than 10 mm can be considered as continuing to be medically fit. Therefore those with arteriovenous malformations are permanently unfit.

Applicants with cavernomas that are deep, with no evidence of previous hemorrhage may be considered fit, all others should be considered unfit. The tendency towards epileptic seizures is not an all or nothing phenomenon.

Most people, under certain conditions, may have a seizure if sleep deprived or withdrawing from alcohol or benzodiazapines, especially if in addition they are taking medications which decrease the seizure threshold eg.

Tricyclic anti-depressants. Those with a distinct epileptiform abnormality on the EEG as opposed to non specific abnormalities, have an increased probability of having further seizures after a single seizure. It is therefore imperative that the diagnosis of a seizure be correct, and the importance of a description of the event cannot be overemphasized.

Although the electroencephalogram EEG is particularly useful it must be reviewed by an experienced reader to be considered supportive of an epileptiform tendency. Individuals with epilepsy are unfit. Persons who have had the following types of seizures may be acceptable. Childhood febrile seizures which are brief, not associated with neurological deficits, and have ceased before the age of five may be considered for medical certification. The individual must have been off all anti-epileptic medications for at least five years and the EEG off medication must be normal.

The seizures of Benign Rolandic Epilepsy of Childhood usually involve the face, tongue or hand and are often precipitated by drowsiness or sleep.

The EEG shows significant abnormalities from the Rolandic area of the brain. Individuals with this condition may be considered for medical certification if they have been seizure free and off medication for ten years. They must have a normal neurological examination and EEG. A sleep deprived EEG should also be normal. An individual with a single epileptic seizure is initially unfit. The case can be reconsidered after five years if the neurological examination is normal and repeated EEGs, including sleep deprivation and additional nasopharyngeal or minisphenoidal electrodes, do not reveal any significant abnormalities.

Neuroimaging, preferably MRI, must first have revealed a normal brain structure. A restricted as or with co-pilot medical certificate can then be granted. Such a restriction may be removed after an additional two years.

Those individuals who have a second seizure should be considered to have epilepsy. Five years after the event, all of the above investigations must be repeated and found to be normal. Applicants for Category 1 medical certification should be restricted to: “as or with copilot” for an additional two years. Those who have had a seizure while on tricyclic antidepressant drugs or other seizure enhancing medications must be considered more prone to seizures than the average population.

They must be considered unfit for five years. This condition is characterized by a transient loss of memory for remote events associated with an inability to form new memories.

It is an unusual condition that usually lasts for hours. TGA is not a seizure disorder and may be due to transient ischemia in the inferomedial parts of the temporal lobes. It is commoner in middle aged or older people, and many individuals are hypertensive: frequently they have been undertaking physically demanding tasks eg. Throughout the episode, the sufferer is socially appropriate, oriented to person but tends to repeat the same question over and over again, this question usually reflecting their disorientation.

If there is a normal neurological examination and EEG at the time of the event and again one year after the event, medical certification may be considered. Narcolepsy presents with periods of excessive daytime sleepiness not prevented by adequate nighttime sleep and often enhanced by boredom.

Excessive sleepiness may be associated with sleep related hallucinations or paralysis and, most importantly, it may be associated with cataplexy which is an abrupt paralysis of variable degree precipitated by surprise or by laughter. Prophylactic medications are imperfect and may alter performance. They include dextroamphetamine and methylphenidate. Fifty-nine percent of the adult population in Canada report some form of headache.

Tension type headaches are not usually disabling but up to three quarters of migraine headaches are sufficiently severe to limit regular activities. Most migraineurs have attacks that last 12 to 24 hours. Migraine can be divided into two categories, migraine with aura classical migraine and migraine without aura common migraine.

The aura may be preceded by a prodrome of mood changes which may interfere with routine activities. The aura itself usually lasts about 20 minutes and immediately precedes the onset of the headache. The head pain itself is thought to be related to a sterile inflammatory response around blood vessels in the face and scalp and the intracranial vessels of the coverings of the brain. This inflammatory response is mediated through vasoactive peptides which cause dilatation, edema and inflammation around the vessels which are innervated by a branch of the trigeminal nerve trigeminal-vascular complex.

Migraine tends to occur at times of let-down from stress, after fasting, and after missing sleep. Flashing lights and bright reflected light may also trigger acute attacks. Migraineurs who have significant auras which can interfere with flight safety and who do not fit into the group 2, ie, too fast onset, too frequent, cognitive impairment, unclear history, should generally be considered unfit for all categories.

They may be considered for restricted medical certification if after 3 years they fit in group 2. Cluster headaches occur only in 0. They recur in bouts lasting six weeks or more, during which time acute attacks occur one to four times per 24 hours. Once the bout is ended, however, the sufferers are usually entirely headache free for months or years.

The individual attacks are extremely intense, localized around one eye and associated with nasal congestion and lacrimation which may impair vision. They are virtually always incapacitating. The applicants should be considered unfit during a bout of cluster headache but during the interval bouts, they may be considered fit.

Between bouts, the applicants do not need to take any medication, but in chronic cluster headache where the bout extends beyond six weeks, medication which might impair functioning may be required. Trigeminal Neuralgia causes piercing, electric shocklike facial pains which have a high frequency of recurrence. Many episodes may occur in a single day.

In older age groups these are often secondary to a loop of blood vessels pressing against the trigeminal nerve: in the young they may be secondary to multiple sclerosis.

Individuals suffering from trigeminal neuralgia are unfit but if they go into remission may be considered for medical certification. Multiple Sclerosis MS has a prevalence of about one in a thousand in Canada. The peak incidence is in the early 30’s with more females than males being affected.

It is the third most common cause of severe neurological impairment in the year age range. The course is variable. Fatigue is one of the most disabling problems in patients with multiple sclerosis. Tumors arising from the brain parenchyma such as gliomas or ependymomas, even when removed and whether or not they are treated with a radiotherapy, leave behind scarring. This increases the probability of seizures and applicants with such a history are therefore permanently unfit. Applicants who have had meningiomas of the cerebral convexities may be considered fit two years post resection under certain specific circumstances.

Current literature suggests that there is no limit as to when a meningioma can recur. The tumor must have been fully removed as defined by repeated neuroimaging.

There should be no neurological sequelae and no history of seizures in association with the tumor. Applicants who have had complete resection of an infratentorial meningioma, acoustic neuroma or other benign extra axial tumors, or applicants who have had a transphenoidal complete resection of a pituitary tumor and have no neurological or endocrinological sequelae and no history of seizures may be relicenced after 6 months to one year.

They will require yearly neurological and endocrinological follow-up. Those who have had an elevation of the frontal lobes in order to approach the pituitary tumor are generally unfit.

This is because the tumor is probably larger and more likely to disturb structures around it and the frontal lobe has been disturbed by the traction involved in the surgery. These factors increase the chance of the applicant developing seizures. Those shunted for acquired hydrocephalus are generally unfit because of the possibility of unexpected shunt failure.

Individual consideration however may be given where accredited medical opinion is that the risk of shunt failure or seizure is low. Applicants shunted in infancy and seizure free throughout adult life without neuropsychological sequelae may be considered for a Category 3 medical certificate.

This is a rare condition in which there is a cystic lesion of the spinal cord or brainstem. These lesions usually develop because of congenital anomalies, less frequently secondary to trauma or tumor. They tend to progress. If the syrinx is below the cervical cord the applicant should be judged as any other paraparetic according to functional abilities.

A practical flight test will be required and, after medical certification, neurological follow-up is required every six months.

A practical flight test should be repeated annually. In applicants where the syrinx involves the cervical cord or brainstem, the neurological deficit may be or become too significant for medical certification. Such applicants are permanently unfit.

Neuromuscular dysfunction in MG is related to antibodies generated against the acetylcholine receptor at the neuromuscular junction. This results in progressive weakness and fatigability which fluctuates with the degree of effort sustained. Some individuals may achieve a remission by thymectomy or immunosuppression. Those who are in remission and stable, with little or no medication two years after the thymectomy, may be recertified.

The presence or development of cardiovascular disease in licensed aviation personnel, with the risk of potential clinical manifestations, continues to be a major concern to aviation medical practitioners. The evaluation and management of aeromedical risk continues to be a balancing act between practicality, risk tolerance and the advances of diagnostic medicine. The advances in medical and surgical treatment of cardiovascular disease have allowed many pilots and air traffic controllers to return, after successful treatment, to licensed duties without jeopardizing aviation safety.

This fourth edition of the Canadian cardiovascular guidelines is intended to assist in the medical assessment of cardiovascular fitness of licensed aviation personnel. It reflects a consensus reached as a result of discussions and recommendations made during an aviation cardiology workshop held in Ottawa, on February 1st, , arranged by Civil Aviation Medicine Branch, Transport Canada.

It must be emphasized that these guidelines are to be used only as a guide to practice and evaluation of licensed aviation personnel. These guidelines should not be confused with the medical regulations set out in the Canadian Aviation Regulations part published by Transport Canada.

Civil Aviation Medicine Branch, Transport Canada, is very grateful for the enthusiastic support and participation of all the expert panel members, and other individuals who provided advice and criticism.

A special word of thanks is owed to Dr. Andreas T. Wielgosz for his efforts in planning and co-chairing the workshop, and taking on the task of writing the text and to Dr. Contact information is available at.

Michael’s Hospital, Toronto, ON. Eric A. Ian G. No disease condition is as rich with data to determine risk of medical fitness to fly as cardiovascular disease. Significant progress is being made in the identification of subsets of patients who are at high risk of a cardiovascular event based on more sophisticated technologies and expanding databases of well defined cases.

Genetic epidemiology, still in its early stages contributes even more precision to an assessment of risk in individuals. The challenge remains to identify in a cost effective manner those at an unacceptably high risk of incapacitation among the majority of otherwise medically fit pilots and air traffic controllers.

This challenge is compounded by the continuous aging of the pilot population as well as the entry of older Canadians who wish to take up flying for the first time. The likelihood of a cardiovascular event increases with age, therefore it is reasonable to consider the application of a different level of scrutiny to older individuals. Nevertheless there are pilots in their 70s and 80s who have been assessed medically fit to fly.

Cardiovascular experts who recently February 1, reviewed the Guidelines published in felt that only a few updates and refinements were required and these have been incorporated. The Guidelines in effect seem to be serving us well as evidenced by no fatal aviation accident in Canada over several decades, with an established cardiovascular cause.

The standards identify broad medical conditions that on the basis of expected risk of incapacitation disqualify a pilot from flying an aircraft. In countries where the standards are applied strictly, affected pilots may never return to flying. Such a strict policy may be unfair to those aviation personnel in whom the risk of sudden incapacitation becomes acceptably low as a result of risk factor modification or rehabilitation including some therapeutic interventions.

