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The other carries a single glucose molecule attached to pregnancy line purchase discount xeloda line the amino acid valine at the amino end of one of the beta chains of hemoglobin women's safety and health issues at work order 500mg xeloda amex. A series of standard solutions is prepared by mixing diferent proportions of these two forms of hemoglobin menstruation begins because 500mg xeloda mastercard. Ideally breast cancer lump feels like discount 500mg xeloda with mastercard, these synthetic samples should mimic a patient sample, but many times they do not because the matrix has undergone a type of manufacturing process and does not resemble a fresh human patient specimen. The manufacturing process stabilizes and extends the analyte life during shipping and storage, but this process changes the matrix of the native human sample. In addition, these samples are often frozen or lyophilized (freeze-dried to remove all liquid) to minimize decomposition of analytes during storage. The process of freezing or lyophilization followed by thawing or reconstitution with liquid may also change some properties of the solution. When the addition of extra substances, or freezing or lyophilization alters the solution properties in a way that biases the measured result, the bias is said to result from a ?matrix efect. If calibrators are used with a diferent method, matrix efects may result in inaccurate calibration. The results are separated into peer groups of participants who use the same method, the same reagent or the same analyzer. The responsibility for meeting these criteria is shared by the manufacturer and the clinical laboratory. A desirable goal for accuracy is that the combined imprecision and bias should not exceed the typical within subject biologic variation (the natural biologic fuctuations of the analyte within an individual over time). The method should be optimized to provide suitable reproducibility and bias, and the calibration process should include traceability to ensure that an accurate value is assigned to the test result. Other professional organizations or regulatory authorities may also set performance targets for many analytes. Two systems are used to ensure that clinical laboratories are performing acceptably. For example, fasting glucose in a nondiabetic is expected to be between 70 and 100 mg/dL (3. The problem could also lie with the operator and be due to a procedural error or staf technique. Before a patient sample can be tested and results reported, the source of the problem needs to be identifed and corrected, and the analytic system brought back ?in control. If there is no established accuracy range for an analyte, the test result is compared with the results from other laboratories that tested the same samples. A statistical range is established for all laboratories reporting results for that analyte or sometimes for subsets of laboratories using the same method (termed peer groups). In this approach, the acceptance limits are the same for all laboratories and methods, as opposed to peer group grading. Only when a laboratory meets the performance criteria for accuracy can it report test results for patient samples. Which of the following sets of values for repeat analyses of a sample (target value of 100) shows the least bias? Patient preparation and proper collection and handling of specimens are important preanalytical steps to ensure the validity of a test result. Automated instrumentation includes numerous algorithms to detect potential sources of error and alert the operator. Preanalytical errors are those that occur during sample collection, transport or processing prior to the analysis step. It is important that patients follow these instructions so that the test result can be compared in a meaningful way to the reference interval. For example, the reference interval for triglycerides is based on a specimen collected after 8?12 hours of fasting (no food or drink other than water). If a patient eats a meal or snack shortly before the blood sample is taken, the triglycerides may be higher than the reference range, erroneously suggesting that the patient demonstrates dislipidemia (abnormal concentration of a lipid fraction). Prolonged tourniquet application time can lead to unrepresentative amounts of certain substances in the specimen. These are mostly high molecular weight substances such as proteins, lipids and protein bound substances like calcium. Use of the wrong anticoagulant for a blood sample, or the wrong preservative for a urine sample, may lead to inaccuracies, either due to a failure to stabilize the analyte or by direct interference in the testing step. A patient specimen collected using a diferent type of tube may produce inaccurate results. For example, if 24-hour urine samples for calcium or magnesium testing are not adequately acidifed by the addition of hydrochloric acid or other acceptable preservatives, insoluble salts of these metal ions may form and precipitate out of solution. Since the test only measures the ions remaining in solution, the result will underestimate the actual