Dulcolax

Stefano Schena, M.D., Ph.D.

• Assistant Professor of Surgery

https://www.hopkinsmedicine.org/profiles/results/directory/profile/10004105/stefano-schena

There was also some reduction in plaque ombrello glass treatment 5mg dulcolax sale, although it was not statistically significant treatment for plantar fasciitis buy genuine dulcolax online. Another study found that the Oral-B Professional Care 7000 symptoms 4 dpo 5mg dulcolax with amex, which has an oscillating 9 medications that can cause heartburn dulcolax 5 mg overnight delivery, rotating head symptoms 7dp5dt order dulcolax 5 mg mastercard, was more effective at reducing plaque and bleeding of gingivitis compared with another electric toothbrush treatment 3 degree heart block order 5mg dulcolax otc. Over three-quarters of people in the United States have hemorrhoids at some time in their lives. Contributing factors are standing or sitting for long periods, being overweight, not exercising enough, and smoking. Internal hemorrhoids (ones that are inside the anal cavity) usually cause painless bleeding at the end of a bowel movement. Blood can be a sign of a serious problem so it is important to be evaluated by a health professional. This often occurs when the hemorrhoid has prolapsed and can be seen outside the anus or it can be caused when a blood clot develops or the hemorrhoid becomes twisted. Although they can be itchy and painful, they sometimes do not cause typical symptoms. When people see spots of blood on the toilet paper and have pain with bowel movements, they often immediately think its hemorrhoids when the problem may really be a small but painful tear called an anal fissure. If stools are dry and hard, the anal sphincter is forced open wider than normal, resulting in a tear, or anal fissure. Anal fissures also cause a sharp, stinging, often severe pain with the passage of each bowel movement (whereas hemorrhoids often cause bleeding but no pain). Herbal Remedies Fiber One of the most common causes of hemorrhoids is inadequate fiber intake. Fiber shows a consistent beneficial effect for relieving hemorrhoid symptoms and bleeding. Seven randomized trials with a total of 378 participants have found fiber improved symptoms including itching, discomfort, and pain. A typical dose of psyllium is 1 teaspoon of the husks in water followed by another glass of water. My favorite is ground flaxseeds, which I mix with brown rice or sprinkle on salads. Whatever the source of fiber, it is important to drink sufficient water or constipation may worsen. Bioflavonoids Bioflavonoids are a type of plant compound that stabilizes and strengthens blood vessel walls and decreases inflammation. They have been found to reduce anal discomfort, pain, and anal discharge during an acute hemorrhoid attack. Side effects of bioflavonoids appear to be mild and rare, making them a promising treatment for hemorrhoids in pregnancy (the flavonoid tangeretin however, should not be used by people taking tamoxifen for breast cancer). The major flavonoids found in citrus fruits, diosmin, herperidin, and oxerutins, appear to be beneficial. Daflon, a product made with citrus bioflavonoids was found to improve symptoms in pregnant women by day four of taking it and to reduce symptoms of pain, heaviness, bleeding, itching and discharge. Witch hazel compress or cream this drug store staple is made from the leaves and bark of a plant called Hamamelis virginiana. It should not be taken internally but instead is applied topically to the anal area in the form of witch hazel distilled liquid, ointment, or medicated pads. Butchers Broom this plant Ruscus aculeatus, which is also known as knee holly, box holly, and sweet broom, gets its name because it was once used by butchers in Europe to clean their chopping blocks. Butchers broom has a long history of traditional use for hemorrhoids and varicose veins. Butchers broom extract has anti-inflammatory and vein-constricting properties believed to improve the tone and integrity of veins and shrink the swollen tissue. The tea has a slightly bitter taste, so a bit of stevia or honey can be used to sweeten it. The tea can be made by steeping 1 teaspoon of the herb in a cup of hot water for 10 to 15 minutes. Butchers broom has also been shown to be effective when applied topically as an ointment or compress. Horse chestnut Description Horse chestnut (Aesculus hippocastanum), like Butchers broom, is often recommended when there is poor circulation in the veins, or chronic venous insufficiency. It relieves symptoms such as swelling and inflammation and strengthens blood vessel walls. Precautions People with an allergy to the horse chestnut family, bleeding disorders, or people taking blood thinners should not take horse chestnut. Although uncommon, side effects have included kidney damage, severe bleeding, bruising, and liver damage. Other Herbs Triphala Description It is an Ayurvedic compound composed of three fruits. It is well known as a bowel tonic that gently relieves constipation without being a harsh stimulant. Exercise Getting Diagnosed A thorough evaluation and proper diagnosis by the doctor is important any time bleeding from the rectum or blood in the stool occurs. Bleeding may also be a symptom of other digestive diseases, including colorectal cancer. Conventional treatment options include cutting off circulation to the hemorrhoid (ligation), shrinking the hemorrhoid chemically (sclerotherapy), burning hemorrhoid tissue with a special device (infrared coagulation), and surgery (hemorrhoidectomy). The definition of a seasonal allergy is an immune system reaction to a natural substance in the environment that occurs during a particular time of the year. Scratchy throat the difference between a seasonal allergy and other allergies the difference between a seasonal allergy and other allergies is that a seasonal allergy will stop at some point, depending on where you live and the substance to you are allergic too. It may be harder to tell when a seasonal allergy begins and ends in the South because the seasons blend into one another, whereas in the North, the changing of the seasons is more distinct. About the Condition: this condition occurs during the spring, summer and early autumn and usually lasts for several weeks, is caused by pollens that enter the nasal passages and cause a hypersensitivity reaction. Conventional treatments include oral decongestants, antihistamines, topical steroid sprays and desensitization. Herbal Treatment: Butterbur is a perennial shrub that grows in Europe, Asia and North America. The main active constituents are petasin and isopetasin, which are believed to reduce smooth muscle spasm and have an anti-inflammatory effect. Butterbur also contains pyrrolizidine alkaloids, which are associated with liver toxicity and carcinogenesis and considered unsafe. In fact, butterbur is in the same botanical family as ragweed and could theoretically trigger an allergic reaction. Type 2 diabetes is a syndrome characterized by high blood sugar resulting from an impaired response to insulin. Type 2 diabetes is usually diagnosed in patients over the age of thirty, but it also occurs in children and teens. It is commonly associated with being overweight, especially around the abdomen area. Symptoms Type 2 diabetes is frequently diagnosed in aymptomatic patients during a routine medical examination. Itching due to vaginal yeast infection Late complications of diabetes include heart disease, infections, skin ulcers, kidney disease, numbness and tingling in the hands and feet, impotence, constipation, pain and poor circulation in the legs, vision loss. Diagnosis Type 2 diabetes is diagnosed when the criteria for fasting high blood sugar are met. A test called the oral glucose tolerance test is often conducted if fasting blood sugar is between 115 and 140 mg/dL (6. For monitoring diabetes, glycosylated hemoglobin (HbA1c) is tested to estimate blood sugar control over the prior three months. Treatments Most people with this type of diabetes are treated with diet, exercise and oral prescription drugs. Several alternative methods may help when used under medical supervision in conjunction with standard treatments. Once herbs and other measures for controlling blood sugar work, medication needs to be adjusted by your doctor. Foods that emphasize vegetables, legumes, whole grains, and fiber can influence the release of sugar into the bloodstream. Foods that should be avoided are refined sugar, processed food, junk food, pastries, and cookies. When checking labels, watch