The Black Vomit (Vomito Negro) of Iquitos, Peru, Identical With Yellow Fever

REPORTS OF CASES Case 1. —On August 19, 1905, three months after my arrival at Iquitos, I was called to attend Mr. G. S., a German, aged 34 and robust, who had recently arrived from Brazil, where he had passed a few days in Manaos on his journey from Europe. He lived in Iquitos above a store. A violent shivering, with intense rachialgia, cephalalgia and fever, had been the first symptoms of the patient's illness. Examining his abdomen, there was noticeable only a wellmarked sensation of pain at the epigastrium. He had fits of vomiting and a temperature of 39 C. (102.2 F.). His eyes were red. I ordered him a saline purge. On the following day I observed that the patient's liver was enlarged and the other symptoms continued. As the purge had caused a good evacuation, I ordered him quinin as a draught and salicylate enemas.