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Over 47 years ago, when the author graduated from medical school, the only therapies for COPD were antibiotics for pneumonia, potassium iodide used as a mucus thinner, and combination products containing ephedrine, a small amount of theophylline, and a minor amount of sedative to deal with the side effects of ephedrine. Inhaled isoproterenol began to be used in the early 1960s. In that era, oxygen was considered contraindicated, and exercise was prohibited for fear of straining the right heart. Corticosteroids were almost never used, even in cases of exacerbations of COPD. One paper in the early 1960s by Noehren, offered new hope that at least some treatments might be beneficial in emphysema. Both medical and surgical approaches to therapy were described (Noehren 1962).

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