Ginger Jake and the blues: a tragic song of poisoning.

Prohibition, "The Noble Experiment", ushered in speakeasys, gangsters and bathtub gin in the 1920s. For many Americans, however, it led to a period of joblessness, hard times, and austerity. The story of Jamaican Ginger ("Jake") poisoning, in which batches of a cheap, alcoholic tonic were laced with tri-ortho cresyl phosphate (TOCP) is one of cynical despicable behavior on the part of those responsible and a tragic enduring legacy for the invisible group of Americans who were victimized. TOCP, a potent organophosphate, caused an axonal dying-back neuropathy affecting mainly large muscle groups. Jake poisoning struck about 50,000 adults, mostly poor middle-aged vagrants with little medical care or social standing. Their symptoms and stories were told not only in medical journals but also in song. Hillbilly jazzmen sang of the "Jake Leg Blues" with a resignation to the fate of their own undoing, brought on by the intemperance of a wasted life. The postscript is grim--those responsible received little punishment; many who drank "Jake" were left both uncompensated and crippled by irreversible paralysis.