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A Voyage North and a Memorable Encounter with Abraham Lincoln
Pres. Abraham Lincoln at Fort Stevens, 12 July 1864 (public domain illustration).
With the Union's Red River Campaign across Louisiana finally over by June of 1864, their supplies replenished, their dead buried, and the traumatic injuries of their wounded on the mend by early July, it was time for the 47th Pennsylvania Volunteers to move on. Still part of the 2nd Brigade of Brigadier General William Dwight's 1st Division in Brigadier General William H. Emory's 19th U.S. Army Corps, Companies A, C, D, E, F, H, and I received orders on the 4th of July to leave Companies B, G and K behind and march for Algiers, Louisiana. Boarding the U.S. Steamer McClellan there on Thursday, 7 July 1864, the bulk of 47th Pennsylvanians then sailed away from the docks at 1 p.m.
According to a diary entry made that day by Corporal George R. Nichols of E Company, the regiment was forced to leave behind those three companies because the McClellan simply did not have enough space for the entire regiment. Noting that they had been ordered to begin packing at 6 a.m. that morning for the march to the steamer, he said "about Nine hundred men was Shoved on her."
Note: Left behind in Morganza, Louisiana under the command of F Company Captain Henry S. Harte to await additional transportation, Companies B, G, and K sailed later that same month aboard the Blackstone, made a brief stop at Bermuda Hundred, arrived in the Washington, D.C. area on 28 July 1864, and reconnected with the remainder of the regiment and the 19th Corps three days later in Maryland at Monocacy.
Carrying sealed orders with instructions that they be opened and read only after the McClellan had traveled "beyond the bar," Companies A, C, D, E, F, H, and I sailed in the dark – figuratively and literally. "The passage down the Mississippi was mostly at night, so I am unable to give you a description of it. An expedition was on the move but what point no one outside of headquarters was able to tell. It was a secret move," wrote C Company Musician Henry D. Wharton to his hometown newspaper. He and his superiors were among the many who speculated that the regiment was headed for new duties near Mobile, Alabama which would place them under the command of Major General William Tecumseh Sherman.
Note: This speculation proved to be completely off the mark, and would result in the utterly incorrect "documentation" by numerous genealogists, historians and news reporters which persists even today that the 47th Pennsylvania had participated in Sherman's March to the Sea and the burning of Atlanta when the 47th Pennsylvania Volunteers were nowhere near Sherman and his troops during those incidents.
The initial secrecy was a smart move, observed Wharton, "for the destination of former expeditions was known weeks before embarking, and by the time the troops reached the point to which they were ordered, the rebs were ready to receive them." New Orleans, he added, was "filled with traitors and spies, ready to do the bidding of Jefferson D.," making it "necessary that the greatest precaution be used when anything extraordinary is going on."
After obtaining a new pilot for the steamer at Pilottown, the McClellan continued on. Once the pilot had helped the steamer to clear the bar, the orders were indeed finally opened and, according to Captain Gobin, "the consternation was great when it was discovered we were bound for the Army of the Potomac."
U.S. Steamer McClellan (Alfred Waud, c. 1860s, U.S. Library of Congress, public domain).
Still steaming for Washington, the 47th Pennsylvanians lost another of their brotherhood when, on 8 July, Private Jonas Snyder of I Company died from consumption (tuberculosis) and related complications. The 45-year-old Carbon County native was buried at sea with full military honors – sixty miles off America's coast in the Gulf of Mexico. In recounting the ceremony for Private Snyder, Wharton noted that:
His body was prepared for burial by nicely sewing it up in blankets, with weights attached to make it sink. The funeral was conducted by Chaplain Rodrock, who read the beautiful sea service from the prayer book of the Protestant Episcopal Church. The 'Flag of our Union' was at half mast, the boat stopped, and as the sun was hiding in the west, the body was launched into the sea, sinking to rise no more, until the great day comes when the soul must give an account for the 'deeds' done in the body.
As the 47th Pennsylvanians grieved their latest loss, the hearts of citizens in Washington City were also troubled as General Jubal Early's Confederate troops marched their way. According to historian Lewis Schmidt, as the first members of the 19th Corps began arriving at Fortress Monroe in Virginia, "their orders were changed and they were sent on to the Capital."
At 7 a.m. on Sunday, 10 July, the 47th Pennsylvanians began rounding the tip of Florida, sailing past Fort Jefferson in the Dry Tortugas, and on past Key West at 2 p.m. An intense yellow fever epidemic among the locals and remaining soldiers stationed there eliminated all hopes of a short sojourn at Fort Taylor.
According to Captain Gobin, "Pleasant weather attended the voyage," and the McClellan finally steamed into Hampton Roads, Virginia on the afternoon of 11 July. But before the ship's anchor could even hit the water, the 47th Pennsylvania Volunteers were receiving new orders – directed to march for Washington, which they did the next morning. Little did they know they would soon have yet another memorable story to be passed down to their grandchildren – and their grandchildren's grandchildren.
An Encounter with Abraham Lincoln
Lincoln Arrives on Horseback at Fort Stevens, 12 July 1864 (Frank Leslie's Illustrated Newspaper, 13 August 1864, public domain).
In an essay penned in 1907 for the Military Order of the Loyal Legion of the United States, The Honorable John Peter Shindel Gobin (now a former Lieutenant Governor of Pennsylvania), recalled how the majority of the 47th Pennsylvania Volunteers suddenly realized they were seeing Abraham Lincoln in the flesh during the summer of 1864 – and how an incident that same day – one which "might have been exceedingly serious in the prosecution of the war" – nearly took the life of their beloved Commander-in-Chief as it brought Lincoln "under the actual fire of the enemy in their attack upon Fort Stevens, July 12th, 1864":
We landed at the Navy Yard, were met by an officer with instructions to move out at once, leaving a detail to look after baggage and horses. Up the avenue and out Seventh St. we at once proceeded, and at intervals were met by handsomely uniformed officers, who urged us to hurry up double quick.
Officers and men moving along discussed the cause of all this, but with no intimation of trouble or information or instructions of what was needed until we heard the sound of artillery and later of musketry.
There appeared to be no unusual commotion in Washington – few people on the streets – nothing to indicate the presence of an enemy, until the sound of firing was heard. The day was very hot the column marched along until Fort Stevens was reached, when, to the great surprise of every one, it was evident that a fight was going on at the front. We halted, and then began the inquiry, 'What's up? Are those Johnnies? Where's Grant?'
Fort Stevens, explained Gobin, "was an earthwork in a line of fortifications built for the defense of Washington. It was a strong earthwork, and apparently easily protected. The guns were mounted en-barbette and were all of heavy caliber." While waiting for new orders, members of the 47th struck up a conversation with an officer from another Union regiment and were told, "'Old Abe's in the Fort.'"
This was so startling, as it was repeated from file to file, that everybody made a rush to get near enough to see him. There was no mistaking him. His tall figure and high hat made him prominent, and I think every man of the regiment had a look at him.
Our Corps badge resembled that of the 5th Corps, and to many inquiries, 'Do you belong to the 5th Corps?' the answer was, 'No, to the 19th.' Considerable curiosity was evinced to know where the 19th Corps was from, and great surprise was expressed as to how we had gotten there from New Orleans, as it was stated, just in time.
In the meantime, numerous officers had been circulating around, various orders had been received, but nobody seemed to know what to do with us, and the regiment stood awaiting definite instructions.
At last it came, to move out to the left and deploy, move forward and connect with Bidwell's Brigade. As we came into line and moved out, a young staff officer rode down the line, shouting, 'You are going into action under the eye of the President! He wants to see how you can fight.' The answer was a shout and a rush. We met with but little opposition. A sparse picket line of dismounted cavalry got out of the way readily, other regiments came in on our left. We did not meet Bidwell's Brigade, but passed over their battle ground, until, after nightfall, we passed over some of the ground they had fought over, and recognized the red cross of the 1st Division, 6th Corps, as being the fighters. They had evidently been on the extreme left of the line in action. We bivouacked that night near the remains of a burnt house which was said to be Montgomery Blair's.
The fighting was virtually over before we arrived, but the camp was full of stories during the night as to what had occurred at Fort Stevens while the President was there. Evidently that fort was within the range of the artillery and the skirmishers of the Rebel Army, and it was rumored that General H. G. Wright had positively ordered the President to get out of the range of danger after an officer had been shot by his side.
Mr. Chittenden, Register of the Treasury, in his account of it says that when he reached the Fort, he found the President, Secretary Stanton and other civilians. A young colonel of the artillery, who appeared to be the officer of the day, was in great distress because the President would expose himself and paid little attention to his warnings. He was satisfied the Confederates had recognized him, for they were firing at him very hotly, and a soldier near him had just fallen with a broken thigh. He asked my advice, says Chittenden, for he said the President was in great danger. After some consultation the young officer walked to where the President was looking over the edge of the parapet and said, 'Mr. President, you are standing within range of 500 Rebel rifles. Please come down to a safer place. If you do not it will be my duty to call a file of men and make you.'
'And you would do quite right, my boy,' said the President, coming down at once, 'you are in command of this fort. I should be the last man to set an example of disobedience.' He was shown to a place where the view was less extended, but where there was almost no exposure. As Mr. Chittenden was present and speaks from personal knowledge, I assume this to be a correct statement.
I have recently seen a publication in which an officer, claiming to be on the staff of General Upton, describes the President as having halted at the side of the road, and with having been struck by a stray bullet. No mention of it is made in any of the accounts hitherto published of his presence. Certain it is, he was in the Fort and not in the road when we reached there. There were no other troops except those in the trenches and in the Fort at that time, and my recollection is that it must have been after dinner, the fight well over as, although we went in immediately and rapidly, we had no serious casualties. Our Brig.-General came to us, as he said, as soon as he could get a horse, and halted us for the night.