out for hidden forms of sugar, such as dextrose, glucose, sucrose, corn sweeteners, fructose, dextrin, high-fructose corn syrup, lactose, modified cornstarch, maltose, malt, fruit juice concentrates, mannitol, sorghum, xylitol, and sorbitol. Foods that have a higher rating on the ?glycemic index, a scale developed by nutrition researchers at the University of Toronto, cause a higher insulin spike than those with a lower rating. Higher glycemic index foods are white bread, bagels, English muffins, packaged flaked cereal, instant hot cereals, frozen desserts, dried fruit, whole milk, hot dogs, and luncheon meat. Lower glycemic index foods are most fresh vegetables, leafy greens, 100% whole grain bread, sweet potato, skim milk, buttermilk, chicken, lean cuts of beef, pork, and veal, white-fleshed fish, and many nuts. There are many factors that can influence glycemic index, such as cooking and preparation method. Herbs, Nutritional Supplements and Vitamins Chromium Chromium is an essential trace mineral. There is a growing body of evidence that shows that chromium may help bring blood sugar levels under control in type 2 diabetes. Fenugreek Fenugreek is a spice commonly used in India and the Middle East in cooking. Numerous studies suggest that fenugreek can reduce blood sugar and cholesterol levels in people with diabetes. Fenugreek seeds can have a bitter taste, so people sometimes prefer to take it in capsule form. Gymnema Gymnema is an Ayurvedic herb that is believed to have a marked effect on blood sugar control. Doctors often prescribe gymnema for mild cases of type 2 diabetes, in conjunction with standard treatments. A typical dose range is 400 to 600 mg per day of an extract standardized to contain 24% gymnemic acids. Vanadium Vanadium is an essential trace mineral that may mimic insulin to help regulate blood sugar. It is found in black pepper, dill seed, and unsaturated vegetable oil, as well as in vitamin supplements. Food sources of zinc include fresh oysters, ginger root, lamb, pecans, split peas, egg yolk, rye, beef liver, lima beans, almonds, walnuts, sardines, chicken, and buckwheat. Other herbs and supplements the function if the digestive organs should be optimized, particularly the liver and pancreas. Dandelion and other bitter herbs, tumeric, and bupleurum are just a few of the herbs that can help with this. Another goal should be to tonify the endocrine system and promote hormonal balance. Ginseng, licorice, oatstraw, and hawthorn are some of the herbs that can tonify the endocrine system. Helpful supplements for diabetes are vanadium, B vitamins (especially vitamin B6), vitamins C and E, and coenzyme Q10. Treating Complications of Diabetes Lipoic acid In Germany, the antioxidant lipoic acid is used widely for the prevention and treatment of peripheral neuropathy in diabetes. This complication usually develops after many years, and is a painful condition affecting the nerves. Lipoic acid occurs naturally in the body, and it is often reduced in people with diabetes. A typical dose for diabetes is 300 to 600 mg per day, divided into two or three doses. There is some research suggesting that evening primrose oil can protect nerves, and help with symptoms such as pain and numbness. Omega-6 oils should be taken in balance with omega-3 oils, found in flaxseed oil, pumpkin seeds, walnuts, and fish oil. From there bacteria often move on to the bladder, causing a bladder infection (cystitis). If the infection is not treated promptly, bacteria may then go up the ureters to infect the kidneys (pyelonephritis). Although they are normal inhabitants of the colon, they can gain entry into the bladder and multiply. Other microorganisms called chlamydia trachoma is and mycoplasma hominis can be sexually transmitted, and infections require treatment of both partners. It involves cleaning the area around the urethral opening, beginning urination, and then collecting urine only from the middle of the stream. This urine sample is then analyzed for the level of bacteria-killing white blood cells (leukocytes). A culture and sensitivity may be performed to determine the type of bacteria that is causing the problem. This helps the doctor select the drug that specifically targets the problem bacteria. Although symptoms may begin to subside within 1 to 2 days, it is important to finish the entire course of medication to ensure that the infection has been completely eradicated. Even though symptoms are better, it does not necessarily mean that the infection is gone.

What meane these bloudy vowes medications not to take during pregnancy generic dulcolax 5 mg free shipping, and idle threats symptoms 7dp5dt discount generic dulcolax uk, Throwne out from womanish impatient mind? But if your selfe treatment yellow tongue discount dulcolax 5mg otc, Sir knight medicine 8 capital rocka dulcolax 5mg visa, ye faultie find medicine 7253 pill cheap dulcolax 5mg, Or wrapped be in loues of former Dame medications john frew buy dulcolax us, With crime do not it couer, but disclose the same. To whom the Redcrosse knight this answere sent, My Lord, my King, be nought hereat dismayd, darkwing. Till well ye wote by graue intendiment, What woman, and wherefore doth me vpbrayd With breach of loue, and loyalty betrayd. It was in my mishaps, as hitherward I lately traueild, that vnwares I strayd Out of my way, through perils straunge and hard; That day should faile me, ere I had them all declard. Then stepped forth the goodly royall Mayd, And on the ground her selfe prostrating low, With sober countenaunce thus to him sayd; O pardon me, my soueraigne Lord, to show the secret treasons, which of late I know To haue bene wroght by that false sorceresse. She onely she it is, that earst did throw this gentle knight into so great distresse, That death him did awaite in dayly wretchednesse. And now it seemes, that she suborned hath this craftie messenger with letters vaine, To worke new woe and improuided scath, By breaking of the band betwixt vs twaine; Wherein she vsed hath the practicke paine Of this false footman, clokt with simplenesse, Whom if ye please for to discouer plaine, Ye shall him Archimago find, I ghesse, the falsest man aliue; who tries shall find no lesse. The king was greatly moued at her speach, And all with suddein indignation fraight, Bad on that Messenger rude hands to reach. Eftsoones the Gard, which on his state did wait, Attacht that faitor false, and bound him strait: darkwing. Who seeming sorely chauffed at his band, As chained Beare, whom cruell dogs do bait, With idle force did faine them to withstand, And often semblaunce made to scape out of their hand. But they him layd full low in dungeon deepe, And bound him hand and foote with yron chains. And with continuall watch did warely keepe; Who then would thinke, that by his subtile trains He could escape fowle death or deadly paines? Thus when that Princes wrath was pacifide, He gan renew the late forbidden banes, And to the knight his daughter deare he tyde, With sacred rites and vowes for euer to abyde. His owne two hands the holy knots did knit, That none but death for euer can deuide; His owne two hands, for such a turne most fit, the housling fire did kindle and prouide, And holy water thereon sprinckled wide; At which the bushy Teade a groome did light, And sacred lampe in secret chamber hide, Where it should not be quenched day nor night, For feare of euill fates, but burnen euer bright. Then gan they sprinckle all the posts with wine, And made great feast to solemnize that day; They all perfumde with frankincense diuine, And precious odours fetcht from far away, That all the house did sweat with great aray: And all the while sweete Musicke did apply Her curious skill, the warbling notes to play, To driue away the dull Melancholy; the whiles one sung a song of loue and iollity. Great ioy was made that day of young and old, And solemne feast proclaimd throughout the land, That their exceeding merth may not be told: Suffice it heare by signes to vnderstand the vsuall ioyes at knitting of loues band. Thrise happy man the knight himselfe did hold, Possessed of his Ladies hart and hand, And euer, when his eye did her behold, His heart did seeme to melt in pleasures manifold. Her ioyous presence and sweet company In full content he there did long enioy, Ne wicked enuie, ne vile gealosy His deare delights were able to annoy: Yet swimming in that sea of blisfull ioy, He nought forgot, how he whilome had sworne, In case he could that monstrous beast destroy, Vnto his Farie Queene backe to returne: