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Inhalation OctOber 2022 25 established the laws of contract within advertising. 7 An industry that had made increasingly dubious claims for cure-all medications had to change. e Carbolic Smoke Ball Company regrouped as a lim- ited company and went on to promote its products with greater care. Mrs. Carlill lived for many years before eventually succumbing to influenza in 1942 at the age of 96 years. Further control was imposed through the 1906 FDA Act, which also helped to reduce the more outlandish and unsubstantiated claims of treatments. is led to a greater role for scientific proof. Drugs that represent the parent compounds of much of today's therapy were pioneered; cortical substance and adrenaline— parents of corticosteroids and beta-agonists—were developed, initially in liquid forms. e first recognized pharmaceutical dry powder for inhalation was introduced by Abbott Laboratories in the late 1940s for the delivery of two formulations: isoetharine bronchodilator and penicillin. ese were presented in "sifter" cartridges, resembling miniature salt cellars. e device, the Aerohalor™, was a clear plastic inhaler suitable for oral or nasal use, and com- prised a port for introducing a sifter cartridge and a steel ball that would move, on inhalation, to impact the sifter and cause some formulation to drop into the airflow (Figure 3). is was an ingenious device, patented by Mack Fields, 8 that helped to establish the need for gelatin capsules. Capsule inhalers rap- idly followed, often for delivery of antibiotic therapy via the nose or lung, for example the Upjohn powder inhaler for penicillin "dust therapy." 9 (in Vienna, Austria) and Ebert (in Berlin, Germany) reported using a feather quill; Lewin (in Berlin) a glass retort; Rauchfuss (in Berlin) a gum squeeze- ball; and omas (in Baltimore, US) a rotating grind wheel against which a material was rubbed as the sit- ting patient inhaled. Meanwhile, in London in 1864, and on behalf of John Jones of New York, Alfred Newton filed a pat- ent on a device that delivered finely divided potas- sium chlorate to the patient (Figure 2), who pressed their face against a box and cranked a handle, which caused feathers to brush the powder into a cloud that then passed through a mesh before being inhaled. 5 e choice of so-called medications in these earlier times was often based on their observable physico- chemical actions outside the body. Today, we under- stand potassium chlorate to be a lung irritant. Control was not far away. Famously, in 1889, Roe invented the carbolic smoke ball to deliver the hygienic properties of carbolic (phenol, pioneered by Joseph Lister for antiseptic surgery) as a lung medication for the treatment and prevention of influenza, which was periodically of epidemic status and responsible for much mortality. A squeeze-ball device delivered a powder formulation comprising largely carbolic acid. Advertising proudly claimed that it would prevent influenza and offered a large sum of money to anyone who used the smoke ball and subsequently developed the disease (a reward that the company had no intention of paying). 6 When a Mrs. Carlill used the product and developed influenza she claimed the prize, was denied, and the whole business ended in a landmark legal battle that Figure 2 Jones inhalation device of 1864 (see reference 5) Figure 3 Aerohalor™ device (Abbott)