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August 6, 1938


JAMA. 1938;111(6):557. doi:10.1001/jama.1938.02790320069031

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To the Editor:—  In a communication to The Journal July 2, Dr. J. L. Henderson criticizes the article by Dr. D. M. Olkon on "Chronic Subdural Hematoma with Acute Psychotic Manifestations" (The Journal, May 14, p. 1664). Dr. Henderson believes that some of the symptoms in Dr. Olkon's patient may have been due to a bromide delirium resulting from excessive self medication with "Bromo-Seltzer."Dr. Henderson falls into a common error in assuming that "Bromo-Seltzer" contains enough bromide to produce intoxication. The toxic factor in "Bromo-Seltzer" is not bromide but acetanilid (McEllroy, W. S.: Methemoglobinemia Due to Bromo-Seltzer Poisoning, The Journal, Dec. 27, 1919, p. 1927). Acetanilid taken in large doses over a long period may produce psychotic manifestations and this and the possibility of blood changes are the main dangers of self medication with "Bromo-Seltzer." Because of the widespread use of "Bromo-Seltzer" the possibility of acetanilid poisoning should always

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