Sprue gives a flatulent dyspepsia with gaseous eructations.
Pellagra gives eructations and pyrosis and very common is a burning sensation going up from the stomach along the line of the oesophagus.
The esophagus is raw in sprue so that swallowing is painful.
Nausea and Vomiting
So many diseases are attended with nausea, besides those in which nausea is accompanied by rather constant vomiting, that it would hardly seem advisable to consider it alone. At the same time the slight nausea which often accompanies bacillary dysentery, as one of the manifestations of toxaemia, is of value in differentiating this type of dysentery from the amoebic one.
In yellow fever there may be early vomiting of whitish or bile-stained mucus but the well-known black vomit is a later feature, only occurring after the fourth day when the other haemorrhagic manifestations set in.
Bilious vomiting is the feature in bilious remittent fever which causes the patient the greatest distress.
In blackwater fever the frequent retching and bilious vomiting tend to exhaust the patient and the persistent vomiting of green bile often precedes death.
Bilious vomiting may be quite a feature of the icteric type of relapsing fever.
Vomiting sickness.—There is a disease known as vomiting sickness which has been noted in Jamaica. It occurs chiefly in children and has a sudden onset with marked vomiting followed by cerebral symptoms and great mortality. Some have thought the disease to be yellow fever but the fever and jaundice of that disease are absent. Scott has thought it to be epidemic cerebro-spinal meningitis, but more recently has suggested that it is possibly due to the eating of some poisonous substance, plant or otherwise, and that it is not an infectious disease. It is now recognized as due to ackee poisoning.