Canada on the other hand has used the concept of flexibility and accredited medical opinion to determine medical fitness where circumstances do not meet the standards as written. Our ability to assess risk in an individual continues to improve as experience with groups bearing similar risk profiles increases.

Progress with the assurance of a safe flying environment e. The risk of a fatal accident occurring as a result of medical incapacitation is dependent on a number of factors. These include the amount of time spent flying, the type of flying eg aerobatics , the risk of an incapacitation occurring at a critical phase of flight and the risk that such incapacitation is not mitigated by the presence of other qualified aircrew.

All of these factors must be taken into consideration in addition to the known medical risk of a given medical condition. Experience with cardiac disease in the general population along with experience with simulators allows an estimation of risk in a fashion similar to that used in other risk evaluation settings by structural engineers.

Where there is insufficient precision in estimating risk for the medical condition of a given applicant, then we continue to determine medical fitness applying a cautious approach. Chest pain, regardless whether typical or atypical for ischemic heart disease, precludes medical certification insofar as it indicates an elevated probability of significant coronary artery disease and an increased risk of an incapacitating cardiac event.

An applicant may be considered medically fit if diagnostic testing indicates that the chest pain is not due to myocardial ischemia. The initial assessment including a review of the symptom history must be made without the effect of anti-ischemic medications that could possibly mask adverse findings.

 
 

Video copilot optical flares wall of lights free

 
 

Most of them are useless and seemingly designed to distract you more than anything else. Try to avoid these items. The best gear is durable, unobtrusive, and easy to use—so you can keep your eyes and your thoughts on the road. You will get bored— miles on cruise control with an automatic transmission can be a pretty dull time.

Revel in it. It would be impossible for us to pick the best overall sunglasses, since your choice will ultimately depend on your personal style. We have picks for cheap sunglasses in a separate guide. In that regard, Maui Jim makes the best sunglasses around, though they are something of an investment. We compared a Maui Jim pair with more than 20 types of sunglasses, driving or otherwise, and found this pair to be the best of the bunch. The Maui Jim sunglasses had the clearest lenses, with no perceptible distortion, on the lightest frames we tested 0.

But during my trip there were a few afternoons when I had completely forgotten I was even wearing the Maui Jims—despite five-plus hours of driving with them on. The clarity of the lenses was also a surprise. As far as specific model recommendations go, I suggest scanning the offerings on the Maui Jim website and reading the fit descriptions to find something that matches your aesthetic sensibilities. Unlike companies that go by lens size only, Maui Jim lists face shape as part of its fit guidelines.

Just keep in mind that bigger lenses tend to be better because they offer more coverage. Maui Jim glasses come with a two-year warranty. After checking with the company, we confirmed that it fulfills warranties on its sunglasses no matter where you buy them. You can tell whether the pair you have is genuine and not a knockoff by confirming that the Maui Jim logo is etched, not just painted onto the lens.

But in reality, for many drivers, a phone is the source for navigation, information, messages, music, and of course phone calls. However, if you hold the phone in your hand as you drive—or look down at it in a cupholder or center-console bin—it can be a major distraction and safety risk.

I enjoy the simplicity of my phone with no accessories, so I like that the iOttie iTap Magnetic 2 mounts offer an attractively easy way to mount and unmount my phone with one hand.

To use the magnetic mount, you have to attach a small metal plate to the back of your phone or to the case. But the plate could interfere with your ability to wirelessly charge your phone. If you want to be able to continue to use that function, consider the following options from our guide to wireless charging phone mounts. This model delivered some of the quickest charging speeds and earned top results for stability. This is the sturdiest vent-mounted model we tested, with fast charging speeds, a firm grip, and a quick way to attach and remove your phone.

The iOttie Easy One Touch Wireless 2—available as a dash and windshield mount or a vent and CD player mount —offers a convenient way to charge your phone in the car while also giving you easy access to audio controls, directions, messages, and more. In our tests , both models were among the quickest at charging our phones. The spring-loaded tension arms made attaching or removing a phone of any size very simple, and they held the phone steady while we drove. And both models offer a wide range of adjustability for positioning your phone where you can readily see it, regardless of the vehicle.

Rain and snow add stress to a road trip, and they also decrease your visibility and your reaction time in an emergency. Along with wipers, rain-repellent windshield coatings can help keep your windshield clear. If you want the most effective rain repellent, pick up the classic Rain-X spray bottle and commit to applying it once a month. If you simply want to give your windshield a boost, Aquapel is almost as effective and can last six times longer between applications—but it is very expensive.

This affordable hydrophobic spray offers effective protection, but it wears off after a couple of weeks. Most auto-supply shops offer a huge variety of Rain-X products, including wiper blades, gels, and washer-fluid additives, but you should stick to the original formula in the ounce spray bottle because it has the most reliably positive user reviews.

Once applied, Rain-X forms a hydrophobic coating that causes water to bead up and quickly slide off your windshield. Most who have used Rain-X agree that it needs to be reapplied about once a month to maintain effectiveness.

Aquapel bonds to your windshield for up to half a year, but it costs more than twice as much as Rain-X. Instead of coating your windshield, it bonds to the glass chemically , and it should last for three to six months before you need to pull out another one-time-use sponge and reapply. YouTube user jwardell posted a day comparison video that shows how Rain-X is more effective initially, but after a month Aquapel still works even after the Rain-X has all but worn off.

For either repellent, proper application is the key to getting the maximum benefit. Then clean it again just to be sure. Both of these repellents dry best in warm weather, out of direct sun. Even when perfectly applied, however, these substances have potential drawbacks. Some who have used them complain that the repellents cause noticeable haziness at night.

Efficient at clearing ice and sweeping snow, this scraper works on vehicles of all sizes. But no other contender offers such a complete scraping-and-sweeping package with so few weaknesses. With the advent of GPS units and smartphone navigation apps both of which we recommend over the onboard navigation systems that might come with a car , the age of the paper road atlas would seem to be over.

A road atlas is the heart of every road trip. Planning a road trip starts with imagining the places you could be next weekend, if you threw a few granola bars and some clothes into the backseat and left everything else behind. Or you could pull out a physical map and highlight a route. And regardless of electronic-device failures, you will always have a map in hand.

For use in the car, we like the classic Rand McNally Road Atlas —just make sure to get an updated edition. The Rand McNally was simple, functional, and easy to follow. Most important, it was fun to use. For most shorter trips, a smartphone can provide all the navigation assistance you need. But should your journey take you off the beaten path and out of your coverage area , we suggest the Garmin DriveSmart Like the best GPS models, the DriveSmart 55 can also connect to a smartphone via Bluetooth, which lets you send destinations to the device, get incoming messages onscreen, and receive extra trip and traffic info.

Similar to a smartphone, the DriveSmart 55 allows multi-touch gestures, such as pinching or spreading for easier zooming on a map. This feature is a clear step up from the resistive displays of less-expensive units, which allow only single-finger gestures and require you to tap on the plus and minus buttons to zoom in or out.

The DriveSmart 55 also provides helpful traffic info in many metro areas. Not quite a shower but pretty darn close, these wipes are amazing after a sweaty day in the desert. Road-trip and backpacking veterans know just how much better a shower can make an adventure after three days and a lot of smelly clothes.

When taking a shower is not an option, or even if you just want to tidy up a bit after a long drive, body wipes can provide some much-needed relief. We considered 22 brands and tested nine different body wipes, including some that were popular on Amazon and others that were recommended on the blogs of seasoned outdoorspeople.

Cheap, portable, and durable, the Sea to Summit Wilderness Wipes were the clear winners. The wipes come in a resealable package, which helps keep them fresher for longer.

You can find them in two sizes, XL 8 by 12 inches, in a pack of eight and Compact 6 by 8 inches, in a pack of On our trip, we preferred the XL wipes for their extra coverage and longer cleaning power. The fully compostable Wilderness Wipes were among the most lightly scented ones we tested, and the lack of alcohol left our skin feeling clean and moist. Effective, EPA-approved, and usually easy to find, these pre-soaked wipes need only four minutes of contact time to neutralize the coronavirus.

Most disinfecting wipes are the same. These wipes can eliminate the coronavirus on hard surfaces—countertops, door handles, and bathroom fixtures—in your home, vehicle, or motel room, but not on fabric or other soft materials. Instead of bleach, which can damage car interiors, Lysol Disinfectant Mist uses quaternary ammonium.

The spray eliminates the coronavirus on hard surfaces in 10 minutes, but on soft surfaces it only sanitizes kills most but not all pathogens. Most mask mandates have been rescinded, but the rules can change or vary depending on where you are.

Based on our research and testing, we have a few recommendations for adjustable masks that should cover most faces comfortably and work well when worn properly. We consulted a range of authorities to zero in on the small but crucial design details that have an outsize impact on how a mask fits and feels. We then commissioned independent lab tests to assess the filtration efficiency and breathability of a variety of cloth masks and filters, including our picks.

If you want to read more about selecting your own mask, check our full review here. Our panel testers liked wearing the lightweight, filter-incorporated Enro Tech Mask formerly called the Enro Face Mask more than any other model as did our junior panelists, who tested pint-size versions for our guide to cloth face masks for kids. This mask tents up over the nose and mouth more than any other one we tested. The drawback: It has to be hand-washed. Long a recommendation in our guide to the best face masks for kids, the Happy Masks Pro is now also an adult pick.

You must hand-wash and air-dry it, though. Due to supply issues, the mask is currently available via waitlist only. A new design, called the Happy Masks Ultra , is machine-washable. We plan on testing it soon. This stylish mask has good clearance off the nose and mouth and—thanks to a sewn-in filter—decent filtration efficiency.

You can choose between adjustable headbands and ear loops, both of which provide a good fit. However, the material feels thicker and less breathable than that of the filter-incorporated Enro and Happy Masks Pro. With the sold-separately filter stuffed in its pocket, this mask with adjustable ear loops fit all of our testers and struck the best balance of filtration and breathability in independent lab testing.

The nose-bridge wire on the Graf Lantz Zenbu Organic Cotton Face Mask hits a nice balance between sturdy and pliable—making for a great seal. Used with its separately sold filter, the mask balances breathability with solid filtration, assuming good fit.

We wish the filter would cover the entire mask to maximize its filtration potential, though. I met my own inevitable conclusion outside an In-N-Out Burger on the last leg of our trip. We tested them against other instant spot removers and assorted DIY methods to see how they handled wine, coffee, lipstick, and mustard stains. In our tests, the Shout wipes easily outperformed the popular Tide to Go pen , and the Shout option was the only stain remover that erased almost all traces of lipstick on the collar of a shirt.

These wipes also did pretty well on the ketchup I spilled. You might find yourself washing your hands a lot on the road, which can result in cracked and dry skin. Aveeno Daily Moisturizing Lotion is thick enough to stay neat in your hand and thin enough to spread quickly and smoothly onto your skin. And unlike its competitors , this moisturizing lotion dries nicely without leaving a greasy film in its wake. Can a long road trip be comfortable? Long hours of sitting in one position, nights spent camping or sleeping in cheap motel beds, and breaks for indigestible fast food are a terrible combination.