the which he shortly did, and Vna left to mourne. Now strike your sailes ye iolly Mariners, For we be come vnto a quiet rode, Where we must land some of our passengers, And light this wearie vessell of her lode. Here she a while may make her safe abode, Till she repaired haue her tackles spent, And wants supplide. And then againe abroad On the long voyage whereto she is bent: Well may she speede and fairely finish her intent. But let that man with better sence aduize, That of the world least part to vs is red: And dayly how through hardy enterprize, Many great Regions are discouered, Which to late age were neuer mentioned. Yet all these were, when no man did them know; Yet haue from wisest ages hidden beene: And later times things more vnknowne shall show. Why then should witlesse man so much misweene That nothing is, but that which he hath seene? And thou, O fairest Princesse vnder sky, In this faire mirrhour maist behold thy face, And thine owne realmes in lond of Faery, And in this antique Image thy great auncestry. The which O pardon me thus to enfold In couert vele, and wrap in shadowes light, That feeble eyes your glory may behold, Which else could not endure those beames bright, But would be dazled with exceeding light. Guyon by Archimage abusd, the Redcrosse knight awaytes, Findes Mordant and Amauia slaine With pleasures poisoned baytes. Whom Princes late displeasure left in bands, For falsed letters and suborned wile, Soone as the Redcrosse knight he vnderstands, To beene departed out of Eden lands, To serue againe his soueraine Elfin Queene, His artes he moues, and out of caytiues hands Himselfe he frees by secret meanes vnseene; His shackles emptie left, him selfe escaped cleene. Him therefore now the obiect of his spight And deadly food he makes: him to offend By forged treason, or by open fight He seekes, of all his drift the aymed end: Thereto his subtile engins he does bend His practick wit, and his faire filed tong, With thousand other sleights: for well he kend, His credit now in doubtfull ballaunce hong; For hardly could be hurt, who was already stong. Still as he went, he craftie stales did lay With cunning traines him to entrap vnwares. And priuie spials plast in all his way, To weete what course he takes, and how he fares; To ketch him at a vantage in his snares. But now so wise and warie was the knight By triall of his former harmes and cares, That he descride, and shonned still his slight: the fish that once was caught, new bait will hardly bite. Vpon the way him fortuned to meet, Faire marching vnderneath a shady hill, A goodly knight, all armd in harnesse meete, That from his head no place appeared to his feete. His carriage was full comely and vpright, His countenaunce demure and temperate, But yet so sterne and terrible in sight, That cheard his friends, and did his foes amate: He was an Elfin borne of noble state, And mickle worship in his natiue land; Well could he tourney and in lists debate, And knighthood tooke of good Sir Huons hand, When with king Oberon he came to Faerie land. Him als accompanyd vpon the way A comely Palmer, clad in blacke attire, Of ripest yeares, and haires all hoarie gray, That with a staffe his feeble steps did stire, Least his long way his aged limbes should tire: And if by lookes one may the mind aread, He seemd to be a sage and sober sire, And euer with slow pace the knight did lead, Who taught his trampling steed with equall steps to tread. Such whenas Archimago them did view, He weened well to worke some vncouth wile, Eftsoones vntwisting his deceiptfull clew, He gan to weaue a web of wicked guile, And with faire countenance and flattring stile, To them approching, thus the knight bespake: Faire sonne of Mars, that seeke with warlike spoile. He stayd his steed for humble misers sake, And bad tell on the tenor of his plaint; Who feigning then in euery limbe to quake, Through inward feare, and seeming pale and faint With piteous mone his percing speach gan paint; Deare Lady how shall I declare thy cace, darkwing. Would God thy selfe now present were in place, To tell this ruefull tale; thy sight could win thee grace. Or rather would, O would it so had chaunst, That you, most noble Sir, had present beene, When that lewd ribauld with vile lust aduaunst Layd first his filthy hands on virgin cleene, To spoile her daintie corse so faire and sheene, As on the earth, great mother of vs all, With liuing eye more faire was neuer seene, Of chastitie and honour virginall: Witnesse ye heaue[n]s, whom she in vaine to helpe did call. How may it be, (said then the knight halfe wroth,) That knight should knighthood euer so haue shent? None but that saw (quoth he) would weene for troth, How shamefully that Maid he did torment. Her looser golden lockes he rudely rent, And drew her on the ground, and his sharpe sword, Against her snowy brest he fiercely bent, And threatned death with many a bloudie word; Toung hates to tell the rest, that eye to see abhord. Therewith amoued from his sober mood, And liues he yet (said he) that wrought this act, And doen the heauens afford him vitall food? He liues, (quoth he) and boasteth of the fact, Ne yet hath any knight his courage crackt. Where may that treachour then (said he) be found, Or by what meanes may I his footing tract? That shall I shew (said he) as sure, as hound the stricke[n] Deare doth chalenge by the bleeding wound. He staid not lenger talke, but with fierce ire And zealous hast away is quickly gone To seeke that knight, where him that craftie Squire Supposd to be. They do arriue anone, Where sate a gentle Lady all alone, With garments rent, and haire discheueled, Wringing her hands, and making piteous mone; Her swollen eyes were much disfigured, And her faire face with teares was fowly blubbered. The knight approching nigh thus to her said, Faire Ladie, through foule sorrow ill bedight, Great pittie is to see you thus dismaid, And marre the blossome of your beautie bright: For thy appease your griefe and heauie plight, And tell the cause of your conceiued paine. For if he liue, that hath you doen despight, He shall you doe due recompence againe, Or else his wrong with greater puissance maintaine. Which when she heard, as in despightfull wise, She wilfully her sorrow did augment, And offred hope of comfort did despise: Her golden lockes most cruelly she rent, And scratcht her face with ghastly dreriment, Ne would she speake, ne see, ne yet be seene, But hid her visage, and her head downe bent, Either for grieuous shame, or for great teene, As if her hart with sorrow had transfixed beene. Till her that Squire bespake, Madame my liefe, For Gods deare loue be not so wilfull bent, But doe vouchsafe now to receiue reliefe, the which good fortune doth to you present. For what bootes it to weepe and to wayment, When ill is chaunst, but doth the ill increase, And the weake mind with double woe torment? When she her Squire heard speake, she gan appease Her voluntarie paine, and feele some secret ease. Eftsoone she said, Ah gentle trustie Squire, What comfort can I wofull wretch conceaue, Or why should euer I henceforth desire, To see faire heauens face, and life not leaue, Sith that false Traytour did my honour reaue? False traytour certes (said the Faerie knight) I read the man, that euer would deceaue A gentle Ladie, or her wrong through might: Death were too little paine for such a foule despight. That short reuenge the man may ouertake, Where so he be, and soone vpon him light. Certes (saide she) I wote not how he hight, But vnder him a gray steede did he wield, Whose sides with dapled circles weren dight; Vpright he rode, and in his siluer shield He bore a bloudie Crosse, that quartred all the field. Now therefore Ladie, rise out of your paine, And see the saluing of your blotted name. Full loth she seemd thereto, but yet did faine; For she was inly glad her purpose so to gaine. Her purpose was not such, as she did faine, Ne yet her person such, as it was seene, But vnder simple shew and semblant plaine Lurckt false Duessa secretly vnseene, As a chast Virgin, that wronged beene: So had false Archimago her disguisd, To cloke her guile with sorrow and sad teene; And eke himselfe had craftily deuisd To be her Squire, and do her seruice well aguisd. For all he did, was to deceiue good knights, And draw them from pursuit of praise and fame, To slug in slouth and sensuall delights, And end their daies with irrenowmed shame. And now exceeding griefe him ouercame, To see the Redcrosse thus aduaunced hye; Therefore this craftie engine he did frame, Against