amount. Some samples can be stabilized by refrigeration, some may require freezing, others may need protection from light, and still others might require analysis within limited timeframes. If a blood sample is not immediately placed on ice, the continued formation of ammonia during transport may cause falsely high results suggesting liver disease when no disease is present. Glucose, on the other hand, is consumed by blood cells when a sample of whole blood is stored at room temperature. Signifcant amounts of glucose can disappear in a matter of 30?60 minutes, risking a failure to recognize high glucose or to falsely identify someone as havingFigure 5-1. Sometimes it is not discovered that an assay is out of control until after patient samples have been analyzed. If the method fails to meet performance standards (?out of control), the results from testing patient samples will be erroneous. In this case, the cause of the problem must be identifed and corrected and then the patient samples retested. Part of the evaluation of test method accuracy includes evaluation of the efect of potential interferents. The indices representing these conditions are abbreviated by the letters H, I and L. Hemolysis results in the sample appearing red; icterus as yellow to brown; and lipemia results in a milky or turbid appearance. Qualitative visual scales, ranging from 1+ to 4+, indicate the relative degree of each of these conditions. E ect of the Presence of H, I or L the color or turbidity of the interferent can alter the readings taken by a spectrophotometer so the absorbance signal does not refect the true concentration of analyte. By taking absorbance measurements at the seven photometric measurements of absorbance at several diferent wavelengths. A mathematical algorithm can designated wavelengths, the concentrations of each of these then be used to compute the relative amount of each interferent and provide a semiquantitative estimate. This estimate can be made during the background reading time, before any active reagents are added, or as a separate test. For example, if the test for potassium has been found to be elevated when H > 2+, but not when L or I are elevated, the laboratory may decide not to report potassium results if H > 2+, or it may choose to report the result with a conditional statement indicating the result is likely to be overestimated because of the high H index. The presence of these antibodies (called heterophile antibodies) can lead to a falsely high or falsely low result. Patients may develop heterophile antibodies if they receive immunotherapies, a vaccine containing serum from another species, or even through environmental exposure. If a provider questions the result, it is possible to repeat the test adding an anti-heterophile antibody or a blocking substance that will bind to the heterophile antibody in the sample before analysis. The anti-heterophile antibody or blocking substance binds to the heterophile antibody in the patient sample and prevents it from interfering in the test. Some immunoassays include anti-heterophile antibodies or blocking agents in the reagents for the test, to reduce the possibility of interferences from heterophile antibodies in the patient sample. This approach is acceptable when only knowing that a result is elevated is sufcient for medical management. In such cases the usual approach is to dilute the sample and reanalyze a diluted aliquot of the sample, mathematically correcting the measured result by a dilution factor. For example, if the original sample is diluted by taking 1 mL of sample and adding 9 mL of an appropriate diluent (a term for the solution used for making dilutions), the measured result in the diluted sample will be multiplied by 10 to give the value for the original sample. Manual dilution and reanalysis steps are often undesirable because they are subject to human error such as mismeasurement, miscalculation and use of the wrong diluent.
In many cases the clinical relevance of in vitro antifungal susceptibility results remains diffcult to womens health supplements discount 500 mg xeloda free shipping interpret breast cancer 86 year old woman cheap xeloda line, and expert advice from a consulting microbiologist or infectious disease specialist may be required women's health clinic greenville sc cheap xeloda 500mg otc. Note: International biosafety guidelines vary in their Rg ratings of fungal species menstrual cycle 9 days late cheap xeloda generic. Acremonium Link ex Fries Key Features: Hyphomycete with solitary, erect, hyaline, awl-shaped phialides producing single-celled, globose to cylindrical conidia, mostly in slimy heads. Descriptions of Medical Fungi 1 Acremonium Link ex Fries the genus Acremonium contains many species; most are saprophytic being isolated from dead plant material and soil. Recently, several Acremonium like species recognised as opportunistic pathogens have been transferred to other genera; Fusarium falciforme (formerly A. Morphological Description: colonies are usually slow growing, often compact and moist at frst, becoming powdery, suede-like or foccose with age, and may be