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Necrotizing (?malignant) otitis externa can be treated (intravenously in the acute stage, then orally on an outpatient basis in the convalescent stage) with ciprofloxacin. For treatment of serious pseudomonas infections, and to deter emergence of resistance, antipseudomonas quinolones should be combined with other antipseudomonals such as piperacillin/tazobactam, ceftazidime, aztreonam, or an aminoglycoside (gentamicin, et al. Topical ciprofloxacin is superior to parenteral gentamicin in treatment of pseudomonas suppurative otomastoiditis (Arch. And they are also active against the ?atypical pathogens: mycoplasma, chlamydia, legionella, and pertussis. Therefore, these drugs should be very useful for treatment of acute otitis media, sinusitis, pharyngitis, tracheobronchitis, epiglottitis (probably), etc. The mild anaerobic activity of moxifloxacin is of limited clinical importance (other than its adverse effect on intestinal microflora). So if anaerobic infection requires therapy, metronidazole can be combined with any of these quinolones. Orally administered they are well absorbed and widely distributed through body tissues, and they are long acting, which allows the advantage of once-a-day dosing. In their parenteral forms they are as potent against these organisms as is ceftriaxone and perhaps vancomycin. Gatifloxacin has been associated with unexpected alterations in blood sugar, especially in elderly patients or those taking oral medications for diabetes. Neurological symptoms such as headache, dizziness, restlessness, stimulation, and insomnia are the most commonly experienced side effects. With ciprofloxacin these are aggravated by concomitant use of nicotine, caffeine, and nonsteroidal anti-inflammatory drugs. Theophylline elimination time is prolonged by ciprofloxacin, so dosage adjustments of theophylline are required. Quinolones are listed among the drugs that prolong the electro cardiographic Q-T interval. It is prudent to avoid combination-use of quinolones with the other listed agents or with antiarrhythmic agents or use in patients with bradycardia, hypokalemia, or acute myocardial ischemia. Bioavailability of all quinolones is impaired by di and trivalent cations in the stomach: Al+++, Ca++, Mg++, Fe++, Zn++, as in vitamins with zinc or iron, antacids, sucralfate (Carafate), and buffering in didanosine (Videx). Therefore, manufacturers have recommended the following: Cipro: Take 2 hours before or 6 hours after Antacids or vitamins with minerals (Zn, Fe) or Levaquin: Take 2 hours before or 2 hours after iron supplements, or calcium or iron enriched Tequin: Take 4 hours before or 4 hours after juices and cereals Avelox: Take 4 hours before or 8 hours after Factive: Take 2 hours before or 3 hours after For simplicity, the patient could take the quinolone at breakfast and the antacids and/or supplements at suppertime, or visa versa. Conversely, quinolone absorption is not impaired by H2 antagonists or dietary milk products. But several studies of cystic fibrosis children and neonates suggest this is not a risk in humans (Arch. Pneumococcal resistance to respiratory quinolones remains low (<1 percent) in the U. Some investigators fear that if use of quinolones as first-line agents for common/minor infections (especially in children) becomes a common practice, their unique role as the only available oral-agents for highly resistant pneumococcal infections will be compromised (Current Inf. J?Vancomycin Vancomycin is of interest to otolaryngologists because it has ototoxic potential and because its use is increasing generally (for treatment of methicillin-resistant staph. It is unrelated to any other class of antibiotic, and therefore there is no cross resistance or allergy with other antibiotics. It is valuable in serious gram-positive coccal infections as a penicillin substitute for allergic patients and/or against resistant organisms. It is bactericidal against almost all staphylococci, streptococci (aerobic and anaerobic), and pneumococci (including ?high-level multi-drug resistant strains), and against clostridium species and enterococci. K), but such usage is thought to be a factor inducing vancomycin-resistant enterococci in the U. Therefore, most such cases should be primarily treated with metronidazole (below). It may create chills, fever, rash and flushing (?red-man syndrome), and phlebitis on intravenous administration, but slow injection and prophylactic use of antihistamines minimize these side effects.

