Frnhly harntested. ANNALJ OF EPIDEMIOLOGY tr tlHSt{iNs #Y rdo JArufrT fV!AVSfi tlr JAKE LEG Ir cifr How the bluesdiagnosed a medicalmystery. 6€r. fl, C^rli BY DAN BAUM DEINE

EARRINGS T\r.John Morgan, a professorat crete event." He sat back and spread his &ry "Behold q J.-lthe City Universityof New York hands. the study, through fotk ill -rq^'S Medical School,likesto call himself a music, of a substance-inducedepidemic," "Pharmaco-ethnomusicology." pharmaco-ethnomusicologist.His first he said. loveis early-Americanvemacular music, Morgan has been researchingthe jake and his apartment,on the Upper West leg on and offfornventy-sevenyears.He ffi BEAN Side,is stackedwith ancientrecords. has put together a CD collection of sev- Someyears back, Morgan waslistening enteen tunes mentioning it, including to the Allen Brotlers"JakeWalk ," one by Gene Autry, and he has written releasedin 7930.In alcazno-backedTen- haJf a dozen medical-joumal articles on ARTICHOKE "I EARRINGS nesseetwang, the brotherssang, cant the subject.In the nineteen-seventies,he eat,I carittalh drinking meanjake, Lord, interviewed a number of the epidemic's I cantwalk." survivingvictims and collected his data, a I.Mevnc & Co. The lyricspinballed through Morgaris teeming baznar of anecdote and chem- 946 Madison Avenue at T4th Street memoryand lit up twice.First wasa lec- istry, in a huge manuscript that has been New York roozr Tel (zrz) 517-7665 turehe'd heard in medicalschool, in 1961: gathering dust for years. He also has a www.imavec.com a professorhad mentioneda strangepa- filthy carton firll of clippings. With a lit- ralpis called'jakewalk" that he hadob- de prodding, he agreed to turn all the "I'm servedduring his residencyin Cincinnati material over to me. not giving up on "I in the thirties.Nextwas a face from Mor- the story mysel-f," he said. just dont gan'schildhood in Ohio, that of a legless mind someoneelse telling it, too." beggarcalled Nigger John. NiggerJohn had had the'jake legi'Morgan recalled A r f"t as we know, the outbreak was his mothertelling him. Shehad saidit in fLfurt detectedin Oklahoma City, by away rhat discouragedfirrther i"q"t y. Eptraim Goldfain, a thirty-four-year-old Stout and bearded,Morgan, who phpician who had emigrated from Ro- is sixry-three,delicately set the arm of mania as a child and had put himself a tumtable on a thiclq spinning record, thtough medical school by operating a and after a moment's hiss we heard streetcar.He was bookistrlv handsome. Paraly "Ishmon what soundedlike puredespair. with swept-backred hair, a cleft chin, and Bracey,one of the Mississippigreats," round hom-rimmed glasses.With a few of ther Morganwhispered. From seven decades partners, he ran a thirty-five-bed clinic caught 'Jake baclgBracey wailed, leg,jake leg, called the Reconstruction Hosoital. On and har what in theworld youtrying to do?Seems February27 ,7930, aman whosi name is who he like everybodyinthe city'smessed up on lost to history staggeredin off the street. few dar accountof drinkingyou." The patient's feet dangled like a mari- oki, fust Strings Morgan has collecteda number of onette's,so that walking involved *irg- place.1 songsabout the jake leg or thejake walk ing them forward and slapping them onto pliesof I Sfrngs for Musical lnstruments "From lGuitar, Basg Orchesfral,Folk & Ethnic themweleam thatsome newkind the floor. He told Goldfain that he had goften i I World's LargestSelection of paralysisappeared in 1930,"he said. strained himself lifting The san "No an automobile, www.juststrings.com songsmention it beforethen." He and a couple of days later his calveshad patients "The beganbending back blunt fingen. begun to tingle. Then his legswent useless ationcri paralysiswas brought on by drinking below the knee. He wasnt in any pain, he Preparc( somethingcalled jake.' It affiiaedenough said,but he could barelyget around. hospital soulsto instigatean entiresubset of folk Sudden paralysisin those daysusually E crtyotn music.Blacks and whiteswere affected. meant polio, but to Goldfain, who re- 5 what lor It renderedmen imDotent.And it rvas counted the patient's history in a medical i Inor no longer inspiring musiciansbv 1934, journal, this didnt look like polio. He *gtttltrvrn whichmeantitwas a catadysmic but dis- didnt pay much attention to the story - the succ

