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The Black Death and Religion During the Middle Ages it was essential that people were given the last rites and had the chance to confess their sins before they died 400 mg levitra plus free shipping erectile dysfunction causes prescription drugs. The spread of the deadly plague in England was swift and the death rate was almost 50% in isolated populations such as monasteries generic levitra plus 400 mg on-line erectile dysfunction diabetes cure. There were not enough clergy to offer the last rites or give support and help to the victims cheap levitra plus 400mg with mastercard erectile dysfunction pills in india. The church could offer no reason for the deadly disease and beliefs were sorely tested. This had such a devastating effect that people started to question religion and such doubts ultimately led to the English reformation. Consequences and Effects of the Black Death plague The Consequences and effects of the Black Death plague were far reaching in England:  Prices and Wages rose  Greater value was placed on labor  Farming land was given over to pasturing, which was much less labor-intensive  This change in farming led to a boost in the cloth and woolen industry  Peasants moved from the country to the towns  The Black Death was therefore also responsible for the decline of the Feudal system  People became disillusioned with the church and its power and influence went into decline This resulted in the English reformation The End of the Plague and the spread of sugar Nostradamus was a healer of sort and he said for people to clean their houses, open the windows and let in good sunshine and clean air. In the recipe listings of "Le Menagier de Paris", 1393, sugar in many various forms is listed 72 separate times. Honey by comparison is only mentioned 24 times, and the price for candied orange peel, made with honey, is precisely the same as that for sugared almonds (10 sous/lb). So, in a quick survey of Europe in the 13th and 14th centuries, sugar was widely available in England, France, Spain, and Italy in powdered form as well as block, in cooking as well as medicinally, and more widely used than honey! Special traffic regulations had been needed for the transport of firewood and cane. So valuable was sugar for the economy that the law allowed compulsory purchase of land for it, and water could be taken from whatever source; workers were also bound to the industry by law and were free from arrest during the season when the refineries were working. During the 42 years following the accession of Alfonso in 1416, "On one occasion Alfonso personally seems to have cornered the market in sugar exports to Flanders," Smith tells us. Kilns for boiling the liquid and ceramic molds to crystallize the sugar into loaves/cones. The perception that all medieval sugar consisted of burnt black cones is a common misapprehension brought on by the experience of those of us who have been part of the Early American historical groups. Do-it-yourself pioneers in America produced some really bad sugars in an effort to be self sufficient, but that should not be projected to our thoughts about Medieval times where industrial production and transport was common. Though some bought the cheaper loaf and saved money by grinding it themselves, powdered sugar was common, and the quality was high. In 1492 Christopher Columbus stopped at the Canary Islands on his famous journey, for rest and provisions for a few days, but ended up staying a month. When he finally left he was given cuttings of sugar cane which became the first to reach the New World. Therefore much later Sugar Cane came to be cultivated in the New World, and as a side effect became multi-sourced particularly due to British Colonial policies (you see how this all links up now) and influence throughout the geographical coverage of the empire in the mid 1600s to mid 1700s. This is really the key point along the timeline where sugar, outside Asia, became commonly available and no longer a rare indulgence of the wealthy. Notably, this was also closely linked to the international slave trade - African slaves became the dominant plantation workers in North America, partly because they turned out to be naturally resistant to Yellow Fever and Malaria, and as a result the British imported over 4 million slaves to the West Indies. At this point (the mid to late 1700s) the Caribbean was the world’s largest producer of sugar, and due to high death rates anyway on sugar plantations, there were only 400,000 African people left alive in the West Indies by the time slavery ended. In 1772 Slavery was declared illegal