With a little planning and a few small luxuries, you can keep the enthusiasm of your trip alive. Skip the fast food, and instead pack your own snacks and water. And stop for as long as you need. It also now has a sewn-in cable that you can cinch down to make the pillow firmer. A good travel pillow is hard to find. During the day, it can fold in on itself a loop-and-toggle closure holds it tight , which makes it easy to stow in a backpack or to toss into the backseat.

At night, the pillow unrolls and expands into a decent bed pillow, though side-sleepers with larger frames may say it has too little padding. But this is a travel pillow, of course, so it will never feel like your home pillow, which is all part of the fun somehow. In spring , Therm-A-Rest released a slightly redesigned version of the pillow. The pillow also has a cord sewn in a loop into its back; you can tighten the cord and cinch it securely to make the pillow firmer.

This liner is a lightweight, moisture-wicking, easy-packing fix for scratchy motel sheets. Not all motels are created equal. Some are fantastic, with their bright neon signs truthfully advertising a cheap, clean, and convenient place to stay. Not every bedroom on the road is as dark as some people would like. Although the mask is adjustable, with Velcro straps, restless sleepers may want to consider other options here.

This blanket offers the greatest warmth and durability for the lowest relative weight, price, and size. It also stuffs away very well when not in use. It helps you to stay warm longer, inside or outside. So far in our testing, the Rumpl has survived four rounds in the washing machine without a snag and it dried within an hour.

And it was notably stain-resistant after encountering dirt, dew, and even coffee. The Hest takes up about the space of a small cot mattress 78 by 25 inches.

Half of the mattress consists of a dense foam layer, and the other half is a high-pressure inflatable base that needs a pump system to inflate. One of the longest and widest of all the single-piece reusable funnels Nancy tested , the Tinkle Belle makes less mess and is easy to use. The more coverage a funnel has, the lower the risk of leakage or spills.

You also get a matching case for your funnel. We like the A1 Windshield Sun Shade , which we found to have the best combination of low cost, decent coverage, and ease of setup. Its pop-up design made it much simpler to install and stow than the accordion—style shades we tested. But the A1 offers several sizing options, ranging from 59 by 19 inches to 69 by 36 inches when fully expanded.

Each of these size options can be compressed down to fit into a circular carrying case, which you can easily store on the door or underneath the seat. Amazon reviewers mention that the build quality is solid and that the metallic finish does a good job against the sun, particularly in hot Southern states like Florida and Texas.

Several reviewers also recommend that you buy a size smaller than you think you need, however, to avoid excessive overhang. Even with the choice in sizes, you still might have difficulty arranging the two plastic circles which provide rigidity within the A1 into a shape that hugs both edges of the front window and that balances off the rear-view mirror. Gaps, loose corners, or overhangs are almost unavoidable. This custom-fitted shade will ensure no sun gets in, even in the sunniest climates.

If maximum temperature reduction is your goal, invest in a custom-fitted WeatherTech SunShade. Thicker than the A1, the SunShade completely blacks out the windshield when you install it. This shade sticks easily to your windows and provides great sun protection for passengers.

We researched 14 shade models and tested two finalists before determining that the Britax EZ-Cling Window Shade is the best around. The Mylar on the back provides some protection against UV rays, and it acts like a large sheet of cling film that seems drawn to your windows once you pull the shades out of the box; the black mesh on the inner surface blocks a good amount of sunlight while still allowing you to see through the shade.

We like the EZ-Cling better than film-only shades because the EZ-Cling has a support ring of firmer material around its perimeter that makes it easier to install without getting wrinkles and bubbles. So he brought two EZ-Cling pairs for testing on a four-day road trip with his family. We also removed them and reapplied them many times as our position relative to the sun changed, and it was easy to do so.

Quick tip: Be sure to wipe your EZ-Clings with water when you first get them. A thin film protects the Mylar sheets during production, and it can leave a waxy residue on your car windows if you use the shades right out of the box without first wiping them down.

This extending shade attaches to a variety of vehicles, whether you have a roof rack or not, and whether you attach it to metal or a composite material such as a pickup-truck bed cover. Although it works best on SUVs and trucks, the MoonShade is lightweight and adaptable enough to work with smaller vehicles.

When deployed, the MoonShade covers 9 by 7 feet, and its height adjusts from 78 inches to 96 inches. The shade mounts in three ways: directly to a roof rack, with very strong magnets, or with surprisingly robust suction cups for composite materials.

We found that all three methods are secure enough for most situations, though as you might imagine, the suction cups are somewhat less stable than a direct mount on a rack. The MoonShade weighs 8 pounds and stows away into a carrying case that measures 28 by 6 inches, which is small enough to fit in the trunk of most cars. The MoonShade is great if you like to pull over in the middle of the day and set up a lunch, or if you tend to do activities outdoors in predominantly shadeless areas, as you find in the Southwest.

You could cross America with no plan at all and survive solely on fast food as your nourishment—without ever having to leave your car. Packing your own snacks and bringing your own water is not only healthier but also safer—you never know when you might be stranded somewhere along the way. We got stranded on our second day of driving, somewhere east of Joshua Tree, California, when we pulled off the side of the road onto a soft, sandy shoulder we were new in this part of the country.

As we waited, I was thankful that Caleigh and I both had full water bottles, more water in the trunk, and plenty of food. A highway patrol officer drove up, gave us a little lesson about sand, and pushed us out with no trouble.

So things turned out fine. The beauty of a road trip is in the unexpected moments. You can be prepared for most of them by having a little food and water on hand. This cooler is lightweight, sturdy, and easy to pack. With enough ice, it will keep contents cold for more than 24 hours without leaking or sweating. If the fields runs down hill, he may land long. Pilots inexperienced in the Arctic may miscalculate their height on final approach because the trees they use for unconscious reference are shorter than trees in the South.

Landing in “whiteout” conditions, where the ground and horizon are obscured, or landing on a smooth, reflective lake makes judgement of height extremely difficult. Particular problems may occur at night when approaching a lighted runway in an otherwise featureless area if in the distance there is a well lit town at a higher elevation. The eye, in the absence of other clues, tends to place the two lighted areas on the same elevation which may lead to premature ground contact.

There is a special problem at night with small light sources, such as stars or distant ground lights. When watched intently they will appear to move and may be mistaken for other aircraft.

This movement of stationary objects is known as autokinesis and has been responsible for accidents. Where the light source is bright or large this illusion is uncommon.

The commonest type of vectional movement illusion is that experienced sitting in a car at a traffic light when the adjoining car creeps forward. This causes a sensation of backward movement and often reflex braking. In the rotational plane similar illusions occur. In a darknened chamber where light from a rotating source is reflected on the walls, the movement of the light on the walls is soon replaced by a sensation of body rotation, the walls appearing fixed.

Other problems are confusion between ground lights and the stars when flying over prairie areas or pilots orienting the aircraft to sloping cloud decks or to the Northern Lights rather than to the true horizon. These may arise from the otoliths, the semicircular canals or from a combination of the two. They are among the most serious of the illusions and the most likely to cause lethal accidents. At rest or in constant motion gravity is the only force acting on the otolithic membrane.

We are used to interpreting gravity as a force pointing to the centre of the earth and, when our plane of movement is changed, falsely interpret sensations according to this precept. A pilot accelerating down the runway and rotating to lift-off is exposed to an acceleration which pushes him back in the seat, together with the force of gravity acting downwards. The resultant is interpreted as a single force acting upwards and backwards.

Because the brain interprets the force of gravity as being vertical, the sensation is of pitch-up and the pilot may instinctively make a forward stick movement for control. This can complicate the situation because causing negative G stimulates an oculo-vestibular reflex movement of the eyes which gives rise to the sensation that the instrument panel is moving upwards, heightening the illusion. This is the known as the oculogravic illusion.

With deceleration, such as that experienced on descent when the flaps are deployed, a pitch down sensation may be felt. These sensations are normal and of no great importance if the pilot is experienced or visual flight is maintained. At night however, particularly taking off from a lighted runway into a dark featureless area, and accident can occur due to inappropriate control movements performed in the transition from visual to instrument flight.

Even an experienced pilot can take as long as 7 seconds to adjust. A common form of disorientation is a sensation of incorrect rotation or absence of rotation caused by the semicircular canals.

The cupola in its neutral position is upright. When the head rotates, the bony canals move but there is inertia in the endolymph. The cupola is therefore deflected leading to a sensation of rotation. Our sensitivity to rotation however is not perfect and can be diminished by any form of distraction. Rotation in the vertical axis of per second may not be perceived.

If a pilot, flying straight and level, gradually drops the left wing by 15 degrees whilst otherwise occupied and suddenly becomes aware from the instruments of this attitude and corrects it at a much faster rate, only the correction will be sensed.

The pilot then feels as though the aircraft has rolled 15 degrees towards the right and will lean towards the left to maintain balance. This is called “the leans” and is extremely common. A different problem arises with prolonged turns at a constant rate, such as those encountered in a holding pattern at a busy airport.

On entering a turn the cupola is deflected by the inertia of the endolymph see Fig. As the turn continues the endolymph will begin to move until it is in equilibrium with the bony canal and at this point the cupola will return to its central position. Depending on the steepness of the turn this may occur in seconds. When the turn is terminated the bony canal will cease to rotate immediately but the endolymph, due to inertia, will continue to swirl thus moving the cupola in the opposite direction.

This gives rise to the impression that a turn in the opposite direction has been entered and the tendency will be to correct this and so to reenter the original turn. Although this is a minor distraction under most circumstances, in instrument meterological conditions it can be extremely serious and lead to a “graveyard spiral”.

Here the inexperienced pilot, having inadvertently entered a steep descending turn under instrument conditions, makes the correct stick movements to control the aircraft but experiencing the sensation of entering a turn in the other direction may re-enter the spiral. As the aircraft is also descending, pulling back on the stick to stop the loss of altitude, although giving rise to a comforting feeling of gravitational pull in the seat, actually steepens the spiral, ultimately driving the aircraft into the ground.

The most extreme form of vestibular disorientation is due to the Coreolis phenomenon. This is thought to be caused when two different semi-circular canals are stimulated at the same time. As an example, a pilot taking off from an airport in instrument conditions, banks towards the left while climbing. So far there is stimulation of the otolith and of one canal. In order to reach a switch or see a gauge however the pilot turns the head quickly downwards and towards the right. Two different canals have now been stimulated and, as all are connected, a movement of endolymph takes place in the third canal.

The result is a sensation of tumbling which may be extreme and worsened by visual problems due to oculo-vestibular reflexes. Even if control of the aircraft can be maintained under these very trying circumstances, the pilot may still be subject to the leans or other abnormal sensations until able to obtain a visual reference.

