The High Steppers

A Ruritan Club Memory

In 1981, after years of turning down invitations to join civic clubs, I joined the Eaton’s Crossroads Ruritan Club in Lenoir City. The club's members were a diverse mix of businessmen, farmers, engineers, politicians, and teachers. All were good old boys with stories to tell.

One of my friends in the club was Cecil Simpson, the first young man from Loudon County to be appointed to a U.S. military academy. He graduated from Annapolis in 1942, just in time to participate in World War II. Like many members of the club, Cecil had memories of Prohibition and the Great Depression.

At the conclusion of one of our meetings, as the older members reminisced about the “good old days," Cecil inquired, “Who remembers the high steppers—that old woman and her grown daughter who lifted their feet high with every step?”

Several members recalled them. Ross Wilkerson added, “It wasn’t just those two women—the whole family walked that way.” They described the gait as looking like they were stepping over an imaginary barrier with each stride.

From that description, I assumed the unusual gait was likely due to a genetic disorder. I didn't think about it again until I read Sara Gruen’s 2006 novel Water for Elephants. In the book, a circus worker named Camel becomes paralyzed after consuming Jamaica ginger.

Jamaica Ginger and the Cause of “Jake Leg”

Jamaica ginger, commonly referred to as Jake, was a popular patent medicine containing 70-80 percent ethanol by weight. During Prohibition, it provided a convenient way to obtain alcohol. To discourage its use as a beverage, the U.S. government required manufacturers to add a certain percentage of solid material to make it less palatable. After several water-soluble solids were tested and rejected, tri-ortho-cresyl phosphate (TOCP), a plasticizer used in lacquers and paints, was chosen. The manufacturers of TOCP claimed it was nontoxic.

In the 1930s, however, the TOCP in Jamaica ginger was found to cause paralysis of the hands and feet in thousands of users. Some victims could still walk, but they lost control of the muscles that lift the toes. To avoid stumbling, they lifted their feet unusually high; their toes flopped downward and struck the ground before their heels, producing a distinctive “tap-click, tap-click” sound. This peculiar gait became known as the Jake walk, and the condition as Jake leg. The disease is now called organophosphate-induced delayed neuropathy. While some victims regained full or partial use of their limbs, for most, the damage was permanent. The total number of victims was never definitively established, with estimates ranging from 30,000 to 50,000.

A Local Memory

Dr. Walter Shea was one of only two physicians practicing in Lenoir City in the 1980s. I asked him if he had ever treated patients with Jake leg. He struggled to recall the condition before saying that he had seen patients with it, but there was no treatment available.