How War Hysteria Helped Create Botox

30 years ago, American physician Andrew Blitzer released the first evidence-based study on the use of botulinum toxin in cosmetology. Prior to this, the drug was called the strongest poison in the world, during the Second World War, military microbiologists believed that one bottle of botulinum toxin was enough to poison the enemy army, and actively worked on its production. How “sausage poison” became the elixir of youth – in the material “Kommersant”.

sausage poison

Botulism was first discovered in the 18th century in Germany. While investigating a previously unknown deadly disease, German doctor Justinus Kerner came to the conclusion that a toxic substance from stale sausage was to blame. After conducting experiments on animals, he isolated and described “sausage toxin” (the name of the disease “botulism” comes from the Latin word botulus, “sausage”).

By modern standards, the researcher knew almost nothing about the toxin. He suggested that the poisonous substance acts on the nerves of a person in the same way as rust on metals, and he was going to use it to treat the “St. Vitus dance.” In Germany, this was the name given to a neurological disease in which patients involuntarily jumped up or twitched their arms and legs. It turned out to be impossible to realize what Kerner had planned then – they could only artificially isolate the toxin after 200 years, and the natural poison remained unpredictable.

Rat farms

In the 20th century, botulinum toxin attracted the attention of the military. Due to its extreme toxicity, it was considered an ideal component for weapons of mass destruction, but it was only possible to isolate it artificially on the eve of World War II.

In July 1934, Germany was accused of using botulinum toxin. This happened five years before the toxin was actually isolated in the lab. The British edition of The Nineteenth Century and After reported that the Germans conducted a series of experiments with botulinum toxin in the London and Paris underground. The publication caused a scandal, but no real evidence of the experiments was found.

In May 1940, French doctors began to record more cases of botulism. The country’s secret services again blamed Germany, saying that the Germans had created three huge “rat farms” in Czechoslovakia and were producing a combat toxin there. The fact is that Clostridium botulinum bacteria most easily appear and multiply in carrion. According to the London Zoological Society, the carcass of a decaying rat remains dangerous for about 35 days. After such news, the French military checked the German shells for toxins: they examined all the surfaces, but found nothing.

Modern researchers believe that botulism spread in military France for natural reasons. From 1940 to 1944 there were food shortages in the country. The locals prepared canned food according to homemade recipes, and Clostridium botulinum bacteria grow faster in airtight jars than outdoors.

At the same time, the French themselves also conducted research on the combat use of the toxin in the Naval Artillery Laboratory. Scientist René Legros believed that a can of botulinum toxin would be enough to poison the entire German army. According to the American Medical Association, he was not very wrong: just 1 g of a substance in crystalline form can poison a million people.

Close to Salisbury

The British Army has had chemical weapons testing laboratories since 1916. They worked at Porton Down, near Salisbury. During the Second World War, researchers worked there with botulinum toxin (codenamed “agent X”) and anthrax (“agent N”). To produce a toxin that can be used during real fights, the researchers could not.

Powder batches with “agent X” differed significantly in toxicity and were not suitable for poisoning enemy products. The aerosols released were also harmless.

They did not cover the walls of the shells with toxin, since it completely decomposed under the influence of heat and could not poison the enemy.

Frustrated by their own failures, the British followed the news from Germany closely. But there were only rumors. In March 1942, the influential Porton Down microbiologist Paul Fields claimed that the Germans had done what the British had failed to do: mass-produce the toxin. He named the names of the developers, specific addresses in Germany and described the production method. According to him, botulinum toxin was released in “huge cement vats.” Fields did not disclose the sources, later it turned out that the facts turned out to be false.

Grafting in Normandy

The longer the war went on, the more the military feared the appearance of combat botulinum toxin. In the spring of 1943, the Allies began planning for the Normandy landings. The operation was commanded by General Eisenhower.

In December 1943, the American station also suspected that Germany was preparing to use botulinum toxin.

The German Jew Helmut Simons became the informant. He worked as a microbiologist at the Zurich Polytechnic Institute. US intelligence suspected him of bias. According to the chief of residency in Bern, Switzerland and the first civilian director of the CIA, Allen Dulles, Simons came to conclusions by deduction, instead of presenting the real facts from Germany.

Eisenhower, unlike Dulles, took Simons’ messages seriously. They decided to double-check the information by finding out the immune status of German prisoners of war (whether they were vaccinated or not). Medics took the blood of 240 German and Italian prisoners and examined it for the presence of antibodies against botulism. The results showed that the Wehrmacht had not recently vaccinated its soldiers against botulism and other infectious diseases.

After verification, Simons’ information was deemed dubious, but disturbing reports continued to come in. In April 1944, North American microbiologists announced that the Germans were developing dry botulinum toxin and could spray it as a powder.

