Aerosol therapy, using a hand-held inhaler, is now the mainstay of treatment for most obstructive airway diseases such as asthma and COPD.  The medications have improved since I have been in practice. I thought you might be interested in a little history about aerosol and inhaler therapy. The inhalation of medication for lung problems actually goes back about 4000 years.  In India, about 2000 BC, leaves of a plant called “Datura Stramonium” were made into a paste and smoked in a pipe.  The Egyptians inhaled the vapors of “Hyosycamus Muticus”.  The plant was placed on hot bricks and the vapors inhaled.  Both of these plants had so-called “anticholinergic” properties similar to today’s Atrovent or Spiriva. A Persian physician, Ibn Sinna, known in Europe as Avicenna, prescribed the inhalation of pine and eucalyptus oils for respiratory diseases.

The term “inhaler” was first used by an English physician, John Mudge and the term “aerosol” was first used around 1920. The first rudimentary attempts at aerosol therapy have a common belief in therapy, which we carry on in medicine today: the slow and deep inhalation of small drug particles can help treat certain lung problems.  The smaller the particles the better the results of therapy will be. There is significant science and engineering associated with modern inhaler therapy.  While many of the medications are equivalent in effect, the device used is an important part of the prescription.  Insurance companies should realize that one size does not fit all.