Jamaican ginger

File:TOCP structure.png

TOCP was the neurotoxin responsible for the paralysis associated with "Jake Walk"

WikiDoc Resources for Jamaican ginger
Articles
Most recent articles on Jamaican ginger Most cited articles on Jamaican ginger Review articles on Jamaican ginger Articles on Jamaican ginger in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Jamaican ginger Images of Jamaican ginger Photos of Jamaican ginger Podcasts & MP3s on Jamaican ginger Videos on Jamaican ginger
Evidence Based Medicine
Cochrane Collaboration on Jamaican ginger Bandolier on Jamaican ginger TRIP on Jamaican ginger
Clinical Trials
Ongoing Trials on Jamaican ginger at Clinical Trials.gov Trial results on Jamaican ginger Clinical Trials on Jamaican ginger at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Jamaican ginger NICE Guidance on Jamaican ginger NHS PRODIGY Guidance FDA on Jamaican ginger CDC on Jamaican ginger
Books
Books on Jamaican ginger
News
Jamaican ginger in the news Be alerted to news on Jamaican ginger News trends on Jamaican ginger
Commentary
Blogs on Jamaican ginger
Definitions
Definitions of Jamaican ginger
Patient Resources / Community
Patient resources on Jamaican ginger Discussion groups on Jamaican ginger Patient Handouts on Jamaican ginger Directions to Hospitals Treating Jamaican ginger Risk calculators and risk factors for Jamaican ginger
Healthcare Provider Resources
Symptoms of Jamaican ginger Causes & Risk Factors for Jamaican ginger Diagnostic studies for Jamaican ginger Treatment of Jamaican ginger
Continuing Medical Education (CME)
CME Programs on Jamaican ginger
International
Jamaican ginger en Espanol Jamaican ginger en Francais
Business
Jamaican ginger in the Marketplace Patents on Jamaican ginger
Experimental / Informatics
List of terms related to Jamaican ginger

Overview

Jamaican Ginger Extract (known in the United States by the slang name Jake) was an early 20th century patent medicine that provided a convenient way to bypass Prohibition laws, since it contained between 70-80% ethyl alcohol by weight.

Jake was not itself dangerous, but the U.S. Treasury Department, which administered the Prohibition laws, recognized its potential as an illicit alcohol source and required changes in the solids content of jake to discourage drinking. The requirement of at least 5 grams of ginger solids per cubic centimeter of alcohol resulted in a fluid that was extremely bitter and difficult to drink. Occasionally Department of Agriculture inspectors would test shipments of Jake by boiling the solution and weighing the remaining solid residue. In an effort to trick regulators, bootleggers replaced the ginger solids with a small amount of ginger and either castor oil or molasses.

A pair of amateur chemists and bootleggers, Harry Gross and Max Reisman, worked to develop an alternative adulterant that would pass the tests, but still be somewhat palatable. They settled on a plasticizer, tri-o-tolyl phosphate (also known as tri-ortho cresyl phosphate or TOCP), that was able to pass the Treasury Department's tests but preserved jake's drinkability. TOCP was originally thought to be non-toxic; however, it was later determined to be a neurotoxin that causes axonal damage to the nerve cells in the nervous system of human beings, especially those located in the spinal cord. The resulting type of paralysis is now referred to as organophosphate-induced delayed neuropathy (OPIDN).

In 1930, large numbers of jake users began to lose the use of their hands and feet. Some victims could walk, but they had no control over the muscles which would normally have enabled them to point their toes upward. Therefore, they would raise their feet high with the toes flopping downward, which would touch the pavement first followed by their heels. The toe first, heel second pattern made a distinctive “tap-click, tap-click" sound as they walked. This very peculiar gait became known as the jake walk and those afflicted were said to have jake leg, jake foot, or jake paralysis. Additionally, the calves of the legs would soften and hang down and the muscles between the thumbs and fingers would atrophy.

Within a few months, the TOCP adulterated jake was identified as the cause of the paralysis and the contaminated jake was recovered, but it was too late for many victims. Some users recovered full or partial use of their limbs, but for most, the loss was permanent. The total number of victims was never accurately determined, but is frequently quoted as between 30,000 to 50,000. Many victims were migrants to the United States and most were poor and consequently had little political or social influence. The victims received very little in the way of assistance, and aside from being the subject of a few blues songs in the early 1930s, they were almost completely forgotten.

References

• Baum, Dan, "Jake Leg", The New Yorker September 15, 2003, p.50-57. (PDF)
• Kidd, J. G, and Langworthy, O. R. Jake paralysis. Paralysis following the ingestion of Jamaican ginger extract adulterated with triortho-chesyl phosphate. Bulletin of the Johns Hopkins Hospital, 1933, 52, 39.
• Morgan, John P. and Tulloss, Thomas C. The Jake Walk Blues: A toxicological tragedy mirrored in popular music. JEMF (John Edward s Memorial Foundation) Quarterly, 1977, 122-126.
• Sara Gruen, (2006). Water for Elephants : A Novel. Chapel Hill, NC: Algonquin Books. ISBN 1-56512-499-5.
• U.S. Congress, Office of Technology Assessment, Neurotoxicity: Identifying and Controlling Posions of the Nervous System, OTA-BA-436 (Washington, DC: U.S. Government Printing Office, April 1990.

External links

• The Epidemiologic Side of Toxicology (slides 6 - 10 deal with the Jamaica Ginger Epidemic)