white, grey, pink, rose or orange in colour. Hyphae are fne and hyaline and produce mostly simple awl-shaped erect phialides with inconspicuous collarettes. Comments: Microconidial Fusarium isolates may be confused with Acremonium, but they usually grow faster and have colonies with a characteristic fuffy appearance. Phialemonium species differ by having short, tapering phialides, mostly lacking a basal septum. Coniochaeta is characterised by having sessile phialidic collarettes that are formed directly on the hyphae. Saksena) Samson the genus Acrophialophora contains 16 species that are most commonly associated with soil, especially from India (Zhang et al. Morphological Description: colonies fast growing, greyish-brown with a black reverse. Phialides fask-shaped with a swollen base and a long, narrow neck, hyaline, smooth-walled or echinulate, 9-15 3-4. Key Features: Hyphomycete with fask-shaped phialides producing long chains of one-celled, limoniform, pale brown conidia, with indistinct spiral bands. Morphological Description: colonies are fast growing, black to olivaceous-black or greyish, and are suede-like to foccose. Microscopically, branched acropetal chains (blastocatenate) of multicellular conidia (dictyoconidia) are produced sympodially from simple, sometimes branched, short or elongate conidiophores. O Molecular Identifcation: Multilocus genotype studies have shown the Alternaria complex currently comprises nine genera and eight Alternaria sections (Woudenbert et al. However, it is estimated that >14% of genbank sequences of Alternaria species are misclassifed, so unknown sequences should be compared to those of well characterised reference strains (Woudenberg et al. Potato dextrose agar and cornmeal agar are the most suitable media to use, and incubation under ultra-violet light is recommended to maintain sporulation. Key Features: Dematiaceous hyphomycete producing chains of darkly pigmented, ovoid to obclavate dictyoconidia, often with short conical or cylindrical beaks. Descriptions of Medical Fungi 5 Aphanoascus fulvescens (Cooke) Apinis Aphanoascus fulvescens is a soil-borne keratinolytic ascomycete that occasionally causes dermatomycosis in humans and animals. Morphological Description: colonies are moderately fast growing, white to tan with the production of numerous spherical, pseudoparenchymatous, buff to light brown cleistothecia (non-ostiolate ascocarps). Aphanoascus fulvescens has a Chrysosporium anamorph showing typical pyriform to clavate-shaped conidia with truncated bases, 15-17. Morphological characteristics overlap so identifcation and reporting of Apophysomyces complex is recommended for most diagnostic laboratories. Morphological Description: colonies are fast growing, white, becoming brownish grey with age, downy with no reverse pigment, and are composed of broad, sparsely septate (coenocytic) hyphae. Sporangiophores are unbranched, straight or curved, slightly tapering towards the apex, up to 540 ?m long, 3-6 ?m in width near the apophysis, and hyaline when young but developing a light to dark brown pigmentation and a conspicuous subapical thickening 10-16 ?m below the apophysis with age. Sporangiophores arise at right angles from the aerial hyphae and often have a septate basal segment resembling the ?foot cell commonly seen in Aspergillus. Sporangia are multispored, small (20-58 ?m diameter), typically pyriform in shape, hyaline at frst, sepia-coloured when mature, with distinct apophyses and columellae. Sporangiospores are smooth-walled, subspherical to cylindrical, (5-8 x 4-6 ?m), subhyaline to sepia in mass. Morphological Description: colonies are fast growing, whitish with scarce aerial mycelium and no reverse pigment. Sporangiophores are erect, generally arising singly, unbranched, slightly tapering towards the apex, up to 100-400 ?m long, 2-3. Sporangia are multispored, small (15-50 ?m diameter), typically pyriform in shape, hyaline at frst, sepia-coloured when mature, with distinct apophyses and columellae. Sporangiospores are smooth-walled, variable in shape, trapezoid, ellipsoidal, sub-triangular or claviform, (5-14 x 3-6 ?m), subhyaline to sepia in mass. In addition, there is a conspicuous pigmented subapical thickening, which constricts the lumen of the sporangiophore below the apophysis, and distinctive foot cells. Sporulation may be stimulated by the use of nutrient defcient media, like cornmeal-glucose-sucrose-yeast extract agar, czapek Dox agar, or by using the agar block method described by Ellis and ajello (1982) and Ellis and Kaminski (1985). Molecular-based identifcation is particularly helpful for the defnitive identifcation of poorly sporulating cultures. Arthroderma insingulare is a geophilic fungus of worldwide distribution which may occur as a saprophytic contaminant on humans and animals. Durie and frey (1957) frst described this soil fungus as Trichophyton terrestre from New South Wales, australia. Morphological Description: colonies are usually fat to downy with a suede-like to granular texture resembling T. The surface colour may range from white to cream, buff to yellow, or greenish-yellow. Reverse pigmentation is usually