- Email: [email protected]
Toothless with Evipan
Toothless with Evipan Marten van Wijhe PII: DOI: Reference:
S2352-4529(17)30172-X doi: 10.1016/j.janh.2017.10.008 JANH 152
To appear in:
Journal of Anesthesia History
Please cite this article as: , Toothless with Evipan, Journal of Anesthesia History (2017), doi: 10.1016/j.janh.2017.10.008
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT Toothless with Evipan Dr Marten van Wijhe
PT
[email protected]
For some years after World War II dental clinics in the Netherlands advertised in the daily
CR I
newspapers to have ones dentures fitted in one day under a general anesthetic. That anesthetic was hexobarbitone, known as Evipan, and the dental practices as “Evipan Institutions”. General practitioners administered the anesthetic, the patient sitting in the dental chair, the
US
airway unprotected. As many as 50 patients a day were relieved of all of their teeth and sent home with dentures. There were a number of fatalities, some practitioners were prosecuted,
MA N
the “Institutions”, which also underpaid their staff and were poor in informing the tax department of their exact income, were closed down, only to pop up again in a neighbouring town.
Investigation of the “Evipan” dental episode finds some shocking matters. From 1933 Evipan
ED
had been advocated in the medical literature as a new safe general anesthetic, with no need for the patient to be starved, and easy to administer by any medically qualified person. The
PT
“Evipan institute” in Rotterdam aggressively advertised in daily newspapers for “information meetings” at local hotels and halls. Patients were then collectively brought to the Rotterdam institute by bus. The first death was reported in 1950, the Dental Practitioners Society
CE
warning the year after against “teeth harvesting” practices. In 1952 the public prosecutor demanded a year in prison against a general practitioner who
AC
had administered a fatal dental anesthetic. The patient had died with a throat pack in place. Although medical writers in the newspapers warned the public not to attend the “Evipan” institutes, the Rotterdam Institute continued to draw patients, even from Belgium and France. Matters seemed to come to rest by 1960 after two more deaths. However, as late as in 1975 questions were asked in parliament regarding the death of a 27-year-old woman after a total dental extraction under Evipan. The 76 year-old GP who had done both the extractions and the anesthetic was fined 2,500 Guilders for unlawful administration of anesthesia. The story ended in 1984 when the institutes went bankrupt and the owner was arrested in Italy for tax evasion. The Evipan episode in the Netherlands illustrates what happens when unscrupulous professionals make use of the public's ignorance and anxieties for personal gain.
S2352-4529(17)30172-X doi: 10.1016/j.janh.2017.10.008 JANH 152
To appear in:
Journal of Anesthesia History
Please cite this article as: , Toothless with Evipan, Journal of Anesthesia History (2017), doi: 10.1016/j.janh.2017.10.008
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT Toothless with Evipan Dr Marten van Wijhe
PT
[email protected]
For some years after World War II dental clinics in the Netherlands advertised in the daily
CR I
newspapers to have ones dentures fitted in one day under a general anesthetic. That anesthetic was hexobarbitone, known as Evipan, and the dental practices as “Evipan Institutions”. General practitioners administered the anesthetic, the patient sitting in the dental chair, the
US
airway unprotected. As many as 50 patients a day were relieved of all of their teeth and sent home with dentures. There were a number of fatalities, some practitioners were prosecuted,
MA N
the “Institutions”, which also underpaid their staff and were poor in informing the tax department of their exact income, were closed down, only to pop up again in a neighbouring town.
Investigation of the “Evipan” dental episode finds some shocking matters. From 1933 Evipan
ED
had been advocated in the medical literature as a new safe general anesthetic, with no need for the patient to be starved, and easy to administer by any medically qualified person. The
PT
“Evipan institute” in Rotterdam aggressively advertised in daily newspapers for “information meetings” at local hotels and halls. Patients were then collectively brought to the Rotterdam institute by bus. The first death was reported in 1950, the Dental Practitioners Society
CE
warning the year after against “teeth harvesting” practices. In 1952 the public prosecutor demanded a year in prison against a general practitioner who
AC
had administered a fatal dental anesthetic. The patient had died with a throat pack in place. Although medical writers in the newspapers warned the public not to attend the “Evipan” institutes, the Rotterdam Institute continued to draw patients, even from Belgium and France. Matters seemed to come to rest by 1960 after two more deaths. However, as late as in 1975 questions were asked in parliament regarding the death of a 27-year-old woman after a total dental extraction under Evipan. The 76 year-old GP who had done both the extractions and the anesthetic was fined 2,500 Guilders for unlawful administration of anesthesia. The story ended in 1984 when the institutes went bankrupt and the owner was arrested in Italy for tax evasion. The Evipan episode in the Netherlands illustrates what happens when unscrupulous professionals make use of the public's ignorance and anxieties for personal gain.