Distinction is sometimes made between two different type of disorientation. Type I is unrecognized and Type II recognized. Obviously a Type I illusion is more likely to lead to an accident or incident. Illusions are also divided into oculo-gyral somatogyral or oculogravic somato-gravic. An oculogyral illusion is defined as the apparent movement of an object in the visual field resulting from stimulation of the semi-circular canals by angular acceleration.

An oculo-gravic illusion is the false perception of tilt induced by stimulation of the otolith by linear accelerations. The terms somato-gyral and somatogravic refer to the resulting body sensations. The relationship between this condition and orientation is striking. The causes of motion sickness are both visual and mechanical, the latter arising from stimulation of the vestibular system. Animals in whom the vestibular system has been ablated or people born with non-functioning labryinths cannot be made motion sick.

The cause of motion sickness has never been completely clarified but it is felt that it results from sensory conflicts, the difference between what is seen or felt and previous orientational experience. Motion sickness, for example, can occur in aircraft simulators and is more common amongst pilots experienced on the type of aircraft being simulated than it is in an inexperienced crew.

Motion sickness increases in frequency up to puberty and then decreases. Women are more subject than men and it is more common in passengers than in aircrew.

Motion sickness may be provoked by anxiety, fear or orientational insecurity. Unfortunately it can become a conditioned reflex.

A trainee pilot, having been motion sick during flight, may become ill on the ground approaching an aircraft. It can be overcome by repeated exposure or adaptation and is rarely experienced by the person in charge of the aircraft or automobile who is aware, and braced for, changes in attitude or direction. Up to one third of military flight trainees become air sick at some point in their training and about 1 in 5 suffer severe air sickness.

Adaptation depends upon gradually increasing stimulation. In trainee pilots who develop severe problems, desensitization programs have been successfully employed. Motion sickness can be much reduced by the use of Scopolamine and nowadays transcutaneous administration of this medication is used in sea sickness.

The drug however creates drowsiness and cholinergic effects and is not suitable for pilots. Small doses of the drug may be used in the initial phases of training when an instructor is in the aircraft but this must be discontinued before solo flight is undertaken.

There is no place for prolonged drug therapy in aircrew. A continuing challenge for those involved in the aeromedical certification process is in making decisions which take into consideration both the rights of the individual and the safety of the public.

This is not always an easy task. One of the areas that has been most challenging is neurology and neurosurgery. Making predictions about the likelihood of subtle or sudden incapacitation is at best an imprecise science. However, modern neurological diagnostic imaging techniques and prospective studies are making outcome predictions more reliable.

These guidelines have been prepared to assist practicing physicians determine whether or not their pilot patients may meet the neurological requirements for the aviation environment. The guidelines are the result of an analysis of the proceedings of a 2 day workshop on neurological disorders and aeromedical certification held in Ottawa, June 3rd and 4th Physicians are reminded that this document should be used as a guide only and should not be confused with the medical standards for aviation personnel published by Transport Canada, Aviation TP Specific questions should be directed to the nearest regional aviation medical office, Civil Aviation Medicine Division, Health Canada.

To all the panel members who participated in the workshop with such enthusiasm, and who gave so generously their expertise and precious time in the development of these guidelines I extend to each of you my sincere and respectful gratitude. To Dr. James M. Wallace, Senior Consultant, Operations Policy and Standards who shouldered the responsibility of writing and editing this document, I thank you for your dedication.

Takahashi, M. George Y. Wallace Sr. Clinical Prof. University of Ottawa Co-Chairman. Henery J. Professor, University of Ottawa. Stephen V. Blizzard Sr. The Canadian Charter of Rights and Freedoms which was enacted in has a number of human rights provisions, one of which states that “no person shall be discriminated against on the basis of disability”.

Given this constitutional background there have been an increasing number of challenges in the Courts and Human Rights Tribunals on refusals to medically certify applicants with neurological disorders. Aeromedical “unfit” assessments must therefore be based on current scientific “state of the art” knowledge. In the aviation environment neurological disease is a recurring concern for those involved in aeromedical certification. The mode of presentation may vary from full-blown grand mal seizures or massive stroke to the insidious onset of cognitive impairment in conditions such as multiple sclerosis and Alzheimer’s disease.

The prevalence and marked variability in severity of migraine has caused difficulty in objectively deciding where the line should be drawn between “fit” and “unfit” assessments. The person who has sustained a significant head injury is subject to the dual dilemma of risk of posttraumatic seizures and also of cognitive impairment. In in the United States, the Federal Aviation Administration solicited a proposal from the American Medical Association AMA to produce an authoritative report on neurological disorders and aviation safety.

The AMA in conjunction with the American Academy of Neurology and the American Association of Neurological Surgeons convened a series of meetings with experts in the field which resulted in the publication in of a special issue of the Archives of Neurology, entitled “Neurological and Neurosurgical Conditions Associated with Aviation Safety”. This document served as one of the primary resources for Canadian aeromedical certification decisions on neurological disorders throughout the ‘s.

Advances in diagnostic imaging and the management of neurological and neurosurgical disorders over the intervening years indicated that more current references were required. It should be pointed out that this document is only guidance material and that each decision will be based on the individual circumstances of the case.

There are two major concerns following head trauma resulting in loss of consciousness. One is the neuropsychological consequences of the trauma in patients who have not had any focal deficits. The other is the possibility of seizure secondary to the trauma. Because of the anatomy involved, these forces cause their greatest focal damage to the orbital, frontal and anterior temporal areas of the brain. Associated with the cortical damage there is diffuse white matter damage.

The result of this is dysfunction in a number of functional executive activities of the brain. These frequently are, 1 slowing of reaction time, impaired memory and deficient ability to perform constantly at a high level over time, particularly in settings of complex activities and choices. Other problems include attention, initiation and proper sequencing of tasks, difficulty in planning and anticipating the future, and difficulty establishing automatic responses to a trigger.

The affected individual may not notice or care that the task is being poorly performed. Problems are exacerbated by stress, fatigue and pain and the handling of simultaneous emergency tasks is particularly affected. Although the problems may be severe, routine IQ and mental status testing may be within normal limits.

Fortunately there is a natural tendency for deficits to improve. Sufficient data to accurately predict the outcome of most types of head injury is unfortunately unavailable. There are a number of ways to predict the outcome of head injury and the most commonly used to date has been the duration of post-traumatic amnesia PTA. Most individuals who have had a PTAof less than 30 minutes are likely to be fit within three months. A person with PTA lasting more than 30 minutes but less than 24 hours will likely be fit from a neuropsychological point of view after a longer time, probably one year.

Those with focal neurological deficits, those who have focal abnormalities on CT scanning or a more prolonged PTA require neuropsychological assessment with particular attention to frontal lobe functioning before medical certification. Flight simulator testing may be useful. Magnetic resonance imaging MRI is more sensitive than CT scanning in defining areas of frontal lobe and white matter abnormality and is therefore an important diagnostic adjunct in those who have had brain injuries.

These people clearly require a more prolonged period off work than those with simple concussion. The probability of epilepsy is greater in those with penetrating skull injuries. Even with full physical and neuropsychological recovery there is an increased probability of seizures for over ten years. The probability of seizures has been correlated with CT scan findings as illustrated in Table 1. These can occur at any age, though they are more common in the older age group.

Individuals frequently are unaware of significant head trauma. Stroke is the third most common cause of death and a leading cause of disability in Canada. The risk of a recurrent stroke following an initial TIA or stroke has been looked at in a number of trials of various antiplatelet medications.

The probability of recurrence does depend on the number of risk factors present and the degree of carotid artery stenosis. Blood pressure control, cholesterol control, antiplatelet medications and cessation of smoking have made significance inroads into reducing the risk of stroke. Surgery has been particularly successful in patients who have significant carotid stenosis. Nevertheless, despite these management techniques, the risk of recurrent stroke remains high. Therefore, the vast majority of applicants who have had a stroke, will remain permanently unfit.

All applicants with stroke secondary to an intracerebal hemorrhage are permanently unfit. The applicant who has a TIA must be evaluated carefully as some will in reality be migraine without headache, seizures, vestibular dysfunction, failure of ocular fusion, multiple sclerosis, brain tumors, subdural hematoma, hypoglycemia or syncope.

Risk factors have to be carefully evaluated including possible cardiac sources of embolus. Applicants with negative imaging of brain, neck and heart and with minimal other risk factors can be considered for medical certification at three years after the event. These are a specific symptom complex with an appropriate abnormality on neuroimaging ascribed to a lacune. The majority are secondary to small vessel occlusion, others may be secondary to an embolus of various possible origins.

They pose two problems one is the risk of recurrent infarct which is significant and the second is the accumulation of lacunes without obvious symptomatology but leading to the insidious onset of dementia The majority of applicants with lacunar infarcts are therefore unfit. Occasional individuals who never had significant deficits and who fully recovered may be considered on an individual basis. These individuals require extensive work-up, including carotid Doppler studies and echocardiography.

They need an MRI to show if there is evidence of significant lacunar disease. If the above investigations do not show significant pathology, the risk factors are controlled and if after four years, the MRI does not show any increase of lacunar disease, the applicant could be considered on an individual basis for medical certification.

Applicants with multiple lacunes are a concern, as they may be developing dementia and are unfit. A patent foramen ovale should not be considered a risk factor for stroke according to recent trials, unless associated with an atrial septal aneurysm.

If there is no evidence of an ongoing or recurrent risk, if there has been no evidence of epilepsy and if the person has no significant sequelae from the thrombosis, they can be considered medically fit two years after the event. During pregnancy and puerperium the risk of stroke is 44 per , The cause for this type of stroke must to be sought as often multiple factors predispose towards such strokes.

One has to look particularly for thrombophilia, anti-phospholipid antibodies, dehydration, cardiac disease and dissection. In those individuals where there has been no significant sequelae, particularly no cognitive difficulties or history of epilepsy and if the etiology of their stroke is not going to be a recurrent or ongoing problem, then they could be considered fit two years after the event.

They are unfit. An endarterectomy will not resolve this problem, as they probably have other arteries significantly involved. Arterial dissections are one of the most common causes of stroke in the young. Applicants who have had a good recovery, in which imaging does not show any evidence of cerebral infarction, who have had no evidence of epileptic seizures, can be considered for medical certification after two years.

They need imaging to show good restitution of flow, with no evidence of aneurysm. There should be no evidence of having had a subarachnoid hemorrhage. There should be no predisposition to further dissections. The majority of applicants who have had a subarachnoid hemorrhage are permanently unfit. There are occasional people who have been successfully treated, who had excellent recovery, and who have never had seizures. Those individuals in which repeated angiography shows that the treatment has been successful can be considered for medical certification at two years.