yellowish-brown although some variants have a deep rose red reverse. Microconidia are large, clavate or pedicellate, usually exhibiting transition forms to more or less abundant lateral macroconidia. Macroconidia are clavate to cylindrical with rounded ends, smooth and thin-walled, and are two to six-celled. Arthroderma uncinatum is a geophilic fungus with a worldwide distribution which may occur as a saprophytic contaminant on humans and animals but infections are doubtful. Morphological Description: colonies are usually fat, powdery, cream, tan to orange tan in colour, with a blackish-purple submerged fringe and reverse. Macroconidia are numerous, smooth, thick-walled, elongate, cigar-shaped, 29-65 x 5-10 ?m, and multiseptate with up to nine or ten septa. Descriptions of Medical Fungi 11 Arthrographis kalrae (Tewari & Macpherson) Sigler & Carmichael Arthrographis is an arthroconidial mould comprising four species: A. These fungi are commonly found in environmental samples (soil, wood, air and water), but are isolated rarely from clinical specimens (Sandoval Denis et al. Morphological Description: colonies with slow to moderate growth, creamy white to tan-coloured. Initially, yeast-like then developing hyphal growth and conidiophores subhyaline, narrow, branched, often in bundles, occasionally forming whitish, large 0. Spherical blastoconidia 2-4 x 2-3 ?m, may also be formed laterally and sessile on undifferentiated hyphae. Key Features: Keratinolytic, in vitro hair perforation positive, growth at 37 c andO tolerance to cycloheximide. Traditionally, clinical microbiology laboratories have relied heavily on morphology-based identifcation methods to differentiate Aspergillus species. However many species, especially members of the section Fumigati have overlapping morphological characteristics, which has allowed several genetically distinct species to be misidentifed (balajee et al. This has led to the clustering of species with overlapping morphologies into ?species complexes, so that laboratories may report more accurately morphology-based identifcations. Identifcation of clinical isolates of Aspergillus to species level may be important given that different species have variable susceptibilities to multiple antifungal drugs. Descriptions of Medical Fungi 13 Aspergillus Micheli ex Link Morphological Description: colonies are usually fast growing, white, yellow, yellow brown, brown to black or shades of green, mostly consisting of a dense felt of erect conidiophores. Descriptions are primarily based on colony pigmentation and morphology of the conidial head. Microscopic mounts are best made using cellotape fag or slide culture preparations mounted in lactophenol cotton blue. Key Features: Hyaline hyphomycete showing distinctive conidial heads with fask shaped phialides arranged in whorls on a vesicle.
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They cause progressive emaciation womens health trumbull ct purchase 500mg xeloda free shipping, anemia and enlargement of the spleen and liver in affected birds breast cancer triple negative buy discount xeloda 500 mg line. Paralysis may be observed where there are massive numbers of erythrocytic forms in endothelial cells of the brain capillaries menopause exhaustion generic xeloda 500mg amex, and death occurs in untreated cases breast cancer 70-year-old woman cheap xeloda 500mg free shipping. Gross lesions include hepatomegally and splenomegally with subcutaneous, pulmonary and epicardial edema. Acute interstitial pneumonia and diffuse reticulo-endothelial hyperplasia in spleen and other organs are present. Cause, life cycle, transmission, and epidemiology: Birds are infected with Plasmodium sporozoites, which are transferred from the mosquito salivary glands to the bloodstream. The parasites undergo schizogony in macrophages and fibroblasts and then liver cells, producing merozoites. These merozoites enter erythrocytes, multiply by schizogony and finally form gametes, which are picked up by mosquitoes during feeding. The nucleus of host cells is displaced by the parasite and host cells are distorted during infection. Microrgametocytes and macrogametocytes also form within erythrocytes but are observed infrequently. Evaluation of blood smear and monitoring the white blood cell counts for a lymphocytic leucocytosis are considered to be a reliable method of ante mortem diagnosis. Leucocytozoon species Clinical signs: Leucocytozoon caulleryi is the most virulent. Infected chickens frequently show signs of anorexia, thickened oral discharge, ataxia, anaemia and have difficulty breathing. In addition, birds may be susceptible to secondary infection that may increase mortality. Cause, life cycle, transmission, and epidemiology: There are two main species of Leucocytozoon commonly found in chickens: L. Leucocytozoon species are most easily distinguished because of their large size and football-like distortion of infected cells, with pointed ends. Leucocytozoon schoutedeni (a new species) has been reported in Uganda and Cameroon. Leucocytozoon gametocytes are found in erythroblasts and mononuclear leucocytes as ovoid (10 by 15 