THE NEV YORITER,JEPTEMBER 15, 2OO3 Jnut lifting the car. Goldfain thought other visits. The men'sfeet dangled, their in Worcester, Massachusetts.Five hun- *re man'ssymptoms suggested lead poi- legs hung dead below the knee. Some dred practically ovemight in Wichita. Six soning.He orderedblood and spinal- could get around on crutches, some hundred and ninety in Topeka. A thou- iluid tests.They cameback negative. couldntmake theirlegs move atall, some sandin Mississippi.The mysteryplague Later that day,another man appeared, could use neither their legs nor their smoteJohnson Ciry Tennessee,particu- "4. erhibiting the samebizarre palsy.And hands. Goldfain knew at once that this larly hard. great many of the victims then another.By the end of the day, was no contagion. No chil&enwere siclq for the first three or four weeks were Goldfain'sclinic had admitted five pa- and hardlyanywomen.The men Goldfain ashamedto come on the sffeets.but thev tientswith the distinctiveparalysis. (jne sawall lived in a seedypart of tovrn knovrn finally came out," aJohnson Cityvictim wrote in a letter to the Swgeon General's "You office. can go on the streetsofJohn- son City now, and in the run of a day,you can count three or four hundred people in the same condition that I am in." In NewEngland, asin the South, the typical victim was an alcoholic man Jiving alone in a cheap rented room, unem- ployed or holding a menial job. Many were veteransof the Great War. A pat of Cincinnati doctors examined a hun&ed and seventeen victims and found their median age to be forty-seven; almost all of themwere eaminglessthan fortydol- "Afa$ lars a week proportion led lone- "Indeed, somelives," the doctors wrote. it would be difficult to imagine anyone having lesscontact with the people about them than someof thesepatients."

fhe economicsof Prohibition, then in I its eleventh yeaq painted a bull's-eye on the urban and small-tolrm poor. City swellscould buy bonded liquor from Can- ada; baclsvoods hillbillies often had ac- 'lls. cessto s Lol,v-income townsfolkdrank what they could get-rubbing alcohol, hair oil, Stemo, doctored antifreeze.What manyof them prefened though,wasjake. Paralysissictims initiallyfeh foot-1fl0pp1t,"and tpalkedwith a rubberJeggedgait. JakewasJamaica extract, one of the hundredsof dubiousbut harrnlesspat- of them, a podiatrist,claimed he had for bootlegging.They struckhimas being ent medicines that.Americans had been caughtthe illnessfrom his own patients, ashamedof their illness.He had only to *ly"g on for a cenhry. A pale-orange and handedGoldfain a list of the ones lookatthem,and the gimyscratdr houses concoction packagedin a two-ounce glass who had gone foot-floppy in the past they lived in, to know they were stew- bottle, it was supposed to treat catarrh, "late few days.The list had sixry-fivenarnes. bums,boozegobs, hooch histers, drunls. flatulence, and menstruation." Be- Oklahoma in 1930 was a hard-luck Within a few davs.in variouslocales causeit was as much as eighty-five-per- place.Thanks to price-killing oversup- in the Easqthe South,and the Midwest, cent alcohol, it packed the kick of fow pliesof wheatand cotton,its peoplehad men beganfolding up. Somefound that jiggers of Scotch. And it was legal. Pat- gotten a head start on the Depression. they couldnt climb out of bed in the ent medicines had been providing an end The samedayrhatGoldfain sawhis five moming. Thosewho could stillwalk all run around temoerancelaws sinceMaine patients,the AmericanHospital Associ had the samerubber{egged gait; one becamethe fusl stateto go dry, in 1851. ationcriticized Oklahoma City's medical doctorin a RhodeIsland hosoitalfooded A botde costing