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Take a bromide.

What is common to Florence, Italy and Baltimore, MD? Not much, one would think. But if you walk along West Lombard Street in Baltimore and stop at the corner of South Eutaw and gaze up, you just might think you're in Florence looking at the tower of the Palazzo Vecchio. Except for one thing. The top of the Emerson tower in Baltimore is bathed in blue light! Why blue? Because that was the colour of the bottle that 'Bromo Seltzer' originally came in. The replica tower was commissioned by Isaac Emerson, the inventor of the famous product that began to cure Americans' headaches about a hundred years ago. It was originally adorned with a huge Bromo Seltzer bottle which had to be removed in 1936 for safety reasons and has now been replaced with a beautiful blue glow.

Emerson graduated with a degree in chemistry from the University of North Carolina and with financial backing from his new wife, opened three small drugstores in Baltimore. It was behind the counter of one of these that he developed his classic formula. The late 1800s were the halcyon days of the patent medicine era and numerous pain-relieving nostrums clamored for the public's attention. Emerson realized that if he were going to be successful, he needed something to distinguish his product from the others. The answer came thanks to his background in chemistry. Fizz! Sodium bicarbonate (baking soda) and citric acid when dissolved in water would combine to produce bubbles of carbon dioxide. That would certainly make his product different. But it wouldn't cure a headache. Acetanilide at the time was already a widely-sold pain reliever, so he decided to add it. Still, many competitors had this ingredient. He needed something else. Some suggest the idea came to him when he read about the eruption of Mt. Bromo, a volcano on the island of Java. Whether spurred by that, or just by his knowledge of chemistry, he decided to add some sodium bromide to the concoction as well. Emerson knew that bromides had sedative properties and could therefore be useful in the treatment of 'tension' headaches. Indeed, bromides had entered medical practice in 1857 when Charles Locock, a London physician, described how he had used potassium bromide to treat a patient with "hysterical epilepsy." He went on to say that he had even tried it "in cases of hysteria in young women, unaccompanied by epilepsy," finding it "of the greatest service." In Victorian times, "hysteria" was a common diagnosis in young women and was thought to be caused by some disturbance in the womb. (The term itself derives from the Greek "hysterikos" meaning "of the womb.") It didn't take long for potassium bromide to be established as a treatment for various nervous conditions.

Bromides actually do have sedative properties so their use was not nonsensical. Their mechanism of action is thought to be due to the close resemblance of the bromide ion to chloride. Chlorides are important in the functioning of nerve cells and chloride overload can cause over stimulation. Since bromides mitigate chloride activity, they can act to reduce seizures and to sedate. Until the advent of the barbiturates, potassium bromide was widely used and even gave rise to the expression "take a bromide" meaning "calm down."

So sodium bromide would be Emerson's other ingredient. But there was yet another component to be added to the Bromo Seltzer mixture, perhaps the most important one. Ingenious advertising. First, Emerson wanted his product to have a really unique look, so he packaged it in a glorious cobalt blue bottle. Then, he decided, it would be promoted as a medication that fights a headache in "three ways." As Americans were to learn, especially fans of The Adventures of Ellery Queen on radio, sponsored by Bromo Seltzer, there was more to a headache than just pain in the human head. Jumpy nerves and an upset stomach also played key roles in the misery. A "sick headache" was the result of this triple whammy! Bromo Seltzer had acetanilide for the pain, bicarbonate to relieve excess stomach acidity and sodium bromide to calm those jumpy nerves. And there was another benefit. Bromo Seltzer dissolved immediately in water so it was ready to go to work right away to relieve headache, soothe nerves and settle the stomach. The noisy fizz of course also helped convince the patient that this was a really active medication. Not everyone, though, liked the loud fizz. A waiter once offered a hung over W.C. Fields some Bromo Seltzer. "No-o-o-o," the comedian moaned, "I couldn't stand the noise."

Most people could stand the noise all right; it was the other ingredients that caused them problems. Like turning their skin blue! This mystery was solved by Bernard Brodie (a McGill graduate) and Julius Axelrod (a Nobel Prize winner in 1970) who discovered that acetanilide, the pain killer in Bromo seltzer, could cause methemoglobinemia, a condition in which hemoglobin loses its ability to bind oxygen. Since oxygenated blood is red and blood that lacks oxygen is bluish, people who suffer from methemoglobinemia develop a blue tinge. Brodie and Axelrod suggested that acetanilide be replaced in Bromo Seltzer by acetaminophen. The pain reliever we are now familiar with as the active ingredient in Tylenol[TM]. That was done and the blue problem vanished.

But there was another difficulty. Some customers who used Bromo Seltzer excessively exhibited symptoms of bromine toxicity, known as 'bromism'. Symptoms ranged from sluggishness and slurred speech to confusion and acne-like eruptions on the skin. This eventually led to the removal of sodium bromide from the product, leaving the modern version with just acetaminophen and fizz. Bromo Seltzer is no longer capable of causing bromism, but that doesn't mean the condition has disappeared. Recently a gentleman showed up at a medical centre in Cleveland, OH with postules on the hands that smacked of bromism. It took a while until the physicians could figure out what was going on. It seems the cause was the consumption of brominated vegetable oil which is a solvent used to dissolve flavours that are to be added to citrus beverages. The 'culprit" turned out to be Ruby Red Squirt[TM], a citrus flavoured pop. But normal people don't have to be concerned about bromism from this product. The gentleman in question was drinking, get this, eight liters of the stuff a day! And for those who try to use this account to highlight the dangers of food additives, I have one thing to say. Take a bromide.

Joe Schwarcz, MCIC, is the director of McGill University's Office for Science and Society. You can contact him at
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Title Annotation:Chemfusion
Author:Schwarcz, Joe
Publication:Canadian Chemical News
Date:Sep 1, 2003
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