The Shorter Oxford Dictionary defines ‘exacerbation’ as ‘an increase in the severity of a disease’—which does not imply reversibility or otherwise. However, we wonder how many chest physicians define exacerbation as ‘an acute and temporary deterioration in either symptoms or signs (and for the sophisticated, biomarkers)’ of asthma, chronic obstructive pulmonary disease (COPD) or whatever. We know that many of our patients do not understand the term; some confuse it with exasperations. The editorial by Mark FitzGerald1 (see page 365) proposes to discard this term in favour of the phrase ‘lung attack’. Is this mere sensationalism or trendy fiddling with what actually works well (as with the Church of England discarding the Book of Common Prayer in favour of …