The starting signal for the treatment with Botox ©, the toxin of eternal youth, occurred in 1987 when the Canadian marriage Carruthers – made up of the dermatologist Alaister and the ophthalmologist Jean – serendipitously discovered that botulinum toxin eliminated wrinkles. To be honest, neither of them noticed the cosmetic effects of the botulinum toxin, she was a grateful patient who did not stop insisting that the ophthalmologist continues with the treatment because her “crow’s feet” had disappeared. During the following years the Carruthers carried out different tests, some on their meats, but they were not able to envision the business that this would lead to, so they did not get to patent their discovery. If they had, they would top the Forbes list of the richest people in the world.
The history of botulinum toxin is much less prosaic than one might think a priori and to know it we have to travel to the end of the 18th century. After the Napoleonic Wars (1792-1815), the hygienic regulations governing food production in Central Europe were relaxed and this led to numerous food poisoning. In the German region of Wurttemberg alone, between 1793 and 1853 four hundred cases of food poisoning were detected with one hundred and a half deaths.
These alarming figures caught the attention of a professor at the University of Tübingen, Johann H. Ferdinand Auttenrieth (1772-1835) who, after auditing medical reports, concluded that, in addition to gastrointestinal symptoms, intoxicated people had pupil dilation (mydriasis) and double vision (diplopia). Very interesting clinical data but which did not resolve the ultimate cause of the poisoning. For a long time, different theories were considered, among them that the poisoning could be related to prussic acid.
The doctor Justinus Kerner (1786-1862), after an exhaustive follow-up of more than a hundred deaths, concluded that the majority of the intoxicated had eaten a typical dish of the area called “Blunden” or “sausage”, cooked pork stomach stuffed with blood sausages.
For this reason, the disease was baptized with the name of botulism, from the Latin bolus, sausage. Botulism is the sausage disease. Kerner was unable to discover the pathogen responsible for the poisoning but concluded his study by saying that the disease was produced from a toxin that developed in unhealthy sausages, that it was lethal even at small doses and that it affected the device so much digestive and nervous system.
We had to wait almost a century for a name and surname to be given to that strange disease. In mid-December 1895 in Ellezelles (Belgium) a musical band was invited to play a funeral elegy. After the ceremony, the orchestra went to the inn “Le Rustic” where they tasted, in the company of other locals, large quantities of the typical salty ham.
The animal had been sacrificed four months ago, it was this “freshness” that was responsible for thirty-four guests falling ill, including the musicians, and three dying – mortality of ten percent.
From the study of contaminated meat and the spleen of one of the deceased, Professor Emile P. Marie van Ermengem (1851-1932), a disciple of Robert Koch, was able to isolate spores of a hitherto unknown bacterium which he baptized as Bacillus botulinus.
Later, seven different toxins would be isolated –identified with the letters A-G- of which four are fatal to humans. The toxins cause the death of patients poisoned by asphyxia by blocking the contractions of the diaphragm muscle. This effect is produced by the inhibition in the release of a neurotransmitter (acetylcholine) that transmits the electrical signal from the nerves to the musculoskeletal system. This blockage is precisely what induces the disappearance of wrinkles and helps us fight the inexorable passage of time.