Daily MOS: The Life Changing Magic of Botulism

There existed a finite day in my life when I last did not think I had wrinkles. And then it happened. Lines that I’d carved into my forehead with exasperation, confusion, and faking orgasms caught up with me. The realization hit that I was now and forevermore… older.

Fortunately, years ago, an eye doctor repurposed a paralytic bacterial neurotoxin after it failed as a bioweapon, turning it into a treatment for strabismus.

I use it to nip my elevens.

Today’s Moment of Science… the life changing magic of botulinum toxin.
Botulism is the illness caused by botulinum toxin. Botulinum, the reason why your mother made you check so thoroughly for dented cans, is a nasty little toxin released by the clostridium botulinum bacteria. It was sometimes referred to as ‘sausage poisoning’ in the 1800s, as most earliest known cases were due to blood sausage. The very word botulism is derived from the Latin ‘botulus,’ meaning sausage. It took about a hundred years from the first documented blood sausage dinner party induced poisoning to scientists identifying the toxin from a smoked ham at a funeral in 1895.

Botulinum does something that, let’s be blunt, is spectacularly fucking terrifying. It blocks the release of acetylcholine, a neurotransmitter essential for sending signals for your muscles to move. This can paralyze an affected area or organism, amongst other unpleasant effects. The US worked to turn it into a bioweapon in WWII, plotting to deploy sex workers to poison Japanese officers using discrete gel caps. But when the gel caps were tested on donkeys, they lived, causing the belief that their bioweapon had failed. In reality, donkeys just happen to be immune to the deadliest toxin on the planet.

Dr. Alan Scott was an ophthalmologist specializing in disorders of the eye muscles in the 1970s. By the time Dr. Scott was researching, botulinum had been isolated and crystallized decades earlier, sitting, waiting for a useful pharmacological application to come along.

Correcting strabismus, otherwise known as crossed eyes, had been tricky to do historically. Surgery often needed repeating, so research in the later half of the 20th century focused targeting the muscles in the eye. Various anesthetics and alcohols failed. But eventually, injecting mere picograms directly into eye muscles, Dr. Scott corrected strabismus for the first time using Botox in the late 1970s.

He would later say he wasn’t sure who was more nervous about those first injections, him or the patient.

It took nearly a decade from the initial paper regarding the efficacy of botulinum toxin in treating strabismus to when what we now know of as Botox was approved for market in 1989. This led to problems for Dr. Scott’s patients. Due to product liability issues, there was a brief shutdown on botulinum manufacturing and his patients resorted to traveling to Canada for their neurotoxin.

It hasn’t always been as easy as driving to the other side of LA to get it on sale via Groupon.

So here’s where the story of Botox takes a turn. It was noticed even when experimenting on monkeys that some of their facial lines relaxed. Dr. Scott’s patients would joke with him that they were coming to get their wrinkles ironed out. Hopping forward another decade, Botox had a rebrand coming.

It didn’t just morph from treatment for strabismus merely to a treatment for vanity. It’s the medical world’s duct tape now, treating everything from headaches to excessive sweating to overactive bladder. And of course, vanity.

Dr. Alan Scott is 88 years old, still doing research on eye muscle disorders, and could not give less a fuck about any of our wrinkles.

This has been your daily Moment of Science, and just a suggestion to start calling Botox parties… sausage parties.

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