Jamaican Ginger Paralysis
A case study on why premarket proof of safety for ingredients is important, and how lack of effective regulation harms honest businesses.
Neal Fortin is Director of MSU's Institute for Food Laws and Regulations. Learn more about ingredient safety regulations with his course "Food Laws and Regulations in the United States," online each fall and spring semester.
"Jake Leg Blues," "Jake Walk Papa," and other songs from 1929 and the early 1930s lamented the paralysis caused by drinking Jamaican ginger extract, commonly called "Jake." The ginger extract typically contained 70 to 80 percent alcohol, and during Prohibition some imbibed it for the alcohol. The extract avoided the alcohol prohibition by being sold as medicine. It was commonly found in pharmacies as a remedy for dyspepsia, nausea, and headache.
Jamaican ginger extract had been a popular patent medicine through the 1800s and early 1900s without ill effects. Jake Leg, a paralytic illness, was caused by the intentional adulteration with tri-orthocresyl phosphate (TOCP). This phenolic compound is soluble in alcohol, miscible with ginger oleoresin, and cheap. TOCP avoided prohibition detection while producing a more palatable alcoholic beverage.
However, TOCP is a slow acting neurotoxin. Weeks after consumption, victims typically noticed numbness in the legs, followed by weakness, foot drop, and eventual paralysis. Later, a similar progression often afflicted the arms. Recovery was slow, and many patients were left with permanent neurological damage. Over 1930 and 1931, this disease affected tens of thousands of Americans with estimates as high as 100,000. So many people were affected that the afflicted founded the "United Victims of Ginger Paralysis Association," which claimed 35,000 members.
In 1930, the laboratories at the National Institutes of Health traced the paralytic illness to the ginger extract produced by a single company, Boston-Hub Products. No law required ensuring the safety of ingredients, so the company had violated no law by adding a poisonous substance. Ultimately, Hub president, Harry Gross, and his brother-in-law and part owner, Max Reisman, were charged with violations of the Prohibition Act and for selling ginger extract USP that differed from the standard for fluid extract of ginger as set in the USP. Each was fined $1,000 and given a two-year suspended prison sentence.
This tragedy highlights the need for premarket proof of safety for ingredients, much like the Elixir Sulfanilamide tragedy of 1937. The scandal also highlights how lack of effective regulation harms honest businesses. Jake Leg was caused by a single company, but the many companies that sold ginger extract saw their market collapse and disappear.
John Parascandola, "The Public Health Service and Jamaica Ginger Paralysis in the 1930s," PHS Chronicles, May-June 1995, Vol. 110, No. 3. 361-363.