Some account of the last yellow fever epidemic of British Guiana / by Daniel Blair, surgeon general of British Guiana ; edited by John Davy, inspector general of army hospitals, etc.

  • Blair, Daniel.
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: Some account of the last yellow fever epidemic of British Guiana / by Daniel Blair, surgeon general of British Guiana ; edited by John Davy, inspector general of army hospitals, etc. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    violent retching, straining, suffusion of face and spasm of recti muscles, at first. But when black vomit is established, all these cease, and the stomach seems to act alone. Then the patient will speak to you, lean his head over the bed, eject his mouthful or basin-full of black vomit, and resume his con- versation with scarcely any interruption. Sometimes it comes up as if in rumination, and at others it is ejected in a spout to a considerable distance. In both latter cases, however, it seems perfectly involuntary. The vomiting in the last stage is generally provoked by swallowing any thing either fluid or solid, but I have seen it induced by the erect position, and the act of falling asleep. The white ropy acid fluid, which is frequently ejected at the close of the second stage in considerable quantities, and with much relief to the symptoms, is generally attended with considerable retching. This is the fluid which, during our epidemic, was called premonitory or precursory fluid, or white vomit.* The first effect of black vomit seems to be of the most salutary kind, particularly on the tongue. Indeed, when with sudden improvement of the tongue and other symptoms there exists dirty or other discolouration of the surface, and at the age of the disease when black vomit might be expected, then succussion will sometimes detect the presence of the effused fluid before vomiting occurs. The scanty clay and snuff-like black vomit generally attends or follows the white vomit of the second stage or mitior form of the disease. Black vomit is rarely black ; it Is generally of a dark brown or umber. Its appearance is sometimes thin, like bog water,— sometimes thick, like molasses. It is rarely homogeneous. A black, thick, filamentous, or flocculent, or granular, or scaly pre- cipitate separates in the basin from the brownish supernatant water, and generally, in reference to space, occupies about ono fourth of the whole. Black vomit seems to be blood acted on by acid, and varying in appearance on account of the different manner of its extravasation, whether in drops, stream, or minute * [In the late endemic in Barbados, a fluid, answering tolerably to the desci'iption of white vomit given in the text, was not of unfreqiient occur- rence, though not so frequent as to arrest attention._ It would be interesting to know what its composition is, especially whether it is serous. The slight- est chemical examination might sulEce to determine the question.]—Ed.