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Quebec's Medical Mystery

JAMA. 1966;196(11):25-27. doi:10.1001/jama.1966.03100240015004.
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Beginning in the late summer and fall of 1965, physicians in Quebec were confronted by a series of patients with symptoms suggesting cardiac insufficiency.

These patients had two things in common: Most were residents of the same section of Quebec, and all were accustomed to drinking unusually large quantities of beer—some of them as much as seven quarts a day.

The attempt to find an explanation for this epidemiological idiosyncrasy, as well as to explain certain unusual, and perhaps unique, features of the underlying disease process has evolved into a major research effort by a host of investigators.

The first patient, a 39-year-old man whose clinical signs included cyanosis, dyspnea and tachycardia, was admitted to a hospital, Aug 24. The second patient, a 47-year-old taxicab driver with similar signs, was hospitalized Oct 20.

Three similar cases appeared in November. In December, there were seven. All were heavy beer drinkers; some


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