BILIOUS VOMITING. 139 



quantities when the fluid is acid, but in larger quantities when there 

 is an alkaline reaction. 



The specific gravity of these fluids varies from 1'025 to 

 1'007 ; they contain from 0*4 to O6 of solid constituents, of which 

 more than half are often inorganic. (Wittstock,* Mulder,t 

 Andral,{ A. Taylor, Becquerel,|| Guterbock,1[ Schmidt). 



The albumen, regarding whose presence or absence in the 

 cholera-dejections there has been so much discussion, can generally 

 only be recognised by the aid of hydrochlorate of ammonia, or, if 

 the reaction of the fluid be alkaline, by its neutralization. 



Biliary matters are contained in the vomited matters under 

 very different conditions. We most commonly find biliary matters 

 vomited simultaneously with the remains of food ; and, by a care- 

 ful chemical examination, the biliary acids may be detected by 

 Pettenkofer^s test in most substances discharged by vomiting; 

 it is also easy to understand how the contents of the small 

 intestine, including the constituents of the bile, are ejected by 

 antiperistaltic motion. We meet with larger quantities of bile 

 mixed with slight remnants of food or only with gastric juice and 

 saliva, in the matters vomited in inflammatory conditions of the 

 abdominal organs, especially of the peritoneum, as well as in 

 cerebral affections of an inflammatory nature ; the vomited matter 

 is then of a grass-green, or verdigris colour (vomitus ceruginosus). 

 The green colour of these fluids is dependent on the green modi- 

 fication of the bile-pigment, which is induced by the action of the 

 free acid of the gastric juice on the brown pigment : the fluid 

 has generally a strong acid reaction, and on the addition of sul- 

 phuric with an admixture of nitric acid, or of the latter acid alone, 

 exhibits the most beautiful changes of colour peculiar to the bile- 

 pigment. It usually contains no substance coagulable by heat, 

 but saliva is present, as, at least, may be inferred from the cir- 

 cumstance that sulphocyanides may be detected in the alcoholic 

 extract. As in all vomited matters, we here find pavement and 

 cylindrical epithelium and fat-globules, in addition to saliva; the 

 fat-globules in this case, when examined under the microscope, 

 usually exhibit a green colour, from the presence of cholepyrrhin. 



Bloody vomiting may, as is well known, be associated with very 

 various conditions. The blood is often still fluid and of a tolerably 

 bright colour when it is ejected very soon after its escape from 



* Pogg. Ann. Bd. 24, S. 525. 



t Natuuren Scheikundig Archif. D. 1, st. 1, 1833. 



J Gaz. m^d. 1847, p. 654. Chem. Gaz. 1849, p. 95. 



|| Arch, g&i. de Med. 4 S^r. T. 21, p. 192. 



If Journ. f. pr. Ch. Bd. 48, S. 780, u. 850.. 



