“A lot kills, a little cures,” wrote the father of toxicology, and botulinum toxin is the poster child for this important pharmaceutical concept. Depending on the dosage and route, this potent bacterial toxin is either a devastating foodborne poison – one of the most deadly toxins known to man, capable of causing paralyzing death – or a wildly popular wrinkle antidote, harnessed and wielded in the pursuit of clearer skin.
Yes, botulinum toxin, or Botox, is best known for its use in cosmetic treatment, smoothing facial crinkles and crow’s feet, but its applications go far beyond the superficial: botulinum toxin can quell migraines, deactivate excessive sweating and salivation, and alleviate painfully contracted limbs in people with cerebral palsy. The therapeutic wonders of botulinum toxin and its wide range of medical applications have only been fully realized since the 1980s, but an inkling of appreciation for the vast possibilities of this powerful neurotoxin were first appreciated over 200 years ago in the work of a physician poet with a passion for psychic phenomena and marionette theatre (1).
This young doctor, Justinus Kerner, was the first person to identify botulinum toxin as the causative agent of a series of devastating outbreaks in Germany caused by suspiciously bad sausages. He is renowned for not only providing the first systematic clinical description of the toxin’s effects but also for testing it on himself and accurately prophesying its use as a curative for a variety of medical ailments.
