The word “asthma” comes from the Greek verb “aazein”, which means to breathe loudly. First used by the 5th century physician Hippocrates as a term for respiratory distress, asthma has been treated using a variety of methods and ingredients over the centuries.
According to an article published in the Journal of Aerosol Medicine and Pulmonary Drug Delivery, people have inhaled substances to treat asthma symptoms for at least 3,500 years, from smoking opium in ancient China to breathing in the fumes of burning herbs in ancient Greece. (1) The earliest known reference to this type of respiratory treatment dates back to an ancient Egyptian papyrus scroll. The papyrus describes people inhaling the vapor of black henbane or stinking nightshade. The plant was placed on hot bricks, then covered with a pot with a hole in it. People breathed in the steam through the hole using a reed stem.
It was not until the scientific and technological advances of the English industrial revolution that the first inhaler was invented. New manufacturing capabilities have spurred the creation of nebulizers, dry powder inhalers, and ceramic pot inhalers. The early 20th century also saw the commercialization of asthma cigarettes, ranging from stramonium to tea leaves.
The major breakthrough came in the 1950s when the metered dose inhaler (MDI) was invented. The first device to effectively deliver medication to the lungs, the MDI paved the way for future asthma technology, including breath-actuated MDIs, spacer devices, and dose meters.
During the 1960s, asthma was recognized as a chronic inflammatory disease. Prior to this point, many scientists considered it to be a psychological condition – a child’s wheeze was considered the suppressed cry for its mother. (2)
However, with new medical knowledge, effective drugs like albuterol (Proventil) became available at the end of the 20th century.
Today, as treatment continues to advance, there is a wide range of asthma inhalers and medications available. Now you can even buy inhaler sensors to electronically track your treatment.
Read on to find out how inhalers have evolved over the years.
The first inhaler was called the Mudge inhaler
English physician and astronomer John Mudge created the first inhaler in 1778.
Based on a pewter tankard, the inhaler allowed people to breathe in opium vapor to treat what was called a “catarrhal cough”, a cough with lots of mucus. To operate the inhaler, users poured water into the mug, closed the lid, and inhaled the vapor through a flexible tube inserted into an opening in the lid.
Thanks to the new manufacturing and technological capabilities brought by the English industrial revolution, this treatment device became popular in homes and hospitals. It was not only used to relieve the symptoms of asthma, but also to administer a surgical anesthetic. (3)
From portable nebulizers to dry powder inhalers
The 1800s saw the invention of the first portable nebulizer, named the “Pulverizer”. The pump handle forced a liquid solution through an atomizer to turn it into vapor. (4) This treatment was recommended for conditions such as pharyngitis, tuberculosis and asthma. (5)
Ceramic pot inhalers have also been invented for people to directly inhale the vapor of boiling plants or chemicals believed to relieve their symptoms.
Dry powder inhalers (DPIs), which deliver medication in powder form, also became popular around this time. A curious DPI was the carbolic smoke ball, which promised to cure asthma in 10 minutes. Users squeezed a rubber ball, forcing a powder through a sieve to turn it into an inhalable spray. (1)
13 year old girl inspired metered dose inhaler
The major breakthrough came in 1956, when George Maison, the president of Riker Laboratories, invented the metered-dose inhaler (MDI) using glass vials and valves designed for perfume bottles. (5)
It was Maison’s daughter who inspired this invention. Suffering from severe asthma and tired of her ineffective and unwieldy squeeze-bulb glass nebuliser, the 13-year-old asked her father why they couldn’t put her medicine in a spray can, like perfume. (1)
Prompted by her question, Maison created the first convenient wearable device that efficiently delivers medication to the lungs. This initiated the development of metered dose inhalers, today the most commonly used device to treat asthma.
Built-in spacers and breath-actuated technology
After the invention of the MDI, doctors noticed that for many people it was difficult to coordinate the movement of pressing the cartridge and inhaling. This resulted in the drugs remaining in the mouth.
Drugs were more likely to reach the lungs with a spacer device. This tube keeps the medicine released between the cartridge and the mouthpiece of the inhaler, so you can inhale at your own pace.
Until the first commercial spacer was developed in the 1970s, doctors and asthmatics experimented with empty toilet paper tubes, plastic cups and vinegar bottles. Fortunately, you can now buy MDIs with built-in spacers.
The 1970s also saw the development of breath-actuated MDIs for people with difficulty in synchronizing this movement. With this technology, it is enough to breathe normally to activate the release of the drug. (1)
Know when to refuel with dose counters
If you have asthma, monitoring your medication is essential to taking care of your health.
In order to help patients know when their inhaler has exceeded or is approaching the last available dose, GlaxoSmithKline Pharmaceuticals developed the first MDI with an integrated dose counter in 2004.
It is now recommended that all new metered dose inhalers be fitted with dose counters or dose indicators. The counters show the number of sprays remaining from the inhaler, while the indicators change color when the medicine runs out. This means you know exactly when you need to refuel, so you’re not caught off guard when your symptoms flare up.