thirty-five cents was preparedness,noting that it had fewer with victims saidthat the min walkedas available in many , groceries, "a hospitalbeds per capitathan any other if they were passing*"o"gh field of and even dime stores. Preachers and f; cityof its size.Nowitwas strugglingwith wetgrass."In Providence,a seventy-year- schoolmarms could slip the flat, dear- 5 what lookedlike a full-blor,vnepidemic. old hobo was sffickenat 11 A.M. at the glass botde into a pocket for a discreet F h one frenetic day,Goldfain visited comer of Friendshipand Plain Streets; nip athome. Common rummies, though, E thirry menon thepodiatrist's list, andin he sat down and couldnt get up. The often took a botde into the store'sback i the succeedingweefts followed up with numberswere frightening: fifty-five cases room, which many jake sellers kept as

THE NEV YORKER,JEPTEMBER 15, 2OO3 5I f low-rent speakeasies.There they could of alcorubor anything thatd bring on went swimmingly.O. B. Van Fossen, mix the jake with Coca-Colaand have drunk Hed takethis oldblackThree-in- a chemistat the Golden Rule oil refin- their own firtive Iitde parry. One shoepolish and strain it through a ery in Wichita, looked out his window The PureFood and Dnrg Act of 7906 oowdermufi It would be iust asclear as one day to seea dozenjake-leg victims had purified neither.It requiredonly water."Though he lived and performed bathing in the slushponds of warm pe- honestlabelling. If a for another twenty-six years,after the troleum refuseand mud. The lime and containedalcohol, morphine, opium, co- Grafton sessionJohnson never recorded sulfur of the slurryr,they'd been told, caine,heroin, alpha orbeta eucaine, chlo- anothersong. Daddy Stovepipe,a singer might do them good. roform, cannabisindica, ctrloral hydrate, who liked to oerformin formalattire. and Some victims, for whateverreason, or acetanilide,the labelhad to sayso. Fur- his wife, Miisissippi Sarah,also appar- did recovervarying degreesof mobility; thermore,if the medicinewas listed in a endy recordedajake{eg song though for others,the paralysiswas permanent. compendiumof drug standardssuch as JohnMorgan hasnever found it. JohnMorgan trackeddoram some severe the United StatesPharmacopeia (U.S.P), Morganbelieves that no otherincident jake{eg victims in 1977.By then, the themedicine hadto meetthose standards hasinspired as muchpopularmusic as the musclefloppiness theyd experiencedin andthe botde could carry the U. S.P label. jake-walkepidemic. Generally, one song the nineteen-thirtieshad evolvedinto a "fluid "There as a extract,"fell under the comesout of a disaster,maybe two. spastictigdity, but they were still crip- Jake, ' U.S.Preqdrcment of four-per-centsolids is nothingto equalthe jake walk he told pled.Autopsies of jake{eggerswho died (in this case,ginger) in a soiutionof alco- me. As a pharmaco-ethnomusicologist,from other causesshowed damage to hol andwater. In I9I9 the VolsteadAa Morgan pala partinrlar attentionto the the centralnervous system, including the , "Alcohol tumed everystate dry, but it bannedonly portrayalof intoxicants. songs, spinal cord'santerior horn cells-the beverageliquor; jake and other alcoholic like heroinsongs, tend to be negativeand samethat go bad in casesof polio and medicinesremained legal. \Mhen the qrs- waming andthe jal

52 THE NEVYORKER,JEPTEMBER 15, 2OO3 his daughter. Two weeks later, Thomas, rvho drove a truckfor an oil company,no- ticed that sometlingwaswrong. He sud- denly found it hard to depressthe brake and clutdr pedals.He beganworking in- doors. but noticed that his hands were "A-fter weak aswell; soon he couldrit walk "he months in bed," Morgan recalled, was able to struggle to his feet and walkwith crutdres, and began working on his par- ents'farm. He would hold tighdy to the plow handles and drag his feet behind the horse, who initially supplied most of the locomotive power. His hands re- turned to normal, a process that took years, and he became a retail grocer. He never walked without crutches again." According to another Johnson City resident, the Kites denied that their Ja- maica ginger oftract had caused the ill- "They ness. pointed out that the bottles were all labelled'United StatesPharma- "WTe copeia 70o/o alco,"'' Morgan explained. a traditionalgay couple----