microns) or elongated (24 by 4 microns) forms. The host cells with elongated gametocytes become spindle shaped, with nuclei appearing as thin bands beside the parasite. The schizogony takes place in the brain, liver, spleen, lungs and many other organs. Merozoites are then released and may enter a new cycle, or may enter erythrocytes or erythroblasts to develop into gametocytes. In the vector the zygote elongates into an ookinete that passes through the intestinal wall to form oocysts under the basal lamina. Diagnosis: Pathological lesions and evaluation of blood smear to demonstration the parasite in infected cells. Control and treatment: Prevention of Leucocytozoonosis is usually directed towards control of black flies or midge populations. In other avian species, anemia, anorexia, and depression have been reported occasionally, but Haemoproteus generally is considered non-pathogenic in most avian species. Post-mortem findings of infected birds include enlargement of the spleen, liver, and kidneys. Some species of Haemoproteus will also form large, cyst-like bodies within skeletal muscles that resemble those seen with Sarcocystis spp. They are found worldwide and are capable of infecting a variety of birds including gamebirds (Galliformes), waterfowl (Anseriformes), raptors (Accipitriformes, Falconiformes, Strigiformes), pigeons, doves (Columbiformes), and perching birds or songbirds (Passeriformes). The gametocytes partially encircle the erythrocyte nucleus forming a ?halter-shaped appearance. Haemoproteus gametocytes often occupy over one-half of the erythrocyte cytoplasm with little displacement of the host cell nucleus. Haemoproteus is transmitted by blood-sucking insects including mosquitoes, hippoboscid flies (louse flies), and Culicoides species (biting midges). Successful transmission depends on the presence of the vector, and therefore infections occur more often in the warmer months of the year. The infective stage is the sporozoite, which is present in the salivary glands of the insect vector. Once the vector bites a new host, the sporozoites enter the bloodstream and invade endothelial cells of blood vessels within various tissues including the lung, liver, and spleen. Within the endothelial cells, the sporozoites go through asexual reproduction to become schizonts, which then produce numerous merozoites. These merozoites penetrate the erythrocytes and mature into either female gametocytes (macrogametocytes) or male gametocytes (microgametocytes). Gametocytes can then be ingested by another blood-sucking insect where they undergo sexual reproduction in the midgut of the insect to produce oocysts. The oocysts rupture and release numerous sporozoites that invade the salivary gland and serve as a focus of subsequent infection for another host once the insect takes its next blood meal. Aegyptinella species Clinical signs: Aegyptinella pullorum causes fever, diarrhea, anorexia and jaundice. At post-mortem there is anaemia, enlargement of the spleen and degeneration of the kidneys. Cause, life cycle, transmission, and epidemiology: the two species of Aegyptinella, A. The developmental cycle of Aegyptinella in the avian host consists of the formation of initial bodies, developmental forms, and marginal bodies. The most common vectors of avian trypanosomes are arthropods belonging to flies in the families Hippoboscidae, Culicudae, Ceratopogonidae and Simuliidae. Within 24-72 hours post-infection, Borrelia anserina spirochaetes appear in the bloodstream and there is marked temperature elevation. Affected birds are listless, have urates around the vent, and manifests leg weakness. Yellow-white variable-sized nodules may be found in the lungs, air sacs, liver and lymphoid tissue. Differential diagnosis: Other lung infections and systemic fungal infections such as aspergillosis, cryptococcosis, and dactylariosis. Cause, transmission, and epidemiology: this is a chronic infectious mycotic disease of man and animals (especially dog and cat). The causative agent is a dimorphic fungus, Histoplasma capsulatum, which is commonly found in soil containing bird and bat manure. Infection is through aerosol inhalation of conidia produced by the mold, which contaminate the respiratory system. It enters the bloodstream at the primary site to cause widespread disease in the body. Diagnosis: Clinical signs, culture of the organism, and tissue granulomatous lesions with intracytoplasmic narrow-based budding yeasts measuring 2-4 ?m in diameter in the macrophages. The fungus grows readily in culture media and soil as a white to brown mold that produces microconidia (3-4 ?m, spiny and spherical) and macroconidia (8-12 ?m, spherical). However, over time, risk will decrease as the eggs are dispersed more widely and new birds are exposed to lower egg doses. Clinical signs and lesions: Typical respiratory signs such as coughing, sneezing, rales, wheezing, and/or gasping are present. Watery discharge from the eyes and/or nostrils, swelling of the head, and head shaking may be observed. Baby chicks show weakness, loss of appetite, reduced water intake, and depression, and huddle around the source of