The Botox Story (1)

At RejuvmeMD we routinely administer botox injections to temporarily smooth out the creases that form on the face as one gets older. Have you ever wondered how it works? Or why it is called botox? The answers to these questions illustrate the human capacity for observation, and our ability to “take lemons and make lemonade”.

From Killer to Cosmetic

The substance itself is a toxin called botulinum, and the bacterium that produces the toxin is named Clostridium botulinum. The “lemons” I mentioned result from the fact that, in large amounts, this toxin can cause botulism—a severe, sometimes fatal food poisoning characterized by nausea, vomiting, disturbed vision and paralysis.

The “lemonade” stems from scientists discovering a way to use the toxin to human advantage. Small, diluted amounts can be directly injected into specific muscles of the face, causing a controlled blocking of signals from the nerve to the muscle. The result is a relaxation and softening of wrinkles. In 2002 the FDA approved Botox for the treatment of frown lines between the eyebrows—called glabellar lines, or “11’s”. It is also extremely effective for forehead lines and crow’s feet (lines around the eye). The word botox is simply a contraction of “botulinum toxin”. When the word is capitalized, “Botox” refers to a specific brand of the toxin to be used as a cosmeceutical.[Keep reading to learn the history behind botox]

From Tragedy to Therapy

As it turns out, the military general Napoleon Bonaparte played an indirect role in the matter. The Napoleonic wars between 1795 and 1813 resulted in a decline in hygienic measures for rural food production due to the general economic poverty brought on by the devastation of warfare. This caused an increase in cases of fatal food poisoning throughout the country now known as Germany. In July 1802 the government in Stuttgart issued a public warning about the “harmful consumption of smoked blood-sausages”.

In 1811 the Medical Faculty of the University of Tubingen issued a list of symptoms of the so called “sausage poisoning” such as gastrointestinal problems, double vision and mydriasis (prolonged dilation of the pupil of the eye), and added a comment in which they blamed the housewives for the poisoning because they did not dunk the sausages long enough in boiling water, trying to prevent the sausages from bursting.

Between 1817-1822 a young medical officer named Justinus Kerner published multiple case reports of lethal food poisonings that he believed to be from an unknown toxic substance from sausages, and he called it “sausage poison”. Decades later, when the toxin was identified, its effects were named botulism, from the Latin word for sausage.

To his credit, Dr. Kerner also foresaw the possible therapeutic uses of the sausage toxin to block the hyperactivity of the nervous system. Two hundred years later, botulinum toxin is used to treat hyperhidrosis (excessive sweating) and hypersalivation.
(1) “Historical aspects of botulinum toxin” by Frank Ergbuth MD and Markus Naumann MD in NEUROLOGY 1999; 53: 1850-1853