THE NEVYORKER,JEPTEMBER I5, 2OO3 53 than a million dollars,apittance eventhen. to soften up America for another war. cesspoolsand outhousepits. They found The very idea that the federalgovemment The onlypublic-health watchdog was their first sample in Findlay, Ohio, and should play a role in fighting the jake leg the federal Hygienic Laboratory a mis- rushed it back to Washington, where test- was controversial. erably underfunded outgrowth of the ing on animalsrevealed something odd. In any case,the govemment had no Ellis Island clinic, which had been estab- Though poisonedjake killed rabbits and Centers for DiseaseControl from which lished in 7887 to screenimmigrants. It panJyzed calves,it was relatively harm- to dispatch regiments of epidemiologists. was in the processof changing its name lessto monkeys and dogs,animals com- As jake leg whipped across the land, to the grander National Institute of monly used to test for toxicity in humans. olenw of theories circulated: that a batch Health, but it had a budget of lessthan a Looming in the baclground of Smith s \\ oflun nua U"encontaminated with lead, million dollars, and a staff of only twelve investigation was the Tieasury Depart- iake: arsenic, nicotine, creosote, or carbolic doctors.One of themwas abespectacled ment's Bureau of Prohibition, which had ton\- acid; that an unscrupulousboodeggerhad forry-two-year-old Russian immigrant jurisdiction over any incident involving chen used toxic wood alcohol or petroleum aI- named Maurice Isadore Smith, who, like alcohol and a budget roughly nine times the I cohol instead of grain alcohol; that the Ephraim Goldfain, had come to the that of either the ED.I.A. or the N.I.H. tacki' "lathyrism, jake-leggers suffered from as a child and worked his It also had badges and tommy guns. mucl which results from the eating of certain waythrough medical schoolto becomea Some health officialsheld the dryagents rinnl:-tt- speciesof beans"; that gatherers of wild pharmacologist. In early 1930, he de- in contempt aspower-hungry, moralistic fluiC "Santo "Itwill ginger on the islandof Domingo' cided that he neededto get his handson cops. do us no good to be identi iake- "Central in America" had accidentally a sampleof poisonedjake. fied with the Prohibition fJnit," one Jique "der- harvested a poisonous root called It wasnt easy.As word of the epi- ED.I.A. official wrote his boss,reason- coulc "hinder ringue." One old jake victim in trlizabeth- demic spread, storekeepers,fearful of ing that it would our work in the T, ton,Tennessee,told Morgan that, because being prosecuted, removed jake from future if manufacturers think we are agenr the biggest local employer at the time their shelves.Consumers smashedtheir snooDersfor the Prohibition outfit." But boilo of the outbreak was a German-orvned botdes to keep familymembers from get- the Prohibition Bureau had the resources solid rayon factory, a lot of people thought ting poisoned.More than once, Smith's and labsfor analyingalcohol. Its chem- solid that the Germans were poisoning the jake investigatorshad to recoverbotdesfrom istsquicklyidentified a sulprising chem- PorR r Leaaeno stoneunturned. You might be surprised how many oPP {t

