"The Great Silk Road" and the First Description of Hypoxia.

The first written reports about the effect of high-altitude air on the human organism in Ancient China (the 30s BC) and in South America during the conquest (late XVI century) are discussed in this paper.

Early history of high-altitude physiology.

High-altitude physiology can be said to have begun in 1644 when Torricelli described the first mercury barometer and wrote the immortal words "We live submerged at the bottom of an ocean of the element air." Interestingly, the notion of atmospheric pressure had eluded his teacher, the great Galileo. Blaise Pascal was responsible for describing the fall in pressure with increasing altitude, and Otto von Guericke gave a dramatic demonstration of the enormous force that could be developed by atmospheric pressure. Robert Boyle learned of Guericke's experiment and, with Robert Hooke, constructed the first air pump that allowed small animals to be exposed to a low pressure. Hooke also constructed a small low-pressure chamber and exposed himself to a simulated altitude of about 2400 meters. With the advent of ballooning, humans were rapidly exposed to very low pressures, sometimes with tragic results. For example, the French balloon, Zénith, rose to over 8000 m, and two of the three aeronauts succumbed to the hypoxia. Paul Bert was the first person to clearly state that the deleterious effects of high altitude were caused by the low partial pressure of oxygen (PO2), and later research was accelerated by high-altitude stations and expeditions to high altitude.

Three journeys to high altitude: medicine, Tibetan thangkas, and Sepu Kangri.

This article begins by highlighting the work of several pioneers of altitude medicine, and their achievements in physiology and clinical observation. Tibetan medicine of the 17th century is then introduced, particularly the medical paintings (thangkas) and the conduct of traditional physicians. Finally, I mention recent British mountain exploration in central Tibet during 1996, 1997 and 1998 and the challenge of Sepu Kangri which, at 6,995m, is the highest peak of the eastern Nyangla Qen Tangla Shan.

The first documented report of mountain sickness: the China or Headache Mountain story.

This article gives the probable location within 65 km of the Big Headache Mountain where mountain sickness was first reported by Too Kin, a Chinese official, in 37-32 B.C. We believe that traveling over the western edge of the Himalayan Karakoram Range or in the Pamirs caused the major difficulties, probably when travelers crossed the Kilik Pass at an altitude of 4827 m or 15837 ft or within 60 km of this pass and at an altitude of at least 4500 m or 14750 ft. We theorize that the route Too Kin described is from Kashi, an important center in Sinkiang or Chinese Turkestan, to Kabul in Afghanistan. This particular route has two other altitude maxima; one at the Ulagh Rabat Pass in Sinkiang about 15 km west of the Muztagata peak where the elevation is 4250 m or 14000 ft, and the other at the Shandur Pass over the Hindu Kush in Pakistan where the elevation is 3734 m or 12250 ft.