The article by Schmidt-Nowara et al (p 451) provides data on early and late pulmonary manifestations and complications of botulism, a rare disease which was recognized as a clinical entity in the late 18th and early 19th centuries in Germany where it was referred to as "sausage poisoning." In a classic investigation in Belgium in 1895, van Ermengem1 discovered that the disease was an intoxication and first isolated the responsible organism, Clostridium botulinum.2 The first botulism outbreak reported in the United States occurred in 1899.3
See also p 451.
The pathogenesis of botulism may involve either ingestion of preformed botulin toxin or toxin production by C botulinum in vivo (toxicoinfection). Foodborne botulism, the syndrome recognized in Germany almost 200 years ago, results from ingestion of preformed toxin. Wound botulism (first recognized in 19434) and infant botulism (first described in 19765 although cases occurring in 1931