Agranulocytosis during treatment with pacatal.

ansemia, was caused by the barbiturates she was taking. Both amylobarbitone sodium and quinalbarbitone sodium, the constituents of tuinal, are closely related chemically to primidone, sodium phenytoin, and phenobarbitone, but a megaloblastic anaemia has not previously been described in association --ith their use. The doses that this patient was taking (gr. 18-20 for 6-8 months) were, however, in excess of the usual doses given. In view of the accumulating evidence that barbiturates interfere with the metabolism of folic acid, it appears desirable that the signs of early folic-acid deficiency should be sought in all patients who receive large doses of barbiturates for any length of time.