Jake-Based Songs (1930s)

General Details:

• Dr. John P. Morgan, a professor at the City University of New York Medical School collected a number of songs about the Ginger Jake syndrome (Jake leg, Jake leg blues, Jake walk) in the 1930s.(1)

Songs:

• 1928 - Lemuel Turner “Jake Bottle Blues”
• 1930 - Allen Brothers “Jake Walk Blues”
• 1930 - Ray Brothers “Jake Leg Wobble” - instrumental
• 1930 - Byrd Moore “Jake Leg Blues”
• 1930 - Ray Brothers “Got The Jake Leg Too”
• 1930 - Narmour and Smith “Jake Leg Rag - instrumental
• 1930 - Tommy Johnson “Alcohol and Jake Blues”
• 1930 - Ishman Bracey “Jake Liquor Blues”
• 1930 - Mississippi Sheiks “Jake Leg Blues”
• 1930 - Daddy Stovepipe “Jake Leg Blues
• 1933 - Asa Martin “Jake Walk Papa”
• 1934 - Willie Lofton “Jake Leg Blues"

Reference:
1 - Morgan, John P. (1982) “The Jamaica Ginger Paralysis" J Am Med Assoc 1982; 248:1864-1867

Image: Jake Based Songs (1930s)
Tags: 1930s - Blues - Ginger Jake - Jake Legs - Jamaica Ginger - Legs - Prohibition - Songs
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Ginger Jake Syndrome (Jake Leg Blues)

General Details:

• A form of organophosphate induced delayed polyneuropathy (OPIDN) which occurred during the US Prohibition Era of the 1930s.
• Affected some 20,000 men in South & Midwest America.
• Characterized by arm & leg weakness & pain after drinking "Ginger Jake" a medicinal alcohol substitute.
• The cause of the disorder was tri-ortho-cresyl phosphate (TOCP, pictured) poisoning which developed because of the adulteration of "Ginger Jake" from a Jamaican ginger extract.
• The association of "Ginger Jake" with the neurological syndrome was first suggested by Oklahoma doctors E. Miles and W.H. Goldfain.
• Dr. Maurice Smith (U.S. Public Health Service) confirmed that tri-ortho-cresyl phosphate (TOCP) was the causative agent.
• Tri-ortho-cresyl phosphate is an organophosphate which selectively inhibits the acetylcholinesterase enzyme activity in mammals and can potentially cause fatal hyperactivity of their acetylcholine neurotransmitters.

Ginger Jake Syndrome Clinical Features:

• Partially reversible neurologic damage.
• Relatively low acute toxicity, so presents with a delayed neurotoxicity.
• Producing a limping "Jake Leg" or "Jake Walk" - terms frequently used in blues music from that era (examples).

References:
Morgan J, Tulloss T (1976). The Jake Walk Blues: An Toxicologic Tragedy Mirrored in American Popular Music. Ann. Int. Med. (1976), 85:6. 804-808.

Image: Tri-ortho-cresyl phosphate Structure
Tags: Blues - Ginger Jake - Neuropathy - OPIDN - Organophospate - Prohibition - TOCP - Tri-ortho-cresyl Phosphate
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Cholinergic Toxidrome

Cholinergic Toxidrome Details:

• From an occupational & environmental health point of view, the cholinergic toxidrome is the most important syndrome to be aware of.
• The other toxidromes (ie anticholinergic, sympathomimetic, opioid, sedative/hypnotic, hallucinogenic) are most often associated with overdoses of drugs or medications.
• SLUDGE or DUMBELLS are simple mnemonics for the common clinical symptoms (see below).
• Clinical interpretation of this toxidrome can be complicated if multiple agents are involved.

Cholinergic Toxidrome Aetiologic Agents:

• Organophosphate pesticides (ie malathion, diazinon)
• Carbamates (ie physostigmine, carbaryl)
• Mushrooms (certain types)
• Sarin (warfare agent)

Cholinergic Toxidrome Pathophysiology:

• The underlying mechanism is excessive cholinergic (acetylcholine) receptor stimulation.
• There are various classes of cholinergic receptors (see table) that can be stimulated in this toxidrome.
• The symptoms induced depend on the relative stimulation of the different receptors.
• Common clinical features can be remembered by the mnemonics SLUDGE or DUMBELLS syndrome.

SLUDGE Syndrome:

• S - Salivation
• L - Lacrimation
• U - Urination
• D - Diarrhoea
• G - Gastrointestinal distress
• E - Emesis

DUMBELLS Syndrome:

• D - Diarrhoea
• U - Urination
• M - Miosis (small pupils)
• B - Bradycardia
• E - Emesis
• L - Lacrimation
• L - Lethargy
• S - Salivation

Tags: Acetylcholine - Carbaryl - Cholinergic Toxidrome - Diazinon - DUMBELLS - Malathion - Muscarinic Receptor - Nicotinic Receptor - Organophosphate Pesticide - Physostigmine - Sarin - SLUDGE Syndrome - Toxidrome

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