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I agree, we could do better, and the ideal situation is one where we have images like those from a textbook. We don't have that yet, though. In the meantime, why not keep one image that does in fact demonstrate vomit in real life? If it really is questionable whether it actually is vomit, then the discussion is another entirely. I don't see the rationale for removing something just because it could be done in another, and more tasteful/better way. A ""bad"" image of a pancake would not just be removed (unless it had extremely bad photographic quality), it would be kept until a better image of pancakes was available. I don't see how vomit should be any different.  "