The 47th Pennsylvanians could breathe a sigh of genuine relief when they were all finally reunited in late July of 1864. President Abraham Lincoln was still safe – and the boys from Companies A, C, D, E, F, H, and I had gotten a very good look at him.
2. Schmidt, Lewis. A Civil War History of the 47th Regiment of Pennsylvania Veteran Volunteers. Allentown Pennsylvania: Self-published, 1986.
3. Wharton, Henry D. Letters from the Sunbury Guards. Sunbury, Pennsylvania: Sunbury American, 1864.
Leave a comment Posted in 1864, Abraham Lincoln, American History, Civil War, D.C., Memorial Day, Military, Pennsylvania Tagged 47th Pennsylvania Volunteers, Abraham Lincoln, America, American History, Army, Civil War, D.C., Fort Stevens, History, Pennsylvania, Sunbury, Union, Washington
Honoring the Battle-Tested Soldier: The Meaning and Value of the Designation "Veteran Volunteer"
A regiment, battalion, or company shall bear the title of 'veteran' only in case at least one-half its members, at the time of muster into United States Service, are 'veteran volunteers.' – excerpt from General Order No. 216, U.S. War Department, 14 July 1863
Second State Color, 47th Regiment, Pennsylvania Volunteer Infantry with stripe designating the unit as "P.V.V." (Pennsylvania Veteran Volunteers"). Presented to Company C Captain Daniel Oyster, 7 March 1865.
Those words above are at the very heart of what it meant when military units fighting for the Union during America's Civil War were honored with the coveted and highly respected label of "Veteran Volunteer," and further clarify the intent of General Order No. 191, which spelled out the expectations of the U.S. War Department for, and the benefits which accrued to, the individual soldiers and regiments ultimately awarded this designation.
A literal "badge of honor," the appellation "Veteran Volunteer" conferred upon its recipients the right to sew "volunteer service chevrons" (or service stripes) on their uniforms and regimental flags, signaling to all whom they encountered that they were battle-tested, long-serving and long-suffering combatants dedicated to the fight to preserve America's Union.
In the case of the men who served with the 47th Regiment, Pennsylvania Volunteer Infantry, the designation was conferred most frequently in the latter part of 1863 and early 1864 during the regiment's service in Florida. Assigned to garrison Forts Taylor and Jefferson in Key West and the Dry Tortugas, the 47th Pennsylvanians had already, by the fall of 1862, defended Washington, D.C. and played key roles in the capture of Saint John's Bluff and Jacksonville, Florida, and had been severely bloodied during the Battle of Pocotaligo, South Carolina in late October of that same year.
In addition to having completed their initial three-year terms of service by the time they re-enlisted in 1863 or 1864, many had also fulfilled their "Three Months' Service," having been among the first responders to President Abraham Lincoln's initial April 1861 call for volunteers to defend the nation's capital following the fall of Fort Sumter.
U.S. General Order No. 191, issued by the U.S. War Department, 25 June 1863:
In order to increase the armies now in the field, volunteer infantry, cavalry, and artillery may be enlisted, at any time within 90 days from this date in the respective States, under the regulations hereinafter mentioned. The volunteers so enlisted, and such of the three-years troops now in the field as may re-enlist in accordance with the provisions of this order, will constitute a force to be designated 'Veteran Volunteers.' The regulations for enlisting this force are as follows:
I. The period of service for the enlistments and re-enlistments above mentioned shall be for three years or during the war.
II. All able bodied men, between the ages of 18 and 45 years, who have been heretofore enlisted, and have served for not less than nine months, and can pass the examination required by the mustering regulations of the United States, may be enlisted under this order as veteran volunteers, in accordance with the provisions hereinafter set forth.
III. Every volunteer enlisted and mustered into service under this order shall be entitled to receive from the United States, one month's pay in advance and a bounty and premium of $402, to be paid as follows:
Upon being mustered into the service, he shall be paid
one month's pay in advance . . . . . . . . . . . . . . . . . . . . $13.00
First installment of bounty . . . . . . . . . . . . . . . . . . . . . 25.00
Premium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.00
Total payment on muster . . . . . . . . . . . . . . . . . . . . . $40.00
At the first regular pay-day, or two months after
muster-in, an additional installment of bounty
will be paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $50.00
At the first regular pay-day after six months'
service, he shall be paid an additional
installment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $50.00
At the first regular pay-day after the end of the
first year's service, an additional installment of
bounty will be paid . . . . . . . . . . . . . . . . . . . . . . . . . . $50.00
At the first regular pay-day after 18 months'
service an additional installment of bounty will
be paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $50.00
At the first regular pay-day after two years'
be paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $50.00
At the first regular pay-day after two and a
half years' service an additional installment of
bounty will be paid, $50.00
At the expiration of three years' service the
remainder of the bounty will be paid . . . . . . . . . . $75.00
IV. If the government shall not require these troops for the full period of three years, and they shall be mustered honorably out of the service before the expiration of their term of enlistment, they shall receive, upon being mustered out, the whole amount of their bounty remaining unpaid, the same as if their whole term had been served. The legal heirs of volunteers who die in service shall be entitled to receive the whole bounty remaining unpaid at the time of the soldier's death.
V. Veteran Volunteers enlisted under this order will be permitted at their option to enter old regiments now in the field, but their service will continue for the full term of their own enlistment notwithstanding the expiration of the term for which the regiment was originally enlisted. New organizations will be officered by persons who have been in service and have shown themselves properly qualified for command. As a badge of honorable distinction, 'SERVICE CHEVRONS' will be furnished by the War Department to be worn by the Veteran Volunteers.
VI. Officers of regiments whose term has expired will be authorized on proper application and approval of their respective Governors, to raise companies and regiments within the period of 60 days, and if the companies and regiments authorized to be raised shall be filled up and mustered in the service within the said period of 60 days, the officers may be commissioned of the date of their original commission, and for the time engaged in recruiting they will be entitled to receive the pa belonging to their rank.
VII. Volunteers or Militia now in service whose terms of service will expire within 90 days, and who then shall have been in service at least nine months, shall be entitled to the aforesaid bounty and premium of $402, provided they re-enlist before the expiration of their present term for three years or the war; and said bounty and premium shall be paid in the manner herein provided for other troops re-entering the service. The new term will commence from the date of re-enlistment.
VIII. After the expiration of 90 days from this date, volunteers serving in three year organizations who may re-enlist for three years or the war, shall be entitled to the aforesaid bounty and premium of $402, to be paid in the manner herein provided for other troops entering the service. The new term will commence from date of re-enlistment.
IX. Officers in service whose regiments or companies may re-enlist in accordance with the provisions of this order before the expiration of their present term, shall have their commission confirmed so as to preserve their date of rank as fixed by their original muster into United States service.
X. As soon after the expiration of their original term of enlistment as the exigencies of the service will permit, a furlough of 30 days will be granted to men who may enlist in accordance with the provisions of this order.
XI. Volunteers enlisted under the provisions of this order will be credited as three year men in the quotas of their respective states. Instructions for the appointment of recruiting officers and for enlisting Veteran Volunteers, will be immediately issued to Governors as states.
Secretary of War E. D. Townsend
1. Reports of Committees of the Senate of the United States for the First Session of the Fifty-First Congress, 1889-90. Washington, D.C.: Government Printing Office, 1890.
Leave a comment Posted in American History, Civil War, Military, Union Tagged American History, Army, Civil War, Fort Jefferson, Fort Taylor, History, Military, Pennsylvania, Union, Veteran Volunteers
Celebrating the Fourth Far from Home
The city was gaily dressed in flags, and the prettiest thing of the kind was that at the guard station, under Lt. Reese of Company C. Five flags were suspended from the quarters, with wreaths, while the whole front of the enclosure of the yard was covered with evergreens and the red, white, and blue. The Navy had their vessels dressed in their best 'bib and tucker', flags flying fore and aft, of our own and those of all nations. It was a pretty sight, and in a measure paid for the fatigue of the boys on their march. At 12 noon, both Army and Navy fired a national salute of thirty five guns. – Henry D. Wharton
The 1863 Fourth of July celebrations in Key West, Florida likely resembled those captured in this image from January 1880 in which former U.S. President Ulysses S. Grant and General Philip Sheridan arrived at the Russell House on Duval Street (Florida Memory Project, public domain).
It was the Fourth of July, 1863, and the native sons of Pennsylvania enrolled for Civil War military service with the 47th Pennsylvania Volunteers were stationed about as far from home as they could possibly be. The men serving with Companies A, B, C, D, and I were stationed at Fort Taylor in Key West, Florida while those assigned to companies E, F, G, H, and K were toughing it out at Fort Jefferson, the Union' remote outpost in the Dry Tortugas. The men from D Company had only just returned to Key West from Fort Jefferson a month earlier.
But life was not all about duty for the Keystone Staters in 1863. According to historian Lewis Schmidt,"July 4th fell on a Saturday, and the celebrations began at Key West at 9 AM when the five companies of the 47th stationed there were reviewed by Gen. Woodbury before the regiment's office. Immediately after inspection, the regiment marched in a 'street parade through the principal streets of the city in the heat of 100 degrees Fahrenheit and the dust almost suffocating.' After which each 'detachment was taken to their quarters, dismissed, and then to enjoy themselves as best they could.'"
Henry D. Wharton, a member of Company C known for his detailed letters to his hometown newspaper, the Sunbury American, added, "The day passed off pleasantly, all seemed to enjoy themselves." Afterward, said Wharton, "the city was as quiet as could be expected."
1. Letters from Henry D. Wharton, in Sunbury American. Sunbury, Pennsylvania: 1861-1865.
Leave a comment Posted in 1863, American History, Civil War, Florida, Fourth of July, History, Military, Pennsylvania Tagged 47th Pennsylvania Infantry, 47th Pennsylvania Volunteers, America, American History, Civil War, Florida, Fort Jefferson, Fort Taylor, Fourth of July, History, Independence Day, Key West, Pennsylvania