If they had an endovascular approach, an angiogram should be repeated yearly for two further years, to show that successful repair has been maintained. An EEG at two years should not show significant abnormalities and particularly no potentially epileptiform discharges.

Those who have perimesencephalic bleeds with normal angiography, could be considered fit at one year if they have had an excellent recovery, as is usually the case. Those with asymptomatic intracranial aneurysms less than 10 mm can be considered as continuing to be medically fit. Therefore those with arteriovenous malformations are permanently unfit. Applicants with cavernomas that are deep, with no evidence of previous hemorrhage may be considered fit, all others should be considered unfit.

The tendency towards epileptic seizures is not an all or nothing phenomenon. Most people, under certain conditions, may have a seizure if sleep deprived or withdrawing from alcohol or benzodiazapines, especially if in addition they are taking medications which decrease the seizure threshold eg. Tricyclic anti-depressants. Those with a distinct epileptiform abnormality on the EEG as opposed to non specific abnormalities, have an increased probability of having further seizures after a single seizure.

It is therefore imperative that the diagnosis of a seizure be correct, and the importance of a description of the event cannot be overemphasized. Although the electroencephalogram EEG is particularly useful it must be reviewed by an experienced reader to be considered supportive of an epileptiform tendency. Individuals with epilepsy are unfit. Persons who have had the following types of seizures may be acceptable.

Childhood febrile seizures which are brief, not associated with neurological deficits, and have ceased before the age of five may be considered for medical certification. The individual must have been off all anti-epileptic medications for at least five years and the EEG off medication must be normal. The seizures of Benign Rolandic Epilepsy of Childhood usually involve the face, tongue or hand and are often precipitated by drowsiness or sleep.

The EEG shows significant abnormalities from the Rolandic area of the brain. Individuals with this condition may be considered for medical certification if they have been seizure free and off medication for ten years. They must have a normal neurological examination and EEG.

A sleep deprived EEG should also be normal. An individual with a single epileptic seizure is initially unfit. The case can be reconsidered after five years if the neurological examination is normal and repeated EEGs, including sleep deprivation and additional nasopharyngeal or minisphenoidal electrodes, do not reveal any significant abnormalities. Neuroimaging, preferably MRI, must first have revealed a normal brain structure. A restricted as or with co-pilot medical certificate can then be granted.

Such a restriction may be removed after an additional two years. Those individuals who have a second seizure should be considered to have epilepsy. Five years after the event, all of the above investigations must be repeated and found to be normal. Applicants for Category 1 medical certification should be restricted to: “as or with copilot” for an additional two years. Those who have had a seizure while on tricyclic antidepressant drugs or other seizure enhancing medications must be considered more prone to seizures than the average population.

They must be considered unfit for five years. This condition is characterized by a transient loss of memory for remote events associated with an inability to form new memories. It is an unusual condition that usually lasts for hours. TGA is not a seizure disorder and may be due to transient ischemia in the inferomedial parts of the temporal lobes.

It is commoner in middle aged or older people, and many individuals are hypertensive: frequently they have been undertaking physically demanding tasks eg. Throughout the episode, the sufferer is socially appropriate, oriented to person but tends to repeat the same question over and over again, this question usually reflecting their disorientation.

If there is a normal neurological examination and EEG at the time of the event and again one year after the event, medical certification may be considered. Narcolepsy presents with periods of excessive daytime sleepiness not prevented by adequate nighttime sleep and often enhanced by boredom. Excessive sleepiness may be associated with sleep related hallucinations or paralysis and, most importantly, it may be associated with cataplexy which is an abrupt paralysis of variable degree precipitated by surprise or by laughter.

Prophylactic medications are imperfect and may alter performance. They include dextroamphetamine and methylphenidate. Fifty-nine percent of the adult population in Canada report some form of headache. Tension type headaches are not usually disabling but up to three quarters of migraine headaches are sufficiently severe to limit regular activities. Most migraineurs have attacks that last 12 to 24 hours. Migraine can be divided into two categories, migraine with aura classical migraine and migraine without aura common migraine.

The aura may be preceded by a prodrome of mood changes which may interfere with routine activities. The aura itself usually lasts about 20 minutes and immediately precedes the onset of the headache. The head pain itself is thought to be related to a sterile inflammatory response around blood vessels in the face and scalp and the intracranial vessels of the coverings of the brain.

This inflammatory response is mediated through vasoactive peptides which cause dilatation, edema and inflammation around the vessels which are innervated by a branch of the trigeminal nerve trigeminal-vascular complex. Migraine tends to occur at times of let-down from stress, after fasting, and after missing sleep. Flashing lights and bright reflected light may also trigger acute attacks.

Migraineurs who have significant auras which can interfere with flight safety and who do not fit into the group 2, ie, too fast onset, too frequent, cognitive impairment, unclear history, should generally be considered unfit for all categories.

They may be considered for restricted medical certification if after 3 years they fit in group 2. Cluster headaches occur only in 0. They recur in bouts lasting six weeks or more, during which time acute attacks occur one to four times per 24 hours. Once the bout is ended, however, the sufferers are usually entirely headache free for months or years. The individual attacks are extremely intense, localized around one eye and associated with nasal congestion and lacrimation which may impair vision.

They are virtually always incapacitating. The applicants should be considered unfit during a bout of cluster headache but during the interval bouts, they may be considered fit.

Between bouts, the applicants do not need to take any medication, but in chronic cluster headache where the bout extends beyond six weeks, medication which might impair functioning may be required. Trigeminal Neuralgia causes piercing, electric shocklike facial pains which have a high frequency of recurrence.

Many episodes may occur in a single day. In older age groups these are often secondary to a loop of blood vessels pressing against the trigeminal nerve: in the young they may be secondary to multiple sclerosis.

Individuals suffering from trigeminal neuralgia are unfit but if they go into remission may be considered for medical certification. Multiple Sclerosis MS has a prevalence of about one in a thousand in Canada. The peak incidence is in the early 30’s with more females than males being affected. It is the third most common cause of severe neurological impairment in the year age range.

The course is variable. Fatigue is one of the most disabling problems in patients with multiple sclerosis. Tumors arising from the brain parenchyma such as gliomas or ependymomas, even when removed and whether or not they are treated with a radiotherapy, leave behind scarring.

This increases the probability of seizures and applicants with such a history are therefore permanently unfit. Applicants who have had meningiomas of the cerebral convexities may be considered fit two years post resection under certain specific circumstances. Current literature suggests that there is no limit as to when a meningioma can recur. The tumor must have been fully removed as defined by repeated neuroimaging. There should be no neurological sequelae and no history of seizures in association with the tumor.

Applicants who have had complete resection of an infratentorial meningioma, acoustic neuroma or other benign extra axial tumors, or applicants who have had a transphenoidal complete resection of a pituitary tumor and have no neurological or endocrinological sequelae and no history of seizures may be relicenced after 6 months to one year.

They will require yearly neurological and endocrinological follow-up. Those who have had an elevation of the frontal lobes in order to approach the pituitary tumor are generally unfit. This is because the tumor is probably larger and more likely to disturb structures around it and the frontal lobe has been disturbed by the traction involved in the surgery.

These factors increase the chance of the applicant developing seizures. Those shunted for acquired hydrocephalus are generally unfit because of the possibility of unexpected shunt failure.

Individual consideration however may be given where accredited medical opinion is that the risk of shunt failure or seizure is low. Applicants shunted in infancy and seizure free throughout adult life without neuropsychological sequelae may be considered for a Category 3 medical certificate. This is a rare condition in which there is a cystic lesion of the spinal cord or brainstem.

These lesions usually develop because of congenital anomalies, less frequently secondary to trauma or tumor. They tend to progress. If the syrinx is below the cervical cord the applicant should be judged as any other paraparetic according to functional abilities. A practical flight test will be required and, after medical certification, neurological follow-up is required every six months. A practical flight test should be repeated annually.

In applicants where the syrinx involves the cervical cord or brainstem, the neurological deficit may be or become too significant for medical certification. Such applicants are permanently unfit. Neuromuscular dysfunction in MG is related to antibodies generated against the acetylcholine receptor at the neuromuscular junction.

This results in progressive weakness and fatigability which fluctuates with the degree of effort sustained. Some individuals may achieve a remission by thymectomy or immunosuppression.

Those who are in remission and stable, with little or no medication two years after the thymectomy, may be recertified.

The presence or development of cardiovascular disease in licensed aviation personnel, with the risk of potential clinical manifestations, continues to be a major concern to aviation medical practitioners. The evaluation and management of aeromedical risk continues to be a balancing act between practicality, risk tolerance and the advances of diagnostic medicine. The advances in medical and surgical treatment of cardiovascular disease have allowed many pilots and air traffic controllers to return, after successful treatment, to licensed duties without jeopardizing aviation safety.

This fourth edition of the Canadian cardiovascular guidelines is intended to assist in the medical assessment of cardiovascular fitness of licensed aviation personnel. It reflects a consensus reached as a result of discussions and recommendations made during an aviation cardiology workshop held in Ottawa, on February 1st, , arranged by Civil Aviation Medicine Branch, Transport Canada. It must be emphasized that these guidelines are to be used only as a guide to practice and evaluation of licensed aviation personnel.

These guidelines should not be confused with the medical regulations set out in the Canadian Aviation Regulations part published by Transport Canada. Civil Aviation Medicine Branch, Transport Canada, is very grateful for the enthusiastic support and participation of all the expert panel members, and other individuals who provided advice and criticism.

A special word of thanks is owed to Dr. Andreas T. Wielgosz for his efforts in planning and co-chairing the workshop, and taking on the task of writing the text and to Dr. Contact information is available at. Michael’s Hospital, Toronto, ON. Eric A. Ian G. No disease condition is as rich with data to determine risk of medical fitness to fly as cardiovascular disease. Significant progress is being made in the identification of subsets of patients who are at high risk of a cardiovascular event based on more sophisticated technologies and expanding databases of well defined cases.

Genetic epidemiology, still in its early stages contributes even more precision to an assessment of risk in individuals. The challenge remains to identify in a cost effective manner those at an unacceptably high risk of incapacitation among the majority of otherwise medically fit pilots and air traffic controllers. This challenge is compounded by the continuous aging of the pilot population as well as the entry of older Canadians who wish to take up flying for the first time.

The likelihood of a cardiovascular event increases with age, therefore it is reasonable to consider the application of a different level of scrutiny to older individuals. Nevertheless there are pilots in their 70s and 80s who have been assessed medically fit to fly. Cardiovascular experts who recently February 1, reviewed the Guidelines published in felt that only a few updates and refinements were required and these have been incorporated. The Guidelines in effect seem to be serving us well as evidenced by no fatal aviation accident in Canada over several decades, with an established cardiovascular cause.

The standards identify broad medical conditions that on the basis of expected risk of incapacitation disqualify a pilot from flying an aircraft.