his praise to stirre vp enmitye Of such, as vertues like mote vnto him allye. So now he Guyon guides an vncouth way Through woods & mountaines, till they came at last Into a pleasant dale, that lowly lay Betwixt two hils, whose high heads ouerplast, the valley did with coole shade ouercast, Through midst thereof a little riuer rold, By which there sate a knight with helme vnlast, Himselfe refreshing with the liquid cold, After his trauell long, and labours manifold. Loe yonder he, cryde Archimage alowd, That wrought the shamefull fact, which I did shew; And now he doth himselfe in secret shrowd, To flie the vengeance for his outrage dew; But vaine: for ye shall dearely do him rew, So God ye speed, and send you good successe; Which we farre off will here abide to vew. Who seeing him from farre so fierce to pricke, His warlike armes about him gan embrace, And in the rest his readie speare did sticke; Tho when as still he saw him towards pace, He gan rencounter him in equall race. They bene ymet, both readie to affrap, When suddenly that warriour gan abace darkwing. His threatned speare, as if some new mishap Had him betidde, or hidden daunger did entrap. And cryde, Mercie Sir knight, and mercie Lord, For mine offence and heedlesse hardiment, That had almost committed crime abhord, And with reprochfull shame mine honour shent, Whiles cursed steele against that badge I bent, the sacred badge of my Redeemers death, Which on your shield is set for ornament: But his fierce foe his steede could stay vneath, Who prickt with courage kene, did cruell battell breath. Certes (said he) well mote I shame to tell the fond encheason, that me hither led. A false infamous faitour late befell Me for to meet, that seemed ill bested, And playnd of grieuous outrage, which he red A knight had wrought against a Ladie gent; Which to auenge, he to this place me led, Where you he made the marke of his intent, And now is fled; foule shame him follow, where he went. So can he turne his earnest vnto game, Through goodly handling and wise temperance. By this his aged guide in presence came; Who soone as on that knight his eye did glance, Eft soones of him had perfect cognizance, Sith him in Faerie court he late auizd; And said, Faire sonne, God giue you happie chance, And that deare Crosse vpon your shield deuizd, Wherewith aboue all knights ye goodly seeme aguizd. But you, faire Sir, whose pageant next ensewes, Well mote yee thee, as well can wish your thought, That home ye may report thrise happie newes; For well ye worthie bene for worth and gentle thewes. So courteous conge both did giue and take, With right hands plighted, pledges of good will. Then Guyon forward gan his voyage make, With his blacke Palmer, that him guided still. Still he him guided ouer dale and hill, And with his steedie staffe did point his way: His race with reason, and with words his will, From foule intemperance he oft did stay, And suffred not in wrath his hastie steps to stray. In this faire wize they traueild long yfere, Through many hard assayes, which did betide; darkwing. Of which he honour still away did beare, And spred his glorie through all countries wide. At last as chaunst them by a forest side To passe, for succour from the scorching ray, They heard a ruefull voice, that dearnly cride With percing shriekes, and many a dolefull lay; Which to attend, a while their forward steps they stay. But if that carelesse heauens (quoth she) despise the doome of iust reuenge, and take delight To see sad pageants of mens miseries, As bound by them to liue in liues despight, Yet can they not warne death from wretched wight. Come then, come soone, come sweetest death to mee, And take away this long lent loathed light: Sharpe by thy wounds, but sweet the medicines bee, That long captiued soules from wearie thraldome free. But thou, sweet Babe, whom frowning froward fate Hath made sad witnesse of thy fathers fall, Sith heauen thee deignes to hold in liuing state, Long maist thou liue, and better thriue withall, Then to thy lucklesse parents did befall: Liue thou, and to thy mother dead attest, That cleare she dide from blemish criminall; Thy litle hands embrewd in bleeding brest Loe I for pledges leaue. With that a deadly shrieke she forth did throw, That through the wood reecchoed againe, And after gaue a grone so deepe and low, That seemd her tender heart was rent in twaine, Or thrild with point of thorough piercing paine; As gentle Hynd, whose sides with cruell steele Through launched, forth her bleeding life does raine, Whiles the sad pang approching she does feele, Brayes out her latest breath, and vp her eyes doth seele. Which when that warriour heard, dismounting straict From his tall steed, he rusht into the thicke, And soone arriued, where that sad pourtraict Of death and labour lay, halfe dead, halfe quicke, In whose white alabaster brest did sticke darkwing. A cruell knife, that made a griesly wound, From which forth gusht a streme of gorebloud thick, That all her goodly garments staind around, And into a deepe sanguine dide the grassie ground. Pittifull spectacle of deadly smart, Beside a bubbling fountaine low she lay, Which she increased with her bleeding hart, And the cleane waues with purple gore did ray; Als in her lap a louely babe did play His cruell sport, in stead of sorrow dew; For in her streaming blood he did embay His litle hands, and tender ioynts embrew; Pitifull spectacle, as euer eye did view. Besides them both, vpon the soiled gras the dead corse of an armed knight was spred, Whose armour all with bloud besprinckled was; His ruddie lips did smile, and rosy red Did paint his chearefull cheekes, yet being ded, Seemd to haue beene a goodly personage, Now in his freshest flowre of lustie hed, Fit to inflame faire Lady with loues rage, But that fiers fate did crop the blossome of his age. Whom when the good Sir Guyon did behold, His hart gan wexe as starke, as marble stone, And his fresh bloud did frieze with fearefull cold, That all his senses seemd bereft attone: At last his mightie ghost gan deepe to grone, As Lyon grudging in his great disdaine, Mournes inwardly, and makes to himselfe mone: Till ruth and fraile affection did constraine, His stout courage to stoupe, and shew his inward paine. Out of her gored wound the cruell steele He lightly snatcht, and did the floudgate stop With his faire garment: then gan softly feele Her feeble pulse, to proue if any drop Of liuing bloud yet in her veynes did hop; Which when he felt to moue, he hoped faire To call backe life to her forsaken shop; So well he did her deadly wounds repaire, darkwing. Therewith her dim eie-lids she vp gan reare, On which the drery death did sit, as sad As lump of lead, and made darke clouds appeare; But when as him all in bright armour clad Before her standing she espied had, As one out of a deadly dreame affright, She weakely started, yet she nothing drad: Streight downe againe her selfe in great despight She groueling threw to ground, as hating life and light. The gentle knight her soone with carefull paine Vplifted light, and softly did vphold: Thrise he her reard, and thrise she sunke againe, Till he his armes about her sides gan fold, And to her said; Yet if the stony cold Haue not all seized on your frozen hart, Let one word fall that may your griefe vnfold, And tell the secret of your mortall smart; He oft finds present helpe, who does his griefe impart. Then casting vp a deadly looke, full low, Shee sight from bottome of her wounded brest, And after, many bitter throbs did throw With lips full pale and foltring tongue opprest, these words she breathed forth from riuen chest; Leaue, ah leaue off, what euer wight thou bee, To let a wearie wretch from her dew rest, And trouble dying soules tranquilitee. Ah farre be it (said he) Deare dame fro mee, To hinder soule from her desired rest, Or hold sad life in long captiuitee: For all I seeke, is but to haue redrest the bitter pangs, that doth your heart infest. Tell then, o Lady tell, what fatall priefe Hath with so huge misfortune you opprest? That I may cast to compasse your reliefe, Or die with you in sorrow, and partake your griefe. With feeble hands then stretched forth on hye, As heauen accusing guiltie of her death, And with dry drops congealed in her eye, In these sad words she spent her vtmost breath: Heare then, o man, the sorrowes that vneath My tongue can tell, so farre all sense they pas: Loe this dead corpse, that lies here vnderneath, the gentlest knight, that euer on greene gras Gay steed with spurs did pricke, the good Sir Mortdant was.