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Several types of large perennial weedy dock plants have been used as medicinal herbs, especially for skin conditions. The plant was also the source of a ?blood purifier, a tonic for arthritis and liver complaints, and as a laxative. Wood sorrel (Oxalis acetosella) is in a different Genus that is characterized by clover-like leaves, but it also contains oxalate and has the typical sour taste of sorrels. Europe, America Roots, leaves Soy bean Glycine max this annual plant, which is indigenous to Asia and widely cultivated here in the Midwest, is the source of many soy-based products, including glycerin, linoleum, paint, soaps, ink, varnish, biofuel and other petroleum and rubber substitutes. Medicinally, soy contains isoflavones, sterols, and coumestrol that are phytoestrogens that mimic the effects of human estrogen. This makes them potentially useful in combating the symptoms of menopause and protecting against osteoporosis. Soy also is believed to inhibit the development and growth of estrogen-sensitive cancers such as some breast, ovary, and prostate cancers. The compound genistein from soy inhibits the growth of new blood vessels that supply tumors. Soy can interfere with the effectiveness of tamoxifen, and soy and tamoxifen should not be used concurrently. Consumption of low fat soy products (25 grams of soy a day) may lower serum cholesterol by about 7%. A sia B eans 28 Spicebush Lindera benzoin Indians and settlers used the berries, twigs, and bark of this shrub for many ailments. A diaphoretic decoction of bark was used especially for typhoid and other fevers and for expelling intestinal worms. In the 1890s, Parke Davis sold spicebush preparations for use as ?an exhilarant and refrigerant. Traditionally it was thought that the plant could chase away darkness, gloom, and the devil, and it was used to cure melancholy, hysteria, and madness. The herbal extract taken internally has proven useful in treating mild to moderate (but not severe) depression. It may also have antiviral activity against viruses that have an envelope, for example herpes and hepatitis B virus. Cautions in the use of this herbal include severe photosensitivity of the skin in some individuals and interaction with other medications. Native Americans made root tea to treat various lung problems, rheumatism, spider bites, and gastrointestinal worms. The plant was useful as a tobacco and coffee substitute, to control flies, and to make cordage. America Roots, Seeds Sweet Annie, Sweet wormwood Artemisia annua Leaves gathered before the plant is in flower were used by settlers to make tea for the treatment of colds, flu, malarial fever, dysentery, and diarrhea. The plant is indigenous to Asia, and it has been used for centuries in Chinese medicine, where it is known as Qing Hao. This herbal medicine was much in the news in the early 2000s when studies proved that this plant was an effective therapy for malaria, even in cases that were resistant to treatment with quinine or chloroquine. The extracted compound of the leaves is called artemisinin (and derivatives artemether and artesunate). Unfortunately, as of 2009, malarial parasites were becoming resistant to artemisinin too. Experiments include attaching artemisinin to the iron-carrying molecule transferrin, which tricks cancer cells into taking up the transferring-artimisinin complex. A related plant Artemisia th absinthium or wormwood is the source of absinthe, an addictive and toxic drink popular in 19 century France. Asia Leaves 29 Tansy Tanacetum vulgare Tansy is a strong smelling herb that was used as an insect repellent and preservative. Before refrigeration, both coffins and meat storage containers were sometimes packed with tansy to prevent decay. Even external use to rid patients of scabies and lice can lead to toxic effects and should be avoided, especially by pregnant women. The famous English herbalist of the 17 century, Nicholas Culpeper, wrote that thyme was ?a notable strengthener of the lungs ?neither is there a better remedy growing for that disease in children which they commonly call chin-cough [whooping cough]. The leaves of tobacco have been applied fresh to heal wounds but more often were dried and then smoked or otherwise inhaled (or blown into the rectum).

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His sonne was this, Geryoneo hight, Who after that his monstrous father fell Vnder Alcides club, streight tooke his flight From that sad land, where he his syre did quell, And came to this, where Belge then did dwell, And flourish in all wealth and happinesse, Being then new made widow (as befell) After her Noble husbands late decesse; Which gaue beginning to her woe and wretchednesse. Then this bold Tyrant, of her widowhed Taking aduantage, and her yet fresh woes, Himselfe and seruice to her offered, Her to defend against all forrein foes, That should their powre against her right oppose. By meanes whereof, she did at last commit All to his hands, and gaue him soueraine powre To doe, what euer he thought good or fit. Which hauing got, he gan forth from that howre To stirre vp strife, and many a Tragicke stowre, Giuing her dearest children one by one darkwing. Vnto a dreadfull Monster to deuoure, And setting vp an Idole of his owne, the image of his