Born in Ramona, Oklahoma, in 1944, Roger Minick grew up in the Ozarks of Arkansas, moved to Southern California in 1956, and entered the University of California, Berkeley, in 1964, where he graduated in 1969 with a degree in history. While at UC Berkeley, Minick began his photography career at the ASUC Studio, a student arts facility, and in 1966 he began a black and white photographic project on the land and people of the Sacramento-San Joaquin River Delta in California. Three years later, the project became Delta West (Scrimshaw Press, 1969), an award-winning book that was listed as one of "Fifty Best Books of the Year" by the American Institute of Graphic Arts in 1970, and from which that same year an image, "Cheng's Hands, 1966″, was featured in Life Magazine.
Between 1965 and 1975, Minick was on staff at the ASUC Studio, serving as director from 1971 to 1975. In 1970, he began a black and white photographic project on the rural Ozarks of Arkansas, receiving a Guggenheim Fellowship in 1972 to complete the series. These photographs were published in the book Hills of Home (Scrimshaw Press, 1975; Ballantine Books, 1976). Also, while at the Studio, Minick not only co-designed his own books Delta West and Hills of Home but also books by other photographers, including Margo Davis's Antigua Black (1973), Richard Misrach's Telegraph 3 AM (1974), and Steve Fitch's Diesels and Dinosaurs (1976).
From 1974 through 1976, Minick worked on Southland, a project in which he photographed freeways, vernacular architecture, and made portraits of people at fast-food outlets and shopping plazas in Southern California. In 1977, he was one of five photographers selected to work on a two-year National Endowment for the Arts Photo Survey project on the Mexican American community, a project co-sponsored by the Mexican American Legal Defense and Educational Fund. The project, Espejo, generated four new photo projects for Minick: Espejo, portraits of East Los Angeles residents, made in front of street murals; Undocumented, migrant farm workers living and working on farmland near San Diego, California; Garment Workers in downtown Los Angeles; and a Mexican rodeo event called Charro in Riverside, California.
In 1980, Minick began work on Sightseer, his first photographic series in color. Images from this series were included in the hardcover book and major traveling exhibition American Photographers and the National Parks, sponsored by the National Parks Foundation and published by Viking. An image from the Sightseer series was also included in The Oakland Museum's 1989 exhibition Picturing California, which traveled nationally and featured Minick's "Woman at Inspiration Point, Yosemite National Park, CA 1980″ on the cover of the catalogue. In 2000, the Los Angeles County Museum of Art featured the same image on the cover of their catalogue for the exhibition Made in California.
From 1981 through 1985, Minick took color photographs in enclosed shopping for a project he called The New Main Street. Also, in 1981 he was commissioned to make a series of color photographs of the interior of the newly renovated Paramount Theater in Oakland, California, which resulted in the book The Oakland Paramount. In 1984, a selection of Minick's work was included in the San Francisco Museum of Modern Art's traveling exhibition and hardcover book Photography in California: 1945-1980. Between 1987 and 1989, Minick began a color series photographing people on the streets of San Francisco which he called StreetWork.
In 1984, Minick entered the graduate art program at the University of California, Davis, where his MFA graduation show in 1986 consisted of both a series of paintings and a series of color photographs. For the next twenty-five years Minick taught photography throughout Northern California, including San Francisco State University, Sacramento State University, San Francisco City College, and the Academy of Art University of San Francisco.
After graduate school, Minick worked on several long-term projects. In 1996, for a project he calls American Biographics, he began photographing in black and white the American Landscape, with particular emphasis on the precarious balance between the natural and the man-made. During this time he also worked on a series he called Perambulations, which concentrated more broadly on often ironic scenes and situations from American life. Also, concurrently, Minick created a series of mixed-media works on canvas, wood and inside glass-covered boxes which combined his own photographs with found images, text and miscellaneous objects. From 1998 to 2003, Minick photographed widely with the inexpensive Holga camera which, because of its plastic lens, is known for its idiosyncratic vignetting, focusing and halation of light. Starting in 2006, Minick switched from analog to digital, and over the next few years experimented extensively making manipulated prints using Photoshop. More recently, the iPhone and its infinite array of apps has become one of his favorite means of making images.
In 2010, Minick founded Perambulation Press, a self-publishing venture which has allowed him to turn several of his recent photo projects into self-published books. Recent examples include: Cell People, a series of photographs in color of people using their cellphones; Seen from Train, a black and white photo-essay documenting the experience of traveling across America by train; The Eternal Stare, close-up black and white studies of Greco-Roman stone heads from European and American museums; The Parthenon Marbles, black and white studies of the so-called Elgin Marbles at the British Museum; EyeEurope, color iPhone images from two road-trips around Western Europe; EyeRamblings, black and white iPhone images taken on road trips around the United States and Western Europe; and Fifty, a survey of fifty photo projects Minick worked on over the span of fifty years.