Morphological Identifcation: On czapek Dox agar medicine zofran cheap dulcolax 5 mg on line, colonies are typically suede like and cinnamon-buff to sand-brown in colour with a yellow to deep dirty brown reverse symptoms of pneumonia purchase cheapest dulcolax. Key Features: cinnamon-brown cultures medications and pregnancy generic 5mg dulcolax otc, conidial heads biseriate with metulae as long as the phialides treatment mrsa purchase dulcolax 5mg fast delivery. Descriptions of Medical Fungi 27 Aureobasidium pullulans (de Bary) Arnaud Aureobasidium pullulans has a worldwide distribution and is usually isolated as a saprophyte symptoms in spanish buy dulcolax 5 mg amex, occasionally from skin and nails treatment zap cheap dulcolax master card. Morphological Description: colonies are fast growing, smooth, soon covered with slimy masses of conidia, cream or pink, later becoming brown or black. Hyphae are hyaline and septate, frequently becoming dark-brown with age and forming chains of one to two-celled, thick-walled, darkly pigmented arthroconidia. These arthroconidia actually represent the Scytalidium anamorph of Aureobasidium and are only of secondary importance in recognising members of this genus. Key Features: Hyphomycete (so-called black yeast) producing hyaline blastoconidia simultaneously from the vegetative hyphae, which may also form chains of darkly pigmented, thick-walled arthroconidia. Basidiobolus ranarum is commonly present in decaying fruit and vegetable matter, and as a commensal in the intestinal tract of frogs, toads and lizards. It has been reported from tropical regions of africa and asia including India, Indonesia and australia. Morphological Description: colonies are moderately fast growing at 30 c, fat,O yellowish-grey to creamy-grey, glabrous, becoming radially folded and covered by a fne, powdery, white surface mycelium. Satellite colonies are often formed by germinating conidia ejected from the primary colony. Microscopic examination usually shows the presence of large vegetative hyphae (8-20 ?m in diameter) forming numerous round (20 50 ?m in diameter), smooth, thick-walled zygospores that have two closely appressed beak-like appendages. Two types of asexual conidia are formed, although isolates often lose their ability to sporulate with subculture. Special media incorporating glucosamine hydrochloride and casein hydrolsate may be needed to stimulate sporulation (Shipton and Zahari, 1987). Primary conidia are globose, one-celled, solitary and are forcibly discharged from a sporophore. The sporophore has a distinct swollen area just below the conidium that actively participates in the discharge of the conidium. Secondary (replicative) conidia are clavate, one-celled and are passively released from a sporophore. References: Strinivasan and Thirumalachar (1965), greer and friedman (1966), Dworzack et al. Descriptions of Medical Fungi 29 Basidiobolus ranarum Eidem Basidiobolus ranarum culture showing satellite colonies formed by germinating conidia ejected from the primary colony. Beauvaria bassiana is the most common species and is best known as the causal agent of muscardine disease in silkworms. Beauveria species are occasionally isolated in the clinical laboratory as saprophytic contaminants. Morphological Description: colonies are usually slow growing, usually not exceeding 2 cm in ten days at 20 c, downy, at frst white, but later often becoming yellow toO pinkish. The genus Beauveria is characterised by the sympodial development of single celled conidia (ameroconidia) on a geniculate or zig-zag rachis. Key Features: Hyphomycete showing sympodial development of single-celled conidia on a geniculate or zig-zag rachis emanating from a fask-shaped conidiophore. Molecular Identifcation: Specifc primers were developed by Hegedus and Khachatourians (1996). Descriptions of Medical Fungi 31 Bipolaris Shoemaker the genus Bipolaris contains about 45 species, which are mostly subtropical and tropical plant parasites. However recent phylogenetic studies have transferred several well-documented human pathogens, notably B. Morphological Description: colonies are moderately fast growing, effuse, grey to blackish brown, suede-like to foccose with a black reverse. Microscopic morphology shows sympodial development of hyaline to deep olivaceous pigmented, pseudoseptate conidia on a geniculate or zig-zag rachis. Key Features: Dematiaceous hyphomycete producing sympodial, pseudoseptate, pale brown, long slender, gently curving conidia, which are rounded at both ends. Comment: the genera Drechslera, Bipolaris, Curvularia and Exserohilum are all closely related. In the past, morphological differentiation of the genera relied upon a combination of characters including conidial shape, the presence or absence of a protruding hilum, the contour of the basal portion of the conidium and its hilum, the point at which the germ tube originates from the basal cell and, to a lesser degree, the sequence and location of the frst three conidial septa. It is the causal agent of blastomycosis a chronic granulomatous and suppurative disease, having a primary pulmonary stage that is frequently followed by dissemination to other body sites, typically the skin and bone. Morphological Description: colonies at 25 c have variable morphology and growthO rate. They may grow rapidly, producing a fuffy white mycelium or slowly as glabrous, tan, nonsporulating colonies. Microscopically, hyaline, ovoid to pyriform, one-celled, smooth-walled conidia (2-10 ?m in diameter) of the Chrysosporium type, are borne on short lateral or terminal hyphal branches. O Microscopically, the organism produces the characteristic yeast phase seen in tissue pathology; ie. Comment: In the past, conversion from the mould form to the yeast form was necessary to positively identify this dimorphic pathogen from species of Chrysosporium or Sepedonium. However, culture identifcation by exoantigen test and/or molecular methods is now preferred to minimise manipulation of the fungus. Key Features: clinical history, tissue pathology, culture identifcation by positive exoantigen test and/or by molecular methods. However this has limited application as it can be used only with pure cultures of B. The genus is highly polyphyletic, as it comprises mitosporic species that are devoid of special distinguishing features (lachance et al. Recently, several taxonomic rearrangements have been made and many well-known Candida species have been renamed and moved to other genera, notably Pichia kudriavzevii (formerly Candida krusei), Meyerozyma guilliermondii (formerly Candida guilliermondii), Clavispora lusitaniae (formerly Candida lusitaniae), Kluyveromyces marxianus (formerly Candida kefyr) and Wickerhamomyces anomalus (formerly Candida pelliculosa). Several species may be aetiological agents, most commonly Candida albicans, followed by C. Descriptions of Medical Fungi 35 Candida Berkhout Identifcation: see Kurtzman, fell and boekhout. Ensure that you start with a fresh growing pure culture; streak for single colony isolation if necessary. Chromogenic Agars are used for primary isolation for rapid species identifcation and detection of mixed fora, especially from non-sterile sites. Dalmau morphology plates are examined in-situ directly under the low power of a microscope for the presence of pseudohyphae which may take up to 4-5 days at 26 c to develop. Physiological and Biochemical Tests: including fermentation and assimilation studies should be performed based on those used at the centraalbureau voor Schimmelcultures (cbS), Delft, the Netherlands (Kurtzman et al. However, they can only be used to identify those species in their respective databases, and may misidentify yeasts that are not represented. Other Supplementary Tests include growth at 37 c, cycloheximide resistance andO hydrolysis of urea. Descriptions of Medical Fungi 37 Candida albicans (Robin) Berkhout Candida albicans is a commensal of mucous membranes and the gastrointestinal tract. Environmental isolations have been made from sources contaminated by human or animal excreta, such as polluted water, soil, air