monstrous parent Geryone. So tyrannizing, and oppressing all, the woefull widow had no meanes now left, But vnto gratious great Mercilla call For ayde, against that cruell Tyrants theft, Ere all her children he from her had reft. She gladly graunted it: then he straight way Himselfe vnto his iourney gan prepare, And all his armours readie dight that day, That nought the morrow next mote stay his fare. Then taking humble leaue of that great Queene, Who gaue him roiall giftes and riches rare, As tokens of her thankefull mind beseene, And leauing Artegall to his owne care; Vpon his voyage forth he gan to fare, With those two gentle youthes, which him did guide, And all his way before him still prepare. Ne after him did Artegall abide, But on his first aduenture forward forth did ride. It was not long, till that the Prince arriued Within the land, where dwelt that Ladie sad, Whereof that Tyrant had her now depriued, And into moores and marshes banisht had, Out of the pleasant soyle, and citties glad, In which she wont to harbour happily: But now his cruelty so sore she drad, That to those fennes for fastnesse she did fly, And there her selfe did hyde from his hard tyranny. There he her found in sorrow and dismay, All solitarie without liuing wight; For all her other children, through affray, Had hid themselues, or taken further flight: And eke her selfe through sudden strange affright, When one in armes she saw, began to fly; But when her owne two sonnes she had in sight, She gan take hart, and looke vp ioyfully: For well she wist this knight came, succour to supply. And running vnto them with greedy ioyes, Fell straight about their neckes, as they did kneele, And bursting forth in teares; Ah my sweet boyes, (Sayd she) yet now I gin new life to feele, And feeble spirits, that gan faint and reele, Now rise againe, at this your ioyous sight. Alreadie seemes that fortunes headlong wheele Begins to turne, and sunne to shine more bright, Then it was wont, through comfort of this noble knight. Then turning vnto him; And you Sir knight (Said she) that taken haue this toylesome paine For wretched woman, miserable wight, May you in heauen immortall guerdon gaine For so great trauell, as you doe sustaine: For other meede may hope for none of mee, To whom nought else, but bare life doth remaine, And that so wretched one, as ye do see Is liker lingring death, then loathed life to bee. And low dismounting from his loftie steede, Gan to recomfort her all that he might, Seeking to driue away deepe rooted dreede, With hope of helpe in that her greatest neede. So thence he wished her with him to wend, Vnto some place, where they mote rest and feede, And she take comfort, which God now did send: Good hart in euils doth the euils much amend. My pallaces possessed of my foe, My cities sackt, and their sky-threating towres Raced, and made smooth fields now full of flowres? Onely these marishes, and myrie bogs, In which the fearefull ewftes do build their bowres, Yeeld me an hostry mongst the croking frogs, And harbour here in safety from those rauenous dogs. Nathlesse (said he) deare Ladie with me goe, Some place shall vs receiue, and harbour yield; If not, we will it force, maugre your foe, And purchase it to vs with speare and shield: And if all fayle, yet farewell open field: the earth to all her creatures lodging lends. With such his chearefull speaches he doth wield Her mind so well, that to his will she bends And bynding vp her locks and weeds, forth with him wends. They came vnto a Citie farre vp land, the which whylome that Ladies owne had bene; But now by force extort out of her hand, By her strong foe, who had defaced cleene Her stately towres, and buildings sunny sheene; Shut vp her hauen, mard her marchants trade, Robbed her people, that full rich had beene, And in her necke a Castle huge had made, the which did her co[m]maund, without needing perswade. That Castle was the strength of all that state, Vntill that state by strength was pulled downe, And that same citie, so now ruinate, Had bene the keye of all that kingdomes crowne; darkwing. When those gainst states and kingdomes do coniure, Who then can thinke their hedlong ruine to recure. But he had brought it now in seruile bond, And made it beare the yoke of inquisition, Stryuing long time in vaine it to withstond; Yet glad at last to make most base submission, And life enioy for any composition. So now he hath new lawes and orders new Imposd on it, with many a hard condition, And forced it, the honour that is dew To God, to doe vnto his Idole most vntrew. To him he hath, before this Castle greene, Built a faire Chappell, and an Altar framed Of costly Iuory, full rich beseene, On which that cursed Idole farre proclamed, He hath set vp, and him his God hath named; Offring to him in sinfull sacrifice the flesh of men, to Gods owne likenesse framed, And powring forth their bloud in brutishe wize, That any yron eyes to see it would agrize. And for more horror and more crueltie, Vnder that cursed Idols altar stone; An hideous monster doth in darknesse lie, Whose dreadfull shape was neuer seene of none That liues on earth; but vnto those alone the which vnto him sacrificed bee. Those he deuoures, they say, both flesh and bone: What else they haue, is all the Tyrants fee; So that no whit of them remayning one may see.