"How To Make Chicken Bone Broth Crock Pot "
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How To Make Chicken Bone Broth Crock Pot is made from animal bones and also connective cells-- usually livestock, hen, or fish-- that have actually been boiled into a broth and also slow simmered for 10 to more than 20 hrs with natural herbs, vegetables, and spices. So why is this relatively basic liquid something you would certainly wish to consume every day How To Make Chicken Bone Broth Crock Pot ?
Also our hunter-gatherer ancestors realized that drinking How To Make Chicken Bone Broth Crock Pot resembled striking dietary gold, as its earliest variation dates back over 2,500 years. Throwing out anything edible was out of the concern back then, so animal unguis, knuckles, bones, and also other connective cells never ever went to lose. Bone broth has a rich history of being utilized in typical Chinese medication as a gastrointestinal tonic, blood building contractor, as well as kidney strengthener due to the high collagen content, bioavailable minerals, anti-inflammatory amino acids, as well as healing compounds that can just be found in bones and also connective cells How To Make Chicken Bone Broth Crock Pot.
See as celeb health and wellness trainer, Thomas DeLauer damages down the ins and outs of what bone broth really is. In just 2 mins, he'll discuss what bone broth is and what it can do for your gut, joint, and skin health and wellness How To Make Chicken Bone Broth Crock Pot.
Some phone call How To Make Chicken Bone Broth Crock Pot meat water. We call it fluid gold.
What makes this stuff so unique? The brief answer is collagen. Bones and connective cells are the only true nutritional sources of kind II collagen-- a healthy protein that's known for maintaining skin smooth as well as flexible and teeth and joints healthy, as well as promoting dozens of various other health and wellness benefits.
Along with collagen, bones are also loaded with several anti-inflammatory amino acids, minerals, and substances that can aid quicken your body's natural recovery processes from things like sporting activities injuries, arthritis, or leaky digestive tract.
So, these "scraps" that most of us usually toss in the garbage are significant dietary giants. Yet when was the last time you devoured on an item of cow's knuckle? Or snacked on an ox tail? We'll presume the answer is never ever.
Since we do not consume bones in their entire type, cooking them into a broth that's simmered for 10 to 20 hours (or even more) is the most effective means to launch their powerful nutrients, and also experience a whole new level of health and wellness.
DEMAND A FAST EXPLANATION ON WHAT EXACTLY IS HOW TO MAKE CHICKEN BONE BROTH CROCK POT ?
View as Celebrity Wellness Instructor, Thomas DeLauer damages down the ins and also outs of what bone broth truly is. In just two mins, he'll speak about what bone broth is and also what it can do for your intestine, joint, and skin wellness how to make chicken bone broth crock pot.
Bone broth has an abundant history of being used as a digestion restorative, particularly in standard Chinese medication some 2,500 years back. Today, it is among the top suggested foods for boosting signs of persistent digestive problems, such as Irritable Digestive Tract Disorder (IBS), Crohn's illness, and colitis.
The factor for why bone broth is so recovery for the gut returns to collagen, which develops gelatin when it's cooked down also additionally. Collagen and gelatin are not only abundant in amino acids that minimize swelling in the GI system-- such as glutamine-- they additionally have the distinct capability to "secure and also recover" openings in the digestive tract cellular lining, which can create a condition called leaky digestive tract syndrome.
Although research study remains in the early stages, there's proof to show that dripping digestive tract is the main underlying cause of digestive system problems. It's also a contributor to autoimmune diseases, depression, brain haze, stress and anxiety, allergies, eczema, acne, and persistent low energy. Most severe of all, leaking intestine can be quiet as well as reveal no signs and symptoms in the early stages. It's additionally believed to influence over 70% of the population.
Bone broth is advised on unique intestine healing diets and protocols, like the GAPS diet, the SCD diet, as well as the Low FODMAP diet regimen.
Whether it's an injury, arthritis, or aching muscle mass, there's no far better method to nourish your bones and also joints than by taking in even more of the nutrients currently found within them, consisting of hyaluronic acid, glucosamine, chondroitin, calcium, and also magnesium. Bone broth is loaded with every one of these nutrients, plus several amino acids that help reduce joint discomfort and also swelling, like glycine as well as proline. It's for these reasons that bone broth is ending up being a best recovery beverage among athletes.
A fun fact: Kettle and Fire Bone Broth was birthed due to the fact that our co-founder, Nick, tore his ACL playing football as well as required a top quality bone broth to help quicken his recuperation time. (You can find out more on that here.).
Following a bone broth diet regimen is excellent for lasting weight reduction. A bone broth diet includes consuming Paleo for 5 days and fasting for two. During this timespan you'll consume bone broth routinely with an increase in use on the fasting days.
The mix of periodic fasting and bone broth speeds up fat burning via burning fat more effectively and also restricting calorie consumption. When doing the diet, we additionally noticed a decrease in cellulite.
Fat-Burning Bone Broth Cocktail How To Make Chicken Bone Broth Crock Pot.
With simply a few active ingredients, this dish is ideal for a tasty and extremely simple fat-burning cocktail that you can work up in a flash on busy mornings prior to job or at nights post-workout.
Even if you had never come across bone broth in the past, you've probably come across collagen, thanks to the appeal industry.
Lots of anti-aging skincare lines add collagen to their face creams, creams, and serums (as well as offer them for a king's ransom). But what many people do not know is that collagen molecules are too big to be absorbed via the skin, which suggests these lotions can't offer much in the means of outcomes.
The bright side is that collagen can be soaked up through your gastrointestinal system. And also due to the fact that there's a direct link in between the intestine and also the skin, including bone broth to your diet plan is mosting likely to have an even more effective as well as lasting effect on the total look as well as health and wellness of your skin.
Allow's not forget hair as well as nails, which are made up of healthy proteins like collagen. Collagen helps enhance nails, and encourages hair to grow in thicker, quicker, and also take on a healthy and balanced shine. (Remember this for the following time you obtain a poor haircut!).
Deep, relaxed sleep is something we could all use a little bit more of. In fact, stats reveal the ordinary individual gets less than 7 hrs of sleep per night, so it is essential to do whatever you can to make those hrs count.
Bone broth is abundant in glycine, an anti-inflammatory amino acid that works with the Central Nerve System (CNS). When taken before bed as a supplement, studies show glycine can improve sleep top quality as well as reduce daytime drowsiness. It's much more efficient when paired with various other sleep-supportive nutrients, like calcium and magnesium.
Every one of the advantages you gain from bone broth, your expanding baby will experience, as well-- consisting of healthy and balanced bones, joints, as well as a strong gastrointestinal system.
When morning sickness hits, it can be impossible to maintain nourishing food down. But bone broth often tends to be relaxing for nausea or vomiting, as well as is generally well tolerated. Best of all, bone broth supplies several of the nutrients you as well as your growing infant demand, consisting of healthy protein, and crucial minerals and vitamins. As an included incentive, the slow simmer time of the bones makes the nutrients in bone broth extremely bioavailable and less complicated to take in than a dietary supplement.
Bone broth can also assist boost fertility, assist you have a much more comfortable maternity by beneficial tight or agonizing joints, and may increase calcium levels in breast milk.
Bone broth is an excellent resource of nutrition on the Paleo diet plan, and also is motivated to consume alcohol during durations of recurring fasting. It also fits in well with macronutrient requirements on the keto diet, as well as might help in reducing symptoms of the keto influenza.
" Not just can bone broth aid you stay clear of keto flu, but it's additionally loaded with minerals that recover leaking gut and also reduce swelling in your intestinal tracts." - Leanne Vogel, Author of The Keto Diet.
The nutrition and healing capacity of bone broth is so effective, that a whole diet-- The Bone Broth Diet Regimen-- has been produced around it.