In countries where the standards are applied strictly, affected pilots may never return to flying. Such a strict policy may be unfair to those aviation personnel in whom the risk of sudden incapacitation becomes acceptably low as a result of risk factor modification or rehabilitation including some therapeutic interventions. Canada on the other hand has used the concept of flexibility and accredited medical opinion to determine medical fitness where circumstances do not meet the standards as written.

Our ability to assess risk in an individual continues to improve as experience with groups bearing similar risk profiles increases.

Progress with the assurance of a safe flying environment e. The risk of a fatal accident occurring as a result of medical incapacitation is dependent on a number of factors. These include the amount of time spent flying, the type of flying eg aerobatics , the risk of an incapacitation occurring at a critical phase of flight and the risk that such incapacitation is not mitigated by the presence of other qualified aircrew.

All of these factors must be taken into consideration in addition to the known medical risk of a given medical condition. Experience with cardiac disease in the general population along with experience with simulators allows an estimation of risk in a fashion similar to that used in other risk evaluation settings by structural engineers.

Public interest in the Whateleys subsided after most of the country folk had seen the baby, and no one bothered to comment on the swift development which that newcomer seemed every day to exhibit.

His motions and even his vocal sounds shewed a restraint and deliberateness highly peculiar in an infant, and no one was really unprepared when, at seven months, he began to walk unassisted, with falterings which another month was sufficient to remove.

Considerable talk was started when Silas Bishop—of the undecayed Bishops—mentioned having seen the boy running sturdily up that hill ahead of his mother about an hour before the blaze was remarked. Silas was rounding up a stray heifer, but he nearly forgot his mission when he fleetingly spied the two figures in the dim light of his lantern.

They darted almost noiselessly through the underbrush, and the astonished watcher seemed to think they were entirely unclothed. Afterward he could not be sure about the boy, who may have had some kind of a fringed belt and a pair of dark trunks or trousers on. Wilbur was never subsequently seen alive and conscious without complete and tightly buttoned attire, the disarrangement or threatened disarrangement of which always seemed to fill him with anger and alarm.

His contrast with his squalid mother and grandfather in this respect was thought very notable until the horror of suggested the most valid of reasons. His speech was somewhat remarkable both because of its difference from the ordinary accents of the region, and because it displayed a freedom from infantile lisping of which many children of three or four might well be proud.

The boy was not talkative, yet when he spoke he seemed to reflect some elusive element wholly unpossessed by Dunwich and its denizens.

The strangeness did not reside in what he said, or even in the simple idioms he used; but seemed vaguely linked with his intonation or with the internal organs that produced the spoken sounds. He was, however, exceedingly ugly despite his appearance of brilliancy; there being something almost goatish or animalistic about his thick lips, large-pored, yellowish skin, coarse crinkly hair, and oddly elongated ears.

He was soon disliked even more decidedly than his mother and grandsire, and all conjectures about him were spiced with references to the bygone magic of Old Whateley, and how the hills once shook when he shrieked the dreadful name of Yog-Sothoth in the midst of a circle of stones with a great book open in his arms before him.

Dogs abhorred the boy, and he was always obliged to take various defensive measures against their barking menace. Meanwhile Old Whateley continued to buy cattle without measurably increasing the size of his herd.

He also cut timber and began to repair the unused parts of his house—a spacious, peaked-roofed affair whose rear end was buried entirely in the rocky hillside, and whose three least-ruined groundfloor rooms had always been sufficient for himself and his daughter.

There must have been prodigious reserves of strength in the old man to enable him to accomplish so much hard labour; and though he still babbled dementedly at times, his carpentry seemed to shew the effects of sound calculation.

It had already begun as soon as Wilbur was born, when one of the many tool-sheds had been put suddenly in order, clapboarded, and fitted with a stout fresh lock.

Now, in restoring the abandoned upper story of the house, he was a no less thorough craftsman. His mania shewed itself only in his tight boardingup of all the windows in the reclaimed section—though many declared that it was a crazy thing to bother with the reclamation at all. Less inexplicable was his fitting up of another downstairs room for his new grandson—a room which several callers saw, though no one was ever admitted to the closely boarded upper story. This chamber he lined with tall, firm shelving; along which he began gradually to arrange, in apparently careful order, all the rotting ancient books and parts of books which during his own day had been heaped promiscuously in odd corners of the various rooms.

He had grown as large as a child of four, and was a fluent and incredibly intelligent talker. He ran freely about the fields and hills, and accompanied his mother on all her wanderings. By this time the restoration of the house was finished, and those who watched it wondered why one of the upper windows had been made into a solid plank door.

It was a window in the rear of the east gable end, close against the hill; and no one could imagine why a cleated wooden runway was built up to it from the ground. The door swung listlessly open, and when Earl Sawyer once stepped within after a cattle-selling call on Old Whateley he was quite discomposed by the singular odour he encountered—such a stench, he averred, as he had never before smelt in all his life except near the Indian circles on the hills, and which could not come from anything sane or of this earth.

But then, the homes and sheds of Dunwich folk have never been remarkable for olfactory immaculateness. The following months were void of visible events, save that everyone swore to a slow but steady increase in the mysterious hill noises. Wilbur was growing up uncannily, so that he looked like a boy of ten as he entered his fourth year. He read 23 investigator handbook avidly by himself now; but talked much less than formerly.

A settled taciturnity was absorbing him, and for the first time people began to speak specifically of the dawning look of evil in his goatish face. He would sometimes mutter an unfamiliar jargon, and chant in bizarre rhythms which chilled the listener with a sense of unexplainable terror.

The aversion displayed toward him by dogs had now become a matter of wide remark, and he was obliged to carry a pistol in order to traverse the countryside in safety. His occasional use of the weapon did not enhance his popularity amongst the owners of canine guardians. The few callers at the house would often find Lavinia alone on the ground floor, while odd cries and footsteps resounded in the boarded-up second story.

She would never tell what her father and the boy were doing up there, though once she turned pale and displayed an abnormal degree of fear when a jocose fish-peddler tried the locked door leading to the stairway.

That peddler told the store loungers at Dunwich Village that he thought he heard a horse stamping on that floor above. The loungers reflected, thinking of the door and runway, and of the cattle that so swiftly disappeared. It had for some time been noticed that dogs had begun to hate and fear the whole Whateley place as violently as they hated and feared young Wilbur personally.

In the war came, and Squire Sawyer Whateley, as chairman of the local draft board, had hard work finding a quota of young Dunwich men fit even to be sent to a development camp. The government, alarmed at such signs of wholesale regional decadence, sent several officers and medical experts to investigate; conducting a survey which New England newspaper readers may still recall.

Wilbur was four and a half then, and looked like a lad of fifteen. His lips and cheeks were fuzzy with a coarse dark down, and his voice had begun to break. Earl Sawyer went out to the Whateley place with both sets of reporters and camera men, and called their attention to the queer stench which now seemed to trickle down from the sealed upper spaces. It was, he said, exactly like a smell he had found in the tool-shed abandoned when the house was finally repaired; and like the faint odours which he sometimes thought he caught near the stone circles on the mountains.

Dunwich folk read the stories when they appeared, and grinned over the obvious mistakes. They wondered, too, why the writers made so much of the fact 24 that Old Whateley always paid for his cattle in gold pieces of extremely ancient date. The Whateleys had received their visitors with ill-concealed distaste, though they did not dare court further publicity by a violent resistance or refusal to talk.

For a decade the annals of the Whateleys sink indistinguishably into the general life of a morbid community used to their queer ways and hardened to their May-Eve and All-Hallows orgies. Twice a year they would light fires on the top of Sentinel Hill, at which times the mountain rumblings would recur with greater and greater violence; while at all seasons there were strange and portentous doings at the lonely farmhouse.

In the course of time callers professed to hear sounds in the sealed upper story even when all the family were downstairs, and they wondered how swiftly or how lingeringly a cow or bullock was usually sacrificed. About , when Wilbur was a boy of ten whose mind, voice, stature, and bearded face gave all the impressions of maturity, a second great siege of carpentry went on at the old house.

It was all inside the sealed upper part, and from bits of discarded lumber people concluded that the youth and his grandfather had knocked out all the partitions and even removed the attic floor, leaving only one vast open void between the ground story and the peaked roof. They had torn down the great central chimney, too, and fitted the rusty range with a flimsy outside tin stovepipe.

In the spring after this event Old Whateley noticed the growing number of whippoorwills that would come out of Cold Spring Glen to chirp under his window at night. He found Old Whateley in a very grave state, with a cardiac action and stertorous breathing that told of an end not far off. The shapeless albino daughter and oddly bearded grandson stood by the bedside, whilst from the vacant abyss overhead there came a disquieting suggestion of rhythmical surging or lapping, as of the waves on some level beach.

The doctor, though, was chiefly disturbed by the chattering night birds outside; a seemingly limitless legion of whippoorwills that cried their endless chapter 2: the dunwich horror message in repetitions timed diabolically to the wheezing gasps of the dying man. It was uncanny and unnatural—too much, thought Dr. Houghton, like the whole of the region he had entered so reluctantly in response to the urgent call.

After a pause, during which the flock of whippoorwills outside adjusted their cries to the altered tempo while some indications of the strange hill noises came from afar off, he added another sentence or two. Only them, the old uns as wants to come back. It was the same for more than an hour, when the final throaty rattle came.

Houghton drew shrunken lids over the glazing grey eyes as the tumult of birds faded imperceptibly to silence. Lavinia sobbed, but Wilbur only chuckled whilst the hill noises rumbled faintly. Wilbur was by this time a scholar of really tremendous erudition in his one-sided way, and was quietly known by correspondence to many librarians in distant places where rare and forbidden books of old days are kept.

He was now tremendously mature of aspect, and his height, having reached the normal adult limit, seemed inclined to wax beyond that figure. In , when a scholarly correspondent from Miskatonic University called upon him one day and departed pale and puzzled, he was fully six and three-quarters feet tall.

Through all the years Wilbur had treated his halfdeformed albino mother with a growing contempt, finally forbidding her to go to the hills with him on May-Eve and Hallowmass; and in the poor creature complained to Mamie Bishop of being afraid of him.

After midnight their shrill notes burst into a kind of pandaemoniac cachinnation which filled all the countryside, and not until dawn did they finally quiet down. Then they vanished, hurrying southward where they were fully a month overdue. What this meant, no one could quite be certain till later. None of the country folk seemed to have died—but poor Lavinia Whateley, the twisted albino, was never seen again. In the summer of Wilbur repaired two sheds in the farmyard and began moving his books and effects out to them.