in England, including overseas slaves not living in England. Poor Blacks are grossly mistreated and paid almost nothing to harvest a dealy product. Later Barbados and the British Leewards were extremely successful in the production of sugar because it counted for 93% and 97% respectively of each island’s exports, largely due to changes in the eating habits of many Europeans. Whereby we may see the sequel of things not always, but very seldom, to be such as is pretended in the beginning. As we can see from the above, when sugar was half a crown for a pound, cinnamon was fourpence the ounce. Imported goods rose and fell with various import laws, but were eminently reasonable in price at all times. Also, we can see that in relationship to other commodities, sugar has come down dramatically in price as well. This would perhaps account for all those description from foreign ambassadors about the English having bad teeth! By the Elizabethian period, the best sugar was considered to be that of Madiera, with those of Barbary (Morocco) or the Canaries a close second. When he saw they were English he ran off , and going ashore, they discovered, "many sorts of sweetmeats and conserves, with great store of sugar, being provided to serve the fleet returning to Spain. In 1585, says "Francis Drake-The Lives of a Hero" of Drake from 2-11 October, "The fleet stayed in the Ria de Vigo, pillaging a few small vessels, including a French ship with sugar and wine from the Azores... Thus, while it was a bit expensive for peasants, it was easily available to Bughers and Merchant classes. Big sugar has a history of Death, Plague, Immune-deficiency, War, Slavery, Deceit, Cancer, Tooth decay, Obesity and is responsible for much of mankind’s most serious problems. Dextrose sugar has spread across the world doing harm and leaving a wake of disease in its path. Mack Smith, and Christopher Duggan "The Sicilian Vespers" by Steven Runciman, Cambridge University Press, 1958 "The Other Conquest" by John Julius Norwich, Harper ∓ Row, 1967 "The Barrier and the Bridge-Historic Sicily" copyright by Alfonso Lowe, Published for America by W. Coulson,"A Source Book for Medieval Economic History", (Milwaukee: The Bruce Publishing Co.

We have three organs that do most of the sugar regu- lating: our adrenals order 400mg levitra plus otc causes of erectile dysfunction young males, the liver discount levitra plus 400mg visa erectile dysfunction causes natural cures, and the islets in the pancreas 400 mg levitra plus fast delivery erectile dysfunction doctors staten island. In severe fatigue, that keeps you partly bedridden, all three organs are heavily parasitized. Killing the viruses is not as important as killing the larger parasites and getting your organs functioning for you again. The adrenals (the outer layer called the cortex) help to regulate the blood sugar in a complex way. The heart of sugar regulation is in your pancreas in the tiny islands of cells that secrete insulin, called the islets of Langer- hans. There is wood alcohol in store-bought drinking water, fruit juice, powders meant to be stirred into bev- erages, even if they are health food varieties. The only beverage you can safely buy (not safe unless you sterilize it, though) at a grocery store is milk. Your first step toward curing your fatigue syndrome is to kill the pancreatic fluke and all other living invaders of the pancreas, liver, adrenals and thyroid. Your energy can bounce back in a few weeks by attending your liver, adrenals and pancreas. Take these supplements for three weeks, then cut the dose in half, and take on alternate days only, as a hedge against possible pollution in these. Although your energy may be normal in three weeks, you are at higher risk for fatigue than the average person. Reinfection with anything will put the new parasites right back where the old ones were. Other bacteria, solvents and toxins will head for the pancreas, liver and adrenals again because these are weakened organs. It could take two years to build your health to its previous level, but is well worth it to have youth, initiative, and a beautiful appearance again. Going back to school is a good use of your time when your initiative has returned but your physical strength is still not up to housework or a job. When your energy comes back to you, it is tempting to overwork: to clean the whole house or to get into some gardening. Our test showed her body was full of bismuth (fragrance) and silver (tooth fillings) especially in the ovaries. She cleansed her kidneys and killed parasites but could not make up her mind to do the expensive dental work. Her skin, kidneys, breasts, brain, ovaries