Contrast Myelography Past and Present

Twenty-seven years ago it was my good fortune to begin a fellowship in radiology at the Mayo Foundation under Dr. Russell D. Carman. To be the first student of this great radiologist privileged to participate in this annual tribute to my former chief is an honor that I accept with great humility and appreciation. Former lecturers have portrayed better than I can hope to do Carman's contributions to radiology. A man is great because of many things, but those of us who worked with Carman were keenly aware that he was fundamentally great because of his uncanny powers of observation which he applied assiduously to his work in an effort to know the truth and impart it to others. Morning after morning, year in and year out, he spent in the operating room and pathologic laboratory, correlating the findings of the fluoroscopic screen and the roentgenogram. He was not satisfied to be right or wrong in a diagnosis, but he must know why. Many a morning when he returned from the hospital with the films of surgical cases under his arm he would put several on the view box and point out to the nearest fellow or associate the significant details of an interesting case. Common was the remark, “We were right but if we had only known the significance of that change we could have done better.” Such was the way that Carman loved to teach and to stimulate the observation of others. He disliked didactic teaching and the reading of papers. He keenly enjoyed the stimulation from the enthusiasm and fresh ideas of younger colleagues and students and was an ardent champion of the younger man. Whatever his contributions to this Society, and they were many, there is no doubt that Carman had a hand in fostering the welcome and encouragement that young radiologists find in our meetings and in our journal. The future of this Society and our great specialty rests on their shoulders. It is bright with opportunities, and through the constantly appearing trails and pathways for exploration they will carry Roentgen's searchlight of medicine to fulfillment of the ideals that Carman always cherished. *********** In the course of development of any method of investigation, it is often worth while to pause, critically review what has been achieved, and in that light contemplate the direction for the future. With that purpose in mind, I have selected the subject, “Contrast Myelography Past and Present,” for my lecture this evening. Thirty years ago (1919) Dr. Walter E. Dandy (1), in describing the use of air for the roentgenographic visualization of the ventricles of the brain, observed that the procedure outlined the spinal cord as well and predicted that the method would also be useful for the roentgenographic localization of tumors affecting the spinal cord. He thus laid the cornerstone for the development of a particular method of diagnosis that has contributed more than anything else to the progress of modern surgery of the spinal cord.