heat. The infectious bronchitis virus infects many tissues of the body, including the reproductive tract. Layer birds show severe and prolonged reduction in egg laying; the few eggs laid have soft or rough shells, and the egg white becomes watery. Lesions outside the respiratory system include swollen kidneys, with ureters and tubules distended and containing whitish uric acid crystals. The severity of infectious bronchitis infection is influenced by the age and immune status of the flock, by environmental conditions, and by the presence of other diseases. Cause, transmission, and epidemiology: Infectious bronchitis occurs in chickens only, but affects all ages and is common on highly intensive farms. The causative virus belongs to the family Cornaviridae, and is easily destroyed by most disinfectants.
Suddein vpriseth from her stately place the royall Dame menstrual cycle day 1-4 order xeloda 500mg without prescription, and for her coche doth call: All hurtlen forth womens health of illinois generic 500mg xeloda overnight delivery, and she with Princely pace women's health university order xeloda discount, As faire Aurora in her purple pall menopause facts discount 500mg xeloda overnight delivery, Out of the East the dawning day doth call: So forth she comes: her brightnesse brode doth blaze; the heapes of people thronging in the hall, Do ride each other, vpon her to gaze: Her glorious glitterand light doth all mens eyes amaze. So forth she comes, and to her coche does clyme, Adorned all with gold, and girlonds gay, That seemd as fresh as Flora in her prime, And stroue to match, in royall rich array, Great Iunoes golden chaire, the which they say the Gods stand gazing on, when she does ride To Ioues high house through heauens bras-paued way Drawne of faire Pecocks, that excell in pride, And full of Argus eyes their tailes dispredden wide. But this was drawne of six vnequall beasts, On which her six sage Counsellours did ryde, Taught to obay their bestiall beheasts, With like conditions to their kinds applyde: Of which the first, that all the rest did guyde, darkwing. Was sluggish Idlenesse the nourse of sin; Vpon a slouthfull Asse he chose to ryde, Arayd in habit blacke, and amis thin, Like to an holy Monck, the seruice to begin. And in his hand his Portesse still he bare, That much was worne, but therein little red, For of deuotion he had little care, Still drownd in sleepe, and most of his dayes ded; Scarse could he once vphold his heauie hed, To looken, whether it were night or day: May seeme the wayne was very euill led, When such an one had guiding of the way, That knew not, whether right he went, or else astray. From worldy cares himselfe he did esloyne, And greatly shunned manly exercise, From euery worke he chalenged essoyne, For contemplation sake: yet otherwise, His life he led in lawlesse riotise; By which he grew to grieuous malady; For in his lustlesse limbs through euill guise A shaking feuer raignd continually: Such one was Idlenesse, first of this company. And by his side rode loathsome Gluttony, Deformed creature, on a filthie swyne, His belly was vp-blowne with luxury, And eke with fatnesse swollen were his eyne, And like a Crane his necke was long and fyne, With which he swallowd vp excessiue feast, For want whereof poore people oft did pyne; And all the way, most like a brutish beast, He spued vp his gorge, that all did him deteast. In greene vine leaues he was right fitly clad; For other clothes he could not weare for heat, And on his head an yuie girland had, From vnder which fast trickled downe the sweat: Still as he rode, he somewhat still did eat, And in his hand did beare a bouzing can, Of which he supt so oft, that on his seat His dronken corse he scarse vpholden can, darkwing. Vnfit he was for any worldy thing, And eke vnhable once to stirre or go, Not meet to be of counsell to a king, Whose mind in meat and drinke was drowned so, That from his friend he seldome knew his fo: Full of diseases was his carcas blew, And a dry dropsie through his flesh did flow: Which by misdiet daily greater grew: Such one was Gluttony, the second of that crew. And next to him rode lustfull Lechery, Vpon a bearded Goat, whose rugged haire, And whally eyes (the signe of gelosy,) Was like the person selfe, whom he did beare: Who rough, and blacke, and filthy did appeare, Vnseemely man to please faire Ladies eye; Yet he of Ladies oft was loued deare, When fairer faces were bid standen by: O who does know the bent of womens fantasy? In a greene gowne he clothed was full faire, Which vnderneath did hide his filthinesse, And in his hand a burning hart he bare, Full of vaine follies, and new fanglenesse: For he was false, and fraught with ficklenesse, And learned had to loue with secret lookes, And well could daunce, and sing with ruefulnesse, And fortunes tell, and read in louing bookes, And thousand other wayes, to bait his fleshly hookes. Inconstant man, that loued all he saw, And lusted after all, that he did loue, Ne would his looser life be tide to law, But ioyd weake wemens hearts to tempt, and proue If from their loyall loues he might then moue; Which lewdnesse fild