The song begins with a litany of complaints: “I can’t eat, I can’t talk, been drinkin’ mean jake, Lord, now I can’t walk.” “Jake” refers to Jamaica Ginger, a patent medicine that was legally available during Prohibition in spite of its high alcohol content.

When patients started showing up with a frightening new constellation of symptoms—the most prominent being an exaggerated gait caused by pain and weakness in the legs—medical professionals struggled to identify the cause. But several recording artists, largely confined to the “race” and “hillbilly” genres, accurately diagnosed the source of the affliction. The tale of woe quoted above was put to wax by the Allen Brothers (Austin and Lee) in a Memphis recording session for the Victor label in June 1930. Though “Jake Walk Blues” tells of personal loss and failure, it is an upbeat number, accompanied by a banjo, kazoo, and guitar.

The earliest report of Jamaica Ginger Paralysis, as it would come to be known, occurred in February 1930, when Dr. Ephraim Goldfain of Oklahoma City started seeing  a series of patients, all men, exhibiting the same symptoms. A March 7, 1930, article in The Oklahoman told of “spinal afflictions, believed to be the result of poison whiskey, which has afflicted 60 men in Oklahoma City in the last ten days. … The strange malady affects the spine, causing a partial paralysis, especially of the feet, resulting in inability to walk normally.”

Jamaica Ginger had been used as a patent medicine for decades without side effects. But under Prohibition, the Treasury Department required that jake be sold with a higher concentration of ginger solids, resulting in an incredibly bitter taste, and tested bottles by boiling the contents and weighing what was left over. To pass this test without rendering jake unpalatable, some bootleggers added castor oil. Harry Gross and Max Reisman, two brothers-in-law from Boston, instead added a chemical plasticizer known as tri-ortho-cresyl phosphate. TOCP was tasteless and cheaper than castor oil. It was also a neurotoxin.

The nexus between American roots music and epidemiology might have been lost to history but for the efforts of John Morgan, a former professor of pharmacology at the City University of New York who styled himself a “pharmacoethnomusicologist” to Dan Baum for a 2003 New Yorker profile and wrote about the phenomenon in a 1976 article in the Annals of Internal Medicine (with coauthor Thomas Tulloss). Morgan, who died of leukemia in 2008, was an advocate of drug-policy reform and the coauthor of the book Marijuana Myths, Marijuana Facts.

The Annals article was subtitled “A Toxicologic Tragedy Mirrored in American Popular Music.” In it, Morgan briefly discussed the medical background of Jamaica Ginger poisoning before moving on to the songs. Morgan apparently felt it necessary to engage in Cliff’s Notes-style explanations such as “commercial recording of rural southern artists (black and white) began in the 1920s.” He helpfully instructed his readers on a particular guitar style requiring that “some hard object … be placed against the strings … and slid back and forth for the desired pitch. This method is sometimes called ‘slide guitar.’” One can almost picture a suburban doctor, relaxing in his Scarsdale study with a martini while listening to Mantovani, contemplating this “slide guitar”—while his teenage son blares the Allman Brothers’ At the Fillmore East from his upstairs bedroom.

One of the songs Morgan considered is by the Mississippi Sheiks, an African-American string band who recorded “Jake Leg Blues” at about the same time as the Allen Brothers recorded their similarly titled song. The Sheiks, apparently having witnessed the ill effects, warned that “if you sell him jake, you’d better give him a crutch too” and “if he drank this jake, it will give him the limber leg.”

The second line refers to another problem alluded to in a number of songs, perhaps most clearly by Mississippi Delta Bluesman Ishmon (sometimes spelled “Ishman”) Bracey. In “Jake Liquor Blues,” Bracey explained: “You have numbiness [sic] in front of your body, you can’t carry any lovin’ on.” To make the point clearer, the next verse featured a second opinion: “Aunt Jane, she come runnin’ and screamin’, tellin’ everybody in the neighborhood ‘that man of mine got the limber trouble, and his lovin’ can’t do me any good.’”