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THE NEV YORKER,JEPTEMDER 15, 2OO3 ical in the suspectjake:tri-ortho-cresyl multimillion{ollar industry devotedto ger."It wascheap, perhaps even cheaper phosphate,orTOCP, aplasticizer formu- subvertingkohibition. Boodeggerswere thancastor oil, andcertainlycheaper than Iatedtokeep synthetic materials frombe- rlt "dy rttippins methyl alcohol out of ginger.And the textbooftssaid itwas safe. comingbritde. Two companiesmade it: denatured"industrialalcohol to makeit fu Smith had seen,even if the boodeg- EastrnanKodakand the Celluloid Co{po- drinkable and distilling potable hooch gers had scrupulouslytried TOCP on rationof NewarlgNewJeney, r,vhich used from aftershavesand perfumes.What dogsand monkeys-the most expensive it for lacquers,resins, and rubber com- theyneeded was away to boostthe solids andhuman-like of testanimds-itwould "Only pounds.TOCP wasnot consideredtoxic. in jakeenough to satisfytheT:menwith- haveseemed harrnless. a chemist Whywould anyoneadd plasticizer to out spoilingthe taste. of some ability could have thought of jake?The mostpersuasive theorywas put They tried molassesand various herbs, fusingTOCP]," Smith wrote in the Oc- forward by severalinvestigators and but what workedbest, at leastuntil 1930, tober, 1930, issueof the jownal,Public chemists.From the start of Prohibition, was castoroil. It had a higher boiling HealthReports.'And hadthere been any- the teasury Departrnenthad soughtto point than alcoholand so stayedbehind, thing known about the pharmacologic tacklethe problemof peoplegetting too to beweighedwiththe ginger,whenthe actionof this substanceand the possible much pleasurefrom patent-medicine alcoholwas gone.Its drawbackwas its dire consequences,it is probablethat it tippling by ordering that the solids in tendencytorisetothe top of abotde,tip- would neverhave been used and the dis- fluid extractsbe doubled.In the caseof ping off the buyerthat somethingother asterwould neverhave happened." jake,this transformeda tastypale-orange than ginger and alcohol lurked inside. Somenewspaper editorials blamed the liqueur into a black symp so bitter it The plasticizerTOCPsolved that. epidemicon Prohibition'sarcane nrles----a couldbe enduredonly if heavilydiluted. After testingSmitl's samples,Prohi- view that wasexpressed more eloquendy To enforcecompliance, govemment bition Bweauchemists described TOCP when the Mississippi Sheiks,a black agentssometimes pulled jake off shelves, in aleffertothe Food,Drug, andlnsecti- stringband, recorded'Jake Leg Blues,"in "a boiled off the alcohol,and weighedthe cideAdministration as tasteless.odor- Juneof 1930.'Youthought the lively man solids.Agents didnt thoroughlytest the lesssubstance,viscous in draracter, soluble would die when you madethe country "be- solids,though, and this providedan op- in alcohol,insoluble in water"whicfi dry,whenyoumade it sothathe couldnot portunity for the clever chemistsof a havesvery muci like oleoresinof gt"- get not anotherdrop of rye,"the Sheils

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THENEVYORI(ER, JEPTEMBER 15,2OO3 I "Well, sang. I know that youwill feelbad TheE whenyouseewhathe has had., . He'sgot deotr thosejake limber-leg blues." IN THE READING ROOM Hub: DeH he poisonedjake sampleseventually Alone in the libraryroom, evenwhenothers diced ledinvestigatorsto HarryGrossand Are there in the room, alone,er

56 THE NEVYORI(ER,JEPTEMBER 15, 2OO3 The ED.I.A. and Prohibition coosfound in j"il." bad-lawver All the victims could Fine VictorianJeaelry - rlenty of distributors who could finger do, really,was petition govemmentof6- . i . $ellow gold and diamonds) Hub as the source of their bad jake. In cialsfor relief There wasnt much hope. December,Gross and Reismanwere in- When United Victims firstformed, Ok- Jicted by a federal grand jury. lahoma'sgovemor, William (Alfalfa Bill) "There BecauseGross and Reisman had para- Murray,declared, arethree kinds lrzed tens of thousandsof people, every- of peopleI haventmuch usefor. One is body involved in the prosecution wanted the manwith jakeitis,'anotheris the in- ro hit them with Prohibition charges, vestor on the stock exchange,and the which canied jail time, instead of merely otherI wont mention."Thevictims per- the administrative fines that would likely sistedanyway'l haveawife andtwo ch.il- be leviedby the ED.I.A. But patentmed- drendependent on me,andwe have been icines came under the jurisdiction of the kicked and cuffed about without