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June 2017

The Old Bromides and Their 21st Century Refreshment

Author Affiliations
  • 1Department of Dermatology, University of Virginia, Charlottesville
  • 2University of Virginia School of Medicine, Charlottesville
JAMA Dermatol. 2017;153(6):564. doi:10.1001/jamadermatol.2017.1319

Bromine is a member of the halogen family of elements. As a group, halogens are highly reactive, and their volatility makes them both toxic and potentially useful in certain medical applications. For example, a bromine containing medication known as brimonidine (Mirvaso) was recently approved for the treatment of rosacea. However, the medical relevance of this element dates back over a century.

During the American Civil War (1861-1865), US Army surgeons experimented with bromine vapors and topical drugs for the treatment of erysipelas and “hospital gangrene” (necrotizing fasciitis). Bromides, or bromine salts, were also used in the past as sedative hypnotics. This practice quite aptly spawned the slang term “bromide” referring to a boring, tedious person or an overused, hackneyed expression, as in “that old bromide.” The most famous of the bromides was Bromo Seltzer. Introduced in the late 19th century as an instant cure for headaches, it became widely popular, based in part on brilliant marketing. Its sleek blue bottle and distinct fizzing noise on adding the pill to water gave Bromo Seltzer a bold sound to match the claims of its advertisement campaign. The salesmen of this drug maintained its success despite several reported toxic effects, including a pustular skin eruption caused by one of its main ingredients, sodium bromide.1

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