Neuropoisons pp 283-301 | Cite as

The Clinical Aspects of Botulism

  • M. Glenn Koenig


Botulism may have been known to antiquity. K. F. Meyer (1928) suggests that Emperor Leo VI of Byzantium (886–911 A.D.) earned the sobriquet, “The Wise,” or “The Philosopher,” possibly because of an edict that forbade the eating of blood sausage due to its harmfulness to health. Nine centuries later physicians of southern Germany recognized the disease as the often fatal syndrome that sometimes followed the consumption of a regionally popular blood sausage. As a consequence the manufacture of that dangerous food product came under strict government surveillance, and the term botulism (botulus is Latin for sausage) was applied to the illness. In 1895 an outbreak of a strange neuroparalytic disorder occurred among 34 members of a musical society who, after performing at a funeral in the Belgium village of Ellezelles, had eaten some raw, salted ham. Three of the musicians died, while 10 became critically ill. The Belgian bacteriologist van Ermengem investigated the outbreak and, in a paper that remains a classic in the annals of bacteriology, showed that a spore-forming anaerobic bacillus produced a toxin responsible for the disease in the sick musicians and caused the illness previously termed botulism (van Ermengem, 1897).


Botulinum Toxin Toxin Production Clostridium Botulinum Neuromuscular Symptom Fatal Syndrome 


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  1. Bishop, G. H. and J. J. Bronfenbrenner (1936), Amer. J. Physiol., 117:393.Google Scholar
  2. Burke, V. and J. C. Elder (1921), Arch. Internal Med., 27:265.CrossRefGoogle Scholar
  3. Cherington, M. and D. W. Ryan (1968), New Engl. J. Med., 278:931.PubMedCrossRefGoogle Scholar
  4. Coleman, G. E. and K. F. Meyer (1922), J. Infect. Diseases, 31:622.CrossRefGoogle Scholar
  5. Dack, G. M. (1962), “Food Poisoning,” 3rd ed., The University of Chicago Press, Chicago.Google Scholar
  6. Dack, G. M. and J. Gibbard (1926), J. Infect. Diseases, 39:173.CrossRefGoogle Scholar
  7. Dack, G. M. and D. Hoskins (1942), J. Infect. Diseases, 71:260.CrossRefGoogle Scholar
  8. Dolman, C. E. (1964), Botulism as a world health problem, in “Botulism. Proceedings of a Symposium” (K. H. Lewis and K. Cassel, Jr., eds.), Public Health Service Publication #999-FP-l, Public Health Service, Cincinnati, pp. 5–30.Google Scholar
  9. Dolman, C. E. and H. Iida (1963), Can. J. Public Health, 54:293.PubMedGoogle Scholar
  10. Dubovsky, B. J. and K. F. Meyer (1922), J. Infect. Diseases, 31:501.CrossRefGoogle Scholar
  11. Erzina, G. A. and V. V. Mikhailov (1956), Bull. Exp. Biol. Med. (USSR), 41:129.CrossRefGoogle Scholar
  12. Esty, J. R. and K. F. Meyer (1922), J. Infect. Diseases, 31:650.CrossRefGoogle Scholar
  13. Gangarosa, E. J. (1969), J. Infect. Diseases, 119:308.CrossRefGoogle Scholar
  14. Haerem, S., G. M. Dack, and L. R. Dragstedt (1938), Surgery, 3:339.Google Scholar
  15. Johnson, H. M., K. Brenner, R. Angelotti, and H. E. Hall (1966), J. Bacteriol., 91:967.PubMedGoogle Scholar
  16. Koenig, M. G., A. Spickard, M. A. Cardella, and D. E. Rogers (1964), Medicine, 43:517.PubMedCrossRefGoogle Scholar
  17. Koenig, M. G., D. J. Drutz, A. I. Mushlin, W. Schaffner, and D. E. Rogers (1967), Amer. J. Med., 42:208.PubMedCrossRefGoogle Scholar
  18. Lamanna, C. and C. J. Carr (1967), Clini. Pharmacol. Therap., 8:286.Google Scholar
  19. Meyer, K. F. (1928), Ueber Botulismus, in “Handbook der pathog. Mikroorganismen” (W. Kolle, R. Kraus, and P. Uhlenhuth, eds.), vol. 4, Gustav Fischer and Urban Schwarzenberg, Berlin and Vienna, pp. 1269–1365.Google Scholar
  20. Meyer, K. F. (1956), Bull. World Health Organ., 15:281.PubMedGoogle Scholar
  21. Meyer, K. F. and B. J. Dubovsky (1922a), J. Infect. Diseases, 31:541.CrossRefGoogle Scholar
  22. Meyer, K. F. and B. J. Dubovsky (1922b), J. Infect. Diseases, 31:559.CrossRefGoogle Scholar
  23. National Communicable Disease Center (1964), Morbidity and Mortality Weekly Report, 13:423.Google Scholar
  24. National Communicable Disease Center (1968), “Botulism in the United States,” U.S. Department of Health, Education, and Welfare, Government Printing Office, Washington, D.C., p. 3.Google Scholar
  25. Polley, E. H., J. A. Vick, H. P. Ciuchta, D. A. Fischetti, F. J. Macchitelli, and N. Montanarelli (1965), Science, 147:1036.PubMedCrossRefGoogle Scholar
  26. Schneider, H. J. and R. Fisk (1939), J. Amer. Med. Assoc., 113:2299.CrossRefGoogle Scholar
  27. Semerau, M. and K. Noack (1919), Z. Klin. Med., 88:304.Google Scholar
  28. Simpson, L. L., F. de Balbian Verster, and J. T. Tapp (1967), Exp. Neurol., 19:199.PubMedCrossRefGoogle Scholar
  29. Tyler, H. R. (1963a), Science, 139:847.PubMedCrossRefGoogle Scholar
  30. Tyler, H. R. (1963b), Arch. Neurol., 9:661.CrossRefGoogle Scholar
  31. van Ermengem, E. (1897), Z. Hyg. Infektionshrankh., 26:1.CrossRefGoogle Scholar
  32. Whittaker, R. L., R. B. Gilbertson, and A. S. Garrett (1964), Ann. Internal Med., 61:448.Google Scholar

Copyright information

© Plenum Press, New York 1971

Authors and Affiliations

  • M. Glenn Koenig
    • 1
  1. 1.Department of MedicineVanderbilt University School of MedicineNashvilleUSA

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