After much debate, the commanders of the Normandy operation decided to vaccinate the soldiers – to inject them with the antidote “toxoid X”.

The military requested 1.5 million ampoules at once – an unbearable burden on the then pharmaceutical enterprises. It was impossible to release so many vaccines at once. The Americans were the first to refuse mass vaccination, the Canadians resisted the longest. On June 6, 1944, troops landed on the beaches of Normandy unvaccinated.

If the vaccination did take place, the allies could be vaccinated with Soviet development. The first antidote against botulism was developed by Russian doctor Ivan Velikanov. He dealt with wound infections in the Military Sanitary Directorate of the Red Army. He made the antidote from formalin. In April 1938 he was accused of espionage and shot. According to investigators, the doctor was personally recruited by Japanese Defense Minister Sadao Araki.

What did Germany really do?

In fact, the allies worried in vain. After the war, US scientific intelligence (the Alsos mission) found out that the Germans paid attention to toxins only in June 1940. The Wehrmacht occupied military laboratories at Le Bouchet in France and found enemy research on the subject. The French not only studied botulinum toxins, but also infected Colorado beetles and ticks with Texas fever – all this they planned to use against Germany.

Taking into account the risks, the Germans created a special informal committee. It follows from Hitler’s orders that the work of the committee was to be limited to defensive research, so it was headed by disinfection specialist Heinrich Kleve. Hitler banned all work in the field of offensive biological weapons. The reasons for this decision are unknown (it is assumed that the Fuhrer was simply afraid of germs).

Heinrich Himmler later ignored Hitler’s orders and allowed some “offensive research”. Since 1943, German doctors have been mixing toxins into the toothpastes and food of concentration camp prisoners.

Nothing is known about industrial production or large-scale research.

Botulinum toxins were also studied by Germany’s allies. In the 1930s, the Japanese built a research facility in Manchuria. The head of Chemical Detachment 731, Shiro Ishii, admitted to testing Type B botulinum toxin on Chinese, Korean, and American prisoners. Medics called the test subjects “logs” and treated them accordingly. In December 1949, the Khabarovsk Tribunal sentenced 12 members of this chemical detachment to terms ranging from 2 to 25 years.

How medical botox appeared

During the war years, President Franklin Roosevelt created the so-called War Reserve. At the urging of US Secretary of War Henry Stimson, the organization developed a plan in case the country was under biological attack. The reserve was headed by George Merck, president of the well-known pharmaceutical firm Merck and Co. The headquarters of the reserve and the test center were opened at the small airport Camp Detrick (Maryland).

During a direct military conflict, the reserve was never used – there was no need. But in peacetime, the story received an unexpected continuation. Young researcher Edward Shantz did not give up research and later obtained a purified toxin in crystalline form. It was his development that interested ophthalmologists.

Practicing ophthalmologist Alan Scott was looking for a way to save patients from strabismus and blepharospasm – painful conditions when the eyelids do not close completely. Scott wrote a letter to Shants explaining his idea and asking him to send him some of the toxin to experiment with. Shantz agreed, sealed the most dangerous toxin in a metal cylinder and sent it by regular mail.

The hypothesis turned out to be correct. Soon, large pharmaceutical enterprises began developing the toxin.

According to articles in Science Direct, doctors now use botulinum toxins for phantom pain after amputation, relieve muscle spasms in the neck, treat migraines and excessive sweating. It is also used during rehabilitation after a stroke and other neurological diseases.

beauty injections

By the 1970s, American pharmacies received a new ophthalmic preparation with microdoses of botulinum toxin inside. It was called “Oculinum” (produced by the pharmaceutical company Allergan).

When “Oculinum” was injected into the eye area, doctors and patients noticed an unusual side effect – it smoothed out wrinkles. By the 1980s, Canadian optometrist Jane Carruthers began giving “beauty shots” to herself and several patients. Finding applicants was not easy. The patients of that time were afraid to suffer and did not want to use a deadly poison in the name of beauty. In 1991, Jane Carruthers spoke about anti-aging injections to members of the Society for Dermatological Surgery.

In 1993, American physician Andrew Blitzer conducted and first published a study on the treatment of wrinkles in the forehead and subcutaneous muscles of the neck using botulinum toxin. Since then, cosmetologists have increasingly used toxins. In 2021, approximately 3.6 million cosmetic procedures were performed worldwide using neurotoxins (such as Botox).

The first Russian drug with botulinum toxin was developed at the Ufa-based enterprise Immunopreparat. Since 2012, it has been registered under the name Relatox. At least 1.6 million patients have already received injections of domestic botulinum toxin.

Ignat Vorontsov