VERONAL
Veronal, a synthetic compound, is a white crystalline powder about four times as powerful as sulphonal, very slightly soluble in water, more soluble in hot water, and in alkaline solutions, and absorption takes place from the intestine.
Symptoms.—In moderate doses it produces sleep without subsequent depression, and does not affect temperature or respiration. In larger doses it may cause erythema and constipation, with alternating semi-coma and delirium. During the last few years fatal cases of poisoning have become rather frequent.
Details of a fatal case by Dr. Durrant reported in Taylor, p. 616, are, briefly: A man aged thirty-three, a heavy drinker, to whom veronal had been prescribed, in fifteen-grain doses, with chloral hydrate and bromide of ammonium, had gradually increased the dose from 15 to 30 grains, or even 60 grains. Five weeks before death he had taken 100 grains, and had recovered in three days. Nine hours after taking 120 grains of veronal with 20 grains of chloral and 40 grains of ammonium bromide he was found deeply comatose, with surface warm, respirations 32, pulse 102, pupils dilated, corneæ insensitive, reflexes absent. Next day not so deeply comatose, he could be made to wince by slapping the face, the pupils were still dilated, temperature 102° F., pulse 110, reflexes still absent. Later he was still constipated, and the breathing impeded by mucus. On the third day he spoke when roused; the temperature, bowels, and pupils the same. With slight remission he became worse, and on the fourth day, in a comatose condition, with muscular flaccidity and absence of reflexes, temperature 104° F., respirations over 40, and the pulse 150, death took place. Post-mortem.—Nothing was found except intense congestion of the lungs, liver, spleen, and brain, due, no doubt, to the asphyxial form of death. The mucous membrane of the alimentary canal was congested, but otherwise normal.
Chemical Tests.—1. Heated dry with sodium carbonate, ammonia is evolved. If held in the mouth of the tube red litmus paper turns blue, turmeric paper brown.
2. A saturated solution acidified with nitric acid gives a white precipitate with Millon‘s reagent soluble in excess.
Treatment.—As for sulphonal.