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The essential oil that is extracted from the leaves and twigs of the Tea Tree is produced only in Australia and has a yield of about 1. Ingredients it Carries: 1, 8-cineole, y-terpinen-4-ol, a-terpineol, cineole, a-pinene, a terpenene, b-caryophyllene, linalool, p-cymene, myrcene. Therapeutic properties: Antibacterial, anti-fungal, anti-microbial, antiseptic, antiviral, balsamic, cicatrisant, expectorant, insecticide, stimulant and sudorific. Contraindications: Most references list no Precautions when using Tea Tree Oil, but it may cause skin sensitization in some people * * * * * Thyme Thyme is indispensable in the kitchen, but it is also indispensable in your herbal closet as a powerful antiseptic (it is an ingredient in Listerine) and expectorant that has been used for thousands of years to loosen phlegm in deep-seated chest infections and to ease bronchitis and asthma. It also supports the gastrointestinal system, especially helping to rid the body of flatulence, as well as easing indigestion, gastritis, dyspepsia and stomach cramps. Thyme is said to calm the nervous system, induce sleep, dispel nightmares, and lift the spirits during depression and increase energy. Plant Description: Thyme is a small, shrubby evergreen that is native to the Mediterranean regions of southern Europe and widely cultivated in the warm, sunny fields of Europe and North America, where it also grows wild in some places. There are many varieties of Thyme, and the cultivated, garden plant is most commonly used in herbal medicine. The woody, downy stems of this hardy perennial are stiff and bear gray-green leaves with blue-lavender-pink to whitish flower clusters that bloom from April to July. The highly aromatic plant, which may reach a height of fifteen inches, has a strong, spicy taste and odor and has been esteemed as an important medicinal herb for thousands of years. History: It was known to the Egyptians, who used it in the embalming process (it is still used in embalming fluid) and as a preservative. The origin of the botanical name, Thymus, is slightly ambiguous, but it is believed to be derived from the Greek word, thymon, or thumus, meaning "strength" or "courage," and although it is a Greek derivative, its roots go deeper. Tracing it back beyond the world of Socrates and Plato, we find that thymos comes from the Indo-European root dheu, which is the base of a wide variety of derivatives meaning, "To rise into flames," "to rise in a cloud" or "to smoke. The altar like elevation in the center of the orchestra of a Greek theater was called the thymele, and sacrificial incense was placed in the thymiaterion, or censer. Thymos, then, was a rising of smoke, a burning of incense, a sacrifice to the gods all taking place within the chest, the inner altar. Roman soldiers bathed in it to maintain their courage and strength before battle, and in medieval times, departing Crusaders received Thyme-embroidered scarves from their women to keep up their spirits and inspire courage. Herbalists in the Middle Ages considered Thyme as an important tonic stimulant and antispasmodic that treated epilepsy and melancholy. During the waves of plague that spread across Europe from the fifteen to the seventeenth centuries, Thyme was used as a germicide (they were right! Thyme is an indispensable flavoring for foods, adding a distinctive flavor to sauces, stews, stuffing, meats, poultry and soups, while at the same time aiding the digestive system. It is a key herb in the bouquet garnithat is so important in French cuisine and is used in many cosmetic and pharmaceutical preparations, including toothpastes, mouthwashes (Listerine) and insect repellents. Some of the constituents included in Thyme are essential oils (cymol, linalool, carvacrol and the simple terpene, thymol, which is a powerful disinfectant), alpha-pinene, flavonoids (apigenin, luteolin), beta carotene, geraniol, limonene, camphor, citral, amino acids, caffeic, caprylic, chlorogenic, cinnamic acid, gallic, vanillic and other essential fatty acids, salicylates, tannin, calcium, iron, magnesium, manganese, phosphorus, potassium, selenium, zinc, B-vitamins and vitamin C. Medical Uses: Thyme is considered an excellent expectorant and antitussive that has been used since ancient times to treat upper respiratory and lung disorders. The herb is said to be ideal for deep-seated chest infections that are marked by thick, yellow phlegm and will help loosen and expel mucous congestion from the lungs and head. It has been used effectively for sore throats, coughs, croup, whooping cough, acute bronchitis, laryngitis and asthma. The bitter principle in Thyme acts as a digestive that supports the gastrointestinal system. It is said to relax the smooth muscle of the stomach, relieving all kinds of stomach upsets (with particular influence on flatulence by calming the stomach and releasing entrapped gas). Thyme is also used to alleviate chronic gastritis, lack of appetite, enteritis, dyspepsia, griping (the sharp pains and grumbling usually associated with trapped gas or diarrhea), indigestion, irritable bowel and colic. Thyme is considered a reliable antispasmodic that has been used to ease convulsions, stomach cramps, epilepsy, menstrual cramps and spasm-induced coughing and diarrhea. As a "nervine" with sedative properties, Thyme is believed to be a good tonic that stimulates and tones up the nervous system, alleviating such nervous disorders as neurasthenia (a functional neurosis marked by intense nervous irritability and weakness), depression, nightmares, nervous exhaustion, insomnia and melancholy.