and plants. Dalmau Plate Culture: branched pseudohyphae with dense verticils of blastoconidia. Spherical chlamydospores, mostly terminal, often on a slightly swollen subtending cell, are formed near the edge of the cover slip. Physiological Tests: + Positive, Negative, v variable, w Weak, s Slow germ Tube + l-Sorbose v L-arabinose v D-glucitol v Fermentation Sucrose v D-arabinose v? Dalmau Plate Culture: pseudohyphae consisting of chains of ovoid or cylindroid cells, and sometimes small verticils of ovoid blastoconidia. Physiological Tests: + Positive, Negative, v variable, w Weak, s Slow germ Tube l-Sorbose L-arabinose D-glucitol v Fermentation Sucrose D-arabinose -? Dalmau Plate Culture: branched pseudohyphae with dense verticils of blastoconidia and spherical, mostly terminal chlamydospores. Physiological Tests: + Positive, Negative, v variable, w Weak, s Slow germ Tube + l-Sorbose L-arabinose D-glucitol + Fermentation Sucrose + D-arabinose M-D-glucoside +,s glucose + Maltose + D-Ribose D-gluconate galactose +,s cellobiose l-Rhamnose Dl-lactate + Sucrose Trehalose s,+ D-glucosamine v myo-Inositol Maltose + lactose N-a-D-glucosamine + 2-K-D-gluconate + lactose Melibiose glycerol w,s,+ D-glucuronate Trehalose v Raffnose Erythritol Nitrate Assimilation Melezitose w,+ Ribitol + Urease glucose + Soluble Starch w,+ galactitol 0. These three species are phenotypically indistinguishable and are best identifed by molecular methods. Physiological Tests: + Positive, Negative, v variable, w Weak, s Slow germ Tube l-Sorbose L-arabinose D-glucitol Fermentation Sucrose D-arabinose -? Microscopy: Ovoid to globose, budding yeast-like cells or blastoconidia, 2-7 x 2-7 ?m. Physiological Tests: + Positive, Negative, v variable, w Weak, s Slow germ Tube l-Sorbose L-arabinose D-glucitol + Fermentation Sucrose + D-arabinose -? Microscopy: Ellipsoid, subglobose to fusiform budding blastoconidia, 4 x 3-6 ?m, with some larger subglobose forms present. Physiological Tests: + Positive, Negative, v variable, w Weak, s Slow germ Tube l-Sorbose + L-arabinose + D-glucitol + Fermentation Sucrose + D-arabinose M-D-glucoside + glucose + Maltose + D-Ribose + D-gluconate + galactose cellobiose l-Rhamnose Dl-lactate Sucrose Trehalose + D-glucosamine myo-Inositol Maltose lactose N-a-D-glucosamine + 2-K-D-gluconate + lactose Melibiose glycerol + D-glucuronate Trehalose Raffnose Erythritol Nitrate Assimilation Melezitose + Ribitol + Urease glucose + Soluble Starch v galactitol 0. Microscopy: Ellipsoid to subglobose budding blastoconidia, 2-5 x 3-7 ?m, with some larger elongated forms present. Physiological Tests: + Positive, Negative, v variable, w Weak, s Slow germ Tube l-Sorbose + L-arabinose + D-glucitol + Fermentation Sucrose + D-arabinose -? Microscopy: Predominantly small, globose to ovoid budding blastoconidia, 3-4 5-8x ?m, with some larger elongated forms present. Dalmau Plate Culture: abundant, much-branched pseudohyphae in a delicate tree like pattern with 2-3 blastoconidia in small clusters at intervals along the pseudohyphae. Physiological Tests: + Positive, Negative, v variable, w Weak, s Slow germ Tube l-Sorbose +,s L-arabinose + D-glucitol + Fermentation Sucrose + D-arabinose M-D-glucoside + glucose + Maltose + D-Ribose v D-gluconate v galactose + cellobiose l-Rhamnose Dl-lactate Sucrose + Trehalose + D-glucosamine v myo-Inositol Maltose -,s lactose N-a-D-glucosamine + 2-K-D-gluconate + lactose Melibiose glycerol + D-glucuronate Trehalose -,s Raffnose Erythritol Nitrate Assimilation Melezitose + Ribitol v Urease glucose + Soluble Starch galactitol 0. Ascospore Formation: asci are unconjugated, persistent, and are transformed from budding cells. O Physiological Tests: + Positive, Negative, v variable, w Weak, s Slow germ Tube l-Sorbose + L-arabinose D-glucitol + Fermentation Sucrose + D-arabinose -? Descriptions of Medical Fungi 49 Candida rugosa complex Candida rugosa has recently been recognised as a species complex of C. Physiological Tests: + Positive, Negative, v variable, w Weak, s Slow germ Tube l-Sorbose v L-arabinose D-glucitol v Fermentation Sucrose D-arabinose -? It is also found as part of the normal human mucocutaneous fora and environmental isola tions have been made from faeces, shrimp, kefr and soil. Microscopy: Spherical to subspherical budding yeast-like cells or blastoconidia, 3. Dalmau Plate Culture: abundant, long, wavy, branched pseudohyphae with numerous ovoid blastoconidia, budding off. Physiological Tests: + Positive, Negative, v variable, w Weak, s Slow germ Tube l-Sorbose v L-arabinose D-glucitol + Fermentation Sucrose v D-arabinose M-D-glucoside v glucose + Maltose + D-Ribose v,s D-gluconate v galactose + cellobiose v l-Rhamnose Dl-lactate v Sucrose v Trehalose + D-glucosamine v myo-Inositol Maltose + lactose N-a-D-glucosamine + 2-K-D-gluconate + lactose Melibiose glycerol v D-glucuronate Trehalose +,s Raffnose Erythritol Nitrate Assimilation Melezitose v Ribitol v Urease glucose + Soluble Starch + galactitol 0. O Chaetomium species are important agents for the decomposition of cellulose waste and plant materials, and are only rarely isolated in medical mycology laboratories. Morphological Description: Chaetomium is a common ascomycete characterised by the formation of darkly-pigmented, globose, ovoid, barrel to fask-shaped, ostiolate ascocarps (perithecia) beset with dark-coloured terminal hairs (setae) which are straight, branched or curved. Key Features: ascomycete producing darkly-pigmented ostiolate perithecia beset with long dark terminal setae. Antifungal Susceptibility: Chaetomium very limited data (Mcginnis and Pasarell 1998a, Serena et al. There are about 70 species of Chrysosporium, several are keratinolytic with some also being thermotolerant, and cultures may closely resemble some dermatophytes, especially Trichophyton mentagrophytes. Morphological Description: colonies are moderately fast growing, fat, white to tan to beige in colour, often with a powdery or granular surface texture. Hyaline, one-celled conidia are produced directly on vegetative hyphae by non-specialised conidiogenous cells. Molecular Identifcation: Chrysosporium is phylogenetically heterogeneous; the polyphyletic origin of the genus was frst demonstrated by vidal et al. Chrysosporium tropicum Carmichael Morphological Descriptions: colonies are fat, white to cream-coloured with a very granular surface. Microscopically, conidia are numerous, hyaline, single-celled, clavate to pyriform, smooth, slightly thick-walled (6-7 x 3. The conidia are formed at the tips of the hyphae, on short or long lateral branches, or sessile along the hyphae (intercalary). References: carmichael (1962), Rebell and Taplin (1970), Sigler and carmichael (1976), van Oorschot (1980), Domsch et al. Descriptions of Medical Fungi 53 Cladophialophora Borelli the genus Cladophialophora is characterised by: (1) the absence of conidiophores, ?shield cells, or prominent hila (attachment points); (2) the ability to grow on media containing cycloheximide; and (3) having dry, non-fragile chains of conidia (Revankar and Sutton 2010). It has recently been re-evaluated by multilocus sequencing and currently contains seven species associated with human infection (badali et al. Cladophialophora bantiana is the causative agent of numerous cases of cerebral phaeohyphomycosis many of which occur in immunocompetent individuals and most of which are fatal (chakrabarti et al. Cladophialophora bantiana has been isolated from soil and is a recognised agent of cerebral phaeohyphomycosis. The fungus is neurotropic and may cause brain abscess in both normal and immunosuppressed patients and is usually fatal. The fungus is likely introduced via inhalation and direct transfer to the brain via the paranasal sinuses, or traumatic head injury. Morphological Description: colonies are moderately fast growing, olivaceous grey, suede-like to foccose and grow at temperatures up to 42-43 c. Synonymy: Cladosporium carrionii Trejos Cladophialophora carrionii is a recognised agent of chromoblastomycosis and it has been isolated from soil and fence posts made from Eucalyptus spp.

