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
Posted by Medicalchemy
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