Case Reports of Toxicity Caused By Commercially Available Products

Consumption of Jamaica ginger, an alcoholic ginger extract that was popular as a beverage in the rural southern United States during prohibition, resulted in a peripheral polyneuritis (39). In reported cases, the first symptom to appear was sore calves for 1 or 2 days. After the soreness disappeared, walking became notably difficult for the case subjects. Subjects could not walk without the aid of a cane or crutches within 1 week. Bilateral weakness of the upper and lower extremities and foot drop, without sensory disturbance or pain, was a common physical finding. The skin on the feet was noted to be red and glossy, but not swollen. Deep tendon reflexes were inconsistent among patients; ankle jerks were not present in any subject, but some had normal knee reflexes. There were no cranial nerve deficits. Although the beverage contained 60-90% alcohol, alcoholic neuropathy was ruled out as an etiology of the syndrome because of the sporadic nature of Jamaica ginger consumption. Jamaica ginger was eventually exonerated as cause of the neuropathy and an adulterating agent, triorthocresyl phosphate, was identified as the putative toxin (40). This chemical had been added to the beverage presumably as a tasteless substitute for the oleo resin of ginger so that the product would be more palatable. Additional research with alcohol and true United States Pharmacopeia (USP) ginger fluid extract failed to produce paralysis. Subsequent reports of cases of neuropathy associated with the use of ginger in any form have not been forthcoming.

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