any Prohibition Bureau only if theywere used homejust verylitde to eatever since I got "beverages" as rather than as medicine, crippled,"a thirty-year-old man named a legal, distinction almost impossible to JoeGordon wrote to his senatorin a spi- prove,especially sincejake labels often car- dery hand from Hot Sp.irS, Arkansas, "This "And ried awaming: preparationmust not in 1933. I'11tell theworld Life looks be usedforbeverage purposes underpen- almosthopeless for me andmylitde fam- ahyof law."Gross and Reismaneventually ily, and God knowswe havestruggled so pleadedguilty to violating the Prohibition hard to Live sincethis awfirll iniustice." laws as well as the Pure Food and Drug Congresswas lobbiedfor years,but it Act. The hitch was that they insisted tlev neverpassed a bill for victims'relief "The were only middlemen. If the judge went jake-legstory is almostcom- easyon them and put them on probation, pletely about class," Morgan says. "If John theywould tum over the much more im- someonehad poisoned the Cana- poltant criminal. The judge complied. dian sourceof bonded Scotch,something In reality, Gross and Reisman were would havebeen done. Butthese menwere the oneswho not only had made the jake mosdy migrants. They came to the city, but had ignored early news reports indi- leaving their women, to get work They cating that their product was responsi- were seenas pooq sloppydrunks."And so ble for the outbreak of paralysis. They thejake-leg tragedydroppeddown the na- also neglected to mention, during plea tional amnesiahole. With its unwelcome Tfltflf vt|0lt bargaining the two barrels shipped in implications about Prohibition and pov- ATMcLEAN HOSPITAL March. When those showed uo in Los erty, and its falling thirtyyears before the Angeles the following yeat andparalyzed eraof class-actionlawsuits, the epidemic QAr* ^r"redpsych iatri c evaluation another two hundred people, the judge would have probably remained forgotten and treatment. Unsurpasseddiscretion revoked Grosst probation. In April, but for the efforts of the Allen Brothers, and sewice. 1932,he beganserving a two-yearprison Ishmon Bracey, Tommy Johnson, the sentence.Reisman never did time. Mississippi Sheiks,Willie Lofton, and 617.855.357oor [email protected] Daddy Stovepipeand Mississippi Sarah. w. mclean.haroard. edu fewpeople tried to suethe distrib- Even Ephraim Goldfain, the fintdoc- Amojorteochingfacili! of Hamrd MedicalSchool utors who sold them the bad iake, tor to treat the illness, took litde apparent andan afiliate of Mowchwtts GeneralHo$ital but nobody went after the one entity pride in his role. He went on to make a with deep pockets: the Celluloid Cor- name for himself locally,pioneering the poration. In May of 7931, some Okla- use of gold in arthritis therapy. He"was homans organized the United Victims of also celebratedin Oklahoma for a rheu- Jamaica Ginger Paralysis,which claimed matism serum he mixed himsef hand- to speakfor thirty-five thousand stricken blowing the glassvials that held the doses people acrossthe country. Unfortunately, and fashioning,instead of the usualtear- the Federal Rules of Civil Procedure, drop top, whimsical animal-head stop- which effectively enabled class-action pers.With his granddaughterSuellen in lawsuits, were seven years in the future, the passengerseat, he would drive among and product-liability law was in its in- the tiny farm communities surrounding for lhe disdminating uamlionu. . . "To a connilmml to exallznu fanry. have brought such suits would Oklahoma Ciry injecting his patients. havebeen almost unthinkable," according He died in 1983. SuellenSinger still en- Rrntak and. Salzs to Andrew Popper, a torts professor at joys telling familv stories about him, but Pam H arrington Exclusiaes the Washington College of Law at Amer- she saysshe knorvs nothing about the hllp: / /uw). hiawahexchtsiaes.com "They'd 1-800-845 6966 ican University. have thrown you jake leg. He never mentioned it. I

THE NEV YORI(ER,JEPTEMBER 15, 2OO3