and pancreas were all loaded with mercury, platinum and other metals. Before the moving date arrived she had cleansed kidneys, killed parasites and done dental work and was feeling noticeably better. She immediately was very fatigued again and worried that the move had been in vain. This time she had a liver full of Salmonella and a return of phosphate crystals in her kidneys. But it was easy to clear up and it was a very useful lesson to her to avoid unsterilized dairy products. Her tissues were full of arsenic from pesticide; her urinalysis showed kidney crystals and her eosinophil count was high 5. She had sheep liver flukes and stages in her pancreas due to a buildup of wood alcohol there. In four months after killing parasites and doing a kidney cleanse she was much improved. She had Ascaris and pancreatic flukes in her pancreas and reacted to sugar in her diet quite strongly, so avoided it. In 6 weeks she had done everything except the mercury removal and was feeling much better. She cleaned her home and cleansed kidneys, killed parasites, and did two liver cleanses. Meanwhile, though, her infertility problem got solved (she got pregnant) and this encouraged her to continue the battle against fatigue after the baby was born. Hector Garcia, age 14, was getting gamma globulin injections every three weeks for his chronic fatigue syndrome. He had pancreatic flukes in his pancreas, sheep and human liver flukes in his liver and intestinal fluke in his intestine. He had a buildup of benzene, propanol, and carbon tetrachloride as well as aflatoxin from his granola breakfasts. He killed parasites with a frequency generator and went off the solvent polluted items in the propyl alcohol and ben- zene lists. Dana Levi, age 16, had chronic fatigue syndrome and dizziness; he was not in school. He had pancreatic fluke in his pancreas, sheep, human and intestinal flukes in his liver! As soon as the para- sites were killed (with a frequency generator) and he changed a lot of his products, he felt better but soon lost his improvement. At the next visit, our tests showed a buildup of vanadium (from burning candles in his bedroom).

It is not recommended to compensate for a possible reduction of activity by a random increase in the usual dose cheap levitra plus 400 mg fast delivery erectile dysfunction doctor uk, as there is a real danger of overdose when using toxic drugs discount 400 mg levitra plus free shipping erectile dysfunction pills in malaysia. In time cheap levitra plus 400 mg with visa erectile dysfunction cures over the counter, certain drugs undergo a deterioration leading to the development of substances much more dangerous, thus an increase in toxicity. Tetracycline is the principal example: the pale, yellow powder becomes brownish and viscous, its use therefore being dangerous even if before the expiry date. An increase in allergen strength has been observed in certain drugs such as penicillins and cephalosporins. Updated: February 2017 Drug quality and storage Suppositories, pessaries, creams and ointments that have been melted under heat should not be used. Oral rehydration salts may be used as long as they keep their aspect of white powder. Humidity transforms them into a compact mass, more or less brownish and insoluble. Expiration Drugs deteriorate progressively and according to various processes, even if stored in adequate conditions. In most countries, regulations impose an obligation on manufacturers to study the stability of their products in standardised conditions and to guarantee a minimum shelf life period. The expiry date indicated by manufacturers designates the date up to and including which the therapeutic effect remains unchanged (at least 90% of the active ingredient should be present and with no substantial increase in toxicity). The expiry date indicated on the label is based on the stability of the drug in its original and closed container. Expired drugs Expiry dates are to be respected due to legal obligations and considerations of therapeutic responsibility. In cases where the only available drugs have expired, a doctor may be led to take on the responsibility of using these drugs. It is evident that a drug does not become unfit for consumption the day after its expiry date. If a product has been stored in adequate conditions (protected from humidity and light, packaging intact and at a medium temperature) and if modification of aspects or solubility have not been detected, it is often preferable to use the expired drug than to leave a gravely ill patient without treatment. Expiry dates for drugs that require very precise dosage should be strictly