Bracey, along with Tommy Johnson, made the first recordings to allude to Jake poisoning in March 1930, as doctors were first grappling with the crisis. According to Morgan, “Tommy Johnson and Ishman Bracey were friends, and both were from Central Mississippi near Jackson. … Both performances, [Johnson’s] ‘Alcohol and Jake Blues’ and [Bracey’s] ‘Jake Liquor Blues’ were backed by the New Orleans Nehi Boys, leading one to believe that they resulted from the same recording session in early 1930.”

At the time of Morgan’s article, there were no extant copies of Tommy Johnson’s record, and Morgan speculated that it had never been issued. It has since surfaced. Johnson was evidently a troubled man who drank heavily; in 1967, about a decade after Johnson’s death, his older brother told journalist and blues researcher Gayle Dean Wardlaw that the musician would “drink anything—bay rum [aftershave], canned heat [Sterno fuel], shoe polish, moonshine, Solo [paint thinner]—anything that had alcohol in it.” Johnson’s taste for Sterno served as the basis for his better-known song “Canned Heat Blues,” which provided the name for the blues-rock band Canned Heat.

Reliable demographic data about victims of jake poisoning do not exist, though the profile of the typical suffer was an itinerant, male heavy drinker. Estimates of the total number varied from fewer than 5,000 up to 60,000, out of a population of 122 million according to the 1930 census. In addition to poor record-keeping and black victims’ being blocked from segregated hospitals (some health-care professionals thought blacks to be immune), the affliction carried a stigma. “On April 1 cards were sent to about 2,500 physicians in the 77 counties [of Oklahoma]. On April 23 approximately 40 per cent of these had been returned and showed 536 cases in 39 counties,” wrote the American Journal of Public Health in 1930. “Because of the tendency to be ashamed of the affliction it is safe to assume that this number represents only about one-third of the cases and that there are therefore between 1,500 and 2,000 in the state.”

Whatever the total number of victims, the outbreak inspired an unusual number of songs. Morgan speculated to Dan Baum that “no other incident has inspired as much popular music as the jake-walk epidemic.” (Another contender may be the 1927 Mississippi River flood: It affected several hundred thousand people, mostly in Mississippi, Louisiana, and Arkansas, and and inspired numerous songs, including “High Water Everywhere” by Charley Patton, “Mississippi Heavy Water Blues” by Barbecue Bob and Kansas City Joe, and Memphis Minnie’s “When the Levee Breaks,” later covered by Led Zeppelin and Bob Dylan.)

The most likely reason for the large number of songs is that the category of people who were recording roots music records around 1930 overlapped with that of people who were looking for ways to get drunk during Prohibition—mostly male, both black and white, and often economically marginal. Morgan didn’t report on which songs were works of journalism carved in wax and which were the work of memoirists, though it is a good bet that Tommy Johnson’s work falls into the latter category. But Morgan did note that most of the songs were “devoid of the sentimentality and moralizing that are an integral part of most narratives of tragedy in American ballads recorded commercially.”

“Jake Walk Blues” by the Allen Brothers is indeed devoid of sentimentality, moralizing, or self pity on the part of the sufferer. The song features a changing point of view from that of the shiftless jake sufferer to that of his woman, who is lacking in sympathy: “Listen here, Papa, can’t you see, you can’t drink jake and get along with me. You’re a jake walkin’ papa with the jake walk blues; I’m a red hot mama that you can’t afford to lose.” Alas, her man won’t change—shiftlessness runs in the family: “My daddy was a gambler and a drunkard too; if he was living today, he’d have the jake walk too. When I die, you can have my hand; I’m gonna take a bottle of jake to the Promised Land.”

Toward the end of the Annals article, Morgan reflected on the ephemeral nature of popular culture and looked forward to what we might lose in the future. “These performances, valuable in many ways, were not saved systematically. … We have never located the Johnson [since found] and Daddy Stovepipe [still missing] recordings, and the Allen Brothers song that generated this project came to us from a German collector.” He included a helpful table of where to locate the songs he discussed, several of which were only available on tape from archives and collectors.

He suggested that “perhaps in 2016 a scholar will bemoan the loss of all prints of ‘My Little Margie,’” a fate that has yet to come to pass.

Clark Stooksbury writes from Knoxville, Tenn.