him with reprochfull paine Of that fowle euill, which all men reproue, That rots the marrow, and consumes the braine: Such one was Lecherie, the third of all this traine. And greedy Auarice by him did ride, Vpon a Camell loaden all with gold; Two iron coffers hong on either side, With precious mettall full, as they might hold, And in his lap an heape of coine he told; For of his wicked pelfe his God he made, And vnto hell him selfe for money sold; Accursed vsurie was all his trade, And right and wrong ylike in equall ballaunce waide. His life was nigh vnto deaths doore yplast, And thred-bare cote, and cobled shoes he ware, Ne scarse good morsell all his life did tast, But both from backe and belly still did spare, To fill his bags, and richesse to compare; Yet chylde ne kinsman liuing had he none To leaue them to; but thorough daily care To get, and nightly feare to lose his owne, He led a wretched life vnto him selfe vnknowne. Most wretched wight, whom nothing might suffise, Whose greedy lust did lacke in greatest store, Whose need had end, but no end couetise, Whose wealth was want, whose ple[n]ty made him pore, Who had enough, yet wished euer more; A vile disease, and eke in foote and hand A grieuous gout tormented him full sore, That well he could not touch, nor go, nor stand: Such one was Auarice, the fourth of this faire band. And next to him malicious Enuie rode, Vpon a rauenous wolfe, and still did chaw Betweene his cankred teeth a venemous tode, That all the poison ran about his chaw; But inwardly he chawed his owne maw At neighbours wealth, that made him euer sad; For death it was, when any good he saw, And wept, that cause of weeping none he had, But when he heard of harme, he wexed wondrous glad. All in a kirtle of discolourd say He clothed was, ypainted full of eyes; And in his bosome secretly there lay darkwing. An hatefull Snake, the which his taile vptyes In many folds, and mortall sting implyes. Still as he rode, he gnasht his teeth, to see Those heapes of gold with griple Couetyse, And grudged at the great felicitie Of proud Lucifera, and his owne companie. He hated all good workes and vertuous deeds, And him no lesse, that any like did vse, And who with gracious bread the hungry feeds, His almes for want of faith he doth accuse; So euery good to bad he doth abuse: And eke the verse of famous Poets witt He does backebite, and spightfull poison spues From leprous mouth on all, that euer writt: Such one vile Enuie was, that fift in row did sitt. And after all, vpon the wagon beame Rode Sathan, with a smarting whip in hand, With which he forward lasht the laesie teme, So oft as Slowth still in the mire did stand. Huge routs of people did about them band, Showting for ioy, and still before their way A foggy mist had couered all the land; And vnderneath their feet, all scattered lay Dead sculs & bones of men, whose life had gone astray. Therewith they gan to hurtlen greedily, Redoubted battaile ready to darrayne, And clash their shields, and shake their swords on hy, That with their sturre they troubled all the traine; Till that great Queene vpon eternall paine Of high displeasure, that ensewen might, Commaunded them their fury to refraine, And if that either to that shield had right, In equall lists they should the morrow next it fight. Ah dearest Dame, (quoth then the Paynim bold,) Pardon the errour of enraged wight, Whom great griefe made forget the raines to hold Of reasons rule, to see this recreant knight, No knight, but treachour full of false despight And shamefull treason, who through guile hath slayn the prowest knight, that euer field did fight, Euen stout Sans foy (O who can then refrayn? And to augment the glorie of his guile, His dearest loue the faire Fidessa loe Is there possessed of the traytour vile, Who reapes the haruest sowen by his foe, Sowen in bloudy field, and bought with woe: That brothers hand shall dearely well requight So be, o Queene, you equall fauour showe. That night they pas in ioy and iollity, Feasting and courting both in bowre and hall; For Steward was excessiue Gluttonie, That of his plenty poured forth to all: Which doen, the Chamberlain Slowth did to rest them call. Now whenas darkesome night had all displayd Her coleblacke curtein ouer brightest skye, the warlike youthes on dayntie couches layd, Did chace away sweet sleepe from sluggish eye, To muse on meanes of hoped victory. But whenas Morpheus had with leaden mace Arrested all that courtly company, Vp-rose Duessa from her resting place, And to the Paynims lodging comes with silent pace. With gentle wordes he can her fairely greet, And bad say on the secret of her hart. Then sighing soft, I learne that litle sweet Oft tempred is (quoth she) with muchell smart: For since my brest was launcht with louely dart Of deare Sansfoy, I neuer ioyed howre, But in eternall woes my weaker hart Haue wasted, louing him with all my powre, And for his sake haue felt full many an heauie stowre. Me silly maid away with him he bare, And euer since hath kept in darksome caue, For that I would not yeeld, that to Sans-foy I gaue. But since faire Sunne hath sperst that lowring clowd, And to my