The nutrients in bone broth make it an effective practical food that can benefit your whole household-- including your fur infants. Bone broth benefits your animal's shiny layer, bones, joints, food digestion, as well as teeth.
Packed with protein - Chicken is a wonderful protein resource and also same goes for hen bones. Pot & Fire bone broth comes packed with 10 grams of protein per serving How To Make Chicken Bone Broth Crock Pot.
Lowers digestive tract swelling - Bone broth aids recover and also seal a leaky gut which is the origin for many autoimmune diseases.
Rich in bone marrow - Bone broth made from 100% turf fed cattle and simmered over long cook times extracts bone marrow that contains healthy and balanced nourishing hormones and lipids.
Packed with amino acids - Comparable to poultry bone broth, the nutrients extracted from beef bones have amino acids like glycine as well as glutamine that boosts food digestion and also repair services your gut cellular lining.
No. Plants are a wonderful resource of minerals and vitamins that can help promote your body to generate its very own collagen, yet there is no known plant food that offers kind II collagen, the form that uses every one of the wellness benefits detailed above.
One point to take into consideration regarding bone broth that establishes it besides plant foods: Even if you do eat a selection of plants that are abundant in collagen-boosting nutrients, if you have a damaged gastrointestinal system or leaky intestine, you might not totally absorb them. On the various other hand, the collagen in bone broth is extremely very easy to absorb, even for those with endangered digestive systems.
Naturally, you don't just need to drink it-- although we do have a cost-free and impressive downloadable bone broth sipping overview for when you do. You can blend bone broth right into your green healthy smoothies, make healthy collagen gummy bears, and use it in whatever from clambered eggs, soups, curries, stews, breakfast bowls, as well as tacos.
We slow-simmer the organic bones to extract the collagen, proteins, and amino acids into a nutrient-rich bone broth. The outcome is a collagen-rich, high protein bone broth that gives your body the nutrients it requires to flourish.
Bone broth is an all-in-one superfood, packed with nutrients that give power and also inspiration, assist you sleep better, make your skin look smoother, and can assist heal digestive concerns like leaky gut.
Bones and also connective tissue are warehouses for vital amino acids as well as minerals-- which are lacking in several diets today. Bone Broth is also an indispensable source of protein, collagen and jelly.
It's not practical to eat whole bones or tissue, yet you can still delight in these health and wellness advantages by sipping bone broth. Collagen is extracted when you simmer bones for a long period of time. Typically, the longer bone broth simmers, the even more collagen you'll remove.
Making bone broth is an easy process, yet one that requires plenty of time and also persistence. If time is out your side we can assist you out keeping that.
Bone broth is made by simmering animal bones as well as cells for at the very least 10 hours with veggies, herbs, and also seasonings such as thyme, garlic, and also bay leaves. Top notch bone broth starts with high-grade ingredients, making use of bones from organic grass-fed animals and also natural vegetables. While any type of bone or tendon can be made use of, knuckles, poultry feet, as well as femur bones often tend to include one of the most collagen.
Simmering bones for an extended amount of time is what provides bone broth its wellness advantages, drawing out the amino acids, minerals, and also collagen. This is a Pot & Fire-tested sluggish stove poultry bone broth dish that features natural chicken bones, sea salt, fresh vegetables like celery stalks, onions, and also bell peppers, and herbs like parsley, rosemary, as well as thyme.
Simply cooking bones (no meat) and water is going to be mainly tasteless. Food preparation the mixture for hours on end isn't mosting likely to make it taste any far better.
The idea that you're obtaining tons of nutrients from the bones is a MISCONCEPTION that won't die, even though it has been debunked many times, consisting of through laboratory tests. The idea that adding vinegar to "launch" those nutrients has additionally been exposed. You simply wind up with a watery mess that tastes of vinegar.
Instead, purchase bones with meat on them. Then add veggies such as onions, carrots, celery, as well as just sufficient water to cover everything (usually 8 or 10 mugs). Skip the vinegar! Simmer for 3 to 4 hours for hen, somewhat longer for beef. Period according to choice. If you have an Instantaneous Pot, 25 to 35 mins has to do with right.
What you will certainly get with this technique is a very flavorful broth that's most likely substantially much more healthy-- consisting of lots of collagen-- and also more healthful than any kind of bone broth, and it will taste one heck of a whole lot far better. You can either eat the meat and veggies (it's called SOUP) or you can strain them out and just consume the broth if you choose.
Check Ina Garten's recipe for chicken broth. It's extremely comparable to this one and has actually been made use of with minor variants by knowledgeable chefs for decades.
There are 2 main distinctions in between bone broth as well as normal broth or supply: simmering time and the component of the pet it's made from (bones or flesh).
Regular broth and supply are simmered for a shorter time period than bone broth, around 2-- 6 hours. The expedited food preparation process lowers the quantity of valuable jelly removed from the bones, decreasing its capacity to boost the immune system, heal digestion issues, and minimize the signs of dripping digestive tract.
Prior To Kettle and Fire was birthed, among our co-founders, Nick, tore his ACL playing soccer (ouch). His bro Justin became aware of the benefits of bone broth for injury recuperation. As his timetable really did not leave much time to make bone broth from scratch, he set out to purchase a store-bought, premium, grass-fed bone broth, given that both of their active timetables didn't leave much time to make the broth themselves. (You can discover more concerning our tale here.).
Despite just how hard Justin looked, the optimal bone broth really did not exist. He searched for one that was one hundred percent natural, fresh-- never iced up-- grass-fed, as well as sluggish simmered (in addition to one that can be delivered without inefficient, clunky product packaging). So, Nick as well as Justin determined to produce a high-grade bone broth on their terms, which is the dish we're happy to use you today.
" Kettle & Fire gives a nourishing, quality bone broth in a delicious and hassle-free shelf-stable format. I love always recognizing that I've obtained terrific broth handy, without congesting my fridge freezer or needing defrosting." - Dr. Sarah Ballantyne, three-time NYT Best-Selling Author.
The gorgeous thing about bone broth is that there's actually no limit to how you can include it to your diet plan. Besides soups, stews, and simple ol' sipping, bone broth blends surprisingly well into virtually any kind of dish-- also healthy smoothies! Right here are our top methods to get it:.
Our bone broth tastes delicious sufficient to sip on its own, yet you can seasoning it as much as fit your palate. We produced our favorite flavor combinations in this totally free downloadable "Bone Broth Sipping Guide" (bone broth matcha lattes, anybody?). Obtain your totally free duplicate right here.
Consuming bone broth does not have to be uninteresting-- there are endless means to spice it and sip it. Obtain immediate accessibility to over 15 of our favorite bone broth drinking combinations, consisting of ginger as well as turmeric bone broth restorative and chili, and also cardamom bone broth elixir. Learn exactly how to use bone broth in your matcha cappucinos, golden milk, as well as exotic fruit healthy smoothies.
Our beef bone broth has a light taste, which allows it to mix conveniently with nearly anything, from healthy smoothies to healthy gummy bears. Our hen bone broth as well as mushroom chicken bone broth enhance the full-flavored taste of soups, stews, and also risotto dishes. A few of our favorites include:.
If you want to experience more power and also vitality than ever before, we reccomend checking out The Bone Broth Diet plan, created by Dr. Kellyann Petrucci.
The Bone Broth Diet regimen not only boosts your consumption of the healing nutrients and also compounds necessary for digestive tract, skin, joint, and also bone health, yet helps deal with systemic swelling, which goes to the root cause of a lot of Western health problems and diseases.
The bone broth diet plan is a 21-day plan that's excellent for any person suffering from a persistent health and wellness problem (such as an autoimmune problem), or any person that wants to reset their digestive system as well as experience radiant health and wellness. Discover more about the 21-day bone broth diet regimen right here.