respected due to a risk of under-dosage. This is the case for cardiotonic and antiepilectic drugs, and for drugs that risk becoming toxic, such as cyclines. Destruction of expired or unusable drugs and material It is dangerous to throw out expired or unusable drugs or to bury them without precaution. Limiting the use of injectable drugs Numerous patients demand treatment with injectable drugs, which they imagine to be more effective. Certain prescribers also believe that injections and infusions are more technical acts and thus increase their credibility. When both oral and injectable drugs are equally effective, parenteral administration is only justified in case of emergency, digestive intolerance or when a patient is unable to take oral medication. Oral drugs should replace injectable drugs as soon as possible during the course of treatment. Limiting the use of syrups and oral suspensions Taking liquid drugs is often easier, especially for young children and more so if they are sweetened or flavoured. It is, however, recommended to limit their use for numerous reasons: – Risk of incorrect usage Outside of hospitals, determining the correct dosage is hazardous: spoons never contain standard volumes (soup spoons, dessert spoons, tea spoons). Oral suspensions should be prepared with a specified amount of clean water, and well shaken prior to administration. Some oral suspensions must be kept refrigerated; their storage at room temperature is limited to a few days, and with syrups there is a risk of fermentation. Confusion between cough mixtures and antibacterial suspensions or syrups is common. Even using a powder for subsequent reconstitution, the costs may be 2 to 7 times higher than an equivalent dose due to the cost of the bottle itself and higher transportation costs due to weight and volume. Prescription, cost, compliance Studying the choice of treatment regimens The choice of a treatment regimen often influences compliance and cost. The shortest and least divided (1 to 2 doses per day) treatments are most often recommended. Considering non-essential medicines and placebos In developing countries as in industrialised countries, patients with psychosomatic complaints are numerous. The problems that motivate their consultations may not necessarily be remedied with a drug prescription. Is it always possible or desirable to send these patients home without a prescription for a symptomatic drugs or placebo? When national drug policy is strict and allows neither the use of placebos nor non-essential symptomatic drugs, other products are often used in an abusive manner, such as chloroquine, aspirin, and even antibacterials. This risk is real, but seems less frequent, which makes the introduction of placebos on a list of essential drugs relevant. Their composition generally corresponds to preventive treatment of vitamin deficiency and they have no contra–indications. Numerous non-prescription drug products (tonics, oral liver treatments presented in ampoules) have no therapeutic value and, due to their price, cannot be used as placebos. Antiseptics and disinfectants Antiseptics and disinfectants Definition Antiseptics are used to kill or eliminate microorganisms and/or inactivate virus on living tissues (intact or broken skin and mucous membranes). Disinfectants are used to kill or eliminate microorganisms and/or inactivate virus on inanimate objects and surfaces (medical devices, instruments, equipment, walls, floors). Certain products are used both as an antiseptic and as a disinfectant (see specific information for each product). Selection Recommended products 1) Core list No single product can meet all the needs of a medical facility with respect to cleaning, disinfection and antisepsis.

Therefore purchase levitra plus 400 mg fast delivery what causes erectile dysfunction in males, routine pulmonary function tests do not appear to helpinpredicting which patients will eventually develop lung toxicity buy cheap levitra plus 400 mg line erectile dysfunction 9 code. Amio- daronereduces peripheral conversion of T4–T3 buy discount levitra plus 400mg erectile dysfunction causes diabetes, resulting in some- what increased T4 levels and somewhat decreased T3 levels even in euthyroid patients. Approximately 10% of patients treatedwith amiodarone eventually develop truehypothyroidism (a low serum T4 level isalways significant in patients taking this drug), and a smaller proportiondevelop hyperthyroidism. Althoughhypothy- roidismcan be treated relatively easily with thyroid-replacement medication,hyperthyroidism represents a difficult clinical problem because of its presentation and its