Present Status of Aerosol Therapy of the Lungs and Bronchi*

Abstract: *This investigation was aided in part by grants from the Josiah Macy. Jr. Foundation New York The Ashtma Research Foundation Boston and the Foundation for Research in Pulmonary Disease New York The writer is indebted to Schenley Laboratories for supplies of penicillin and to Hynson Westcott & Dunning for the phenosulphonphthalein used in the lung function tests and Van Patten Pharmaceutical Co. for sodium ascorbate. Much of the technical work was done by Mr. B. Sklarofsky. Summary 1. Penicillin aerosol therapy of the lungs was initiated and organized for the Technical Division Chemical Warfare Service by the writer in 1942 in collaboration with the Macy Foundation and other agencies. 2. The relationship of aerosols to general problems in the Chemical Warfare Service (Chemical Corps) is discussed. 3. Definitions of aerosol atomization nebulization vaporization and aerosolization are considered. The physical chemistry of aerosol stability is briefly outlined. 4. Large particle atomization and small particle nebulization are described in detail and their clinical applications indicated. 5. It is shown an the basis of the study of particle size distribution by radius and by weight that rebreathing is inefficient and not desirable. 6. Simple apparatus is described which is inexpensive and which can be used for all routine antibiotic aerosol therapy of the lungs. 7. The clinical application of aerosol therapy is considered from the point of view of the use of epinephrine penicillin streptomycin sulfonamide and hydrogen peroxide aerosols. Preliminary data are discussed an the use of antibiotic and hydrogen peroxide aerosols in the treatment of secondary infection in pulmonary tuberculosis. 8. The difficulties and importance of using hydrogen peroxide aerosols are stressed in connection with the presence of catalase in the sputum. 9. It is emphasized that in the presence of a suitable anticatalase hydrogen peroxide will become one of the most efficient antibiotic substance for pulmonary therapy. 10. Experiments with Vitamin C and Chlorophyll aerosols are mentioned. 11. An aerosol test for lung "function" using phenolsulfonphthalein aerosol is outlined. ___MH

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