Editing Inhaler (section)

==History==
[[File:PenetroInhalador.JPG|thumb|upright|Penetro brand inhaler from mid 20th century Mexico, part of the permanent collection of the [[Museo del Objeto del Objeto]]]]
[[File:Mudge inhaler.jpg|thumb|upright|Inhaler designed by John Mudge in 1778]]
The idea of directly delivering medication into the lungs was based on ancient traditional cures that involved the use of aromatic and medicinal vapors. These did not involve any special devices beyond the apparatus used for burning or heating to produce fumes. Early inhalation devices included one devised by John Mudge in 1778. It had a pewter mug with a hole allowing attachment of a flexible tube. Mudge used it for the treatment of coughs using opium. These devices evolved with modifications by Wolfe, Mackenzie (1872) and better mouth attachments such as by Beigel in 1866. Many of these early inhalers needed heat to vaporize the active chemical ingredient. The benefits of forced expiration and inspiration to treat asthma were noted by J. S. Monell in 1865. Chemicals used in inhalers included ammonia, chlorine, iodine, tar, balsams, turpentine camphor and numerous others in combinations.<ref>{{cite book| title=Inhalation in the treatment of disease: its therapeutics and practice| author=Cohen, J. Solis| year=1876| publisher=Lindsay & Blakiston| place=Philadelphia|url=https://archive.org/stream/63720410R.nlm.nih.gov/63720410R}}</ref> [[Julius Mount Bleyer]] used a variation in 1890 in New York.<ref>{{cite journal|year=1890| title=A new method of larygeal and bronchial medication by means of a spray and tube during the act of deep inspiration. Read in the Section of Laryngology and Otology at the Forty-first Annual Meeting of the American Medical Association, Nashville, Tenn., May, 1890.|author=Bleyer, J. Mount| journal=Journal of the American Medical Association|volume=15|issue=18|pages=634–636|doi=10.1001/jama.1890.02410440006001a| url=https://zenodo.org/record/1447247}}</ref>

[[File:Beigel mouthpiece.jpg|thumb|left|upright|Mouthpiece for an inhaler designed by Dr Beigel (1867)]]
In 1968, Robert Wexler of [[Abbott Laboratories]] developed the Analgizer, a disposable inhaler that allowed the self-administration of [[methoxyflurane]] [[vapor]] in air for [[analgesia]].<ref name=Wexler1968/> The Analgizer consisted of a [[polyethylene]] cylinder 5&nbsp;inches long and 1&nbsp;inch in diameter with a 1&nbsp;inch long mouthpiece. The device contained a rolled [[Candle wick|wick]] of [[polypropylene]] [[felt]] which held 15&nbsp;[[Litre#SI prefixes applied to the litre|milliliters]] of methoxyflurane.

Because of the simplicity of the Analgizer and the [[Pharmacology|pharmacological]] characteristics of methoxyflurane, it was easy for patients to self-administer the drug and rapidly achieve a level of [[Procedural sedation and analgesia|conscious analgesia]] which could be maintained and adjusted as necessary over a period of time lasting from a few minutes to several hours. The 15&nbsp;milliliter supply of methoxyflurane would typically last for two to three hours, during which time the user would often be partly [[Amnesia|amnesic]] to the sense of pain; the device could be refilled if necessary.<ref name=Romagnoli1970/>

The Analgizer was found to be safe, effective, and simple to administer in [[Obstetrics|obstetric]] patients during childbirth, as well as for patients with [[bone fracture]]s and [[joint dislocation]]s,<ref name=Romagnoli1970/> and for dressing changes on [[burn]] patients.<ref name=Packer1969/> When used for labor analgesia, the Analgizer allows labor to progress normally and with no apparent [[adverse effect]] on [[Apgar score]]s.<ref name=Romagnoli1970/> All [[vital signs]] remain normal in obstetric patients, newborns, and injured patients.<ref name=Romagnoli1970/> The Analgizer was widely utilized for analgesia and [[sedation]] until the early 1970s, in a manner that foreshadowed the [[patient-controlled analgesia]] [[infusion pump]]s of today.<ref name=Major1966/><ref name=Dragon1967/><ref name=Firn1972/><ref name=Josephson1974/> The Analgizer inhaler was withdrawn in 1974, but use of methoxyflurane as a sedative and analgesic continues in Australia and New Zealand in the form of the [[Penthrox inhaler]].<ref name=Babl2007/><ref name=Grindlay2009/><ref name=Babl2006/><ref name=McLennan2007/><ref name=Penthrox2009/><ref name=RADAR2010/>