treatment. Amiodarone-induced hyperthyroidism sometimes manifests as an exacerbation of the pa- tient’s underlying ventricular tachyarrhythmias. Further, because amiodarone itself containsasig- nificantamountofiodine, patients receiving amiodarone have high- iodine stores, whichthus precludes the use of radioactive iodine for thyroid ablation. Tomake matters worse, treating amiodarone- induced hyperthyroidismwith antithyroid drugs can be difficult or even impossible. Sometimes thyroidectomy is the only feasible meansofcontrolling amiodarone-induced hyperthyroidism. Significant photosensitivity occurs in about 20% of patients taking the drug,and some patients eventually develop ablue-gray discol- oration of sun-exposed skin, which can be quite disfiguring. Neurologic side effects are rare but can include ataxia, tremor, sleepdisturbances, and peripheral neuropathy. Ocular symptoms(most often, poor night vision or halo vision) occasionally accompany the corneal microdeposits seeninvirtually all patients taking amiodarone. Amiodarone canpotentiate the effect of beta blockers and calcium blockers and lead to negative inotropic effects and bradyarrhythmias. Sotalol Sotalol, a noncardioselective beta blocker, was initially developed as an antihypertensive agent. Clinical pharmacology Sotalol is well absorbed from the gastrointestinal tract, and peak plasma concentrationsoccur within 2–3 hours after an oral dose. The drug is not metabolized; it isexcreted unchanged by the kidneys, and the dosage should be reducedinpatients with renal insufficiency. Dosage The usual starting dosage of sotalol is80mg twice daily, and the dosage is increasedgradually, as needed,to240–320 mg/day in di- videddoses. Indications Sotalol isapproved for the treatmentofsignificantventricular ar- rhythmias but can be useful for treating all types of tachyarrhyth- mias. Adverse effects and drug interactions The major side effects of sotalol are related to its noncardioselective beta-blocking effects (e. Exacerbation of congestive heart failure is most commonly seeninpatients whose left ventricular ejection fractions are less than 0. So, for in- stance, if sotalol isbeing used to treat atrial fibrillation, the relative safety of using the drug (i. Thus, suchapatient shouldnever be senthome taking sotalol untilheor she has been observedinsinus rhythm. Therefore, the drug should be usedwith trepidationinpatients taking potassium- wasting diuretics—another good reason to avoid the drug in patients with congestive heart failure. A multicenter randomized trial using D-sotalol in patients with ventricular arrhythmias was stopped be- cause of an excess of suddendeath in the D-sotalol arm. Clinical pharmacology After intravenous infusion, ibutilide is extensively metabolized to eight metabolites. More than 80% of the drug isexcretedinthe urine, only 7% as unmetabolizedibutilide. The drug issubjectto pronounced first-pass metabolismwhengiven orally, which is why only the intravenous formis available. Dosage Ibutilide is infused as a 1-mg intravenous bolus during a period of 10 minutes. If the arrhythmiabeing treated (atrial fibrillation or atrial flutter) persists for 10 minutes after the infusion has been completed,asecond 1-mg bolus can be administered. Indications Ibutilide is indicated for the elective conversion of atrial fibrillation or atrial flutter. Inclinical studies, the efficacyof ibutilideadministrationinterminating these arrhythmias (after two 1-mg doses) was 44%. The incidence of sustained ventricular arrhythmias was muchhigher in patients with a history of congestive heart failure (5. Most ventricular arrhythmias were seenwithin 1hourofthedrug infusion,butsome were seennearly 3 hours after the infusion. Itis thought that the arrhythmogenic potential of ibutilide is increasedwhenit is used with other drugs that prolong the duration of the actionpotential. Ibutilide should also be avoided in patients receiving phenothiazines, tricyclic antidepressants, tetra- cyclic antidepressants, or antihistamineagents that block the H1 re- ceptor. Clinical utility of ibutilide The overall clinical utility of ibutilide probably ought to be con- sideredmarginal, mainly because of the disadvantages of the drug. The incidence of torsades de pointes with ibutilide is also troubling,and the relatively prolonged monitoring required after its use (regardless of whether it is effec- tive) can be quite inconvenient. Its major side effect, typical for drugs with these elec- trophysiologic properties, is torsades de pointes. While it iselim- inated by both the kidneys and the liver, the renal route of elimina- tionis particularly important clinically.