Syndromes

• Feeding difficulties
• Breathing difficulty (from breathing in asphalt)
• "Clean catch" urine culture. This test may be done to identify the bacteria and determine the best antibiotic for treatment.
• Headaches that occur while sleeping and with at least one other symptom (such as vomiting or confusion)
• Sun lamps can cause severe sunburn.
• You develop new symptoms
• Painful sores and infections of the leg or foot, which if left untreated, leads to removal of the foot or leg 
• Endoscopy -- the placement of a camera down the throat to see the extent of burns to the esophagus and the stomach
• Abscess or infection

It is said to act like peppermint in the way it soothes minor digestive upsets and colic ombrello glass treatment order generic dulcolax line. The flavonoids and saponins in Marjoram Leaf are thought to promote healthy arteries and heart symptoms xeroderma pigmentosum discount dulcolax 5mg overnight delivery. Laboratory experiments claim that it prevents cholesterol buildup symptoms 9dpo purchase generic dulcolax on line, improves blood circulation and may reduce high blood pressure medications of the same type are known as purchase 5 mg dulcolax with visa. Marjoram Leaf contains caffeic acid treatment 3rd stage breast cancer buy 5 mg dulcolax visa, a phenylpropanoid medications order dulcolax 5mg with mastercard, which is an analgesic and anti inflammatory, and when used internally or externally, the leaf eases pain, confirming its age-old use for alleviating aches and pains. Used externally, it eases toothache pain, rheumatic pain, muscular pain, bruises, arthritis, sprains and stiff joints. Used internally, Marjoram Leaf eases severe stomach cramps, spasms and painful menstruation (and will stimulate suppressed menstruation). As a mild diuretic, Marjoram Leaf will promote the flow of urine, helping to relieve stomach bloating and clearing the body of toxins and cleansing the blood. This action is also said to benefit eruptive diseases and skin disorders, particularly eczema. Marjoram Leaf is also a diaphoretic and stimulates perspiration, which also helps to rid the body of toxins through the skin. Moreover, this quality assists in reducing fevers and helps to relieve cold and flu symptoms. Marjoram Leaf is considered a natural disinfectant, antiseptic, antifungal and antibacterial that possesses healing qualities and combats infection. The flavonoids in Marjoram Leaf are believed to have an antioxidant effect against the free radicals that can damage important cellular molecules or other parts of the cell. Marjoram Leaf can be infused as an aromatic tea for colds, headaches, simple gastrointestinal disorders and tension. Those who are allergic to members of the mint family (thyme, basil, sage, oregano, etc. Marshmallow Root aids the body in expelling excess fluid and will soothe the mucous membranes and a dry, hacking cough. The herb is good for easing bladder infection, digestive upsets, fluid retention, intestinal disorders, kidney problems, sinusitis and sore throat, and it is a natural source of beta-carotene, amino acids, minerals and vitamins. History: Marshmallow Root is a rich source of healing mucilage, and its botanical name, Althaea, is derived from the Greek, althe, which means, "to cure. Long used as a healing and soothing herb, Marshmallow was eaten by the Egyptians and Syrians and mentioned by Pythagoras, Plato and Virgil. The plant was enjoyed as a highly nutritious food by the Romans in barley soup and in a stuffing for suckling pig, while classical herbalists praised its gentle laxative properties. Marshmallow Root is a hardy perennial that is native to Europe and is found in the western part of the United States, thriving along riverbanks and in waste places and roadsides in wet, marshy areas. The plant bears hibiscus-like blossoms of light red to white or purple in color and may grow to a height of four to six feet. All parts of the plant are used in various ways, medicinal, decorative, culinary, and cosmetic purposes, but the root is mainly used for medicinal purposes. Marshmallow Root is rich in mucilage, paraffin, pectin, lecithin, quercetin, salicylic acid, tannins, amino acids, beta-carotene, calcium, iron, magnesium, manganese, phosphorus, potassium, selenium, zinc, and vitamins B-1, B-2, B-3 and C. The herb is used in many lung preparations and cough syrups to alleviate a dry, hacking cough, whooping cough and laryngitis. Because it contains salicylic acid (the natural forerunner of synthetic aspirin), Marshmallow has been used to relieve the pain of headaches and muscle aches; and along with its ability to expel excess fluid and mucus, it helps to ease sore throat and sinusitis. Marshmallow Root is an old-time remedy for gastrointestinal disorders and strengthening the digestive system, because it contains polysaccharides that form a protective layer on the stomach lining and will lower stomach acids. As a diuretic, Marshmallow Root increases the flow of urine and rids the body of excess fluid. It has been used to improve kidney function, soothe the urinary tract and relieve cystitis and bladder infections. Marshmallow improves the functioning of the immune system, since it is known to stimulate phagocytosis, the immune process in which cells called macrophages engulf and digest infectious microorganisms that attack healthy cells and cause serious disease. Used externally, Marshmallow Root may be used in an ointment as an emollient to soften and soothe skin and dry hands. Used internally and externally, the high mucilage content will also promote rapid healing of diaper rash, skin ulcers, sunburns, psoriasis, and eczema and problem skin. Precautions: None * * * * * Mate Mate is a powerful stimulant and more popular in its native South America than tea or coffee (it is the national drink of Argentina! Mate has a reputation as a nutritious tonic that not only stimulates the body (providing youthful vigor and energy), but it also stimulates the mind (promoting mental acuity and clarity). Plant Description: Mate is a large, white-flowered, evergreen shrub that grows wild near streams in moist, well drained soil in sun or shade and requires at least a forty-five-degree Fahrenheit temperature to succeed. It is native to South America and has been cultivated as a very valuable commercial crop in northern Argentina, Southern Brazil, Paraguay, and Uruguay (and has been naturalized in Texas). The tree produces a large red fruit or drupe (which is never consumed) and leafy shoots that may be picked at intervals throughout the year in the same way as tea. History: the leaves are used in herbal medicine and made into a tea that is the "beverage of choice" in much of South America. Because of its enormous popularity, Mate is heavily cultivated as a valuable crop and has displaced great areas of rain forest canopy trees. Although the trees sometimes reach a height of twenty feet, they are still much lower than the rain forest canopy they replace and have, thus, created an environmental issue. A beverage made from the leaf is the national drink of Argentina, where it is touted as an energizer and a tonic, and it is so popular that the average Argentine consumes about eleven pounds annually! The odor is not particularly agreeable and the taste rather bitter, but it is drunk at every meal and every hour. Mate was first brought under cultivation by Jesuit missionaries, who had learned of the herb and its many benefits (as a cooling drink and a folk remedy for scurvy) from the South American Indians; and the Jesuits risked their safety, searching for the shrubs in the dense jungles of Brazil, where it grew wild. The name Mate (pronounced mah-tay) is derived from the Spanish word, meaning "gourd," which was the vessel in which the drink was infused in the same manner as tea, and the cup passed around. Some of the constituents in Mate include caffeine, theobromine, chlorogenic acid, chlorophyll, rutin, tannin, ursolic acid, vanillin, choline, inositol, nicotinic acid, pyridoxine, trace minerals, B-vitamins, vitamins C, and E. Medical Uses: Mate has been used for centuries as an invigorating, bracing tonic that revitalizes the body, while also stimulating the mind, and some even claim that it combats the ageing process. It produces a natural energy without interfering with sleep (although it is not recommended for insomniacs). Mate is generally considered a powerful stimulant that will also help to enhance the efficacy of other stimulant