Wilbur was closing all the doors and windows on the ground floor, and seemed to be taking out partitions as he and his grandfather had done upstairs four years before. He was living in one of the sheds, and Sawyer thought he seemed unusually worried and tremulous. His height had increased to more than seven feet, and shewed no signs of ceasing its development. He had never seen a city before, but had no thought save to find his way to the university grounds; where, indeed, he passed heedlessly by the great white-fanged watchdog that barked with unnatural fury and enmity, and tugged frantically at its stout chain.

Wilbur had with him the priceless but imperfect copy of Dr. This much he could not civilly refrain from telling the librarian—the same erudite Henry Armitage A. Miskatonic, Ph.

Princeton, Litt. Johns Hopkins who had once called at the farm, and who now politely plied him with questions. He was looking, he had to admit, for a kind of formula or incantation containing the frightful name Yog-Sothoth, and it puzzled him to find discrepancies, duplications, and ambiguities which made the matter of determination far from easy.

As he copied the formula he finally chose, Dr. Armitage looked involuntarily over his shoulder at the open pages; the left-hand one of which, in the Latin version, contained such monstrous threats to the peace and sanity of the world. Not in the spaces we know, but between them, They walk serene and primal, undimensioned and to us unseen. YogSothoth knows the gate.

Yog-Sothoth is the gate. Yog-Sothoth is the key and guardian of the gate. Past, present, future, all are one in Yog-Sothoth. He knows where the Old Ones broke through of old, and where They shall break through again. They walk unseen and foul in lonely places where the Words have been spoken and the Rites howled through at their Seasons. The wind gibbers with Their voices, and the earth mutters with Their consciousness.

They bend the forest and crush the city, yet may not forest or city behold the hand that smites. Kadath in the cold waste hath known Them, and what man knows Kadath? The ice desert of the South and the sunken isles of Ocean hold stones whereon Their seal is engraven, but who hath seen the deep frozen city or the sealed tower long garlanded with seaweed and barnacles? Great Cthulhu is Their cousin, yet can he spy Them only dimly. As a foulness shall ye know Them.

Their hand is at your throats, yet ye see Them not; and Their habitation is even one with your guarded threshold. Yog-Sothoth is the key to the gate, whereby the spheres meet. Man rules now where They ruled once; They shall soon rule where man rules now. After summer is winter, and after winter summer.

They wait patient and potent, for here shall They reign again. The bent, goatish giant before him seemed like the spawn of another planet or dimension; like something only partly of mankind, and linked to black gulfs of essence and entity that stretch like titan phantasms beyond all spheres of force and matter, space and time.

Armitage, halfready to tell him he might make a copy of what parts he needed, thought suddenly of the possible consequences and checked himself. There was too much responsiblity in giving such a being the key to such blasphemous outer spheres. Whateley saw how things stood, and tried to answer lightly. He thought of the wild tales he had heard, and recalled the old Sunday stories in the Advertiser; these things, and the lore he had picked up from Dunwich rustics and villagers during his one visit there.

Of this he had long felt certain. Now he seemed to sense the close presence of some terrible part of the intruding horror, and to glimpse a hellish advance in the black dominion of the ancient and once passive nightmare. He locked away the Necronomicon with a shudder of disgust, but the room still reeked with an unholy and unidentifiable stench. Yes—the odour was the same as that which had sickened him at the Whateley farmhouse less than three years before.

He thought of Wilbur, goatish and ominous, once again, and laughed mockingly at the village rumours of his parentage. Born on Candlemas—nine months after May-Eve of , when the talk about the queer earth noises reached clear to Arkham— What walked on the mountains that MayNight? What Roodmas horror fastened itself on the world in half-human flesh and blood? Armitage set about to collect all possible data on Wilbur Whateley and the formless presences around Dunwich. He got in communication with Dr.

A visit to Dunwich Village failed to bring out much that was new; but a close survey of the Necronomicon, in those parts which Wilbur had sought so avidly, seemed to supply new and terrible clues to the nature, methods, and desires of the strange evil so vaguely threatening this planet. Talks with several students of archaic lore in Boston, and letters to many others elsewhere, gave him a growing amazement which passed slowly through varied degrees of alarm to a state of really acute spiritual fear.

As the summer drew on he felt dimly that something ought to be done about the lurking terrors of the upper Miskatonic valley, and about the monstrous being known to the human world as Wilbur Whateley. The Dunwich horror itself came between Lammas and the equinox in , and Dr. Armitage was among those who witnessed its monstrous prologue. Those efforts had been in vain, since Armitage had issued warnings of the keenest intensity to all librarians having charge of the dreaded volume.

Wilbur had been shockingly nervous at Cambridge; anxious for the book, yet almost equally anxious to get home again, as if he feared the results of being away long. Early in August the half-expected outcome developed, and in the small hours of the 3d Dr.

Armitage was awakened suddenly by the wild, fierce cries of the savage watchdog on the college campus. Deep and terrible, the snarling, half-mad growls and barks continued; always in mounting volume, but with hideously significant pauses.

Then there rang out a scream from a wholly different throat—such a scream as roused half the sleepers of Arkham and haunted their dreams ever afterward—such a scream as could come from no being born of earth, or wholly of earth. Armitage, hastening into some clothing and rushing across the street and lawn to the college buildings, saw that others were ahead of him; and heard the echoes of a burglaralarm still shrilling from the library.

An open window shewed black and gaping in the moonlight. What had come had indeed completed its entrance; for the barking and the screaming, now fast fading into a mixed low growling and moaning, proceeded unmistakably from within.

Some instinct warned Armitage that what was taking place was not a thing for unfortified eyes to see, so he brushed back the crowd with authority as he unlocked the vestibule door. Among the others he saw Professor Warren Rice and Dr. Francis Morgan, men to whom he had told some of his conjectures and misgivings; and these two he motioned to accompany him inside. The inward sounds, except for a watchful, droning whine from the dog, had by this time quite subsided; but Armitage now perceived with a sudden start that a loud chorus of whippoorwills among the shrubbery had commenced a damnably rhythmical piping, as if in unison with the last breaths of a dying man.

The building was full of a frightful stench which Dr. Armitage knew too well, and the three men rushed across the hall to the small genealogical reading-room whence the low whining came. For a second nobody dared to turn on the light, then Armitage summoned up his courage and snapped the switch.

One of the three—it is not certain which—shrieked aloud at what sprawled before them among disordered tables and overturned chairs. Professor Rice declares that he wholly lost consciousness for an instant, though he did not stumble or fall. The thing that lay half-bent on its side in a foetid pool of greenish-yellow ichor and tarry stickiness was almost nine feet tall, and the dog had torn off all the clothing and some of the skin.

It was not quite dead, but twitched silently and spasmodically while its chest heaved in monstrous unison with the mad piping of the expectant whippoorwills outside. Bits of shoe-leather and fragments of apparel were scattered about the room, and just inside the window an empty canvas sack lay where it had evidently been thrown. The thing itself, however, crowded out all other images at the time.

It would be trite and not wholly accurate to say that no human pen could describe it, but one may properly say that it could not be vividly visualised by anyone whose ideas of aspect and contour are too closely bound up with the common life-forms of this planet and of the three known dimensions.

It was partly human, beyond a doubt, with very man-like hands and head, and the goatish, chinless face had the stamp of the Whateleys upon it. But the torso and lower parts of the body were teratologically fabulous, so that only generous clothing could ever have enabled it to walk on earth unchallenged or uneradicated. The back was piebald with yellow and black, and dimly suggested the squamous covering of certain snakes.

Below the waist, though, it was the worst; for here all human resemblance left off and sheer phantasy began. The skin was thickly covered with coarse black fur, and from the abdomen a score of long greenish-grey tentacles with red sucking mouths protruded limply. Their arrangement was odd, and seemed to follow the symmetries of some cosmic geometry unknown to earth or the solar system. On each of the hips, deep set in a kind of pinkish, ciliated orbit, was what seemed to be a rudimentary eye; whilst in lieu of a tail there depended a kind of trunk or feeler with purple annular markings, and with many evidences of being an undeveloped mouth or throat.

When the thing breathed, its tail and tentacles rhythmically changed colour, as if from some circulatory cause normal to the non-human side of its ancestry.

In the tentacles this was observable as a deepening of the greenish tinge, whilst in the tail it was manifest as a yellowish appearance which alternated with a sickly greyish-white in the spaces between the purple rings. Of genuine blood there was none; only the foetid greenish-yellow ichor which trickled along the painted floor beyond the radius of the stickiness, and left a curious discolouration behind it. As the presence of the three men seemed to rouse the dying thing, it began to mumble without turning or raising its head.

Armitage made no written record of its mouthings, but asserts confidently that nothing in English was uttered. At first the syllables defied all correlation with any speech of earth, but toward the last there came some disjointed fragments evidently taken from the Necronomicon, that monstrous blasphemy in quest of which the thing had perished. A change came over the yellow, goatish face of the prostrate thing, and the great black eyes fell in appallingly.

Outside the window the shrilling of the whippoorwills had suddenly ceased, and above the murmurs of the gathering crowd there came the sound of a panic-struck whirring and fluttering. Against the moon vast clouds of feathery watchers rose and raced from sight, frantic at that which they had sought for prey.

All at once the dog started up abruptly, gave a frightened bark, and leaped nervously out of the window by which it had entered. A cry rose from the crowd, and Dr. Armitage shouted to the men outside that no one must be admitted till the police or medical examiner came. He was thankful that the windows were just too high to permit of peering in, and drew the dark curtains carefully down over each one.

By this time two policemen had arrived; and Dr. Morgan, meeting them in the vestibule, was urging them for their own sakes to postpone entrance to the stench-filled reading-room till the examiner came and the prostrate thing could be covered up.

Meanwhile frightful changes were taking place on the floor. One need not describe the kind and rate of shrinkage and disintegration that occurred before the eyes of Dr. Armitage and Professor Rice; but it is permissible to say that, aside from the external appearance of face and hands, the really human element in Wilbur Whateley must have been very small.

When the medical examiner came, there was only a sticky whitish mass on the painted boards, and the monstrous odour had nearly disappeared. Apparently Whateley had had no skull or bony skeleton; at least, in any true or stable sense. He had taken somewhat after his unknown father. Yet all this was only the prologue of the actual Dunwich horror. Formalities were gone through by bewildered officials, abnormal details were duly kept from press and public, and men were sent to Dunwich and Aylesbury to look up property and notify any who might be heirs of the late Wilbur Whateley.

They filed a ponderous report at the court-house in Aylesbury, and litigations concerning heirship are said to be still in progress amongst the innumerable Whateleys, decayed and undecayed, of the upper Miskatonic valley. No trace of the ancient gold with which Wilbur and Old Whateley always paid their debts has yet been discovered. It was in the dark of September 9th that the horror broke loose.

The hill noises had been very pronounced during the evening, and dogs barked frantically all night. Early risers on the 10th noticed a peculiar stench in the air. He was almost convulsed with fright as he stumbled into the kitchen; and in the yard outside the no less frightened herd were pawing and lowing pitifully, having followed the boy back in the panic they shared with him.