Here's a great deal on a 2013 Kia Optima Hybrid. This 4 door, 5 passenger sedan still has less than 90,000 miles! It features a front-wheel-drive platform, an automatic transmission, and a 2.4 liter 4 cylinder engine. Kia infused the interior with top shelf amenities, such as: front and rear reading lights, variably intermittent wipers, front bucket seats, front dual-zone air conditioning, cruise control, an overhead console, and power windows. Kia ensures the safety and security of its passengers with equipment such as: dual front impact airbags, front side impact airbags, traction control, brake assist, a panic alarm, and 4 wheel disc brakes with ABS. Electronic stability control stands out as a technologically savvy innovation, keeping you better connected to the road. Our aim is to provide our customers with the best prices and service at all times. Please don't hesitate to give us a call.


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Eduardo Freitas Wiki, Nationality, F1 Race Director, FIA
February 18, 2022 February 18, 2022 Editor
Eduardo Freitas Biography – Eduardo Freitas Wiki
Eduardo Freitas is the new F1 race director alongside former DTM race director Niels Wittich. Eduardo Freitas and Niels Wittich will act alternatively as Race Director, assisted by Herbie Blash as a permanent senior advisor, FIA President Mohammed Ben Sulayem announced in a statement on 17 February 2022.
Prior to his appointment, Freitas had not worked directly in F1. However, he has worked alongside both former F1 race director Michael Masi and his predecessor Charlie Whiting in FIA conferences and race director meetings at the governing body, including the 2020 Portuguese Grand Prix at Portimao.
Freitas is the former FIA World Endurance Championship Race Director. He had been the race director in the World Endurance Championship since its inception in March 2012. With over 40 years of experience in motorsport, Freitas was in charge of every WEC event, including the Le Mans 24 Hours.
Freitas began his motorsport career as a mechanic, first with a passion for motorcycles before moving into the world of karting in 1979. He progressed from a track marshal up the ranks until he became a race director in karting.
Freitas was working as clerk of the course at Estoril in 2002 when he was asked to take charge of the FIA GT and ETCC championships for a season and he remained in that role until the end of 2009.
The FIA then promoted Freitas to the FIA GT1 world championship before he became race director for the World Endurance Championship in 2012. He also acts as race director in the European Le Mans Series and Asian Le Mans Series.
Eduardo Freitas Nationality
Eduardo Freitas is of Portuguese nationality.
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Case report | Open | Open Peer Review | Published: 20 March 2018
Fitz-Hugh-Curtis syndrome associated with tuberculous salpingitis and peritonitis: a case presentation and review of literature
Laura Coremans ORCID: orcid.org/0000-0003-0390-776X1 &
Frederik de Clerck2
Fitz-Hugh-Curtis syndrome or acute perihepatitis is considered a rare complication of pelvic inflammatory disease, mostly associated with chlamydial or gonococcal salpingitis.
Peritoneal tuberculosis is a rare site of extra-pulmonary infection caused by Mycobacterium tuberculosis. Infection usually occurs after reactivation of latent tuberculous foci in the peritoneum and more seldom after contiguous spread from tuberculous salpingitis.
We describe a case of a 21-year old female of Somalian origin diagnosed with Fitz-Hugh Curtis syndrome associated with tuberculous salpingitis and peritonitis, presenting with new onset ascites.
Acid fast stained smear and polymerase chain reaction for Mycobacterium tuberculosis on ascitic fluid, endocervical culture and tuberculin skin test were all negative. Eventually, the diagnosis was made laparoscopically, showing multiple peritoneal white nodules and perihepatic "violin string" fibrinous strands.
To our knowledge, this is the first case where Fitz-Hugh-Curtis syndrome is associated with both peritoneal and genital tuberculosis and where ascites was the primary clinical finding. Female genital tuberculosis has only rarely been associated with Fitz-Hugh-Curtis syndrome and all cases presented with chronic abdominal pain and/or infertility. Ascites and peritoneal involvement was not present in any case. Moreover, most patients with Fitz-Hugh-Curtis syndrome show no evidence of generalized intra-abdominal infection and only occasionally have concomitant ascites.
Peritoneal tuberculosis is a rare site of extra-pulmonary infection caused by Mycobacterium tuberculosis (TB). Infection usually occurs after reactivation of latent tuberculous foci in the peritoneum, after hematogenous spread from primary pulmonary TB [1, 2]. Less frequently transmural translocation from an infected small intestine or contiguous spread from tuberculous salpingitis occurs.
Fitz-Hugh-Curtis syndrome is defined as acute perihepatitis with typical "violin-string" adhesions between the liver and the anterior abdominal wall or the diaphragm, associated with pelvic inflammatory disease [3]. In the majority of cases it is associated with chlamydial or gonococcal salpingitis.
We present a case of Fitz-Hugh Curtis syndrome associated with tuberculous salpingitis and peritonitis, presenting with new onset ascites.
A 21-year old female presented on the gastroenterology outpatient clinic with high-grade fever for 3 days and epigastric pain for 3 weeks. She was of Somalian origin and was living in Belgium since 2 years.
Her medical history consisted of malaria in her childhood and one month prior she gave birth to her first child. The labor was induced with secondary cesarean section because of general discomfort, raised inflammatory laboratory markers and raised liver function tests of unknown cause.
Clinical examination revealed abdominal distention and tenderness in the epigastric region without muscular defense. She denied having vaginal purulent discharge and lower abdominal pain. Her vital signs demonstrated a blood pressure of 100/73 mmHg, a heart rate of 124 bpm and a body temperature of 38 °C.
Laboratory studies revealed raised inflammatory markers (total WBC count of 11,700/mm3, CRP level of 170 mg/l), mild microcytic anemia (Hb 10.2 g/dl, MCV 76 fL), significant thrombocytosis (953,000 /mm3) and mildly raised liver function tests (AST 23 U/L, ALT 51 U/L, alkaline phosphatase 279 U/l, gamma-glutamyl transferase 74 U/l). Bilirubin, albumin and prothrombin time were normal.
Viral hepatitis, human immunodeficiency virus (HIV) and Malaria were excluded.
Abdominal ultrasound confirmed the presence of ascites in the small pelvis and around the liver, with normal liver size and parenchyma. Subsequent abdominal computed tomography (CT) revealed peritoneal thickening and hypervascular adnexes with a small para-uterine abcedation on the right side, suggestive for pelvic inflammatory disease (PID) (Fig. 1). There were no enlarged lymph nodes and the liver veins were patent.
a and b. Contrast-enhanced CT images of the abdomen showing peritoneal thickening and hypervascular adnexes with a small para-uterine abcedation on the right side
Diagnostic abdominal paracentesis with evacuation of purulent fluid was performed. Ascitic fluid analysis showed a serum-ascites albumin gradient less than 1.1 g/dL with cytology showing a predominance of lymphocytic cells.
Acid fast stained smear (Ziehl-Neelsen staining) and polymerase chain reaction (PCR) for M. tuberculosis on ascitic fluid were negative.
Tuberculin skin test was negative and there were no signs suggestive of (previous) tuberculosis on chest radiography.
Gynecological evaluation revealed purulent cervical discharge, cervical motion tenderness and adnexal tenderness. Endocervical culture was negative for Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis. Acid fast stained smear was also negative.
Subsequently a diagnostic laparoscopy was performed, showing multiple peritoneal white nodules and perihepatic "violin string" fibrinous strands (Fig. 2). These findings were very suggestive for peritoneal tuberculosis with Fitz-Hugh Curtis syndrome.
Intraoperative laparoscopic photo showing multiple peritoneal white nodules (left) and perihepatic "violin string" fibrinous strands (right)
Acid fast stained smear and PCR for M. Tuberculosis on peritoneal biopsies were both negative.
Since the perioperative findings were very suggestive, the patient was started on quadruple anti-tuberculous therapy, consisting of isoniazid, rifampin, pyrazinamide and ethambutol. Rapid clinical improvement and regression of the inflammatory markers and ascites was observed.
The pathology report of the peritoneal biopsies eventually confirmed peritonitis with granulomas.
Four weeks after starting anti-tuberculous therapy direct cultures for M. Tuberculosis on peritoneal biopsies and endocervical swab were reported as positive. Ascites cultures remained negative.
To our knowledge, this is the first case where Fitz-Hugh-Curtis syndrome is associated with both peritoneal and genital tuberculosis and where ascites was the primary clinical finding. Sharma et al. already described 3 cases of Fitz-Hugh-Curtis syndrome associated with female genital tuberculosis, however they all presented with chronic abdominal pain and/or infertility [4]. Ascites and peritoneal involvement was not present in any case.
Fitz-Hugh-Curtis syndrome provides a diagnostic challenge as it can mimic many other diseases (most often acute cholecystitis). Clinical presentation includes sharp pain in the upper right quadrant, fever and in most cases, but not always, signs of salpingitis [5]. Most patients show no evidence of generalized intra-abdominal infection and only occasionally have concomitant ascites [3, 5].
Contrast-enhanced abdominal computed tomography usually shows linear contrast enhancement of the liver capsule [6]. This was not present in our case.