and healing herbs. Mate is recommended for balancing and strengthening immune function and toning the nervous system. It is said to help restore the entire system and ease mild nervous depression, soothe tension headaches and fight fatigue. As a diaphoretic, Mate helps to promote perspiration (thereby also removing toxins from the body through the skin) and lowering fever and cooling the body. The herb is also believed to be a powerful diuretic that encourages urine flow and helps the body expel excess retained fluid. Mate is considered an excellent antioxidant that fights free radicals in the system. Mate is believed to possess anti-inflammatory properties that are helpful in alleviating rheumatic conditions and inflammatory bowel disorders. The herb is also thought to stimulate the production of cortisone, which is a natural anti-inflammatory. As a stimulant, Mate is thought to help relieve constipation, and because it is high in mineral content, the herb helps to restore minerals that may be lost in the laxative process. Mate is the source of trace minerals and considered very nutritious and sustaining. It was frequently carried as the only refreshment on journeys lasting several days. Because Mate is especially rich in minerals such as magnesium, manganese and potassium, it helps the body maintain electrolyte balance and restore lost minerals caused by rapid weight loss due to a high protein diet. Supporting its reputation as a stimulant, Mate is said to stimulate the burning of fat. It is also thought that the caffeine stimulates weight loss by short-circuiting the feedback mechanisms that keep the body from producing more adrenaline when stimulated by other weight loss herbs. While probably not actually affecting weight loss by itself, it appears to boost the stimulant properties of other herbs. Mate is thought to be a depurative, an agent that cleanses and purifies the blood. Dosages: Take two (2) capsules, one (1) to two (2) times each day with water on an empty stomach. Precautions: Pregnant or nursing women and people who suffer from insomnia should not use Mate, because of the stimulating effects of the caffeine content. The herb should not be taken with meals, since it may interfere with the absorption of nutrients, and Mate should not be used in large amounts (many times the recommended dosage), as it is a potent stimulant. It is believed to be a strong stimulant that efficiently cleanses and removes waste products from the body, and has been used to treat constipation, jaundice and other disorders associated with waste product buildup. Native Americans also used Mayapple to remove warts and expel worms from the intestines. Plant Description: Mayapple is a perennial plant that is native to and grows abundantly in North America and is sometimes called Mandrake, but should not be mistaken for European Mandrake (Mandragora officinarum a poisonous herb of the nightshade family), and Mayapple thrives in moist, humus rich, well-drained soil in woodlands and clearings in sheltered semi-shade. In the autumn, the roots are collected, dried and crushed into powder, and the powdered rhizomes (roots) are used as a potent purgative. History: this application was well known to Native Americans long before it was "rediscovered" in conventional American medicine and listed in the United States Pharmacopoeia from 1820 to 1926. Native Americans used minute doses as a purgative, emetic, liver tonic and vermifuge (to destroy and expel worms), and for topical application in removing warts. The Menominee tribe used it on plants and potato crops as an effective insecticide, a use that is now being studied extensively in laboratories. It is an acrid, caustic herb with an unpleasant smell, and because it is so potent, it is not advisable for self-medication in specific applications; therefore, it is always recommended that one should seek an experienced health care provider when using this herb. Some of the constituents in Mayapple are lignins (including the most important, podophyllotoxin) and resin (podophyllin). Medical Uses: Mayapple has mainly been used (in controlled dosage) as a very potent purgative cathartic, a strong laxative that causes rapid, watery evacuation of the intestines and bowels. It is considered an alterative, or agent that cleanses and stimulates the efficient removal of waste products from the system, while at the same time altering and improving the course of an ailment. As a cholagogue, it has been used to stimulate the production and flow of bile (which also aids in the digestive process), and has a reputation for supporting liver function. Some say it has no equal when used for liver ailments and has been used in cases of jaundice, biliousness and for the removal of body obstructions. The eliminative properties of Mayapple (in both the bowel and liver) make it effective for a number of complaints marked by accumulation of waste products in the system (including arthritic and skin problems). Mayapple is also considered a vermifuge, an agent that destroys and expels worms from the intestinal tract. Used externally, Mayapple is said to be effective in wart removal, especially helping venereal warts, and the root is said to possess antiviral properties. There is a derivative in Mayapple called podophyllotoxin (the agent responsible for removing warts), and recent studies have shown some promising results for its use as a possible anticancer and antitumor substance, which may be used in treating human cancers. In tests, it has been found to stimulate the immune system while suppressing lymph cells and appears to be more toxic to leukemia cells than normal cells. Thus far, it is too severe for the digestive tract for practical purposes, but a synthetic derivative is being used in Europe in chemotherapy (trademarked Vepeside) for lung and testicle cancers. Dosages: Take one (1) to two (2) capsule, one (1) time each day with water at mealtimes. This herb should be used with great caution (it is always advisable to use it in consultation with a physician), and it is subject to restrictions in many countries. It is the natural version of aspirin without the digestive upsets and bleeding that may accompany the synthetic product. It is even said to soothe digestive upsets, as well as the pains and aches of inflammatory ailments. Plant Description: Meadowsweet is a stout perennial wildflower that thrives in the rich, wet soils of marshes, bogs, ditches, damp meadows and moist woods in sun or partial shade. The plant, with its fernlike foliage, pinnate leaves and fragrant, cream-white flower clusters, dislikes acid soil and grows up to six feet tall with a creeping, underground root. Meadowsweet was introduced to North America from Europe and now grows wild throughout eastern Canada and the United States. Meadowsweet was one of the three most sacred herbs of the Druids, the others being water mint and vervain; and in medieval Europe, the fragrant plant was considered an important strewing herb. Meadowsweet is an astringent, aromatic herb, and the entire plant and flowers are used in herbal medicine. In 1653, the pharmacist, Nicholas Culpepper, noted the use of the herb as a remedy for fevers, colds and flu. Some sixty years thereafter, the pharmaceutical company Bayer produced acetylsalicylate, a synthetic substance with the same properties as its natural forerunner. Herbalists consider the plant to be one of the best remedies for digestive upsets, and the natural salicylic acid content is a longtime favorite for the symptoms of cold, flu, headaches and rheumatic pains and aches. Some of the constituents in Meadowsweet include salicylic acid, flavonoids (quercetin, rutin), tannins, mucilage, anthocyanidin, avicularin, coumarin, essential oil (methyl-salicylate, hyperoside), salicin, vanillin, glycoside and citric acid (vitamin C). Medical Uses: Probably the most famous use of Meadowsweet is for its aspirin-like qualities without the unpleasant side effects of synthetic acid. Some herbalists regard Meadowsweet as the best plant remedy for hyperacidity and heartburn. It is an antacid herb that heals and soothes the digestive tract and strengthens and tones the system. Unlike synthetic aspirin, Meadowsweet offsets the acidic effects of salicylic acid. Long use of aspirin can lead to gastric ulceration and bleeding, but Meadowsweet does not produce these side effects and is actually a gentle digestive remedy for acidity.

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