Between gasps Luther tried to stammer out his tale to Mrs. Corey, unable to extract more information, began telephoning the neighbours; thus starting on its rounds the overture of panic that heralded the major terrors. They would do that. Whatever had burst loose upon the world had assuredly gone down into the great sinister ravine; for all the trees on the banks were bent and broken, and a great avenue had been gouged in the precipice-hanging underbrush. It was as though a house, launched by an avalanche, had slid down through the tangled growths of the almost vertical slope.

From below no sound came, but only a distant, undefinable foetor; and it is not to be wondered at that the men preferred to stay on the edge and argue, rather than descend and beard the unknown Cyclopean horror in its lair.

Three dogs that were with the party had barked furiously at chapter 2: the dunwich horror first, but seemed cowed and reluctant when near the glen. Someone telephoned the news to the Aylesbury Transcript; but the editor, accustomed to wild tales from Dunwich, did no more than concoct a humorous paragraph about it; an item soon afterward reproduced by the Associated Press. That night everyone went home, and every house and barn was barricaded as stoutly as possible.

Needless to say, no cattle were allowed to remain in open pasturage. Frye proposed telephoning the neighbours, and Elmer was about to agree when the noise of splintering wood burst in upon their deliberations.

It came, apparently, from the barn; and was quickly followed by a hideous screaming and stamping amongst the cattle. The dogs slavered and crouched close to the feet of the fear-numbed family. Frye lit a lantern through force of habit, but knew it would be death to go out into that black farmyard. The children and the womenfolk whimpered, kept from screaming by some obscure, vestigial instinct of defence which told them their lives depended on silence.

At last the noise of the cattle subsided to a pitiful moaning, and a great snapping, crashing, and crackling ensued. The Fryes, huddled together in the sitting-room, did not dare to move until the last echoes died away far down in Cold Spring Glen. Then, amidst the dismal moans from the stable and the daemoniac piping of late whippoorwills in the glen, Selina Frye tottered to the telephone and spread what news she could of the second phase of the horror.

The next day all the countryside was in a panic; and cowed, uncommunicative groups came and went where the fiendish thing had occurred. Two titan swaths of destruction stretched from the glen to the Frye farmyard, monstrous prints covered the bare patches of ground, and one side of the old red barn had completely caved in. Of the cattle, only a quarter could be found and identified. Some of these were in curious fragments, and all that survived had to be shot.

Earl Sawyer suggested that help be asked from Aylesbury or Arkham, but others maintained it would be of no use. Old Zebulon Whateley, of a branch that hovered about half way between soundness and decadence, made darkly wild suggestions about rites that ought to be practiced on the hill-tops.

He came of a line where tradition ran strong, and his memories of chantings in the great stone circles were not altogether connected with Wilbur and his grandfather. Darkness fell upon a stricken countryside too passive to organise for real defence. In a few cases closely related families would band together and watch in the gloom under one roof; but in general there was only a repetition of the barricading of the night before, and a futile, ineffective gesture of loading muskets and setting pitchforks handily about.

Nothing, however, occurred except some hill noises; and when the day came there were many who hoped that the new horror had gone as swiftly as it had come. There were even bold souls who proposed an offensive expedition down in the glen, though they did not venture to set an actual example to the still reluctant majority. When night came again the barricading was repeated, though there was less huddling together of families. In the morning both the Frye and the Seth Bishop households reported excitement among the dogs and vague sounds and stenches from afar, while early explorers noted with horror a fresh set of the monstrous tracks in the road skirting Sentinel Hill.

As before, the sides of the road shewed a bruising indicative of the blasphemously stupendous bulk of the horror; whilst the conformation of the tracks seemed to argue a passage in two directions, as if the moving mountain had come from Cold Spring Glen and returned to it along the same path. At the base of the hill a thirty-foot swath of crushed shrubbery saplings led steeply upward, and the seekers gasped when they saw that even the most perpendicular places did not deflect the inexorable trail.

It was here that the Whateleys used to build their hellish fires and chant their hellish rituals by the table-like stone on May-Eve and Hallowmass. Now that very stone formed the centre of a vast space thrashed around by the mountainous horror, whilst upon its slightly concave surface was a thick and foetid deposit of the same tarry stickiness observed on the floor of the ruined Whateley farmhouse when the horror escaped.

Men looked at one another and muttered. Then they looked down the hill. Apparently the horror had descended by a route much the same as that of its ascent. To speculate was futile. Reason, logic, and normal ideas of motivation stood confounded. Only old Zebulon, who was not with the group, could have done justice to the situation or suggested a plausible explanation. Thursday night began much like the others, but it ended less happily. The whippoorwills in the glen had screamed with such unusual persistence that many could not sleep, and about 3 a.

There was nothing more. No one dared do anything, and no one knew till morning whence the call came. Then those who had heard 31 investigator handbook it called everyone on the line, and found that only the Fryes did not reply.

The truth appeared an hour later, when a hastily assembled group of armed men trudged out to the Frye place at the head of the glen. It was horrible, yet hardly a surprise. There were more swaths and monstrous prints, but there was no longer any house.

It had caved in like an egg-shell, and amongst the ruins nothing living or dead could be discovered. Only a stench and a tarry stickiness. The Elmer Fryes had been erased from Dunwich. In the meantime a quieter yet even more spiritually poignant phase of the horror had been blackly unwinding itself behind the closed door of a shelf-lined room in Arkham.

The curious manuscript record or diary of Wilbur Whateley, delivered to Miskatonic University for translation, had caused much worry and bafflement among the experts in languages both ancient and modern; its very alphabet, notwithstanding a general resemblance to the heavily shaded Arabic used in Mesopotamia, being absolutely unknown to any available authority.

The final conclusion of the linguists was that the text represented an artificial alphabet, giving the effect of a cipher; though none of the usual methods of cryptographic solution seemed to furnish any clue, even when applied on the basis of every tongue the writer might conceivably have used.

One of them, a heavy tome with an iron clasp, was in another unknown alphabet—this one of a very different cast, and resembling Sanscrit more than anything else. The old ledger was at length given wholly into the charge of Dr. Armitage, both because of his peculiar interest in the Whateley matter, and because of his wide linguistic learning and skill in the mystical formulae of antiquity and the Middle Ages. That question, however, he did not deem vital; since it would be unnecessary to know the origin of the symbols if, as he suspected, they were used as a cipher in a modern language.

It was his belief that, considering the great amount of text involved, the writer would scarcely have wished the trouble of using another speech than his own, save perhaps in certain special formulae and incantations. Accordingly he attacked the manuscript with the preliminary assumption that the bulk of it was in English.

Armitage knew, from the repeated failures of his colleagues, that the riddle was a deep and complex one; and that no simple mode of solution could merit even a trial.

He interspersed his study of the books with attacks on the manuscript itself, and in time became convinced that he had to deal with one of those subtlest and most ingenious of cryptograms, in which many separate lists of corresponding letters are arranged like the multiplication table, and the message built up with arbitrary key-words known only to the initiated. The older authorities seemed rather more helpful than the newer ones, and Armitage concluded that the code of the manuscript was one of great antiquity, no doubt handed down through a long line of mystical experimenters.

Several times he seemed near daylight, only to be set back by some unforeseen obstacle. Then, as September approached, the clouds began to clear. Certain letters, as used in certain parts of the manuscript, emerged definitely and unmistakably; and it became obvious that the text was indeed in English. On the evening of September 2nd the last major barrier gave way, and Dr.

It was in truth a diary, as all had thought; and it was couched in a style clearly shewing the mixed occult erudition and general illiteracy of the strange being who wrote it. Almost the first long passage that Armitage deciphered, an entry dated November 26, , proved highly startling and disquieting. It was written, he remembered, by a child of three and a half who looked like a lad of twelve or thirteen.

That upstairs more ahead of me than I had thought it would be, and is not like to have much earth brain. Grandfather kept me saying the Dho formula last night, and I think I chapter 2: the dunwich horror saw the inner city at the 2 magnetic poles. They from the air told me at Sabbat that it will be years before I can clear off the earth, and I guess grandfather will be dead then, so I shall have to learn all the angles of the planes and all the formulas between the Yr and the Nhhngr.

They from outside will help, but they cannot take body without human blood. That upstairs looks it will have the right cast. I can see it a little when I make the Voorish sign or blow the powder of Ibn Ghazi at it, and it is near like them at May-Eve on the Hill. The other face may wear off some. I wonder how I shall look when the earth is cleared and there are no earth beings on it. He that came with the Aklo Sabaoth said I may be transfigured, there being much of outside to work on.

Armitage in a cold sweat of terror and a frenzy of wakeful concentration. He had not left the manuscript all night, but sat at his table under the electric light turning page after page with shaking hands as fast as he could decipher the cryptic text.

He had nervously telephoned his wife he would not be home, and when she brought him a breakfast from the house he could scarcely dispose of a mouthful. All that day he read on, now and then halted maddeningly as a reapplication of the complex key became necessary.

Lunch and dinner were brought him, but he ate only the smallest fraction of either. On the morning of September 4th Professor Rice and Dr. Morgan insisted on seeing him for a while, and departed trembling and ashen-grey. That evening he went to bed, but slept only fitfully. Wednesday—the next day—he was back at the manuscript, and began to take copious notes both from the current sections and from those he had already deciphered.

In the small hours of that night he slept a little in an easy-chair in his office, but was at the manuscript again before dawn. Some time before noon his physician, Dr. Hartwell, called to see him and insisted that he cease work. He refused; intimating that it was of the most vital importance for him to complete the reading of the diary, and promising an explanation in due course of time. That evening, just as twilight fell, he finished his terrible perusal and sank back exhausted.

His wife, bringing his dinner, found him in a half-comatose state; but he was conscious enough to warn her off with a sharp cry when he saw her eyes wander toward the notes he had taken. Weakly rising, he gathered up the scribbled papers and sealed them all in a great envelope, which he immediately placed in his inside coat pocket.

He had sufficient strength to get home, but was so clearly in need of medical aid that Dr. Hartwell was summoned at once. Armitage slept, but was partly delirious the next day.

He made no explanations to Hartwell, but in his calmer moments spoke of the imperative need of a long conference with Rice and Morgan. His wilder wanderings were very startling indeed, including frantic appeals that something in a boarded-up farmhouse be destroyed, and fantastic references to some plan for the extirpation of the entire human race and all animal and vegetable life from the earth by some terrible elder race of beings from another dimension.

He would shout that the world was in danger, since the Elder Things wished to strip it and drag it away from the solar system and cosmos of matter into some other plane or phase of entity from which it had once fallen, vigintillions of aeons ago. At other times he would call for the dreaded Necronomicon and the Daemonolatreia of Remigius, in which he seemed hopeful of finding some formula to check the peril he conjured up.