loathed life now shewes some light, Vnder your beames I will me safely shrowd, darkwing. Thereto said he, Faire Dame be nought dismaid For sorrowes past; their griefe is with them gone: Ne yet of present perill be affraid; For needlesse feare did neuer vantage none, And helplesse hap it booteth not to mone. Dead is Sans-foy, his vitall paines are past, Though greeued ghost for vengeance deepe do grone: He liues, that shall him pay his dewties last, And guiltie Elfin bloud shall sacrifice in hast. O but I feare the fickle freakes (quoth shee) Of fortune false, and oddes of armes in field. Why dame (quoth he) what oddes can euer bee, Where both do fight alike, to win or yield? Yea but (quoth she) he beares a charmed shield, And eke enchaunted armes, that none can perce, Ne none can wound the man, that does them wield. Charmd or enchaunted (answerd he then ferce) I no whit reck, ne you the like need to reherce. But faire Fidessa, sithens fortunes guile, Or enimies powre hath now captiued you, Returne from whence ye came, and rest a while Till morrow next, that I the Elfe subdew, And with Sans-foyes dead dowry you endew. Ay me, that is a double death (she said) With proud foes sight my sorrow to renew: Where euer yet I be, my secrete aid Shall follow you. The faithfull knight in equall field subdewes his faithlesse foe, Whom false Duessa saues, and for his cure to hell does goe. At last the golden Orientall gate Of greatest heauen gan to open faire, And Phoebus fresh, as bridegrome to his mate, Came dauncing forth, shaking his deawie haire: And hurld his glistring beames through gloomy aire. And forth he comes into the commune hall, Where earely waite him many a gazing eye, To weet what end to straunger knights may fall. There many Minstrales maken melody, To driue away the dull melancholy, And many Bardes, that to the trembling chord Can tune their timely voyces cunningly, And many Chroniclers, that can record Old loues, and warres for Ladies doen by many a Lord. Soone after comes the cruell Sarazin, In wouen maile all armed warily, And sternly lookes at him, who not a pin darkwing. At last forth comes that far renowmed Queene, With royall pomp and Princely maiestie; She is ybrought vnto a paled greene, And placed vnder stately canapee, the warlike feates of both those knights to see. A shrilling trompet sownded from on hye, And vnto battaill bad them selues addresse: Their shining shieldes about their wrestes they tye, And burning blades about their heads do blesse, the instruments of wrath and heauinesse: With greedy force each other doth assayle, And strike so fiercely, that they do impresse Deepe dinted furrowes in the battred mayle; the yron walles to ward their blowes are weake & fraile. The Sarazin was stout, and wondrous strong, And heaped blowes like yron hammers great: For after bloud and vengeance he did long. The knight was fiers, and full of youthly heat: And doubled strokes, like dreaded thunders threat: For all for prayse and honour he did fight. Both stricken strike, and beaten both do beat, That from their shields forth flyeth firie light, And helmets hewen deepe, shew marks of eithers might. At last the Paynim chaunst to cast his eye, His suddein eye, flaming with wrathfull fyre, Vpon his brothers shield, which hong thereby: Therewith redoubled was his raging yre, And said, Ah wretched sonne of wofull syre, Doest thou sit wayling by black Stygian lake, Whilest here thy shield is hangd for victors hyre, And sluggish german doest thy forces slake, To after-send his foe, that him may ouertake? Goe caytiue Elfe, him quickly ouertake, And soone redeeme from his long wandring woe; Goe guiltie ghost, to him my message make, That I his shield haue quit from dying foe. Therewith vpon his crest he stroke him so, That twise he reeled, readie twise to fall; End of the doubtfull battell deemed tho the lookers on, and lowd to him gan call the false Duessa, Thine the shield, and I, and all. And to him said, Goe now proud Miscreant, Thy selfe thy message doe to german deare, Alone he wandring thee too long doth want: Goe say, his foe thy shield with his doth beare. Therewith his heauie hand he high gan reare, Him to haue slaine; when loe a darkesome clowd Vpon him fell: he no where doth appeare, But vanisht is. Not all so satisfide, with greedie eye He sought all round about, his thirstie blade To bath in bloud of faithlesse enemy; Who all that while lay hid in secret shade: He standes amazed, how he thence should fade. At last the trumpets Triumph sound on hie, And running Heralds humble homage made, Greeting him goodly with new victorie, And to him brought the shield, the cause of enmitie. Wherewith he goeth to that soueraine Queene, And falling her before on lowly knee, To her makes present of his seruice seene: Which she accepts, with thankes, and goodly gree, Greatly aduauncing his gay cheualree. So marcheth home, and by her takes the knight, Whom all the people follow with great glee, Shouting, and clapping all their hands on hight, That all the aire it fils, and flyes to heauen bright. Where many skilfull leaches him abide, To salue his hurts, that yet still freshly bled.