Symptoms and signs, physical examination and laboratory findings of peritoneal tuberculosis are nonspecific. Symptoms have an insidious onset and include ascites, diffuse abdominal pain, low-grade fever and weight loss, developing over a period of several weeks to months [7]. Lab abnormalities may include mild to moderate anemia, peripheral -usually lymphocytic- leukocytosis, increased alkaline phosphatase or transaminases and hypoalbuminemia [7].
Abdominal ultrasound may show typical fine mobile strands [8]. Computed tomography findings include peritoneal thickening, omental cake and enlarged mesenteric lymph nodes. Computed tomography findings include peritoneal thickening, omental cake and enlarged mesenteric lymph nodes.
Ascitic fluid analysis typically shows a serum-ascites albumin gradient (SAAG) less than 1.1 g/dL with protein level of more than 2.5 to 3 g/dL [9]. Cytology typically shows a predominance of lymphocytic cells.
The differential diagnosis of ascites with lymphocytic predominance and SAAG of less than 1.1 g/dL includes peritoneal carcinomatosis, nephrotic syndrome, pancreatitis and peritoneal tuberculosis [10]. The main advantage of calculating the SAAG is its specificity for ascites caused by portal hypertension [9]. A SAAG of more than 1.1 g/dL indicates portal hypertension with an accuracy of 97% [10].
Acid fast stained smear on specimens collected from sites of suspected extra-pulmonary TB has low sensitivity (less than 5% on peritoneal fluid). However because false-positive results are unlikely, recent guidelines recommend performing acid fast stained smear on ascitic fluid and peritoneal biopsies, under the condition that a negative result is not used to exclude peritoneal tuberculosis [11].
Gene amplification tests such as PCR to detect M. tuberculosis on ascitic fluid and peritoneal biopsies are another rapid and non-invasive test [11]. However low sensitivity has been reported in smear-negative patients (48%) [9].
Tuberculin skin testing is mostly used as a screening tool for latent tuberculosis, given its low sensitivity and low positive predictive value [9].
Elevated serum CA-125 levels (> 35 U/mL) and adenosine deaminase activity (ADA) of ascitic fluid (> 30 U/l) have been proposed as easy, non-invasive tests for peritoneal tuberculosis with high sensitivity and specificity (respectively 83% and 50% for CA-125 and 93% and 94% for ADA) [12, 13].Therefore measuring ADA levels is recommended in the diagnostic work-up for peritoneal tuberculosis [11].
Since CA-125 is a tumor marker associated with ovarian cancer, ovarian malignancy should be excluded before making the diagnosis of peritoneal tuberculosis in case of elevated CA-125 values, especially because the clinical manifestations may show high resemblance.
Some studies also suggest a role for serum CA-125 levels as a follow-up marker in monitoring the response to anti-tuberculous therapy [14, 15].
For a definite diagnosis of peritoneal tuberculosis, microbiological and/or histological confirmation is needed [16]. To date, direct culture of M. tuberculosis on ascitic fluid or peritoneal biopsies is the gold standard for diagnosis of abdominal tuberculosis, with a reported sensitivity of 45 to 69% [11]. However it can take up to 6 weeks before cultures become positive.
This means that in the majority of cases, as well as in the case presented here, diagnostic laparoscopy and direct visualization of the peritoneum is needed in the diagnostic process [16, 17]. Therefore a high index of clinical suspicion is needed to avoid delay in treatment initiation and risking increased mortality [9].
In most developed countries, laparoscopy is easily accessible, appears to be relatively safe with a reported complication rate of less than 3% and has a high diagnostic sensitivity (93%) and specificity (98%) [9]. In the case described herein laparoscopy also allowed for direct visualization and biopsy of the para-uterine abcedation described on abdominal CT.
In regions where laparoscopy is less easily accessible, percutaneous ultrasound- or CT-guided biopsy of the peritoneum or mesenteric lymph nodes can be considered as safe alternative with low incidence of complications [18, 19].
However in the presence of large amounts of ascites, ultrasound-guided biopsy is less appropriate as hemostasis during biopsy through local pressure with the transducer is difficult to achieve [20]. In our patient no easily accessible, pathologically enlarged lymph nodes were visualized.
Typical macroscopic findings include multiple white nodules or tubercles, enlarged lymph nodes, "violin string" fibrinous strands and omental thickening. Peritoneal carcinomatosis, sarcoidosis and Crohn's disease may mimic the laparoscopic findings of peritoneal tuberculosis [9]. Even in the absence of histological or bacteriological confirmation, the characteristic laparoscopic appearance is sufficient reason for initiating anti-tuberculous therapy. Similarly, in ocular tuberculosis the diagnosis is frequently presumed based on macroscopic findings (solitary tubercles, miliary choroidal tubercles, tuberculoma's e.g) as ocular tissue for microscopic evaluation is difficult to obtain [21].
Microscopic examination of peritoneal and lymph node biopsies in peritoneal tuberculosis show caseating granulomas in up to 100% of patients, as was the case in our patient [16].
Treatment for tuberculous peritonitis is the same as for pulmonary disease, with an intensive phase of 2 months of isoniazid, rifampin, pyrazinamide, and ethambutol followed by a continuation phase of 4 months of isoniazid and rifampin [22, 23]. Response to treatment is best assessed clinically, with resolution of symptoms and ascites [24].
Adenosine deaminase activity
PCR:
SAAG:
Serum-ascites albumin gradient
WBC:
White blood cells count
Mehta JB, Dutt A, Harvill L, Mathews KM. Epidemiology of extrapulmonary tuberculosis. A comparative analysis with pre-AIDS era. Chest. 1991;99(5):1134–8.
Golden MP, Vikram HR. Extrapulmonary tuberculosis: an overview. Am Fam Physician. 2005;72(9):1761–8.
Peter NG, Clark LR, Jaeger JR. Fitz-Hugh-Curtis syndrome: a diagnosis to consider in women with right upper quadrant pain. Cleve Clin J Med. 2004;71(3):233–9.
Sharma JB, Malhotra M, Arora R. Fitz-Hugh-Curtis syndrome as a result of genital tuberculosis: a report of three cases. Acta Obstet Gynecol Scand. 2003;82(3):295–7.
You JS, Kim MJ, Chung HS, Chung YE, Park I, Chung SP, et al. Clinical features of Fitz-Hugh-Curtis syndrome in the emergency department. Yonsei Med J. 2012;53(4):753–8.
Tsubuku M, Hayashi S, Terahara A, Furukawa T, Ohmura G. Fitz-Hugh-Curtis syndrome: linear contrast enhancement of the surface of the liver on CT. J Comput Assist Tomogr. 2002;26(3):456–8.
Sheer TA, Coyle WJ. Gastrointestinal tuberculosis. Curr Gastroenterol Rep. 2003;5(4):273–8.
Pereira JM, Madureira AJ, Vieira A, Ramos I. Abdominal tuberculosis: imaging features. Eur J Radiol. 2005;55(2):173–80.
Sanai FM, Bzeizi KI. Systematic review: tuberculous peritonitis--presenting features, diagnostic strategies and treatment. Aliment Pharmacol Ther. 2005;22(8):685–700.
Runyon BA, Montano AA, Akriviadis EA, Antillon MR, Irving MA, McHutchison JG. The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites. Ann Intern Med. 1992;117(3):215–20.
Lewinsohn DM, Leonard MK, LoBue PA, Cohn DL, Daley CL, Desmond E, et al. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention clinical practice guidelines: diagnosis of tuberculosis in adults and children. Clin Infect Dis. 2017;64(2):111–5.
Ali N, Nath NC, Parvin R, Rahman A, Bhuiyan TM, Rahman M, et al. Role of ascitic fluid adenosine deaminase (ADA) and serum CA-125 in the diagnosis of tuberculous peritonitis. Bangladesh Med Res Counc Bull. 2014;40(3):89–91.
Tao L, Ning HJ, Nie HM, Guo XY, Qin SY, Jiang HX. Diagnostic value of adenosine deaminase in ascites for tuberculosis ascites: a meta-analysis. Diagn Microbiol Infect Dis. 2014;79(1):102–7.
Simsek H, Savas MC, Kadayifci A, Tatar G. Elevated serum CA 125 concentration in patients with tuberculous peritonitis: a case-control study. Am J Gastroenterol. 1997;92(7):1174–6.
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Chow KM, Chow VC, Szeto CC. Indication for peritoneal biopsy in tuberculous peritonitis. Am J Surg. 2003;185(6):567–73.
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Caspi B, Wolach V, von der Walde J, Weiss Y, Appelman Z, Hagay Z. Diagnosis of abdominal tuberculosis by transabdominal ultrasound-guided needle biopsy. Ultrasound Obstet Gynecol. 2000;16(6):569–70.
Pombo F, Rodriguez E, Martin R, Lago M. CT-guided core-needle biopsy in omental pathology. Acta Radiol. 1997;38(6):978–81.
Wang J, Gao L, Tang S, Li T, Lei Y, Xie H, et al. A retrospective analysis on the diagnostic value of ultrasound-guided percutaneous biopsy for peritoneal lesions. World J Surg Oncol. 2013;11:251.
Albert DM, Raven ML. Ocular Tuberculosis. Microbiol Spectr. 2016;4(6). https://doi.org/10.1128/microbiolspec.TNMI7-0001-2016.
Demir K, Okten A, Kaymakoglu S, Dincer D, Besisik F, Cevikbas U, et al. Tuberculous peritonitis--reports of 26 cases, detailing diagnostic and therapeutic problems. Eur J Gastroenterol Hepatol. 2001;13(5):581–5.
Nahid P, Dorman SE, Alipanah N, Barry PM, Brozek JL, Cattamanchi A, et al. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America clinical practice guidelines: treatment of drug-susceptible tuberculosis. Clin Infect Dis. 2016;63(7):e147–e95.
Hopewell PC. Updating the international standards for tuberculosis care. Int J Tuberc Lung Dis. 2014;18(3):253.
No funding was provided.
All data analyzed during this study are included in this published article.
Ghent University Hospital/AZ Sint-Lucas Ziekenhuis, Groene Briel 1, 9000, Ghent, Belgium
Laura Coremans
Department of Hepatology and Gastroenterology, AZ Sint-Lucas, Groene Briel 1, 9000, Ghent, Belgium
Frederik de Clerck
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LC is the main author of the manuscript and performed the literature search. FDC was the consultant in charge and edited the manuscript. Both authors read and approved the final manuscript.
Correspondence to Laura Coremans.
Written permission for publication of this report and the individual clinical data was obtained from the patient and is available for review by the editor.
Fitz-Hugh-Curtis syndrome
Peritoneal tuberculosis
Tuberculous salpingitis


