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Myodil arachnoiditis

Iatrongenic and forensic illness

7 Oxgangs Rd, Edinburgh, UK, EH10 7GB

EXTRACT

All iatrongenic illness is fascinating. The threat of litigation apart, it engenders feelings of guilt, or of relief at near misses. When I was a neurological trainee in the 1950s and 1960s I served as the agent who injected Myodil (Pantopaque in North America:ethyliodophenyl-undecanoate), or air, into the lumber theca for the neuroradiologists, for subsequent screening of spine and head – myelography and air- encephalography. The air injections were instantly nasty, with headache, vomiting and sometimes loss of consciousness. The injection of Myodil, a viscous oil, was not painful if one was reasonably competent, but attempts to remove it after the screening could be very disagreeable, and were inevitably incomplete, and therefore not done in many centres.

Later, I myself must have referred some patients injudiciously for myelography, which became a lesser cause of future trouble after the advent of water-soluble media in the 1970s – unlike Myodil these were of course ...

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