History and application of botulinum toxin injection

Botulinum toxins, like digitalis, atropine, and paclitaxel, have become indispensable as routine medications, although they were first recognized for their toxicological properties. In the early 18th century, Kerner, a German physician, published the first accurate and complete description of the clinical symptoms of foodborne botulinum toxin poisoning, and in the late 18th century, Professor van Ermengem, a Belgian microbiologist, first isolated the causative organism from food and food poisoning victims –Clostridium botulinum. In the 1970s, Alan Scott, an ophthalmologist at the Smith-Kettlewell Eye Research Center in San Francisco, directed his research toward non-surgical treatment of patients with strabismus, convinced that the same effect of myotomy could be achieved by a chemical that weakened the force of the extraocular muscles pulling on the eye. After a series of animal studies and clinical studies, Dr. AlanScott eventually received approval from the U.S. Food and Drug Administration (FDA) to begin using Botulinum Toxin Type A for the treatment of strabismus and blepharospasm in humans. The use of botulinum toxin type A in cosmetic surgery dates back to the 1980s, when ophthalmologist Jean Carruthers noticed an unexpected effect on the brow when treating blepharospasm: a noticeable improvement in the frown lines between the eyebrows, resulting in a calm, natural-looking expression. This indication was approved worldwide.