text:
Marbriano de Orto (geboren in 1460 in het bisdom Doornik - februari 1529 of voordien nog in Nijvel; als Marbriano Dujardin ?) was een Brabantse of Henegouwse polyfonist en zanger.

Leven en afkomst
Marbriano de Orto werd geboren als onwettige zoon van een priester. Zijn achternaam "Dujardin" is verlatijnst tot "de Orto". Zijn opleiding zou hij aan de kerken van het bisdom Doornik hebben gekregen.

In december 1483 werd hij zanger bij de pauselijke kapel, waar hij drie pausen diende: paus Sixtus IV, paus Innocentius VIII en paus Alexander VI. De kapel telde 18 tot 20 musici, overwegend afkomstig uit de Nederlanden. Gedurende de liturgie zongen ze koralen en slechts zelden werd meerstemmige muziek gebracht. Het koor zong niet enkel in de Sixtijnse Kapel, maar ook in andere kerken, wanneer de paus de mis opdroeg, vaak in de private sfeer. De voornaamste componisten van de kapel waren toen Josquin Desprez die er verbleef van september 1486 tot 1494, en Gaspar van Weerbeke, aantoonbaar in de periode 1481–1489 en opnieuw tot ongeveer 1499.

Bijzondere steun ontving De Orto van Innocentius VIII, die hem prebenden toekende en die ervoor zorgde dat de Orto's zonde-door-onwettige-geboorte werd kwijtgescholden. Ook verkreeg de Orto in december 1486 een levenslange, jaarlijkse uitkering uit inkomsten van het bisdom Doornik. In twee pauselijke bullen van 30 juli 1496 werd over De Orto gesproken als over de deken van Nijvel; uit documenten van die tijd kunnen we opmaken dat de benoeming overigens op tegenstand is gestoten. Het ambt moet De Orto ergens tussen 1489 en 1496 zijn toegekend. Hij is echter pas na 1499 uit Rome vertrokken om zich in Nijvel te vestigen.

In Nijvel was het middelpunt van De Orto's leven de Sint-Gertrudiskerk; tot het eind van zijn leven onderhield hij met de kerk betrekkingen. Daarvan getuigen talrijke geschenken, waarvan de kostbare, nog tot op heden in de kerk tentoongestelde, bronzen relikwieënkist getuigenis aflegt.

Op 24 mei 1505 werd De Orto zanger in de kapel van Filips de Schone. De hertog legitimeerde hem niet enkel, maar benoemde hem ook meteen tot zijn premier chappelain, een uiting van bijzondere waardering.

De Orto begeleidde de hertog op zijn laatste reis naar Spanje. De reis, waaraan ook Alexander Agricola, Pierre de la Rue, Nicholas Champion en Antonius Divitis deelnamen, begon op 10 januari 1506. Er werd over water gereisd; zangers en instrumentalisten hadden een eigen schip. Stormweer dreef op 13 januari 1506 een deel van de vloot, ook het schip van de musici, naar Falmouth. Heel erg waarschijnlijk had De Orto tijdens de storm de gelofte afgelegd de "Vita Gertrudis" in het Latijn en het Frans te vertalen. Op 27 april 1506 landde de vloot in La Coruña. Filips en zijn gevolg trokken voor de zomer naar Valladolid en Burgos, waar de hertog op 25 september 1506 aan koorts bezweek.

Al gauw na Filips dood keerde De Orto naar de Nederlanden terug en was daar de latere keizer Karel V, des hertogs zoon voor wie Margaretha van Oostenrijk nog het regentschap voerde, bij de reorganisatie van de hofkapel behulpzaam. Volgens een document van 1509 was De Orto "eerste kapelaan" van Karel. Dit ambt wisselde hij in de periode van 1510 tot 1517 om de zes maanden met Anthoine de Berghes. Deze wisselbeurt had met De Orto's verblijfsplichten in verschillende kerken te maken. In 1510 wordt hij als kanunnik aan de Onze-Lieve-Vrouwekathedraal (Antwerpen) aangesteld, en in 1513 verbindt eenzelfde functie hem aan de Sint-Goedelekerk in Brussel.

Ofschoon zijn naam in een betaallijst van 21 juni 1517 is doorgestreept, tekent hij in een document van 18 mei 1518 nog steeds als "kanselier en eerste kapelaan van Karel". In 1522 bleef hem omwille van zijn leeftijd de taak bespaard Karel V op zijn reis van Engeland naar Spanje te begeleiden.

Marbriano de Orto stierf in februari 1529 of kort voor die datum. Hij werd in de Sint-Gertrudiskerk in Nijvel begraven. Zijn grafsteen werd in 1940 tijdens bombardementen op de stad vernield.

Het werk

Missen
 Missa dominicalis
 Missa J'ay pris amours (2 credo's zijn bewaard)
 Missa La belle se sied
 Missa L'homme armé
 Missa Petita camusetta (Mi-mi)
 Missa sine nomine

Fragmenta missarum
 Kyrie in honorem beatissime virginis
 Credo Le serviteur
 Credo (vijfstemmig)

Motetten
 Ave Maria gratia plena
 Ave Maria mater gracie
 Da pacem Domine
 Descendi in ortum meum (Superius verloren)
 Domine non secundum
 Salve regis mater/Hic est sacerdos (naar aanleiding van de kroning tot paus van Alexander VI op 26 augustus 1492. Anoniem overgeleverd, maar met grote waarschijnlijkheid van De Orto)

Liturgische werken
 Lamentatio Jeremie prophete
 Lucis creator optime
 Ut queant laxis (Vers 2, Nuncius celso, door Guillaume Dufay gecomponeerd)

Chansons
 D'ung aultre amer
 Et il y a trois dame a Paris (Les troys filles de Paris)
 Fors seulement
 Je ne suis poinct (Bassus verloren, maar waarschijnlijk met tenor in de canon)
 Mon mary m'a diffamée
 Se je perdu mon amy
 Venus tu m'a pris

Andere werken
 Dulces exuviae (Tekst: Vergilius, Aeneïs IV 651-654); La mi la sol (tekstloos)

Zuid-Nederlands componist (voor 1830)
Renaissancecomponist
Persoon in de Nederlanden in de 15e eeuw
Persoon in de Nederlanden in de 16e eeuw
16e-eeuws componist

redpajama_set_name: RedPajamaWikipedia


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