SIR,-Recently I was called to see a girl
aged 4 years who had had abdominal pain
and vomiting for 24 hours. As I was taking
the history from the parents the child vomited
once again. To my surprise, and that of her
mother, the vomit appeared blue. Its volume
was about 50 ml., and on standing a powdery
substance fell to the bottom of the container.
This was a rather beautiful pale cobalt. The
supernatant fluid was colourless. Observation
was carried out in daylight, but the vomit was
unfortunately not kept. A previous vomit
had been put by for my inspection; this
showed gastric juice coloured green by
On questioning, the mother stated that the
child had been given sips of diluted orange
squash or water in the past 24 hours. A
kaolin mixture had also been given, fourhourly.
There had been no opportunity totake
any other drink such as blackcurrant
juice, nor to suck any paint or ink.
Examination of the patient showed evidence
of appendicitis, and appendicectomy was
carried out successfully a few hours later. As
far as I know there was no more blue vomiting.
I cannot suggest a satisfactory reason for
the production of the blue colour. Bile pigments
had probably been adsorbed by the
kaolin, but why blue, a primary colour, had
resulted I do not know. Perhaps your
correspondents can provide an explanation ?
-I am, etc.,
Bristol. A. P. RADFORD.