***"While DCS is commonly thought of as a bubble disease, bubbles are probably only the gateway to a complex array of consequences and effects."*** DCS may develop when a diver's degree of supersaturation is so high (or, stated another way, if the elimination gradient is so steep) that a controlled transfer of inert gases from the body's tissues to the bloodstream — and then from the bloodstream to the lungs and the lungs to the environment — is not possible. If that removal process is inadequate, inert gases will come out of solution and form bubbles that can distort tissues, obstruct blood flow, cause mechanical damage (to the joints, for example) and/or trigger a cascade of biochemical responses. Although much is known about DCS, its mechanisms of insult are still being investigated. And while DCS is commonly thought of as a bubble disease, bubbles are probably only the gateway to a complex array of consequences and effects.